Does Universal Health Care (UHC) work? Yes, if you are measuring some kind of non-existent average person, it absolutely works in the short run, and for this mythical average person it may even work in the long run if you have a free market system such as the US somewhere in the world to do the heavy lifting of advancing new technology and providing overflow services for the rest of the world. But no, if you are focusing on what the system was “designed” to do.
The system was designed to help people who do not have good access to health care. Like many government programs, this refers to the poor, with sizable subgroups among the elderly and minorities. The logical question is, how well are existing UHC systems doing in that regard?
England started UHC around 1950. After 30 years, around 1980, they conducted a major study of their health care system and determined that the poor had worse access to health care than when the program started. Undaunted, they redoubled their efforts, resolved to improve the system and make it work. After another 10 years, they did another major study and found that things had gotten yet even worse than before.
This is probably hard for a lot of people to swallow, but based on economic principles, this is exactly what you would expect. UHC takes away the free market incentives for buyers to spend their money wisely and for sellers to provide desired services at a fair price. With UHC you are essentially giving away something for free, so people tend to use more of it. People who would ordinarily overlook something minor rather than pay for a doctor’s visit start coming in. Demand increases. The result is that some combination of quantity and quality must suffer. In practice, waiting times to see a doctor go up, time spent per patient goes down, and the availability of expensive treatments goes down. As to the actual cost of UHC, Canada and other countries have some figures on that which look good, but beware government statistics. If you dig into it, it turns out that Canada really isn’t even sure exactly how much it spends on health care. Ya think it may be a wee bit more than they’re reporting?
UHC works on the mythical average person because if you take a system where 50% of the money is spent on about 5% of the cases, you can absolutely improve overall results by not spending so much on that 5%, but rather by spreading it around to others. The result is more health on average, but the bottom line is that more people from that 5% category die. If you live in one of the UHC countries, like England, France, Germany, or Italy, and you get breast cancer or prostate cancer, you have about a 50% chance that you will die of that cancer. In the United States, if you get one of those cancers, your chance of dying of that cancer is about 20%. Under UHC, these patients die while waiting for treatment, or in the case of diseases which require costly equipment, they die because there is no treatment available, period. You can see this, to pick one example, in the statistics on use of dialysis by people with kidney disease. In socialist countries, a much smaller percent of people have access to this life-saving equipment. Although the socialistic intent is to help, in practice it tosses these people aside in favor of the already healthy. Nice.
In England, the average wait to get a heart bypass is two years. If you think about it, most people who need a bypass don’t have two years to live - that’s why they need the bypass! In contrast, Bill Clinton got a bypass in 3 days. Now, obviously he is a special case, but the bottom line is that anyone in the US can get prompt treatment. The wait for a bypass is somewhat better in Canada, but there is a reason. The Canadian system has an important safety valve - the US. It’s pretty easy for rich Canadians to go outside the system and hop on over to the US for their treatment. But if the US goes to UHC, that will go away.
A couple of stories.
My mother was on a bicycle trip in Italy and had an accident, going over the handlebars, fracturing some bones in her face and knocking a couple of teeth out. Now sure, they did the emergency work and stopped the bleeding, but there was a lot of work to be done besides that, and my toothless mother waited, and waited, and waited. Besides dental work, there was some plastic surgery had to be done within about 10 days, otherwise the scars wouldn’t heal properly. After waiting about 5 days the Italians had finally lined up a surgeon, but they couldn’t get an anesthesiologist and wouldn’t have another opportunity to even look for one for another couple of days. My parents finally decided to just come back to the US. They made some quick arrangements, arrived in the US one evening and the very next morning my mother met with a dentist and then immediately after with a plastic surgeon.
The father of an old friend of mine was a doctor up in Canada. When he ran blood tests on himself, he sent them to the US for processing so he could get the results in a few days instead of a few weeks.
Now, I do meet a lot of healthy, young, well-educated Canadians, Brits and Europeans who are quite satisfied with their system. But think about it - these are exactly the people who don’t typically need much in the way of health care, and this is the segment that UHC benefits the most.
What about the poor, you know, those people we were trying to help? Well, in UHC, money doesn’t matter. But what does matter is connections to get to the top of the line, know-how to get through the system, and flex time during the day to wait long hours to see a doctor. The poor have none of this. And under UHC there are no other options - there is nowhere to go but “the system.” Additionally, while it’s nice in theory to have free health care, you can’t really force people to actually use it, at least not if you want to call yourself a free society.
Similar to the retirement situation related above in the Sarbanes-Oxley discussion, workers should be allowed to spend pre-tax dollars on any health care plan, regardless of whether it is company provided or not. Again, the government feels otherwise.
