NC Near Bottom in Infant Mortality

Cuba has hit upon a solution to the embarrasment of a high infant mortality rate. All prenatal services are free and mandatory, and if there is any sign whatsoever of a problem with the baby, it is aborted immediately.

From the DHHS press release

“Healthy women tend to have healthier babies. Pregnancy is a huge challenge to a woman’s body. If her general health is poor, she won’t be able to meet the physical and other challenges of growing a healthy baby.”

Research shows that women smoking or being exposed to secondhand smoke while pregnant is related to poor birth outcomes. Currently, all local health department maternal health programs are required to provide supportive “quit” services for women — especially pregnant women — who use tobacco.

A radio report on this today also mentioned that infants should not be exposed to second hand smoke. Seems obvious but it has to be restated all the time. Children just fall under the chariot wheels of the free-marketeers. Too bad property rights don’t extend to children’s lungs.

How about “Crushed under the oppressive weight of Adam Smith’s invisible hand?”

From a 2002 Congressional Research Report

The total cost of stationing U.S. troops in South Korea is over $2 billion annually. The current South Korean direct financial contribution is below $350 million annually.

Not exactly “free”. In return we get flooded with cheap cars which are damaging our auto industry which also has difficulty accessing the Korean market.

If it weren’t for Scandinavian exceptionalism, you would have exactly NO examples of even superficially successful socialism to counter the massive failures of the USSR, China under Mao, North Korea, Cuba, Nicaragua under the Sandanistas, most of post-independence Africa, and numerous other third world economic nightmares.

It’s 2007 guys, the jury has long been in on the relative merits of free markets vs. socialism. Free markets by themselves are not sufficient to create nirvana, but they are more than necessary. In fact, they are indispensable.

Greg, if we had opted years ago not to invest in the freedom of South Korea, we could have saved a few dollars and protected our inefficient automobile industry a litte longer (at the expense of low-income American consumers, of course). So in a round-about, morally obtuse way, I guess you have a point.

Wake up and smell the corporate incentives. We don’t have a ‘free market’ economy in the U.S. either.

Nor is anyone advocting anarchy, or denying that government has a role in the economy. The whole arguement is over what that role should be, and history has proven conclusively that a limited role is generally better. Judging by your writings, you guys clearly disagree. That’s fine, but if you’re going to write things like “Children just fall under the chariot wheels of the free-marketeers” and that they are “Crushed under the oppressive weight of Adam Smith’s invisible hand” don’t blame others for concluding that you’re a little nuts.

If you’re going to write like a Soviet apparatchik you’re going to be taken for one.

In addition, if those infant mortality rates are coming from largely from the population that supposed to be served by Medicaid, why aren’t you blaming Medicaid for not getting eligible people into the program? And did you ever think that maybe there are other factors to infant mortality besides your pet theories about lack of socialized medicine (which are weak at their face)?

I agree with you Greg. It’s not enough simply to call someone a commie. Though in Jim’s defense, he was simply responding to the ridiculous invisible hand trope/freemarket wheel metaphors from above that added nothing of substance to the debate, either. Use of such language suggest a profound lack of understand about how markets work. (So shame on them both.)

That said – and to your request, Greg – there are positive free-market measures that can be taken to improve access to and quality of care:

1. Let people buy health insurance in other states to kill the BCBS monopoly and let people choose the kinds of policies they want (rather than foisting them on people with costly mandates.)
2. Move away from employer-based insurance created by the taxcode, which distorts markets and limits competition.
3. Move to consumer-driven models like HSAs that discourage rich people from charging Viagra to the pool, and everyone from going to MDs for sniffles. (In short, mitigate the expense account effect.)
4. Stop expanding children’s Medicaid which makes healthcare less affordable for everyone else, including the less affluent, lower middle class. Children are lower risk and cheap to insure, so removing them from the pool drives up premiums (which in turn causes people to self insure).
5. Reduce the 7 year protectionism of generics via patents to 5 years to shorten the window for access to cheaper meds.

These are just a few. I’ve got loads of ‘em.

OK, I’ve had a couple beers so am fully chilled. But still waiting on some substance here… (Hell, if I wanted comedy we’d go read NCBlue. But I demand and expect top-notch thinking from Porkgressive Plus. You’re the only lefties in the state we can respect, so please: don’t let us down!)

BTW, Steve, if it will help my traffic, I’ll be more hyperbolic and ribticklin’.

Notwithstanding the fact that I asked about free-market solutions for reducing infant mortality and not broad health & insurance issues I have the following responses to Max’s comments:

1. I agree that BCBS is a monopoly but I see that as a product of the market, (having participated in more than one competing plan). I have had insurance outside state lines. It didn’t help much and gave me less recourse when the plan abruptly folded. The closest analogy that comes to mind is out-of-state sub-prime lenders holding loans originated in-state but now exempt from state remedies.

2. Agreed

3. Problematic: I don’t agree that HSAs are consumer-driven models. I think they are driven by people who want to be closer to their cash than their health. Even if I agreed with the premise I would agree with the “Viagra” observation, but not with the “sniffles”. The “working wounded” are more a danger to other people (co-workers, family members, children’s classmates and their families) than they are to themselves. People should see a doctor, even a doc-in-the-box or nurse practitioner. Some serious problems present initially as “sniffles” and should be intercepted early (especially for pre-natal women).

4. Couldn’t disagree more. (See Max Borders above: “why aren’t you blaming Medicaid for not getting eligible people into the program?:”) Adding children to a pool from Medicaid may decrease average costs of individual premiums but will increase the cost of of family insurance, resulting in fewer children and adults insured. (Also divorce rates, custody and parental issues make coverage and continuity complicated for many kids).

5. I would tend to agree but I do think drug companies should recoup their research investment. I don’t have a major problem with the 7 years but I do have a problem with the proliferation of delivery mechanisms that artificially extend patent protection beyond 7 years. (ie injected, snorted, inhaled, sublingual, skin patch etc.)

One important of increased infant mortality is the increase in premature births. Technology can prolong life without necessarily improving it. The same technology that reduces infant mortality may indeed be raising it simultaneously. This is a separate discussion.

I think that the health of the mother is critical. Most Western European countries have lower infant mortality rates than the US. They must be doing something right that we can learn from.