“Universal” Health Care Kills

What good is having medical insurance if you cannot get medical care? Peddlers of “universal health care” — from Hillary, Obama, to Colorado congressional candidate Jared Polis — don’t get this.

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

Since patients prepay through taxes, medical care appears “free.” Hence, they have strong incentive to over-consume and providers need not compete on price. To contain costs, governments restrict your access to life-saving treatment. In countries with such “universal coverage,” patients die waiting for treatment.

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

This week the Globe and Mail reported that

Inside Sylvia de Vries lurked an enormous tumour and fluid totalling 18 kilograms. But not even that massive weight gain and a diagnosis of ovarian cancer could assure her timely treatment in Canada.

She sought treatment in the United States, as do Canadians in need of intensive care and emergency cardiac care.

“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 healthcare,” wrote Canadian Chief Justice McLachlin when striking down legislation banning private insurance in 2005. Last year a New York Times headline read: “As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging.”

And England? The BBC reports that “up to 500 heart patients die each year while they wait for potentially life-saving surgery.” The Times reports that a British woman “will be denied free National Health Service 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.” “Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives,” reports another article.

Consider politically-controlled health care in America: Medicaid and Medicare. Doctors are five times more likely to refuse seeing new Medicaid patients than privately-insured patients. 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.

ABC News reports that “Medicare rules bar cancer drugs for patients,” including the privately-insured. As the population ages and Medicare costs continue to increase, Medicare may further restrict patients and doctors.

“Single payer” advocates cite international comparisons of life expectancy to support their cause. But life expectancy depends on factors unrelated to healthcare, such as unintentional injury and homicide. Health economist Robert Ohsfeldt found that 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 reported that “U.S. patients have better survival rates than European patients for most types of cancer.” Last August the Telegraph reported that the “UK cancer survival rate lowest in Europe,” and that it’s highest in the United States.

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

Not a Massachusetts-style “individual mandate,” which forces everyone to buy insurance. This is essentially single-payer in disguise. Insurance regulations severely limit competition, so insurance companies are effectively government contractors for politically-defined insurance.

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

Instead, we must recognize how government policies have crippled free markets.

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; they know that losing you as a customer requires that 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 paying for medical care out-of-pocket and rewards buying insurance. So “insurance” has become prepaid medicine, and patients over-consume like business travelers dining on their company’s expense account.

Further, legislation mandating minimum benefits makes insurance unaffordable for many. Consider: Colorado law compels widowed wives to pay higher premiums for prostate screening, maternity, and marital therapy. Sponsors of Colorado House Bill 08-1327 recognize this injustice. Just as businesses incorporated in other states can operate in Colorado, Coloradans should be able to buy affordable policies from insurance companies that meet less damaging regulations of another state.

So remember, the uninsured aren’t the problem, but a symptom of political meddling in our most important personal choices.

(Thanks to Amy at the Independence Institute, versions of the following article were published in the Colorado Daily, Hawaii Reporter, and the Salida Mountain Mail.

12 Comments

Filed under coverage isn't care, Policy - National, single payer

12 responses to ““Universal” Health Care Kills

  1. Wayne Van Scoyoc

    How exactly do patients “overconsume” health services when it’s health professionals making all the decisions on tests and treatments?

  2. What is your source for you 1st fact? and what makes you think U.S doctor error will be fixed by universal health care?

  3. Universal health care- Not actually free- money comes from taxes or cut in other areas like education or defense.
    Unfair- Do you want to be the one paying for all the smokers and obese people’s bad decisions?
    Inefficient- There is a reason people come to the U.S from Canada for Healthcare
    Long Term Problems- like, social security and other govt. run programs, Healthcare is likely to become somewhat corrupt and fail in the future. Universal health care may provide more jobs, but these jobs aren’t going to be as rewarding in money. No one is going to want to be a doctor, when in the universal health care you need far more. (14+ million job industry)
    Obsolete- It’s against the law to turn someone away who is in need of emergency care, regardless of if they do or do not have insurance. Other govt. run programs like medicare and medicaid already help fund people in need. 
    Do you want to save money? … Or people’s lives?

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  6. Kent

    One thing that jumps out to me is the statement “potentially life saving” most of the examples of people in Canada having to wait for “potentially life saving” heart surgery are already 20-30 years past life expectancy. The government run health uses triage system that allocates the surgeries to those who need them most and those who are most likely to recover and those that will benefit the most. In the U.S. Doctors get paid for surgeries whether the patient lives 20 years or 10 hours. They don't care how long the patient lives as long as they get their money. I know this from working at a heart hospital in the U.S. Working closely with surgeons. In the U.S. Many surguries are done on people who won't benefit just to get the profit. People in Canada have been known to come to the U.S. For care but the Canadian government reimburses most costs. Don't forget that the number 3 cause of death in the U.S. Is doctor error….higher than any other nation.

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  9. Stan

    “…an estimated 18,000 die in the US each year for lack of insurance and therefore medical care.”

    Well, considering that nearly 200,000 people die each year from medical mistakes, it looks to me that you’re more than 10 times better off being in the group that dies due to lack of insurance and therefore medical care.

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  11. Kent

    One thing that jumps out to me is the statement “potentially life saving” most of the examples of people in Canada having to wait for “potentially life saving” heart surgery are already 20-30 years past life expectancy. The government run health uses triage system that allocates the surgeries to those who need them most and those who are most likely to recover and those that will benefit the most. In the U.S. Doctors get paid for surgeries whether the patient lives 20 years or 10 hours. They don’t care how long the patient lives as long as they get their money. I know this from working at a heart hospital in the U.S. Working closely with surgeons. In the U.S. Many surguries are done on people who won’t benefit just to get the profit. People in Canada have been known to come to the U.S. For care but the Canadian government reimburses most costs. Don’t forget that the number 3 cause of death in the U.S. Is doctor error….higher than any other nation.

  12. Carlene

    Mr. Schwartz has lots of criticisms and no solutions. Some complaints are the same for our current system as for ‘universal health care’, such as they both encourage over and inappropriate use. He mentions lots of anecdotal stories of failed cases in Canada, but doesn’t mention that an estimated 18,000 die in the US each year for lack of insurance and therefore medical care. I question some statements, such as ‘burned out doctors in Canada’, when the fact is that US doctors are paid more because they see more patients and work longer hours than most. Mr. Schwartz also compares ‘single payer systems’ which have government run medicine, such as Great Britain, with others which have government run reimbursement but independent medical care. He also fails to mention the huge difference in cost for American medical care – on average more than twice as much as Canada and all the other first world countries with single payer systems.

    Brian replies:
    Re. 18,000, see my earlier post about this study here.

    Re. “burnout” in Canada, see the NY Times article I quoted and linked in the article, here.

    Re. the distinction between “‘single payer systems’ which have government run medicine, such as Great Britain, with others which have government run reimbursement but independent medical care.” He who pays the piper calls the tune, or so the saying goes. If physicians are paid only by government, I do not understand how they could be independent of government’s control. If you are paid by only one employer, you’re not very independent compared to say, and “independent contractor” who has many clients, or employers.

    Re. cost: American medical care is expensive – partly because of government regulations on insurance, licensing, and prescription drugs. On the cost comparison, I’d see myth 2 and myth 10 here. But on a more conceptual level, if government bureaucrats can deliver a product for less money, then why don’t they do it in a free market? Let them implement their ideas and sell their insurance product to willing customers and physicians who want to participate. Why the need to make it crime for others not to participate?

    (BTW, the US does not have a free market in health care. In fact, if you like socialized medicine, or whatever you prefer to call it, the U.S. is pretty close. Read the post and links here.)

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