Fantasyland

To jolt the health policy debate out of the August doldrums, nearly 8,000 physicians announced this week that they are supporting a taxpayer-funded, single-payer health care system based on ?an expanded and improved version of traditional Medicare.?



In this fantasyland plan, the federal government would pay for all physician and hospital care ? without any co-payments or deductibles ? and also would cover prescription drugs, medical equipment, long-term care, rehabilitation services, and dental care. The authors claim that their plan, described in detail in the current Journal of the American Medical Association, would SAVE $200 billion a year.


Where should we start?


First, today?s Medicare covers only about half the health care expenses of seniors, with 90% of beneficiaries obtaining supplementary coverage. The proposed universal version of Medicare would have to be very much ?improved? ? and much more expensive ? to even match the average private health plans that the great majority of working Americans have today, plans that are much more comprehensive than current Medicare.


The list could go on and on, but perhaps an article in The New York Times this week is the best way to show where this all-you-can-eat health care buffet would lead. It describes the experience of the residents of Wales in the United Kingdom seeking dental care from their government-run National Health Service.


??On a rainy Monday morning two weeks ago, 600 people turned up outside Brynteg Dental Surgery, a tiny white-stucco office, to secure one of the 300 advertised appointments to see a National Health Service dentist,? the Times reports.


?Wales is so lacking in government-subsidized dental treatment that some people pitched tents overnight rather than miss a chance for a slot?


?Not anticipating the dental mob, Mr. [Steve] Acworth, 56, arrived too late, which he said was too bad, considering he does not really have any teeth to speak of.

??My crowns all fell off,?” he said. “?I got some really bad dentistry and it ruined all my root work. I have no front teeth and one pair of molars, which meet on the right side of my mouth. I can’t bite anything…?

?Heather Davies, 25, the office manager who handed out numbers, deli style, on the morning of registration, said she was still getting nasty phone calls from some of the 300 people she had to turn away.


?People hurled curses and rude gestures at her. One man threatened her, saying, ?I know what time you get off work,? Ms. Davies recounted. She felt compelled to telephone the police. In fact, the office now has a direct hot line to the police.


??Because they are paying national insurance, people feel they are entitled to service,?” Ms. Davies said.?


How audacious!


So this is where it leads: Angry patients paying high taxes for universal access to health and dental care, only to be turned away after sleeping on sidewalks all night, with dentists calling the police to protect themselves from desperate patients.


Donald Palmisano, the dynamic new president of the American Medical Association, gets it right in saying single-payer systems lead to ?long waits for health care services, a slowness to adopt new technologies and maintain facilities, and development of a large bureaucracy that can cause a decline in the authority of patients and their physicians over clinical decision-making.?


We also agree with Dr. Palmisano?s ? and the AMA?s ? prescription: ??The solution to the health care question is a mix of private and public sector financing, with coverage and care remaining in the private sector. The AMA?s health insurance proposal advocates refundable tax credits inversely related to income, individually selected and owned health insurance, and other reforms.?


The battles continue between advocates of government-run health care and those, like us, who are trying to build a consumer-driven system organized through competitive, free markets.


Yes, Americans are frustrated with the health care system ? millions of uninsured, high costs, and bureaucratic intrusion. But more bureaucracy and centralized control in an era of dramatic new medical treatments and technologies simply can?t prevail. The United States has an obligation to lead the world to a better system, not turn back to the failed systems of the last century.


And finally, Health Policy Matters will take a vacation next week. Hopefully Washington will too.

Grace-Marie Turner

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To jolt the health policy debate out of the August doldrums, nearly 8,000 physicians announced this week that they are supporting a taxpayer-funded, single-payer health care system based on ?an expanded and improved version of traditional Medicare.?



In this fantasyland plan, the federal government would pay for all physician and hospital care ? without any co-payments or deductibles ? and also would cover prescription drugs, medical equipment, long-term care, rehabilitation services, and dental care. The authors claim that their plan, described in detail in the current Journal of the American Medical Association, would SAVE $200 billion a year.


Where should we start?


First, today?s Medicare covers only about half the health care expenses of seniors, with 90% of beneficiaries obtaining supplementary coverage. The proposed universal version of Medicare would have to be very much ?improved? ? and much more expensive ? to even match the average private health plans that the great majority of working Americans have today, plans that are much more comprehensive than current Medicare.


The list could go on and on, but perhaps an article in The New York Times this week is the best way to show where this all-you-can-eat health care buffet would lead. It describes the experience of the residents of Wales in the United Kingdom seeking dental care from their government-run National Health Service.


??On a rainy Monday morning two weeks ago, 600 people turned up outside Brynteg Dental Surgery, a tiny white-stucco office, to secure one of the 300 advertised appointments to see a National Health Service dentist,? the Times reports.


?Wales is so lacking in government-subsidized dental treatment that some people pitched tents overnight rather than miss a chance for a slot?


?Not anticipating the dental mob, Mr. [Steve] Acworth, 56, arrived too late, which he said was too bad, considering he does not really have any teeth to speak of.

??My crowns all fell off,?” he said. “?I got some really bad dentistry and it ruined all my root work. I have no front teeth and one pair of molars, which meet on the right side of my mouth. I can’t bite anything…?

?Heather Davies, 25, the office manager who handed out numbers, deli style, on the morning of registration, said she was still getting nasty phone calls from some of the 300 people she had to turn away.


?People hurled curses and rude gestures at her. One man threatened her, saying, ?I know what time you get off work,? Ms. Davies recounted. She felt compelled to telephone the police. In fact, the office now has a direct hot line to the police.


??Because they are paying national insurance, people feel they are entitled to service,?” Ms. Davies said.?


How audacious!


So this is where it leads: Angry patients paying high taxes for universal access to health and dental care, only to be turned away after sleeping on sidewalks all night, with dentists calling the police to protect themselves from desperate patients.


Donald Palmisano, the dynamic new president of the American Medical Association, gets it right in saying single-payer systems lead to ?long waits for health care services, a slowness to adopt new technologies and maintain facilities, and development of a large bureaucracy that can cause a decline in the authority of patients and their physicians over clinical decision-making.?


We also agree with Dr. Palmisano?s ? and the AMA?s ? prescription: ??The solution to the health care question is a mix of private and public sector financing, with coverage and care remaining in the private sector. The AMA?s health insurance proposal advocates refundable tax credits inversely related to income, individually selected and owned health insurance, and other reforms.?


The battles continue between advocates of government-run health care and those, like us, who are trying to build a consumer-driven system organized through competitive, free markets.


Yes, Americans are frustrated with the health care system ? millions of uninsured, high costs, and bureaucratic intrusion. But more bureaucracy and centralized control in an era of dramatic new medical treatments and technologies simply can?t prevail. The United States has an obligation to lead the world to a better system, not turn back to the failed systems of the last century.


And finally, Health Policy Matters will take a vacation next week. Hopefully Washington will too.

Grace-Marie Turner

SHARE THIS ARTICLE

About the author