"Free" Health Care

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Registered: 03-27-2003
"Free" Health Care
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Wed, 07-21-2004 - 8:58am
http://www.townhall.com/columnists/walterwilliams/ww20040721.shtml

Free health care

Walter E. Williams

July 21, 2004


Let's start out by not quibbling with America's socialists' false claim that health-care service is a human right that people should have regardless of whether they can pay for it or not and that it should be free. Before we buy into this socialist agenda, we might check out just what happens when health-care services are "free." Let's look at our neighbor to the north -- Canada.

The Fraser Institute, a Vancouver, B.C.-based think tank, has done yeoman's work keeping track of Canada's socialized health-care system. It has just come out with its 13th annual waiting-list survey. It shows that the average time a patient waited between referral from a general practitioner to treatment rose from 16.5 weeks in 2001-02 to 17.7 weeks in 2003. Saskatchewan had the longest average waiting time of nearly 30 weeks, while Ontario had the shortest, 14 weeks.

Waiting lists also exist for diagnostic procedures such as computer tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Depending on what province and the particular diagnostic procedure, the waiting times can range from two to 24 weeks.

As reported in a December 2003 story by Kerri Houston for the Frontiers of Freedom Institute titled "Access Denied: Canada's Healthcare System Turns Patients Into Victims," in some instances, patients die on the waiting list because they become too sick to tolerate a procedure. Houston says that hip-replacement patients often end up non-ambulatory while waiting an average of 20 weeks for the procedure, and that's after having waited 13 weeks just to see the specialist. The wait to get diagnostic scans followed by the wait for the radiologist to read them just might explain why Cleveland, Ohio, has become Canada's hip-replacement center.

Adding to Canada's medical problems is the exodus of doctors. According to a March 2003 story in Canada News (www.canoe.ca), about 10,000 doctors left Canada during the 1990s. Compounding the exodus of doctors is the drop in medical school graduates. According to Houston, Ontario has chosen to turn to nurses to replace its bolting doctors. It's "creating" 369 new positions for nurse practitioners to take up the slack for the doctor shortage.

Some patients avoided long waits for medical services by paying for private treatment. In 2003, the government of British Columbia enacted Bill 82, an "Amendment to Strengthen Legislation and Protect Patients." On its face, Bill 82 is to "protect patients from inadvertent billing errors." That's on its face. But according to a January 2004 article written by Nadeem Esmail for the Fraser Institute's Forum and titled "Oh to Be a Prisoner," Bill 82 would disallow anyone from paying the clinical fees for private surgery, where previously only the patients themselves were forbidden from doing so. The bill also gives the government the power to levy fines of up to $20,000 on physicians who accept these fees or allow such a practice to occur. That means it is now against Canadian law to opt out of the Canadian health-care system and pay for your own surgery.

Health care can have a zero price to the user, but that doesn't mean it's free or has a zero cost. The problem with a good or service having a zero price is that demand is going to exceed supply. When price isn't allowed to make demand equal supply, other measures must be taken. One way to distribute the demand over a given supply is through queuing -- making people wait. Another way is to have a medical czar who decides who is eligible, under what conditions, for a particular procedure -- for example, no hip replacement or renal dialysis for people over 70 or no heart transplants for smokers.

I'm wondering just how many Americans would like Canada's long waiting lists, medical czars deciding what treatments we get and an exodus of doctors.

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iVillage Member
Registered: 02-16-2004
Wed, 08-11-2004 - 2:48pm
First of all, there's no such thing as "free" health care. Where does everyone think the government is going to get the money to fund "free" health care? The Money Fairy? We will all pay for our health care whether it's private or "free."

I haven't seen anything to indicate that government-funded healthcare is any better than privately funded healthcare, in spite of its claims. There are just as many stories of people who don't get the care they need in Canada and Britain as there are in the USA. What bothers me is this notion that so many people have that government is naturally better at handling these things than private individuals. The US government can't even build a bathroom without spending $300,000 and creating 40,000 pages of regulations, so why on Earth would anyone want to entrust their very lives to them? Our government is a bloated, inefficient, incompetent bureaucracy that screws up every industry it tries to take over. I'd rather place my trust in a company that relies on the satisfaction of its customers for its existence than the government.

