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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

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