Friday, May 8, 2009

Ready for Health Rationing?

National health care is all the rage in the U.S. today. A majority of Americans apparently believe that they will enjoy their current level of care, but via a government single-payer plan that will be cheaper than what they pay today. Dream on. What is actually delivered will look more like health care a' la DMV, VA Hospitals and Medicare. Too harsh? Perhaps, but I think not. Take Canada as Exhibit 1.

What does government run health care look like in our neighbor to the north? Not so good, I'm afraid and whatever the Canadians did right in banking ( see blog 5/5/09), they have booted it badly in health care to the point that hospitals in this country are targeting a large and apparently growing market of Canadians unable to get timely care in their own county. (www.nytimes.com/2000/01/16/world/full-hospitals-make-canadians-wait-and-look-south.html?sec=health) Even in the Great Northwest, Canadians are coming across the border in force to get medical treatment that is simply unavailable at home. (www.cmaj.ca/cgi/content/full/162/4/547). Basic laws of economics are at work here - there is no such thing as a free lunch.

Most people think of paying a price for something in dollars, but there are many ways to pay a price. Take airlines. For those of us old enough to remember when you got real meals in coach, had room to stretch your legs before you bumped the seat in front of you, and had generally friendly and courteous airline employees - we know flyers have paid a price in the quality of service for $199 transcontinental roundtrips. Flying today is like riding a bus, maybe worse. Passengers are jammed in seats guaranteed to generate DVT, snarled at by gate agents and flight attendants alike, and then blithely ignored when their baggage ($15 please) doesn't show up on the carousel on the other end, having probably been pilfered by a luggage handler or TSA employee. I'd take the train but it never shows up. The dollar price is low, but the aggravation price is off the charts. You pay the price!

Health care is the same. If you pay for health care with taxes instead of through your employer with some nominal co-pay, the first thing you will notice is that your taxes will go up. Then there is the problem of paying for medical services for all those people who pay no taxes, which is currently in the neighborhood of 50% of the total U.S. population. Next there is the administrative cut the government will take. Private insurance companies have to compete on rates against other companies and run efficiently to earn a profit for shareholders. If government has a monopoly on health care, where is the incentive to be efficient? No Federal agencies leap immediately to mind as lean and mean. Bloat is the order of the day and when administrative costs start their inevitable run (and I do mean run) up, will it be the bureaucrats or the rest of us who get first dibs on the actual tax dollars? Hmmm - let me think. Politicians and bureaucrats always put themselves first and thus patient care will go into the tank, just like it has in Canada.

What's your health - or better yet your child's health - worth? We are going to pay a huge price if we take the same failed approach as Canada and the least expensive part will be in dollars. Don't say you weren't warned.

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