Universal Health-Care: Greater Equality or Less Freedom?

Among the top-tier Democratic presidential contenders, a virtual prerequisite platform caveat is the advocacy for a universal health-care system in America. I myself have engaged in debates here in Europe about the ostensible inequities of the American system when held up to the more humane and socialized models found in Europe and Canada. To argue against a one-payment system is to face an uphill battle against an onslaught of emotional cants, coupled with saccharine personal anecdotes about close family members sans medical insurance, struggling to make ends meet. In a world where emotions and good intentions are sacrosanct, defending a privatized heath care system is becoming a more lonesome business these days.

The truth is, even before I had all the facts before me, there was something about the socialized plan that struck me as far-fetched. Of course, in a perfect world, (and there’s the catch) we shouldn’t have to pay for health care or anything, for that matter. But then, in a “perfect” world, would we even be menaced by the illnesses we now scramble to find cures for in the first place? Perfect worlds and fanciful utopias aside, we face some hard questions about the consequences of a state-run heath care policy; basic questions that perhaps come more naturally to those who have delved into the fundamentals of economic inquiry.

If the government is to provide free health care, where will the money come from to pay for all the costs? Medical research and treatments rank among the most costly fields out there. Tie this in with America’s three hundred million-plus population, and the price tag starts to get dizzyingly high. Further, what about competition’s indispensable role in the market as a refiner of quality and catalyst for innovation? If profits and salaries are to be set artificially by the state, might not doctors and researchers feel less motivation to work as hard? How will these MDs, who have invested mightily in terms of money, time and other opportunity costs to become doctors, react to state- regulations governing their practice? My reckonings on the one-payment health-care plan have brought me to focus on two chief criticisms: First, socialized health care treats doctors unfairly and second, in an ironic sense, it is perhaps even more cruel to those it is designed to benefit; namely, the ill.

To be sure, most Americans who advocate a one-payment system sincerely believe that this is the best path to follow. It is a sad reality that there are many, some aver up to 47 million, in America without medical insurance. And full candor requires the admission that a privatized system is not a perfect one. The quest, however, for the perfect system and best system, in light of hard facts and in a world of contingencies, are two very different objectives.

Years back, I studied under a great professor of political science who took delight in bursting the bubbles of well intentioned, know-it-all-type students who advocated such statist projects as the universal heath care plan. “Politics, and politicians, are about one word:” he would thunder, “POWER.” To emphasis the word, he would always say it with a little gravitas, using his fingers as quotation marks. Of course, one must be careful not to over-generalize, but the more I listen to certain politicians (on the left and even on the right) these days, Lord Acton’s adage that “power corrupts and absolute power corrupts absolutely” becomes all the more attractive.

Returning then, to the health-care debate: I am convinced that, from perspective of politicians, the dubious heath-care scheme is more about amassing power and expanding control over the lives of citizens than their professed desire to provide quality health-care to the less fortunate. Americans shouldn’t be distracted by the pandering and pietistic jargon of politicians. A sensible look into the fruits of European and Canadian health-care policies should prove convincingly that state-run heath care programs are counterproductive and in fact most detrimental to those in need. Americans should see through the rosy euphemisms propped up by politicians to defend this policy. Plans to introduce such fallacious systems in the United States should be strongly resisted.

A fascinating study by the Karolinska Institute in Sweden, recently reported by the UK’s Telegraph, looked at the rate at which 64 new cancer-fighting drugs were introduced in Australia, Canada, Japan, New Zealand, South Africa, 19 European countries and the United States. The title of the article ever so delicately hints to the study’s findings: “Cancer Survival Rates Worst in Western Europe.”

The study reports the following:

“The proportion of female cancer patients surviving five years beyond diagnosis in France, Spain, Germany, Italy were 71 per cent, 64 per cent, 63 per cent, and 63 per cent respectively. In the UK, it was 53 per cent.” The news get even more grim for the indisposed of the UK, as only four out of 10 there “have access to new treatments provided since 1985.”

Dr. Nils Wilking, an oncologist at the Karolinska Institute observed, “Where you live can determine whether you receive the best available treatment or not…In the US we have found that the survival of cancer patients is significantly related to the introduction of new oncology drugs.”

Then comes the devastating clincher:

“The proportion of colorectal cancer patients with access to the drug Avastin was 10 times higher in the US than it was in Europe, with the UK having a lower uptake than the European average.”

The medical field in the US is already heavily regulated, but in spite of that, the study demonstrates that the American health-care system still far outpaces the hamstringed, socialized health-care systems of Europe and the rest of the world. After reflecting on the Karolinska Institute’s findings, one should ask: “If I or a loved one were struck by cancer, where would I rather be to ensure the quickest access to the most effective treatments?”

