Univeral health care is an awful idea and is being sold with lies.
The sentence includes a link to this post. Now, we can discuss the merits of various health-care-financing plans; yet the post to which Neil links only concerns the notion that the various Democratic plans will "destroy" private health insurance companies, a "fact" about which they "lie". Perhaps, perhaps not.
My point here is to ask the question - why not do some actual research on the issue of health care, health care financing, health care policy, and link to these research pieces if you are going to insist that universal health care is so awful? For example, there's this piece from the Henry J. Kaiser Family Foundation comparing per capita health care spending between the United States and the OECD. The piece uses a number of metrics to examine the disparities between health care spending in the various countries, all of which clearly show the US spends far more per person on health care than those countries that have nationalized health care (the most important figure, for me, shows that we spend nearly 16% of our income, per person, via private health insurance, than those countries that support their public health care systems through public means, i.e., taxes).
Now, a consideration of cost would be moot if we in the United States were satisfied with health care, or our health care, on the whole, was managed both efficiently and comprehensively. As this 2004 article from WebMD.com shows, however, while there are few majorities that report favorably on health care delivery across the spectrum of industrialized countries, not just greater dissatisfaction in the US is reported, but certain facts are discussed that are pertinent.
"In no country is the majority of adults satisfied," says Cathy Schoen, a vice president at the Commonwealth Fund, a nonprofit group that conducted surveys of some 7,000 patients in the five countries.
The U.S. is the only industrialized country that does not offer government-sponsored health coverage for all citizens. Proponents of market-driven health care often point to long wait times for services in other countries when warning of the dangers of a government-run system.
Sixty percent of patients in New Zealand told researchers that they were able to get a same-day appointment with a doctor when sick, nearly double the 33% of Americans who got such speedy care. Only Canada scored lower, with 27% saying they could get same-day attention. Americans were also the most likely to have difficulty getting care on nights, weekends, or holidays without going to an emergency room.
Four in 10 U.S. adults told researchers that they had gone without needed care because of the cost, including skipping prescriptions, avoiding going to the doctor, or skipping a recommended test or treatment.
Meanwhile, 26% of Americans surveyed said that they had faced more than $1,000 in out-of-pocket health care costs in the last year, compared with 14% of Australians, and 4% of Britons.
"The U.S. stands out as the patients the most exposed to medical bills," Schoen says.
So, not only is the issue one of cost, it is one of availability. Related to cost is the willingness to undergo treatment due to cost.
While critics of publicly-run national health programs often point to what they call "rationing of health care" in such systems, it is pretty clear that health care in the United States is already rationed on a cost-basis; those who cannot afford it are far less likely to seek early treatment, and overall it is far more difficult to receive treatment at awkward times - nights, weekends, holidays - that is as (relatively speaking) inexpensive as an office visit (ER visits are outrageously expensive).
American dissatisfaction not only with cost, but with the delivery of services, and their general availability, is driving the move toward reforming the entire system.
Comparing actual deliver of services is a thornier issue, more difficult to quantify, yet still there is data available. First, there is this study, whose summary reads:
RESEARCH OBJECTIVE: This presentation is part of a panel with 3 papers on international comparison of primary care delivery. This paper will focus on European countries. Objective was to study health care provision and patient experiences with primary health care, to determine differences between countries, differences between single handed and group practices and differences between practices in rural and urban areas. STUDY DESIGN: Practices in 9 countries were recruited (stratified sampling). Physicians and staff completed questionnaires developed by an international panel (EPA). Per practice a minimum of 30 patients visiting the practice completed validated written questionnaires (e.g. EUROPEP). A trained observer visited the practices to collect additional data. POPULATION STUDIED: 270 practices in 9 countries (U.K., Netherlands, Germany, Belgium, France, Switzerland, Austria, Slovenia and Israel) participated; over 8000 patients contributed. PRINCIPAL FINDINGS: On average 87% of the patients were positive about their regular doctor (range 80-93% between countries), while 80% were positive about organisation of services (range 67-91%). There was a wide variation found in most aspects of care delivery between practices in different countries. Patients in single handed practice were more positive about both the physicians and the organisation of services than patients in group practices. CONCLUSIONS: This project was a first large scale test to see if good international, comparative data on practice performance and patient experiences can be collected in a reliable and practical way. It showed that the instruments and methodologies used were feasible and acceptable. Data interesting for European policy making were gathered. The project was the start of a European data base (TOPAS-Europe)with comparative data on different aspects of practice performance and patient experiences in primary health care in a large number of European countries (15-20), launched in the beginning of 2005 in Berlin. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The data collected by the different validated European instruments are valuable for individual practices (feedback, plans for improvement), for policy making at a national level as well as for policy making and comparison at an international level. Data will be linked to OECD data. New instruments (e.g. Commonwealth Fund study) will be added in the future.
What is important to note about the information I gathered for this post was these individual pieces were discovered using Google - it took me about 45 minutes to search, read, and aggregate this information. Not being up on the latest research, it took very little time to discover a whole host of available information.
Now, Neil is perfectly fine believing that universal health care is a bad idea. He is even fine believing that the Democrats secretly wish to destroy private health insurance. It might be nice, however, if he used actual research data, rather than link to a right-wing website, which in turn links to a Heritage Foundation presentation that hardly counts as scholarly research.
