Single-Payer Follies


Friday, October 10, 2008

Wait Time Down in Canada, Still over 3 Months 

By Grace-Marie Turner

Categories:  Single-Payer Follies

The median wait time for Canadians seeking surgical or other therapeutic treatment dropped to 17.3 weeks in 2008 from 18.3 weeks in 2007, according to a new study from the Vancouver-based Fraser Institute.

The fall in waiting time between 2007 and 2008 results from a decrease both in the first wait -- the wait between visiting a general practitioner and attending a consultation with a specialist -- and in the second wait -- from the time that a specialist decides that treatment is required to treatment.

Among the provinces, Ontario achieved the shortest total wait in 2008, 13.3 weeks, with British Columbia (17.0 weeks), and Manitoba (17.2 weeks), next shortest. Saskatchewan exhibited the longest total wait at 28.8 weeks; the next longest waits were found in Nova Scotia (27.6 weeks) and Newfoundland & Labrador (24.4 weeks).

Wednesday, October 8, 2008

Canadians Pan Canadian System 

Cost comparisons must account for taxes

By Grace-Marie Turner

Categories:  Single-Payer Follies

Canada's government monopoly, single-payer health care system is one of the worst ways to achieve universal health insurance coverage -- and Americans should avoid adopting a similar system, concludes this new study from the Vancouver-based Fraser Institute.

The study shows that health care in Canada appears to cost less because Canada does not cover many advanced medical treatments and technologies, common medical resources are in short supply, and access to health care is often severely delayed.

Even on health insurance coverage, the Canadian system does not perform much better than the U.S. when it comes to actually delivering insured access. The study concludes that both Canada and the U.S. should look to countries such as Switzerland or the Netherlands, where the government is not in the business of providing health or drug insurance at all. Instead, individuals in those nations are required by law to purchase comprehensive health insurance in a regulated, pluralistic private-sector market.

People in other health care systems often pay more than Americans do, once taxes are taken into account, writes CMPI's Peter Pitts. Add in the high non-monetary costs of rationed or denied care and waiting lists, and suddenly the vaunted European systems commonly touted as models for the U.S. don't seem like a good deal at all.

Friday, October 3, 2008

Sally Pipes on National Health Care 

By John LaPlante

Categories:  Single-Payer Follies

Sally Pipes recently participated in a debate on universal coverage. It included John Stossel (ABC News), MIchael Cannon (Cato Institute), Paul Krugman (New York Times) and Art Kellerman and Michael Rachlis.

You can watch her opening statement on YouTube.

Friday, October 3, 2008

New Report Compares US and Canadian Health Care 

By Nathan Benefield

Categories:  Single-Payer Follies

I doubt this will surprise regular readers of this blog, but Canada's single payer health system isn't all that Michael Moore makes it out to be. From a new report of the Fraser Institute.

On a comparable basis, Canadians have fewer doctors and less high-tech equipment than Americans. Canadians also have older hospitals and have access to fewer advanced medicines than Americans. Health care appears to cost less in Canada than in the United States partly because Canadian government health insurance does not cover many advanced medical treatments and technologies that are commonly available to Americans. If Canadians had access to the same quality and quantity of health care resources that American patients enjoy, the government health insurance monopoly in Canada would cost a lot more than it currently does.

Not only do Canadians have fewer health care resources than Americans, experience also shows that the Canadian health system is not financially sustainable in the long run. Ever since the single-payer system was established in Canada in the early 1970s, government spending on health care has grown faster than the ability of governments to pay for it. In Ontario, Canada’s largest and most populated province, health spending will soon consume close to half of all government revenues.

Another false economy of the Canadian health system is the money saved by delaying access to necessary medical care. Canadian patients wait much longer than Americans for access to medical care. In fact, Canadian patients wait much longer than what their own doctors say is clinically reasonable (Esmail and Walker, 2007b). Many Canadian patients wait so long for treatment that, in practical terms, they are no better off than uninsured Americans. In Canada, the government promises everyone that they have health insurance coverage for all medically necessary goods and services; but, in reality, access to treatment is often severely limited or restricted altogether.

