Should the U.S. Have Universal Healthcare?

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By Dr. Merrill Matthews, resident scholar with the Institute for Policy Innovation

Because health care spending decisions are political rather than based on supply and demand, virtually all single-payer systems face shortages and ration care.   The degree of rationing depends on the country, the budget, current political pressures and the disease with the most political clout (e.g., cancer, HIV/AIDS, heart disease, etc.).

For many years the Fraser Institute in Canada has published a list of waiting times in the various Canadian provinces based on the care needed.   In some cases the wait can last for months. In England , for example, the Times of London recently reported:

"Health service dentists have been forced to go on holiday or spend time on the golf course this month despite millions of patients being denied dental care. ... Many have fulfilled their annual work quotas allotted by the National Health Service and have been turning patients away because they are not paid to do extra work. This is despite the fact that more than 7 million people in Britain are unable to find an NHS dentist."

And for the last few years, newspapers have been filled with accounts of Great Britain’s National Institute for Clinical Excellence, or NICE (has any government agency ever been so misnamed?), which routinely refuses to fund certain new breakthrough prescription drugs because the committee deems them as too expensive.   From a recent edition of the Yorkshire Post:

"A man with terminal cancer has been refused a drug by the NHS that could extend his life—despite offering to pay part of the cost himself. ... David Swain’s offer to meet the monthly 2,000 pounds cost of Erbitux was refused, he said, because the National Institute for Health and Clinical Excellence ruled it was too expensive."

But at least the public gets good preventive care, right?   From London ’s Daily Mail:

"Twice Katie asked for a Pap smear test, but was told she was “too young” to need one. Now 24, she is dying from cervical cancer, one of many young women who have fallen victim to a scandalous change in health policy."