My mom sent me an email copy of an interesting commentary piece by a person whose name I recognized: Dr. David Gratzer. He's a Canadian doctor, practicing in both the U.S. and Canada, and a crusader for capitalist (e.g., for-profit) medicine. Here's a quote from this latest piece, which appeared in Investor's Business Daily:Dr. Gratzer is particularly good at rebutting the arguments of liberals who cite the “evils” of American medicine (think Michael Moore and Sicko). For example:Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care.
I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic — with a three-year wait list; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks.
Government researchers now note that more than 1.5 million Ontarians (or 12% of that province's population) can't find family physicians. Health officials in one Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment.
These problems are not unique to Canada — they characterize all government-run health care systems.
If you have even the slightest inclination to support socialized medicine, or any legislation that reduces the independence or profitability of American medicine, please … read the whole thing. Another relevant commentary piece (in the Wall Street Journal) is here, an index of Dr. Gratzer's essays here, and his books here.Americans live 75.3 years on average, fewer than Canadians (77.3) or the French (76.6) or the citizens of any Western European nation save Portugal. Health care influences life expectancy, of course. But a life can end because of a murder, a fall or a car accident. Such factors aren't academic — homicide rates in the U.S. are much higher than in other countries.
In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don't die in car crashes or homicides outlive people in any other Western country.
And if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50%; the European rate is just 35%. Esophageal carcinoma: 12% in the U.S., 6% in Europe. The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England — a striking variation.
In my travels I have had the opportunity to meet and get to know quite a few people who live in countries with socialized medicine – especially in England, Germany, Estonia, and Russia. In each of these countries, I have posed a similar question to several people: “Suppose your spouse or child had a life-threatening cancer. Suppose that you were independently wealthy and could afford to have your loved one cared for anywhere in the world. Where would you take him or her for treatment?” Every single person I have asked this question of instantly said “America”.
Why is this so obvious to the people who live under socialized medicine? Most of the people I talked with had never even been to America – and yet they are absolutely certain our medical system delivers superior care. When I probed this, the typical answers were variants of “our system is so bad that America's must be better” and “America is where all the rich people go, and they'd know better than I”, with a few “I have friends or relatives who have moved to America, and they tell me the medical system is wonderful there”.
But our liberals tell us – against all evidence that I'm aware of (not to mention common sense!) – that socialized medicine is superior.
My mom's reaction to this editorial was to suspect it was exaggerated, but generally on target. I'm glad her instincts are to suspect the evils of socialist medicine. But I cannot for the life of me understand why so many Americans (including my mom) have so much trouble believing just how bad socialized medicine really is. For me, the essential problems are obvious: (1) any system in which a desirable good or service is “free” will inevitably lead to shortages and rationing, and (2) any system that does not provide financial incentives for success and excellence will decay into shoddiness. Our public education system suffers from these two problems. Socialized medicine, everywhere I've ever been, suffers from them as well. Examples of drug rationing, surgery backlogs (a form of rationing), and diagnostics rationing abound. Doctors – especially the good ones – flee from those countries to America, where they can make good money. Why is this so hard for so many Americans to absorb? I cannot fathom it.
Hello brother dear,
ReplyDeletejust a short comment.
I'm not necessarily for or against socialist medicine. I am, however, most adamantly in favor of an improved system which strives for equitable treatment for all -- NOT just for those who are 'independently wealthy.' I am an admitted idealist --
I remain convinced that with collaborative effort and determination, an IMPROVED system is indisputably needed and feasible, and I applaud the efforts of those willing to face the wrath of the independently wealthy to make it happen.
Holly
Greetings, oh sisterly one...
ReplyDeleteDo you really think that only the "independently wealthy" in America have access to good health care today? My own observation is that only those in the lowest income ranges -- far below average incomes -- have poor access to health care here. Statistics back me up on this: if you count everyone with major medical insurance (or better), those who choose to self-insure (this includes a considerable swath of the self-employed) and those on government insurance programs (at both the state and federal level), only about 10% to 15% of Americans (depending on whose numbers you want to believe) have no access to health care today. That's not a huge number. It's higher in a few states where illegal aliens are present in large numbers (California, Arizona, New Mexico, Texas, and, interestingly, Tennessee).
However, I'm in agreement with you that our health care system needs to be improved. I wouldn't agree with the implication of your comment, though: that it is badly broken today.
The kind of improvements I favor include the following:
-- the elimination of tax-favored status for health care costs to companies.
-- an across-the-board, unlimited, uncapped tax deduction for personal purchases of health care insurance (including long-term care).
-- a legislative mandate for health insurance companies to pool all actuarially similar persons together, and to mandate unified products across that pool. In other words, to force an end to the artificial pricing differences that are so common today.
The above changes would have many impacts, the most important of which all devolve from the introduction of national competition into an industry that is today artificially split up (by government mandates!) into hundreds of separate markets -- reducing competition and increasing prices. One direct, very predictable result of the above changes will be insurance products that are illegal today, but which make a great deal of sense to most people: products that cover the major risks (e.g., cancer, long-term or chronic illnesses, etc.) while letting the insured person control their expenditures on more routine visits and tests. In areas where this approach has been tried, the total reduction in health care expense has been between 30% and 45%, with no measurable dimunition of the quality of the health care delivered.
Then, in addition to the largely regulatory changes above, I'd like to see federal subsidies for those people who truly can't afford even the more competitive insurance products. There are several approaches to such subsidies that I would support; my main concern is that they be limited to those who truly need them, and not go to society's leeches. The leeches can rot in their own personal hell, so far as I'm concerned.
BTW, I know quite a few independently wealthy people. I don't know a single one of them who would oppose effective reform of our health care system. But I also don't know a single one of them who thinks it's a good idea to throw money at anything that even resembles our current system, or (most especially!) any one of them who believes that increased government participation could possibly help. I suspect this is for different reasons than you might perceive opposition to reform: wealthy people tend to be well-traveled, and to know people in other countries. That's particularly true for European countries where socialized medicine, in many forms, has been the norm since before WWII. They are, of all Americans, the best informed about socialized medicine's actual performance.
And they oppose it, overwhelmingly.
Think about that, while you contemplate what "improvements" might actually do some good...