“The Selfish Leftist Heart” pointed out that Medicare for All (“MFA”) is a misleading moniker for proposals that provide health insurance coverage for only a select, relatively wealthy group of people who happen to live in America. “The Immorality of Medicare For Less Than All” explained how (1) MFA supporters give themselves too much credit for being empathetic when they sanguinely and uncritically condone proposals that deny billions of poorer people their “human right”[i] to healthcare, and (2) if the first point was brought to their attention, many of them would switch their demands to “Medicare For Everyone in the World” (“MFE”). The post ended with this: “However, neither MFA for Americans only nor everyone in the world is a moral proposition” and a promise to explain why that is true in this post. This post will sort out what is immoral about MFE.
Author’s Note: An essential premise for the following argument that support for MFA is immoral is the following:
No matter how positive the benefits of a policy are (e.g., every poor person in the world getting all the healthcare they need would be immensely positive), the policy is, nevertheless, bad if its negative consequences are greater than its positive consequences. Supporting proposals that do more harm than good is immoral.
Why not MFE? In a word, math.
About 7.75 billion humans are alive today.[ii] The sum of the annual GDP[iii] of every country totals about $87 trillion.[iv] That means that humans are producing goods and services of a mere $11,225 per person per year ($30/day). Over the long haul, humans cannot consume more goods and services than they produce. So, the average consumption per person per year cannot sustainably exceed $11,225. If some people consume more than that amount, there will be less than that amount available to be consumed by others. Just under one billion people live on less than $2/day (which is about one billion fewer than were living at that level in 1990).[v]
The average per-person consumption (which includes the consumption of healthcare) of Americans in the bottom 10% is over $15,000 per year.[vi] So, if world GDP were redistributed so that consumption by all the people of the world were equalized, the amount of consumption of “poor” Americans would fall about 25% from what they currently consume, i.e., MFE would mean more healthcare coverage for billions of desperately poor people, but vastly less healthcare for all Americans, including the about 11 million “poor” Americans to which MFA would provide healthcare coverage. Because food and shelter are higher human priorities than healthcare, the resources people would have to consume healthcare would be what is left over after sufficient resources are used to obtain food and shelter. Consequently, what would be available American poor people for healthcare would fall by more than 25%.
However, having healthcare coverage does not mean that healthcare, much less high-quality/timely healthcare, can be obtained. The infrastructure to deliver timely healthcare to most poor people in the world does not exist even if there were sufficient medical professionals to provide healthcare to everyone. Significant doctor shortages exist across the even wealthy parts of the world.[vii] Those shortages exist with billions of people having little to no access to healthcare. Nationalized healthcare systems typically impose long wait-times, do not provide the latest drugs if pharmaceutical companies refuse to slash their prices to near the cost of production (which drug companies will not always do), and decide not to provide healthcare when a bureaucrat determines that the cost/benefits analysis is not in the patient’s (or bureaucrat’s) favor. Passing a law to provide something does not magically cause the thing to materialize.
On the contrary, demanding the production of more of something (e.g., healthcare) typically causes the price of the thing demanded to rise. This is because the currently available volume of things is that which is economically feasible to deliver at the existing market price. In order to fund the motivation and means to produce more of the thing, the cost of the thing must rise.[viii]/sup> Demanding more healthcare be provided means either that the cost of healthcare will rise or the production system will become uneconomic/dysfunctional. For example, if providers are ordered to produce healthcare at a below-market price the number of people willing to stay in the healthcare business and the number of people deciding to enter the healthcare business will fall.
A man-made law cannot change the natural laws of economics any more than a law banning hurricanes would change the incidence of hurricanes. (Unsurprisingly, laws that ignore the natural laws of economics usually create more damage than hurricanes, albeit of a different sort.)[ix]
Given these realities, providing the level of healthcare that is available to America’s poor to all the poor of the world would require more money than the world can produce.
No moral person who is aware of reality could support the MFE. The same is true of MFA. Let’s sort that out in the next post.
[i] Healthcare is not something to which people have a human right. More on that in a future post.
[vii] See “Europe faces a shortage of doctors,” “U.S. faces 90,000 doctor shortage by 2025, medical school association warns,” “Poor salaries and overwork led to shortage of doctors in China,” “Dubious cure for doctor shortage. ‘The number of doctors per 1,000 people [in Japan] is 2.2 — about two-thirds of the average level in industrialized economies.,” “India suffering critical shortage of doctors…”
[ix] The discussion in this paragraph highlights a major confusion that confounds the public debate about “the cost of healthcare.” Providers of healthcare incur costs to research, invent, develop, produce, and deliver healthcare and consumers of healthcare incur costs to purchase healthcare. These two kinds of “healthcare costs” have few things in common and, in many respects conflict with each other, yet when people argue for or against MFA, they mindlessly draw no distinctions between the two. This adds major irrationality and confusion to those debates. The topic is well worth sorting out in a future post.