Socialism, Fantasy And Reality

Over in Congress, Republicans are gradually getting their act together on rolling back Obamacare, at least in part.  That of course has brought out a torrent of hysterical reaction from the progressive punditocracy.  To these people it seems just glaringly obvious that there is a moral imperative to provide "healthcare for all" through some kind of government handout or coercion.  After all, we all know that socialized provision of goods and services works flawlessly, and the government has an infinite pile of free money to pass out.  We do know those things, don't we?

On Monday, the New York Times op-ed page had no fewer than three pieces on the subject of Republican healthcare proposals by the in-house columnists, each more hysterical than the next.  Not meaning to give the likes of Krugman a pass on this one, but let me focus on the piece by Charles Blow, titled "Republican Death Wish."   Excerpt:

The A.C.A. had made a basic societal deal: The young, healthy and rich would subsidize access to insurance for the older, sicker and poorer. But this demanded that the former gave a damn about the latter, that people genuinely believed that saving lives was more important than saving money, that we weren’t living some Darwinian Hunger Games of health care where health and wealth march in lockstep. . . .  Let’s cut to the quick: Access to affordable health care keeps people alive and healthy and keeps families solvent. Take that away, and people get sick, run up enormous, crippling debt and in the worst cases, die. It is really that simple.

"Access to affordable healthcare" keeps people "alive and healthy."  This is one of those things that is just so blindingly obvious that it has to be true.  So what is the actual evidence?

• There's that big randomized trial out of Oregon in 2013 that found, after two years, that there were "no significant improvements in measured physical health outcomes" between those with access to Medicaid and not.  A follow up study after five years showed that the same results persisted.
• The big selling point of Soviet communism was supposedly the free universal access to health care.  In the early years, life expectance under communism did increase -- but then, it also increased in the capitalist countries that had nothing like free universal health care at the time.  By the end of the Soviet Union in the late 80s, that country was facing what was by then called a "health crisis," accompanied by dramatically lower life expectancy, particularly for men, than in the capitalist countries without the free universal health care.  This study from the British Medical Journal in 1988 shows male life expectancy in the late-stage Soviet Union as only 65 years.  Wait, doesn't "access to affordable healthcare" keep people "alive and healthy"?  Maybe not so much.  And by the way, in post-communism Russia, life expectancy has not recovered.

And then, can we please look at what is going on down there in Venezuela.  Free universal health care was the core promise of Hugo Chavez and his Bolivarian revolution.  For the latest, check out, for example, from Fox News on April 7, "Venezuela's health crisis nearing catastrophe, government pleads for help":

Triple digit inflation and a decaying socialist economic model have left medications ranging from simple anti-inflammatory drugs to chemotherapy medication out of reach for most Venezuelans. Patients are asked to bring their own. . . .  [M]any other ills afflict the Venezuelan public health system. According to the most recent National Survey of Hospitals, 97 percent of services provided by hospitals are faulty, 75 percent of hospitals suffer from scarcity of medical supplies, and 63 percent reported problems with their water system.  The children are the most affected by the sanitary crisis. According to confidential data gathered by the Ministry of Health leaked to the press, last year 11,000 Venezuelan babies died within their first year if life.

It goes on and on from there, in great and depressing detail.  The promise of "access to affordable healthcare for all" proved to be false -- without a vibrant private economy, the government couldn't deliver.  Well, but at least the people in Venezuela aren't starving.  Actually, as you probably already know, they are.  The Wall Street Journal reports on May 5 that "[t]hree in four Venezuelans said they had lost weight last year, an average of 19 pounds."  The causes include "nationalization of farms as well as price and currency controls."  

The claim that "access to affordable healthcare" keeps people "alive and healthy" turns entirely on the assumption that the socialized costs of the "affordable healthcare" do not degrade economic performance and leave the people poorer.  In other words, to believe the claim, you have to believe in the infinite pile of free money that the government can spend without cost to the people.