Some years ago, when I was a slip of a lad, I found myself commiserating with a distinguished American songwriter about the death of one of his colleagues. My 23-year-old girlfriend found all the condolence talk a bit of a bummer and was anxious to cut to the chase and get outta there. “Well,” she said breezily. “He had a good innings. He was 85.”
“That’s easy for you to say,” he said. “I’m 84.”
That’s where Obamacare leads: You’re 84, and it’s easy for him to say. Easy for him to say what you need — or don’t need. Relax, he assured an audience of puffball-lobbing plants in Portsmouth, N.H. . . . By the way, when I mock “puffball-lobbing plants,” obviously all such events are stage-managed, but the trick is to make it not quite so obvious. When Nixon was campaigning in ’68, Roger Ailes used to let a couple of dirty no-good long-haired peaceniks into the room so his candidate could swat ‘em down: It ginned up the crowd, made for better TV, and got the candidate pumped. “Thought it went well tonight,” he’d say. “Really socked it to those hippies.” In essence, Ailes stage-managed it to look un-stage-managed. If those who oppose Obamacare are merely a bunch of “un-American” “evil-mongers” (according to, respectively, Nancy Pelosi and Harry Reid), the cause would benefit from allowing the president to really sock it to a couple of them once in a while. To retreat behind a wall of overly drooling sycophants does not help Obama at this stage in the game.
Anyway, there he was reassuring the crowd that provision for mandatory “end-of-life counseling” has “gotten spun into this idea of ‘death panels.’ I am not in favor of that.” Well, that’s good to know. So good that a grateful audience applauded the president’s pledge not to kill them. He has no plans, as he put it, to “pull the plug on Grandma.”
The problem with government health systems is not that they pull the plug on Grandma. It’s that Grandma has a hell of a time getting plugged in in the first place. The only way to “control costs” is to restrict access to treatment, and the easiest people to deny treatment to are the oldsters. Don’t worry, it’s all very scientific. In Britain, they use a “Quality-Adjusted Life Year” formula to decide that you don’t really need that new knee because you’re gonna die in a year or two, maybe a decade-and-a-half tops. So it’s in the national interest for you to go around hobbling in pain rather than divert “finite resources” away from productive members of society to a useless old geezer like you. And you’d be surprised how quickly geezerdom kicks in: A couple of years back, some Quebec facilities were attributing death from hospital-contracted infection of anyone over 55 to “old age.” Well, he had a good innings. He was 57.
This ought to be of particular concern to Americans. As is often pointed out, U.S. life expectancy (78.06 years) lags behind other developed nations with government health care (United Kingdom 78.7, Germany 78.95, Sweden 80.63). So proponents of Obamacare are all but offering an extra “full year” of Euro-Canadian geriatric leisure as a signing bonus.
“Life expectancy” is a very crude indicator. Afghanistan has a life expectancy of 43. Does this mean the geriatric wards of Kandahar are full of Pashtun Jennifer Lopezes and Julia Robertses? No. What it means is that, if you manage to survive the country’s appalling infant mortality rates, you have a sporting chance of eking out your three-score-and-ten. To say that people in Afghanistan can expect to live till 43 is a bit like saying the couple at No. 6 Elm Street are straight and the couple at No. 8 are gay so the entire street is bisexual.
Which brings us to the United States and its allegedly worst health system in the developed world. Here’s the reality: The longer you live in America, the longer you live. If you’re one of those impressionable Meet the Press viewers who heard Mayor Bloomberg bemoaning U.S. life expectancy and you’re thinking, “Hey, I’m 77. Just about at the end, America-wise. Maybe it’s time to move up north or over to Europe, and get a couple of bonus years,” don’t do it! If you’re old enough to be a Meet the Press viewer, your life expectancy is already way up there.
America is the Afghanistan of the western world: That’s to say, it has a slightly higher infant mortality rate than other developed nations (there are reasons for that which I’ll discuss in an upcoming column). That figure depresses our overall “life expectancy at birth.” But, if you can make it out of diapers, you’ll live longer than you would pretty much anywhere else. By age 40, Americans’ life expectancy has caught up with Britons’. By 60, it equals Germany’s. At the age of 80, Americans have greater life expectancy than Swedes.
How can this be? Well, amazingly, millions of freeborn citizens’ exercising their own judgment as to which of the latest drugs, tests, and procedures suits their own best interests has given Americans a longer, better, more fulfilling old age to the point where there are entire states designed to cater to it. (There is no Belgian or Scottish Florida.) I had an elderly British visitor this month who’s had a recurring problem with her left hand. At one point it swelled up alarmingly and so we took her to the emergency room. They did a CT scan, X-rays, blood samples, the works. In two hours at a small, rural, undistinguished, no-frills hospital in northern New Hampshire, this lady got more tests than she’s had in the last decade in Britain — even though she goes to see her doctor once a month. He listens sympathetically, tells her old age often involves adjusting to the loss of mobility, and then advises her to take the British version of Tylenol and rest up. Anything else would use up those valuable resources. So, in two hours in New Hampshire, she got tested and diagnosed (with gout) and prescribed something to deal with it. It’s the difference between health “care” (i.e., going to the doctor’s every month to no purpose) and health treatment — and on the latter America is the best in the world.
President Obama has wondered whether this is a “sustainable model.” But from your point of view, what counts is not whether the model’s sustainable but whether you are. I am certainly in favor of reform. I would support a Singapore-style system of personal health accounts — and Singapore, for Mayor Bloomberg’s benefit, has the third-highest life expectancy in the world. But, under any government system that interjects a bureaucracy between you and your health, the elderly and not-so-elderly get denied treatment. And there’s nothing you can do about it because, ultimately, government health represents the nationalization of your body. You’re 84, 72, 63, 58, you’ve had a good innings. It’s easy for him to say. And even easier for his army of bureaucrats.