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Health Freedom Watch
August 2006

Contents:


Virginia Teen Claims Victory, Right to Refuse Chemotherapy Affirmed

Abraham Cherrix, the Virginia teen who refused chemotherapy, says he is pleased with the results of his recent legal battle and claims victory for winning his health freedom. He announced the following at his website: “Breaking news! Case won! The judge agreed to allow me to see an oncologist of my choice! My alternative treatments WILL continue. He also ruled that my parents were not guilty of medical neglect, and social services no longer has any jurisdiction over my case! Free, happy, and ready to live, that’s me!”

The following excerpt is from an August 16 press release from Abraham’s Journey, a 501(c)3 nonprofit organization founded to protect the legal rights of patients to choose the health treatments of their choice:

“After a long legal struggle Abraham and his family have regained the power to pursue the treatment they believe will provide the most effective cure to Hodgkin’s disease!

“On Wednesday, August 16, 2006 Accomack Circuit Court Judge Glen Tyler cleared Abraham’s parents of all charges of medical neglect and allowed Abraham to pursue alternative treatment under a doctor of the family’s choice.

“Although prepared for a two-day trial, the family was able to reach a settlement with the Department of Social Services—Abraham will now be able to pursue a preferred course of treatment while being monitored by a board-certified oncologist in Mississippi who is experienced in alternative cancer treatment.

“With this decision Abraham is now able to resume life with his family and continue fighting for his health….”

The Virginian-Pilot reports, “In a consent decree entered in Accomack County Circuit Court, Cherrix and his family agreed to have him treated by a board-certified radiation oncologist in Mississippi. They promised to report to the court every three months on the progress of that treatment, and they agreed to leave final authority with Judge Glen A. Tyler until Abraham turns 18. The county department of social services agreed to end its efforts to force the Chincoteague youth to submit to a second round of chemotherapy for his Hodgkin’s disease.”

Some might view the consent decree less than satisfactory in ensuring absolute health freedom and privacy. But for Abraham and his family, they fought hard to secure the right to choose one’s health-care treatment and are delighted that they successfully defended that freedom.

Sources:

  • “Breaking News! Case Won!”, “My Journey” (personal website of Abraham Cherrix), site accessed August 21, 2006: (http://abrahamsjourney.com/theHOMEpage.html).
  • “Freedom to Choose Treatment!”, “Abraham’s Journey”, site accessed August 21, 2006: (http://www.abrahamsjourney.com/index.html).
  • “Court, Teen With Cancer Come to Terms on Treatment Plan,” Virginian-Pilot, August 17, 2006: (http://home.hamptonroads.com/stories/print.cfm?story=109388&ran=172519).

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Reminder: Submit Your Comments on Upcoming National Health Reform by August 31!

The deadline for submitting comments on national health reform is drawing near so people need to submit their comments soon—by August 31.

The Citizens’ Health Care Working Group (CHCWG) is accepting public comments on its interim recommendations for reforming the nation’s health care system. As of August 15, many individuals and 16 groups had submitted comments. It appears that most of the groups strongly favor single-payer health care, while a few voiced concerns about costs and the lack of taxpayer representation. Following are excerpts from some of the groups’ comments:

American Public Health Association (APHA): “Since 1950, APHA has vigorously supported and promoted the concept of universal health care throughout the United States…. APHA was an original supporter of the Health Care that Works for All Americans Act [section of law that created CHCWG]…. Ultimately, the organization and administration of health care should be through publicly-accountable mechanisms to assure maximum responsiveness to public needs, with a major role for federal, state and local government health agencies….”

Consumers Union: “Consumers Union’s commitment to advocate for universal health care stems from the very beginning of our existence…. We hope that [the CHCWG] recommendations will spark long overdue Congressional action on this most pressing issue.”

