Putting the Health Care Debate in Perspective: Are People Dying in the Streets?By Capitalist in Chief
Are people in America dying in the streets while every other civilized country provides healthcare to its citizens?
To answer this question, let’s first put the size of the healthcare problem in the U.S. into perspective.
Counting the Number of the Uninsured in America
When Obama ran for president, he touted health care reform as a big issue because there were 47 million people uninsured in America.
This figure comes from the Census Bureau. And according to the Census Bureau there were 47 million people without health insurance in the United States in 2006.
But out of those, 9.3 million live in a household with an income of $75,000 a year or more, and also 10.2 million are not citizens of the U.S.
Let’s discount those from the uninsured figure to arrive at a number encompassing people we’d sanely expect to have a claim for receiving government assistance, (which is always funded by money that’s reluctantly taken away from someone else.)
47 – 9.3 – 10.2 = 27.5 million.
However, there may be some who are non-citizens and are in households making more that $75,000 a year, and we don’t want to double subtract those. Since the latter are 1/3 of the population, with no further information, we can expect the double counting to be 3.3 million. So 27.5 + 3.3 = 30.7 million.
So now we’re at a point where the number of the uninsured we’d sanely expect to be given government assistance in the matter is no more than 30.7 million or about 10% of the population in the United States.
But the problem posed by the above figure of 10% is much further diminished by the following fact:
Not Having Health Insurance Does Not Necessarily Mean You Are Sick or Can’t Get Healthcare If You Are!
Let’s see why:
- 8.5 million of the uninsured live in households of incomes between $50,000 and $74,999. Like those in households making over $75,000 per year, at least some are able to afford insurance, but just choose not to get it. Still others in America, especially those making between $50,000 and $74,999, may also afford to pay for doctor visits and medication out of their own pocket should the need arise, though admittedly probably not for major illnesses.
- 19 million of the uninsured are young adults between the ages of 18-34. I would venture to guess that most won’t encounter anything but a minor illness until they’re older, at which point many would be earning more money and able to afford insurance anyway. And in addition, high deductible health insurance for this demographic is inexpensive… well, at least in states whose government does not interfere and allow such coverage.
- By law, emergency room care has to be provided to anyone walking in. The patient is still liable for the expenses incurred, and often hospitals work out discounts and financing, but good luck to hospitals trying to collect from those who truly can’t afford it.
- There are those who are uninsured and qualify for a government plan (Medicare, Medicaid, etc.), yet have not signed up.
- Many government assistance programs, provide healthcare to the uninsured. Those don’t count as insurance, but still give healthcare in certain instances.
For example, the Prenatal Care Assistance Program (PCAP) in New York, is a “comprehensive prenatal care program that offers complete pregnancy care and other health services to women and teens who live in New York State.” To qualify, the woman can earn up to 200% of the federal poverty level, which means this is available to many who don’t qualify for Medicare.
Another example is the HIV Uninsured Care Programs (ADAP), which provides “access to free healthcare (HIV Drugs, Primary Care, Home Care, and APIC) for New York State residents with HIV infection who are uninsured or underinsured.”
- There are clinics across the USA providing free healthcare for the uninsured.
For example, the New York City Free Health Clinic is a private clinic providing healthcare to uninsured people in NYC.
Here’s the Web site of Georgia’s free clinic network.
And here’s the Web site of the National Association of Free Clinics (NAFC), “whose mission is solely focused on the issues and needs of the more than 1,200 free clinics and the people they serve in the United States.”
- There are resources of financial aid for those who are uninsured and fall victim to serious illness.
For example see the Memorial Solan-Kettering Cancer Center’s financial assistance program.
Therefore, the problems with the healthcare system in the U.S. may be a government actionable “crisis” for a percentage of the population that’s well into the… single digits!
Just looking at the Census Bureau report, it’s not possible to calculate exactly for how many of the 10%, not having insurance is a big problem or a problem at all, but one thing is for sure, all the above factors mean that for quite a large number of the uninsured, not having insurance is NOT a big problem. Therefore, for simplicity, let’s say of the 10%, it’s a problem for half. Maybe a little more, maybe a little less.
Therefore, all the panic, crisis, “people are dying on the streets”, “we should join every other civilized nation”, “in America people have to choose between food and healthcare” rhetoric of the left, in reality is actually referring to about 5% of the population who don’t have access to all the healthcare they need, but they do have access to some!
Reality Check: What This Debate Really Comes Down To
We all know that liberals and socialists demand government intervention in private industry because of their compassion for others, or at least that’s what some of them claim.
And as such, the following sentence comes out the mouths of proponents of national healthcare very frequently: “How can we live in a country where some people don’t have access to basic healthcare?”
First of all, the premise of the question is flawed. As shown above, we’d be hard pressed to find people unable to receive any basic healthcare at all in the U.S. should they seek it.
Is it good that 5% have problems getting full access to healthcare they need? Of course not.
However, and this is key, in countries that have a national healthcare service, a.k.a. single payer systems, people do not get access to all the healthcare they need either! Otherwise, there wouldn’t be a need for private supplemental health insurance in the U.K., and there wouldn’t be a need for average Canadian citizens to seek treatment across the border in the United States at their own expense.
