By Dr. Richard Kelley

With the National Basketball Association in the middle of playoffs, you are probably hearing the terms “fast break” and “full court press” frequently, as sportscasters and writers describe the tactics teams use to overwhelm the opposition. The terms also metaphorically describe the actions of the Obama administration, as it pulls out all the stops to implement radical changes in our nation’s health care system.

President Obama fired the opening salvo at a news conference on Monday when he said, “I will not rest until the dream of health care reform is achieved in the United States of America. … We’ve got to get it done this year. We don’t have any excuses. The stars are aligned.” House Speaker Nancy Pelosi pledged to meet a July 31 deadline to have legislation passed by the House and in place to support Obama’s goal.

There is no question in my mind that – even though the President and the Democratic Party leadership in Congress deny it – their goal is for America to have a “single-payer,” national health care system controlled by the federal government and funded by increased taxes on citizens of almost every economic status.

Some say that if Obama has his way, the U.S. will have “socialized medicine,” although surveys indicate many are not clear about what the term means. (See What is Socialized Medicine? below.)

Since health care insurance is such an important benefit for all members of our ‘ohana based in the U.S., I would like to share my thoughts with you on this topic, interpret what is happening, and predict what the future may hold.

———————

Having practiced medicine under both the free market and partially government-controlled (Medicare, Medicaid) systems in the past and being currently involved in health care as the chairman of the Colorado Neurological Institute, I am convinced that the President and Congress are headed in the wrong direction.

If the Obama administration achieves its goals and there is expanded government involvement in health care, there will be significant problems:

• The overall cost of health care will go up significantly.
• Patients will face hurdles, roadblocks, and, yes, rationing when they try to access the system.
• The quality of health care will go down.
• The future of important medical research and development will be jeopardized.

There is no question that today’s U.S. health care system has its problems. Author Dr. David Gratzer sums it in a single paradoxical sentence: “Everybody agrees that it is the best in the world, but nobody really likes it.”

Unfortunately, the root of most of the problems can be traced back to government involvement in the years since World War II. (See Government Actions or Inaction below.)

The overall cost of health care in our nation will go up significantly.Like every government program, any health care system run by the federal government will expand and cost far more than predicted when proponents “sold” it to voters and taxpayers. This is exactly what has happened with Medicare, Medicaid and CHIP (Children’s Health Insurance Program).

In fact, as the President was announcing his plans for legislation for expanded, high-quality, affordable health care, the trustees of Medicare and Social Security reported that both of these programs, which now consume more than one- third of the entire federal budget, are running out of money!

As reported by the New York Times, Medicare, as it stands today, will run out of money in just eight years, two years sooner than projected last year and about 20 years sooner than predicted as recently as 2002.

Patients will face hurdles, roadblocks, and, yes, rationing when they try to access the system.
The Times also quoted Treasury Secretary Timothy Geithner as saying the only way to keep Medicare solvent is to control runaway growth in both public and private health care expenditures. Translation: Cut back on utilization by rationing.

There are many ways to ration health care. The national health care systems in Canada and the United Kingdom do it by limiting facilities, limiting authorized procedures, and making patients wait a long time for tests, procedures, physician appointments, etc.

But one does not have to go to a foreign country to document this. In the U.S., rationing is the norm of the health care system that the Department of Veterans Affairs provides to our troops after they are discharged.

Another painful example of health care rationing in the U.S. is found in this week’s news. The Centers for Medicare and Medicaid Services just announced they would not pay for “virtual” colonoscopy screening. This procedure, done by x-ray, is much less degrading and painful than a regular colonoscopy. So, the aged and lower-income citizens covered by those federal health care programs will have to endure the insertion of a long tube into their body if they want to be screened for colorectal cancer, which kills some 50,000 Americans every year.

One final thought about the hurdles patients would face in a national health care system: Under such a system, employees will almost certainly be unionized, sooner or later. The service mentality common to government offices like the Department of Motor Vehicles will eventually spread to hospitals and doctors’ offices.

The quality of health care will go down.
Rationing reduces costs by cutting down people’s use of health care services, but this results in a terrible personal cost to patients through increased incidence of illness and shortened life spans.

