The UK: A Glimpse at Our Healthcare Future?

You gotta love Medicaid’s enablers.

Last week, in a letter to the editor that ran in the Albuquerque Journal (unavailable online), Bill Jordan of “New Mexico Voices for Children” repeated the (unintentionally) hilarious claim that Medicaid “is saving the state money while providing care to our children, seniors, the disabled and neighbors in need.” And with all those federal bucks flowing into the state from Obamacare, New Mexico’s increased “cost” to expand coverage 100 percent since 2013 has been only 5.5 percent!

Evidently, in Jordan’s fantasyland, no one in New Mexico pays federal taxes, but let’s leave that issue aside for now. As Dr. Deane Waldman (a member of the board of directors of “beWellnm, New Mexico’s Health Insurance Exchange”) and Dayal Rajagopalan noted last summer, the actual results of Medicaid coverage are far different than the paradise depicted by Jordan and his ilk:

In 2013, an Oregon study compared the new enrollees of expanded Medicaid to the individuals who had no insurance. Researchers found that spending $545 billion in Medicaid expansion showed “no significant improvement in measured health outcomes” in Oregon. This was in spite of Oregon’s Medicaid program being considered one of the best in the country, with doctor compensation rates far above the national average.

Another study, performed by a team at Harvard, looked at three states that expanded Medicaid, and only one of them had any statistically significant reduction in mortality. A third study by the University of Virginia found that patients with Medicaid coverage did worse after surgery than uninsured patients who ho to a private Mohs surgeon. Because of Medicaid expansion in Illinois, nearly 800 enrollees died while waiting for medical care, called “death by queueing.”

“Voices” might also want to check out what’s going on in the United Kingdom, where healthcare is “free.” (We’re not halfway to single-payer in the Land of Enchantment, but we’re awfully close. As of November, 41.9 percent of New Mexicans were on Medicaid.) The UK has ordered hospitals “to cancel all non-urgent surgery until at least February.” A rough flu season has induced the axing of 50,000 operations. The news comes on the heels of October’s proposal to “ban patients from surgery indefinitely unless they lose weight or quit smoking.” In November 2016, the National Audit Office called the National Health Service’s financial problems “endemic,” and the chair of the public accounts committee called “on the prime minister to address the realities of increasing deficits in NHS trusts, long-term workforce problems, unrealistic efficiency targets and the impact these financial stresses are having on the quality of services.”

Liberals’ delusions and virtue-signalling can’t overcome the reality that socialized healthcare … stinks. The UK offers jarring proof of what’s to come if New Mexico and the nation continue to ignore market-oriented reforms of health insurance.

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10 Replies to “The UK: A Glimpse at Our Healthcare Future?”

  1. There is little doubt that the NHS has some serious management issues. On the other hand, it costs around half as much (in percentage of GDP) as the US system (see https://www.weforum.org/agenda/2016/04/which-countries-have-the-most-cost-effective-healthcare/) and in a variety of measures on quality and outcomes outperforms the the US healthcare system (see https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/#59b6656d576f).

    I’m no fan of the NHS, but the US healthcare system is both extremely expensive and not particularly effective.

    1. “[T]he US healthcare system is both extremely expensive and not particularly effective.”

      Agreed, for the most part — that’s why we need a healthcare MARKETPLACE, not a healthcare “system.” The notion that we have anything even approaching capitalism in healthcare is laughable. Medicare, Medicaid, employer-provided “insurance,” endless mandates and regulations — you can thank the Big Government crowd for all that.

      The GDP argument is a beloved talking point for the left, but dig into it a bit, and it’s pretty weak. The U.S. has a far more self-destructive population than most developed nations. We drink too much booze, eat too much, smoke cigarettes, do not cultivate strong social bonds, and fail to commit to regular exercise. In 2009, Health Affairs concluded that “three-quarters of the $2 trillion-plus that we spend on U.S. health care each year goes to paying the bills for chronic illness: cardiovascular and pulmonary disease, cancers, diabetes, arthritis, high blood pressure, depression.”

      In addition, as the Cato Institute’s Michael Tanner understands, “Single-payer systems in countries such as Great Britain and Canada do spend less on health care than we do. But they do so at the cost of less care, less innovation and longer wait times.” I can certainly attest to that — my sister, who lives in the UK, is delighted to have enough funds to escape the dumpster fire that is the NHS.

      1. I’m certainly not advocating an NHS style system which is not only a “single payer” system, but for the most part, a “single employer” system in which most health care workers are employed by the NHS. (I had a couple of doctor friends who worked for the NHS for a while and heard plenty of horror stories).

        I do know quite a few Canadians who have lived in both countries, and I can’t think of one who preferred US health care to their home county’s system. I lived in Germany for around 13 years and certainly preferred their system to our Rube Goldberg mess. It consists of a universal multi-payer health care system paid for by a combination of statutory health insurance and private health insurance which allows individuals to seek almost any type of care they wish whenever they want it. It is only slightly more expensive (in percentage of GDP terms) than the British model (10.8% vrs. 9.1%) and much more customer friendly. See https://en.wikipedia.org/wiki/Healthcare_in_Germany

        I agree that many healthcare problems in the US can be traced back to various self-destructive behaviors, but in terms of alcohol and cigarette consumption the US lags well behind almost every European country. See https://en.wikipedia.org/wiki/List_of_countries_by_cigarette_consumption_per_capita

        and https://en.wikipedia.org/wiki/List_of_countries_by_alcohol_consumption_per_capita

        Only in obesity rates is the US ahead of most European countries. See https://en.wikipedia.org/wiki/List_of_countries_by_body_mass_index

        As such, I don’t think that this argument is necessarily conclusive.

