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The sixth is outdated facilities and medical equipment.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 4 of 15)
46. And PPS, George
Are you also offended because they are violating your rights by taxing you for police and fire protection, and requiring safe drugs and foods? Seems to me there is no place written that these are American "rights."
Jack Lohman at 8:53PM on Jun 24th 2007
47. Jack, I really hate dealing with the "true believers". I am supposed to buy your analysis after I find you reference me back to yourself at "Fighting Bob" as an "expert" and throw in some weird stock chart with handwritten notations without even bothering to explain the point they are supposed to be making. You keep claiming that it will "only" be 16% with neither justification nor even a nod to the other people's experience or even an acknowledgment that the current Medicare program has expanded wildly beyond expectations.
Then to boot, when you can't counter an objection you attempt to wave it away as a "diversion". Then, when all else fails, you claim I must be an industry representative. Not only is that a particularly stupid objection, it is massively wrong.
You then completely misunderstand the drug development process and confuse it with generics. You complain about the Canadian doctors with the dubious claim that they just want to be "millionaires" and make absolutely no attempt to even wonder what else might prompt them to leave the Canadian system and what that experience might hold for a similar situation in the US.
You turn out to be a surprisingly non curious guy who thinks he has the answers, but does not even understand the questions. I am astonished by your comments that indicates you believe that medical technologies will invent themselves and that the new drugs will come along in the absence of any incentive for people to work to develop them.
Besides all that, you never provide a single reference to even begin to back up you statistics. Based upon your work here and at "Fighting Bob", I find you worthless as both a source and a debater. On the other hand, you would make a great politician. You probably should spend a little time learning how to use Google, too.
Rick
Rick Caird at 9:01PM on Jun 24th 2007
48. [Overheard at Heritage and CATO]
Man the propaganda catapults, men!
"The most brilliant propagandist technique will yield no success unless one fundamental principle is borne in mind constantly...it must confine itself to a few points and repeat them over and over."
-- Joseph Goebbels
"See in my line of work you got to keep repeating things over and over and over again for the truth to sink in, to kind of catapult the propaganda."
-- George W Bush, May 2005
tigger at 9:08PM on Jun 24th 2007
49. Rick, I really don't care what you believe. You claim not to be an industry rep but there is every indication that you are. I did not confuse me-too drugs with generics. You apparently do not realize that one is created by the original manufacturer and the generic by a competitor. I did not pass myself off as an expert, I sent you to a description of some of the problems I wrote about in health care because I did not want to rewrite the 600 word op-ed on this blog. You criticize me because you have provided stacked studies by right wing conflicted groups and I won't accept the results. You are wasting the time of all those reading this blog, including mine and yours. Give it up.
Jack Lohman at 9:44PM on Jun 24th 2007
50. Håvar wrote:
I am now cancer free and kicking after a swift and effective treatment from a socialized medicine healthcare, and all it cost me was ca. $200.
I would like to know what percentage of your taxes, as well as Norway's current income tax rate, goes toward medical care. I'm guessing that the $200 it cost you for your treatment (BTW, congratulations on your recovery) represents a miniscule amount of the true cost.
David at 10:39PM on Jun 24th 2007
51. Havar writes: "You say that your motive is to retain the US as a free society, but a free society has to be cared for. Freedom is to, as in my case, live through a serious illness without having it ruining my financial future. My freedom to chose exactly which doctor is going to treat me, or my freedom from having to pay a modest tax is irrelevant to that."
Kids, Havar should not be taken lightly. Norway has the highest standard of living in the world. The US is eight. Doesn't that tell you something?
Phil at 11:03PM on Jun 24th 2007
52. I also have to totally agree with Jack Lohman - its barbaric not to have national healthcare. Moreover, I was looking at Wikipedia on Canada's economy, and they get a lot of US investment and setting up of US owned business because the companies do not have to pay for the group policies. I guess just their share in taxes. Anyway, it must be cheaper for business, because they choose to move to Canada.