No government healthcare program we can implement is ever going to give all the healthcare anyone needs to everybody. The NHS (National Healthcare Service) in the U.K. doesn’t do it, the Canadian system doesn’t do it, the French don’t do it, and Medicare and Medicaid in the U.S. don’t provide comprehensive healthcare for those who are covered.
Michael D. Tanner of the Cato Institute, a libertarian think-tank, writes the following points about government controlled healthcare systems around the world:
- Health insurance does not mean universal access to health care. In practice, many countries promise universal coverage but ration care or have long waiting lists for treatment.
- Rising health care costs are not a uniquely American phenomenon. Although other countries spend considerably less than the United States on health care, both as a percentage of GDP and per capita, costs are rising almost everywhere, leading to budget deficits, tax increases, and benefit reductions.
- In countries weighted heavily toward government control, people are most likely to face waiting lists, rationing, restrictions on physician choice, and other obstacles to care.
- Countries with more effective national health care systems are successful to the degree that they incorporate market mechanisms such as competition, cost sharing, market prices, and consumer choice, and eschew centralized government control.
You can access Tanner’s full analysis of international health systems here on the Cato Institute’s Web site.
You may also read this December 2008 New York Times article about Bruce Hardy, an NHS cancer patient in the United Kingdom, who was deprived of life saving, yet costly, medicine because “at that price, Mr. Hardy’s life is not worth prolonging.”
And you may read this March 2010 Daily Mail article about how thousands of NHS cancer patients are denied life saving drugs:
Last year the Government’s drugs rationing body, NICE, promised to make it easier for patients suffering from rarer cancers to receive life-prolonging drugs on the NHS.
Today, we reveal just how hollow that pledge has proved.
Since it was made, ten drugs – which could have provided as many as 20,000 cancer sufferers with precious extra months or years – have been rejected on the grounds they are too expensive.
I suppose the British government just doesn’t have enough money to pay for everyone’s care after all!
Therefore this debate is really about whether approximately 5% of the population in the United States should receive somewhat more healthcare than they do now. And it’s not whether they would go from no healthcare to complete coverage, just whether they’ll get somewhat more… at the expense of others. No, not the rich “others”, everybody! That includes you and me and all of middle class America.
So What’s Wrong With Providing More Healthcare to Those 5%?
There’s nothing wrong, as long as you can actually do it in a way that doesn’t make things worse overall. And, experience has shown this is extremely difficult or impossible to do so with more government involvement in the health care industry.
I just gave examples of cancer patients in the U.K. being denied care by the NHS. But, as some may say, healthcare is also being denied by the “evil” insurance companies in America. That sometimes happens, however despite that “evil”, cancer treatment outcomes, for example, are better in the United States than anywhere else in the world, even if you count those with no insurance.
The following is from the National Center for Policy Analysis Web site:
According to the survey of cancer survival rates in Europe and the United States, published recently in Lancet Oncology:
- American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared to 56 percent for European women.
- American men have a five-year survival rate of 66 percent — compared to only 47 percent for European men.
- Among European countries, only Sweden has an overall survival rate for men of more than 60 percent.
- For women, only three European countries (Sweden, Belgium and Switzerland) have an overall survival rate of more than 60 percent.
These figures reflect the care available to all Americans, not just those with private health coverage. Great Britain, known for its 50-year-old government-run, universal healthcare system, fares worse than the European average: British men have a five-year survival rate of only 45 percent; women, only 53 percent.
You can find the full article here.
U.S. cancer survival rates are also higher than those in Canada.
So I suppose the “evil” private insurance industry indeed fairs better at providing care than the “benevolent” governments around the world.
And there are concrete reasons for that. Primary among those is that once the health care system is opened up to strong government influence, the decision making process starts running on political merits and not on the merits of science or quality of care.
Obamacare isn’t even in effect and this is already happening! This past week, the vote of Democratic Senator Mary Landrieu from Louisiana (to start debate on the Senate health care bill) was bought off with $300,000,000 of state aid. The following is from a Wall Street Journal article dated November 22, 2009:
Take Louisiana Democrat Mary Landrieu, who claims to have grave concerns about the bill’s cost. Those worries became less pressing when Majority Leader Harry Reid added language on page 432 of the 2,074-page opus that would raise the bill’s cost by increasing federal Medicaid subsidies for “certain states recovering from a major disaster.” Guess which state is the only one that would qualify under that wording?
This political gratuity was quickly reported as costing $100 million, but Senator Landrieu made clear after her floor speech that her vote couldn’t be bought that cheaply. “I will correct something. It’s not $100 million, it’s $300 million, and I’m proud of it and will keep fighting for it,” she told reporters.
Was Senator Landrieu’s vote cast on the health care quality or finance merits of the bill? No! It was cast on the merits of a dollar taken from each and every person in the United States to increase her chances of reelection in Louisiana. So that’s how socialized health care reduces costs! What a plan!
I can already hear liberals saying “but private health care isn’t about quality care either, it’s all about PROFIT!” To that I say that even assuming the motivation is all about profit, there is far more direct connection between profit and quality of product in private industry than between political gain and quality of product in the government sector. And I dare anyone to demonstrate otherwise!
Therefore, instead of legislating government takeovers of an industry, perhaps we should do something else.