September 29, 2000
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 fatal.
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.
Robert Moffit is director of domestic policy studies at The Heritage Foundation and James Frogue is a former health-care policy analyst.
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