The Case Against Government Healthcare

This is a guest post by Pete Arnold in response to an ongoing debate between him and Staffing Robot.

Pete writes:

As someone who works in healthcare, I have to respond as many of these items seem to be in line with the talking points to defend government run healthcare. The devil, however, is in the details.

Higher Satisfaction in Canada?

“However, according to the stats, the vast majority of Canadian’s are satisfied with their system of care. “

The Wikipedia article you referred to here referenced a Gallup poll from 2003. And while I do not trust polls in any case (especially when it comes to politically charged issues), if you are going to use one, I would at least ask for the most recent one. The 2006 Gallup poll (three years newer than the 2003 pool) lists quite a different story.

Broken down, the results are as follows:

“The results of three recent Gallup Polls* show that more than half of residents in the United States (53%), Canada (52%), and Britain (55%) describe their respective healthcare systems as “excellent” or “good.” “

United States

Excellent: 16%

Good: 37%

Only Fair: 33%

Poor: 14$

Canada

Excellent: 8%

Good: 44%

Only Fair: 34%

Poor: 14%

Great Britain

Excellent: 11%

Good: 44%

Only Fair: 30%

Poor: 15%

But that aside, I do not trust polls, and will get into why as I continue.

VA Care

In regard to care you have received at the V.A., to this I can only agree that those who serve our country defending our freedom, risking life and limb for the rest of us had better be receiving better care than normal.

The government said that in 1990 Medicare would cost $12 billion despite it costing $107 billion. Can you imagine what the actual cost would be if they say only $1 trillion?

Shortage of Staff and Glut of Beds and Equipment?

“Often times, private hospitals, clinics and imaging centers will establish their entities next to competing medical centers creating a shortage of staff and a glut of beds or imaging equipment such as MRIs. This equipment and these facilities are expensive.”

Yes, multiple entities do compete, giving us all a choice of where to go. As I have stated earlier, I have seen clinics in situations such as this use even the savings/ease of parking as a benefit to choosing their hospital/clinic over a competitor. I would rather have competition put in place through capitalism then the stagnation that would take place in the face of a government run “We’re Your Only Choice” facility.

As far as the “glut” of beds goes, we can use this “glut” example for not only hospital beds, but equipment and staff. Much like any businesses, if the workload does not require a full time staff, the hospital will not provide it.

A survey of hundreds of physicians rated the MRI and CT scanner as the most important medical innovations of the late 20th century.

The United States does indeed have more of these devices (or the “most important medical innovations”) then most of the world per million people.

CT

Canada: 12.0

United States: 34.0

MRI

Canada: 6.7

United States: 25.9

I am grateful that my wait time for a CT Scan or MRI is not what it is in Canada.

The data behind a “glut” of hospital beds, however, just doesn’t add up.

Hospital Beds per Per 1000 People

Canada: 3.4

United States: 3.2

Same with the shortage of staff.

Practicing Physicians, Density per 1,000 Population (head counts)

Canada: 2.18

United States: 2.43

Practicing Nurses, Density per 1,000 Population (head counts)

Canada: 9.02

United States: 10.57

We have more tools then Canada for our healthcare providers to do their jobs, more nurses and more providers, while having fewer hospital beds.

Unnecessary Facilities?

“These facilities are unnecessary in terms of needing more beds or care options in a particular area that already had a lack of demand.”

Multiple locations in one area = Choice for the consumer. In this case, that is choice of the patient.

“Situation has happened several times here in the Portland market causing situations of vacancy in the newly established medical center, as well as exacerbating those in the centers with which they’re competing.”

Competition breeds innovation.

US Medical Advancements

“There’s no question that having a privately run healthcare system in the U.S. has led to major advancements in healthcare and medicine.”

Agreed. Did you know that 84% of the Nobel prizes for medicine have gone to Americans in the last 43 years? This advancement, given to the rest of the world is here BECAUSE of the system we have.

America develops new treatments, gets them first, and yes… pays more for them.

