Many advocates of government-run health care claim that Medicare is “the most successful government program in history” and urge policy makers to expand it to encompass our entire medical delivery system. These people are, of course, delusional. As IBD points out, Medicare is actually a pig’s breakfast:
Anyone who thinks a national single-payer system would be an improvement isn’t paying attention. Medicare, which provides coverage for less than 15% of the population, can’t get it right.
One of the things it can’t get right is physician payment:
Payments have been so late in some cases that doctors from New York to California have had little choice but to take out loans — some as large as $3 million — to bridge the gap.
And even if Medicare could get the money there on time, it’s not enough:
In too many instances, the compensation that is eventually provided by Medicare — an amount determined by bureaucrats, not the market … is simply not enough to cover the physicians’ costs.
Why should you care about how much doctors get paid?
First, some doctors are cutting back on the number of Medicare patients they see — limiting medical care access for the elderly who rely on Medicare and have paid into it for 40 years or more.
And future access for the growing elderly population looks even worse:
Second, the arrangement kills incentives for medical school students to practice family medicine, which already seems to be a dying art, as only 8% of 2006 U.S. medical school graduates opted for family practices.
So, Medicare has contrived a situation in which both patients and their doctors get the shaft. That’s government-run health care folks—-lose, lose.
In last week’s U.S. News and World Report, Newt Gingrich plugged our videos:
More government bureaucrats involved in your healthcare would be destructive. Other countries with similar systems face lengthy and often deadly waiting lists. That is the only way to ration unlimited demand in the face of static supply. Go to YouTube and view the short films of Stuart Browning for a flavor of the Canadian system.
I have written before about the deplorable NHS policy of restricting access to life-saving medications. Anyone doubting that the “reformers” who now control D.C. have the same thing in mind for us should read this WSJ piece:
In Britain, a government agency evaluates new medical products for their “cost effectiveness” before citizens can get access to them … Here in the U.S., President-elect Barack Obama and House Democrats embrace the creation of a similar “comparative effectiveness” entity.
What do they mean by “cost effectiveness” and “comparative effectiveness”? They mean that dying patients will not be allowed access to certain drugs if they ”cost too much.”
In Britain, a government agency evaluates new medical products for their “cost effectiveness” before citizens can get access to them. The agency has concluded that $45,000 is the most worth paying for products that extend a person’s life by one “quality-adjusted” year.
In other words, they decide how much your life is worth and withhold any treatment whose cost exceeds that arbitrary amount. The worst feature of this grotesque and deadly policy is that it won’t save any money:
The Congressional Budget Office says that government-run comparative effectiveness studies won’t actually save much money.
Even more ironic, this policy will be implemented at a time when the federal government is involved in a wild orgy of spending. I wonder how many of the people who hailed O’s inauguration yesterday have any idea what sort of “change” they’re in for.
Many advocates of “universal” health care tell us that the best way to fix American health care is to expand Medicare to cover everyone. They ignore the fact that the program is already fiscally unsustainable, even if its scope remains static. George Will explains why:
When Medicare was created in 1965, America’s median age was 28.4; now it is 36.6. The elderly are more numerous and medicine is more broadly competent than was then anticipated.
Meanwhile the number of people who pay the bills is shrinking in proportion to the number of people generating them:
In the 43 years since America decided that health care for the elderly would be paid for by people still working, the ratio of workers to seniors has steadily declined.
This has caused the geniuses who run the Medicare system to revert to price controls, the standard model that all government bureaucrats (everywhere) use for “cost containment”:
Medicare is a price-fixing system for upward of 12,000 procedures and drug codes — and for hundreds of categories of equipment.
This hasn’t worked, of course (price controls never work). Medicare is careening toward bankruptcy. Yet single-payer advocates claim government should have MORE control over the health system. And the apparatchiks are willing:
Governments with powerful political incentives to behave this way will play an increasingly large role in health care. As is said, if you think health care is expensive now, just wait until it is free.
Will stole that last line from P.J. O’Rourke, who coined it in a 1993 piece for Cato. But it still captures the magical thinking that surrounds the debate over government-run health care.
Many people think the government should provide free medical care because it is a “right.” The problem is that there is no such thing as “free” health care. Medicare demonstrates just how “not free” it is.
+ May 2009
+ May 2008
+ May 2007