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Unhealthy

 

Maybe you saw the full-page ad in The New York Times. Under a huge headline that said “Your New Doctor?,” Uncle Sam was pointing his finger right at you. But instead of stars or stripes, his tall hat had a big red medical cross on it and he had a stethoscope around his neck.

It was paid for by the Cato Institute, a well-heeled think tank. It said Americans worry that “government-run health care” will reduce health care quality, increase costs, limit choice of doctors, increase the federal deficit. And the ad concluded that health care reform is needed but a government takeover is not the answer.

The proclamation is a fine example of the alarmist propaganda spreading through the media. The ad has such enormous type that there’s room for only a few words, but it succeeds in distorting facts and derailing honest debate.

Yes, a “government takeover” of our health-care system would be something to be concerned about. But Congress isn’t planning one. The United States already offers “government-run health care” under the Veterans Administration; it owns the VA hospitals, employs the doctors, and runs the whole program—just as in a socialist state. But no congressional plan is remotely like that.

How any plan being discussed in Congress would reduce the quality of health care or raise its cost is a mystery that isn’t solved by a visit to the Cato Institute Web site. The site does say, rather unhelpfully, that a good way to control costs is to have patients, not insurance companies, pay medical bills. Nor does the Cato Institute explain how any congressional plan would limit your choice of doctors beyond the kinds of limits already set by insurance companies, HMOs and hospitals.

The Cato Institute’s last point, an increased federal deficit, is a legitimate worry. Opponents claim a government overhaul of the U.S. health-care system will soak us $1 trillion over the next 10 years. The $1 trillion is a big spooky number, cited everywhere from Fox News to The New York Times. Actually, the Congressional Budget Office found that the House tri-committee health bill would increase the federal deficit by $239 billion over 10 years.

Conservatives who enjoy complaining about how much a government overhaul would cost over 10 years don’t dare mention how much our busted system costs for just one year right now. The United States spends 17 to 20 percent of its gross domestic product on health care; last year that amounted to $2.4 trillion.

The free-market hands-off approach hasn’t controlled health-care costs. Health insurance companies, pharmaceutical companies, clinics and laboratories are designed to charge as much as they can. And some doctors like to make big bucks, too. They’ve had decades to get together and devise a more-efficient, less-expensive system. But it hasn’t happened. When it comes to health care, there’s nothing in the free-market system to encourage such controls.

In the coming weeks, we can expect more distortions of fact and more plain lies. Here’s what opponents of government action will be saying:

Government involvement will produce rationing. Unless you’re very, very rich, your health care is already rationed. Health insurance policies don’t commit to paying for all the treatments you may need. And if you discover you have a medical problem that your insurance won’t cover, don’t bother trying to get a different policy. Insurance companies don’t like to cover a preexisting condition.

Government involvement will force us to be like Canada or Great Britain. The foreign plans most closely resembling what Congress has been working toward are in France and the Netherlands. Though differently organized, both offer universal coverage with a mix of private and public plans. Anyway, if you like your current insurance you can keep it, unless your ailments grow so costly that your for-profit insurance company drops you. Insurance companies do that.

Government involvement will mean long waits for treatment. Alarmists like to cite England and Canada, where patients do wait longer for specialty treatment or elective surgery than in the United States; yet, on balance, Canadians and Britons have better good health care than we do in many important respects. People in the Netherlands and France also have to wait for specialty treatment, but they’re far less likely than Americans to forgo seeing a specialist because they can’t afford to. And a Commonwealth Fund survey found that 60 percent of Dutch patients and 40 percent of French patients got same-day appointments with their regular physicians. In the United States, only 26 percent can do that.

A ‘public plan’ of government health insurance will drive private plans from the marketplace. You’ll notice that the U.S. Postal Service hasn’t killed off FedEx or UPS, nor have very good but less-expensive state universities and colleges been the death of private institutions.

—Gene Mirabelli


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