How many of us remember that when we were children and were trying to get our parents to let us do something we really wanted to do, and they were reluctant to approve, we would use the line, “But everybody’s doing it!” Of course, the standard parental retort was, “If everybody jumped off a cliff, would you?”
How do you argue with that logic?
As the controversy in the United States rumbles on about the best way to deliver and pay for health care, I hear a line similar to our childish coaxing of our parents being used by those who want to substitute our current health care “system,” if you could call it that, with single payer health care.
This is what I generally read, more or less, when someone decides that the only way out of the country’s current health care troubles is establish a single payer system:
“Most of the other industrialized countries have single payer health systems.”
To me, establishing a single payer system in the U.S. could be compared to jumping off a cliff – it is downright dangerous for many reasons, and we don’t need to do it just because all the “most of the other industrialized countries have single payer health systems.”
Before I go any further in this discussion, maybe it’s time for me to define this single payer health care phenomenon that so many people tout as the best way to deliver health care. Although I believe that most people understand this, single payer health care is administered and paid for, using various methods, by the central government in a country. In our case it would be the federal government if single payer “health care,” God forbid, were implemented on nationwide basis here. Some countries, Canada for example, have a “public health care plan” that is administered by one huge insurance bureaucracy. The funding for these “health care systems” is generally provided by taxing the populace, and that includes Canada’s plan.
A couple of states in the union have attempted and failed to implement single payer “health care.” Those states are Vermont and Colorado. Now California is attempting to establish a single payer system.
In fact, according to an article on the website called “Healthy California,” (1) the California Senate voted 23 to 14 on June 1 to pass Senate Bill 562. This bill appears to be just in the “concept” stage right now, but its basic premise is to guarantee universal health care to every Californian. Once again, I am SO GLAD I don’t live in California anymore.
Single payer health care systems have become, for the most part, a pipe dream for people who believe that everybody should have access to health care.
But does everybody have access to the health care they need in those systems?
In my last post, I already stated that British doctors have been very unhappy with the pay and the working conditions in the National Health Service, Britain’s single payer health system. According to the article I was working from, many of the doctors were ready to go on a “work stoppage.” Work stoppages would deprive people of access to care. So how is care access improved?
However, that is just one element contradicting the “access to health care” argument for single payer health care. The media in Britain and Canada regularly bemoan troubles with access in their single payer systems.
Here are just a couple of examples.
According to a 2015 article in CBC News/British Columbia, entitled “Patients’ ‘Lives Ruined’ As Hip Surgery Waits Grow” written by Kathy Tomlinson (2), the average 2013 wait times for hip replacement surgeries in British Columbia were 48 weeks. They were 54 weeks in Alberta (note: more than a year). The article portrays the stories of two women who were in excruciating pain and disabled because of the long wait that is not a necessity in the United States.
In an April 2017 editorial in the National Review entitled “The Pitfalls of Single Payer Health Care: Canada’s Cautionary Tale,” (3) author Candace Malcolm states that Canada’s situation has not improved. Actually, it appears that Canada’s situation is only getting worse.
Malcolm writes that the “government central planners” in the Canadian health care system address the issue of fund scarcity by rationing care and capping the number of procedures that are offered in a given year. Well so much for access to and quality of care in a “Medicare for All” system.
The only assertion made by Malcolm that I would argue with is the ranking of care quality for Canada as one step above the United States. The ranking was done in 2014 by the Commonwealth Fund, which appears to be very pro-Obamacare and uses metrics that many doctors view as irrelevant. The reference to this ranking is a little confusing because Malcolm goes on to say that many Canadians resort to the United States to get the care they need and that the U.S. provides a “parallel private system for very sick and very rich Canadians while acting as the driving force for global medical innovation.”
The British National Health Service doesn’t necessarily provide exemplary care either.
In one heavily publicized situation, a man who was suffering from frostbite after he fixed his son’s car in wintry conditions was told he would have to have his leg amputated below the knee. However, that surgery was called off. This man did his best to self-treat his gangrenous toes. and he visited a doctor every six weeks, but he eventually learned that he would need to have those toes amputated.
One British article in Metro about the situation was entitled “Man Cut Off Own Toe With Pliers After Being Forced to Wait for Operation.”(4)
The article reported that 57-year-old Paul Dibbins was told he would have to wait six weeks to have his toes removed even though they were gangrenous and there were clearly no other remedies. He is quoted as saying, “I did it because it’s what had to be done, my doctor told me my toes were going to kill me.”
Clearly, the British health care system did not comprehend the urgency of the situation – either that or the system had more very urgent situations than it was equipped or funded to handle adequately. So, I would argue that access to needed care was not in available in that case.
The Independent, an English publication, published an article in October of 2016 entitled, “‘Myth’ That NHS is Best Healthcare System in World ‘Must Be Debunked,’ says Conservative MP.” (5) The article was forecasting an upcoming speech by Owen Paterson, a conservative member of Parliament. Author Aine Fox wrote that Paterson was expected to speak regarding a report commissioned by UK 2020, a think tank founded by him. One of the many assertions in the report states that avoidable deaths resulting from serious diseases were more numerous, by the thousands, than many other places around the globe.
An interesting point I have observed whenever I read about demands by British citizens, doctors or leaders “to fix” the problems in the NHS is that the government is expected to take full responsibility for the remedies.
How about some enterprising, free-thinking physicians there stepping forward to suggest that the British government set some basic policies that would free people to develop a much more functional free market system? However, sadly enough, when people are stuck on a belief that the government bears responsibility for some aspect of their lives, it is hard for them to break away from that belief.
In light of all this knowledge, does the U.S. really want to get entrenched in that path? Why can’t we find another way to solve problems in U.S. health care that do exist?
Other solutions exist, and they are already active in the U.S. economy – surgical centers with low transparent pricing, Health Savings Accounts, Direct Primary Care practices that do not accept third-party payments … and others.
Sources for Further Reading: