Tag Archives: Health care

Health care

World Health Organization ranking biased, not reliable

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A letter in the Wichita Eagle written by Brad Beachy of Wichita makes the case for “so-called socialized medicine” to be brought to the United States. Part of Beachy’s argument relies on a ranking produced by the World Health Organization. That ranking has a number of problems.

The ranking Beachy refers to was produced in 2000, and hasn’t been updated since then. So it’s getting a little old. Worse than that, it contains a number of techniques and biases that work against countries that rely on markets instead of government to provide health care.

A recent paper from the Cato Institute provides some useful analysis of the World Health Organization rankings. (See WHO’s Fooling Who? The World Health Organization’s Problematic Ranking of Health Care Systems)

For example, there are two sets of rankings. As the Cato report explains: “One ranking claims to measure “overall attainment” (OA) while another claims to measure “overall performance” (OP). These two indices are constructed from the same underlying data, but the OP index is adjusted to reflect a country’s performance relative to how well it theoretically could have performed.”

Using the OP rankings, the United States is number 37. But using the OA rankings, the United States is 15.

25% of a country’s ranking is based on “financial fairness,” which is determined by looking at the “dispersion in the percentage of household income spent on health care.” As the reports says “The FF factor is not an objective measure of health attainment, but rather reflects a value judgment that rich people should pay more for health care, even if they consume the same amount.”

The report notes this introduces a bias against countries that rely on market mechanisms for paying for health care.

There’s another problem with FF, too: “Put more simply, the FF penalizes a country because some households are especially likely to become impoverished from health costs—but it also penalizes a country because some households are especially unlikely to become impoverished from health costs. In short, the FF factor can cause a country’s rank to suffer because of desirable outcomes.”

The Cato study goes on to document additional problems with the WHO ranking. Problems with the rankings were noticed earlier, too. An earlier analysis of this report from Cato (We’re Number 37 in Health Care! concluded this:

Overall, the WHO rankings’ mathematical formulations serve only to distract attention from the authors’ underlying distaste for individual choice in health care. The report largely ignores the extraordinary benefits the American marketplace brings to health care worldwide, such as new drugs, advanced diagnostic instruments such as MRIs and CAT scans, and lifesaving therapies for cancer and heart-disease patients. Under a WHO-style health care system, lifesaving research and innovation would be stifled and individual choice would be discarded in favor of collective control. Bureaucrats would decide who receives care — and who does not — on the basis of statistical tallies that devalue the lives of the elderly, the disabled and the chronically ill.

By contrast, a free-market health care system upholds the right of every person to make his own decisions. Patients are given choices, not issued numbers, and doctors are freed from impersonal “expert panels” dictating what care they can and cannot provide. The WHO’s idea of government-provided universal health care is a fantasy that masks a system of dangerous, formula-based rationing. If you value your health, don’t trust the WHO.

Health care

Obama-style health care: the effects in England

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In the debate of what to do about health care, advocates — such as President Obama — cite countries that spend much less than the United States. An example is the United kingdom.

The president believes that if we can control costs through better medical practice and efficiency gains, we too can have more health care provided at less cost.

The Wall Street Journal article Of NICE and Men tells us how Great Britain is able to control its costs. It’s through the National Institute for Health and Clinical Excellence, or NICE.

Originally it was established to “ensure that the government-run National Health System used ‘best practices’ in medicine.” This sounds like a good program, doesn’t it?

But as the Journal article details, it hasn’t quite worked out that way. The article concludes: “But it [NICE] has by now established the principle that the only way to control health-care costs is for this panel of medical high priests to dictate limits on certain kinds of care to certain classes of patients.”e

Politics

Articles of interest

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Chemical security, national health care, global warming cost, school order.

Extending security standards better decision

A letter in the Montgomery Advertiser makes the case for extending the present Chemical facility anti-terrorism standards. Legislation is under consideration that would give government the ability to regulate processes and technologies.

“Although we believe CFATS should be reauthorized and made permanent, we do not support current draft legislation that replaces CFATS and extends the power of the DHS to dictate how a product is made. Decisions pertaining to feedstocks, processes and products should be left to the engineers and safety experts at local facilities.”

The Stealth Single-Payer Agenda

George F. Will’s column explains that while President Obama and Congress are presently considering a “public option” health care plan, this is just the first step on the road to a single-payer plan. “The puzzle is: Why does the president, who says that were America ‘starting from scratch’ he would favor a ‘single-payer’ — government-run — system, insist that health-care reform include a government insurance plan that competes with private insurers? The simplest answer is that such a plan will lead to a single-payer system.”

The Big Chill
Congress shouldn’t fight global warming by freezing the economy.