iVillage Member
Registered: 08-10-2004
Wed, 08-11-2004 - 6:04pm
Actually one can get into medical school with as low as a 3.0, if they have high enough MCAT scores and have done some good research in undergrad. I've worked at both a 4 year university and a medical school in student services. Some people have to apply several times to get in. Depends how badly they want it. Also depends on the cohort of that year that they are competing against. Medical schools limit the # of admissions for the same reason that all graduate programs cap their admissions, resources, i.e. classroom space, number of faculty to teach courses, lab equipment, etc. It's also the same for residency programs. They have to have enough resources available for the residents. The AMA( I think you called them the ABA, that's for law schools) does not accredit the medical schools. The Liaison Committee on Medical Education does the accrediting of allopathic (M.D.) schools. There is a different accrediting body for D.O.'s. All respectable universities are accredited by some outside body, SACS, etc. It's actually a very arduous process when you are up for reaccrediting. It is also very expensive to start a medical school from scratch. The Texas legislature alloted $44 million to expand a 2-year clinical site in El Paso to a full 4-year medical school. It's in a much needed location, but most states, Texas included do not have that much budget for new schools. Many medical schools are expanding the number of students in their admitted class to help with the need for doctors. Another issue you have to look at, is that not all doctors want to do primary care. They choose dermatology or radiology so they can have somewhat of a normal life after they finish their education. And who wouldn't want to have a normal life, with semi-normal hours, and not be paged at every evening meal or have to go to the hospital every weekend? Can't really blame some of them for not going into internal medicine or OB/Gyn.

We already have a form of what you are talking about w/ the tuition for work, it's called the National Health Service Corps. Doctors can have a portion of their loans forgiven if they choose to go to an underserved area, where there may not be a doctor in an entire county. There are takers. But, not everyone wants to do that. You can't make people go work somewhere, just because you think they should go there. Why single out the doctors? What about pharmacists, PA's, nurses, lawyers, MBA's? And there is a BIG difference between lawyers and doctors. Law school is 3 years post bachelors, where the students can work while they are in school. There are a lot of evening law programs so people can maintain their current career. I do not know of a medical school where the students can work while in school. They have to live on loans, grants, family assistance, etc. And medical school goes year round, without much of a break, it is 4 years post bachelors, with an addition 3-12 years of residency making a paultry $33,000/year for having 7 years of college and working 60-80 hours a week. Medicine is a different kind of calling than a lot of professions. The doctors have a life in their hands, and have an impact on the lives of the family members, friends, etc. Lawyers do not have dying people coming to them expecting them to help or fix it and make the pain go away. Lawyers don't have to deal with the feelings when one of their patients died after they did everything they could to save them and then they have to go tell the husband or wife of 50 years that they just couldn't save their loved one. That takes a lot of dedication and devotion to one's vocational calling!

I know all too well about the loans. We are paying on $90,000 right now. It is a long term mortgage, but then if you actually want to own a home, you have to get a mortgage in addition to that one!

I think your wife's OB/Gyn was very lucky to only have had 1 case of uterine cancer in thousands of patients. I would think that's the exception and not the rule. What about cervical or ovarian cancer? And they just had a hysterectomy w/o any chemo or radiation? That's pretty severe. I'm sure the med tech's did a fine job of triaging the patients. Many hospitals are starting to do that with nurses as a cost saving method. It's great for those who are not really sick. But for those who are, aren't they glad they have a qualified doctor to see? If it was me or someone I love, I would rather they have a board certified physician taking great care of them. But, that's just me.

I don't like it that so many people do not have insurance or that there are so many people who have insurance, but have to fight with their insurance company to get things done. But, taking it out on the doctors is simply not fair. They don't go into medicine for the money. Ask some of them. They do it to help people. We have many friends who were in my husband's class in medical school or residency program or have worked for about 20 years. Many of them say if they had it to do over, they would not go into medicine. Doctors are not business people. How many do you know that have a business background or went to school in business? I know 1. But, you have a lot of business people, insurance companies, telling the doctors how to practice medicine. Makes a lot of sense, huh?

iVillage Member
Registered: 08-10-2004
Wed, 08-11-2004 - 6:05pm
Thanks!
iVillage Member
Registered: 08-12-2004
Thu, 08-12-2004 - 7:25pm
Thank you for that lesson in Econ 101. I agree in total with what you have said and see understand the wisdom in your dissertation. You have certainly explained, in a much needed way, for everyone to really understand the danger of too much government. I have been a small business owner for many years and am unfortunately too aware of the problems that can arise from "over-governing" in any particular area that is best left to independent contracters. Doesn't matter if they are physicians or bricklayers. When anyone feels that they can't earn what they have rightfully worked for, then the exodus of docters from Canada makes perfect sense.
iVillage Member
Registered: 08-07-2004
Thu, 08-12-2004 - 8:23pm
I recently met a man who worked for a small business for 20 years without any health care benefits. He started out making 18 thou a year, 20 years later he was making 22 thou a year. Then he got sick, very sick, and couldn't do his job anymore. He needed serious health care, and he needed it right away. He had to quit his job of course, he was too old & sick & had no choice. The small business owner said thanks & good bye, no pension either. This man then applied for Medicaid and got it. So the general public, the taxpayers picked up the tab for his treatment. I think the small business owner took advantage of a man who was a minority race and was poorly educated. I'm sure the business profits increased by a higher percentage than the raises this laborer got. So who covers the costs? Taxpayers, not the business owner & not the man in question. You as a business owner certianly have a vested interest in keeping things the way they are. I, as a taxpayer resent the "system" we have, requiring me to cover the bills. If I am going to pay, I should have a say in the so called system.

