December 15, 2009

THE SENATE'S IATROGENIC HEALTHCARE PLAN

Sam Smith

While no one that we can find has produced a comprehensive, factual summary of who and how many will be helped or hurt by pending healthcare legislation, it is clear that the measure will cut both ways - and to an uncertain degree will prove iatrogenic, i.e. the procedures will create new disease.

It may not be so obvious. Consider, for example, a comment by Dr. Steffie Woolhandler of Physicians for a National Health Plan: "In our studies, we found that 62 percent of all bankruptcies in the United States are due at least in part to medical illness or medical bills and that the majority of folks in medical bankruptcy started that illness with private health insurance."

The pending healthcare bill greatly increases the chances of bankruptcy in two ways:

- By mandating purchase of health insurance by many currently uncovered Americans, which the legislation's authors think they can afford, but which their checking account may say they can't.

- By subsidizing to an inadequate degree private health insurance plans - with the same effect.

I've not seen one article that addressed this issue.

And while there have been pieces about the potential loss of coverage under Medicare, many of these have been disingenuously dismissive. This is a serious question, all the more so because of the strong effort on the part of some Democratic senators and the nefarious Peterson Foundation to undermine both Medicare and Social Security.

Further, much of the statistical arguments and review have centered around budgets rather than human life. There is no Congressional Humanity Office to detail what effect a measure like this will have on our lives.

There is no doubt that the pending legislation is one of the greatest subsidies ever granted to a private industry. There is no doubt that much of the legislation is indefensible both morally and pragmatically. There is no doubt that some people will be helped and others hurt, but no seems interested in determining how many of each and in what ways.

Oddly, the Democrats promoting this legislation may be digging their own graves. It is predictable that after any such a complicated bill is approved, unfortunate details of the measure will trickle out, especially around election time. There are few things worse for politicians than for it to be discovered that they voted for some bad policy they didn't even know they were approving. In 2010 and 2012, the healthcare bill could easily be as risky as a highway around Baghdad.

Still, just as there are strong arguments for handing your wallet to a robber, so there are strong arguments for voting for this measure. If it saves tens of thousands of lives, the fact that it also unconsciously subsidizes the health insurance industry is a problem we may want to put on hold.

But it would help if some of the honest players in the battle could give us some of the basic facts such as how many people will be positively or negatively affected.

One thing is sure. Barack Obama, Harry Reid and Nancy Pelosi have left us feeling far more ill than before. And we don't need iatrogenic politicians on top of all our other problems.