Public Citizen: “Given the emerging consensus on health care reform, we are surprised and extremely disappointed that the Interim Recommendations of the Citizens’ Health Care Working Group did not address the issue of payment under a national health program. Yet many of those who took part in the town meetings or submitted comments to the Working Group advocated for a single payer, and, among the 1,814 respondents who expressed a desire for a ‘single health care system,’ fully 46% recommended a single-payer system. Public Citizen supports single payer, universal health care….”

Durk Pearson & Sandy Shaw: “Many Americans are not represented by [the CHCWG]…. [T]he Working Group consists of 14 individuals from diverse backgrounds…. Fourteen people are purported to ‘represent’ 300,000,000 Americans. This is a far worse level of ‘representation’ than even that of the Senate, where two Senators are elected to represent all those in one State in the U.S. Senate. Yet, even those 100 Senators are subject to election, whereas the members of the Working Group are not…. There is no representative in the Working Group that represents taxpayers, arguably the largest and most important group of people who will be affected by this proposal, as taxpayers will have to bear the brunt of the costs of any government health care system.”

U.S. Government Accountability Office, Comptroller General: “One of the realities that needs to be considered is the large and growing long-term fiscal gap facing the U.S. government…. For example, the total unfunded obligation for the current Medicare program alone was approximately $30 trillion and growing as of September 30, 2005.”

To read the Citizens’ Health Care Working Group’s interim recommendations and submit comments, see: http://www.citizenshealthcare.gov/speak_out/comment.php. Comments must be received by August 31, 2006.

Source: (http://www.citizenshealthcare.gov/recommendations/orgcomments.php).

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Is Health Insurance to Blame for Spiraling Medical Costs?

While many people think that technology is the major driver of rising health costs, new research shows that the spread of medical insurance over the past 40 years may actually be the real culprit. In her paper “The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare,” MIT economist Amy Finkelstein estimates that the introduction of Medicare and the corresponding spread of health insurance may account for nearly half the increases in real per capita medical spending between 1950 and 1990.

According to BusinessWeek, Finkelstein believes that consumers opt for more medical services if someone else pays for it. But more important, her research shows that the more significant effect on rising health costs may be that insurance guarantees a steady source of revenue for hospitals and health-care providers. “Such ready cash encourages them to build new cardiac-care centers and stock up on the latest high-tech equipment, knowing it will be paid for,” notes BusinessWeek.

This new research may shine some light on the upcoming debate on universal health care and mandatory medical insurance.

Sources:

  • “So That’s Why It’s So Expensive: Blame Insurance, Not Just Tech, for Spiraling Health Costs, Says an MIT Economist,” by Howard Gleckman, BusinessWeek Online, August 14, 2006: (http://www.businessweek.com/magazine/content/06_33/b3997089.htm?chan=search).
  • “The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare,” by Amy Finkelstein, National Bureau of Economic Research, April, 2006: (http://www.nber.org/~afinkels/papers/Finkelstein_Medicare_April06.pdf).

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What Every American Should Know about Mandatory Universal Health Insurance

The following summary is being submitted to the Citizens’ Health Care Working Group on behalf of the Institute for Health Freedom:

While advocates of mandatory universal health insurance aim to help the uninsured, their agenda nevertheless could have serious negative consequences for all, including the very population they aim to help. If history is any indication, a mandatory universal health-insurance system would end up costing much more than advocates claim. That in turn would lead to higher prices and less freedom of choice for everyone.

How do we know this? We already have evidence of what happens under a single-payer health plan in the United States. Many people may not realize it, but single-payer health care has already been tried in the United States on one subpopulation: seniors. Medicare is the biggest-spending single-payer health plan in the United States and the world. If citizens want to see what will really happen under such a system, they need only look at the imploding Medicare system. Consider empirically how Medicare has affected:

  • Taxpayer-financed health-care costs,
  • Out-of-pocket health-care costs,
  • Life expectancy and poverty rates,
  • Choice of insurance,
  • Choice of doctors and health-care providers, and
  • Health privacy.
Taxpayer-Financed Health-Care Costs

When Medicare was debated in 1965 (the year it was signed into law), business and taxpayer groups were concerned that spending might grow out of control. Single-payer advocates assured them that seniors could easily be covered with only a small increase in workers’ payroll taxes. The federal government’s lead actuary in 1965 projected the hospital program (Medicare Part A) would grow to $9 billion by 1990.