In a Wall Street Journal column, Pete Du Pont explains the enormous cost of the Waxman-Markey global warming bill and how little warming it would stop. “Manzi estimates the additional economic costs of the bill would be 0.8% of gross domestic product, while the economic benefits would be just 0.08% — so the costs would be 10 times the benefits. The cost of reducing emissions turns out to be greater than the cost they impose on societies. According to a 1999 Federal Reserve Bank of Dallas estimate, the emissions cuts the Kyoto Protocol would have required in 2010 were likely to reduce America’s GDP by $275 billion to $468 billion, or $921 to $1,565 per person, and of course Kyoto does not apply to fast-growing developing countries such as China and India.”

Taking back control of the classrooms

“The dirty little secret of America’s schools is that teachers have lost control of the classroom. Disrespect is commonplace. Disorder is an epidemic — 43 percent of high school teachers say they spend more than half their time maintaining order instead of teaching, according to a Public Agenda survey. Learning is impossible in these conditions. One misbehaving student steals the floor, spoiling the learning opportunity for the other 29 students. ‘You know, it really doesn’t take very many kids to ruin a classroom,’ observed David Adams, superintendent of Shelbyville Central Schools.”

Phillip K. Howard explains that the problem is too much law: “There is a broad perception — by teachers and students alike — that teachers lack the legal authority to enforce respect and order.”

Health care

In Wichita, protest of ABC’s Obama coverage

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Here’s a message from a local patriot and activist. She is rightly concerned about ABC News — the national organization, not the local affiliate — and its upcoming coverage of the Obama administration:

Protest in Wichita in front of ABC affiliate KAKE news TV at 1500 N. West St., Wichita this Wednesday, June 24th starting at 4 p.m. until 6:30 p.m. Please join us! We are protesting how ABC is propagandizing the American public and deceiving them.

What is she concerned about? The editorial ABC Self-Nationalizes For Obama supplies some background:

Media Bias: As much of the U.S. private sector, including health care providers, resists government takeovers, what a sorry sight to see ABC News leap forward to make itself a propaganda arm of the government. … This Wednesday, on every show from “Good Morning America” (kicking things off with an interview with the president) to “World News Tonight” (broadcast from the Blue Room) to a prime-time special called “Prescription for America” (and emanating from the East Room), the network will puff the Obama administration’s trillion-dollar plan to nationalize U.S. health care. …

This isn’t your grandfather’s propaganda. Forget public service announcements. Just as some newspaper ads trick themselves up to look like news stories to enhance their credibility, making a partisan program indistinguishable from the nightly “news” is a propaganda tool in the same vein. … Under the cover of news, ABC can present the president’s side of the health reform issue as “factual” and leave out the real costs and concerns about government control and rationing of health care. …

The best proof that the public is getting propaganda is that ABC is refusing to take ads from critics who are offering to pay for them. Among those turned away: the Republican National Committee and a group called Conservatives for Patients’ Rights. …

It all amounts to a sad corruption of American journalism. Once upon a time, people would go into journalism to expose the seamy underbelly of American politics. Today, ABC News, in its abject submission to the Obama administration on health care, has decided to become the seamy underbelly.

For more information about the event, contact Larry Halloran at LarryHalloran@aol.com. Click to get a Google map to the location.

Health care

Government health care rations by making patients wait

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David Gratzer, a physician born and raised in Canada, gives us in the United States a preview of what government health care is all about: the waiting.

His recent Wall Street Journal piece is titled Canada’s ObamaCare Precedent: Governments always ration care by making you wait. That can be deadly.

He tells this story: “But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system. The problems were brought home when a relative had difficulty walking. He was in chronic pain. His doctor suggested a referral to a neurologist; an MRI would need to be done, then possibly a referral to another specialist. The wait would have stretched to roughly a year. If surgery was needed, the wait would be months more. Not wanting to stay confined to his house, he had the surgery done in the U.S., at the Mayo Clinic, and paid for it himself.”

An Ontario woman with a 40-pound liquid-filled tumor in her abdomen was within weeks of death when an American surgeon — working in Michigan — removed the tumor.

“Ironically, as the U.S. is on the verge of rushing toward government health care, Canada is reforming its system in the opposite direction.” In 2005, the Canadian Supreme Court “struck down key laws in Quebec that established a government monopoly of health services.” Private-sector health care is growing in Canada, with 50,000 patients per year seeing private doctors in British Columbia. The United Kingdom and Sweden have initiated reforms, moving away from total government control.

Dr. Gratzer asks “Why are [Americans] rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?”

