My mother is very old. This means that she no longer actively contributes to society. Her working and child-rearing days are over. She lives off of her diminishing savings, a small pension and her social security checks. In a utilitarian world, she has no value. Because — thankfully — we haven’t yet reached that moral abyss, in our world, she has a high value: my sister and I love her, and her friends like and respect her.
I mention this because I spent this morning in the hospital with my mother. She has a recurring heart problem that can be fixed by cardioversion (i.e., electric shocks).
From the moment her heart went flippy-wacky this morning, she received the following treatment: a phone call with her cardiologist; a visit from the onsite doctor at her retirement home; double doses of heart medicine; an ambulance trip to the emergency room; an hour stay in the ER, complete with IVs and blood tests from two different nurses; an ER bedside visit from her cardiologist; a trip up to the cardioversion room, which involved the nurse and an orderly to move the gurney; an hour-long prep, involving forms to fill out, expensiive monitors, all sorts of special sticky things that were put on her back and chest as part of the procedure; an anesthesiologist; the procedure itself by the cardiologist; and then a follow-up EKG to get a good sense of her sinus rhythm.
I don’t know how much this morning’s care will cost (especially since it will be billed straight through to Medicare and her insurance), but I can guarantee you it will cost a lot of money. Someone has to pay for the drugs, the ambulance, the ER bed, the lab tests, the cardioversion equipment, the EKG machine, and the eight people who took care of her (two EMTs, two nurses, a tech, and three doctors).
My mom’s stay raised two questions vexing to the statist: First, do people in their high 80s deserve this kind of high level treatment? In hardcore Soviet countries, the answer was always no, but it was never so crudely stated. The fact was that everyone got equally lousy, minimalist care, but the elderly, by being sicker and more fragile, died more quickly.
European socialist countries also answer that question with a “no.” They’re also not crude in stating it as a standard treatment principle. It’s just that, if you read the British papers, you’ll discover that elderly people are ignored in hospitals, and that treatments that disproportionately benefit the elderly are phased out as too costly relative to their benefit.
(Apropos the manifestly abysmal care in socialist countries, we’ve all been told repeatedly that the care there is better than American health care. To understand the vast fraud perpetrated on those trying to figure out whether socialized or free market medicine is better, you must read this Commentary Magazine article. It’s behind a pay wall, so you either have to pay for the article itself or subscribe to Commentary Magazine. I recommend the latter. For a relatively low price, you get what must surely be the best magazine around.)
Second, how do you deal with the fact that modern medicine is so labor and equipment intensive? Two hundred years ago, my mom would have been bled. That would have been the end of the treatment and probably the end of my mom, too. It would also have been very, very cheap. Even fifty years ago, a practitioner’s options were limited to a few pills, some surgeries, and palliative care.
Today, the options seem endless — and they’re very costly. The only way to bring down the cost is to refuse treatment, which can be done either through price controls, which make treatment prohibitively expensive for the provider, or through rationing, which makes the absence of treatment potentially deadly for patients.
Oh, wait, I forgot. There is one more way to bring costs down: the free market. Competition is a beautiful thing. As always, let me mention here the flash drives that used to sell for hundreds of dollars, and are now given away for free, like pens. But for the socialists caught in their dilemma, the free market is the one route they refuse to consider.