##################################################################### WE CAN HAVE AFFORDABLE HEALTH CARE By Vincent H. Miller & Jarret B. Wollstein ##################################################################### Affordable, comprehensive health care has become one of the most important issues of our time. Health care costs are increasing far faster than inflation and 13% of Americans have no health insurance at all. As our economy becomes troubled, more and more Americans are worried sick by the prospect of being without health care coverage. Across the country Americans are debating replacing our ``free market'' system with a government-guaranteed National Health Insurance, such as in Canada. THE CANADIAN MODEL The alleged superiority of Canadian national health care does not stand up well to close scrutiny. Michael Walker of Canada's prestigious Fraser Institute points out that the claimed administrative costs-savings in Canada are illusory: ``The Canadian system controls costs not through efficiency, but by rationing health care delivery.'' Long waiting lists and chronic shortages of equipment and services have resulted in waits of up to four years for elective surgery. Limited access to such basic diagnostic pr ocedures as CT-scan examinations have produced waiting lists a year long. Canadian heart patients now flock across the border to hospitals in Detroit and Cleveland before they die waiting for bypass surgery in Canada. The more control government exercises over health care, the more absurd the situation becomes. In Britain, the National Health Service has become so bureaucratic and inefficient that it costs $60 merely to change a light bulb in an NHS hospital. In Canada some low-level directives even dictate the amount of suture thread that may be used in an operation -- and the amount of oxygen allowed per patient. THE PUSH FOR STATE MEDICINE Despite the dismal performance of government-run medical services throughout the world, there is now considerable lobbying in the U.S. for a state-run national health care system. Politicians offer the utopian promise of universal ``free'' health care with unlimited access, but what they do not explain is how the enormous costs would be covered. A socialized health care system would require a doubling of income taxes or the addition of a new national 10% value-added-tax. Either alternative would destroy man y businesses, financially devastate the middle class, and plunge America into depression. WHY THE HIGH COST? Thirty years ago an uninsured American could afford to pay for a routine operation. Today the cost of even a brief hospital stay has become ruinously expensive. What has caused medical costs to skyrocket out of control? There are three major factors: (1) Lack of incentives to economize, (2) government regulations and bureaucracy, and (3) the litigation explosion. 1. Lack of Incentive to Economize. Over 50% of Americans now receive some government health care entitlements, such as Medicare or Medicaid; and eighty-seven percent of Americans have their medical bills covered by insurance companies. Since third parties pay the bills (at state-dictated rates) there is no incentive for anyone -- from patients, to doctors, to hospitals -- to exercise restraint in consumption of medical resources. Because patients don't pay directly out of their own pockets, few ever ask how much a medical procedure may cost or if there is a less-expensive alternative. Similarly doctors and hospitals have little incentive to comparison-shop or economize. 2. Government Interference In Health Care. Contrary to popular opinion, we do not have a free market in medical services in the U.S., but one of the most regulated markets in the world. The government now disburses over 40% of health-care funds. Over 800 federal and state laws (some hundreds of pages long) govern all health-care providers and institutions. According to some estimates, for every man-hour of health services provided by doctors, two hours are spent filling out government paperwork. In the Marc h 1991 issue of Private Practice magazine, Francis A. Davis estimated that government red tape has increased the cost of medical care by at least 50%. Current regulations tremendously increase the cost of health care in America: FDA Regulations. U.S. drug certification requirements are the most burdensome in the world. It now takes 12 years and costs over $231 million to develop, test and certify a single new drug. The introduction of some life-saving drugs -- which have long been used safely in Europe -- have been delayed for years or decades. Delays on Propranolol, used to treat angina and hypertension, resulted in at least 30,000 avoidable American deaths during the period FDA blocked its entry. Medical Licensing. U.S. doctors are the most regulated in the world. The declared purpose of medical licensure is to assure quality health care. The actual effect has been to drastically limit the number of doctors and greatly increase the cost of health care. Medical procedures favored by the AMA monopoly have been pushed at the expense of less costly alternatives. Independent practitioners -- such as midwives, osteopaths, homeopaths and chiropractors -- have been severely harassed and driven from hospita ls by AMA-dominated medical boards. A particularly tragic effect of medical licensing has been the disappearance of competent medical services from most poor communities, particularly rural ones. When the cost of medical services rise, the poor must do without. 