Politics

Government-run health care focus of June 6 demonstration

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This Saturday, Wichita-area citizens will have an opportunity to let their fellow citizens and the Obama administration know of the dangers of government control of health care.

The event will be on Saturday, June 6, 2009, from 11:00 am to 1:00 pm. The location is the pedestrian bridge over Kellogg (US 54/400 highway) at Pattie Street. Meet on the south side of Kellogg. You can click on a Google map of the location.

Protest event organizers say this is your opportunity to wake up the public, to get people talking to each other about government control of health care, to watch these videos to become informed, and to spread information throughout the country. Please send an email to students@cox.net for more information on the protest event, to ask your questions, and to volunteer to hand out literature, send emails, etc.

This is a follow-up event to this protest event. More information can be found there.

Politics

Demonstrating against government control of health care

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America Protests 2009-05-24 08

Today a dedicated group of citizens worked for two hours to get out the message that government control of our health care is not in our best interest.

Another protest will be held on June 6.

One of the banners (and an adorable puppy) promoted the website Free Market Cure. The mission of this site is: “Free Market Cure is dedicated to correctly diagnosing the problems with the U.S. health care system and promoting solutions which preserve and extend individual liberty. Our central premise is that many problems in our medical system are either caused or exacerbated by government intervention — and that a strong dose of Capitalism is the cure for what ails the U.S. health care system.” This site is full of useful information.

Here’s a link to some photos of the event. Video is below.

Sedgwick county government

Sedgwick County industrial park chasing uncertain industries

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Sedgwick County is considering becoming a developer of an industrial park. The county is limiting itself to deals described as a “home run,” meaning a company that plans to hire more than 1,000 workers.

The problem is that there are few of these deals each year. Maybe just five to eight. But Sedgwick County’s policy makes those odds even worse.

That’s because the county wants to limit tenants of the park to those in “clean” industry, specifically the composites and alternative-energy industries. This likely means the number of deals will be less than five to eight each year.

It could even be none. That’s because of the nature of the two industries.

Consider composites. One of the most promising avenues for their use is in medical devices, and Wichita is actively pursuing that market. Parts used in hip replacements are often given as an example.

The problem with the medical parts market is that it may not exist in its present form after a few years. As the United States considers nationalized health care, we must recognize this means that expensive surgical procedures such as hip replacements will be rationed. Here’s the Wall Street Journal reporting on Canada’s experience:

On the other side of the country in Alberta, Bill Murray waited in pain for more than a year to see a specialist for his arthritic hip. The specialist recommended a “Birmingham” hip resurfacing surgery (a state-of-the-art procedure that gives better results than basic hip replacement) as the best medical option. But government bureaucrats determined that Mr. Murray, who was 57, was “too old” to enjoy the benefits of this procedure and said no. In the end, he was also denied the opportunity to pay for the procedure himself in Alberta.

If the U.S. adopts Canadian-style health care, it doesn’t seem that medical devices will be a growth market.

The other industry Sedgwick County wants to limit itself to — alternative energy — has its own set of problems. Primarily, the industry exists only because of large government subsidy. As the Production Tax Credit for wind energy was about to expire last year, industry advocates warned Congress that without the tax credits, the wind energy industry would be in trouble.

This is a typical quote: “If we move into 2009 and it [the production tax credit] hasn’t been extended, new orders will shrink and it will be a major blow to these new US [wind] manufacturing, investment, and jobs across many states.”

The two industries that Sedgwick County wants to bet on, as you can see, have uncertain futures.

Politics

The audacity of hopelessness

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The Audacity of Hopelessness
Gregory L. Schneider

President Barack Obama has had his way with business in his first hundred days in office. He is the only president in American history to fire a CEO of a private business, Rick Wagoner of General Motors. He called bondholders of Chrysler Corporation speculators after they refused a government-financed deal that would have paid them one-third or less of what they are owed; they would rather go through regular bankruptcy proceedings. Recently, out of fear of a nationalized health care system, private insurance trade associations and health care providers have pledged to the president that they will reduce $2 trillion in health care costs over the next decade. It might be the audacity of hope for President Obama, but it’s hopelessness for the private sector.

The health providers, according to the Wall Street Journal, said they would reduce costs by simplifying administrative costs, making hospitals more efficient, reducing hospitalizations, and improving health care information technology. This last cost reduction goal plays to the president’s good graces, as it is a key component in what he believes will reduce health care costs. If the costs can be reduced then there may be no problem with the providers committing themselves to do so. But much depends on the other health care plan floating through Congress, the one that could force an end to private insurance — despite what supporters say — through the crowding out of the private market and its replacement with the public insurance Obama favors.