Similar studies of the health care system in Canada have mirrored the findings of the Karolinska Institute. The Vancouver, British Columbia-based Fraser Institute releases a yearly publication, aptly titled, "Waiting Your Turn." As the title suggests, the report takes a look at the length of the waiting period for patients; that is, the time between a general practitioner’s referral to a specialist and the patient’s actual meeting with the specialist for treatment. The results speak for themselves: The waiting period ranges from 4.9 weeks for oncology to 31.7 weeks for neurosurgery. Understandably, Canadians afflicted with illness are a little uneasy with the idea of waiting weeks or months for lifesaving medical care, resulting from backlogged hospitals, clinics and treatment centers. When health-care is free, i.e. socialized, doctor’s offices and hospitals are inundated by “patients” who are hot to the idea of a free check-up. As a result the privilege is abused, as people head to the doctor for any minor cough, sniffle or hangnail. As a result, those who really need serious medical attention are forced to “wait their turn.” To accommodate the burgeoning caseload, doctors are then forced to allot a fixed, artificial set of minutes per patient, regardless of the degree or severity of the illness. Back in 2000, the Canadian Medical Association Journal published an article entitled, "U.S. Hospitals Use Waiting-List Woes to Woo Canadians.” Here’s an excerpt from the article: "British Columbia patients fed up with sojourns on waiting lists as they await tests or treatment are being wooed by a hospital in Washington state that has begun offering package deals. A second U.S. hospital is also considering marketing its services." The article goes on the juxtapose the waiting period for an MRI in Canada (10 to 28 weeks) with the waiting period for the same scan at the Olympic Memorial Hospital in Washington State, (2 days). And surprise of surprises, Cleveland, Ohio has emerged as the most popular destination for Canadians in need of hip replacement surgery.

The Karolinska and Canadian studies place essential rules of the market under the spotlight; rules often overlooked or ignored by the disciples of socialized heath care:

- The first deals with quality: Goods circulated in an open economy will be challenged continuously by the drive of the competitor next door to develop a better product. Higher quality is a direct consequence of free competition. This key element is absent in nations with socialized health-care.

- The second rule deals with prices and costs: When governments apply price controls and ignore the laws of supply and demand, shortages necessarily result, due to a demand that outpaces the available supply. And, as a consequence of the decrease in supply, both prices and cost will surge. It is important not to confuse cost with price. Economist Walter Williams explains: “The cost of having or doing something is what had to be sacrificed.” In other words, the shortages that will naturally result from price controls will cause people to “pay” in other ways. To explain the meaning of cost, Williams uses the example of reading a newspaper that has been given to you for free: Sure, you didn’t pay for the journal, but you sacrificed time and the opportunity to do other things in return for reading the paper; hence the cost. As the Karolinska study demonstrates, the cost to the patient for waiting to receive life-saving, albeit free, treatment can be deadly. Further, in a state-run health care system, those who pay for the program are the taxpayers. The ever-increasing price of health care will result in swelling taxes to fund innovation, equipment, medicine, etc. Another salient angle of the taxpayer’s relevance to the health care issue deals with the question of “rights.” Income taxes, among others, are a confiscation of a portion of the individual’s income by the government (local and/or federal), for the purposes of the government. We’ve all become inured to the typical action-line, “People have a right to health care.” But when the state assumes the costs of health-care, the advocates of the health-care-via-tax-increase must also proclaim in the same breath that, “Someone else doesn’t have a right to the fruits of his labor.” To indulge in a cliché: Since money doesn’t grow on trees the government must take it, some might stay steal it, via heavier taxes. To say that Peter has a “right” to his X ($health care$), is to say at the same time that Paul doesn’t have a “right” to his Y (hard-earned income).

- The third rule has to do with opportunity. Innovators and researchers in medicine will naturally gravitate to environments where they foresee the opportunity for maximum profit. In the United States, we see countless drug companies racing and competing to find cures and treatments. The result is a fertile supply of medicine to the general public. The Karolinska study again seems to verify this assertion. The profit potential in the United States is very high because of the free market economy, which allows the producers of goods to “battle it out” and convince the public that its product is the best out there among others like it. The potential for enormous profits serve as a stimulus for creating a successful product. Related to this theme: Canada has witnessed an exodus of doctors who, realizing the opportunity to make a better living in the United States, have moved south of the border. Rather than receive a fixed salary from the government, these doctors prefer to give their skills a fair shake in the open market and receive the more competitive payment they believe their abilities are capable of bringing in.

The gerrymandering of certain politicians to sanction government supervision of health-care should be exposed for what it is—a power grabbing, wealth redistribution scheme, masquerading as a righteous cause. Privatized health-care benefits everyone, with the exception of the government (one less thing to control): First and foremost the patient, then, of course the doctors, the country and the economy. Local communities, churches and voluntary organizations need to do much more to band together to help those in need of medical treatment. Some churches have already taken the lead in this regard by creating a pool of donations from among the parishioners to purchase expensive prescription medicine for the elderly and less fortunate members of the parish. This is an example of real charity at work. If the federal government wants to help, they could start by massively slashing taxes so that citizens would have more of their own money to donate to such causes.