Friday, November 05, 2010

Huckabee Knows Healthcare... Not!

I was just watching Huckabee on van Susteren's FOX show and he was criticizing the Obama health care reform. I don't know if he was calling for complete repeal or not, I couldn't figure that out, but I did pick up one argument. (Video is here and argument starts at about 4:30).

He asked, "How can we afford to provide care for all these people who are currently uninsured. Surely, it will cost money, more money that what we are spending now." Really? Based on what evidence? If Joe Blow, who currently doesn't have insurance, delays going to the doctor and later his sore throat turns into pneumonia, a quick visit to his family doc and a Z-pack might have avoided the emergency room visit, hospitalization for and subsequent empyema drainage. We won't let him die, so we are paying for it anyway! The difference is that with Obamacare, Joe Blow has to pay something into the insurance system.

Huckabee inexplicably uses the specific example of "a woman going to her ob/gyn" which will "surely cost money." Surely. Of all the examples to use, the Huckster picks the one field of medicine that has been shown unequivocally to be cost effective. In fact, it is so cost effective that prenatal care services are the broadest covered medical service across the USA. Even with our collective reluctance to provide socialized medicine-- to those according their need--- to a person, every pregnant woman gets prenatal care. Why? Because even the most capitalist knows that the cost of NO prenatal care is far higher than just giving the woman Medicaid. Neonatal intensive care, birth defects, maternal morbidity.. it's costly. The threshold for Medicaid is set very low so that all women-- with or without a job or resources- get the care they need, increasingly through the Medicaid system. The fact is that the new health care reforms will require more employers and women to pay for their own care, thus reducing the burden on taxpayers and Medicaid systems. Obamacare will save tax revenue, at least in this one area.

Another irony of Huckabee using ob/gyn care is that numerous studies as well as experience in socialized systems show that provision of universal access to birth control services is associated with lower rates of unwanted pregnancies, teen pregnancies and abortions. This would reduce the financial burden on society. Today there are numerous hurdles for young women to obtain counseling for birth control and STD prevention.

The third irony is that non-reproductive health care for women is also extremely cost effective. Since the Pap smear became available, cervical cancer death has all but become preventable. The Pap smear: the mother of all cost-effective screening tests! By increasing access to this one service, not to mention STD screening, mammography and the recently available HPV vaccine, we could dramatically reduce the cost of treatment of diseases with prevention and early detection.

Overall, ob/gyn services are far and away the most cost-effective services in the entire medical field. This is the reason most opponents of health reform never mention obstetric and gynecologic care as reasons for denying care to people. The women who benefit most from these services are young and often single. and usually do not enjoy financial status, thus their ability to pay for services out-of-pocket is limited. Mandates for employer coverage, federal subsidies and payroll deductions would have beneficial impact in paying for these cost-effective preventive and screening services.

The only reason I can figure that Huckabee would use ob/gyn services as a problem with health care reform is that he just doesn't understand medical economics. Even the most battle-hardened anti-government Tea Partier knows better than to deny ob/gyn care... because it's the best bargain in all of medicine.

Apparently, Huckabee has had a long-standing problem understanding medical economics, and the collective benefit of mandatory health insurance.

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