So, its a win win situation. No one dies from lack of healthcare (which is simply inexcusable and none of the BS from the insurance and drug companies is going to stop Americans from getting national healthcare - its a tidal wave of support); and you get to help the economy for all.
Phil at 11:16PM on Jun 24th 2007
53. Phil
You are correct as to Norway having the highest standard of living. Iceland is number two. We're talking of two countries with a total poulation of five million and, I would guess, rather small military budgets. The "standard of living" comparison seems somewhat specious.
David at 12:36AM on Jun 25th 2007
54. David writes: "You are correct as to Norway having the highest standard of living. Iceland is number two. We're talking of two countries with a total poulation of five million and, I would guess, rather small military budgets. The "standard of living" comparison seems somewhat specious."
Hi David - I do not think it specious. Hillary wants to expand our military for our own protection, but we as a nation need to drop the idea that we are the world's policeman in conflicts that do not involve us - and we especially need to stop the bleeding both in terms of real blood and money in Iraq. Its time to take care of Americans for once instead of paying for someone else's defense. I also think we should stop all foreign aid. What are we doing giving money to other countries to help them, when we aren't helping 47 million Americans. I'm not being contentious at all - I'm glad you posted your opinion - but all these arguments have been presented by REPUBLICANS every single time the Democrats try to improve Americans lives, and the people of this country have FINALLY caught on to the charade.
Phil at 11:53PM on Jun 24th 2007
55. Phil:
I also agree to a suspension of foreign aid.
The Iraq War has been fraught with mistakes but that does not diminish the reports of numerous intelligence agenecies throughout the world of Saddam's WMD programs. Every soldier's death is tragic but pales in comparison to totals from past wars, especially for the duration of the current conflict.
I've read of figures of one trillion dollars as the cost of the Iraq War, a hugh sum indeed. This would pay for roughly one year of Medicare and Social Security budget expenses.
As for improving people's lives, the War on Poverty was a case of colossal mismanagement and waste that in many cases perpetuated the standing of those it intended to help. Good intentions are worthless if not born out by success.
BTW, I'm one of those 47 million Americans without insurance but am reluctant to cede to the government the power to coerce me into mandatory coverage.
David at 12:25AM on Jun 25th 2007
56. Sorry about the repost.
David at 12:38AM on Jun 25th 2007
57. Michael Moore is not even American he is Canadian making money downing the Americans. He is not a person who can be trusted and his movies are not allowed in my house if they are brought in they are destroyed.
Brenda at 9:48AM on Jun 25th 2007
58. All I hear day in and day from the neo-cons in this country is how Communist or Socialist Liberals are, especially with regards to Universal Healthcare
They forget of course that our own beloved Military is itself a huge Communist entity. We all, as a community, pay for our defense.
Yet when Liberals suggest that we also, as a community, pay for the health and well being of every US Citizen, we are labeled Commies or un-Americans by our esteemed colleagues on the right.
This government of ours runs on our tax dollars…is it so all fired crazy to suggest that the government we support, supports us when we are sick?
Nope.
Besides, the sooner those American Citizens are well again, the sooner we can get back to funding this Great Experiment again with our hard earned tax dollars!
Universal Health Care is a win, win.
Unfortunately the execs in Big Pharmaceutical and the HMO’s will take a hit and they’ll cry “wolf” about how detrimental this will be to the economy.
I will weep for the multi-millionaires whose gravy train will be pulling out of town once we initiate Universal Health Care but as they themselves would say…hey, that’s business.
Bobo at 9:56AM on Jun 25th 2007
59. I believe all Americans should very suspicious of everything that the Heritage Foundation spits forth. They are a dangerous propaganda machine.
Tom Austin at 10:00AM on Jun 25th 2007
60. I Agree with Micheal Moore. This countries health care system is severely broken in favor of the rich.
Ginger at 10:21AM on Jun 25th 2007