On universal healthcare

01 April 2009

I want you to think, for a moment, about the quality of care you get from Medicare and Medicaid. Sorry, didn’t mean to depress you. Imagine now that these systems, along with various state level support for healthcare, had about 14% more money. Yay, that sounds good, right? Currently about 44% of all health dollars are spent by the taxpayer. I am asking you to imagine what it would be like if that were 50%. Except that, and this is the stretch, I want you to imagine that that 50% is actually the only money being spent on healthcare. Imagine that Medicare and Medicaid, with this small lift in their budgets, had to pay for not half the medical procedures in the US, but all of them. Welcome to the NHS.

Britain’s Nationalized Health Service works about as well as most nationalized industries: HMO meets DMV. Spending on health per head is about half what it is in the US. Now that is not quite as bad as it may sound. Doctors are paid a lot less in Britain, and if you had a fully federalized health system they would be paid less in America too: at least while they were working. They would be impossible to fire and have gold-plated pensions, but their annual salaries would generally be lower.

So, what is the quality of service like? Well, doctors, as you know, are intelligent and well-educated people. There is a slight tendency for doctors to be a little patronizing and arrogant in their dealings with lesser mortals. Try to imagine that magnified by their being civil servants.

Waiting lists of “non-essential” operations – such as those to relieve the chronic pain that renders you unable to work – can be months long. Even when you turn up for your appointment, arriving at the correct time, you can be waiting for several hours. There are, of course, government targets to reduce waiting lists. So now hospitals don’t put you straight on to the waiting list. You have to wait a few months first. That’s right, there is actually a waiting list to get onto the waiting list.

Democrats seem to want such a system in America. I could not recommend it. What is worse, in order to avoid any proper discussion of the principles involved, it is all being rolled into the “stimulus” – Barack Obama’s plan to borrow his way out of debt. Adopting the stimulus is, apparently, an emergency, and it is unpatriotic to question whether or not it is a good idea. Some Democrats have been quite openly saying that the economic crisis gives them the opportunity to push through plans they have been planning for years, but lacked the support to implement.

It is interesting that Democrats accused the Bush administration of using 911 as an excuse to push through policies that he had wanted to pursue all along – the invasion of Iraq, for instance. They always had to argue that this was some hidden agenda. Yet now, Democrats talk quite openly of using another national crisis to push through an old agenda. Yet this is hardly a policy which should be adopted without discussion or scrutiny.

America has the most developed healthcare system in the world. Other countries get a free ride on developments paid for in America. Don’t throw it away.


First published in the Common Sense series for Lake Champlain Weekly.

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