OK. I got an email from Cato Institute, a free market think tank. They have launched a web site at: Healthcare.Cato.org, which offers a number of in-depth studies on health care in the USA and elsewhere, and also provides suggestions for positive real-world solutions to rising costs and all the other problems US health care and health insurance is supposed to have.
I got so fascinated with two of these reports that I never got around to reading the alternative solutions... Anyway, following are some well-documented facts from the Cato reports. And I strongly suggest that anyone who's really interested in this subject -- and all Americans should be right now -- that you go to the web site and download the full reports. They're PDF files and free of charge.
Let's start with any projected costs for socialized medicine. I wrote in another blog that Medicare costs were wildly underestimated in the mid-1960s when that system was first implemented. At the time I wrote that, I couldn't find the statistics. (They used to be at a government site, but darned if I can find them now.) Anyway, this is from Cato's "Obamacare to Come -- Seven Bad Ideas for Health Care Reform," by Michael Tanner.
However, cost estimates for government programs have been wildly optimistic over the the years, especially for health care programs. For example, when Medicare was instituted in 1965, it was estimated that the cost of Medicare Part A would be $9 billion by 1990. In actuality, it was seven times higher -- $67 billion. Similarly, in 1987, Medicaid's special hospitals subsidy was projected to cost $100 million annually by 1992 (just five years later); however, it actually cost $11 billion -- more than 100 times as much. And in 1988, when Medicare's home care benefit was established, the projected cost for 1993 was $4 billion, but the actual cost was $10 billion. If the current estimates for the cost of Obamacare are off by similar orders of magnitude, we would be enacting a new entitlement that could bury future generations under mountains of debt and taxes.
In the report, "The Grass Is Not Always Greener," author Michael Tanner reviews socialized health care systems from about a dozen nations around the world, including those most highly rated by the U.N.'s World Health Organization (WHO.) WHO rates the US system about 37th or 38th, largely because it's not government-run, doesn't guarantee universal accessibility, and doesn't come as part of a package of other social programs. Apparently WHO doesn't put much weight on how effective a health care system is in terms of actually preventing and curing disease. Those other factors are more important -- which might actually explain why the world in general is such a mess. But I digress...
The US is first in things like treating cancer and other "incurable" diseases, is first in access to technological and pharmaceutical innovation, and in a number of other areas that most US citizens highly prize -- and prize above the system's egalitarianism.
Anyway, France took the #1 spot on WHO's Health Care Hit Parade. A few facts:
- French doctors have an average annual income of $55,000 (this was in 2008. They've gone on strike since then, so maybe now they make more.)
- French citizens pay 18.8% in payroll taxes for their health care system, yet still....
- Many French citizens also buy supplemental private insurance to cover the very extensive list of "co-pays" they must pay, even in their socialized system. The French manage their system and control costs by tacking on co-pays to discourage use of certain things -- like shopping around for doctors and fancy drugs.
In Germany, doctors typically earn 20% of a US physician's annual income, which Cato noted is about $146,000, and about $260,000 for specialists. German doctors also have threatened to strike for better wages.
In Norway:
Approximately 23 percent of all patients referred for hospital admission have to wait longer than three months for admission. The Norwegian government has responded by repeatedly and unsuccessfully atempting to legislate waiting lists out of existence. For example, under the 1990 Patients' Rights Act, patients with a condition that would lead to "catastrophic or very serious consequences" have a right to treatment within six months, if the treatment is available. In 2001, after several government reports had documented repeated violations of this policy, the government passed a new mandate requiring that a patient's medical condition be at least "assessed" within 30 days. Despite these paper
guarantees, waiting lists have not been substantially reduced.
In Greece, something like 45% of the health care system is funded by "informal payments" to doctors and health care providers. These are bribes.
On waiting lists in the UK:Waiting lists are a major problem. As many as 750,000 Britons are currently awaiting admission to NHS [National Health Service] hospitals. These waits are not insubstantial and can impose significant risks on patients. For example, by some estimates, cancer patients can wait as long as eight months for treatment. Delays in receiving treatment are often so long that nearly 20% of colon cancer patients considered treatable when first diagnosed are incurable by the time treatment is finally offered.
In some cases, to prevent hospitals from using their resources too quickly, mandatory minimum waiting times have been imposed. The fear is that patients will flock to the most efficient hospitals or those with smaller backlogs. Thus a top-flight hospital like Suffolk East PCT was ordered to impose a minimum waiting time of at least 122 days before patients could be treated or the hospital would lose a portion of its funding.
In Portugal, the central government gives the various regions a block grant for health care, so care is very uneven from one area of the country to the other. In addition, you can't change doctors. So if you're unhappy with your doctor, or if your region doesn't have an MRI, for example, you just move to another part of the country.
Cato somewhat recommends the Swiss system, if you really feel you need socialized medicine after reading all this. In Switzerland, insurance is provided by private companies, and every citizen is required to buy a policy. Low-income individuals and families get government subsidies of some kind to pay for it. Costs in Switzerland are pretty well-contained because people actually have to pay for their own policies. That is, they have some idea of how much health care really costs.
If it seems like I'm quoting an awful lot, it's because these reports are so, so good and enlightening.
Don't listen to the pie-in-the-sky from politicians. Look up the facts! Go to:
Healthcare.Cato.org .
Then call your congressman and tell him to be very, very careful and to read the bill this time.
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