Jeff Hoard wonders why Americans are suspicious of Socialized Medicine. This article for the Heritage Foundation by Kevin Fleming may help him understand. (The Executive Summary of Fleming's heavily footnoted piece is here). Based in part on an analysis of the British and Canadian experiences, Fleming describes the ten things one can expect from a single-payer health system.
The first is reduced quality of care. For example, only three of 29 countries studied by the OECD had fewer practicing physicians than Britain. And in a study of cancer survival rates in 17 countries, Britain ranked near the bottom in lung cancer, colon cancer, and breast cancer survival. Britain has fewer medical oncologists than any country in Western Europe.
The second is periodic funding crises. Providing "free" medical care increases demand for it. When the government responds by restricting spending, as it has in Britain, patient demand far outstrips health care supply. As Fleming shows, this has been the pattern under Britain's single-payer system. Indeed, Britain has underinvested in health care during the past 30 years compared to the European average.
The third is politically driven inequalities. As Fleming documents, Canada has a three-tiered system. The wealthy jump queues by going to private clinics or to the U.S. for rapid treatment. The second tier consists of the well-informed and the aggressive, who push their way to the front of the line. This leaves behind the elderly, the poor, and the disenfranchised. Similarly, a 2002 investigation showed that in Britain more than 10,000 private-pay patients were given preference over National Health Service patients in Britain's best hospitals.
The fourth is labor strikes. Strikes are common in state-operated enterprises. The health care industry has proven to be no exception. CBC News reports that Canadians have "come to expect [strikes] as part of the negotiating process between doctors and the government." In the past three years, Canada has experienced major health care related work stoppages in New Brunswick, British Columbia, and Ontario.
The fifth is personnel shortages. According to Fleming, Canada has a serious shortage of physicians such that 18 percent of Canadians have trouble finding a doctor. Canada has 2.1 physicians per 1,000 people, compared to an OECD average of 2.8.
The sixth is outdated facilities and medical equipment. In government-run industries, equipment purchasing and technology investments are driven by politics. Fleming shows the adverse consequences that have resulted from this reality in Britain and Canada. For example, according to the president of the Canadian Association of Radiologists, much of the country's diagnostic equipment "is so outdated it would not be used by radiologists in the U.S."
The seventh is waiting times. This is topic Michael Moore didn't want to discuss. Waiting times in Canada and Britain are notoriously long. In Canada, for example, the average wait time between general practitioner referral and specialty consultation is 17.7 weeks.
The eighth is signifcant variations in patient care based on region and economic status. This, of course, is a major problem with health care in the U.S. But Fleming shows that it exists to a substantial degree under single-payer systems, as well.
The ninth is financial waste. In 2001, Britian reportedly lost 20 percent of its total spending on its national health care system due to "waste, fraud, and inefficiency." Britain now has more administrators than consultants in the system.
The tenth is loss of personal liberty. Personal freedom in the health care context means that patients can choose their treatments and which doctors will provide them. Under Socialized Medicine, a government official makes these choices. Pressure also arises for government officials to impose behavioral decisions on individuals in order to keep health care costs down. Americans tend to be quite suspicious of giving the state this kind of power, particularly in the life and death context of health care.
In sum, as the U.S. grapples with the issue of health care reform, there are very good reasons to eschew Socialized Medicine.
Reader Comments ( Page 14 of 15)
196. Bobo, I agree with most of what you say, except Gore was the hillbilly and Bush was born and raised in Maine...He bought that "ranch" just before deciding to run for office...the ranch that has no horses because he's afraid of horses..
jolie at 11:19PM on Jun 25th 2007
197. dumb people, you are aptly named..dumb person would be better..
jolie at 11:25PM on Jun 25th 2007
198. The fear that one is thought worthless, the love of life and fear of death ... OUR Proper Health Care Program would take those anxieties and dilemmas and very seriously address itself directly to them. OUR Proper Health Care Program can be trusted to look the patients in the eye, ask to be trusted, be in the "fight" with them - truly care - be efficient, affordable. ...People who are denied access to proper health care suffer a very real deprivation. Paul's "courtly " version taken in its totality trivialized this.
margaret Callinan at 10:48PM on Jun 28th 2007
199. I've read most of the comments on this thread, both sides seem to be stuck on the "im right, youre retarded" portions of their arguments.
Just to give a hint of my background; I am a young male, a veteran of Iraqi Freedom, and an American in the process of immigrating to Canada.