Why is the health care industry, which vehemently opposed Hillary Clinton’s efforts to nationalize health coverage in 1993 and 1994, now supportive of the effort to do so? One thought is that it’s better to be a player on the inside negotiating the terms of surrender rather than one on the outside being dictated the terms. The conventional wisdom among conservatives is that this represents “a craven gesture of submission,” a kowtow to the American emperor as National Review editor Rich Lowry called it in his column.

But look a little deeper as CATO Institute health care fellow Michael Cannon did on National Review Online (May 11, 2009) and there may be a different reason for why the health care industry caved and gave such promises to Obama. According to Cannon, “the basic math of universal coverage is this: it will cost a minimum of $120 billion per year to cover the uninsured. Over ten years, it can easily cost $2 trillion.” The Congressional Budget Office (CBO) has not recognized the assumed savings from health care reform which are a major component of the Obama argument — reform health care and costs will decrease.

“So it may be,” Cannon continues, “that the industry’s overture is actually an effort to cook the books by ganging up on the CBO: “See, you silly number-crunchers? Even the industry believes these reforms will reduce spending. What’s in it for the industry? Universal coverage gives them a huge revenue boost in the short term — and then every lobbyist at the White House will fight for those spending reductions over the long term. The industry isn’t negotiating its surrender — they’re negotiating the surrender of even more of our money.”

Every economic decision the Obama administration has made since it took office in January has resulted in the politicization of private business. Look at the auto companies; look at the banks and Wall Street firms. Want to get out of government managed programs, like the Troubled Asset Relief Program (TARP)? You have to prove your worthiness, jump through hoops and then the administration may let you out of the program. Or it may not. Better to enter bankruptcy and reject the federal dole than to suffer the full consequences of government bailouts.

That is a lesson I hope business learns quickly and begins to resist the trend toward socialized medicine (i.e., higher taxes, rationed care and a weakened health care system) on top of nationalized banks, auto companies and whatever else this administration has in store. That truly is the audacity of hopelessness.

Gregory L. Schneider is a Senior Fellow with the Kansas-based Flint Hills Center for Public Policy.  A complete bio on Dr. Schneider can be found at http://www.flinthills.org/content/view/24/39/, and he can be reached at greg.schneider@flinthills.org.

Politics

Government-run health care focus of May 24 demonstration

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Next Sunday, Wichita-area citizens will have an opportunity to let their fellow citizens and the Obama administration know of the dangers of government control of health care.

The event will be on Sunday, May 24, 2009, from 11:00 am to 1:00 pm. The location is the pedestrian bridge over Kellogg (US 54/400 highway) at Pattie Street. Meet on the south side of Kellogg.

You can click on a Google map of the location. There’s also a Facebook event page.

This event is part of the America Protests Facebook group.

Protest event organizers say this is your opportunity to wake up the public, to get people talking to each other about government control of health care, to watch these videos to become informed, and to spread information throughout the country.

This is the line in the sand. We must prevent passage of the current “Health Care Reform” bill. The public has no idea why it’s irreversible. They have no idea of the consequences of this bill. As long as we remain willing to go about our daily lives without rising up and holding mass demonstrations the public will remain complacent.

Please sign up to attend the protests. May 24 and June 6 are the two days planned. You can click on the Facebook event page for more information. The guest list for the first protest on May 24 is private; your name or picture will not be displayed when you choose to attend.

Please notify everyone you can of this protest. We want people to line the street with free information, brochures, and flyers to inform the public and get the alarm sounded across the country.

Please send an email to students@cox.net for more information on the protest event, to ask your questions, and to volunteer to hand out literature, send emails, etc.

What are the dangers of government-run health care? Indian (native American) health care is totally funded and run by the United States Government. This is what health care for everyone else will look like if we don’t speak up to prevent it.

It took 10 years to get one bill to the floor in Congress for debate — just one bill to try to make improvements in Indian health care. If you think nationalized health care will be run any better you’re fooling yourself.

Dick Morris described the irreversible nature of implementing Obama’s “Health Care Reform:” “The other radical changes Obama is bringing about in our nation can always be reversed. New taxes can be repealed or lowered. That which was nationalized can be privatized. Government which has grown can be cut. But once the health care system is extended to cover everyone, with no commensurate increase in the resources available, the change will be forever. The vicious cycle of cuts in medical resources and in the number of doctors and nurses will doom health care in this country. This wanton destruction will not be reversible by any bill or program. A crucial part of our quality of life — the best health care in the world — will be gone forever.”

This is a very important video explaining why government-run health care is irreversible:

Politics

Is it greed when someone else pays?

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A letter to the editor in today’s Wichita Eagle under the title “Greed rules” states, in part: “There is no reason that the United States remains the only civilized nation in the world not to have a single-payer health system except that greed rules our country.”