 

Tuesday, September 23, 2008

Arizona's Prop 101: Opponents of Patient Choice Sow Confusion 

"Freedom of Choice in Health Care Act" Is So Simple A Child Can Understand It

By John R. Graham

Categories:  Arizona, Single-Payer Follies

The Arizona Republic (via the Tucson Citizen) ran an article yesterday quoting some Arizona's health care elites' concern that Proposition 101 is "too ambiguous".  On the contrary, it could not be simpler.  And that's what terrifies these elites.

Prop 101, the "Freedom of Choice in Health Care Act", is a constitutional amendment that would prevent the state from outlawing Arizonans' freedom to spend their own money on health care of their choice (as discussed previously in this blog).  Less than one hundred words long, any child who can read should be able to understand its intent.

Of course, it should not be necessary for the people of any state to demand this of their government via the constitution: not long ago, such choice would have been taken for granted by any American.  No longer.

A recent op-ed by the state assembly's Democratic leader and a member of the Physicians for a National Health Plan made the absurd allegation that Prop 101 "protects the private insurance industry".

This claim is utter nonsense.  Prop 101's plain language makes clear that the state can neither forbid any Arizonan from buying private health insurance, nor can it compel him to to so.  Thus, it protects Arizonans from either a government-monopoly system (like Canada's), or mandatory private health insurance (like in Massachusetts).

Unfortunately, the anti-Prop 101 writers cannot understand this freedom because of their ideological blinders.  Indeed, their only alternative "reform" is so-called "single-payer" health care.  In Arizona, this took the shape of the Orwellian-named "Arizona Health Security Act", which would have driven every Arizonan into a government-monopoly system.

Imagine a "Home Security Act" that outlawed private houses, and compelled everyone into governmen-owned barracks!  Such a law would be unthinkable.

The fact that it is not only thinkable, but doable, for health care, should lead all Arizonans to appreciate the need for a constitutional amendment like Prop 101.

Thursday, September 11, 2008

Why Are Clinical Trials Few in the UK? 

Blame the NHS

By Grace-Marie Turner

Categories:  Pharmaceuticals, Single-Payer Follies

Pharmaceutical companies from around the world have been scaling back clinical research in the United Kingdom, largely because of government parsimony, says Peter Pitts.

The main culprit is Britain's National Institute for Health and Clinical Excellence, the government agency responsible for comparing the effectiveness of different treatment options. When the National Health Service decides not to cover a drug, it hinders the ability of drug companies to recoup research and development expenses.

NHS practices also make British patients less-than-appealing subjects for clinical trials. Most patients in the U.K. aren't currently receiving the highest-quality medical treatment, so clinical trials that compare the average British patient with a patient taking an experimental drug simply don't yield much useful information. America should avoid the mistakes of the U.K. and make sure we keep the interests -- and hopes -- of patients first in our pursuit of health care reform, writes Pitts.

Thursday, August 28, 2008

When 'Free' Health Care Isn't 

By Paul Hsieh

Categories:  Single-Payer Follies

Here's the ninth myth listed at BigGovHealth.org, which provides a lot of useful facts in the discussion of health care:

Fact: People in other health care systems often pay more than Americans do, sometimes in the form of taxes. And they may also incur high costs if they need a drug that is not covered by their health system or want to see a specialist.

In the US, a family of four with an employer-based PPO will have around $15,609 total this year in health care costs. Of this amount, $9442 will be paid by the employer and the employee will contribute $3,492 in premiums and $2,675 on copays, etc. [1] That's about 6 percent of average family income. [2]

In Canada, while the percentage of taxes used to provide health care varies, it is estimated that 22% of taxes collected went to the health system in 2004.[3] Several provinces, including Quebec, Ontario, Alberta, and British Columbia, also charge additional premiums.[4] Canadians also may spend money to receive private treatment for procedures or drugs that are not covered by the government system.

Citizens of the UK pay 11 percent of each pound they make in weekly income between £100 - £670 for the NHS, plus an addition 1 percent of income over £670 a week.[5] Though the copay for drugs is low, many drugs are not covered, often because they not considered cost efficient. And anyone who uses their own money to buy powerful but expensive drugs not paid for by the NHS finds him or herself shut out of the NHS for having gone outside the system.

