John Edwards and Cleft Palates

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In
the Democratic debates Monday evening, the inevitable question regarding
a healthcare "solution" emerged, soliciting each candidate's
response. While all the candidates offered their packaged remarks
on how they would provide healthcare to every American through
government programs, one candidate struck a chord.

The most
passionate apologist for state healthcare services was John Edwards
who advocated a system of mandatory compliance facilitated by a
story of one unfortunate American citizen by the name of James Lowe.
Exploiting the misery of another, Mr. Edwards sought to bypass logic
by preying upon the emotions of the unsuspecting public. In the
"evidence" for why the state must coerce individuals to
"participate" in a health plan, he evoked the situation
of Mr. Lowe, a poor Appalachian man suffering from a cleft palate.
For those unaware, a cleft palate is a birth deformity where the
part of the skull consisting of the roof of the mouth does not form
completely, dividing the roof of the mouth from the front teeth
to the uvula (often splitting it directly). Frequently this condition
is coupled with a similar division in the upper lip leaving a gap
beneath one or both nostrils. A combined cleft lip and palate is
the condition of which I personally suffer from and occurs in approximately
one
in seven hundred births
.

In Mr.
Edwards example, the sufferer was fifty years old when he received
the procedure to mend his deformity, before which, he was unable
to talk. This individual case is very troubling, and even as one
who has undergone many surgeries to resolve the same defect, the
thought of going for such an extended period of time with no help
is unbearable. Can we use this terrible example as a justification
for mandatory government healthcare?

Certainly
not. What Mr. Edwards did not inform the audience is that those
children born with cleft lips and palates throughout poor America
and the developing world are not cared for by socialized healthcare
systems. Private charities in partnership with American doctors
perform the bulk of those surgeries to poor children not only in
America, but as in the case of Operation
Smile
undertaking over eight thousand surgeries annually in
Bolivia, Brazil, Cambodia, Colombia, Ecuador, Egypt, Ethiopia, Gaza,
Honduras, India, Jordan, Kenya, Mexico, Morocco, Nicaragua, Panama,
Paraguay, Peru, Philippines, Russia, Thailand, Venezuela, and Vietnam.
Even Mr. Edwards’ own example of James Lowe received his medical
care through a charity, Rural Area Medical Health Expedition. What
makes all this possible? The absence of socialized medicine in America.
Even socialized healthcare systems in developed countries, such
as Britain in 2001, accept late-term abortion of infants with clefts
not on the basis of women’s rights, but the existence of what socialized
medicine deems a debilitating handicap. No, Mr. Edwards, a mandatory
socialist healthcare system will not fix more clefts, or save more
lives.

However,
Mr. Edwards has alluded to a larger myth seeping into the fabric
of the American psyche. It is increasingly accepted in the United
States that the healthcare system is terrible in relation to other
developed countries. Espoused by every socialist commentator who
despises individual well-being, the oft-cited report by the World
Health Organization
on the ranking of healthcare in countries
lists the United States as a measly 37th, immediately
above Slovenia. However, the study's methodology requires closer
examination.

In the World
Health Organization's ranking, France is number 1 and the United
Kingdom ranks 18. The U.S. spends 13.7% of its GDP per year on healthcare,
while France spends 9.8%, and the UK spends 5.8%. In France, government
spending is 77% of the total spent on healthcare, in the UK it’s
97%, and in the U.S. its 44%.

Why is the
U.S. doing so abysmally? Our friends at the WHO have biased themselves
against privatized medicine. Part of their index is “fairness in
financial contribution” which is nothing more then another way of
saying government pays for it. The ranking does not, however, incorporate
individual tax burdens in these states (e.g., France) to really
encapsulate how this “government service” is being paid. Such things
as the distribution by government of $250,000 speeding fines in
Finland as a means for paying for their government healthcare are
in no way included.

If you look
at the method, the United States gets hurt in this “fairness” variable,
but is ranked 1st in responsiveness. France is 17th, the United
Kingdom is 27th. Additionally, the system ranks “level of health,”
which has a myriad of causal variables completely unrelated to the
quality of the health system. Maybe the reason Americans are less
healthy is because of the food we eat, less exercise we engage in,
stress levels, etc. The quality of the health system when comparing
industrialized states is almost irrelevant to determining such things
as life expectancy.

If you remove
health “levels” which really don’t tell us anything about the healthcare
system beyond “oh they have one," and you remove the health
“fairness” variable, which is nothing more than government provision
of healthcare, you get a better understanding of the "responsiveness"
of the system. Using the WHO's own numbers:

  1. United
    States
  2. Switzerland
  3. Luxembourg
  4. Denmark
  5. Germany
  6. Japan
  7. Canada
  8. Norway
  9. Netherlands
  10. Sweden

Furthermore,
if we look at the World Health Organization's numbers on the fairness
variable, of those listed the United States and Switzerland rank
the lowest in financial contribution by government. What we may
also seek to include is the level of doctors’ ability, which is
not included by the WHO. I would, however, expect that to closely
correlate with per capita dollars spent, resembling our current
ranking.

I can make
any kind of ranking say anything I want it to by weighting and including
variables to manipulate my results. The WHO undercounts system performance
and dramatically overcounts the fairness variable without including
any indicator of where the "fairness” is reached.

There are still
many problems with the U.S. healthcare system, but those problems
are a result of government intervention and cartelization of the
industry. It is particularly due to the looting medical-malpractice
lawyers such as Mr. Edwards himself that healthcare costs are so
inordinately high. In the words of Congressman Ron Paul, "Capitalism
should not be condemned, since we haven't had capitalism."

Mr. Edwards’
healthcare system would dissolve the private healthcare industry,
eliminate the individual innovation of doctors, and destroy the
ability of charitable interests such as Operation Smile to help
children not only in America, but throughout the world. Mr. Edwards
would remove that capability, and make every individual suffering
from any disability dependent not on themselves, not on the goodwill
of others, but on an unrestrained, uncaring state seeking not to
protect but coerce.

Yes, Mr. Edwards,
living for fifty years with an untreated cleft palate is a hell
which neither you nor I have any capacity to imagine. From personal
experience, I can tell you that dealing on a day-to-day basis with
such a physical deformity is far more difficult then spending ten
minutes with your assistant teasing
your hair
. However, you advocate the greatest evil in this regard
I can fathom: to destroy the freedom of individuals and deprive
the poor of the charitable work and ingenuity of the most successful
doctors in the world by creating a healthcare system which does
not provide, but destroys.

July
25, 2007

Patrick
Rhamey [send him mail]
is a summer fellow at the Ludwig von Mises Institute.

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