I wonder: Is it greed to want someone else to pay for your health care?

Politics

Articles of Interest

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Bailout costs rise, local election turnout, health care, light bulbs, newspapers, Kansas coal prospects

Estimate of TARP’s Cost to Taxpayers Increases (Wall Street Journal) “The Congressional Budget Office has quietly altered its estimate of the ultimate cost to taxpayers of the $700 billion Troubled Asset Relief Program, now figuring the initiative will be much more expensive in the long run than it previously figured. In January, the CBO pegged the ultimate cost to taxpayers of the $700 billion TARP at $189 billion. When the agency issued revised numbers in late March, it revised that to $356 billion, a change that drew little attention.” I don’t imagine this will be the last time we see the cost of bailouts rising.

Expected Turnout For Tuesday’s Election: 12 Percent (Brent Wistrom in the Wichita Eagle) “The six candidates for Wichita City Council have clashed on many fronts. But they agree on one thing. The projected turnout for Tuesday’s election is dismal.”

That’s ridiculous (Letter to the editor of the Wichita Eagle) A letter-writer makes the case for government provided health care by illustrating a scenario where if a citizen calls for police or fire assistance, they’ll have to make payment arrangements before receiving service. This, of course, is a ridiculous comparison and ignores the context in which these services are provided. Besides, it wouldn’t be a bad thing to look into private provision of police and fire protection.

Climate Change’s Dim Bulbs (George F. Will in the Washington Post) Will comments on some of the problems with compact fluorescent light bulbs (CFL), as recently noted in a New York Times article The Bulb That Saved the Planet May Be a Little Less Than Billed. He concludes: “Worrywarts wonder what will happen when a lazy or careless, say, 10 percent of 300 million Americans put their worn-out bulbs in the trash. Stop worrying. What do you think? That Congress, architect of the ethanol industry and designer of automobiles, does not think things through?”

Life After Newspapers (Michael Kinsley in the Washington Post) Kinsley claims that people are getting more news and analysis than ever. It’s just online. If true — I was not aware of this — then there is hope for newspaper companies to survive: “Sorry, but people who have grown up around computers find reading the news on paper just as annoying as you find reading it on a screen. … If your concern is grander — that if we don’t save traditional newspapers we will lose information vital to democracy — you are saying that people should get this information whether or not they want it. That’s an unattractive argument: shoving information down people’s throats in the name of democracy. But this really isn’t a problem. As many have pointed out, more people are spending more time reading news and analysis than ever before. They’re just doing it online.”

Sebelius holding coal cards (Tim Carpenter in the Topeka Capital-Journal) Analysis of the “coal bill,” which passed the Kansas house, but with fewer votes than it has in the past. House Speaker Mike O’Neal said earlier this year that there would be enough votes in the house to override the governor’s promised veto, but it looks like the vote count is moving in the wrong direction.

Politics

Articles of Interest

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Us v. Them: The People and the Political Class (Jack McHugh, Mackinac Center for Public Policy). “The fundamental problem facing our nation is that true representative government has been supplanted by an inbred, self-serving, self-perpetuating political class that does not represent the people. As a result, the government has escaped the control of the people.” McHugh explains how resistance to term limits, campaign finance regulations, public employees and their unions, even the political parties, work against the interests of the people.

When Change Is Really More Of The Same (Howie Rich of Americans For Limited Government). “No more lobbyists dictating terms. No more bitter partisanship. No more wasteful earmarks.” Can President Obama deliver on the promised change? “Not hardly” says the author.

What Are the Odds of a Depression? International evidence suggests there is a 20% chance our stock-market crash will lead to much worse. (Robert J. Barro, Wall Street Journal) It’s a grim picture: “The bottom line is that there is ample reason to worry about slipping into a depression. There is a roughly one-in-five chance that U.S. GDP and consumption will fall by 10% or more, something not seen since the early 1930s.”

Sweden’s Government Health Care (Walter E. Williams). What about health care in Sweden, a country often described as a place where socialism works? “Malmo, with its 280,000 residents, is Sweden’s third-largest city. To see a physician, a patient must go to one of two local clinics before they can see a specialist. The clinics have security guards to keep patients from getting unruly as they wait hours to see a doctor. The guards also prevents new patients from entering the clinic when the waiting room is considered full. Uppsala, a city with 200,000 people, has only one specialist in mammography. Sweden’s National Cancer Foundation reports that in a few years most Swedish women will not have access to mammography. … I wonder how many Americans would like a system that would, as in the case of Mr. D. of Gothenburg, prohibit private purchase of your own medicine if the government refused paying.” Further information is at Sweden’s Single-Payer Health System Provides a Warning to Other Nations and Mammography at risk in Sweden, says Cancerfonden.

