Sunday, May 07, 2017


There are other fallacies in Kimmel's sob story, besides what Shapiro exposed:

i) For many or most folks, Obamacare made healthcare far less affordable. And some physicians are leaving the medical profession because they aren't adequately remunerated under Obamacare. 

ii) There's no one-to-one correspondence between affordability and availability. Kimmel praises the world-renown pediatric heart surgeon who operated on his newborn. But there's only so many world-renown pediatric heart surgeons in the world. Even if every patient could afford it, that doesn't mean everyone will magically have access to world-class physicians. Patients outnumber cream-of-the-crop medical specialists by a wide margin. 

iii) Kimmel acts as if conservatives were happy with the situation prior to Obamacare. But many conservatives think we needed to overhaul the system long before Obama or Hillary. For instance, tort reform to lower malpractice premiums. Likewise, competition between states for health insurance. 

iv) Kimmel is a rich talkshow host. It's not as if he can't afford to pay out of pocket. 

v) Finally, if we lowered tax rates, more people could afford healthcare. Likewise, more people could afford to donate to hospital charity funds. 


  1. I entirely agree with the post. I'd like to add:

    1. It's hard to be moved by crying celebrities who have the luxury of bringing their kids to Cedars-Sinai, which by reputation in Los Angeles is a very posh hospital in Beverly Hills. A hospital for celebrities.

    Perhaps Kimmel should head down to a public or county hospital like the LAC+USC Medical Center if he wants a more accurate taste of what it's like to be in something like a gov't run hospital. Or one of the many VA hospitals in the Los Angeles area.

    2. I think Kimmel is in essence making an appeal to emotion. If we really care about dying kids, then we should have universal healthcare (by which he most likely means a gov't run single payer healthcare system).

    However, if we have such a system, what if there are more dying kids overall? Or what if more kids live but more kids have to live a significantly diminished quality of life? Or what if kids benefit (however negligibly) to the detriment of others?

    It's like saying, if we really care about the poor, then a rich country like the US should end poverty by giving everyone enough money. Sure, I guess, and while we're at it, we might as well say everyone should get to ride on their very own unicorn and bask all day in rainbows and sunshine.

    3. From what I've seen, most physicians don't support a single payer system. The major exception that comes to mind is academic physicians who tend to be insulated from the economic (among other) realities of practicing medicine. For example, pure academic physicians (not hybrid models) don't have to worry about hiring or firing staff since the university hires and fires their staff, paying for their staff including providing healthcare benefits, paying rent since the university provides for their clinics and offices, attracting patients since patients are referred to them, purchasing malpractice insurance which the university absorbs, hiring lawyers to defend them in case of a law suit which the university would provide if they're sued, etc.

    4. As Bernie Sanders said, his vision for a gov't run single payer system is "Medicare for all". Indeed, Medicare (basically gov't health insurance for the elderly) and/or Medicaid (basically gov't health insurance for the poor) are arguably a microcosm of what we can expect if the gov't runs healthcare. However, just look at how "well" Medicare/Medicaid is doing. For one thing, Medicare/Medicaid is the single largest chunk of our healthcare costs. For another, it's chock full of healthcare rationing. Also, there's poor access to physicians. And the list goes on.

    5. Even a liberal economist like Paul Krugman has said:

    Now, it’s true that single-payer systems in other advanced countries are much cheaper than our health care system. And some of that could be replicated via lower administrative costs and the generally lower prices Medicare pays. But to get costs down to, say, Canadian levels, we’d need to do what they do: say no to patients, telling them that they can’t always have the treatment they want.

    Saying no has two cost-saving effects: it saves money directly, and it also greatly enhances the government’s bargaining power, because it can say, for example, to drug producers that if they charge too much they won’t be in the formulary.

    But it’s not something most Americans want to hear about; foreign single-payer systems are actually more like Medicaid than they are like Medicare.

    And Sanders isn’t coming clean on that — he’s promising Medicaid-like costs while also promising no rationing. The reason, of course, is that being realistic either about the costs or about what the system would really be like would make it a political loser.

    1. 6. I agree with tort reform. A huge cost of healthcare is that most physicians are all but forced to practice defensive medicine. Tons of lab and imaging tests to CYA rather than because they're really needed. For example, Gallup estimates defensive medicine costs $650-$850 billion per year. That's just ridiculous. I've seen opponents of tort reform cite much lower figures like $50 billion per year (usually because they're only citing a narrow spectrum of costs rather than the full spectrum), but even $50 billion per year is nothing to sneeze at.

      7. What currently often happens to uninsured patients diagnosed with a serious condition like an acute cancer is: (a) they're immediately admitted to a private hospital, (b) they're treated until they can be safely discharged, then (c) they're referred to a public or county hospital for continuity of care.

      Every physician involved in such a patient's care knows they won't be paid. They know they're providing pro bono work as it were. The patient may sometimes receive a bill, but there's zero expectation the patient will pay the bill.

      But all this is possible due to important factors like charities (as Ben Shapiro points out) as well as other patients paying a fair amount for their healthcare so doctors can afford to take a hit to their pockets now and again.

      If we have a gov't run single payer system, then the gov't (directly or indirectly) sets how much a treatment plan costs, how much doctors are paid (e.g. salaries +/- limited bonuses), etc. This arguably takes away a lot of the incentive for people to make charitable contributions as well as for physicians to go above and beyond the call of duty.

      8. By contrast, here is something from a private practice oncologist (radiation) based in Texas that I read some months ago:

      I'm in private practice and we own/lease all our equipment. If our patients qualify for it we have the ability to write off their whole treatment. As we're not owned by an academic medical center or employed by a hospital we get to make our own rules. I'm actually a radiation oncologist, which admittedly does make it easier to treat those who can't pay, as we don't really have too many consumables used for a treatment - just the electricity to run the machine. Patients with insurance naturally do pay, which subsidizes our ability to treat others for free. It's one of the things I'm really proud of about our practice.