Misc. Thoughts on Healthcare

On Friday night, Alvin the Student Symposium slave driver forced me to show up to Dordt’s prestigious Distinguished Alumni Dinner to hobnob with the rich and powerful. (Just kidding buddy – I had a good time.)

At the dinner, I had the good fortune of sitting at a table with an alumnus from Canada. When I told him I was a political studies major, we started talking about healthcare. I asked him what he thought of Canada’s healthcare system. He got really excited and started talking about how great it works. He told me that his youngest daughter was born extremely premature and had to spend five weeks in the hospital, but that thanks to the Canadian system, all he paid for the treatment was $50. “We don’t understand the American fear of government getting involved,” he said. "We should take care of each other. Isn't that the Christian thing to do?"

I was not surprised by any of this. In my experience, Canadians transform into healthcare missionaries whenever they talk to Americans. It’s a national pride thing. (Not that us Yanks would know anything about excessive patriotism.) I once saw a poster of a group of Mounties that read: “Canada: Leading the World in Being Just North of the United States.” For many Canadians, I think, Canada’s great achievement is “Leading the World in Having Better Healthcare than the United States.”

But then the alumnus surprised me. “The system isn’t perfect of course,” he said. “I’ve been waiting for a shoulder replacement for two and a half years now.”

Come again? Two and a half years? So the terrible rumors are true!

“But I’m OK with that,” he continued. “I’m young and healthy. [He is.] I’m not gonna die. I’m willing to wait if that means everyone is taken care of.”

My Canadian alumnus friend reveals a collective mentality that is anathema to most Americans. I’d like to think that we’re a generous people, willing to help our neighbor in need. But when it comes down to it, we want to take care of ourselves. We want to ensure our own well-being by working for our own healthcare, and being able to buy whatever we need, when we need it. We don’t want charity, and we don’t want to share; we want to earn what we need.

That is both a curse and a blessing for the American system. A curse, because it means the poor will have much worse healthcare than the wealthy, and a blessing, because the profits that guide our system ensure that supply never falls behind of demand, as it does in Canada, where 800,000 people are on waiting lists for treatments.

Ideal healthcare reform would keep the profit incentive in American medicine, while making coverage accessible to everyone. I believe the best way to do this is through tax credits based on need, paid out to American employers and citizens, along with an individual mandate to buy insurance, which will ensure that everyone will pay into the new system and keep it viable. This is part of Obama’s proposal; the other part of his proposal – creating a not-for-profit public plan that will compete with private plans – is what worries me. There’s nothing like profit to keep supply up with demand, and screaming “Healthcare should be about people, not profits!” a billion times won’t change that.

Over at the Weekly Standard, Fred Barnes has an excellent piece on what the American healthcare system gets right. I’ll quote a few statistics from it here:

• “The United States has 27 MRI machines per million Americans. Canada and Britain have 6 per million. The United States has 34 CT scanners per million. Canada has 12 per million, Britain 8.”
• Because American health care plans typically cover more than government plans in other countries, out-of-pocket healthcare spending by Americans amounted to less than 12.6% of national health spending in 2007 – less Canada, Japan, and most European countries.
• 66.3 % of American men and 63.9% of American women with cancer survive five years after diagnosis. 47.3% of European men and 55.8% of European women survive the same amount of time.
• 99% of prostrate cancer patients in the U.S. survive five years. Only 77.5% of European patients do. 90% of American breast cancer patients survive five years, while only 79% of European patients do. Prostate cancer mortality is 604% higher in the UK, and breast cancer mortality is 88% higher.
• 56% of Americans who could benefit from cholesterol-reducing drugs are taking them. Only 36% of the Dutch, 29% of the Swiss, 26% of Germans, 23% of Britons and 17% of Italians who could benefit are taking them.

Finally, when Rep. Joe Wilson of South Carolina shouted “You lie!” at President Obama during his address last Wednesday, I was a little giddy, because part of the reason I sat down to watch it, rather than read it later, was my hope that something like that would happen. Obama and Pelosi whipping their heads to the right side of the chamber – priceless.

What set Wilson off was Obama’s claim that, “There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I'm proposing would not apply to those who are here illegally.”

Sure, Wilson is a jerk for disrespecting the president like that. And if the part of healthcare reform that bothers you the most is the prospect that illegal immigrants might benefit from it, you should probably check yourself for prejudice. But Wilson wasn’t wrong. The healthcare bill does not provide benefits to illegal aliens – but neither does it provide any meaningful way of keeping them from benefiting from it. Obama was, in fact, pretty darn well lying.

Obama went on to say, “And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.” OK – but will federal dollars be used to help buy insurance plans that will fund abortions? Of course they will.

The immigration and abortion controversies need to be solved separately from this debate. But let’s not pretend healthcare reform won’t affect them.