Uncle Sam, MD

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  • 01/23/2008
What's the difference between "universal" health care and "government" health care? Just who are these 47 million uninsured Americans that everyone's talking about?

Here's a new op-ed (from both the San Francisco Examiner and the Washington Examiner) that addresses both issues.


Peter Pitts: Uncle Sam, M.D.?

On both sides of the political aisle, presidential candidates have labeled universal health coverage as the moral challenge of the decade. But is a government-run health care system the best means to bring this about?

Well, that depends on whether you want your health insurance and medical services to be provided by the same folks who run the Department of Motor Vehicles and Federal Emergency Management Agency.

Look abroad and you’ll see the disastrous effects of a government takeover of the health care industry.

In Canada, patients languish on surgical waiting lists for months. In the province of British Columbia, for example, more than 75,000 citizens were waiting for surgery at the end of September 2007. Even for serious procedures such as cardiac surgery, the average wait time is more than nine weeks.

In the single-payer health systems dotting Europe, price controls on prescription drugs have reduced the supply of treatments available to patients. Good news for the bean counters, but bad news for the sick.

What’s more, price controls have caused an atrophy of the European pharmaceutical industry. Fifteen years ago, European firms were responsible for 80 percent of drugs invented worldwide; today, they account for less than 20 percent of new drugs.

So not only have European patients taken a hit, thanks to reduced availability of medicines, so has the European economy.

Such dirty secrets are why most advocates of universal health care harp exclusively on access to insurance, which everyone agrees is important. In doing so, they obscure these insidious aspects of a government-run system.

But the fact is, access to health insurance is not a problem for most Americans.

Among those who work full- time, for instance, the vast majority receive access to either a health maintenance organization or a preferred provider organization through their employer. Older Americans have Medicare, while Medicaid serves the poor. Active and former military personnel are in the insurance system run by the Department of Veterans Affairs. Self-employed people may acquire individual policies or exploit the benefits of high-deductible insurance policies and health savings accounts.

Even for the indigent, care is widely available — at either a heavily subsidized level or often for free. And it’s illegal to turn a patient away from a hospital emergency room for lack of an insurance card.

Vaccinations are often free for children and the elderly, and free or low-cost walk-in clinics have grown in popularity throughout the country.

When it comes to prescription drugs, both manufacturers and retailers have set up programs to provide needed medicines to low-income patients at reduced cost.

So in a very real sense, “universal health care” already exists.

What about the oft-cited 47 million Americans who “lack insurance?” Such a number sounds catastrophic, but an examination of the details reveals that such figures are not always what they seem.

First, included in that number are scores of healthy young people — close to 20 million, by some accounts — who elect not to buy health insurance even though they can afford it. They voluntarily choose not to have health insurance — which is quite different from not being able to get health insurance.

That figure also includes 10 million illegal aliens. None of the politicians currently touting his or her plan for universal coverage has addressed this significant portion of the uninsured pool. And if the government can’t identify who’s here illegally anyway, how can it possibly ensure that they’ve purchased health insurance too?

Finally, the 47-million statistic isn’t static. Most of those who are without insurance are only without it temporarily — as when switching jobs.

When we get down to brass tacks, it turns out that many politicians and media types have created a phony verbal distinction between “universal health coverage” and “government-run health care.” Universal coverage is not possible without government coercion — and all the disastrous side effects that come along with it.

Our current system may be problematic. But the “free lunch” promised by advocates of government-run health care is anything but. Its costs are clear: price controls that stifle medical innovation, and a rationing of medical services that leaves many patients out in the cold.

Peter Pitts is president of the Center for Medicine in the Public Interest and a former Food and Drug Administration associate commissioner.

While it's nice having a doctor in the family -- it shouldn't be your Uncle Sam.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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