Rationing by waiting & underproviding to the sick
WASHINGTON D.C. (Texas Insider Report) Left-wing Democrats in Congress have decided on a new version of Medicare for All." Health care will be nominally free but access to it will be determined by bureaucratic decision making.
Turns out its going to be nothing like the Medicare Program seniors are used to. What they have in mind is what we see in Canada.
Heres what to expect.
Overproviding to the Healthy Underproviding to the Sick.
The first thing politicians learn about health care is this: most people are healthy. In fact they are very heathy spending only a few dollars on medical care in any given year. By contrast 50 of the health care dollars will be spent on only 5 of the population in a typical year.
Politicians in charge of health care however cant afford to spend half their budget on only 5 of the voters including those who may be too sick to vote at all. So there is ever-present pressure to divert spending away from the sick toward the healthy.
In Canada and in Britain patients see primary care physicians more often than Americans do. In fact the ease with which relatively healthy people can see doctors is probably what accounts for the popularity of these system in both countries.
But once they get to the doctors office British and Canadians patients receive fewer services. For real medical problems Canadians often go to hospital emergency rooms where the average wait in Canada is four hours.
In Britain one of every ten emergency room patients leave without ever seeing a doctor.
A study by former Congressional Budget Office director June ONeill and her husband Dave ONeill found that:
- The proportion of middle-aged Canadian women who have never had a mammogram is twice the U.S. rate.
- Three times as many Canadian women have never had a pap smear.
- Fewer than 20 of Canadian men have ever been tested for prostate cancer compared with about 50 of U.S. men.
- Only 10 of adult Canadians have ever had a colonoscopy compared with 30 of US adults.
These differences in screening may partly explain why the mortality rate in Canada is 25 higher for breast cancer 18 higher for prostate cancer and 13 higher for colorectal cancer.
A study by Brookings Institution scholar Henry Aaron and his colleagues found that:
- Britain has only one-fourth as many CT scanners as the U.S. and one-third as many MRI scanners.
- The rate at which the British provide coronary bypass surgery or angioplasty to heart patients is only one-fourth of the U.S. rate and hip replacements are only two-thirds of the U.S. rate.
- The rate for treating kidney failure (dialysis or transplant) is five times higher in the U.S. for patients age 45 to 84 and nine times higher for patients 85 years of age or older.
We can see the political pressure to provide services to the healthy at the expense of the sick in our own countrys Medicare program. Courtesy of Obamacare every senior is entitled to a free wellness exam which most doctors regard as virtually worthless.
Yet if elderly patients endure an extended hospital stay they can face unlimited out-of-pocket costs.
Rationing by Waiting
Although Canada has no limits on how frequently a relatively healthy patient may see a doctor it imposes strict limits on the purchase of medical technology and on the availability of specialists. Hospitals are subject to global budgets which limit their spending regardless of actual health needs.
In addition to having to wait many hours in emergency rooms Canadians have some of the longest waits in the developed world for care that could cure diseases and save lives.
The most recent study by the Fraser Institute finds that:
- In 2016 Canadians waited an average of 21.2 weeks between referral from a general practitioner to receipt of treatment by a specialist the longest wait time in over a quarter of a century of such measurements.
- Patents waited 4.1 weeks for a CT scan 10.8 weeks for an MRI scan and 3.9 weeks for an ultrasound.
Similarly a survey of hospital administrators in 2003 found that:
- 21 of Canadian hospital administrators but less than 1 of American administrators said that it would take over three weeks to do a biopsy for possible breast cancer on a 50-year-old woman.
- 50 of Canadian administrators versus none of their American counterparts said that it would take over six months for a 65-year-old to undergo a routine hip replacement surgery.
Everyone (except American Indians and veterans) will be in the same system.
John C. Goodman President of the Goodman Institute for Public Policy Research is one of the nations leading thinkers on health policy. The Wall Street Journal has called him the father of Health Savings Accounts he is a Senior Fellow at the Independent Institute and is the author of the widely acclaimed book Priceless: Curing the Healthcare Crisis.
