Sunday, April 6, 2008

The Deadly Downsides of Insuring Everyone

The soundbite "Health Insurance for All" generates widespread assent. But like most bumper-sticker rhetoric, closer analysis is required. Let me ask you a question:

It's well-acknowledged that the U.S. health care system is creaking under its weight. For example, over 120,000 people die annually as the result of healthcare-practitioner errors. Now, what do you think will happen when we ask our health care providers to add 47 million uninsured to their patient rolls, a group that has above-average health care needs but pays little taxes and will likely pay little into the new government-mandated system that will almost assuredly be enacted under a Democrat presidency?

Not only will more deaths result, but there will be long waits for health care, and refusal to provide care in such gray-area situations as a 75-year old male needing and wanting bypass surgery. Lest you think I'm making that assertion based only on the well-publicized nightmare experiences of some people in Canada who, for example, desperately needed surgery but couldn't get it, let me refer you to the U.S.'s current experiment in covering everyone: Massachusetts. And lest you think my source of information about the Massachusetts insurance-for-all system is some conservative rag, my source is the New York Times.

I do believe that basic health care is a right, but we cannot provide it for the whole world, including the 13 million and skyrocketing number of illegal immigrants. (And once we do, the number of illegal immigrants will accelerate further.) However we decide to reform health care, it is only right that there be tiers: basic health care for all, but, for moderate cost, other people should be covered for a wider range of procedures, allowed to choose their health care providers, and have faster access to them.

To increase the number of qualified health care providers, we need to realize that doctor, nurse, and allied-health practitioner training programs (currently designed primarily by academics rather than by top clinicians) can be significantly shortened with minimal impact on patient care. In fact, if those training programs were developed and taught by top clinicians instead of by academics, I'd predict that care quality would actually improve.


Anonymous said...

I have yet to understand why so many are pushing for this. I haven't heard a convincing argument for universal government-mandated health care yet.

You make some good points, Mr. Nemko. I'd like to raise an additional question: with several glaring examples of failing universal health care programs around the world and now in Massachusetts, what makes the supporters of such a program for all Americans think that it will work here? Why will the US version be different than, say, the UK version? And if this is pushed through, what "universal" idea will be tossed around next?

Not only will there be more deaths due to error and long waits, but I think there will also be more deaths because of, for lack of a better term, the worth of a human life. If health care is left up to the government officials, I suspect that they will the ones deciding whether a treatment needed to save a patient's life is worth giving to the patient, just like health insurance companies do now. With all the additional patients, there will only be so much treatment to go around, and sooner or later, your life may not be worth saving.

If some of the policy makers had to live by some of the laws and plans they made (can you imagine if Hillary Clinton met her end because she had to wait a few days too long for a kidney?), I have a feeling that less of the bad ones would be made.

Kare Anderson said...

what an insightful perspective on this issue - thank you


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