I generally don’t like to get into topics that are too high concept or topics that don’t immediately and directly impact young people, but this morning I had a conversation with a coworker who wanted to better understand the concept of universal health care. After having this conversation, I felt that this is an important enough topic to cover here.
My friend started from a position that universal free health care for all residents of the country would be a good thing. His belief is that the current system is broken, and too many people today have no health coverage, which causes undue stress to the nation’s emergency rooms, which ultimately raises costs to those insured. If everybody had quality, affordable coverage, he surmised, then costs would go down for everybody. He also believed that having a public (government) option that competes with the current private (consumer) system would help to drive down expenses and would result in better, more affordable coverage to everybody.
I’m going to keep the concepts as simple to understand as possible, so understand that there are details that are unique to each type of program. For this conversation, I’m not terribly interested in the details. I want people to understand the concepts involved.
First, we need to understand what we are dealing with. In America currently, we have a healthcare system where the majority of covered people are covered through insurance companies that offer services as part of a benefits package. That is, most full-time employees of a company are offered insurance through the company they work for. This coverage is generally offered at a substantial discount for the employee (sometimes even free), and a discount for eligible family members (spouses, domestic partners, minor children). When the employee needs to see their doctor, they contact their insurance carrier and make an appointment. The patient pays a fee, called a co-pay to the provider, and goes about their merry way.
Some people do not have insurance. Some do not have an employer that is able to offer coverage, some are not eligible for their employers’ plans, and some deliberately choose not to get insurance because they believe that they would be better off spending that money elsewhere.
That last group of people, who have deliberately made the choice not to get medical coverage get free coverage from hospitals. Hospitals in America have a rule that they cannot refuse treatment based on inability to pay. So these people go to the emergency room for mundane things like colds and flu virus. They get their treatment, and the cost of that treatment is passed on to the rest of the covered people. Wait times are measured in hours in most cases.
America currently does offer some government subsidized insurance programs. These include: Healthy Families, MediCare, and state coverage like California’s MediCal. People who fall within certain income levels get free or discounted medical care.
Canada offers a sort of hybrid system. The medical practitioners (doctors, nurses, etc.) are in the private sector, and are not government employees. But Canada’s laws state that Canadians must receive medically necessary care free of charge to the patient. In essence, Canadians pay taxes so that they don’t have to pay when they go to the doctor. Because there is free health care, Canadians have to wait in line longer than Americans do to get to quality care. Many Canadians actually plan trips to the United States where private medicine is both more readily available, and of a better quality than they can get at home. Wait times can be days to weeks.
Probably the best illustration of modern, socialized medicine is that of the United Kingdom. In England, a patient sees their primary physician for free. If any medical problems present themselves, the doctor will contact hospitals within the national network to see if any hospitals can see the patient. The hospitals judge the urgency of all cases compared with each other. This greatly extends wait time for weeks from a primary appointment to seeing a treating physician.
In both cases of Canada and the United Kingdom, private insurance is growing because of the extensive wait times. The citizens, many of whom are used to a socially provided medical system, are willing to pay the extra money in order to guarantee they will be seen by a professional in a reasonable amount of time.
So, if countries that have had socialized medicine are running away from it, should we run towards it?
Sometimes, I drive by the local DMV and see just how efficient government control can be. I don’t like waiting in lines to renew my license, and I’m pretty sure I wouldn’t like waiting in even longer lines to determine if I were sick enough to be seen by a government doctor any better.
As to the argument that more people would be covered, I look at it like this. EVERYBODY gets to ride the bus. It generally sucks. Not everybody gets to drive a car. Driving is significantly better.
I’m worried that the government is going to, once again, get involved where it doesn’t belong. I’m worried that I will lose my insurance coverage because my company had been underbid by the government. I’m more worried about all of the people younger than me who are going to be stuck in a government line at some hospital while they are dying of diseases that could easily be treated.
The moral here? Don’t just back a stance because some charismatic authority figure tells you to. Do some basic research and take nothing at face value. Politicians lie. Lobbyists lie. Common sense rarely lies. Stick with common sense.