United States government

Be Wary of Government Control of Health Care

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In Canada, some patients have to travel to the United States for life-saving medical treatment. Patients are also denied to right to pay for their own treatment in Canada, as was the case of a 57-year old man denied a hip replacement operation by the government.

The Wall Street Journal article “Too Old” for Hip Surgery: As we inch towards nationalized health care, important lessons from north of the border reports on these and other cases of how health care is rationed in Canada. “The experiences of these Canadians — along with the untold stories of the 750,794 citizens waiting a median of 17.3 weeks from mandatory general-practitioner referrals to treatment in 2008 — show how miserable things can get when government is put in charge of managing health insurance.”

Economics

Drug Runaround: Solved by Universal Health Care?

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A letter writer in the July 12, 2008 Wichita Eagle has issues with his health insurance coverage, and wants us to discard our present system in favor of universal health care coverage.

Mr. Ronald Voth of Halstead (a candidate for the Democratic party nomination for the U.S. House of Representatives for the fourth district of Kansas in 2006) criticizes the health insurance company he uses. He doesn’t say how he obtained this coverage, but if he’s like most Americans that don’t receive their health care from the government, he and his family probably have an insurance policy selected and paid for by his employer. While many employers let their employees choose from a few variations of coverage, for most employees, they have to take what their employer is willing to provide. There isn’t much of a market for individual health insurance policies in America.

If there were a large market for private health insurance, customers would have the benefit of companies competing for your business in free markets. This means that if Mr. Voth doesn’t like the coverage he’s getting from his current provider, he can change. But for most people whose policies are provided and largely paid for by their employers, switching insurance carriers is not a realistic option. This employer-provided coverage, a relic from the circumvention of World War II price controls, results in less competition for customers.

With market-based competition comes innovation. With universal health care provided by government comes the opposite. I wonder if Mr. Voth knows that Canadians come to places like Wichita to get the health care they can’t get under their universal system? See Wichita’s Galichia Provides What Government Health Care Doesn’t.

Mr. Voth claims that universal care systems in other countries are cheaper than ours, and that’s true. But we should ask why. The article referenced below states: “… because the U.S. is so much wealthier than other countries, it isn’t unreasonable for it to spend more on health care. Take America’s high spending on research and development. M. D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does.”

(By the way, the high cost of health care can’t be blamed on high-paid CEO’s. If the CEO of a large insurance company that has 10 million customers is paid, say, $100 million a year, that’s only $10 per customer per year.)

For more information about universal health care in other countries, the article The Ugly Truth About Canadian Health Care provides balanced criticism of the Canadian health care system.

Economics

Wichita’s Galichia provides what government health care doesn’t

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A recent editorial in The Wichita Eagle (Dr. Bill Roy: Universal care is most economic, efficient) contains several mistaken impressions. One may be disproved by recent developments in Wichita.

The writer states “It has never been a secret that a single-payer system is the most economic, efficient and fair way of providing universal care.” Here’s something interesting that I’m sure the author of this opinion piece knows, but somehow disregards. In Canada, home to the type of health care system the writer favors, many people come to the United States for care. In fact, Wichita is now providing service to Canadians who, for one reason or another, are not satisfied with their own government-provided free care. “[Wichita’s] Galichia Heart Hospital treated its first out-of-country patient last month, a Canadian who needed a hip replacement and was willing to pay cash instead of waiting months — or even years — for what is considered elective surgery in Canada.” (Some U.S. hospitals try to draw foreigners with flat-rate care, May 29, 2008 Wichita Eagle.)

Someone needing a hip replacement in the United States probably doesn’t consider their need for surgery to be “elective.”

While we in the United States may complain about high drug costs and drug advertisements on television and in print, at least we have new drugs. We may complain about waiting a few weeks to see a specialist, but we usually get to see one. And some people complain that expensive advanced medical equipment has been installed in two of Wichita’s hospitals, when one should be sufficient. But we have these things. Countries with government health care often don’t: “All provinces continue to use rationing in an effort to contain the growth in government health spending. Governments ration health care with policies that reduce the effective supply of health professionals, reduce the availability of advanced medical equipment, and restrict the scope of coverage for new medicines under public drug insurance plans. Such rationing drives up waits for specialist medical care and inhibits access to new drugs.”

This passage is from a report titled Paying More, Getting Less 2007 from Canada’s Fraser Institute. The report makes this conclusion: “Based on the data and analysis in this report, we conclude that public health insurance, as it is currently structured in Canada, tends to produce rates of growth in government spending on health care that are not financially sustainable through public means alone. This is occurring while governments are restricting and reducing the scope of benefits covered under publicly funded health insurance.”

