This is the first in a series where in I shall address the fallacy that Government in charge of your health care is good. It is so not good.
Where ObamaCare Is Going
The government single-payer model that liberals aspire to for the U.S. is increasingly in trouble around the world.
Aug. 13, 2014 7:12 p.m. ET
The liberal attraction to making government
the sole source of health-care insurance has not abated even as the
deficiencies in ObamaCare, a halfway move toward the single-payer model,
have become increasingly evident. The question is whether growing signs
of single-payer trouble overseas will be enough to discourage this
country's flirtation with socialized medicine.
The
Obama
administration showed its hand long ago with the nomination of
Tom Daschle,
an advocate for Britain's socialized National Health Service, as
secretary of Health and Human Services in 2009. (Mr. Daschle withdrew
amid criticism for nonpayment of taxes.) The White House installed
another outspoken NHS fan,
Donald Berwick,
as an interim appointee (2010-11) to run the Centers for Medicare
and Medicaid Services.
This summer,
the Commonwealth Fund—a private foundation focused on health care that
is a favorite of progressive policy types—issued a report ranking the
NHS as the best medical system among those in 11 of the world's most
advanced nations, including Canada, France, Germany, Switzerland and
Sweden. Coming in last: U.S. health care.
Yet the Commonwealth rankings are
contradicted by objective data about access and medical-care quality in
peer-reviewed academic journals. For instance, Americans diagnosed with
heart disease receive treatment with medications significantly more
frequently than patients in Western Europe, according to
Kenneth Thorpe
in Health Affairs in 2007. In Lancet Oncology in that same year,
Arduino Verdecchia
published data demonstrating that American cancer patients have
survival rates for all major cancers better than those in Western Europe
and far better than in the U.K.
Similar
examples concerning the deadliest and most significant diseases abound
in medical journals. One may ask why the Commonwealth Fund's health-care
rankings published in June don't reflect that reality. Theanswer lies
in the report's methodology, which relied heavily on subjective surveys
about "perceptions and experiences of patients and physicians."
Yet
even as the single-payer system remains the ideal for many on the left,
it's worth examining how Britain's NHS, established in 1948, is faring.
The answer: badly. NHS England—a government body that receives about
£100 billion a year from the Department of Health to run England's
health-care system—reported this month that its hospital waiting lists
soared to their highest point since 2006, with 3.2 million patients
waiting for treatment after diagnosis. NHS England figures for July 2013
show that 508,555 people in London alone were waiting for operations or
other treatments—the highest total for at least five years.
Even
cancer patients have to wait: According to a June report by NHS
England, more than 15% of patients referred by their general
practitioner for "urgent" treatment after being diagnosed with suspected
cancer waited more than 62 days—two full months—to begin their first
definitive treatment.
In response the
British government has enlisted private care for help, including most
recently through the Health and Social Care Act 2012. In May last year,
the Nuffield Trust, an independent research and policy institute, along
with the Institute for Fiscal Studies, the U.K.'s leading independent
microeconomic research institute, issued a report on NHS-funded private
care. The report showed that over the past decade the NHS, desperate to
reduce its ever-expanding rolls, has increasingly sent patients to
private care. The share of NHS-funded hip and knee replacements by
private doctors increased to 19% in 2011-12, from a negligible amount in
2003-04.
In 2006-07, according to the
report, the NHS spent £5.6 billion on private care outside its system.
This increased by 55% to £8.7 billion in 2011-12, including a 76% rise
in spending on nonprimary care, going to £8.3 billion from £4.7 billion,
despite significant reductions in spending on private care attributed
to the financial crisis.
Britons who can
afford to avoid the NHS are eager to do so. Even with a slight decrease
due to the 2008 financial crisis and its aftermath, about six million
British citizens buy private health insurance and about 250,000 choose
to pay for private treatment out-of-pocket each year—though NHS
insurance costs $3,500 annually for every British man, woman and child.
The
socialized-medicine model is struggling elsewhere in Europe as well.
Even in Sweden, often heralded as the paradigm of a successful welfare
state, months-long wait times for treatment routinely available in the
U.S. have been widely documented.
To
fix the problem, the Swedish government has aggressively introduced
private-market forces into health care to improve access, quality and
choices. Municipal governments have increased spending on private-care
contracts by 50% in the past decade, according to Näringslivets
Ekonomifakta, part of the Confederation of Swedish Enterprise, a Swedish
employers' association.
Swedish
primary-care clinics and nursing facilities are increasingly run by the
private sector or receive substantial public funding. Widespread private
competition has also been introduced into pharmacies to tear down the
previous government monopoly over all prescription and non-prescription
drugs. Though Swedish economist Per Bylund calculates that the average
Swedish family already pays nearly $20,000 annually in taxes toward
health care, about 12% of working adults bought private insurance in
2013, a number that has increased by 67% in five years, according to the
trade organization Insurance Sweden. Almost 600,000 Swedes now use
private insurance, though they are "guaranteed" public health care.
The
recent Veterans Affairs scandal, following the disastrous ObamaCare
rollout, was a red flag about problems of nationalized health. Now
concrete evidence is coming in from other countries that have tried it
for decades. The reality is that the key goals for health-care
reform—reducing spending, expanding access to affordable coverage,
preserving personal choice and portability of coverage, promoting
competition in insurance markets, and maintaining excellence in
medicine—do not require government to directly provide insurance or
health care.
I get the progressives ,"lima charlie".
BUFF, out,
