Health
The People Cheering Brian Thompson’s Murder Can’t Have the Medical Utopia That They Want
Whether private or public, third-party payment for health care is a huge problem.
Evoking a collective scream of despair from socialists and anti-corporate types, police in Pennsylvania arrested Luigi Mangione, a suspect in the murder of UnitedHealthcare CEO Brian Thompson. Thompson, they insist, stood in the way of the sort of health care they think they deserve and shooting him down on the street was some sort of bloody-minded strike for justice.
The assassin’s fans—and the legal system has yet to convict anybody for the crime—are moral degenerates. But they’re also dreaming, if they think insurance executives like Thompson are all that stands between them and their visions of a single-payer medical system that satisfies every desire. While there is a lot wrong with the main way health care is paid for and delivered in the U.S., what the haters want is probably not achievable, and the means many of them prefer would make things worse.
“Unlimited Care…Free of Charge”
“It is an old joke among health policy wonks that what the American people really want from health care reform is unlimited care, from the doctor of their choice, with no wait, free of charge,” Michael Tanner, then of the Cato Institute, quipped in 2017.
The problem, no matter how health care is delivered, is that it requires labor, time, and resources that are available in finite supply. Somebody must decide how to allocate medications, treatments, physicians, and hospital beds, and how to pay for it all. A common assumption in some circles is that Americans ration medicine by price, handing an advantage to the wealthy and sticking it to the poor.
“Today, as everyone knows, health care in the US can be prohibitively expensive even for people who have insurance,” Dylan Scott sniffed this week at Vox.
The alternative, supposedly, is one where health care is “universal,” with bills paid by government so everybody has access to care. Except, most Americans rely on somebody else to pay the bulk of their medical bills just like Canadians, Germans, and Britons. And while there are huge differences among the systems presented as alternatives to the one in the U.S., third-party payers—whether governments or insurance companies—do enormous damage to the provision of health care.
Third-Party Payers, Both Public and Private, Raise Costs
“Contrary to ‘conventional wisdom,’ health insurance—private or otherwise—does not make health care more affordable,” Jeffrey Singer, a surgeon and senior fellow with the Cato Institute, wrote in 2013. “The third party payment system is the principal force behind health care price inflation.”
In the U.S., the dominance of third-party payment, whether Thompson’s UnitedHealthcare, one of its competitors, Medicare, Medicaid, or something else, makes it difficult to know the price for procedures, medicines, and treatments—because there really isn’t one price when third-party payers are involved.
Several years ago, the first Trump administration required hospitals to publish prices for services. My local hospital offers an Excel spreadsheet with wildly varying prices for procedures and services, from different categories of self-pay, Medicare, Medicaid, and negotiated rates for competing insurance plans.
“A colonoscopy might cost you or your insurer a few hundred dollars—or several thousand, depending on which hospital or insurer you use,” NPR’s Julie Appleby pointed out in 2021.
That said, savvy patients paying their own bills can usually get a lower price than that paid by insurance.
“When government, lawyers, or third party insurance is responsible for paying the bills, consumers have no incentive to control costs,” Arthur Laffer, Donna Arduin, and Wayne Winegarden wrote in the 2009 paper, The Prognosis for National Health Insurance. After all, the premium or tax is already paid, right?
Other Countries Struggle With Similar Issues
Concerns about rising costs, demand, and finite resources apply just as much when the payer is the government.
“State health insurance patients are struggling to see their doctors towards the end of every quarter, while privately insured patients get easy access,” Germany’s Deutsche Welle reported in 2018. “The researchers traced the phenomenon to Germany’s ‘budget’ system, which means that state health insurance companies only reimburse the full cost of certain treatments up to a particular number of patients or a particular monetary value.” Budgeting is quarterly, and once it’s exhausted, that’s it.
Last year in the U.K., a Healthwatch report complained: “We’re seeing a two-tier system emerge, where healthcare is accessible only to those who can afford it, with one in seven people who responded to our poll advised to seek private care by NHS [National Health Service] staff.” Britain’s NHS remains popular, but it has long struggled with the demand and expense for cancer care and other expensive treatments.
And Canada’s single-payer system famously relies heavily on long wait times to ration care. “In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment,” the Fraser Institute found last year. “This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.”
You have to wonder what those so furious at Brian Thompson that they would applaud his murder would say about the officials managing systems elsewhere. None of them deliver “unlimited care, from the doctor of their choice, with no wait, free of charge.” Some lack the minimal discipline imposed by what competition exists among insurers in the U.S.
We Need Less Government Involvement in Medicine
“Policymakers need to understand that the key to ‘affordable health care’ is not to increase the role of health insurance in peoples’ lives, but to diminish it,” Cato’s Singer concluded.
