Tuesday, September 01, 2009

Blind Compassion

A friend of mine posted a link to this column by Nicholas Kristof, saying that another tragedy of our medical system is that it causes divorce.

The logic is somewhat twisted. The number one reason people get divorced, so this logic goes, is because of money issues. And supporters of socialized medicine say that medical bills are the number one money issue people have (the truth is that infidelity, communication breakdown and abuse (physical, emotional or psychological) cause more divorces than financial pressures). Anyway, if, as they argue, that medical bills are the biggest cause of money woes in a marriage and money problems is the main reason people get divorced, if we socialized medicine, we would have fewer divorces because people wouldn't have the same money problems. I don't buy that argument, but the linked column makes an even worse one.

Kristof recounts the woes of "M," a woman married to a man who had started displaying symptoms of dementia. The doctors explained that as the disease progressed, her husband would eventually need to be institutionalized. "M" was told that the costs would be devastating but there was a solution: divorce him.

“I was blown away,” M. told me. But, she said, the hospital staff members explained that they had seen it all before, many times. If M.’s husband required long-term care, the costs would be catastrophic even for a middle-class family with savings.

Eventually, after the expenses whittled away their combined assets, her husband could go on Medicaid — but by then their children’s nest egg would be gone, along with her 401(k) plan. She would face a bleak retirement with neither her husband nor her savings.

We faced similar concerns regarding my father. He was a thrifty man and had put away some money for a rainy day (or our inheritance). As the cost for his caregivers rose, his savings were eroded. We never had to deal with selling his home and possessions or even depleting his savings, but my siblings and I did have to think about how we would afford his care if and when those things were gone.

The part that struck me about the argument made was the sort of thing that drives liberals (like my friend) nuts: these people wanted to defraud the Medicaid system so "M" could keep her 401(k), an inheritance from a first husband, and her house.

Liberals like to play this victim game: find a sympathetic face to exploit make a political point you favor. It can be a a child, a grieving mother, or even a death. No matter how tasteless the display may be, liberals think it shows compassion to use people's personal tragedies to bludgeon opposition to their policies.

Currently, my friend thinks it is heartless that I would point out the advocacy of Medicaid fraud, or that you save for retirement precisely to pay for the expenses at the end of your life. For him, and others who think this way, this anecdote simply shows another evil consequence of our health care system, and to question this behavior is heartless and wrong.

Kristof goes on to cite this study, which argues that 18,000 people die every year because they lack insurance. But as I pointed out here, the study lumps in chronic illnesses such as high blood pressure and diabetes (which are very treatable) with arguably deadly conditions (cancer, for instance). And the study also argues that pap smears and mammograms are unavailable to those without insurance (a thoroughly false claim).

These sorts of sleight-of-hand tricks draw in many well-meaning people, just like my friend. But in the end, it's not compassionate to encourage Medicaid fraud and it's not truthful to state that nearly 20,000 people die annually because we don't have socialized medicine.