Proponents of an American, national health-care, single-payer program never fail to tell us that all the other industrialized nations in the world have universal health care funded by their national governments. The implication is that the United States is somehow derelict for not providing tax-supported, government-run health care paid for by "somebody else."
First, there is no "someone else."
Second, I personally fail to understand why the proponents of national health care would want to be so inhumane as to force American citizens into a bureaucratic, governmental nightmare. Most of us know governmental involvement makes health care harder to get and increases costs. Even in the unlikely event that government promises to pay for everything, there is no guarantee that such a system would pay enough to motivate others to provide the expertise and equipment required to treat a particular patient. As the Oregon Health Services Commission snippily told Medicaid clients who complained about their inability to find a doctor, "Having coverage does not always guarantee access."
For example, most of the millions of "uninsured" Americans are eligible for some kind of health plan! Here in the North Bay, I count 12 health-care options, half of which are funded or subsidized by taxpayer dollars.
Most low-income citizens are eligible for Medi-Cal or Medicaid but have not applied for many reasons. Others counted as "uninsured" are actually healthy, affluent young adults who self-insure, and some are temporarily uninsured because they are waiting to become eligible in a new job. And, of course, undocumented aliens are often not insured but can access America’s superb health-care system simply by walking into any hospital emergency room. Expanding a tax-supported health- care system that already exists for many uninsured people is a poor solution to the problem.
The largest, single-payer systems in the United States Medicare and Medi-Cal/Medicaid have sabotaged private health care by systematically over-promising, over-regulating and underpaying. More and more health-care providers simply refuse to take Medi-Cal and Medicare patients, aggravating patient problems and making care for the poor and elderly even harder to get.
Single-payer health care makes access difficult because government focuses more on budgets than on patients. In a profit-oriented health system, patients can influence services by changing their spending patterns. And since only about 4% of citizens in industrialized countries are seriously ill at any given time, politicians in search of votes are loath to spend huge sums on such a small segment of the voter population. Instead they buy voters by funding relatively inessential health programs to coddle the larger numbers.
If experience in America with our Medicare, Medicaid and veteran’s health care is not enough, the horror stories of medical hell from other industrialized nations abound. In Britain the government system provides transportation to and from its filthy hospitals and hellish emergency rooms, where patients languish in agony, fear and pain for days, awaiting medical help. Since treating sick people is more expensive than letting them die, single-payer systems also discriminate against the very people who need help the mostÑthe elderly and the powerless. I call it "covert euthanasia"—the hidden practice of killing the helpless.
Covert euthanasia is very efficient and does not affect national statistics on medical effectiveness. It saves tax dollars since 90% of a human’s medical expenses occur in the last year of life. Many elderly have no ability to object or no advocates who might complain. They are no longer productive to society, and premature death shortens their lives only a few months. Euthanasia is the perfect bureaucratic solution. In an article that ran in the Denver Post last year, Linda Gorman called single-payer health care Òthe road to medical hellÓ and detailed the particularly grim results that come from combining government-run health care with legalized euthanasia, as is the case in the Netherlands.
The poor performance of single-payer systems can be seen in cancer mortality ratiosÑthe death rate divided by the incidence of disease. For breast cancer, the U. S. mortality ratio is 25%. In Canada and Australia, it is 28%; in Germany, 31%; in France, 35%; and in New Zealand and the United Kingdom, 46%. The ratios are even worse for prostate cancer.
Last year, my wife Bergen and I spent a month in South America, visiting Brazil, Uruguay, Argentina, Chile, and the British Falkland Islands. It was quite a vacation and a wonderful learning experience on a number of levels.
One of the things that I learned over and over as I talked with more than two dozen middle- and lower-class citizens of these ten cities in seven countries is that their governments’ practice of health care stinks. What is the common reaction of these ordinary people across the entire continent of South America? Translated and paraphrased, all about the same direct and to the point: "I guess the system is OK for the poor people who could not afford health care otherwise, but my family and I would never use it. It is everyone’s last choice because it is inadequate, incompetent, rationed and it takes too long to get it."
No matter what the income level of the citizens I talked toÑtaxi drivers, shop clerks, entertainers, business owners, bus drivers, gauchos, waitresses, butchers, police, attorneys, cooks, gravediggers and one jockeyÑthey all considered themselves middle class even though their monthly incomes ranged from a low of $800 up to $8,000 in U.S. dollars. None of them thought themselves so mired in poverty that they had to use the government system. They took personal pride in their ability to pay for their health care and prescriptions themselves, either with cash or through private health insurance.
Incidentally, I had similar responses in my travels to Italy, Greece, France, Turkey, Great Britain and Spain over the past decade. These European countries all have government-operated, single-payer health-care systems. The people who can afford private health care in the U. S. or in their own country seldom use the government system. Those who cannot afford private health care struggle hard so their families will not have to suffer government medicine.
There are many reasons for the crisis in our system of health care. The largest reasons are unhealthy lifestyles, government intervention, and the rapid growth of medical science and pharmacology. A single-payer system fails to address any of these issues. Fifty years of experience around the world shows us that single-payer systems are not the answer. They produce lousy health care at exorbitant costs, both financial and human.
Jim Johnson is chairman & CEO of Heritage Financial Services, Benefits and Insurance Inc. in Santa Rosa and president of the North Coast Association of Health Underwriters.
