Friday, August 2, 2019

What "Free" Health Care for All Means

My doctor recently ordered a CAT scan of my chest. It took three days, from the time he made the appointment with the imaging service, to when he got back the results. Fortunately, everything was normal. This type of immediate service is not available in Canada, or Great Britain, which are often touted as models for health care.

Whatever you call it, Medicare for All, or Free Healthcare, or Single Payer (Government) System, this type of system is endorsed by most, if not all, of the Democratic candidates for president: Bernie Sanders, Elizabeth Warren, Andrew Yang, Bill de Blasio, Julian Castro and, with some reservations, Kamala Harris and Pete Buttigieg.

Sounds nice and fair and why shouldn't a nation of our wealth have "free" health care also? Well, there are problems to be aware of, before you decide if you want this or not. And to make matters worse, there is actually a bill before the House of Representatives called H.R. 1384, "To establish an improved Medicare for All national health insurance program." I'll deal with that a little later. 

In the debates, Sanders pointed to the nation across the river from Detroit to shame Americans about health care not being treated as a "yooman right" in this country.

It's true that all Canadian citizens and legal residents (though not immigrants there illegally) get "free" health care, but only in the sense that you don't get a bill after seeing a doctor or visiting a hospital. Medical care is subsidized by taxes, but the price comes in another form as well -- rationing. A 2018 report from the Fraser Institute, a Canadian think tank, found that wait times between seeing a general practitioner and a specialist average 19.8 weeks. That's the average. There are variations among specialties. Those hoping to see an orthopedist wait an average of 39 weeks in Nova Scotia, while those seeking an oncologist wait about 3.8 weeks.

Marc Palazzo, executive director of the Coalition Against Socialized Medicine writes: "Under such a system, faceless bureaucrats in Washington – rather than patients and doctors – would control nearly all healthcare decisions, from the doctor you can see to the medicines you are prescribed. And decisions about those prescriptions would be made with primary consideration going to the overall cost to the system rather than which drugs will be most effective for an individual patient’s situation. Access to medical procedures, doctors and treatments would similarly be subject to government spending caps. All of this decided behind closed doors!"

The cost of socializing America’s healthcare system is astounding; despite being championed as “free,” estimates put the price tag at over $32 trillion [over 10 years]. Even doubling today’s tax rates could not pay for it. (Current revenues from personal income tax are about $2.8 trillion a year). What’s more, the true costs are nearly impossible to calculate, given that it also covers all undocumented immigrants in the United States – a number estimated to be at least 11 million people.

Across the pond, where the people of Great Britain have their National Health Service, nearly 5 million people are waiting for appointments. Health care is provided by a single payer — the British government — and is funded by the taxpayer. All appointments and treatments are free to the patient (though paid for through taxes), as are almost all prescription drugs. The maximum cost of receiving any drug prescribed by the NHS is $12.

But, and there's a big but: Emergency room visits can take up to 12 hours; and British cancer patients fare worse than those in the United States, according to Forbes Magazine. There are many other problems.

Sally C. Pipes goes on in Forbes to report: 

The NHS also routinely denies patients access to treatment. More than half of NHS Clinical Commissioning Groups, which plan and commission health services within their local regions, are rationing cataract surgery. They call it a procedure of "limited clinical value." 
It's hard to see how a surgery that can prevent blindness is of limited clinical value. Delaying surgery can cause patients' vision to worsen -- and thus put them at risk of falls or being unable to conduct basic daily activities. [Note: I had cataract surgery in my right eye about four years ago; without it I'd probably not be able to drive, nor have 20/20 vision in that eye.]

To add to the problems, there is a shortage of doctors and nurses in Great Britain, the budget is under pressure, the average wait time for referrals is more than 60 days and more than 250,000 British patients have been waiting more than six months to receive planned medical treatment. 

Patients needing surgery fare worse. The Guardian reports that there are 4.3 million patients on waiting lists, a 10-year high. "In May [2019], for example, 211,434 patients had been on the waiting list for more than six months, up from the 197,067 who were in that position a month before and up by almost half compared to a year earlier, the NHS England data shows."

But it's obvious that the Democratic party thinks they can run our health care system better than the Canadian or the Brits. Washington has been "fixing" our health care system since 1965. It was their fixes that made our insurance unaffordable and our care unavailable. 

The cost of free health care? Deane Waldman, M.D., M.B.A, in a report for the Texas Public Policy Foundation, reported this: 

In July 2018, Charles Blahous of Mercatus Center calculated the cost of single payer/”Medicare for All.” He reported a cost of $32.6 trillion over 10 years. This means H.R. 1384 will nearly double current unsustainable spending on healthcare, adding $3.2 trillion to the $3.5 trillion we expended for healthcare in 2018 (Blahous, 3). Funding “Medicare for All” would consume all the money we currently expend on other national priorities such as education, military, infrastructure, security, etc. Professor Blahous estimated that paying for “Medicare for All” would double both federal individual as well as corporate taxes (Blahous, 21)! 

I highly recommend you read this eight-page report. There are solutions to our healthcare system that do no require a total government takeover. Start with these reports herehere, here, and this comprehensive history and suggestions here

And finally, from one of my favorite economic authors: The Free Market Works in Health Care...When It's Allowed. 

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