Hopeless Change

Always check the vintage of ideas that academic, political and media-elites label “new.” “In 1918, the Soviet Union became the first country to promise universal ‘cradle-to-grave’ healthcare coverage, to be accomplished through the complete socialization of medicine,” Yuri N. Maltsev writes in the Free Market newsletter published by the Ludwig von Mises Institute. “The ‘right to health’ became a ‘constitutional right’ of Soviet citizens.”

“The proclaimed advantages of this system were that it would ‘reduce costs’ and eliminate the ‘waste’ that stemmed from ‘unnecessary duplication and parallelism’—i.e. competition.” Perhaps you could argue that that little experiment in “transforming health care” resulted in “fewer and better Russians.”

“In the depths of the socialist experiment, healthcare institutions in Russia were at least a hundred years behind the average U.S. level,” Maltsev recounts. “Moreover, the filth, odors, cats roaming the halls, drunken medical personnel, and absence of soap and cleaning supplies added to an overall impression of hopelessness and frustration that paralyzed the system.”

“According to official Russian estimates, 78 percent of all AIDS victims in Russia contracted the virus through dirty needles or HIV-tainted blood in the state-run hospitals.” Less primitive, more humane and modern versions of this system have not fared much better.

According to Sara Hudson of the Centre for Independent Studies in Australia, “In the last 15 years, Commonwealth funding for Indigenous specific health programs has increased by nearly 400% with no appreciable improvements in health outcomes.”

“But addressing the health problems facing Indigenous communities requires more than just increased funding. Indigenous people in Australia have a dual health care system – along with mainstream medical services such as GPs and hospitals, there are state and territory run health clinics specifically for Indigenous patients, and Aboriginal Community Controlled Health Services (ACCHS).

“Funding is provided through a range of different health programs, which are delivered in so many conflicting ways it is not surprising that there are service gaps in some areas and duplication of services in others. By neglecting to target resources, consult with communities, or evaluate the various health programs, the government is abdicating its responsibility to provide decent health care to Aboriginal and Torres Strait Islanders.

“Commonwealth attempts to improve the service delivery of primary health care to remote communities has focused on strengthening and expanding the number of ACCHS. But this has had a limited effect on Aborigines and Torres Strait Islanders living in remote communities, as most ACCHS are located in cities and towns.

“Only half of the 200 or so ACCHS meet their financial reporting requirements to the Office of the Registration of Indigenous Corporations, with few consequences applied for those who don’t. This leniency has resulted in financial mismanagement, insolvency and even fraud.

Malcolm A. Kline is the executive director of Accuracy in Academia.