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Health Care’s Life-Saving Potential

January 8, 2010

Yglesias explores what he sees as Bart Stupak’s “strange views on human life”:

The expansion of health insurance contained in this bill will save lives. But unless it also includes some restrictions on the ability of insurance plans to cover abortions, Bart Stupak will kill it. And that’s the pro-life position! Perhaps most absurdly of all, my understanding is that this really is the official Catholic Church position on issues of life and death. Taking political action to save the lives of children and adults is morally praiseworthy, but the obligation to take political action aimed at securing legal restrictions on abortions is paramount and actually overrides obligations to aid the poor and the sick.

This seems to make sense, except that Yglesias takes for granted that “the expansion of health insurance contained in this bill will save lives”.  Will it?  Although it may seem counterintuitive to some, it’s not a given that it will.

Proponents of the bill appear to be ready to state that because it will extend insurance to 11% of the population that did not previously have it, lives will be saved due to the bill’s implementation.  Okay, but what about the consequences of the other parts of the bill?  For example, the demonstrated number one cause of death in the United States is heart disease.  Because this bill eliminates the ability of insurers to discriminate against consumers based on their medical history, this means that people who have a history of heart problems or don’t take care of themselves (which would make them more susceptible to heart disease) will have zero incentive to change their unhealthy ways because they know their health care premiums will never go up.  Isn’t this likely to exacerbate the problem of heart disease, which is what kills more Americans than anything else?

Another example: the Mayo Clinic recently quit seeing Medicare patients at one of its locations in Arizona, and is seeing less of them in Minnesota because it lost $840 million last year because of Medicare’s “low reimbursement rates”.  This is likely to get worse:

Mayo is probably a leading indicator of where other hospitals and doctors are headed. Physicians on average earn 20% to 30% less from Medicare than they do from private patients, and many are dropping out of the program. While about 92% of family physicians participate in Medicare, only about 73% of those are now accepting new patients. In some specialties—neurology, oncology, gynecology—in places like Manhattan and Washington, patients can struggle to find any doctor who’ll accept Medicare.

The $500 billion in Medicare cuts planned as part of ObamaCare won’t help this trend. The hospital industry agreed earlier this year to chip in $100 billion over the next decade in lower annual payment increases for Medicare. The chief Medicare actuary estimates that up to 20% of hospitals could become unprofitable as a result of the scheme.

It seems inane to assume that the services doctors provide to Medicare patients will be unchanged if payments to the doctors are cut to even lower levels than they already are.  Since the elderly are the demographic that requires the most medical attention, doesn’t it follow that more of them will die as a result of this bill than otherwise would have?  It would appear that it does, especially since the elderly are adversely affected by nine out of the top ten leading causes of death in this country in a more profound way than the rest of the population is.  And I doubt that the health-care bill will affect the number of people that die in accidents.  Maybe this bill will save lives, but there’s no real evidence of that.  And to lambaste Bart Stupak for objecting to something he sees as federally-funded murder because of a dubious assessment of a piece of legislation is really deplorable.

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