August 27, 2012

Obamacare and the vanishing medical miracle

Obamacare is an imminent threat to people with life-threatening medical conditions.

People with serious medical conditions often achieve miraculous results in the U.S. thanks to a private health care system that gives them the freedom to track down and go to doctors with the right knowledge and experience. These people, who have the greatest and most urgent health care needs, will be stymied by Obamacare’s new layers of bureaucracy. Instead of swiftly obtaining the right diagnosis and treatment, they will lose precious time submitting forms and filing appeals.

As every physician knows, it’s important to arrive at a correct diagnosis as soon as possible because medical conditions are most treatable in their early stages.

A recent article in The Wall Street Journal illustrates the point. “Facing Lifesaving Heart Surgery, Twice” bemoans the plight of people who had heart surgery as children only to experience further heart problems as adults. Doctors were often baffled because their hearts had been reconfigured during childhood. In some cases, the best course of action proved to be going back to the pediatric hospitals and surgeons who performed the original operations. This is possible in a private health care system because patients are correctly viewed as customers. Under Obamacare — a system that perceives people with serious medical conditions as financial burdens to a government already deeply in hock — these patients are more likely to find themselves boxed in by rules designed to contain costs.

People with serious medical conditions quickly discover that there are three key components to effective medical care. The first is a timely and accurate diagnosis. Getting the right diagnosis may require not just a second opinion, but a third and a fourth. The second component is a complete list of treatment options. Multiple opinions and options require the free flow of information that only a competitive health care marketplace can deliver.

The final component is the freedom for patients to choose what they judge to be the best course of treatment. Patients and their families are best qualified to make these decisions because they are the ones most directly affected. Under Obamacare, it’s presumed that government officials are better qualified to make these decisions, and it’s a safe bet that they will be instructed to weigh each patient’s anticipated future contributions to society against the long-term costs of keeping that patient alive.

President Obama made it clear that this is exactly where we are headed when he said, “Maybe you are better off not having the surgery, but taking the painkiller.” He was doubtlessly thinking ahead to a time when the cost to government will take precedence over what’s best for the individual. Government-run health care is the most cold-hearted health care. For example, the U.K.’s National Health Service denies kidney dialysis to patients over the age of 55 just to save money.

Another way that Obamacare will hurt people with life-threatening medical conditions is by stifling innovation. Today, the U.S. has more CT scanners, PET scanners and MRI machines than any other country. And as the country that pioneered implantable cardio-defibrillators, the heart-lung machine and robotic surgery, the U.S. offers more and better treatment options. Thanks to our private health care system, entrepreneurs are free to develop powerful new solutions, and if government ever gets out of the way they will be free to drive down costs. In stark contrast, public health care systems start by constraining costs; most innovative solutions never get off the launching pad.

It’s understandable that people with life-threatening conditions are attracted to government programs such as Obamacare. Many of these people feel they have twice lost life’s lottery: first by having a medical condition they did not ask for, and second by being saddled with extraordinary health care expenses.

Unfortunately, Obamacare provides only false security. Subsidized or even free care is of no value if it doesn’t provide the right diagnosis and the right treatment at the right time. Nor does it help to encumber hospitals, doctors and patients with massive new regulations. The only way to reduce the cost of health care while maintaining or improving quality is to permit and encourage vigorous competition.

Give the patients who consume the most health care the freedom to shop for services and make their own buying decisions and they will help drive down prices for everyone else.

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