The Case of Alfie Evans

One of the most disturbing and heart-wrenching stories in the last several weeks surrounds the fate of a baby boy deemed by the UK High Court and health officials, against the will of his parents, unfit for further medical treatment.

After a long legal battle, Alfie Evans, a 23-month-old boy with a neurological disorder, was denied continual life support and nutrition assistance by health officials at the Alder Hey Children’s Hospital in Liverpool where he spent more than a year receiving treatment and ventilation. Despite support from the public, Pope Francis and the Italian government granting him citizenship, the High Court ruled to ban his parents, who claim Alfie to be a victim of a medical misdiagnosis, from taking him out of the country for further medical assessment and treatment.

Alfie was placed on life support in December 2016 after contracting bronchitis, the common cold and developing a chest infection that eventually lead to seizures. After admitting him to the hospital, his parents, Thomas and Kate Evans, were told he wouldn’t survive. Alfie not only survived but overcame the infection, came out of a coma and began to move around and open his eyes. Since then, he had been struggling with what has been deemed a “mystery illness” that left much of his brain damaged and nonfunctional.

On April 23, 2018, after a High Court ruling deemed there to be “no hope,” health officials ended his life support and denied him nutrition, but he had continued to breathe unassisted in what had been seen by many supporters of the Evans family as a fight for his life. He was allowed to go home to be with his parents, but he High Court also ruled that his parents would not be permitted to leave the country in an effort to seek treatment elsewhere.

On Saturday, April 28, 2018, Alfie passed away.

For many, this situation begs the question: is universal healthcare only universal so long as the State says it is? As can clearly be seen in this case, government officials in charge of nationalized healthcare determine who deserves it and who doesn’t regardless of the wishes of the individual or their guardians. Consideration is universal, but access to treatment isn’t if deemed no longer unnecessary.

Centralization of Healthcare Decisions

For some Americans, access to healthcare is seen as a right with nationalization as the apparent answer to the high costs of medical procedures and availability of care. Proponents of universal healthcare policies, like Bernie Sanders, Corey Booker, Elizabeth Warren and other progressive politicians campaign strongly on the issue and point to European countries as exemplary beacons of success and the inevitable future path of the healthcare industry. Given how government naturally expands its power with little to no restraint and thereby seeps into nearly ever facet of life, it definitely appears to be an inevitability.

What tends to go undiscussed by progressives who push so hard for it are the issues that stem from having a centralized approach to solving health-related issues. The bill of goods being sold, as with most government programs promised to fix any issue, is that in addition to “free,” open access to healthcare services, courts and bureaucrats would have the final say in how an individual receives treatment, if at all. In Alfie’s case, we can already see this in action. Not only has he been denied care by the State, but he and his parents have been denied the freedom to leave the country and seek alternative treatment options elsewhere.

While healthcare costs tend to be undeniably high here in America, what many proponents of universal healthcare seem to neglect is the freedom of choice: Would you rather take the risk of being in debt but having your child receive the treatment you think he or she needs, or would you rather have “free” access to treatment but leave your child’s care or eligibility of care subjected to the rulings of courts and government health officials? In this highly personal matter of an individual’s health, many in opposition to universal healthcare would rather take the risk of receiving the care they choose to pay for, even if it means coming at a high cost.

Government programs tend to promise lower risks but instead often incentivize increased risk (For example, government-enforced gun-free zones provide the allure of safety from being shot, but 93% of mass shootings occur in gun-free zones.). By default, life is not risk averse, and governmental attempts to guarantee lessened risks or costs are more often than not futile and pave unforeseen pathways to worse predicaments.

Why is Healthcare So Expensive?

If asked this question, Bernie Sanders would likely explain that high healthcare costs are due to the collusion of the 1% and corporate greed bred by capitalism and free markets. But is this true?

The short answer: no.

Support for nationalized medical care has been a progressive mainstay in political conversations throughout the 20th century and has even seeped into conservative political conversations (Henry Hazlitt explained that because of the enormous popularity of nationalized healthcare in Britain, many conservatives opposing it were afraid to decentralize it, essentially going along thinking, “We’ll administer this socialism better because we don’t believe in it.” The National Health Service Act was passed in the UK in 1946.). Many special interest groups involved in the medical industry were formed to petition the government and introduce regulations aimed at enforcing restrictive medical licensing, creating federal drug patents and drug patent extensions, granting federal subsidies for particular hospitals, and restricting the construction of medical facilities just to name a few.

[For a more detailed explanation on the exploding costs of medical care due to government regulation, please read the article “How Government Regulations Made Healthcare So Expensive.”]

All of these controls effectively limited the supply of physicians, medical service and hospital construction amid the growing demand and subsidization of each, and as a result the price of medical care has since skyrocketed.

Under the Internal Revenue Code of 1954, the IRS granted tax deductions for health-insurance premiums sponsored by employers. Milton Friedman wrote that “medical care expenditures are exempt from the income tax if, and only if, medical care is provided by the employer. If an employee pays directly for medical care, the expenditure comes out of the employee’s after-tax income. If the employer pays for the employee’s medical care, the expenditure is treated as a tax-deductible expense for the employer and is not included as part of the employee’s income subject to income tax. That strong incentive explains why most consumers get their medical care through their employers or their spouses’ or their parents’ employer.”

Prior to the implementation of these tax incentives, individuals did not necessarily go through third-party buyers. They could pay directly for affordable healthcare. Today, over 70% of those insured with medical coverage go through third parties, and opponents of the exemptions argue that this tax incentive suppresses the function of markets, increasing demand and driving up prices.

