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Why Is Government Health Insurance Good Only For Some

Elizabeth Lee Vliet MD's picture

On June 24, President Obama admitted that he and his family would not participate in the government regulated health insurance plan being proposed for all the rest of us. Members of Congress would also be exempted from the “public plan” they think is “good enough” for the rest of us. If it is so good for the American people, why do our elected officials want to exempt themselves? Wake up, everyone. Pay attention, here. Your life and health may be at stake.

We do need to revamp our health insurance to make private insurance more affordable, more accessible, and portable - not tied to a job. But “revamping” should not mean throwing out the baby with the bathwater.

It is a fantasy that government-run healthcare is better overseas. It is a fact that Canadian, British, and European government-run health systems delay access and ration treatment. Government-run health systems around the world always cut costs by rationing, by limiting access to cutting-edge diagnostic services and by decreasing coverage of the newest medications.

Government-run systems spend less by denying services and using age cut-offs to avoid paying the bill for the elderly. Yet “CanadaCare” is exactly the model that Washington bureaucrats are proposing for all of us, except the President and Members of Congress.

Clearly, our health insurance needs fixing. But U.S. medical services are still the best in the world. Why destroy medical care that IS working for 90% of Americans who are satisfied with their health care to fix problems that affect 5-10% of the population?

It is not accurate that there are “47 million Americans” without insurance – this number is seriously misleading. Approximately 1/3 of this “47 million” are illegal immigrants, not American citizens. Approximately 1/3 are working young people who make more than $50,000 per year (7 million make more than $75,000 per year!) and can afford health insurance but chose to spend their money elsewhere. The remaining 1/3 of the “47 million” – about 5% of the American population - have a serious problem and need our help. This is the group who has pre-existing medical problems and can’t afford health insurance, but make too much to qualify for health insurance under Medicaid that covers all poor people.

America leads the world in innovation, cutting edge diagnostic technology, and effective new medicines to cure more diseases than ever before. The statistics summarized below tell the story of why people come here from around the world for state-of-the-art care not available where they live. Canadians have only a government-run system. They have no private pay options at all. They come to America when they need services quickly or services not available in their government system.

Canadians needing urgent consultations or special studies like MRIs are at the mercy of waiting lists that can take months. In 2008, Canadians waited an average of 17.3 weeks from seeing a primary care doctor to getting a specialist appointment. The wait for a hip replacement can be 12 to 24 months. Americans tend to be impatient about waiting for something to be done. Do you really want to wait six months or more to get your MRI when you have a crisis?

I doubt many government bureaucrats who make our health care decisions have been patients in a hospital under nationalized health. I have been. I have experienced the enormous difference between United States hospitals and the United Kingdom.

My situation was frightening as a young woman, but even more appalling now that I am a trained physician. The hotel doctor thought I had acute appendicitis and sent me to the ER. I was in the London ER for over 24 hours, and had no diagnostic or blood tests (standard evaluation in the US), before being moved to an open ward of 24 flu victims. I spent another two days being “watched.” I never saw the same doctor or nurse twice –and still no diagnostic studies. It was a “wait and see what happens” approach. When I didn’t get worse, they “guessed” it wasn’t appendicitis. I was discharged. I still wonder what really caused such intense pain, but I left with no answers. My episode turned out not to be life-threatening, but what if it had been?

A 2007 study in The Lancet Oncology shows why Americans don’t hop on a plane to go to Cuba or Bogota for their medical care! Cancer treatment and survival statistics for sixteen different types of cancers in Europe and the United States shows:

* The United States leads the world in treating breast and prostate cancers.

* Women with breast cancer have a 14% higher survival rate in the United States than in Europe.

* Men with prostate cancer have a 28% higher survival rate in the USA than in Europe

* Men in the United States have a 66% five-year survival for sixteen types of cancer, but in Europe it is only 47% five-year survival.

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* American women have a 63% chance of living five years after a cancer diagnoses, compared to 56% for European women.

* There is a 90% survival rate in the USA for five cancers – breast, prostate, thyroid, testicular and melanoma. In Europe, only ONE, testicular cancer, has a 90% survival rate.

Innovation in American medicine leads the way over 25 other countries (Annals of Oncology, 2007):

* Sweden’s Karolinksa Institute said that 50% of new cancer drugs during the last eleven years were first launched in the United States. Our innovation benefits the entire world for cancer therapy.

* From 1995-2005, the United States launched 12 new cancer drugs but the U.K. had only 4, Switzerland only 3, Germany only two, and France had only one.

* Americans also have better access to new cancer drugs: The new lung cancer drug Erlotinib is ten times more likely to be prescribed for US patients than for Europeans. Herceptin for breast cancer is more available to US women.

* New technologies for diagnostic imaging are more available in the United States than in Europe or Canada.

* US patients see specialists and have diagnostic tests months sooner than patients in countries with nationalized health systems.

Nine of 10 middle-aged American women (90%) have had a mammogram, compared to less than 72% of Canadian women. The government saves money with fewer mammograms, but what about women’s lives? What if YOU are that woman?

Breast cancer survival rates are higher if cancer is caught earlier. Most US women have mammograms every year after age 40 so we detect cancers at earlier stages. The U.K. National Health Service only allows a mammogram every 3 years, and only for women from age 50-70. After that, you are “too old” for screening. That’s why deaths from breast cancer are higher in the United Kingdom.

My British friend said this about her breast cancer experience:

“Now that I am a [breast cancer] statistic, I am having mammograms every 2 years, but a lot can happen in 2 years. Men here have no screening whatsoever for prostate cancer. hen they thought I might have a recurrence of my cancer spreading to my bowel, I was told it would be 4 or 5 months before I could get the urgent endoscopy and colonoscopy.”

We Americans have an independent spirit and remarkable creativity in solving problems. Let’s apply American “can-do” attitudes to fixing the current problems without destroying what IS working. Improved health care needs to focus on these principles:

  • empowering individuals to have more say over their care,
  • respecting the power of free markets and competition to keep costs down,
  • providing tax incentives for people to purchase their own health insurance based on their individual needs. We do this for car insurance, why not for people?
  • less government intrusion and bureaucratic regulations, not more

A nationalized medicine system, imported from Canada or Europe, does not do any of these.

Pushing America’s extraordinarily innovative and flexible health care system into a rigid “one-standard-fits-all” government-run bureaucracy is not the answer. Certainly, whatever system is created, our legislators and President need to also participate. If it’s “good enough” for the people, it’s “good enough” for our elected officials who are supposed to work for us taxpayers.

Reform what needs to be changed to improve our heath care system. Do not let government bureaucrats demolish the entire system. We need to put medical choices and privacy in the hands of patients and their doctors first, not government.

© Elizabeth Lee Vliet, M.D. July 14, 2009