Why do people die in this country? Because they lack health insurance? Or because they lack health itself? The data would show that it's the latter--lack of health itself--by a ratio of more than 50:1. Yet for some reason, the liberal left prefers to talk about the former.
No liberal leftist talks more about the need for health insurance than Alan Grayson, former Democratic Member of Congress from Florida. Elected to the House in 2008, Grayson soon gained prominence/notoriety for his provocative/inflammatory TV soundbites. In 2009, for example, on the floor of the House, he summed up his view of the GOP position on healthcare: "Don't Get Sick! And If You Do Get Sick, Die Quickly!"
Grayson was defeated for re-election in 2010, having served just a single term, but he is hoping for a political comeback in 2012. And he has managed to stay in the public eye through the same tactic of hot talk, as when he appeared on Keith Olbermann's Countdown show--now exiled to Current TV--and called the tea party "sadistic."
And on January 4, Grayson took to the pages of The Huffington Post, attacking GOP presidential candidate Rick Santorum for rejecting the premise of an Iowa student's question--that Americans are dying because they lack health insurance.
In response, Grayson wrote, "Wake up, Rick." He continued, "The student was referring to the same study that I publicized on the Floor of the House two weeks after it was published in the American Journal of Public Health. Here it is. It documents that 44,789 Americans die each year because they have no health insurance."
And so Grayson, always flamboyant, added his own further contribution to the debate: "I started a website called www.NamesOfTheDead.com. I invited surviving family and friends to tell me about people whom they had loved and lost, because they had no health coverage. And they did--thousands of them. I read some of their stories on the House Floor."
Okay, there you have it. For the sake of argument, let's accept for the time being that the 44,789 number of deaths is accurate. But here's a question: How many Americans die each year? Well, in 2009, according to the Centers for Disease Control, some 2,423,712 Americans died. So we can compare Grayson's 44,789 number and the CDC's 2,423,712 number. And we see that the number of people who die from lack of health insurance represents just 1.8 percent of all those Americans who die, period. To put it another way--and not to get too morbid--a true "names of the dead" website would be more than 50 times larger than the site Grayson has in mind.
And if we were to go Grayson-esque, plucking out particularly sad stories, we could note that in 2007--the most recent year for which data are available--nearly 40,000 Americans under the age of 14 died. That is, nearly as many children passed away as the uninsured. Indeed, to review the causes of death for infants, for example, is to read a litany of tragic demises, including Sudden Infant Death Syndrome (SIDS), bacterial sepsis, respiratory distress. How many of these deaths would have been prevented by the extension of health insurance? Some, perhaps, but undoubtedly more deaths would be prevented if medical science could eliminate, say, bacterial sepsis. Sepsis was once a huge killer, and now it is only a small killer. But with better drugs, perhaps it could be not a killer at all.
And of course, the same medical reality holds true for adults. The actor Patrick Swayze had plenty of financial resources for combating pancreatic cancer, but he died of the disease, in 2009, for one reason: There was no cure. Those interested in the ravages of this particular malady might wish to look at the new book, Worth Fighting For: Love, Loss and Moving Forward, by Swayze's widow, Lisa Niemi Swayze. Her book notes that life expectancy for pancreatic cancer victims is normally about six months, but Patrick extended it to 21 months. A moving story, to be sure, but it would be better if pancreatic cancer were not such an emphatic death sentence: Progress against the disease would require progress in medical science, not healthcare finance. The National Cancer Institute estimates that pancreatic cancer killed 37,660 Americans last year.
In other words, a lot more people die--and die prematurely and tragically--from lack of health than from lack of health insurance. More than fifty times more, as we have seen. Yet Grayson's invective never mentions scientific transformation; it's political transformation that he is after.
So why are Grayson-type liberals so focused on health insurance, while ignoring the larger medical reality of sickness and death? When did health insurance become an end in itself, ignoring the obviously key variable of medicine? What could explain this perverse shift in emphasis, from science to finance?
We might speculate on two possible reasons: one shallow, one deep:
First, pure partisanship, purely and simply. The American left is in favor of national health insurance, while the right is against it. So if you're a partisan brawler looking for a brawl, you're sure to get one in re: national health insurance, pro and con. And Grayson is obviously a brawler.
Second, and more deeply, we have seen a great shift in thinking within the left over the last century. The left was once fully enamored with science; according to one of Lenin's Soviet slogans, "Communism is Soviet power plus the electrification of the whole country."
In the US, a moderate liberal such as Franklin D. Roosevelt believed in national health insurance--even if he never proposed actual legislation--and yet he was open in his advocacy of scientific solutions to health challenges. In 1938, he actively supported the creation of the National Foundation for Infantile Paralysis, aka the March of Dimes, to support research on a polio vaccine. Obviously American health has been vastly improved because of the Salk Vaccine; as an aside, we might note that the vaccine has been a money-saver, too--no more expenditures on once-ubiquitous iron lungs.
Meanwhile, in the United Kingdom, at around the same time, the march of science was seen as essential to the march of socialism. The final push to achieve national health insurance began with a close linkage between health finance and health science. The 1945 campaign manifesto of the British Labour Party was entitled "Let Us Face the Future"; it was forward-looking document, seeking to harness together socialism and scientism. And upfront--in the third paragraph of the campaign document--Labour promised "comfortable, labour-saving homes that take full advantage of the resources of modern science and productive industry."
Indeed, the Labour manifesto specifically sought to link high-tech medicine to health insurance: "In the new National Health Service there should be health centres where the people may get the best that modern science can offer, more and better hospitals, and proper conditions for our doctors and nurses. More research is required into the causes of disease and the ways to prevent and cure it." It was a message powerful enough to defeat wartime-hero Winston Churchill in the July 1945 national elections.
In other words, back in the 40s, the left saw science as an ally. Yet in the decades since, left-leaning bureaucracies have veered away from their former alliance with science. Why? As the historian C.P. Snow observed a half-century ago, the politico-bureaucratic culture is ultimately different from the scientific culture, and, between the two, "a gulf of mutual incomprehension" opens up wide. Indeed, over time, bureaucrats focus on what they like to do, which is to manage, while scientists focus on what they like to do, which is to transform. So in the end, the managerialists and the transformationalists come into conflict. And most of the time, the managers prevail. Bureaucrats recognize medicine as NIH--that's an acronym for "not invented here," for those who thought maybe it stood for something else--and so they seek to degrade it, relative to their own preferred solution, which is bureaucratic redistribution.
Thus science is subordinated, and thus a leftist such as Alan Grayson can see a medical problem only through the prism of bureaucracy.
In addition, as we know, the environmental movement of the 70s came to see science and technology--of all kinds--as an enemy, and human beings were regarded as a further part of the problem. Within this green mindset, it's hard to get excited over high-tech Salk-like breakthroughs, and so the environmentalists become one with the bureaucratists, jointly administering a shorter and more regimented life for all of us.
Meanwhile, if the American people understood the game as it is being played, they would stoutly reject this ongoing attempt to privilege bureaucrats over doctors and medical science. Yet Grayson & Co. are effective propagandists for the anti-science point of view. And if they can say with a straight face that we should focus on 44,789 uninsured deaths and not think too much about the aggregate of 2,423,712 deaths, they are well on their way to the perpetuation of bureaucratic, not scientific, dominion over healthcare.
Health insurance is a useful tool for advancing health. Yet health insurance is only a proxy for the larger goal of medical progress--because health insurance is only as good as the medical system backing it up. And so in the tragic case of Patrick Swayze, health insurance proved irrelevant.
The real goal is achieve a healthy, productive population able to live long and happy lives. And that takes science, not politics.