July 19, 2007
Oh, and about those wait times for medical treatment. . .
When all their other arguments about the advantages of the current US health care system compared to universal, single-payer systems in France, Canada, England, Germany, etc. are shown to be false, apologists for the US health care system turn to their trump card: alleging that wait times to see a doctor in those countries is longer than it is in the US. This statement by the lobbying group America's Health Insurance Plans is typical: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care."
The problem with this type of allegation is that the US does not systematically collect data on wait times, whereas the other countries do collect the data and make them public. The assumption seems to be that in the US, if there is no data, then the wait times must be zero. No data, no problem!
But using the scant data that is available, BusinessWeek points out that except in a few selected, non-emergency situations, even this charge is false: "In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems."
As Paul Krugman points out in his New York Times July 16, 2007 column:
[B]y and large, opponents of universal health care paint a glowing portrait of the American system that bears as little resemblance to reality as the scare stories they tell about health care in France, Britain, and Canada.
The claim that the uninsured can get all the care they need in emergency rooms is just the beginning. Beyond that is the myth that Americans who are lucky enough to have insurance never face long waits for medical care.
. . .
[N]ot all medical delays are created equal. In Canada and Britain, delays are caused by doctors trying to devote limited medical resources to the most urgent cases. In the United States, they're often caused by insurance companies trying to save money.
This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. ''It was only later,'' writes Mr. Kleiman on his blog, ''that I discovered why the insurance company was stalling; I had an option, which I didn't know I had, to avoid all the approvals by going to 'Tier II,' which would have meant higher co-payments.''
He adds, ''I don't know how many people my insurance company waited to death that year, but I'm certain the number wasn't zero.''
(You can read about Kleiman's plight here, which occurred despite having what he calls "fancy-dancy health insurance through my employer, which as it happens also owns one of the world's dozen best medical centers".)
And what about that favorite of US health care apologists, the waiting time for hip replacements? Krugman looked at that too:
On the other hand, it's true that Americans get hip replacements faster than Canadians. But there's a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.
That's right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that's what they call their system) because it has more lavish funding -- end of story. The alleged virtues of private insurance have nothing to do with it.
Krugman's conclusion is right on target:
The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America.
POST SCRIPT: Déjà vu
As usual, cartoonist Tom Tomorrow succinctly captures how the media is colluding with the administration in fanning the flames for war with Iran, exactly the way it did with Iraq.