Tuesday, March 8, 2016

Three Lessons from Primaries
It’s  11:30AM.   Primaries are underway in Michigan, Mississippi,  Idaho, and Hawaii.   Until now,  Donald Trump has dominated the populist right by winning  all the big primaries except Texas, and Bernie Sanders has surprised on the socialist left by winning primaries in 8 states.
I am wondering what lessons will be learned  from these primaries tonight  and from  those that lie ahead on  March 15.

Clouds of doubt  are gathering  about  Trump’s populism and Sander’s socialism.

 To me there are three health care  lessons  learned so far.
One,   America Is a Centrist Nation.  We prefer a combination of  government care (Medicare and Medicaid),  and employer-based coverage.
Two,   Populist Anger Is Not Necessarily An Acceptable Answer to Republicans. This is evidenced by the negative reactions by Republican and Libertarian health care experts to  Donald Trump’s 7 point health plan (Julie Rovner,  “TrumpCare Takes It on the Chin, “ Kaiser Health News, March 4, 2016).   
Three,  Universal  Coverage Is Not the Same as Universal Care.
I was thinking of the third lesson  as I listened to Bernie Sanders proclaim health care as a universal  human right and as Hillary Clinton says all we need is an ObamaCare fix.      Universal coverage has great emotional appeal to Socialist young, minorities, and the intellectual elite,  but not to Democrat seniors and to  middle class workers.  Ubiquitous coverage tends to overlook four fundamentals:
- The transition from ObamaCare to Medicare-for-All would cost a projected $15 trillion in a country now $19 trillion in debt. 

- Medicare-for-All would require increased taxes across the board - from the rich, the poor, the middle class, the old, the young, the sick, the well.

-  Physician shortages are growing every day, making it more difficult to care for mounting numbers in Medicare (55 million), Medicaid (70 million),  and health exchanges (10 to 15 million).
- “Universal  Coverage,” as practiced in other advanced nations,  does not always produce  results  that would be acceptable to all Americans, e.g., loss of choice, rationing, and waiting lines.
I highlighted the following  facts  in a previous blog, “Comparative Health Statistics among Nations,” dated January 20, 2011, with these statistics.

Percentage of American men and women who survived a cancer five years after diagnosis:
U.S., 65%
England, 46%
Canada, 42%

Percentage of American  patients diagnosed with diabetes who received treatment within six months:
U.S., 93%
England, 15%
Canada, 43%

Percentage of American  seniors needing hip replacement who received it within six months:
U.S., 90%
England, 15%
Canada, 43%

Percentage of Americans  referred to a medical specialist who see one within one month:
U.S., 77%
England, 40%
Canada, 43%

Number of MRI scanners (a prime diagnostic tool) per million Americans:
U.S., 71%
England, 14%
Canada, 18%

Percentage of  seniors (65+) in various nations with  with low income, who say they are in "excellent health":
U.S., 12%
England, 2%
Canada, 6%
As the primaries continue and a deeper factual knowledge about the  consequences of health plans of Trump and Sanders grows,  doubts are growing about  health care plan proposals of Donald Trump on the populist right and  Bernie Sanders on the progressive left.  
If  I may quote  my historical forbearers , this  growth of doubt is not unprecedented:
“From doubt to denial is a short step.” Alfred De Musset ( 1810-1857); “Doubt grows with knowledge. Goethe (1749-1842);   “A little knowledge is a dangerous thing. Drink deep or taste not the Pierian spring." Alexander Pope (1688-1744).
 Sometimes you get what you pay for.  Sometimes it sounds too good to be true.    Sometimes things are not what they seem.  Sometimes a little knowledge is a good thing.  Sometimes extremes meet in the center.  Sometimes  you can prove anything with statistics. Sometimes,  there is no "free lunch." Sometimes you can fool some of the people some of the time but not all of the people all of the time.  And sometimes the gold mine of clichés, bromides, truisms, banalities, maxims. stock phrases,  trite sayings, and old chestnuts contain nuggets of truth that come in handy.

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