When plasma TVs came out, many of them cost in excess of $40,000. The people who had to have them spent the money. That’s America. We are the rich guy down the block to the rest of the world. We are the wealthiest one percent on the earth, and our wealth is able to sell new technologies like this. Now, plasma TVs don’t cost $40k anymore. You can get a 42″ unit for less than $800. As much of a shame as it was that someone paid $40,000 for that same thing seven years ago, those who paid for it paved the way for newer cheaper versions that we all could afford.

Now with healthcare. There is a new high-tech medical something-or-other out that might save my life. But my insurance does not cover it (even though I am one of the 310+ million insured in the country).

Am I out of luck? Do I now go without that possibly life saving treatment?

Perhaps.

Or, like many Americans, I can do the same thing the guy with the plasma TV did. I can borrow, ask my parents, my family, my church, take out a loan, and get that new high-tech possibly life saving treatment.

The point is while it is groundbreaking, and insurance wouldn’t cover it, it is still an option for me.

The free market makes it so. The government is not even controlling our healthcare as much as they want to and they are already saying things like “maybe you’re better off not having the surgery, but taking the pain pill.”

I do not trust them to fork out the $40,000 for my plasma TV of new uncovered treatment and am grateful that we live in a place that not only pioneers advancements, but where there is always a way when one has the will.

Healthcare Costs are Simply Too High?

“The costs of healthcare are simply too high, the system is broken and we need a new solution.”

I agree to the level that costs are high and that the system is not perfect. However, government is not the solution. Freedom and competition, in my opinion and my experience in the industry, is the solution.

We should be able to pick and choose what insurance we want. We should be able to choose insurance from another state. We should be able to keep the same insurance even though we switch jobs.

Government regulation limits our choices here. And when limits in choices are made, competition falls to stagnation.

Family Income is Lower Now than Eight Years Ago

“Average family incomes are lower now than they were 8 years ago.”

Your source from this is from 2004 and talks of 2000. A recent source shows the average family income to be greater now than eight years ago.

Costs Are Rising

“What employers paid for workers increased by 25%, all due to healthcare costs. The costs are expected to rise by another 10% in the next year alone.”

The more regulation you get, the more government control… the more things cost. This is true as much with healthcare as it is with automobile costs (which have also risen dramatically in the past 10 years)

Also look at how people spend their healthcare money. The average person spends more time researching that plasma TV purchase then they do a major surgery.

Additionally, most people don’t use tools available to them to compare prices of services.

As an example, while working for the Universality of Minnesota, people could come in and have Service A performed by Dr. X at the U for $40,000. If they went to a U of M clinic outside of campus, they could have that same procedure performed by the same doctor for $20,000. If they went to the private clinic of that provider, the service would be closer to $10,000.

I do not have a source for this other then my own experience with billing folks at the U and looking up various services on mainstreetmedica.com before I go in for any health service.

But the same service could cost X, or 2x or 4x. If I am an educated shopper, I can save my insurance company thousands of dollars in just one service, thus saving my insurance company money and thus keeping the cost of health insurance policies down.

In this example, I agree that it is too bad these prices have gone up but the more we as shoppers pay attention to prices, the more we can keep them down. The more competition there is, the more they will decrease. (Though I would not trust your source which is clearly biased on the issue for any data on healthcare reform.)

Bankruptcy Costs

“62% of all bankruptcies in the U.S. are caused by healthcare costs. “

I do not refute this number in any way. And it is indeed unfortunate that the high costs of some components of healthcare have been a factor of some bankruptcies. A question to ask however is: Would these people have survived if they would have not had the care? Also, what was it that caused their bankruptcies? Did they have insurance? Were the procedures not covered? You can see why these are important questions. It is a completely different story if 100% of the bankruptcies caused by healthcare costs were plastic surgeries.

With my examples above however, I would rather risk bankruptcy then be denied service from my government because I will not be a proper return on investment for how much longer I have to contribute tax money into the health system. The point here is that we as Americans still have more of a choice and have options available to us (even if that choice is fiscally damaging) that others do not.

The US is Behind Cuba?

“The U.S. is 45th in the world when it comes to infant mortality – behind Cuba.”

