Hurry up and Die..

09/18/2013 08:06

The Inescapable Outcome of Socialized Medicine..

by Michael Tennant

Japan's "universal" health care system, like all such systems the world over, is in trouble, with costs rising and the population aging. Nearly 25% of Japanese are over the age of 60, a proportion expected to increase to 40% over the next 50 years. Since the old generally require more -- and more expensive -- medical treatment than the young, the increasingly aged population is putting a severe strain on Tokyo's health care budget. End-of-life care, which can last for months at great expense, is especially problematic.


One Japanese politician, however, has come up with a solution: Just let the elderly die, instead of treating them.

"Heaven forbid if you are forced to live on when you want to die. I would wake up feeling increasingly bad knowing that [treatment] was all being paid for by the government," finance minister Taro Aso said during a meeting of the national council on social security reforms. "The problem won't be solved unless you let them hurry up and die." (Emphasis added.)

Aso's remarks constitute a classic gaffe, defined by journalist Michael Kinsley as a mistake that occurs "when a politician tells the truth -- some obvious truth he isn't supposed to say." (As befits such a gaffe, Aso was forced to backtrack; outright lying, on the other hand, seldom gets a politician into serious trouble.)

The truth in Aso's statement is that denying health care to the most vulnerable is the inevitable outcome of socialized medicine: By making health care seem free, universal health insurance increases the demand for medical services. That drives up the price of the services, putting the squeeze on the government's budget.

At first, the government will raise taxes to cover the extra costs; indeed, Japan has already set in motion an eventual doubling of its sales tax for just that reason. After a while, however, the people resist having more and more of their wealth confiscated, leaving the government no alternative but to cut services; and the people who use those services the most will be the first to feel the pinch.

That is, in fact, what is already happening in Great Britain, a country that has suffered under socialized medicine for 65 years. There, under a program of sedation and dehydration called the Liverpool Care Pathway (LCP), National Health Service (NHS) hospitals euthanize about 130,000 people a year, most of them elderly and many of whom, doctors argue, could go on to live significantly longer. The LCP is known also to be used to kill children and babies who are deemed beyond help. Hospitals are paid handsomely by the NHS for meeting goals for use of the LCP. According to Dr. Patrick Pullicino, a British neurologist, one reason for the increased use of the LCP is "pressure on beds" -- the shortage of care that always occurs under socialized medicine.

Despite Aso's lack of tact -- he also referred to elderly patients who cannot feed themselves as "tube people" who each cost the government "several tens of millions of yen" per month -- he does seem to understand the underlying problem with his country's health care system. He did, after all, say that he would feel bad about forcing taxpayers to foot the bill for his own end-of-life care, and later added that he had instructed his family to refuse such long-term care for him.

Five years ago, when he was prime minister, he complained of having to pay ever-increasing taxes to cover health care for people in his own age group "who dodder around and are constantly going to the doctor" while he "[walks] every day and [does] other things" to stay healthy. That, in a nutshell, is the problem with socialism: It forces some people to subsidize others -- even when those others act irresponsibly.

Unfortunately, Aso did not draw the correct conclusion from his insight. He assumed that socialized medicine must continue, and declared that denial of care, the denouement of every universal health care system, must follow in order to keep the system afloat. He should, instead, have called for an end to Japan's failing experiment in bucking the law of supply and demand and for a return to a free market in health care.

A free market would provide high-quality health care at low prices, making it accessible to the overwhelming majority of Japanese. For those unable to afford it, some providers would offer care at reduced rates or even for free. And knowing that government wasn't going to look after people, charities, religious organizations, and mutual-aid societies would rise to the occasion and ensure that the remaining people got the care they needed.

Lest anyone think that is a utopian fantasy, let it be known that that is exactly how health care was handled in the United States prior to the mid-20th century, and Americans weren't then known to die in the streets from lack of care. Yes, some probably fell through the cracks and died even though medical treatment could have saved them, but under universal health care, some people die when bureaucrats make deliberate decisions to deny care to them because it costs too much. That can hardly be considered an improvement.

Aso deserves credit for his honesty: Unlike other devotees of socialized medicine, he flatly admits that it means bumping people off. Sad to say, just like other devotees of socialized medicine, he fails to recognize that the only way to prevent that tragic outcome is to jettison the whole failed system and let freedom reign.


2013 Agora Financial, LLC. Article originally appeared here.


[Ed. note: It's called the Independent Payment Advisory Board. Or the IPAB for short. But in the past, you probably heard it referred to by other names. To the supporters of the Affordable Care Act (ACA), it's going to bring order to chaos and bring down out of control health care costs. To opponents, they came up with a more colorful title. Death panels.

In the buildup to the reform over three years ago, the IPAB became a hot button issue that was sure to draw a reaction from anyone who brought it up. Critics used it to scare people into thinking that a board of faceless bureaucrats had the final say in their health matters. In response, proponent of the law called these claims baseless and dismissed it as nothing more than a scare tactic.

But a funny thing happened during this spirited, albeit, empty debate. No one ever bothered looking into what the IPAB really was. Much like the rest of the law, no one really knew how things would turn out until well after the bill was signed by the President. And now we're five months away from the first major changes of the ACA, but the people in charge of it aren't doing a great job keeping us informed.

It's probably because the more people learn about the increasingly unpopular law, the more they the more they become skeptical, as shown by a recent poll by PerryUndem Research. But it's important that you understand what the IPAB, as well as the rest of the ACA really means for ordinary Amercians. Because, in the end, you're going to have to deal with the law's repercussions, whether you like them or not.

To begin, both the supporters and the critics of the IPAB are correct. This board was set up in a way that allows it to operate outside the political environment. An environment that causes people to focus only on short term gains that will help them get re-elected. To do this, any changes that they make can only be overturned with a three-fifth supermajority in the Senate.

In this regard, it's almost like a Federal Reserve for health care. An organization that operates outside of the democratic process, whose decisions will ultimately affect the lives of possibly every American.

But what, exactly, will their decisions entail? Their job is to bring Medicare spending back to target levels. One of the president's goals in reforming the health care industry was lowering costs across the board. Unfortunately, instead of allowing the free market to find the best solution, he's charged more bureaucrats with the job.

And though the law states that the IPAB can't ration health care or restrict benefits for those receiving Medicare, we're not holding our breath that the government will stay within the confines of the law. Especially if you consider that this administration has a long legal history of finding legal justifications for pretty much everything (military activity in Libya, droning U.S. citizens, unprecedented wiretaps, etc...).

In the end, this is just another government agency meant to fix a government created problem. When the next set of problems arise because of the IPAB, there will be another government solution for that as well. The cycle will continue with the costs rising along the way. And costs will definitely rise.

Remember, this is just one aspect of the ACA that people are beginning to understand. When there's no more room to hide beyond future deadlines, the country will get a crash course on all the problems that await. Let's just hope there's time to fix things before our elected politicians start taking drastic actions.

Unfortunately, other countries around the world with similar problems don't have that luxury. As you'll see in today's article by Michael Tennant, a freelance writer writing for the Future of Freedom Foundation, Japan has some trying times in store for them. Especially when their politicians (and former Prime Minister) think the best solution for their health care cost trouble is for more of their citizens to die off