Sunday, April 10, 2011

ObamaCare and Cynthia

We recently marked the first anniversary of the greatest single assault on individual liberty in my lifetime, and maybe since the founding of the country: ObamaCare. As we continue to debate what the real effects of that law will be, I think back to an episode that occurred almost twenty years ago and which has special meaning to me.

Twenty years ago a fragile, extremely premature baby girl was born. That person is now a normal, healthy, bright, energetic young woman in college studying creative writing and journalism, getting ready to go out into the adult world on her own.

At the time of her birth, it was not at all a given that she would make it this far. You see, Cynthia was born at twenty-four weeks gestation, and weighed in at one pound eleven and a half ounces. The birth was life threatening to mother and child. After she (and her mother) survived the birth, it was unclear whether Cynthia’s life span would be measured in hours, days, months, or years. She was right at the edge of what was considered to be somewhat viable for prematurity at the time.

The doctors in the Stanford Children’s Hospital neo-natal intensive care unit told her parents that her chances of long term survival were somewhere around twenty-five percent, but that even if she made it for the long term she would most likely have some serious problems of one sort or another with brain development, eyes, heart, lungs, digestive system, or just about anything.

Cynthia spent the first five months of her life in the hospital. That’s not five days or five weeks, but five months. She had highly specialized medical care around the clock. There were many ups and downs. The doctors more than once signaled to Cynthia’s parents that she might not live through the next twenty-four hours.

But a miracle started unfolding. Every day that Cynthia lived without a serious incident improved her chances of a more positive outcome. And gradually, ever so slowly, she started getting better. Some of the major health threats began to fade. Brain bleeding did not occur; instead, her brain slowly developed normally. Her heart grew and functioned properly. Her digestive system improved. Her eyes progressed and it started to look as though she would not be blind; that she might even see normally.

One significant milestone was when she got off of the respirator and started breathing on her own. Then she was able to be taken out of the incubator and be held by her mother. She started being fed orally instead of intravenously. She followed an object with her eyes. Then she actually cried out loud, a major developmental achievement.

Another major milestone was when she got out of the neo-natal intensive care unit and went to the regular neo-natal unit.

And on one glorious day, little baby Cynthia, at the tender young age of five months, was well enough to go home for the first time. By this time, she had fattened up to a whopping four and a half pounds.

Although the major dangers were behind her, Cynthia was still not completely out of the woods. She had an oxygen tube under her nose and a tank at home and one that was portable. She used this for several more months, but her lungs continued to develop and she got off of the oxygen.

Cynthia continued to grow, but faced more health challenges. She showed a profound lack of speech development, but responded to speech therapy. At toddler age, she started walking on her knees, but couldn’t stand up due to some ankle problems. She had progressive casts put on both legs; these are casts that bend the foot upward thus stretching the tendons in the ankle. The “progressive” part is that the casts were taken off every couple off weeks and new ones were put on that bent the foot and stretched the tendons even more. The she moved to progressive braces that work in the much the same way except that instead of being replaced, they were tightened up periodically by her parents. Finally, she walked normally.

As she went through school, there were learning issues. Specialized tutors and other programs addressed these, and Cynthia did well in school. In some areas, she excelled, particularly languages.

Cynthia played Little League Baseball and then softball, all the way through high school. She played some basketball. She learned to swim.

Now, Cynthia is a sophomore in college studying creative writing and journalism.

And as you have probably figured out, this story is dear to me because Cynthia is my daughter.

I am a religious person, and I still think about what role God played in all of this. I am sure there was a role, but I don’t claim to know what and why. I’ll find out someday.

But one thing I am sure of is that the miracle of Cynthia came about here on Earth because she had access to the best, most advanced medical care in the world. Her years of treatment were paid for because her father had a medical insurance plan available to every employee where he worked, from the president of the company on down. The various specialists that saved her were there not because of some government bureaucrat or some government mandate or some government run health care system, but because of a free market health care system that is the envy of the world.

A few days after Cynthia was born, I thought I had better find out what this was all going to cost. I called the hospital billing department and asked. They said her treatment would cost an average of $5000 per day. The doctors had told us that Cynthia would be in the hospital for a minimum of 90 days. Do the math. The first three days of her life cost $27,000. The final bill, years later, was over $800,000, plus what we had spent on our own for tutors and such.

And through it all, I was never asked by anyone, anywhere, how I was going to pay all of those bills. Not once. Cost or how the bills were going to be paid was never a consideration of the doctors or hospital in deciding what treatment Cynthia would receive.

I do not want to think what this ordeal would have been like if some nameless, faceless government bureaucrats in a far off city were making decisions about how much my daughter’s life and well being were worth given how many other people the government had to take care of with a limited budget.

Yes, Cynthia’s story is a medical miracle. But America has always been a place of medical miracles. Since 1970, American doctors have won more Nobel Prizes for Medicine than all other countries combined. According to McKinsey and Co., thousands of foreigners come to the United States every year for medical treatment they cannot get at home – due to rationing or simply because it is just not available.

Consider cancer, as just one example. Compared to the U.S., breast cancer mortality is 9% higher in Canada (according to the government statistics of each country), 52% higher in Germany and 88% higher in the United Kingdom (according to studies published in Lancet Oncology). Prostate cancer mortality is 604% higher in Britain.

Other studies show that patients who need knee and hip replacement, cataract surgery, and radiation treatment wait months longer in the United Kingdom and Canada than in the United States.

The facts and history are irrefutable. The American health care system is far better at fostering innovation and responding to patient needs. On the other hand, the history of government run health care systems is there for all to see. Are we going to learn from that history or are we doomed to repeat it?

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