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
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
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:
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
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.
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.
‘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.