The Cowboy Social Darwinism of Rick Perry

 “Perrycare” vs. “RomneyCare” 

Rick Perry promises  to bring his “Personal Responsibility ” health reform to the rest of the country. He also vows to dismantle President Obama’s health care reform.

One of his main tactics is to fiercely attack Mitt Romney for putting through a 2006 health care reform in Massachusetts, which was a model for Obama’s new reforms. Even Romney, in the sights of the Tea Party, has been forced to backtrack on the success of his reforms.

But if Romney had guts and conviction, and the Republican Party wasn’t so crazy, he should be proud of the success of his 2006 health reform in Massachusetts.

Tens of thousands of babies, children, women and men die needlessly every year in Texas because of the lousy health care system promoted by Perry’s eleven-year reign as governor.

Is this Rick Perry’s better idea?

The facts are very clear: Texas ranks 50th, LAST, in terms of residents covered by health insurance. 25% of Texans have no insurance. Massachusetts ranks number 1 and the comparable number is 5%.

What does this disparity in insurance coverage mean?

Plenty. For every 1000 live births, one and a half more babies die needlessly — 6.3 deaths in Texas compared to 4.8 in Massachusetts, according to America’s Health Ranking, a non partisan group dedicated to finding policies to improve state health services. See How Massachusetts and Texas rank among the states in healthcare.


It means that Texas has 44 more cardiovascular deaths per 100,000 population, 237.8 vs 281.4

It means that almost twice as many Texas workers are killed because of occupational fatalities than in Massachusetts — 5.6 vs 3.0 per 100,000 in population.

In Texas, deaths from infectious disease are more than 50% higher than in Massachusetts — 20.4 per 100,000 vs 13.6 in Massachusetts.

By almost every measure you look at, life is vastly more unhealthy in Texas than in Massachusetts.

In Texas, more people are obese, there are more smokers, fewer high school graduates, more violent crime, 40% more children in poverty, the air is more polluted, half as many primary care doctors per capita, more mental health absences, more premature deaths and more pregnant teenage girls. Massachusetts ranks 1st of all states in the lowest percentage of teenage pregnancy, and Texas ranks 50.

Governor Rick Perry has no real health care plan. His free market ideology keeps the poor from seeing doctors and going to hospitals. Naturally they die faster and younger. It’s a kind of cowboy social Darwinism that lets the poor and helpless die so that someday, generations from now, they will breed a healthier genetic stock.

But Texas’s hold down the costs — no matter how many thousands of preventable deaths it leads to — is working, sort of. The state spends $51 per person in public health funding annually while Massachusetts spends $125. If Rick Perry had his druthers, he would bring the whole country down to the “let’m die in the streets, but we will hold down costs.”

It’s no surprise that after five years, most people in Massachusetts like their health care system just fine. (Even if they did elect Scott Brown in 2008, who ran on an anti health care platform). A recent poll by the Boston Globe and Harvard School of Public Health finds that 63% of Bay State residents support the health care law and only 21% oppose it.

But make no mistake about it. All the plans are screwed up.

Neither Romneycare, nor Perrycare, nor even Obamacare is going to solve the healthcare mess in this country. All three are a hodgepodge of deeply flawed, special interest dominated, magical thinking, and not likely to tackle the real problem. Escalating free market costs are going to destroy any kind of reforms currently proposed, if we don’t stop squandering the funds we do spend on health care.

Although Americans, and especially politicians, don’t like to admit that we can learn anything from other countries around the world, it’s an undisputed fact that most developed nations in the world have secure, excellent health care at a cost of about half as much as we pay in this country. A statistic that the US media mostly ignores.

The US ranks 40th in health care around the world. as measured by the 16 bottom line public health statistics, according to consistent year after year statistics from the World Health Organization. Life expectancy is longer in more than 20 other countries. A WHO study released just last week had the US ranked 41 in terms of newborn death rates, behind South Korea, Cuba, Poland, Andorra and Israel. See my previous blogs “Cuba has better Health Care Than the US” and “Poor Little Greece Has Better Health Care Than The US”

The reason most other countries achieved these astonishing results — at half of what we spend — is that their single payer systems — think Medicare — allows for tremendous cost cutting measures that have not been possible with our free market system. This is why Canada’s health care costs about 9 percent of its Gross Domestic Product. Whereas, in the US, the cost is almost twice as much, an embarrassing 17 percent of GDP.

A new Columbia University study just out today in the journal Health Affairs found that American doctors are paid higher fees than their counterparts in Canada, France, Germany and the United Kingdom. In the US orthopedic surgeons are paid an average of $442,450 while in Britain the comperable figure is $324,138.

If we would ever get our drug prices under control — try negotiating with the drug companies like the Veterans hospitals do, and impose efficient control,, over hospital and doctor costs — we could we would save about $1.3 trillion each year, and the annual deficit would soon disappear.

What the Republicans will eventually come to realize (as conservatives around the world already know) is that the free market system does not work with healthcare. Just as the free market system would not work providing police forces, fire fighters or public schools. If everyone had to hire their own private policeman, it would be tremendously more expensive and would not protect everyone. There would be chaos — inefficient and not cost effective. This is what the rest of the developed world knows and Americans have yet to learn.

2011-09-07-romneytable.JPGThe above table was compiled from data from:


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About Blake Fleetwood

Blake Fleetwood Blake Fleetwood was formerly on the staff of The New York Times and has written for The New York Times Magazine, New York Magazine, The New York Daily News, the Wall Street Journal, USA Today, the Village Voice, Atlantic and the Washington Monthly on a number of issues. He was born in Santiago, Chile and moved to New York City at the age of three. He graduated from Bard College and did graduate work in political science and comparative politics at Columbia University. He has also taught politics at New York University. He can be reached at
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