Unfortunately, Medicaid is administered capriciously, so some people get it unnecessarily, and others are denied for no discernable reason.

This sucks, and we should be doing something different. Health care shouldn't be free, but it should be affordable.
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Registered: 04-18-2004
Fri, 08-13-2004 - 4:31am

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iVillage Member
Registered: 07-05-2003
Fri, 08-13-2004 - 6:20pm
And what was the man who was working for 20 years without health coverage doing about his situation?
iVillage Member
Registered: 03-26-2003
Fri, 08-13-2004 - 7:18pm
Some of the information you give is skewed. The reason for the shortage of doctors is the same reason that the shortage of doctors are in shortage everywhere in the world, including the good old U.S.A. Not enough people are training to be doctors. The same goes for all other medical personel. While some doctors choose to leave Canada, nurses are flocking to the borders to be allowed to work there due to the high wages, especially in B.C.

As to the figures that were given re:waiting lists, this has partly been due to the areas of Canada, most of Canada, who live in remote areas and must travel to or wait for medical care. It also is due to a number of strikes by medical personel through-out the country to recieve equitable pay for the service they provide.

There is no equitlable system of health care; there are just some that are more equitable than others. A system where people are denied basic health care, such as getting medication for a baby with thrush when a single mother who has a 3 week old baby and is on welfare for the six weeks after the baby is born, is not at all fair. Yet, that is what we have. I can not get my medication for my chronic severe illnesses or see a doctor for them because I can not afford to buy medical insurance and, if I could, would not be eligible for coverage even if I could. I am not eligible for medical coverage through the state. I can't get free prescriptions through the programs provided by the major drug companies because I can't see a doctor and have to have a prescription in order to be on these programs. I can't get into the "free" clinic in our area because there is a 3 month waiting list for an appointment. Yet, my dh, who is a Canadian citizen, can walk into a clinic at any time and see a doctor when he has the flu.

The Bush Administration is silently going behind closed doors and getting rid of all social expeditures as much as they can as soon as they can. Who does this serve? The wealthy and the powerful. It serves no one else. The day that the Bush Admin. came out in support of the military of this country in a very public manner, was the day before they closed the doors and cut the veteran's benefits. When our country's veterans were sworn in, they were PROMISED that the country would take care of their medical, dental and vision care for the REST OF THEIR LIVES. This has been cut.

I do believe that the MOST equitable way of serving a country's medical needs is in a national program of health care. Is that likely to happen here? No. Why? Because it is not the "average person" who is in charge of and running this country. It is those who benefit by the "average person" NOT recieving this. Why does the "average person" put up with this instead of fighting it. On the off-chance, the far-reaching chance, that they will one day know ahead of the rest of us what the next big thing on the market will be and become one of the top 1% who run this country.

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iVillage Member
Registered: 08-07-2004
Fri, 08-13-2004 - 8:03pm
What do you think a person with 22 thou per year can do about obtaining health care? Do you have any idea what private health insurance costs? He was doing what most people in his situation do, praying he wouldn't get sick. BCBS costs over $400.00 a month for an individual to purchase by themselves, but if you are part of a group, it's much less. Wanna bet the owner of that small business had insurance? But he couldn't bother to find a group plan & offer it to his employees, with some cost sharing between the two of them. The end result? We pay.


< And what was the man who was working for 20 years without health coverage doing about his situation? >

iVillage Member
Registered: 07-05-2003
Sat, 08-14-2004 - 12:33am
allianor wrote - "What do you think a person with 22 thou per year can do about obtaining health care? Do you have any idea what private health insurance costs? He was doing what most people in his situation do, praying he wouldn't get sick. BCBS costs over $400.00 a month for an individual to purchase by themselves, but if you are part of a group, it's much less. Wanna bet the owner of that small business had insurance? But he couldn't bother to find a group plan & offer it to his employees, with some cost sharing between the two of them. The end result? We pay."

$400 a month is about right, and it isn't too much to pay for healthcare. The problem in the US isn't lack of healthcare, it's that healthcare costs money and many don't like paying what it costs.

Too many seem to think health care is something magic that springs from the ground... it doesn't. For someone to get free, low cost or subsidized health care, someone else has to pay for it. All you can do is transfer the costs. You can transfer costs to taxpayers, to providers, or to other sources, but at the end of the day there is no free, there is no cheap, there is no really low cost health care... there are only ways to make others pay for it.

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