This is a fun one. The infant mortality is a poor thing to judge a healthcare system by. Not because we are listed as 45th but because of the system used to calculate this.

(Your source here, a site praising Michael Moore’s movie Sicko, is highly dubious by the way.)

There is an incredible disparity in the ways this statistic is measured around the world.

Example: While 45th place for US infant-mortality rate is attributable to infants who die on the day of their birth, some countries don’t “reliably register” those deaths at all. In the US, if a baby shows ANY sign of life whatsoever, it is considered a “live birth“.

In other countries, a “size” or “weight” standard is used to determine whether a birth is “live.”

“In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless.”

So, if I count my automobiles by the number of sets of four tires I have, but you count your automobiles by the number of cars you have, we will arrive at two very different numbers.

Also, Cuba aborts many at the first sign of trouble.

Moore didn’t mention this in his movie though.

On top of this, the United States has a higher rate of “very pre-term” babies (babies born at less than 32 weeks and who die at about 30 times the rate of our average) than most other countries.

In fact, this number of “very pre-term” accounts for ONE HALF of all infant deaths in the United States. Why is this?

As someone who has aided in fertility clinics, I can tell you that not all citizens of the world are capable of spending tens of thousands of dollars to attempt to have a child when they are unable. This is another example of where our richness as a nation, though a benefit, doesn’t help our infant mortality rate.

Otherwise, we have the same infant survival rate as Norway when all these standards are applied across the board. Norway as you know has one of the lowest infant mortality rates in the world.

US Life Expectancy

“When it comes to life expectancy the U.S. is 50th – behind Bosnia and South Korea. “

Life expectancy is another terrible way to judge a healthcare system. Many people die for reasons that cannot be controlled by doctors.

This can be skewed hard core by two things: cars and murder.

America loves our cars. Other countries don’t drive nearly as much or as far as we do. More driving means more accidents. I would encourage you to look up the statistics for the 49 countries ahead of us listed there on Wikipedia. Something tells me that there are more deaths due to automobiles in the United States per capita then Liechtenstein or Faroe Islands.

Also, America’s national murder rate (thanks to a few high crime cities in the nation) bring our national murder rate up to four times greater than that of some European countries.

Murder and car accidents have nothing to do with the quality of our healthcare system despite the fact that they lower the overall American life expectancy. (As an ex-Canadian physician explains) when those factors are taken into account, some argue that the US has the highest life expectancy.

Is our healthcare system at fault for gang violence? I submit that it is not.

Millions of Uninsured Americans

“47 million Americans are without health insurance, 8.7 million are children. “

Ten million of these people are illegal aliens or other non-citizens who wouldn’t qualify for “universal” care even if we had it. Not that I am against giving healthcare to people in need, but if you violate federal law by committing identity theft to come into the country…

So, we’re down to 37 million. For this number, this is where personal responsibility comes in.

About 18 million of these people have a household income of over $50,000 a year.

More than half of them (over 9 million) make over $75,000 a year.

Now, how many of these people who don’t have insurance are able to afford cable TV or cell phones? Not choosing health insurance is their fiscal freedom of choice.

14 million already have access to insurance though they choose not to apply for it.

Now, it is impossible to tell exact numbers for the uninsured, as many of these categories overlap. But the number of uninsured is far lower than the 47 million number that keeps coming up. I could provide additional sources if you wish, but this should be enough for a little research now. I appreciate your excitement on this topic, and I hope this information is helpful to you.

Additionally, this point is about health insurance, not healthcare itself. Much like “millions of Americans do not have car insurance” is separate from the ability for those same people to receive preventive care and the quality of the services when a catastrophic failure occurs. If the issue is simply the percentage of people who are covered by insurance, then that should be addressed.

But even now, as pointed out by the Census, millions of Americans qualify , but choose not to have insurance.

I too think the healthcare could use an overhaul; I just think any fix needs to include the reduction in the Federal government’s control, not an increase. And as shown above, you have to be careful where you get your information from, especially when (dare I say) that information is given by those who wish to grow government. Because as government power grows, our power shrinks.

Pete Arnold