As the list of Democratic Party candidates for president grows, it appears the centerpiece for most of them will be health care, whether a one-payer system, so-called “Medicare for All,” or some other national health care system.
On Nov. 3, Dr. Scott W. Atlas, a senior fellow
at Stanford University’s Hoover Institution and a member of the Working Group on Health Care Policy, wrote a detailed and insightful article for the Wall Street Journal, titled “The False Promise of Medicare for All.”
The purpose of this column is to draw from his research and get you ready for the barrage of mostly untrue, unsupported rhetoric the candidates are going to use to convince you that government-run health care is a viable concept.
Medicare for All is estimated to cost more than $32 trillion over its first decade. Even doubling federal personal income and corporate taxes will not be enough to pay for it. But beyond the unaffordability issue, what might we expect in terms of actual health care?
In 2017, a record 4.2 million patients were on England’s National Health Service waiting lists. After having received their diagnoses and referrals, 458,000 patients waited longer than four months for treatment.
In Canada the median wait-time between diagnosis and seeing a specialist was 10.2 weeks.
In Britain, more than 19 percent wait two months or longer to begin their first urgent cancer treatment, while 17 percent wait more than four months for brain surgery. Most U.S. patients face little or no wait-time for urgent care.
Canadians with heart disease wait three months for their first treatment. For life-changing orthopedic surgery, like hip or knee replacement, they likely wait 10 months.
“Medicare for All” is no promise of access to quality medical care. If brought to the United States, the only reliable promise would be worse health care and higher taxes. America’s poor and middle class would suffer the most because, let’s face reality, rich folks don’t need health insurance of any type. They can just write a check and move to the front of the line, or join a quality private-practice health care group.
Whatever the nationalized health system, it will not be “free.” There is a saying going around, “You will never believe how expensive medical care can be until it is ‘free.’” Some years ago, the British Liberal Party sold their people on a national health care concept as “free,” and their resulting taxes rank right up there among the highest in the world.
Every country that has tried nationalized health care has ended up with fewer quality health care professionals, much higher taxes, longer wait times for care, pain, suffering, permanent disability, forgone wages and, in many cases, premature death. This is not an overstatement.
But, you say, we are not the UK or Canada; the U.S. can do it better. You are certainly entitled to your own opinion but not your own facts.
The fact is we have had government-run medical care in this country for decades; it’s called the Veterans Administration, and it has been such a dismal failure that the whole process has been under extreme scrutiny for the past several years and is not fixed yet. It is clearly documented that veterans have died waiting for an appointment or treatment.
Currently, less than one-third of Americans are enrolled in Medicare and Medicaid. Between 2004 and 2017, “mistakes and improper Medicare and Medicaid payments” averaged $48 billion per year. Do we surmise that all that graft, corruption, mistakes and improper payment will magically disappear? I am much more inclined to believe the $48 billion will grow right along with the expansion of the program. Why?
To answer that, what do the U.S. Postal Service (established 1775,) Social Security (1935) Fannie Mae (1938,) “War on Poverty” (1964,) Medicare and Medicaid (1965) and Freddie Mac (1970) all have in common? They are big government-run programs, and they are all broke. Big government cannot effectively and efficiently “run” Medicare for All.
Having said all of the above, the larger issue is not about dollars or even the quality of health care. It is about something bigger, something much more important. Too often we use a shorthand to define our democracy as simply a system of free elections and leave it at that.
More than 30 years ago Isaiah Berlin said, “The defining proposition of democracy is that it mandates means (elections, parliaments, markets) but not ends.” Democracy leaves the goals of life entirely up to the individual. Whereas the socialistic states decree life’s purposes.
The “free” message may be good politics but it will eventually end badly for all Americans.
Retired Lt. Gen. Marvin L. Covault, U.S. Army, is the author of “Vision to Execution,” a book for leaders.