Medical Doubletalk

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I was recently at a presentation given by a nationally active advocate for socialized medicine. Of course, that is not what the advocate called it; it was “affordable healthcare for all,” or something like that.

She was arguing two things: first, that it was a shame that millions of Americans were not getting care when they needed it, and second, that if we gave them care it wouldn’t necessarily cost any more, because it was costing us already when the uninsured went to emergency rooms.

It sounded to me like she was contradicting herself – that people were getting care and that they were not getting it – but I let it go. I was thinking about the cost. Wasn’t it true, I said, that in the past when government promised new medical benefits, those benefits always ended up costing more – a lot more – than the advocates thought?

Yes, she said, it was so. But it was that way because people hadn’t used the best science in determining what treatments to offer. If we used the best science, cost wouldn’t be such a problem.

She also said the medical system should be made sensitive to the needs of individuals, not governments and employers. That sounded good. But to an individual, the “best science” is the technique with the best chance of getting him well. From the system’s point of view, the “best science” may be the technique with the best results per dollar, measured statistically. It seemed, somehow, that this advocate was appealing to both ideas at once.

I came away with the feeling of having heard a something-for-nothing argument – and the worry that it had a fetching quality.

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