I've read many complaints against social healthcare stating that a "goverment lackey" will judge our healtcare needs. That party politics will dictate what treatment we get as patients. In response I have to ask this question: Who do you think decides now? Corporate lackeys, lackeys who are bought and paid for by companies that invest ungodly amounts of money into lobby groups, who intern onfluence our goverments policies over see your health care now. The difference between the corporation and the goverment is virtuaolly nil. Both entities are more concerned with the bottom line then you. Changing to social healthcare will insure more people. The people that make the decisions in those persons treatments may be different, their motives arent.
We've read tons of posts about Canadian doctors moving to the US, of course they do.. Free market medical practice pays much more what more explination do you need? Implementing socialized health care in the US would take away that incentive to practice here. Good for US medical students; Good for the Canadian healthcare system; not so great for the people that can actually afford to SEE these specialists.
We could continue on and in the end it comes to the simple facts: both systems have problems. All goverments are inherently flawed in SOME way. It comes down to what we, the people of the United States of America, are willing to put up with. Millions dead due to rising private health costs.
Millions overlooked in inneffectual goverment oversight programs that have stupendous amounts of wastes. We can pay more..ALOT more in taxes in the noble effort to help everyone, and still miss some. Or we can say f%*k it, Im covered and most people I know are... so why fix what dont break me? Either way we'll face problems , it wont get fixed easy. It damn sure wont be fixed FAST. The basis of this country, the reason I fought and watched good men die, is so we can have this debate. So that in the end, WE the People can make our mark and let the majority decide.
The point to this post? Call your congressman or woman and demand a national referendum on social healthcare. Let the people decide what kind of ineffectual system they want to put up with for the next 100 years. Maybe after that much time we can get it right.
E4-P at 10:53AM on Jun 26th 2007
200. As someone who does not have insurance, I don't understand why Moore wants to turn over healthcare to the Government. He criticizes everything else they do, but wants to take away all other healthcare options?
I currently use the Health Dept. clinic when needed, and pay on a sliding scale. I'm certainly glad they're available, but as someone who has had insurance and super health care in the past, I'll be the first to say "No way". What your money & insurance do is give the AVERAGE Doctor incentive. When they are getting pd the same no matter what, you might as well pick a number and find a soft bench and a good, long book. The first H.D. visit I had, I had been there 3 hours and the Dr was saying his goodbyes when I pointed out that he had never asked me what I was there for. Also, make sure you've done your research before you follow any advice or get that prescription filled. But that's a good idea in any case, I suppose. LSS, No thanks, Michael.
Kim at 12:05AM on Jun 26th 2007
201. Mr. Lundstroms's commentary is the most logical, concise, and compelling argument against federal interference with our lives I have heard to date.However, it is too late for reason.
I believe the U.S. is on an irreversible downhill trend towards socialism and abdication of personal responsibility.The elected have learned how to bribe the majority with promises of cradle to grave security,for the most part they are unnacountable to thier constituents, except as applies to the ability to aquire more entitlements,and how well they serve the new religion of environmentalism.
It isn't the America that I was born into, nor the one I donned a uniform to serve.
Chris Leete at 11:59PM on Jun 25th 2007
202. We have socialized schooling,firehouses,roads,now lets be real here,,,45 Million uninsured,,we are paying for them to,,so lets start a national health service, it will take some of the burden off all of us. Thank you Mr Moore for telling it like it is,,tired of being scamed by these insurance companies anyway.
betty atwood at 12:03AM on Jun 26th 2007
203. The Blogger wrote many points on why"Socialized Medicine" isnt as good as in Britian...etc. Well, our plan doenst have to be THAT inefficient. These bloggers seem always to take the side of BIG BUSINESS....They are protecting the INSURANCE COMPANIES, the DRUG COMPANIES, the LArge Hospital Chains(who schmuck Bill Frist is a big shot). Just Becuase other countries have systems that do not work, does that mean if we institute one it cantr work...HOW ABOUT ISRAEL,,,,I heard theirs is incredible. How about Scandinavia.???I was in Budapest last August and my freind not only had a miscarriage, but needed an operation for a tumor...tht was discovered while I was there , and within a week, she visited a few times..and had the operation...There was no 17 week wait.
Secondly, I will not go point by point with the blogger... The rich can always get medical aid. But the poor and middle class can not afford insurance..its getting rediculous. WHY? First we have to control the friggen lawyer and their rediculous mal practice suits..with astonomical millions that they sue for. The insurance companies in turn, charge the DRs horrible rates...and they inturn charge this to the patients. The DRUG companies are raping the people ad charge rediculous amounts for drugs...they claim its for research, but if you look...our government gives the companes research money too. We need to buy drugs cheaply and fairly. Percriptions shouldnt cost any more than what we are paying for the co-pay itself... The medical schools put limits on how many DRS they allow in...that is why there is a shortage.......THE AMA, tries to keep the number of DRS low, so the DRS can make mega bucks.....its a vicious cycle...and now, the insurance companies make the decisions on your care and procedures not the drs.....They are becoming the MEDICAL NAZIS.
