“Universal health care” is a seductive idea. As Americans, it appeals to our sense of
fairness, justice and equity. It’s only
right. Furthermore, it’s essential that
“the children” are assured of access to the full range of health care services
they need: dental, vaccinations, doctor visits and hospital and emergency care when
necessary. So, who could possibly be
opposed to making sure everyone is covered, especially “the children”? Probably no one, including
me.
However, the Kaiser
Commission on Medicaid and the Uninsured reported that only about 18 percent of the
population is uninsured. Another
estimated 25 percent are covered by Medicare and Medicaid. So, if only 18 percent of the population does
not have health insurance and 25 percent are covered by Medicare and Medicaid,
why is it necessary to create a universal or national health care program that
includes the remaining 57 percent who already have health insurance?
To accomplish this, the Federal government would take
over all health care, thereby nationalizing the entire system. Seems like a pretty drastic way to solve an
18 percent problem.
The universal health care issue is very complex and
open to a wide range of interpretations by both Left and Right, which are
generally buttressed with reams of statistics.
But, numbers can be deceiving and are easily manipulated.
If we adopt a universal health care plan, who’s
going to decide what type of coverage should be provided and how the plan
should work? Obviously,
politicians and bureaucrats.
But, why do we keep expecting
politicians to know what should be done about our health care system? How about the politicians in Canada and Great
Britain? Have they solved the problem in
their societies? In England, where the
private practice of medicine was outlawed when socialized medicine was first
established, to make it work they were eventually forced to allow the use of
private physicians.
In Canada, the story is much the same, except
the private practitioners the Canadians use are in the United States. Thousands of Canadian citizens routinely cross
the U.S. border for bypass surgery, angioplasty or joint replacement, even
cancer surgery, etc. Why? Because there is often an interminable wait for care
in their own country, generally many months, even
years. It’s not unusual for Canadian
patients to become irrevocably ill or die while they are waiting.
All state-run health care systems have one
thing in common: rationing. The rationing
of resources that is. The reason is a
devilishly simple principle found in all nationalized programs: They are free,
or so low cost that it’s almost free, along with the proven economic fact that
demand increases as prices are reduced.
Give something away that people want and soon you can “sell” everything
you have and more. The flip side of
unlimited demand is shortages, and not having enough doctors, nurses,
technicians, facilities or equipment ultimately leads to rationing.
That’s been the problem with socialized medicine
everywhere it has been implemented: in England, Canada, Japan, Germany and the
former Soviet Union, to name just some of the countries where it has been
adopted. People from all over the world,
including those nations that have nationalized health care, come to the U.S.
for treatment when they have major illnesses, such as severe heart trouble or
cancer.
Most Americans don’t realize that socialized
medicine is already being adopted in this country. How can that be, you may wonder? If that’s true, it’s the first you’ve heard
of it. We certainly don’t have
socialized medicine in America!
Perhaps not yet, but we’ve been on a
slippery slope headed in that direction for quite a while. Socialized health care programs control costs
by fiat, and we already have that with our Medicare and Medicaid programs.
Price controls have never worked,
ever, in any society at any time in history.
They were tried as early as 301 A.D. by a Roman emperor, Diocletian
(243-316 A.D.), who enforced them with the death penalty. But, it didn’t work then and it hasn’t worked
since. Price controls always create
shortages, increase costs and disrupt markets.
Look at what happened after 1984, when
the government changed its method of reimbursing hospitals for inpatient care
of Medicare patients; from cost plus to a complex system of classifying
illnesses and assigning comparative values and specific payments to each,
called Diagnostic Related Groups (DRG). Since
DRGs are not based on costs, many hospitals started losing money at that
point. A few years ago, the system was
extended to include physicians’ fees, so the government now decides how much
they will pay for the full spectrum of seniors’ health care, regardless of the
actual cost.
As
a result, Medicare payments have failed to keep up with increases in medical
practice costs
It is an unfair and unsustainable
system for paying physicians, whose compensation was cut 5.4 percent in 2002. Additional cuts were averted in the years 2003
through 2005, but only after Congress and the Administration intervened with
temporary fixes.
Medicare and Medicaid payments are
determined solely by the government, and annual cost of living increases for
hospital fees have generally been capped at between 1-1/2 percent and 2-1/2
percent, in spite of the fact that the cost of doing business in the health
care industry has been rising for years at an annual rate of from 6 percent to
14 percent.
Around 70 percent of many hospitals’
patients are seniors, whose bills are paid by Medicare, and the government
determines, in its sole discretion, the prices that can be charged for inpatient
hospital care, then pays only 80 percent of those amounts. The differences between a hospital’s standard
fees for service and the amounts that Medicare pays must be written off. They cannot be collected from the
patient. No matter how you look at it or
what you call it, that’s “price control”.
If you think Medicare and Medicaid
have been breaking the bank, just wait until universal health care is adopted. We need only to look at the recently
established Medicare prescription drug plan (Part D) to get an idea of how much
these programs cost.
So,
if a universal (read nationalized) health care plan is not the answer, what is?
For one thing, I believe competition
should be restored to the system, which means less regulation. Proponents of universal health care argue,
among other things, that government programs have far less overhead and no
profit, but they fail to note that government control simply shifts expenses to
the providers. It’s still there, but
price controls make it possible to ignore the costs.
Like the proverbial frog being cooked
in a pot of cold water, Americans are gradually becoming aware that the quality
of their health care is declining, even as costs continue to go up. It just hasn’t sunk in yet. When it does, they will undoubtedly be led to
believe government has the answers and demand more control, regulation and
oversight. And, our politicians will be
only too willing to oblige. When that
happens, don’t be surprised at the type or quality of the health care we end up
with over time.
Whatever
your own conclusions, remember one thing: our politicians and government
bureaucrats won’t have to rely on whatever health care plan they establish for
everyone else. As usual, they will have
their own, superior plan. And, it will
not be a part of the nationalized health care system that the rest of us will
be required to use. If you doubt that
assertion, just look at the health care plan that our Federal legislators and
government employees have now.