The subject of universal health care (or socialized medicine) has been thrust to the forefront of the national conversation. Jingoized by every Democrat presidential candidate and exploited by Michael Moore as documentary fodder, free health care for all is being sold like snakeoil to credulous Americans. There are aspects of socialized medicine, however, that have not been exposed by the American press, the proponents of universal health care or in Michael Moore's documentary.
"FREE" MEANS "PREPAID"
The most obvious component of "free" health care is that, in fact, it is not free. Socialized medicine is paid for through taxation, and in countries in which it is practiced, these taxes are paid by everyone. Much like our own "Social Security" tax, which imposes a 15.2% tax on anyone who works for a living, socialized medicine schemes are paid for through a combination of income taxes and national sales taxes, or VAT taxes. In other words, working people pay for "free" health care through payroll taxes and taxes on purchases. Nonworking people and individuals working for cash still pay for "free" health care every time they buy gasoline, food or clothing.
The cost to the taxpayer of funding socialized medicine reduces the overall quality of life of every participant in the program. Health care may be "free," but taxes imposed on automobile, clothing and consumer good purchases make these items out of reach for many middle class citizens.
NICE WORK IF YOU CAN GET IT
Another aspect of socialized medicine that is rarely discussed is that it is rationed. Universal health care programs are the equivalent of a government-run HMO. There are "gatekeepers" at every juncture point in the program, whose job it is to assess your condition and decide whether or not you warrant further care. The gatekeepers are trained physicians, but first and foremost, they are government bureaucrats. Their job is to limit the use of health care in order to keep costs down. As a result, there have been instances in Great Britain of children dying of tonsillitis because they were put on a nine-month waiting list to see a doctor, and in Canada, one woman's skin cancer metastized before she was allowed to see a dermatologist because it was mistaken for a rash by her regional gatekeeper.
Gatekeepers use a number of factors to regulate the dispensation of health services, not the least of which is the patient's economic status or economic potential. In short, low-wage, low-skilled patients whose tax potential doesn't serve the needs of the state are less likely to receive care, whereas skilled individuals who have a steady employment record have a better chance of receiving care. For example, in Holland, attending physicians are allowed to determine when critically ill or injured patients should not be resuscitated.
It was discovered that Dutch physicians are more likely to pull the plug on low-income black patients than they are on high-wage white patients. Lifestyle choices are also a determining factor in health care delivery. Patients who look like Michael Moore, smoke cigarettes (or other substances) or drink excessively won't be a high priority when the inevitable heart attack, stroke, or liver disease kicks in. Universal health care does not guarantee equal treatment.
Can a patient get around the system and get a second opinion? If they have enough money to buy their way out, some can. Canadians skeptical of, or disappointed with, their diagnosis or treatment protocols routinely cross the border and buy treatment in the United States. However, some countries make buying health services outside the national system illegal. Physicians who sell their services to willing buyers can be fined or jailed, even if the patient's situation is critical. Practicing medicine without the government's permission is treated the same as robbing a bank.
GO TO SCHOOL FOR 30 YEARS AND EARN MINIMUM WAGE
The amount of regulation combined with abysmally low wages for doctors inherent in universal health care schemes has lead to a shortage of doctors in countries that have imposed it. After completing twenty years of post high school education and fulfilling rigorous licensing requirements, physicians aren't happy earning less than a union auto worker with a tenth-grade education. British, Australian and Canadian-born physicians leave their respective countries and move to, well, the United States or Japan, where they can earn what their skills are worth.
This situation has lead countries like Great Britain to recruit high-skilled, low-wage doctors from Pakistan and Indonesia to fill vacancies. As recent events in London and the Glasgow Airport show, this solution has lead to other, more catastrophic, problems with national security.
CAN YOU SAY WALTER REED HOSPITAL?
The United States already has a prime example of government-provided health care. It's called the Veteran's Administration, and the scandalous conditions uncovered recently at Walter Reed Hospital should be a clue as to how well the government delivers health care services. Unsanitary conditions, nonfunctional equipment and a lack of staff were some of the issues plaguing Walter Reed, and the veterans whose lives were at stake were virtual hostages to this health care nightmare. The government has demonstrated it can't take care of a relatively small segment of the population; does any reasonable person believe that imposing this system of health care delivery on the entire country is feasible?
The high cost of health care is a challenge that must be dealt with on a number of levels. Reducing the power insurance companies have to dictate how health care is delivered, real tort reform that discourages frivolous lawsuits by patients who believe that winning a lawsuit is like winning the lottery, and encouraging the use of cash for routine health maintenance (e.g. physical checkups, inoculations, etc.) are things that can help reduce overall health care costs. Putting the health care system under the auspices of the government is a cure that is worse than the disease, and may well prove fatal to the patient in the long run.
