It is unfortunate that the so-called debate over health care reform has degenerated into the usual political mess. It does not help that many advocates of reform essentially default to a position in favor of total government takeover, just as it is counterproductive for opponents to call all reformers closet communists. The fact is, U.S. health care is a very inefficient blend of both private and public parts, with counterproductive and over-controlling regulations driving up the cost at least as much as any so-called laissez-faire greed. Truth be told, it is the huge amount of government intervention that drives much of that cost increase.
The truth is being told about health care by the head of a think tank, the Pacific Research Institute, who emigrated to the U.S. from Canada, the home of many American reformers’ model health care system. Her book, The Top Ten Myths of American Health Care, should be required reading for the entire U.S. Congress. It would help if newspaper editors would read it, too. Ms. Pipes ably deflates the most extreme cases for public (meaning bureaucratic) control of health care.
The Myths
In no particular order, here are the top ten myths than Ms. Pipes identifies as working against any clear understanding of the issues:
1. Preventive medicine saves money – Ms. Pipes shows clearly that prevention programs simply do not save money. However, government is already beginning its drive to intimately regulate people’s behavior in the name of health care reform. This is the height of the nanny-state syndrome.
2. Government health care is efficient – If government health care programs are more efficient elsewhere, why do tens of thousands of people from all over the world visit the U.S. for medical treatment annually? It is because they want advanced, high-tech procedures that are not available, or are strictly rationed, at home. In addition, even U.S. government studies show that Medicare wastes up to $1 of each $3 spent. That is not efficient by any stretch of the imagination.
3. Importing drugs will reduce health care costs – When you import drugs from a government-controlled health care system you are actually importing price controls, not drugs. The drugs that are cheaper overseas are a limited category of brand-name medicines that are price-controlled by government. As we learned in #2, above, dishonest comparisons are rampant in this debate.
4. Some 47 million people have no health care – This statistic is bogus as it conflates health care with health insurance. It turns out that the vast majority of uninsured Americans are (a) high- or middle-income earners choosing for various reasons to go without, (b) non-citizens or (c) people that qualify for government programs. Of course there are hardship cases, but the actual number of what are called chronically uninsured people is closer to eight million, one-sixth of the much-ballyhooed number.
5. High prescription drug costs push up total expenditures – Increases in drug costs trail those of medical treatment in general. On the whole, these so-called expensive drugs drive costs down by offering effective alternatives to more expensive options like surgery or hospitalization.
6. Americans spend too much money on health care – You cannot measure costs without considering benefits. Recent studies show that Canada’s much-touted lower prices for prescription drugs are more than offset by the fact that Canadians spend double or triple what Americans do on generics. Comparing apples to apples helps in these analyses. Also, huge numbers of people benefit from the so-called expensive care, sophisticated treatment that is not even available elsewhere (and may not be available in the U.S. for long).
7. Computers and IT will dramatically reduce health care costs – Ms. Pipes would remind her readers that there are a dozen different federal agencies that share oversight of health care technology. They already produce miles of red tape and libraries full of conflicting procedures.
8. Forcing people to buy insurance will work – In her book, Ms. Pipes recites the horrendous record of American states that have taken this approach, finding that reform advocates are not honest about such required sacrifices as higher taxes, coerced premium payments, waiting lists, one-size-fits-all policies, rationing of care and strictly controlled access to leading-edge medicine.
9. Major new spending is needed for the poor – Another popular myth is that new government spending is needed to help the poor but numerous existing programs already cover truly poor Americans. Procedural flaws and low payments discourage doctors from taking on Medicaid and Medicare patients. Again, apples and oranges.
10. Other nations’ government care is better than America’s private care – Nationalized systems produce waiting lists, not timely treatments, and no study show any advantage in medical outcomes in Britain, Canada or anywhere else. Government care means rationing, with limited access to new procedures and experimental drugs. People endure devastating pain, suffer from treatable conditions and die while waiting for bureaucratic health care systems to get to their name on a long, long list.
There is no question there are improvements to be made, to any human system, but the notion that a government takeover of health care (by the people who brought us the failed War on Poverty, War on Drugs and wars in Iraq and Afghanistan) is the answer is not just erroneous, but dangerously so. America’s insurance companies, health care providers and pharmaceutical firms, in a market environment free of coercion and political maneuvering, can contribute great expertise to the reform of an already good, but imperfect, American system. Do not believe the bogus promises of politicians. We know how those always turn out.
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