March 22, 2000

March 22, 2000 | Commentary on Health Care

A Prescription for Trouble

Several hundred members of the American Medical Students Association (AMSA), many of them representing the country's finest medical schools, gathered in white coats on the steps of the U.S. Capitol on March 16 to rally for government-run health care. To anyone familiar with what socialized medicine inevitably brings - long lines, rationed care, frustrated doctors - it was like watching prisoners rally for more jail time.

The rally organizers correctly pointed out that 44 million Americans lack health insurance, a number that continues to expand. Several speakers, including Reps. Henry Waxman, D-Calif., and Jim McDermott, D-Wash., claimed that government-run health care is necessary to give these people equal access to medical care at little or no cost. But what has been the experience in countries that have tried socialized medicine?

Consider Canada and Britain, both of which are often cited as "models" for American health care by supporters of a government-run system. Canadians wait a median of six weeks to see a specialist following a referral from their family doctor. They are then forced to wait about another seven weeks to receive the treatment the specialist recommends. Should they need a CAT scan, the median wait is five weeks; for an MRI, 11 weeks. In America, you can get an MRI for your family pet within a day or two.

Indeed, among the 29 countries that belong to the Organization for Economic Cooperation and Development, Canada ranks 21st in availability of CAT scanners, and 19th in availability of MRIs. In availability of overall medical technology, only three countries consistently rank below Canada: Mexico, Poland and Turkey.

Waiting lists for emergency surgeries in Canada are sometimes so long that the procedures never take place. The Canadian Medical Association reported last year that 121 patients in Ontario scheduled for bypass surgery had been permanently removed from the waiting list. The reason: They had waited so long they were deemed medically unfit to undergo surgery without an unacceptable risk of dying. Similar examples, equally shocking, abound.

In Britain, survival rates for cancer rank far below the average for an industrialized country. The World Health Organization estimates that 25,000 people in Britain die unnecessarily of cancer every year - people who would likely have survived had they been in the United States. For a British man with colon cancer, the five-year survival rate is 41 percent; in the United States, 64 percent. For lung cancer, the survival rates are 6 percent and 13 percent, respectively. Women with breast cancer in Britain survive in 67 percent of cases after five years, compared with 84 percent of American women.

The structure of the British system is rigged so that the authority of government bureaucrats to limit spending undermines the ability of doctors to deliver care. The health service is divided up into 115 local authorities, with each one given a fixed budget. It is up to these local authorities to determine how to spend the money, and - more ominously - who to spend it on. It is not uncommon for elderly patients requiring expensive care to be left untreated so that budget targets can be met.

So the question arises: Do AMSA members know what they're asking for? I spoke with several students at the rally to find out if these doctors-to-be truly understood the implications of government-run health care. No one I encountered had the foggiest idea. I asked Ron from Emory University if he thought the switch to a single-payer system would negatively affect patient care. "I don't see why," he said. Laura from the Medical College of Georgia told me, "I don't know much about [a single-payer system], I just support it."

Responses like this were typical. Yet these students were prepared to lobby in support of a single-payer health-care system that neither they nor their elected representatives fully understand. The inevitable results of such a system - which the students obviously don't realize - include substandard technology, lengthy waiting lists and minimal physician autonomy.

Despite its good intentions, single-payer, government-run health care does not come close to delivering what Americans have come to expect from the best health-care system in the world. Sorry Doogie - I'm afraid you've misdiagnosed this one.

James Frogue is a health-care policy analyst for The Heritage Foundation, Washington-based public policy research institute.

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