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The sixth is outdated facilities and medical equipment.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 5 of 15)
61. An article from the Heritage Foundation? I bet this is "fair and balanced". Why not have The Carlyle Group write about world peace.
ben at 10:23AM on Jun 25th 2007
62. One thing we all have to remember, who ever and what ever is decided, that's what will happen. There aren't enough people with the courage to stand up and say, "No!, that's not what WE want" It will be accepted whether it's good or bad. If you think you have a choice or a say, what goes on here, you have been living in a dream world. The Constitution can't help or save us, remember, "It's just a piece of paper"
David Rosenberg at 12:48PM on Jun 25th 2007
63. Who is going to listen to the Heritage Foundation? They are nothing but a conservative so called think tank i.e. a disguised lobby for the right.
Richard Quiggle at 10:32AM on Jun 25th 2007
64. Im suspecious of everything the Heritage found does.Certainly they have no concernfor the average man inhe street.They are founded by teh wealthy. Under the present system health care is also rationed, but it is price rationing. If you can aford it you get it. If not there are many cases whee people die in the waiting rooms of emergency wards. Why limit life only to the wealthy? Give me socialized medicine, some care is better tahn none at all.
bob U. at 10:59AM on Jun 25th 2007
65. Like we don't wait in America??? Not for emergency care, but we wait and wait and wait for insurance companies to grant us permission to get life-saving procedures.
A little lazy thinking there, Paul.
Mike at 10:41AM on Jun 25th 2007
66. David writes: "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."
What an ironic day to write this, as I'm going into the hospital at 1:30 pm for that staff infection that is almost impossible to kill.
David, while I am, as you know strongly in favor of national healthcare, I do see your point that if you do not want health insurance for whatever reason, when we get it you should be able to "opt out" and also not pay any of your percentage of taxes associated with it.
This topic is one that I feel strongest about, but I won't be able to discuss it if I'm dead - so if the thread is still going on in a few days I'll join back in. But, David, thank you for your comments. I NEVER mind an opposing opinion - thats what comments are all about - but you have class in the way you set forth yours. I hate it when things erode to everyone name calling like "moron", "idiot" and the zillions of others. So, I also appreciate your politeness.
Phil at 10:41AM on Jun 25th 2007
67. The obviously uninformed who approve of socialized medicine in the USA should take some time to interview the real public of Canada. They have been enduring and suffering through socialized medicine for years and can tell you of the many thousands of people who have died, waiting in "line" to be seen by a doctor or to have a necessary surgery done in order to save their life. Socialized medicine is not the answer. I want the freedom to choose the doctor who will be on my team, if ever I am in a life or death situation. And I also demand the right to be seen by him in an acceptable time period. Socialized medicine does not give the patient these rights!!!!
sue at 10:44AM on Jun 25th 2007
68. Universal Health Care is better than no health care. OVer 45 million AMERICANS do not have any health care insurance. Many of these AMERICANS work hard, pay taxes, pay mortgages, and VOTE. But because they either work for an employers that does not supply health insurance or they are self employed, make a good living but cannot afford private health care insurance they are out in the cold. Those that are illegal in this country use the free system to get all the care they possible ever will need. Since those that are here illegally own little the system cannot recovery anything from them. On the other hand, a AMERICAN that must use the "free" system, is trapped by collectors trying to recovery cost. If this AMERICAN has managed to buy a home, and save something for their future the collectors will do all in their power to take this away.
Some sort of Universal system at a reasonable price should be made available to this group of AMERICANS.
Stan at 10:46AM on Jun 25th 2007
69. you think it will be any different here under government control? it won't be.it will be just as bad, if not worse.it will amount to 1/7th of our
whole economy ,just to START with.
NAME ANYTHING RUN BY THE GOVERNMENT THAT THE PRIVATE SECTOR CAN'T RUN BETTER. AND CHEAPER.
robert seaton at 10:47AM on Jun 25th 2007
70. You just have to love the fear mongering “socialized medicine” buzzword so often used by so-called “conservatives”. Sort of conjures up memories of “commies under the bed” and that sort of thing. Such a soothing bit of right wing nostalgia, isn’t it? Ah, for the good old days! Please tell me they’re not really gone. Look, as any anyone who can reason knows, a single payer health system is no more “socialized” than your local police force, fire department, school system, public works, etc., etc. Hello! We’ve got one of the worst health care systems in the industrial world that manages, at the same time and with the generous help of the insurance and pharmaceutical cartels (God bless ‘em!), to be the world’s most expensive. Wow! I mean how would you like to have a health care system geared toward the good of the fully insured public and at half the cost. Ghastly thought, is it not? And as for the Heritage Foundation, it’s so obviously a special interest joke that one would think everyone would get it… Well, I guess maybe not everyone.
Charlie at 10:49AM on Jun 25th 2007
71. WE ALREADY HAVE HEALTH CARE "RATIONING" IN AMERICA, as that is EXACTLY the idea behind "MANAGED" health care: they limit who gets how much and when they should get it, as that's how they generate revenues. Its time to give single payor system a shot because what we have now is no longer affordable or acceptable.
Robb at 10:57AM on Jun 25th 2007
72. David,
Some relevant numbers and figures can be found here:
http://www.ssb.no/english/subjects/09/01/helsesat_en/
Take note that the costs for administration in health care are less than 2.7% in Norway.
Of course the small fee I paid don't come close to the real expences, I never thought so, but as a 20 year old I never paid any taxes, so I come out just fine :P
The joke aside, just consider this figure:
http://www.ssb.no/english/subjects/09/01/helsesat_en/fig-2007-04-26-01-en.html
Håvar at 11:00AM on Jun 25th 2007
73. Heritage Foundation? Not too biased, are they?
Try telling someone with NO healthcare about the reduced quality of care they'll receive. Tell them they're better off neglecting themselves or dying than taking a shot with that old x-ray machine.
The Social Darwinists are really starting to stink up the joint, aren't they ?
Jean at 11:17AM on Jun 25th 2007
74. This is more elitist baloney. In Italy healthcare IS a right and it is written in their constitution. Yes I'm totally in favor of socialised medicine and taking the profit motive out. Sorry capitalists, this is a moral issue you can fleece people selling cosmetics, tobacco, operating gambling casinos, sending our kids to die over the price of oil, but the obscene profits insurance company CEO's have made at the expense of our care is criminal. Now I'm well aware that greed motivates most people and money is all America is about but when it comes to at least basic healthcare we as a society need to take care of everyone. This would aslo be good for business as they would be relieved from being responsable for employee plans and make us competitive with most other countries which we desperately need to do.
Here's a thought. Since we've been forced to die so big oil can reap the largest profits in their miserable history how about they kick a little back to fund healthcare!(and alternative energy, education, and prisons to put their CEO's in-and the corporate media propagandists!)
Karl at 11:42AM on Jun 25th 2007
75. I like the USA health care. Everything is free mon Viva Mexico!!
Poncho at 11:21AM on Jun 25th 2007