Thursday, November 27, 2008

The Case Against Universal Healthcare

By Douglas Kohn

To implement a ‘universal health care’ plan in America would be one of the greater follies of our government. There are many reasons to be against it, but there is one glaring one. We already have it. America has had universal health care for many years. It may not be like Britain’s National Health Service but it is on just as great a scale relative to our population. The simple fact is, anyone within the geographical boundaries of the United States of America, even a tourist, can go into a hospital emergency room where by American law, the hospital is obligated to treat them even if they are unable to pay. Even if an individual has so much as a head cold, they can go to a hospital where they will receive treatment, and if they are unable to pay their bill, there are no consequences.

This goes beyond the Medicare and Medicaid programs that target the poor and the elderly respectively. The bottom line is, there is no one who is denied health services in the United States when they go for treatment. This is despite what Michael Moore may have us believe. The 47 million uninsured or under insured in America still have access to all the health care they could possibly need. For this reason alone, a ‘universal health care’ law would be simply redundant.

The other reason that ‘universal health care’ would be folly is America’s great tradition of scientific research is far beyond that of other nations. According to Economist Magazine’s World in Figures 2007, America spends 2.59% of its GDP on R&D (research and development). As a percentage it ranks 7th among all nations listed. However, as a hard number, no nation comes even remotely close to what America spends.

This number includes the very hefty amount of money spent by drug companies on R&D. Yes, this drives up the cost of many drugs in America (where 1/7 of GDP is spent on health care), but it pushes the bounds of the medically feasible. This is a service to America and to mankind that no one in their right mind can doubt the great achievements that result from American research. The bottom line here is that if new costs are imposed on insurance companies and hospitals engaged in activities such as clinical trials, this country will look more and more like Europe, where relative to their economic power very little R&D is done. The only sizeable country that rivals America in scientific achievement is Japan. The others on the list are very small countries all with populations of under 10 million and GDPs comparably small.

There are other factors that make medical care much more expensive relative to other developed nations but the primary reason for high cost health care in America is R&D. This is widely noted by leaders of pharmaceutical companies.

The last reason to oppose ‘universal health care’ is that there is no reason to impose greater costs on the American taxpayer for those who can afford their own health insurance and medical care. The existing bureaucracy has become so complex that many people who can afford it simply opt out of the existing system and pay medical costs out of pocket. We have programs for the poor and elderly, we have emergency rooms that take literally anyone and also impose great costs on the taxpayer. Why, if someone can afford to pay for their own health insurance, should the tax payer take up the burden? At the very least we may look at the logic on car insurance, where laws prohibit owning an uninsured vehicle.

The last reason that ‘universal health care’ is a bad idea in America is that when the government runs an economic entity in this country it usually is handled terribly. The late great economist Milton Friedman eloquently put it; ‘if the US Government ran the Sahara Desert, in five years, it would be out of sand.’ Look at every single government run program. Social security is going to be bankrupt in the near future, welfare was a disaster, Medicaid and Medicare are becoming ever more cost prohibitive. Even our great military is such a disaster, that $2.5 trillion of its budget went missing. Nearly every time the government steps in to run something in America, it runs over budget or is unsustainable in the long term. One can only imagine with the massive bailouts of the idiot bankers of Wall Street, how badly underestimated the overall costs will be.


Phil said...

Very good article and you used my favorite Friedman quote. I do, however, believe it is necessary to drive down the costs of health care, but the way to do that is to return health care to the free market rather than the government bureaucracy that controls it today. Senator McCain had a great idea to allow people to purchase insurance over State lines, but another idea that should be given serious consideration is to allow Americans to purchase medicine overseas. Obviously this would require strict oversight because our massive Federal government imposes ridiculous drug laws, but it would certainly make prices drop.

All in all though, I completely agree. More government will make health care more expensive in the long-run, just like Medicare and Medicaid did.

Anonymous said...

Hi There

I hate to tell you this but you are wrong. Emergency treatment is what it say's. EMERGENCY. You can go once only, there is no follow up.

If you go to a hospital with a basic infection you can not return for follow up treatment.


DSKohn said...

There are certain regulations that will have to be in place in the drug industry. You have to remember that it was US government stupidity, rigidity, incompetence and bumbling that kept thalidomide from being marketed here.

Driving down costs is essential, unfortunately I think more people, at least from a Libertarian or Conservative perspective, know what is going to drive prices higher better than what could bring them down from where we are now.

John: On the contrary you can and there are free clinics everywhere. Nothing stopping anyone from telling an emergency room that they are there for an emergency. Even the most expensive surgeries end up going on the taxpayer tab.