I blog about free markets in medical care and transparent pricing.
My father once asked the noted economist Walter Williams at a speech given by Williams if people in Washington were ignorant or evil. Williams laughed and said,”both!” He added “arrogant” to his description. Lew Rockwell once wrote that “on the one hand we have the stupid party. On the other hand, the evil party. Sometimes they get together and do something stupid and evil. And that’s what is called bipartisanship!”
Time to give the politicians a break, though. Let’s rather turn our thoughts to Paul Krugman, a lessor economist, if you can even call him that and someone the Austrian economists think less of than Lew Rockwell thinks of most politicians. Mr. Krugman (he has a Ph.D. from MIT but as Walter Block has said, if recalls were ever in order this qualifies) has written a piece in the hopefully soon to be bankrupt New York Times on health care. He exhibits in the piece the same disregard for facts that have characterized his other writings. Here are some of his claims:
1) Uninsured people avoid the emergency rooms for fear of large bills and so they die. If the poor are avoiding the emergency rooms, why was health care for the poor in the emergency rooms bankrupting hospitals? This, of course, is also a lie. Otherwise, why is there a building crane in front of every big city emergency room I’ve ever seen?
2)Expansion of Medicaid saves lives. Oops. Wrong again. Makes you wonder if he’s wrong intentionally. This has been proven false by Professor June O’Neill, former director of the Congressional Budget Office, in her study.
3) “And surely the fact that the United States is the only major advanced nation without some form of universal health care is at least part of the reason life expectancy is much lower in America than in Canada or Western Europe.” Yes he really wrote this. This is actually a myth the advocates of “universal coverage” love to promote. Even if you believed this, could there be other variables at work?!
4) “So there’s no real question that lack of insurance is responsible for thousands, and probably tens of thousands, of excess deaths of Americans each year.” You’re beginning to get an idea of what a great economic “scientist” he is, aren’t you? Actually this has been studied by Richard Kronick recently and this entire idea has been completely debunked. You can read the abstract of his study here. His conclusion: ”The Institute of Medicine’s (a government-funded institute) estimate that lack of insurance leads to 18,000 excess deaths each year is almost certainly incorrect. It is not possible to draw firm causal inferences from the results of observational analyses, but there is little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States.”
Now keep in mind that Mr. Krugman is the poster child for Keynesian economics, the economic thought that holds that an individual or a government can borrow its way to prosperity. It is this economic thought that has prevailed in this country for a long time, primarily because statists (like those in control of the government) love to spend the wealth belonging to future wage earners, as the future voter’s wrath represents no threat to them. Krugman, as a mouthpiece for this bankrupting insanity, bears a lot of responsibility, but instead of having lost all credibility, he is a liberal media darling. The central bank and deficit spending have no greater advocate than our dear Mr. Krugman (yes…I’m not calling him Dr. on purpose).
Here are some facts. A Medicaid card, rather than kept in a patient’s wallet, might as well be worn around their neck, a scarlet letter that precludes entrance into most physician’s offices. This card gives many, just like our Canadian brethren to the north, only a right to hope for care. Many physicians are curtailing their exposure to Medicare patients, as well, due to payment and regulatory hassles, threats of stiff penalties (including jail time for miscoded claims), and artificially low price controls. Physician “opting out” of Medicare is at an all time high. To put it rather bluntly and as Dr. Jane Orient has wisely said, “coverage doesn’t mean care.”
Think about it. If you have “insurance” coverage (whatever that means) and your insurance company decides that they don’t want to pay for a bone marrow transplant, or they set the payment for one so low that no one will do it (one and the same thing), you are not going to get a bone marrow transplant. Period. If the IPAB (Independent Payment Advisory Board) decides that the payment to a physician for an open heart surgery is less than anyone is willing to do it for, guess how many open heart surgeries will be done? Folks like Krugman will be in charge of deciding what these types of procedures are worth, not the market. Even more government involvement in health care is what he is advocating.
As I blogged the other day, 1.5 million individuals declare bankruptcy every year, 62% of which are for medical bills. 78% of those filing for medical bill reasons had insurance. These folks have “coverage.” Is this the security Mr. Krugman would bring to us all?
The brilliant Bob Murphy has challenged Krugman to a debate, an event Walter Block would characterize as the intellectual equivalent of taking candy from a baby. The equally brilliant economist William Anderson likens Krugman’s receipt of the Nobel prize as “an intellectual event matched only by the sacking of Constantinople in 1453.” His Nobel prize has afforded him a pulpit from which to spew his leftist vitriol, one the New York Times has been all too happy to provide, as their printing of this opinion piece would indicate. Maybe he’ll go away when The NY Times does.
G. Keith Smith, M.D.
P.S. Many thanks to the National Center for Policy Analysis for the links to the above refuting studies. You can read their review of Krugman’s piece here.