        1. I’m comfortable sticking with the U.S. as the most self-destructive country in the developed world. We’re not Greece or Germany on smoking, but there’s plenty of room for improvement. Alcohol is a tough one, because consumption per capita isn’t a very useful metric, given that we have a fair amount of teetotalers — myself included — to balance off the drunks. Obesity, as you note, is epidemic. Cocaine, heroin, meth, etc. abuse is at similarly disturbing levels. And violence here is pretty awful.

          In 2005, an epidemiologist looked at Americans’ commitment to maintaining four no-brainer health habits: regular exercise, not smoking, consuming fruits and vegetables daily, and keeping BMI under control. Three percent passed the test. I’d love to see a similar analysis done for all OECD countries. I doubt I’d be surprised at the results.

          Mental illness is a major contributor, although too rarely discussed, to the health crisis. WHO data show that we’re pretty much the worst of the worst, and depression, PTSD, anxiety, social isolation, OCD, etc. are obviously major causes of eating disorders, sedentariness, substance abuse, suicide attempts, etc. Our sky-high divorce rate is another contributor.

          Healthcare analysts (of any perspective) who ignore our hardcore self-destructiveness are committing policy malpractice. People in other countries take better care of themselves, and their loved ones, so they generally spend less than we do on healthcare. It’s not much more complicated than that. Americans have always been wild and reckless and impetuous and self-indulgent. That’s great, for the most part, for economic innovation and artistic expression. It is not so great for health.

          As for “our Rube Goldberg mess,” why not scrap it, and replace it with a market system? This is probably heresy for those of us in the libertarian movement, but personally, I’d be willing to compromise on an individual mandate, if government removed itself from healthcare/health insurance altogether. Make me buy a catastrophic policy so that I don’t ask taxpayers to pick up the tab if something goes horribly wrong, and have me pay the relatively small sums for annual checkups, prescription RXs, etc. I’d take that deal in a millisecond — with freewheeling competition, it would be almost absurdly affordable. And when Americans had to directly pay more of the costs of their irresponsibility, our collective health condition would soar.

          1. Dowd, thanks for the thoughtful and detailed reply. I have to say that I am irritated by being forced to pay for the irresponsible actions and lifestyles of other people.

            As to “why not replace it with a market system”: In a true market system for health care, those who choose not to get sufficient insurance would have to face curtailment of health care if the costs of their health care needs exceed their resources.

            Although this can reasonably be viewed as simply a consequence of their own irresponsibility, it is pretty difficult to imagine a societal consensus to “push grandma out onto an iceflow” when her money runs out.

          2. U.S. charitable giving in 2016 was $390 billion. A sizable chunk of that sum would go a long way toward providing coverage in a marketplace with radically reduced costs induced by vibrant competition. I’d be happy to make an annual contribution to charitable health insurance. (Not health CARE, health INSURANCE. Not the same things.)

            Plenty of people with limited means buy cars, and thus insurance for their cars. They do it because government mandates coverage, but when compared to health “insurance,” is almost totally disconnected from auto insurance. Imagine a world in which people saw commercials for health insurance as often as they see “Flo” and the little green lizard today. It might be annoying, but affordability would be stellar.

            For those who are truly needy but unable to access charitable offerings, I would be willing to compromise on a health-insurance welfare program. But it would have to be local/state-based, time-limited, and it wouldn’t cover people who smoke, drink, are obese, etc. Personal responsibility has to enter into things at some point. With no social stigmas for any kind of self-destructive behavior anymore, the welfare complex incentivizes all manner of depravity. This isn’t about puritanism — I’m a libertarian who supports maximum free speech, decriminalizing drugs, and rural-Nevada-style legalization of brothels — it’s about not wrecking the country with wildly unaffordable health-related expenditures.

            But the political class has it too good, giving away “free” stuff, to make the changes that are long overdue. Eventually, the bills will arrive. It will be an ugly time, I’m afraid.

  2. We can’t have either a well-functioning government system or an efficient free market for healthcare if we tinker with demand without addressing supply.

    We need more attention to measures that increase the supply of healthcare and reduce its cost, such as: malpractice tort reform; expanded medical education with incentives for general practice; increased use of telemedicine; expanded roles for nurse practitioners and physicians’ assistants, etc. We’re seeing one positive step with the FDA’s focus on streamlined approval for generic drugs to promote competition and reduce prices.

    If we have a competitive, interstate market for health insurance, I can see an individual mandate, like the requirement for auto insurance, to purchase a bare-bones catastrophic policy.

  3. In Jan 13th ABQ Journal there is an article (not finding online) by Nicole Tiggemann that describes the differences between Medicare and Medicaid and all i can think about when reading is how expensive the programs are to ADMINISTER, forget the actual healthcare services provided. In considering the comments preceding mine, a great quotes comes to mind from the infamous GE corp (probably from Jack Welch): “In God we trust, all others bring data.” The data does not support the current government involvement, but does support Dowd Muska’s point of a private MARKETPLACE.

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