The Nature of the Disease

Cuba, a lovely Communist paradise, which millionaire leftists like Michael Moore and Steven Spielberg have told us has health care vastly superior to our own, is experiencing an outbreak of cholera. There are at least 15 dead and a thousand sick, but the advanced Cuban health care system is on the case. The authorities have banned any mention of "cholera" and doctors are putting down “acute respiratory insufficiency” as the cause of death for the epidemic.

But there's no need to sneer at Cuba for handling the problem the way that all governments handle problems-- by denying that it exists. According to the Cuban government, there is no serious cholera outbreak. According to the European Union, there's no Eurozone meltdown. According to Obama, the private sector is doing just fine.

Accountability and government bureaucracies don't go together. When the latter are put in charge of health care, then cholera patients end up doing just as fine as the private sector while the bosses smile and offer themselves another pay raise. That is how euthanasia happens in the UK's NHS, the envy of six-figure bureaucrats and seven-figure activists on this side of the ocean. Difficult patients are just set aside, denied food and water, and allowed to be just "fine" until they die.

The problem with putting the government in charge of things is that the government is very bad at "things". Put the same people responsible for a 15 trillion dollar deficit, a pandemic of debt, in charge of health care and, before you know it, we'll have a cholera outbreak to call our own.

Cholera was one of two virulent pathogens to emerge out of Indonesia is the sixties. The seventh pandemic came out of Indonesia in 1961 just as Barack Hussein Obama came squalling out of his mother's womb. By 1971, as Obama moved to Hawaii, cholera came to Africa. In 2008 it swept the kleptocracy of Zimbabwe, even as Obama was preparing to turn the United States into another Zimbabwe. Now it has taken root in the Republic of Cuba, whose advanced health care botched the treatment of Hugo Chavez, who might seriously be reconsidering the whole socialism thing, and is equally inept at fighting cholera.

The last major cholera outbreak in the United States took place almost exactly one-hundred years ago. Today the vast majority of cholera cases in the country are brought in from outside by foreign travelers. And these days we have a lot of those poor huddled masses yearning to cough up some TB, steal some copper, apply for food stamps and vote the Democratic Party ticket. While we probably won't face a pandemic for some time, the collectivization of health care under government authority will leave us equally ill-equipped to face it when it does come.

The government collectivization of health care shifts us from a system where medical professionals diagnose and treat individual diseases to a national system that focuses on prevention and education gimmicks as cost-cutting measures. The collectivist health care system is interested in healthy workers, not in patient care. Its bosses have their own profit-and-loss ratios and count on keeping people from getting sick. If they do get sick, it is assumed that it is their own fault because they ate too much or ate the wrong things or didn't exercise enough or just got too old.

Government health care is a lot like the health insurance industry. Most of the money is spent on offices where bureaucrats measure the cost of care, pinch pennies, deny treatments and study the arcane knowledge, not of medicine, but of the bureaucracy that manages medicine.

The difference between the two is that the financials on government health care are much more unsustainable, the accountability is utterly lacking and the cruelty and apathy are much greater. Few private businessmen still believe that they 'own' other people and that their lives can be disposed of, but that attitude is second nature to government officials who not only believe it, but who are obligated to function that way, They are not mere businessmen, but the custodians of the lives of hundreds of millions of people.

That is the nightmarish essence of government health care. That is the nature of the disease.

Agriculture in the Soviet Union broke down because the means of production were under the control of a vast army of bureaucrats who understood nothing about farming and whose jobs and survival depended on constantly generating new ideas to improve agriculture and covering up their failures. Toward the end of the Soviet Union, the USSR had gone deep into debt buying American wheat even while the overseers at the former "Breadbasket of Europe" were reporting record harvests.

Political projects, unlike business projects, can never fail. The shovel-ready projects are always digging, the stimulus plans are always stimulating, and we are always on the way up-- no matter how low we go. Businesses measure success and failure in money. Governments don't have that metric. A project doesn't fail on the financials and it doesn't fail when it does not achieve its goals or any goals. It only fails when its failure, actual or imagined, is used by the opposition to successfully embarrass those associated with the project.

In a one-party state or a one-party media, there can be no failure. Actual horrific failures can and do occur, but they are not acknowledged except as a mechanism for replacing one generation of politicians with the new generation of incompetents, thieves and buffoons. Nothing ever gets better because improving things is not a function of the system, nor does the system have any capacity for improving things except by short-circuiting it through temporary bouts of micromanagement or a crisis that invests the people in the system with a temporary sense of urgency to get things done.

Why is Cuba's health care system superior? Because it's socialist. The reasoning is a closed loop and it is the same closed loop that is used to defend ObamaCare. It's not just the label, it's the reasoning behind it that says that the way to improve the delivery of a product or service is by building a vast delivery infrastructure around it to measure and dispense it in the best way possible. Such a system must be superior in its performance because it is modern and scientific. Therefore, it works even when the cholera cases are piling up.

We all know that bigger is better. The more people you put behind the lines to work out the logistics and decide who lives and dies and the exact schedule for Item D of Subsection 728 of Function Y, the better the system will work and the happier the people will be. It is a fallacy that never goes away because turning every human affair into a factory where no one does anything useful seems so reasonable. It's how so much of our society works. And that is the nature of the disease.

The bigger a system gets, the less capable of performing a function it becomes. The more detached a system is from its direct function, the more it exists not for the sake of the function, but for its own sake. Such a system can be called a disease or a cancer, but it's also like cholera, an infection of the system that leads to massive waste and eventually the death of the system.

During the ObamaCare debate, Keith Olbermann insisted that the debate was a matter of life and death. And it is. Universalizing the delivery of a service through a central government system drastically worsens the quality and value of the service.

If you doubt that, consider the decreasing quality of the educational system as it became more centralized and universalized. Now imagine an average quality of health care as bad as the average quality of education. Imagine a system based on fraud and cover-ups, rife with resource shortfalls, where the staff is unhappy, the doctors and nurses barely know what they're doing and most of their efforts are dedicated to trying to keep up with the latest government quality initiatives which can never be met.

We have bits and pieces of that system in place already, but there are countries that have the whole awful shebang. World powers where patients die pleading for a drink of water and modern socialist utopias battling a disease whose name they dare not speak. There is no escaping those results with a commission or two. There is no use putting the best and brightest experts in a room and getting them to author some thousand- page monstrosity that will fix the problem. You can't cure a disease with more of the same disease.

Free things are nice to have, but they are also very expensive. Not only do they cost three times as much as a comparable service, but they are so bad that it is hard to find a service to compare them to.

Walmart is cheap and the products are worth what you pay for them, because even the same brand names sell cheaper and poorer-quality versions of the same products to the giant retailer. That is how it works. Walmart squeezes the manufacturer and the supplier and, under the iron law of human affairs, they struggle to maintain consistent profits by providing a cheaper and worse product.

Now imagine the government as a giant Walmart with offices full of useless employees, armies of unnecessary executives, stores that spend hundreds of millions on advertising without once ever turning a profit. Imagine the quality of products and services that such an infrastructure will provide. Imagine what comes out the other end after the manufacturers and suppliers have been squeezed to cut costs as much as possible.

Those are your government services. That will be your health care if the Cuban cholera follows the Indonesian cholera to America. That is the nature of the disease.