Bill Gates of Microsoft fame (or infamy) visited the Claremont Colleges this past week. You can watch that visit here. What follows is a transcript typed by one of my associates of that event.
Gates, after discussing his foundation’s work, had harsh words for America’s health care system.
Our health care system has huge problems. It’s got equity problems where the poorest in the country of all the rich countries our poorest quarter get the worst health care so the accessibility is a huge problem.
We spend 17.8 % of GDP, the number two, which is Switzerland, spends 12.3% so you have — it’s mind blowing — you have over a five percent of GDP difference. That means that one out of every twenty people in the country are excess people in our health care system that other countries that get better results than we do, don’t have. If you take inefficiency disadvantage like that, than you take how much we spend on defense versus everybody else, and how much we spend on legal stuff versus everybody else, you can start to say, ‘Wow. How do you stay competitive with those things?’ So our medical system has to change. I happen to like the Swiss system and the German system the best, which are not a single payer Canadian or British type system, but I’d take any rich country’s medical system over ours. Ours is provably the worst. [Audience laughter]. It is the most expensive and the least equitable.
Gates walked back a bit from that statement. “Now you have to be a little careful, because everybody else drafts off of us. We do a lot of the research. We do more basic research, our consumers pay more per drug. What other countries do is watch what happens here. If something is cost-effective, they adopt it, usually with about a three-year lag. Many of the things we do, like care at the end of life, or various therapies that are unbelievably expensive, they just don’t adopt those things. “
In other words, the Europeans have death panels.
That might be an unfair characterization, if Gates hadn’t himself said something similar in July 2010. Gates, whose foundation purports to support the equal worth of every human life wherever it is lived, makes an exception in favor of “death panels.” Could that be the way our medical system has to change? It seems likely. After all, his father, Bill Gates Sr., served on the board of Planned Parenthood.
Meanwhile, back at the Claremont Colleges, Gates insults the American public.
“There’s a true schizophrenia,” Gates noted. “If you talk to voters, they think the federal government spends too much money and they should spend less, they say, ‘Yeah, absolutely.’ Then you name specific things like Pell grants for students and they say, ‘No, not that.’ How about NIH, medical research funding? “No, you shouldn’t really cut that.’ Pretty soon you prove is that what the American public is against is arithmetic.”
(Maybe so. In fact, 71% of Americans — a clear majority — supports reducing foreign aid, according to an Economist/YouGov poll. )
Later, he endorsed the DREAM Act, which would make illegal immigrants throughout the country into automatic citizens and the death tax, which both he and his father support. Throughout his talk, Gates criticized U.S. military spending, which he says gets in the way of health care spending.
“There are topics I know more about and there are topics I know less about,” he answered, but went on.
“I think the defense budget needs to shrink. It won’t shrink dramatically enough to make room for these health care cost increases. Unless you bend the curve on medical costs, you’ve got a huge problem. You end up spending so much of society’s resources on people past the age of 65, which is fine in a way, but what that means that you’re not re-investing into the young. If you look at state budgets over the last twenty years, the amount of money for education as a whole — particularly higher education because that gets hit first — that’s gone down very substantially. California’s a perfect example of this…
In terms of military things, obviously, war is the biggest waste of money there is and the theory that you can send your army over some place and that somehow those people will like you better, I think that’s a very difficult theory. I mean, even if you didn’t accidentally shoot a few people every once in a while, so I’m still trying to understand that one. They’re going to like us, they are really going to like us. Because we’re going to be there for awhile and then we are going to leave and we will have shot people. “
The military may cost a lot — and it does — but the cost of appeasement is far greater and part of what makes that bill never come due is a strong military that wards off potential threats. If Europe paid for its own defense, it couldn’t afford the welfare state it sneeringly advertises and the medical system Gates so loves. Arms races are expensive and Gates should be proud, not dismissive, of the country that keeps the Pax Americana.