It ended up costing more than $66 billion that year.

Just three years after Medicare was passed, a Tax Foundation study found that public spending on medical care had nearly doubled. Consequently, Medicare payroll taxes and taxes in general increased over the years to pay for skyrocketing health-care costs.

In 2005 Medicare cost more than $336 billion. Taxpayers will face a much larger Medicare tax burden in the coming years. By 2030 the number of Medicare beneficiaries is predicted to be about 90 percent greater than today. But the number of workers paying Medicare taxes will be only about 15 percent greater. Therefore, tomorrow’s taxpayers will have to pay much more to support the large number of baby-boomers who will begin entering Medicare during the next decade.

Given this track record, it’s certain that a universal health-insurance program would cost much more than its advocates claim.

Out-of-Pocket Health-Care Costs

How has single-payer health care affected out-of-pocket costs? One of the most persuasive arguments for creating Medicare was that it would help reduce seniors’ out-of-pocket medical spending. However, Medicare did not achieve that goal: health-care costs increased much faster than federal actuaries had projected.

Within one year after Medicare started, Walter Reuther, president of the United Auto Workers, told the House Ways and Means Committee that many retired people were actually worse off because of the passage of Medicare. In 1967 the New York Times reported that some seniors were paying more for certain medical services than they had paid before Medicare started, and this kept some people, especially the poor, from seeking health care.

Today’s seniors are spending out of pocket about the same percentage of their incomes for health care as they were spending before Medicare was created. The single-payer program clearly did not meet its purported goal. Rather, the program led to skyrocketing costs for all seniors. Arguably, seniors would have been better served had the free market in health care been allowed to work, with a safety net for those unable to pay for health care.

Life Expectancy

Some might argue that Medicare is worth the higher taxes and health-care costs because thanks to the program, seniors are living longer. But to determine whether they are living longer because of Medicare, it is important to examine life-expectancy trends for seniors before the program was created.

Life expectancy for seniors at age 60 increased significantly between 1930 and 1960—five years before Medicare was created. In fact, overall average life expectancy in the United States increased from 47.3 to 69.7 years between 1900 and 1960. Life expectancy was low in the early 1900s primarily because infant mortality was high. However, those who reached age 60 typically lived at least ten more years.

If life expectancy for seniors was increasing before Medicare’s enactment, post-1965 increases cannot be attributed to the program. The trend merely continued.

Poverty Rates

More seniors are undoubtedly better off financially today than before 1965, leaving the impression that Medicare is mainly responsible for lifting seniors out of poverty in the 1960s and 1970s. Supporters of single-payer health care often tout this interpretation of the facts.

However, what they neglect to tell the public is that seniors’ poverty rates were declining long before 1965. The percentage of seniors living in poverty had declined from 57 percent in 1947 to 35.2 percent in 1959—six years before Medicare started. Thus even if the decline in poverty continued after 1965, there is no reason to attribute it to Medicare. A better explanation is the explosion in economic growth, fueled by economic freedom that occurred in the United States after World War II.

Choice of Insurance

If the past is any indication, the freedom to choose private health insurance and doctors (and other providers) will be severely restricted by a single-payer plan, regardless of what advocates intend. The Medicare bill promised seniors that the program would not interfere with their choice of insurance or doctors. However, existing rules force nearly all seniors to rely on Medicare to pay their hospital bills—even if they want and can afford to pay for private insurance.