In Germany, coverage from a public sickness fund currently can range significantly in cost, from around 12.2 to 16.7 percent of income, with the employee paying a bit under half. As of fall 2008, premiums are to be standardized from the federal level and health care experts anticipate that they will be set around 15.5 percent.[6] Private patients can generally expect to pay more than they would in the public system.

In France, employees contribute only to 0.75% of their salaries towards medical care, but also pay a 7.5 percent General Social Contribution, the majority of which is earmarked for the health system. This base coverage reimburses people for the majority of costs for doctors visits and for a portion of the costs of medications.[7] On top of the government coverage, almost all French residents have supplementary coverage from a mutuelle, costing approximately 2.5 percent of salary.[8]

(See original article for references)

As always, these sorts of economic facts are tremendously helpful in reinforcing the underlying moral point that health care is not a right. Health care is a commodity that must be created by the thought and work of a rational mind. There is no such thing as a "right" to something that must be produced by another.

When a government attempts to guarantee health care as a "right", it can only do so by violating the actual rights of doctors and other health care providers, who are forced to provide that service on the government's terms and for the government's prices, rather than on their own terms in a free market.

The results we see in Europe and Canada are the result of this idea put into practice.

Thursday, August 28, 2008

Single-Payer: The Rest of the Story 

By John LaPlante

Categories:  Single-Payer Follies

Our current way of financing health care isn't perfect, and it could certainly use some fixes. But as we can learn from other nations, the solution isn't to go down the road of government control.

Check out BigHealthGov.org. It has testimonials from people who have suffered from Big Health, government style.

Tuesday, August 26, 2008

Wisconsin Candidates In Full Retreat on Universal Health Care 

By Christian Schneider

Categories:  Single-Payer Follies, Wisconsin

Last fall, Wisconsin Senate Democrats pushed hard for a new single-payer style state health insurance system (unironically known as "Healthy Wisconsin"), which would have raised taxes on workers by $15.2 billion.

While passage of Healthy Wisconsin was always a longshot (even the state's Democratic governor derided the plan), Senate Democrats continued to push for passage, believing universal health care was the central issue on which they could base their 2008 campaigns.

According to their own candidates, they were wrong.

The Wisconsin State Journal today examined the health care plans of several Democrats seeking election to the state senate - and none of them embrace the costly universal plan:

When Senate Democrats unsuccessfully pushed a plan to give health coverage to every person in the state last year, they all voted for it together.

But though health-care reform remains a top issue for Democrats on the campaign trail, incumbent and first-time candidates are no longer united in embracing the $15 billion plan, and some are backing away from it.

"The issue is money and right now, not many legislative candidates are talking about big, broad programs simply because we all understand that practically speaking, there's no money," said Jim Holperin, a new Democratic Senate candidate who praised the Healthy Wisconsin plan but said his focus was on reviving the economy.

The once-united Senate Democrats now acknowledge differences on the signature proposal that defined their agenda for the last two years and would restructure one-sixth of the state's economy.

UW-La Crosse political scientist Joe Heim said several Senate candidates he's observed generally seem to be distancing themselves from the controversial plan.

"I may be wrong, but I do think they're avoiding the specifics of it," Heim said.

Of course, the primary reason Democrats are distancing themselves from the plan like it's a pair of thrift store underwear isn't because of finances - it's because the voters of Wisconsin have wisened up to the significant downsides of government-run health care.

Naturally, we here at the Wisconsin Policy Research Institute take full credit for this turnaround in public opinion, just as we will take credit when the Packers make the playoffs this year.

Monday, August 25, 2008

Reality Check, Please 

By Sally Pipes

Categories:  Single-Payer Follies

With Democrats convinced 2008 is their year, the campaign trail is awash with promises to make universal health care a reality by the end of the next president's first term.

The basic argument of those who support a government takeover of the health care system is familiar. As New York Times columnist Paul Krugman once put it, "America's health care system spends more, for worse results, than that of any other advanced country."

Krugman's line has been repeated so often it's considered gospel truth in most public debates - people rarely check to see if it matches the facts. As the American humorist Josh Billings quipped, "the problem with the world ain't ignorance, it's the things people know that just ain't so."

If they did, they'd probably be surprised. Socialized health care isn't all it's cracked up to be.

(Read the rest in Sunday's DCExaminer)

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