Single-Payer Health Care Systems Ration Care
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."
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Whatever the system health will be rationed. With free enterprise medicine it will be rationed by the market; when you have a national health system you will have rationing of a somewhat different kind. Rationing is inevitable; the only question to decide is how the rationing is to be done.
America has chosen one path; other advanced countries have chosen another.
M. Glass
The only person who would ever invoke "having to wait" as a reason to reject universal health care is someone who is wealthy enough to get access at all! Given the choice between waiting for care or not having care at all, I'm sure most people would choose the former!
Signed,
a proud and grateful and healthy Canadian
The article about dental care in the UK paints a picture similar to how health care is already rationed in the U.S. When denied coverage by the national plan, individual patients can pay by private means.
The article states,"Patients have been told they must either pay privately or return in April when the new work year begins." In the U.S. patients may pay privately as well when insurance does not cover a medical procedure. Also the British deficiency in care is not based upon government rationing care, as much as it is a poor administering of benefits. The care is available, british patients simply aren't acessing it. Again from the article:
"“Patients in pain have had to shop around to find a dentist that has not used up their quota,” he said.
The British Dental Association fears that other dentists have been unable to meet their quotas and will be forced to pay back thousands of pounds to the NHS. " implying that care was available, and underutilized.
Current U.S. healthcare is also subject to regional shortages. The issues claimed here are not indicitave of single-payer health care systems, but rather a natural effect of any economy .
What's more, I don't see that this fully addresses the health care debate right now. Current plans describe a general plan, or multi-payer plan, which is very different from single-payer systems in place in other countries. This seems more like deliberate deception by experts who would know the difference.
It's just that insurance companies ration the care instead.
Watch SICKO by Roger Moore don't buy the lies. Big medicine does not want universal health care they would lose too much money.
I had to endure 5 years in the military healthcare system and it was AWFUL. I had NO choice in who I could see because I was required to use the on-base clinic unless they put in for an exemption to refer me to a civilian (which took MONTHS of chasing down to get the one time they actually permitted it). The providers ranged from at best inexperienced to at worst completely incompetent. Procedures that are considered routine in the civilian world such as a 2nd trimester ultrasound were simply not done (I had to go off-base and pay 100% of the costs out of my own pocket).
I may not be thrilled with the expense of my current PPO plan, but it's a MILLION times better than what I experienced in the military system.
I don't think military structured health care is an equitable comparison. Most European universal health care systems allow public choice in institutions and doctors and even allow privatized specialists for those that want, and are able, to spend out of their own pocket.
Universal doesn't have to mean single option. Let's be creative and allow privatization, but not to the point that we have become, so that health care is exclusively for the wealthy. A system that leaves people on the street rather than meeting their basic human needs is tragic and should be condemned for such treatment. When a citizen's only "health care" is emergency aid, there is no care at all.