Universal health care is not the answer
I disagree with Dr. William Bezdek's op-ed article promoting universal health care ("At stake: The health of a nation," July 19). Specifically, I disagree with his position that "health care should be a universal right and the government should protect that right." Yes, it is the society's obligation to provide help to needy. However that "help" is not a "right."
If you go to Sears to buy a washer and a dryer, you pay an appropriate price to Sears -- set by the seller, based on market conditions, quality of the product and competition. We do not have that choice in health care. The price is already set by the payer -- be it the government (Medicare/Medicaid) or the insurance industry. If this sounds like wage and price control, it is. Why not let the markets decide the quality, price and service? When the government takes over anything, the cost always goes up and the level of service always goes down. Just look at the VA health care system.
A recent editorial in Investor's Business Daily puts several myths to rest. Among these are the following (I have paraphrased some of them):
"Health care crisis": 47 million is the number quoted by everyone. However, when analyzed, there are about 12 million people who are really unable to buy insurance. The others can either afford it but choose not to, are illegal immigrants, or are young and consider themselves invincible.
"Government-run health care produces better results": Look at these statistics: According to the Heritage Foundation, breast cancer mortality in Germany is 52 percent higher than in the U.S.; the U.K.'s rate is 88 percent higher. For prostate cancer, mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. Mortality from colorectal cancer is 40 percent higher in the U.K.
But what about the health care paradise to our north? Americans have almost uniformly better outcomes and lower mortality rates than Canada, where breast cancer mortality is 9 percent higher, prostate cancer 184 percent higher and colon cancer 10 percent higher.
Then there are the waiting lists. With a population just under that of California, 830,000 Canadians are waiting to be admitted to a hospital or to get treatment. In England, the list is 1.8 million deep.
Before you sign up, you might want to check with people in countries that have the kind of system the White House and Congress have in mind. Recent polls show that more than 70 percent of Germans, Australians, Britons, Canadians and New Zealanders think their systems need "complete rebuilding" or "fundamental change."
"The poor lack care": The law says anyone who walks into hospital emergency room must be treated. America has 37 million people in poverty, but Medicaid/Medical covers 55 million at a cost of $350 billion per year.
"Health care reform will save money": Few of the plans now coming out of Congress will save anything, says the CBO's current chief, Douglas Elmendorf. In fact, he says, they'll lead to substantially higher costs in the future -- costs that will be "unsustainable."
I have several solutions in mind. Now, some of these are sure to be controversial, but they offer alternatives to a large, stodgy, government-run bureaucracy and are worth a debate.
* Let the people buy their own insurance and make it tax deductible, in much the same way that your employer gets a deduction. Encourage health savings accounts.
* Let consumers and employers form consortiums across the state lines and negotiate with insurance plans. Give them more responsibility for the costs and let them shop around for the best available service at a lowest possible cost. Make the entire amount spent for medical care tax deductible.
* Impose meaningful tort reform. MICRA has worked in California. Create an environment where the physicians do not have to practice defensive medicine.
* Reward high-quality medical service, innovation and research appropriately.
* Accept the fact that some people will not buy insurance even though they can afford it. Provide county- or state-government run hospitals or clinics for those people. These can be federally funded. Let it be a choice. There is no need to herd the entire population through a federal-government system to cover a few.
* Identify some of the models that have made even Medicaid HMO's successful. Use those models to administer the programs at local levels, rather than establishing a Health Czar to administer them from Washington.
* Study the effectiveness of certain preventive services such as screening mammograms. Expand the scope of such preventive services, rather than denying payments for them.
* Hospital costs are extremely high while outpatient services offer better value to the patients and referring physicians compared to in-hospital services. This is a well documented fact, proven by various specialties like surgery centers, sleep centers, imaging centers, etc. The proposed plans promote hospital-based services over outpatient services to appease the stronger hospital lobby. The focus should be the opposite -- promote outpatient services and urgent care centers, rather than hospitals and emergency departments.
* Any plan imposed by the politicians will have loopholes to help their contributors -- look at the GM and Chrysler deals. Let the people make choices, give them freedom. Have effective oversight and sensible regulations. Punish the violators severely. That will improve the system, not the other way around.
I don't profess to be an expert in the field. However, I have been around a block or two. I have seen the results of government-imposed solutions while growing up under a socialist regime in India. Believe me, such solutions did not work there and will not work in the U.S. We should not be adopting policies that have already failed in other countries.
Dr. Girish Patel is founder and medical director of Truxtun Radiology Medical Group.
