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Sat 28 Jul, 2007 04:45 pm
Government vs. private medicine
July 27, 2007
Walter E. Williams - Sometimes the advocates of socialized medicine claim that health care is too important to be left to the market. That's why some politicians are calling for us to adopt health-care systems such as those in Canada, the United Kingdom and other European nations. But the suggestion we would be better served with more government control doesn't even pass a simple smell test.
Do we want the government employees who run the troubled Walter Reed Army Medical Center to be in charge of our entire health-care system? Or, would you like the people who deliver our mail to also deliver health-care services? How would you like the people who run the motor vehicles department, the government education system, foreign intelligence and other government agencies to also run our health-care system? After all, they are not motivated by the quest for profits, and that might mean they're truly wonderful, selfless, caring people.
As for me, I would choose profit-driven people to provide my health-care services, people with motives like those who deliver goods to my supermarket, deliver my overnight mail, produce my computer and software programs, assemble my car and produce a host of other goods and services I use.
There's absolutely no mystery why our greatest complaints are in the arena of government-delivered services and the fewest in market-delivered services. In the market, there are the ruthless forces of profit, loss and bankruptcy that make producers accountable to us. In the arena of government-delivered services, there's no such accountability. For example, government schools can go for decades delivering low-quality services, and what's the result? The people who manage it earn higher pay. It's nearly impossible to fire the incompetents. And, taxpayers, who support the service, are given higher tax bills.
Our health-care system is hampered by government intervention, and the solution is not more government intervention but less. The tax treatment of health insurance, where premiums are deducted from employees' pretax income, explains why so many of us rely on our employers to select and pay for health insurance. Since there is a third-party payer, we have little incentive to shop around and wisely use health services.
There are "guaranteed issue" laws that require insurance companies to sell health insurance to any person seeking it. So why not wait until you're sick before purchasing insurance? Guaranteed issue laws make about as much sense as if you left your house uninsured until you had a fire and then purchased insurance to cover the damage.
Guaranteed issue laws raise insurance premiums for all. Then there are government price controls, such as the Medicaid reimbursement schemes. As a result, an increasing number of doctors are unwilling to treat Medicaid patients.
Before we buy into single-payer health care systems like Canada's and the United Kingdom's, we might want to do a bit of research. The Vancouver, British Columbia, Fraser Institute annually publishes "Waiting Your Turn." Its 2006 edition gives waiting times, by treatments, from a person's referral by a general practitioner to treatment by a specialist. The shortest waiting time was for oncology (4.9 weeks). The longest was for orthopedic surgery (40.3 weeks), followed by plastic surgery (35.4 weeks) and neurosurgery (31.7 weeks).
As reported in the June 28 National Center for Policy Analysis' "Daily Policy Digest," Britain's Department of Health recently acknowledged 1 in 8 patients waits more than a year for surgery. France's failed health-care system resulted in the deaths of 13,000 people, mostly of dehydration, during the heat spell of 2003. Hospitals stopped answering the phones, and ambulance attendants told people to fend for themselves.
I don't think most Americans would like more socialized medicine in our country. By the way, I have absolutely no problem with people wanting socialism. My problem is when they want to drag me into it.
Walter E. Williams is a nationally syndicated columnist and is an economics professor at George Mason University.
Washington Times
First a comment... you are writing far too many threads on exactly the same topic. Every one knows my pet political issue, yet you will see the restraint I show in starting new threads on this issue. Just a comment.
I will respond on this one because it has at a core a clear untruth-- that government run services are failures.
Our education system for all of its critics-- has led unquestionably to the strongest economy in the world. Public education has, since its inception, been incredibly effective at creating an American workforce with skills to be both productive as workers and innovative as leaders.
You can't argue with clear success.
Other successful government programs include medical research, a development program that led to the internet (including a great government funded browser that got the whole thing going), space exploration (including moon landing and Martian robots that still haven't quit) and a post office that delivers mail reliably and cheaply with no cost to taxpayers.