Free markets

Michael Moore Confirms that Government Health Care is Sicko

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This is an excellent article that exposes how little some people like Michael Moore think about the systems they consider corrupt and unworkable. It appears that Mr. Moore is so consumed with an anti-market bias that he hasn’t really considered the true causes of the problem with healthcare in America. He isn’t the first person to have problems with an anti-market bias, nor do I suspect he’ll be the last.

Michael Moore Confirms that Government Health Care is Sicko
by Diana M. Ernst, Pacific Reserach Institute

Michael Moore showed up in Sacramento last week to promote his film Sicko. Senator Sheila Kuehl hailed Moore as a prophet of truth to the American people but the filmmaker is so mired in his own health hysterics that he regularly contradicts himself .

He rails against “for-profit” health care, but 85 percent of U.S. hospitals are non-profit, and almost half of privately insured Americans have polices from non-profit health insurers.

Moore referred to the Martin Luther King Jr.-Harbor hospital in Los Angeles, where a patient died of a perforated bowel after lying on the emergency room floor for 45 minutes. Since 2004, the hospital has received more than a dozen state and federal safety citations. Hospital errors included leaving sick patients unattended which resulted in death for three of them, giving patients the wrong medications, and using Taser stun guns to restrain psychiatric patients.

This hospital is not private, however. It is owned by the County of Los Angeles. So much for reliable government care. And the private insurers Moore rails against are currently selling health policies laden with government mandates and regulations.

The Council for Affordable Health Insurance (CAHI) has reported that mandated benefits have increased to the more than 1,800 today. In some states, mandated benefits have raised the cost of individual health insurance by 45 percent. Government solutions that create more government amount to nothing but expensive salt in the wound. Such is Governor Schwarzenegger’s plan to tax hospitals and physicians for mandated health coverage, and such is Senator Kuehl’s government monopoly plan, promoted as a “single payer” system.

We need to help insurers to be more competitive, not scrap them for big-government bureaucracy. Mr. Moore’s foolish preference of abolishing private insurance in favor of government-run, single-payer health care will not create universal care, only a government monopoly. In other words, Moore thinks the government should provide “free” health care that isn’t required to meet any standards.

Mr. Moore also thinks Canada is a good role model, but two years ago the Canadian Supreme Court found that government monopoly health care violates basic human rights. The winning plaintiff in this case, Mr. Zeliotis, needed hip surgery. When he tried to pay privately for his operation rather than wait in the public line (which takes two to four years) the Canadian government stopped him. Mr. Zeliotis argued against government interference with his freedom to choose private medical care. The denial of such a choice prolonged his pain and threatened his safety.

Mr. Moore also likes the single-payer system in Cuba, a one-party communist state. Some 11 million Cubans attend run-down facilities, receive dated prescription drugs, and are even required to bring their own sheets, food and soap to the hospital. Communist Party bosses get better treatment but when it came time for the great dictator Fidel Castro to go under the knife, he flew in a specialist from Spain. To adopt the health-care system of a totalitarian dictatorship like Cuba would be kind of, well, sicko. But government-run health care also presents problems right here at home.

Medicaid was instituted in the 1960s under President Johnson for the poor, but it has grown far beyond its capacity, putting its financial capabilities under great strain. In order to keep costs down, Medicaid underpays physicians, who have increasingly stopped accepting Medicaid beneficiaries as a result. Government restrictions on physicians also make it challenging to get prescription drugs for Medicaid patients.

Mr. Moore’s remedies fail as heath-care reform and do not even amount to effective propaganda. He needs less rhetoric and more direct experience. He should get on a Canadian waiting list for treatment, try the “second” system that serves most Cubans, or follow a Medicaid patient’s struggle to get health care from the government.

Meanwhile, union nurses and hospital employees were among 1,000 people who must have taken sick time to cheer Michael Moore Tuesday. Perhaps Speaker Nuñez and Senator Kuehl will investigate how patient care suffered while their caregivers took to the streets.

Free markets

Employer-paid health insurance

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In the past I have written on how the system in America where almost everyone gets their health insurance through their job (Let’s Pay for Our Own Health Insurance) does not serve us well. Now I have become aware of even more evidence as to why we should all choose and pay for our own health insurance.

A Harvard study (Illness And Injury As Contributors To Bankruptcy) concluded that of families that declared bankruptcy, about half cited medical bills as the reason. Of those, 76% had medical insurance at the time they became sick. Some of the problem is that when people become seriously ill, they can’t work. After they lose their job they have no income, and they can’t pay the premium to continue their existing coverage.

Many types of insurance, and some health insurance policies, I have found, offer an option called “waiver of premium.” This option, if selected and paid for, pays the policy’s premiums when the insured can’t. This would help in the case where people are too sick to work and can’t afford their premiums. They would still be covered.

If your employer, through whom you get your health insurance, doesn’t offer this waiver of premium option, you realistically have no way to obtain it. But if we all chose and paid for our own health insurance, those who wished to could have this option. This is just one more reason why the current system of employer-provided health insurance does not work well.

Free markets

Let’s Pay for Our Own Health Insurance

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Having most people obtain medical insurance, and therefore their healthcare, from their employers is a peculiar tradition that leads to several less-than-optimal situations.

I would venture to guess that most employees don’t know the cost of their insurance. They probably pay a portion of the cost through a deduction on their payroll checks and they know what that amount is, but that is a long way from knowing the total cost. Knowing — and having to pay for — the entire cost of something is a good motivator for controlling its cost.

It makes no more sense for employers to provide health insurance than it does for employers to provide auto or homeowners insurance.

With employer-provided coverage, when people change jobs, they likely lose their coverage.

At most companies, employees are not rated according to their likely healthcare expenditures. There may be a cost for a single employee, another cost for an employee and spouse, and another cost for employee with spouse and children. Never have I seen a case where the cost to the employee was based on how many children there were in the family, even though each additional child adds a predictable risk and associated cost. Other types of insurance, such as auto and homeowners, are priced very carefully based on the characteristics of the driver, auto, and property being insured. This illustrates that present health insurance plans are not so much insurance against catastrophic loss as much as they are pre-paid healthcare plans that cover every little cost. But even then, they aren’t priced very carefully according to their likely cost.

Having employers provide healthcare removes choice from employees. If an employee doesn’t like the plan offered by their employer, they are certainly free to purchase one they prefer. But this will likely be more expensive, partly because of the fact that employer-provided plans are paid for with pre-tax dollars. A plan that is privately purchased would be paid for with after-tax dollars.

Removing the ability to choose health care plans from most people also removes competition amongst health care plan providers. Introducing competition to the marketplace is good for consumers.

The fact of employer-provided health insurance creeps into issues such as same-sex marriage. Advocates of same-sex marriage or civil unions point out that same-sex partners are denied the employer-provided health coverage that their partner enjoys.

What if we decided to stop employer-provided health coverage? There are a few obstacles.

Currently, since health insurance is often paid for with pre-tax dollars, people would pay more in tax. This could be overcome, of course, by lowering tax rates.

It may be that employers, since they often purchase insurance plans for large numbers of employees, are able to get price discounts based on volume. Wholesale purchasing, so to speak. I do not know how this would impact families purchasing plans one at a time. There may be significant sales costs. Certainly families would face choices and would have to think about them. But being more informed is better.

Some people, undoubtedly, would decide to forgo the purchase of health insurance, and therefore risk becoming a burden to us all if they become ill. This is a real problem because currently our healthcare system treats those who can’t afford to pay, sometimes with little concern given to if they will ever be able to pay. (Recently the New York Times and Wall Street Journal have given coverage to cases where hospitals have aggressively collected debts from poor people. The Times thought this a tragedy.) The fact is that the cost of care given to those who can’t — or won’t — pay is paid for by the rest of us who do pay. It would take a disciplined system to refuse to treat those who have chosen to forgo purchasing insurance.

In a Reason Magazine article titled Mandatory Health Insurance Now! we find this paragraph:

Why not just tell Americans they are responsible for buying their own health insurance from now on? If people couldn’t pay for medical care, either through insurance or out of pocket, they wouldn’t get it. “After people begin to notice the growing pile of bodies by emergency room entrances,” Tom Miller wryly suggests, “they will quickly get the message and go get medical coverage.”

The solution to the problem, the article says, is in the slogan for a proposal by The New America Foundation: “Universal coverage in exchange for universal responsibility.” All of us would have to purchase our own insurance plans. The employer-provided plans would end. The problem, of course, is that even a plan covering only catastrophic expenses for a family of four might cost $3,600 annually, which is out of the reach of many low-income families. So the rest of the taxpayers would have to subsidize the purchase of these plans. We already do this now, so does anything change?

Yes, I think things would change for the better. If we could truly enforce the “universal responsibility” part of the plan — everyone has to pay his or her own way — this plan has a chance.

Additional reading:
To Guarantee Universal Coverage, Require It
Health Insurance Required
Insurance Required
Universal Coverage, Universal Responsibility: A Roadmap To Make Coverage Affordable For All Americans (full report)