While physicists assure us that a perpetual motion mechanism cannot exist, they clearly have never met the proponents of single-payer government health care. Contrary to all empirical evidence and good sense, the proponents of herd health keep coming.
Sally Pipes does a good job of detailing the joys of the British National Health System, another of the bad ideas rapidly sinking the Sceptred Isle that should scream warnings to their trans-Atlantic cousins.
Now typical of the NHS:
- 12 hour ER waits.
- Cancer treatments delayed for over 2 months.
- 4.3 million on waiting lists for surgery (“Adjusting for population, that would be like having everyone in the state of Florida on waiting lists.” I live in Florida, and when I need it, I don’t want to wait.)
- “In Scotland, fewer than 80 percent of patients receive needed diagnostic tests — endoscopies, MRIs, CT, scans and the like — within three months.”
- “…almost 30,00o died in the past year while waiting for treatment — an increase of 57 percent compared to 2013.”
The U.K. has severe – and worsening – shortages of physicians and nurses. Their post-op survival rates are significantly worse than in the U.S. Despite funding increases well in excess of inflation, advocates continue to blame a lack of adequate funding. Pipes reiterates a point I have tried to make for many years: the salient feature of government care is unrestrained demand. This invariably, rapidly leads to over-utilization, cost overruns, price inflation, budget shortfalls, attempts at cutbacks, rationing, reduced payments, scarcity, and finally loss of access and the disappearance of services. We have already seen this in Medicare, Medicaid, and in the VA.
- And so the never-ending proponents for single-payer care keep coming, and what are their arguments?
- “It will be more efficient.” While Big Insurance is currently no model of efficiency, it at least has the potential for competition, if we would quit empowering government to prop it up in crony corporatist arrangements. Any system that has already devised nine different ICD-10 codes for turtle-related injuries cannot be a demonstration of preferable efficiency. Any all-powerful bureaucracy that can mandate massive private business expenditures in unproven, unwanted IT systems is by definition, inefficient.
- “It will be cheaper.” New York’s Ocasio-Cortez, congressional candidate and the human embodiment of the word “blithering” favors such a system that by her own statements would cost a new $32 trillion. Cut that figure in half, and it is still hilarious.
- “It will be higher quality.” As has been amply demonstrated on this blog, there is no objective, reproducible definition of “quality.” Quality measurements are arbitrarily conjured and disseminated by third-party payers on pain of financial loss, and the only value they have ever demonstrated is the utility with which they are used to deny payment for work already done. To paraphrase John D. MacDonald, when the man says “quality,” you can already see him reaching into his pocket for three walnut shells and a rubber pea.
- “Most of the industrialized world already has it.” At one point most of the industrialized world had markedly higher syphilis rates, too. The economic impact on Britain has been a negative one, and likewise in Canada. I have read some cogent commentaries defending the German system, but it still brings restrictions more demanding U.S. voters (and their lawyers) are unlikely to suffer. At best, the worldwide jury is still out, and the argument is not conclusive. The herd is not always the safest place.
- “It makes economic sense.” Sure, and that’s why nations with single-payer care have GDP growth rates so much higher, and unemployment rates so much lower, than ours. Check out the comparative tax rates, and get back to me. Nothing about a single-payer system will make our economy more robust or give us a leg up on our competitors.
- It will be more “fair.” The moral club underlies the majority of the do-gooder arguments for single-payer. Their assertions are that everyone has a right to basic care, and that providing such is a moral imperative. The insinuation is that everyone will have the same level of care and same access to MRI’s, advanced transplant surgery, cosmetic plastics, and cutting edge chemo, which is of course nonsense. The connected will have better access, and better care. The wealthy will go and buy it, somewhere. The hoi polloi will have free amoxicillin and flu shots, and plenty of highly controlled opioids to control the metastatic pain. Health care will be as fair as the housing spectrum back in the USSR, where the best leaders got a dacha, but everyone had some sort of shelter. If you want to see a do-gooder writhe on a stick, ask them to define the term “fairness.”
None of this is any defense of our thoroughly corrupt Big Insurance industry. But it was made worse by the influence of government health care, and still worse by the sleazy giveaways at the core of the ACA. Will even MORE government fix these problems?
Not even a little bit.