September 29, 2000
By Robert E. Moffit, Ph.D. and James Frogue
Supporters of government-run health care frequently point to the
"universal health coverage" offered in countries such as Canada and
Britain as a model for the United States. An apparently approving
Vice President Al Gore recently told an MTV audience he expects
European-style coverage for Americans "within this decade."
He may want to talk with James Hughes-Onslow first. A reporter
for Britain's Daily Telegraph, Hughes-Onslow recently found
out more than he wanted to know about his country's government-run
health care when it took four months for him to receive an
operation for colon cancer. And his wait was short: He had to "pull
every string available" to move up Britain's long waiting lists and
finally get treated for a condition that could easily have been
Such waiting lists are an inevitable by-product of any system of
socialized medicine. Demand outpaces supply, so the government must
ration care. Because prices are fixed, the only way politicians and
bureaucrats can "control" demand is to limit supply, which entails
long waiting lists for many types of medical conditions.
Dr. Richard Davies, a cardiologist at the University of Ottawa,
recently wrote in the Canadian Medical Association Journal
that "Canadian patients are being forced to wait much longer than
is really necessary" for heart bypass surgery. Using figures from
the Cardiac Care Network of Ontario, he showed that more than 1,500
patients were on the provincial waiting list at any given time in a
typical year. Sadly, some die while waiting for surgery, while
others are taken off the list because they've become "medically
unfit for surgery" due to their extended waiting time.
Similar revelations are coming out of Britain. According to
The Guardian, in 1998 more than 1.3 million British patients
were on waiting lists for medical care. The new Labor government,
elected in 1997, promised to tackle the problem, but 100,000
more patients were added to the waiting lists in a year. It
is now a scandal.
Well, critics retort, what about drug prices? Aren't they
cheaper in Canada? Yes, some are (though not all) because of
government price-fixing. But when a government buys drugs, it must
also ration them. With no private-sector alternatives, patients
have no choice but to accept what their government-not their
doctor-decides is best.
Drug access is every bit as important as drug prices. The
government has to "approve" the drugs it pays for; then again, it
might not approve. The reduced availability of many desirable drugs
leads many Canadians to head south to the United States to buy
drugs they can't get at home-at any price.
Government management of the drug market means that bureaucrats
control an individual's access to medicine. There are many examples
of the inefficiencies produced by such interventions. One
64-year-old Canadian patient was being treated for peptic ulcers
with a drug called omeprazole, but the government demanded that he
switch to an older, less expensive drug. Three days later, he was
hospitalized and required a complete blood transfusion. After 10
more days and several more transfusions, he was able to leave the
hospital. When discharged, he was taking the same
drug-omeprazole-that he had been taking in the first place.
Government-run "universal health care" also subjects patients to
substandard care. Budget-conscious bureaucrats seldom approve
pricey new technologies, as their budgets are always stretched to
the maximum. A survey of teaching hospitals in Washington State,
Oregon, and British Columbia found that 18 surgical and diagnostic
procedures commonly available to patients in the United States are
not available to Canadian patients.
In Britain, lack of access to modern technologies and medicines
poses high risks for patients, especially in cases involving cancer
and cardiovascular disease. Recently, the World Health Organization
estimated that 25,000 Britons have died unnecessarily.
There's no question that the American health-care system is
imperfect and that U.S. policymakers need to address its
weaknesses. But any solution that involves government-run
"universal health care" should be avoided like the plague.
Moffit is director of domestic policy studies at The
Heritage Foundation and James Frogue is a
former health-care policy analyst.
Distributed nationally by Scripps-Howard News Wire
Government-run health care: a world of hurt
Robert E. Moffit, Ph.D.
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