The idea that profit driven companies will be compelled to put customers needs first is laughable. The profit model has brought us tobacco companies responsible for the deaths of their customers, McDonalds Big Macs selling obesity to kids and Ford Pintos blowing up for a clear profit.
There are two problems with greed based healthcare. First of all... it is a captive market since everyone needs healthcare. Companies interested in profits want to give as little care at the highest price.
Worse insurance companies have found out long ago that it is cheaper to pay marketers (to trick consumers into paying full price for less than full coverage) and lawyers (to protect their asses when consumers get upset about this) than to pay doctors.
Greed is a fine way to get companies to provide services we can do without.
Greedy insurance companies are very dangerous indeed since it is far too easy for them to trap the people who depend on them (especially when people have nowhere to go but greedy, unregulated insurance companies).
When it comes to something as important as healthcare... I would prefer the public mechanism that brought me the Internet and kept brave little rovers on Mars for over year to the private mechanisms that brought me the Ford Pinto.
I would also add (as has been pointed out many times) there are objective measures of the sucess of a health care system-- particularly infant mortality rates, life expectancies and disease outcomes.
It is easy to show that countries like Canada have very good results on objective measures at a much lower cost per person covered.
ebrown_p wrote:greed based healthcare
Hey! What a nice, descriptive term, ebrown! I like that.....
ebrown_p wrote:I would also add (as has been pointed out many times) there are objective measures of the sucess of a health care system-- particularly infant mortality rates, life expectancies and disease outcomes.
It is easy to show that countries like Canada have very good results on objective measures at a much lower cost per person covered.
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The shortest waiting time was for oncology (4.9 weeks). The longest was for orthopedic surgery (40.3 weeks), followed by plastic surgery (35.4 weeks) and neurosurgery (31.7 weeks).
And...some of the wait times in Canadian ERs are as long as 5 days. Pack a couple of bags of food before your next visit to an ER, should you live in Canada.
ebrown_p wrote:
It is easy to show that countries like Canada have very good results on objective measures at a much lower cost per person covered.
One often-heard argument, voiced by the New York Times' Paul Krugman and others, is that America lags behind other countries in crude health outcomes. But such outcomes reflect a mosaic of factors, such as diet, lifestyle, drug use and cultural values. It pains me as a doctor to say this, but health care is just one factor in health.
IBDeditorial.com
Nothing like a 5 day visit to a Canadian ER, now is there E-Brown?
old europe wrote:ebrown_p wrote:greed based healthcare
Hey! What a nice, descriptive term, ebrown! I like that.....
Where's the "greed"? :wink:
Where's that 5 days in the ER? I've never heard of such a thing happening
No kidding, me either!! I think we're being maligned, Montana! Bunch'a hosers!
What a surprise: a new thread with new unsourced rumours by Miller.
Walter Hinteler wrote:What a surprise: a new thread with new unsourced rumours by Miller.
Walter E. Williams is a nationally syndicated columnist and is an economics professor at George Mason University.
Washington Times
Quote:Its 2006 edition gives waiting times, by treatments, from a person's referral by a general practitioner to treatment by a specialist. The shortest waiting time was for oncology (4.9 weeks).
Really?
For my husband, it was 3 days from GP to urologist, and less than an hour from urologist to oncologist.
Your link above worked (for me at least), Miller.
So these personal remarks by that person are disqualifying the study, you mean?
So, my real life experiences don't count?
I don't have a lot of ER experience -- been in one maybe 4 times. The first time was supporting a co-worker who thought he was having a heart attack. I told the triage nurse "heart" and they had him in treatment before I started the admitting paperwork. The next 3 times were for my husband -- one horrible time of 10 hours (the day after Christmas, and a flu epidemic, ER was swamped), the next time was maybe one hour of wait time, and the final time was no wait time at all (arrival by ambulance).
I'm not saying that there isn't problems, but these reports that are posted here show a completely different picture than my own experiences, or those of other Canadians that I've talked to.
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