As Friedman pointed out, food is more vital to human survival than health insurance, and had the U.S. government implemented similarly strict licensing for food distributors and sellers, federal food patents and extensions of patents, restrictions to the amount of grocery and convenience stores, and granted tax deductions to employers for food allotment for employees, the access to foodstuffs would be limited and the cost astronomical compared to what we pay today, which many would claim is already too high. Treating the food industry like the healthcare industry would be devastating. The diminishing access to food would be met with an increase in demand.

The 1935 Social Security Act signed into law by Franklin D. Roosevelt paved the way for the government takeover of public welfare, but medical care was not included in the bill out of fear that it would harm its passage. After FDR, Harry Truman’s attempts with the so-called “Fair Deal” to include national healthcare as an extension of the government’s responsibility failed, but by the time Lyndon B. Johnson was president, the U.S. Congress was finally able to pass the Social Security Amendments of 1965. These amendments created the supplementary health benefits programs Medicare and Medicaid which were instituted to aid the elderly and poor families in obtaining health insurance benefits.

The government estimated in 1965 that by 1990 Medicare expenses would total $12 billion; however, spending totaled $110 billion that year, a 1,200% increase. They were a bit off. Today, Social Security and Medicare aren’t included in the U.S. budget despite being legal obligations but account for upwards of $80 to over $100 trillion in unfunded liabilities.

Given that the most ardent of statists tend to glorify science as the cornerstone of human existence, it is odd, though unsurprising, that when it comes to their clamoring for government fixes to social issues, they tend to disregard the science of economics along with historical context and neglect to try and foresee the potential long-term impacts of the policies they push for. What is seen are bureaucrats and politicians gathering around a president signing a bill into law intended to be for the best interest of the public, but what is unseen are the aftereffects of these policies that tend to escalate at an increasing rate once the initial perpetrators leave office and/or die off. Once these busybody career politicians depart, it opens the door to a new generation of busybodies conditioned to confuse the status quo with a natural order.

These euphoniously-named progressive campaigns and programs like the “Great Leap Forward,” the “New Deal,” the “Fair Deal,” and the “Great Society” were not based on any prior experimentation with treatment or control groups (as can be witnessed with the failing experiment of universal basic income). There was no aspect of the scientific method involved; instead, people within the government’s domain were used and are still being used as guinea pigs in what could be called an era of “The Great Failed Social Experiments.”

Government Exacerbates Problems with More Government “Solutions”

Because he is the poster child of governmentizing everything, let us ask, “WWBS (What Would Bernie Say)?” What is his solution to the high cost of healthcare? His solution: a single-payer system like the UK’s in which your health is in the hands of courts, bureaucrats and politicians. In America, the virus of socialism is not as widespread, and the idea of a single-payer system is less pervasive (for now), but many liberal and progressive politicians still favor increases to subsidization, regulation and spending as a fix.

The also euphoniously-named Affordable Care Act enacted in 2010, often referred to as Obamacare, was just that. It became the Medicare and Medicaid program for the middle class, implementing more regulations, bailing out monopolistic insurance companies, mandating fines for those choosing not to carry insurance, and ultimately increasing the costs of healthcare for both those who purchased insurance from the government-controlled “exchange” and those who have healthcare benefits through more traditional means. It was the corporatization of healthcare disguised as a pseudo-competitive market.

For a significant number of people with healthcare plans subsidized since the ACA was passed, their premiums, deductibles and other out-of-pocket costs make up 10% to 25% of their annual income. Costs have increased so dramatically that many people are choosing to bypass having medical insurance all together and pay the mandate penalty, a penalty legislators have argued to increase in an effort to strongarm individuals into not opting out. This stopgap legislation, as Ron Paul puts it, failed to correct the problems caused by prior federal laws, created new ones and will likely be used to fan the flames of fully nationalized healthcare. While some theorize that it was designed to be a failure, others argue that it was indeed designed to pass. Regardless of the motive, one thing is certain: it was another way to increase government control of the market, buy votes in exchange for “free” stuff and sell out to special interest groups.

What is rarely ever adequately explained is how an expenditure that accounts for such a large portion of someone’s income could be adequately funded to the tune of trillions of dollars by the federal government. If the exploding national debt reaches over $21 trillion with trillions more in unfunded liabilities, where do they plan to get the funds if not by raising taxes and printing money? Reports of inefficiency and overcrowding in UK hospitals are often met with complaints by politicians that they aren’t getting enough funding.

In the private sector, you go out of business if you’re inefficient and unable to provide a promised service; in the public sector, you get more funding by extracting it from tax payers.

The failures of government, and especially the federal government, are often not realized until it is too late. Government steps in to solve a problem, creates more problems and tries to solve those problems by creating more problems disguised as solutions. For people uninterested in basic economics or historical context, it is hard to convince them that nationalized healthcare and more government involvement is a bad idea, especially when each generation is brought up conditioned by the ever-increasing intrusion and meddling of markets by government.

Freeing the market offers an increase of choice at lower costs through voluntary means. Governments enforce a lack of choice at an ultimately higher cost. Unfortunately, it may likely take more heartbreaking yet predictable occurrences like that of Alfie Evans to have an impact capable enough to change the hearts and minds of people fixated on the idea that government is there to help.

The road to hell is paved with good intentions, and government, as Thomas Sowell puts it, makes it a superhighway.

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