My family found that true when we contracted with a primary care practice that refuses insurance. We pay fixed annual fees, which includes exams, laboratory services, and some procedures. My doctor caught my atrial fibrillation when he walked me across his clinic hall on a hunch to run an EKG.
The Surgery Center of Oklahoma famously follows a similar model for much more than primary care. It publishes its prices, which don’t include the overhead and uncertainty of dealing with third-party payers.
Those examples point to a better health care system than what exists in the United States—or in most other countries, for that matter. They’re probably not the whole answer, because it’s unlikely that one approach will suit millions of people with different medical concerns, incomes, and preferences. But making people more, rather than less, responsible for their own health care, and getting government and other third-parties as far out of the matter as possible, is far better than cheering the murder of people who supposedly stand between us and an imaginary medical utopia.
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From the Brownstone Institute
This article was co-authored with Mary Beth Pfieffer.
In a seismic political shift, Republicans have laid claim to an issue that Democrats left in the gutter—the declining health of Americans. True, it took a Democrat with a famous name to ask why so many people are chronically ill, disabled, and dying younger than in 47 other countries. But the message resonated with the GOP.
We have a proposal in this unfolding milieu. Let’s have a serious, nuanced discussion. Let’s retire labels that have been weaponized against Robert F. Kennedy, Jr., nominated for Health and Human Services Secretary, and many people like him.
Start with discarding threadbare words like “conspiracy theory,” “anti-vax,” and the ever-changing “misinformation.”
These linguistic sleights of hand have been deployed—by government, media, and vested interests—to dismiss policy critics and thwart debate. If post-election developments tell us anything, it is that such scorn may no longer work for a population skeptical of government overreach.
Although RFK has been lambasted for months in the press, he just scored a 47 percent approval rating in a CBS poll.
Americans are asking: Is RFK on to something?
Perhaps, as he contends, a 1986 law that all but absolved vaccine manufacturers from liability has spawned an industry driven more by profit than protection.
Maybe Americans agree with RFK that the FDA, which gets 69 percent of its budget from pharmaceutical companies, is potentially compromised. Maybe Big Pharma, similarly, gets a free pass from the television news media that it generously supports. The US and New Zealand, incidentally, are the only nations on earth that allow “direct-to-consumer” TV ads.
Finally, just maybe there’s a straight line from this unhealthy alliance to the growing list of 80 childhood shots, inevitably approved after cursory industry studies with no placebo controls. The Hepatitis B vaccine trial, for one, monitored the effects on newborns for just five days. Babies are given three doses of this questionably necessary product—intended to prevent a disease spread through sex and drug use.
Pointing out such conflicts and flaws earns critics a label: “anti-vaxxer.”
Misinformation?
If RFK is accused of being extreme or misdirected, consider the Covid-19 axioms that Americans were told by their government.
The first: The pandemic started in animals in Wuhan, China. To think otherwise, Wikipedia states, is a “conspiracy theory,” fueled by “misplaced suspicion” and “anti-Chinese racism.”
Not so fast. In a new 520-page report, a Congressional subcommittee linked the outbreak to risky US-supported virus research at a Wuhan lab at the pandemic epicenter. After 25 hearings, the subcommittee found no evidence of “natural origin.”
Is the report a slam dunk? Maybe not. But neither is an outright dismissal of a lab leak.
The same goes for other pandemic dogma, including the utility of (ineffective) masks, (harmful) lockdowns, (arbitrary) six-foot spacing, and, most prominently, vaccines that millions were coerced to take and that harmed some.
Americans were told, wrongly, that two shots would prevent Covid and stop the spread. Natural immunity from previous infection was ignored to maximize vaccine uptake.
Yet there was scant scientific support for vaccinating babies with little risk, which few other countries did; pregnant women (whose deaths soared 40 percent after the rollout), and healthy adolescents, including some who suffered a heart injury called myocarditis. The CDC calls the condition “rare;” but a new study found 223 times more cases in 2021 than the average for all vaccines in the previous 30 years.
Truth Muzzled?
Beyond this, pandemic decrees were not open to question. Millions of social media posts were removed at the behest of the White House. The ranks grew both of well-funded fact-checkers and retractions of countervailing science.
The FDA, meantime, created a popular and false storyline that the Nobel Prize-winning early-treatment drug ivermectin was for horses, not people, and might cause coma and death. Under pressure from a federal court, the FDA removed its infamous webpage, but not before it cleared the way for unapproved vaccines, possible under the law only if no alternative was available.
An emergency situation can spawn official missteps. But they become insidious when dissent is suppressed and truth is molded to fit a narrative.
