Universal Health Care Is the Wrong Prescription

Published June 1, 2008

“Universal health care” is false advertising for politically controlled medicine, with government as the “single payer” insurer. Having coverage does not guarantee getting medical care.

Since patients prepay through taxes, medical care under such systems appears to be free. This gives patients strong incentives to over-consume, while providers need not compete on price.

To contain costs, governments restrict access to life-saving treatments. In countries with such universal coverage, patients die waiting for treatment.

Physician Burnout

The Canadian Medical Association Journal reports in one year 71 Ontario patients died while waiting for coronary bypass surgery and more than 100 others became “medically unfit for surgery.” The Canadian Broadcasting Corporation reports, “109 people had a heart attack or suffered heart failure while on the waiting list. Fifty of those patients died.”

Even so, health care workers face a heavy workload under such systems. “Physicians across Canada are in an advanced stage of burnout due to work conditions,” which “causes them to retire early … or simply leave,” a former Canadian Medical Association president told The New York Times. He “attributed much of the problem to technological shortages and the powerlessness doctors feel when patients complain about long waits for treatment.”

“Access to a waiting list is not access to health care,” wrote Canadian Chief Justice Beverley McLachlin when striking down legislation banning private insurance in 2005. Private medical care is surging in Canada because of these problems with the government system.

‘Politically Controlled’

The same problems plague the British health care system. The BBC reports, “up to 500 heart patients die each year while they wait for potentially life-saving surgery.” The Times reports a British woman “will be denied free National Health Service [NHS] treatment for breast cancer if she seeks to improve her chances by paying privately for an additional drug.”

A Daily Telegraph headline reads, “Sufferers pull out teeth due to lack of dentists.” Another article says, “doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.”

Politically controlled health care in America–Medicaid and Medicare–is much the same. Doctors are five times more likely to refuse to see new Medicaid patients than privately insured people. Increasing reimbursement rates won’t help much–more than two-thirds of doctors reported being overwhelmed by Medicaid’s billing requirements, paperwork, and delays in payment.

In addition, ABC News reported, “Medicare rules bar cancer drugs for patients,” including the privately insured.

U.S. Survival Rates Better

“Single payer” advocates cite international comparisons of life expectancy to support their cause. But life expectancy depends on factors unrelated to health care, such as unintentional injury and homicide. Health economist Robert Ohsfeldt found when accounting for these two factors, life expectancy in America is comparable to that of Canada and England.

What really matters is your chance of surviving a serious illness. The American Cancer Society notes, “U.S. patients have better survival rates than European patients for most types of cancer.”

So if politically controlled medicine isn’t the solution, what is?

Certainly not a Massachusetts-style “individual mandate” that forces everyone to buy insurance. This is essentially single-payer in disguise. State insurance regulations severely limit competition, so insurers are really government contractors for politically defined benefits.

To contain costs, Massachusetts authorities will “probably cut payments to doctors and hospitals” and “reduce choices for patients,” the Boston Globe reports. Sound familiar?

Reducing Patient Choice

The solution, instead, is to recognize how government policies have crippled the market. Because the tax code deeply discounts employer-provided insurance, you’re essentially stuck with your employer’s non-portable plans. Hence, insurance companies can afford to be stingy and deny you care, because they know they’re highly unlikely to lose you unless you change jobs.

With government as “single payer” it’s even worse–to change insurance providers you must move to a different state or country.

Our current system also encourages thoughtless over-consumption and skyrocketing costs. The tax code punishes people who pay for medical care out of pocket and rewards us for buying insurance. So “insurance” has become prepaid medicine, and patients over-consume like business travelers dining on their company’s expense account.

Government Meddling

Legislation mandating minimum benefits also contributes to the problems by making insurance unaffordable for many. For example, Colorado law compels widowed wives to pay higher premiums to cover prostate screening, maternity, and marital therapy.

Some Colorado legislators recognize this injustice. Just as businesses incorporated in other states can operate in Colorado, they note, Coloradans should be able to buy affordable policies from insurance companies that meet the less-damaging regulations of another state.

While “universal health care” may provide health insurance, it doesn’t guarantee health care. The uninsured are not the problem but instead are a symptom of the real problem: Government meddling in personal choices over how we care for ourselves and our families.

Brian blogs about health care policy at PatientPowerNow.org, the health care blog for the Independence Institute in Golden, Colorado. His free-market health care proposal to the Colorado Blue Ribbon Commission on Health Care Reform can be seen at his Web site, http://www.whoownsyou.org.