Socialized Medicine Elsewhere Shows Why It Is a Failure

By Grace-Marie Turner

Britain’s system of socialized medicine is enough to make your teeth hurt – literally.

Its citizens rely upon the government-run National Health Service that is designed to provide free access to every medical service, including dental care.  But like all socialized medicine schemes, it has produced long lines, a shortage of medical professionals, and shoddy care.

William Kelly, a resident of a working-class suburb of Manchester, represented the frustrations of many Britons when he plucked out one of his own teeth last year. Why? Because the pain had become intolerable, and the wait to see a dentist was unbearably long. When he spoke with The New York Times last summer, Kelly had been unable to get a dentist appointment for six years.

At the beginning of 2006, only 49 percent of British adults and 63 percent of children were registered with public dentists. Because dentists are paid on a per-patient basis, the government’s system encourages public dentists to treat as many patients as possible, often leading to inadequate care and roughshod work.

With pay tied directly to the number of patients a dentist sees, for example, it makes more sense — financially, at least — for a dentist to extract teeth rather than perform a more complex and time consuming root canal.  And the pool of available dentists is shriking as more are leaving the National Health Service to work in the private sector where they can be paid more.

Last April, 2,000 dentists did just that, according to the British Dental Association. In understandable frustration, many Britons have resorted to “Do it Yourself Dentistry” kits sold in pharmacies.

Take the case of Gordon Cook, a 55-year-old security manager. After failing to find an NHS dentist, he resorted to fixing his front tooth with superglue, according to a November article in the Daily Mail. For three years, Cook constantly reapplied the glue to a loose crown before finally finding a dentist.

“You can't really taste it but you do have to be careful not to use too much, in case you glue your mouth shut,” said Cook.

But don’t expect advocates for socialized medicine to be honest about the major failings of the supposedly utopian English system.

Defenders of European-style healthcare will often observe that the United States spends a greater percentage of its GDP on healthcare than any other country in the world. And, with measures like life expectancy, America’s outcomes are often worse than those countries with socialized systems.

But these arguments fail to take into account the quality of care provided.

Because socialized medicine rejects the basic laws of supply and demand — and because state-administered systems do not pay doctors what the market determines they are worth — there is a serious discrepancy between the number of doctors and number of patients. This leads to the inevitable “waiting times” that one hears so much about in countries like Great Britain and Canada.

A report by the Canadian Fraser Institute found that the average wait time from referral by a general practitioner to a specialist is 18 weeks, the longest ever recorded in Canada.

Despite all the attempts made by the Canadian government to improve this problem, the average wait time actually rose by an astonishing 91% between 1993 and 2006. No matter how much money the Canadian government throws into the program, the problem does not go away.  They just haven’t figured out how to repeal the laws of supply and demand.

Further, in the interest of national budgets, state-administered health systems have an incentive to put saving money before patients.

Japan, for example, spends only about half as much of its GDP on healthcare as the United States. But the comparatively low salaries doctors receive have caused a serious shortage of cancer specialists in a country where cancer rates are rising and the disease is the leading cause of death.

Indeed, “cancer refugees” — cancer patients desperately seeking care — have become a national crisis. At a recent event protesting the Japanese government’s lackadaisical approach to battling cancer, a cancer sufferer cried, “While Japan has become economically prosperous, cancer patients are in the same position as refugees who wander in search of food, water and someone who can help.” The patient died seven months later.

Those who advocate for universal healthcare may have their hearts in the right place, but they would do well to examine how the systems they support are actually performing around the world. So the next time you hear about the wonders of socialized medicine, remember Gordon Cook and his mouth full of superglue.

*************

Grace-Marie Turner is president of the Galen Institute, a non-profit research organization focusing on free-market solutions to health reform.  She can be reached at P.O. Box 19080, Alexandria, VA, or at turner@galen.org.

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By Grace-Marie Turner

Britain’s system of socialized medicine is enough to make your teeth hurt – literally.

Its citizens rely upon the government-run National Health Service that is designed to provide free access to every medical service, including dental care.  But like all socialized medicine schemes, it has produced long lines, a shortage of medical professionals, and shoddy care.

William Kelly, a resident of a working-class suburb of Manchester, represented the frustrations of many Britons when he plucked out one of his own teeth last year. Why? Because the pain had become intolerable, and the wait to see a dentist was unbearably long. When he spoke with The New York Times last summer, Kelly had been unable to get a dentist appointment for six years.

At the beginning of 2006, only 49 percent of British adults and 63 percent of children were registered with public dentists. Because dentists are paid on a per-patient basis, the government’s system encourages public dentists to treat as many patients as possible, often leading to inadequate care and roughshod work.

With pay tied directly to the number of patients a dentist sees, for example, it makes more sense — financially, at least — for a dentist to extract teeth rather than perform a more complex and time consuming root canal.  And the pool of available dentists is shriking as more are leaving the National Health Service to work in the private sector where they can be paid more.

Last April, 2,000 dentists did just that, according to the British Dental Association. In understandable frustration, many Britons have resorted to “Do it Yourself Dentistry” kits sold in pharmacies.

Take the case of Gordon Cook, a 55-year-old security manager. After failing to find an NHS dentist, he resorted to fixing his front tooth with superglue, according to a November article in the Daily Mail. For three years, Cook constantly reapplied the glue to a loose crown before finally finding a dentist.

“You can't really taste it but you do have to be careful not to use too much, in case you glue your mouth shut,” said Cook.

But don’t expect advocates for socialized medicine to be honest about the major failings of the supposedly utopian English system.

Defenders of European-style healthcare will often observe that the United States spends a greater percentage of its GDP on healthcare than any other country in the world. And, with measures like life expectancy, America’s outcomes are often worse than those countries with socialized systems.

But these arguments fail to take into account the quality of care provided.

Because socialized medicine rejects the basic laws of supply and demand — and because state-administered systems do not pay doctors what the market determines they are worth — there is a serious discrepancy between the number of doctors and number of patients. This leads to the inevitable “waiting times” that one hears so much about in countries like Great Britain and Canada.

A report by the Canadian Fraser Institute found that the average wait time from referral by a general practitioner to a specialist is 18 weeks, the longest ever recorded in Canada.

Despite all the attempts made by the Canadian government to improve this problem, the average wait time actually rose by an astonishing 91% between 1993 and 2006. No matter how much money the Canadian government throws into the program, the problem does not go away.  They just haven’t figured out how to repeal the laws of supply and demand.

Further, in the interest of national budgets, state-administered health systems have an incentive to put saving money before patients.

Japan, for example, spends only about half as much of its GDP on healthcare as the United States. But the comparatively low salaries doctors receive have caused a serious shortage of cancer specialists in a country where cancer rates are rising and the disease is the leading cause of death.

Indeed, “cancer refugees” — cancer patients desperately seeking care — have become a national crisis. At a recent event protesting the Japanese government’s lackadaisical approach to battling cancer, a cancer sufferer cried, “While Japan has become economically prosperous, cancer patients are in the same position as refugees who wander in search of food, water and someone who can help.” The patient died seven months later.

Those who advocate for universal healthcare may have their hearts in the right place, but they would do well to examine how the systems they support are actually performing around the world. So the next time you hear about the wonders of socialized medicine, remember Gordon Cook and his mouth full of superglue.

*************

Grace-Marie Turner is president of the Galen Institute, a non-profit research organization focusing on free-market solutions to health reform.  She can be reached at P.O. Box 19080, Alexandria, VA, or at turner@galen.org.

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About the author