Some supporters of universal health insurance promote a system of “everybody in, nobody out.” This initiative clearly strips citizens of their freedom to pay privately for health insurance. It is well known that “he who pays the piper calls the tune.” If citizens can’t pay privately for health care and health insurance, they won’t have the final say over their own decisions. Rather, these private health-care decisions ultimately will be controlled by the government—the one paying the bills. That is why all citizens should carefully consider how a single-payer plan might restrict their freedom to purchase private health insurance.

Freedom Is Costly Under Medicare

Many Americans may not realize it, but they may not decline to enroll in Medicare Part A hospital coverage when they become eligible at 65 without paying a huge cost. The only way citizens can reject participation in Medicare Part A—even if they can afford to pay privately for their own health insurance—is if they forgo the Social Security benefits they were taxed for and promised all their working lives. Since giving up Social Security benefits is too costly for most seniors, they have no choice but to participate in Medicare. Once enrolled, they are then forced to abide by more than 100,000 pages of Medicare rules and regulations dictating what services are covered for most seniors.

Moreover, once having participated, if you want to get out of Part A, you have to pay back any money previously paid under the program, plus any Social Security benefits received—supposedly your own money.

Choice of Doctors and Other Providers

Once seniors are forced to enroll in Medicare Part A, the federal government effectively prevents them from spending their own money on any services that Medicare covers. This restrictive policy was enacted in the Balanced Budget Act of 1997. Section 4507 says doctors may not accept private payment for Medicare-covered services unless they stop treating all Medicare patients for two years. One might wonder why anyone would want to pay for services covered by Medicare. One reason might be to maintain one’s privacy, which brings us to the final point.

Health Privacy

Currently some Americans choose to pay privately for medical services in order to maintain their privacy. However, a single-payer plan would eliminate that option. Confidential doctor-patient relationships would become a thing of the past. Look at what has happened with Medicare.

Under rules established in 1999, patients receiving home health care are required to divulge personal medical, sexual, and emotional information. Government contractors—mainly home health nurses—are directed to record such things as whether a senior has expressed “depressed feelings” or has used “excessive profanity.” If seniors refuse to share medical and lifestyle information, their health-care workers are required to answer for them.

Yet, an overwhelming majority of Americans do not want the government or other third parties to have access to their personal health information without their permission. This deep concern about medical confidentiality was revealed in Gallup survey commissioned by the Institute for Health Freedom in 2000 (see: http://www.forhealthfreedom.org/Gallupsurvey). Key findings include:

  • 78 percent feel it is very important that their medical records be kept confidential.
  • 92 percent oppose allowing government agencies to see their medical records without their permission; 82 percent object to insurance companies gaining access without permission; and 67 percent oppose researchers seeing their medical records without the patient’s permission.
  • 91 percent oppose a federal requirement to assign everyone a medical identification number, similar to a Social Security number, to create a national medical database.

Conclusion

Before agreeing to a mandatory universal health-insurance system, citizens should consider carefully how it could affect them in the long run, both as taxpayers and as patients. Empirical evidence shows that single-payer health care in the United States (Medicare) has:

  • Cost taxpayers much more than it initially promised,
  • Increased consumers’ out-of-pocket health-care expenses,
  • Did not significantly change the already-upward trend in life expectancy,
  • Did not significantly change the already-downward trend in poverty,
  • Restricted citizens’ choice of health insurance,
  • Restricted citizens’ choice of doctors, and
  • Invaded citizens’ health privacy.

This summary is a compilation of government reports, scholarly papers, and historical newspaper articles cited in Medicare’s Midlife Crisis (Cato Institute, 2001) by Sue A. Blevins. A version of this summary was published in the Institute for Health Freedom’s newsletter Health Freedom Watch (September 2002) and is being disseminated today because of its relevance to the upcoming debate on mandatory universal health insurance.

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Health Freedom Watch is published by the Insitute for Health Freedom. Editor: Sue Blevins; Assistant Editor: Deborah Grady. Copyright 2006 Institute for Health Freedom.