Dr. Gratzer documents this in his book, THE CURE – How Capitalism Can Save American Health Care. He summarizes research studies that show cancer survival rates in the U.S. are much higher than in countries with government-controlled health care systems. “Women who get breast cancer in Europe are four times as likely to be diagnosed after the tumor has spread than women in the United States. … The market analyst Datamonitor finds that 95 percent of American women tend to be diagnosed in early stages I or II. By contrast, [only] 80 percent of European women are diagnosed at these stages.” This leads to a striking difference in mortality.

Breast Cancer Mortality Ratio*
United Kingdom – 48%
France – 35%
Germany – 32%
Canada – 28%
United States – 25%

* Those who die of the disease divided by those diagnosed. (Percentages interpreted from bar chart)

Dr. Gratzer, who has practiced medicine in both Canada and the U.S., provides a number of other examples of superior health care outcomes in the U.S., as compared to countries with a government-controlled system.

The future of important medical research and development will be jeopardized.

There was an excellent article on this topic recently in the Wall Street Journal by John C. Lechleiter, Chairman and CEO of pharmaceutical giant Eli Lilly & Co. He points out that medical research under America’s free market health care system has produced any number of amazing advances, which have increased average life expectancy from 57 years to 78 years in the past six decades. No other country, particularly none with government-controlled health care systems, has produced as many life-saving and life-enhancing breakthroughs. Lechleiter is seriously concerned that a government monopoly health care system will curtail access to new medicines and procedures. He urges that any health care reform be structured so that research and innovation can continue as before.

————————

There are many ways to reform health care if our politicians are willing to leave it in the free-market arena. My suggestions and thoughts in this area will be presented in a future edition of Saturday Briefing.

In the meantime, read, listen, and participate in the national debate. Your health, comfort, and even your and your family’s lives may depend on it!

Oh, by the way, if you like government-monopoly schools, you’ll love government-monopoly health care!

————————

What is Socialized Medicine?

WebMD Health News reported that a 2008 poll of 2,000 people by the Harvard School of Public Health on the issue of socialized medicine found:

• 79% thought that in a socialized medicine system, the government makes sure everyone has health insurance.
• 73% thought the government would pay most of the cost of health insurance.
• 32% said they think it means that the government tells doctors what to do.

When the same group was asked if they thought socialized medicine would make the U.S. health care system better or worse:

• 45% said they thought it would improve health care.
• 39% said they thought it would worsen health care.
• 4% said they thought it wouldn’t make much difference.
• 12% didn’t know or didn’t answer.

————————

Government Actions or Inaction: The Source of Many Problems

• In 1943, the Internal Revenue Service decided that employer-sponsored health insurance benefits would not be taxable to the employee as income. This 1) led to a two-class health care system – those with a work benefit who receive it tax-free and those without the benefit (such as the self-employed) who had to buy it with precious after-tax dollars. And 2) the traditional bottom-up, patient-physician relationship was suddenly changed to a top-down patient-insurance-physician triangle with the insurance company effectively employing the physician and calling the shots.

• Multiple state government regulations limit the free market insurance model and require that health insurance coverage include such things as podiatry services, chiropractic treatments, and acupuncture. This has forced people who do not need or want that kind of coverage to pay for it anyway through higher-than-necessary health insurance premiums.

• The “nationalization” of all emergency rooms in 1986 by the Emergency Medical Treatment and Active Labor Act, which has forced hospitals and their physicians to provide free or discounted care to almost everyone who comes through the door. The losses on this care have to be shifted to others – both those with and without employer-provided health insurance.

• Bowing to heavy pressure (that is, campaign contributions) by America’s trial lawyers, Congress and state legislatures have repeatedly failed to pass meaningful limits on medical malpractice claims and awards. This has led to a sharp increase in the price of insurance to protect doctors from the cost of such awards, which, in jury trials, averaged an astonishing $3.83 million (in 2005) according to the Insurance Information Institute. Nationwide, medical malpractice tort costs totaled more than $30 billion (in 2006), and the trend continues upward. These costs are all built into what individuals and their employers pay for health care and health care insurance.

• The refusal of the massive government health care insurance programs (Medicare, Medicaid and CHIP) to pay market rates for physician and hospital services has caused massive cost-shifting to everyone else who pays for health care, whether through a private insurance program or direct payment to the providers.