MIKE MOORE knows that we need socialized medicine. But we do not have to copy any other country..we must develope a system that works and one that is equitable..to both the patinets, the DRs, and everyone involved. Keep the lawyers out of this. Regulate the drug companies.. and the INSURANCE companies should be in the insurance business...not investing in real estate and other unrelated business....that would cause them to raise their rates if their other business fails..COMPLICATED YES..BUT necessary. Too many people are not getting medical care in this country...and although it is not a constitutional right...mahybe it should be. I feel everyon, who is willing to work, is entitled to a roof over their head, food intheir stomach, and medical care. Well fed, healthy people make for a happy country.
M.Lubman at 12:39AM on Jun 26th 2007
204. Here is the dirty little secret of Universal health care . It will be excellent for the first couple of years , then comes the gradual decline of services coupled with higher taxes and like the NHS in the UK , the rationing of services , medicines , medical appointments and the like down the line .
Look at France , they had a very , very good socialized health care system until the economic reality hit them , it became unsustainable and headed for bankrupcy . You can only tax people that high and hold prices low for so long that sooner or later , you will have to pay the economic piper by mass layoff of medical personnel , closing of hospitals , rationing of medical , nursing and hospital services , etc .
Also , Universal health care creates havoc on all aspects of the health care industry by creating a massive amount of government red tape . To anyone who had work in american nursing homes can attest to this . Also , UHC creates an atmosphere of entitlement , CYA attitude as well as risk averse to any form of new treatments , innovations until cleared by the higher ups . Want tons of paperwork and waste time , try sending an application to the government for needed medications that are not on the list for your patient . You are lucky if you get their response on a timely manner .
E4-P , I thank you for your service for your country , but I strongly disagree with you about about rising health costs caused millions of americans dead . With all do respect , we will be the first to know about it considering that we work in the health care industry .
For the second point , US medical students will not benefit at all under your example . The sad fact is that medical students are next to useless in a clinical setting because they still lack the knowledge necessary to diagnose and treat the patient . In fact in an emergency , we would rather have those Canadian doctors to work with us in reviving a patient rather than American medical students whom we have to baby sit in a code .
Wil Cruz at 12:52AM on Jun 26th 2007
205. M. Lubman
Nobody is entitled to anything that entails other people's time , expertise and commitment .
And oh btw , have you ever wondered why a lot of medications are very expensive , ask the drug companies on how they are very well regulated by the government . Just a food for thought .
Wil Cruz at 12:54AM on Jun 26th 2007
206. Under socialized medicine ther are no CEO's of health insurance company making 55,000.00 an hour. What if the bonus and outrages paychecks of the administrators went to actual health care. If all the money roled from the super rich was used for real care. We could insure many people at a reasonable rate.
Kevin at 1:31AM on Jun 26th 2007
207. An objective assessment from the Heritage Foundation? Don't make me laugh. Lets let the Canadians and others speak for themselves, okay. Ask a Canadian and you'll hear: lines not a big deal, care is excellent, and they do not pay ultra high taxes to pay for it. The shocking thing is that our system is such a nightmare that foreigners won't even visit here without buying special insurance to protect them from our ridiculous system.
Dave at 1:28AM on Jun 26th 2007
208. The Canadians aren't satisfied with their HC system. Neither are the British, French, or majority of countries with predominantly public HC systems.
Calling this article unbiased isn't a logical argument. It's a weak minded fallacy.
John Irby at 1:31AM on Jun 26th 2007
209. To those espousing the virtues of socialized anything, I say to you, "When was the last time the government did anything better than the private sector?"
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Creating Nobel Prize winners.
Steve J. at 3:09AM on Jun 26th 2007
210. I may as well throw my two cents into this discussion. Health care is a complex issue regardless of which angle you choose to look at it from. I can see the point in the argument against government sponsered health care, there are some valid points and concerns. However, I don't think leaving so many people without access to health care, and it being extremely costly even to those that do have insurance, is the answer. Also, I think you have to view with skepticism anything backed by the Heritage Foundation. The foundations president, one Edward Fuelner,has authored numerous op-ed pieces in the Chicago Sun Times, and he is pretty much an extreme right-wing, big buisiness talking head. I'm not saying he's necessarily always wrong, but he rarely does anyhting but trumpet the extreme conservative talking points, and rarely substantiates his points, other than to say that since it's what the Republican party stands for, it must be right, and any other POV is bound to lead to total Armegeddon. I'm sure that this article wouldn't have appeared on their site if it didn't just cater to the extreme right exclusively.
billyberu1 at 2:49AM on Jun 28th 2007