The government’s failures of transparency and oversight are why we are at this juncture today. RFK—should he overcome powerful opposition—may have the last word.
The conversation he proposes won’t mean the end of vaccines or of respect for science. It will mean accountability for what happened in Covid and reform of a dysfunctional system that made it possible.
Republished from RealClearHealth
Author
From the Brownstone Institute
The only way to restore public trust in vaccination – which has taken a big hit since the lies attending the rollout of the Covid-19 vaccine – is to put a well-known vaccine skeptic in charge of the vaccine research agenda. The ideal person for this is Robert F. Kennedy, Jr., who has been nominated to lead the Department of Health and Human Services.
At the same time, we must put rigorous scientists with a proven track record of evidence-based medicine in charge of determining the type of study designs to use. Two ideal scientists for this are Dr. Jay Bhattacharya and Dr. Marty Makary, who have been nominated to lead the NIH and FDA, respectively.
Vaccines are – along with antibiotics, anesthesia, and sanitation – one of the most significant health inventions in history. First conceived in 1774 by Benjamin Jesty, a farmer in Dorsetshire, England, the smallpox vaccine alone has saved millions of lives. Operation Warp Speed, which rapidly developed the Covid vaccines, saved many older Americans. Despite this, we have seen a sharp increase in general vaccine hesitancy. Vaccine scientists and public health officials who did not conduct properly randomized trials made false claims about vaccine efficacy and safety and established vaccine mandates for people who did not need the vaccines, sowing suspicion and damaging public trust in vaccination.
What went wrong? The purpose of the Covid vaccines was to reduce mortality and hospitalization, but the randomized trials were only designed to demonstrate short-term reduction in Covid symptoms, which is not of great public health importance. Since the placebo groups were promptly vaccinated after the emergency approval, they also failed to provide reliable information about adverse reactions. Despite these flaws, it was falsely claimed that vaccine-induced immunity is superior to natural infection-acquired immunity and that the vaccines would prevent infection and transmission.
Governments and universities then mandated the vaccines for people with superior natural immunity and for young people with very low mortality risk. These mandates were not only unscientific but with a limited vaccine supply, it was unethical to vaccinate low-mortality-risk people when the vaccines were needed by older high-risk people around the world.
Since government and pharmaceutical companies lied about the Covid vaccine, are they also lying about other vaccines? Skepticism has now spread to tried-and-true vaccines that are proven to work.
And there are real, unanswered vaccine safety questions. Seminal work from Denmark has shown that vaccines can have both positive and negative non-specific effects on non-targeted diseases, and that is something that must be explored in greater depth. Vaccine Safety Datalink (VSD) scientists studying asthma and aluminum-containing vaccines concluded that while their “findings do not constitute strong evidence for questioning the safety of aluminum in vaccines…additional examination of this hypothesis appears warranted.”
While VSD and other scientists should continue to do observational studies, we should also conduct randomized placebo-controlled vaccine trials, as RFK has advocated. Since we have herd immunity for many diseases, such as measles, trials can be ethically conducted by randomizing the age of vaccination to, for example, one versus three years old, while spreading the trial over a large geographical area so that the unvaccinated are not all living close to each other.
I am confident that most vaccines will continue to be found safe and effective. While some problems may be found, that is more likely to increase rather than decrease vaccine confidence. For instance, it was found that the measles-mumps-rubella-varicella (MMRV) vaccine causes excess febrile seizures in 12- to 23-month-old children. MMRV is now only given as a second dose to older children, while the younger kids get separate MMR and varicella vaccines, resulting in fewer vaccine-induced seizures that scare parents. Although safety studies were inconclusive, it was also wise to remove mercury from vaccines. Even if we end up with fewer vaccines in the recommended vaccine schedule, that’s not necessarily a terrible thing. Scandinavia has a very healthy population with fewer vaccines in their schedules.
We won’t restore vaccine confidence by preaching to the choir. After the Covid debacle, Kennedy’s stated goal is to return to evidence-based medicine free from conflicts of interest. Letting him do that is the only way that skeptics will trust vaccines again, and those of us who trust vaccines have no reason to be afraid of that.
Attempts by the public health and pharma establishments to derail the nominations of RFK, Bhattacharya, and Makary are the surest way to further increase vaccine hesitancy in America. The choice is stark. We cannot let lopsided “pro-vaccine scientists” who clamp their hands over their ears at the mildest questions do any more harm to vaccine confidence. As a pro-vaccine scientist, and in fact, the only person ever being fired by the CDC for being too pro-vaccine, the choice is clear in my mind. To restore vaccine confidence to previous levels, we must support the nominations of Kennedy, Bhattacharya, and Makary.
Republished from RealClearPolitics
Author
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