"The only way to put the patient first is to put the patient in control." Orthopedic surgeon and U.S. Representative Tom Price.
The cancer that plagues the American health care seems complicated, but easily distills to one simple problem: Government, government, government. After all, there is really only one major difference between the fire, life and auto insurance you can afford; and the health insurance you can't.
between the over-the-counter drugs you can pay for and the prescription drugs you can't. between the five-star resort you can sometimes afford and the hospital stay you never will. The difference is a history of government "helping" people.
The government's first major venture into the health care business was in 1965 with Medicare and Medicaid for the elderly and poor. These programs grew like all programs do. Recently, another one was born, S-CHIP, which sallies into Pediatrics. Besides these directly-run programs, the feds have taken indirect control with sweeping, unfunded mandates such as EMTALA. That is the 1986 law that requires emergency rooms to treat any patient for anything, whether they can pay or not. There are also hundreds of health insurance mandates (see Lesson 22). With each growth spurt of the government into health care, the industry has been transformed from a functional business into a perverted "system." This decay was predictable to anyone who paid attention to Canada, Europe, or to world history. The failure rate of socialism and socialized medicine is 100%. Government health care is the reason sick Canadians and Europeans pay cash to get care in the United States. It's also why sick Americans are starting to fly to India for the same thing.
Government has ruined health care in the same familiar ways it ruins any business in which it dabbles: 1. Expansion of bureaucracy and regulation (see lessons 5 & 22). 2. Distortion of the price/value relationship, which in turn depraves consumer behavior (see Lessons 10 & 11). Medicare and Medicaid are, after all, subsidies. Subsidies are simply price controls with a carrot instead of a stick. 3. Monopolization. Government makes the rules and collects the taxes. Businesses can't compete. How many senior citizens do you know who are not on Medicare? 4. New opportunities for fraud and waste (see Lesson 12).
All this ultimately leads to the same thing every time: Lots of free nothing. In the Soviet Union they had free cars that didn't run, and free food but empty stores. Many Socialist dictators print lots of free money that won't buy anything. Many inner cities have free schools that don't teach. Likewise, Communism provides free health care, but no doctor in the hospital, no bandages on the shelves, no sheets on the bed. Socialism is a little better. In Canada, you can see a doctor in about 10 hours, you can get an urgent surgery in a few months, and you can get an elective surgery in a few years. The reason is very, very simple: Limited resources are most efficiently distributed and used when millions of people act freely. They are most inefficiently used when distributed by a few people acting "fairly."
But no matter what nightmare goes on in Canada & Europe, socialized medicine in the United States will be much, much worse. That's because the American doctor will have an additional master, besides Washington bureaucrats, besides state licensing boards, besides hospital staff requirements, ....oh, and besides the patient. The American doctor also must answer to the American trial lawyer, and the U.S. has more lawyers than anyone. You see them on t.v. every day, begging you to sue somebody. This is also a problem of government. Many trials are nothing more than government-run, government-enforced muggings.
The solution, of course, is to reduce government. 1. Medicare and Medicaid must be dramatically reduced. It can be done painlessly if it is done slowly, over decades. "But Professor, who will pay when Grandma gets sick?" The same people who are paying now: you and Grandma. (If you don't realize that, then please go back to Lesson 1 and start over). The only difference is that she and you will have more to spend by cutting out the middle man; you will spend more wisely by paying directly; and everything will be cheaper, like it was before. 2. EMTALA must be revised. Emergency rooms are for emergencies. E.R.'s must have the right to turn away non-emergent cases. 3. Health insurance companies must be DEregulated (see Lesson 22). 4. Tort law must be reformed. Right now, it is too cheap for lawyers to wage senseless lawsuits, and too easy for companies to settle.
Part of the solution is also to combat a twisted idea that is growing in popularity: that health care should be equal for all. Somewhere is the best surgeon in the world. She can't help everybody, she's just one person. The only way to equalize surgery is to forbid people who can afford her from seeing her; or to forbid her from operating on anyone. That is the sickness of the Socialist mind.