3. Litigation. The proliferation of accident and malpractice lawyers who encourage lawsuits and outlandish damage awards, are paralyzing medicine. Many doctors now pay malpractice insurance premiums of $100,000, $150,000, even $250,000 a year -- costs they must pass along directly to their patients. In some medical specialties, such as obstetrics, the danger of malpractice suits is causing a large number of doctors to leave. Other doctors cope by running patients through batteries of unnecessary and costly tests, just to avoid ruinous law suits. THE SOLUTION What is the solution? The solution is not more government taxes, plans and regulations. More bureaucracy will neither improve health care nor lower costs. We need to eliminate stifling bureaucracy, increase control over our own health care, and create new and innovative health-care choices. Here are some alternatives: 1. Privatize Health Care. The health benefits we receive from government are paid for by our tax dollars. Under the present system, government decides how much of our money to spend on health care, consumes over half of those funds on bureaucratic overhead, and then controls what health services the remaining half of our own money may be spent on! This system is not only coercive, but uneconomical as well. Freedom of choice in health care can be increased for the needy by replacing Medicaid and Medicare with health-care vouchers, and by making all medical expenses (including medical insurance) tax-deductible. 2. Curtail Damage Awards. Outrageous malpractice awards are the major cause of escalating medical premiums. Our laws, judges and juries must distinguish between true negligence, which should be legally actionable, and "acts of God" and human imperfection, which are unavoidable. 3. Deregulate Medical Research & Marketing. Burdensome government testing and certification procedures have added enormously to the cost of new drugs. Procedures must be streamlined, and liability should be limited -- just so long as patients are fully informed of the risks and benefits of drugs. Patients and their doctors -- not government bureaucrats, should decide which drugs to use. 4. End Medical Monopolies. The American Medical Association is a coercive monopoly which makes it difficult or impossible for alternative providers, such as nurse-practitioners, chiropractors and nutritionists, to market their services. Legal restrictions denying consumers their choice of practitioners and therapies should be repealed. 5. Teach Healthy Life-Styles and Prevention. For many, disease prevention and a healthy life-style is the best therapy. By improving diet and fitness, and decreasing known carcinogens -- such as alcohol, tobacco, and fat -- we can improve our health without ever-more expensive treatment. Today the number one cause of death is cardiovascular disease, which is largely preventable through diet and fitness. Yet only 34 out of 100 medical schools give even a semester-long course in nutrition. 6. Encourage and Expand Charitable Care for the Poor. When doctors are spending 10 to 20 hours a week filling out forms and reports required by Medicare, Medicaid, the FDA and other state and federal agencies, they have little time left to help the poor. Eliminating medical monopolies and reducing unnecessary government regulations would greatly increase the number of health-care providers. Case loads and costs would decrease, and the quality and variety of services would increase. Enormous health care reso urces would become available to help the poor. A WARNING If you want to know how National Health Insurance might work in America, we have a model. For over 60 years the Veterans Administration has handled the health needs of millions of disabled and discharged servicemen. Investigations of the VA have found abominable conditions -- bordering on cruelty: long waiting lists for surgery, filthy hospitals, severe shortages of staff and drugs, antiquated equipment, artificial limbs denied amputees, and indifferent and hostile administrators. In short, you find a syste m very much like that of the Soviet Union. In looking at the Veterans Administration medical services, you are seeing the future of health care in America -- if National Health Insurance were to be enacted. As one U.S. Health & Human Services official put it, the country does not need a medical delivery system ``with the compassion of the IRS, the efficiency of the post office, at Pentagon pricing.'' RECOMMENDED READING Why We Spend Too Much on Health Care (Joseph Bast - Heartland Institute) .......................... $8.95 Health Care in America: The Political Economy of Hospitals and Health Insurance (Frech III) .................. $14.95 For these and other books and tapes write: Freedom's Forum Books, 1800 Market Street, San Francisco, California 94102. Add $2.50 Postage & Handling for 1st book and $1.00 for each additional item. Additional (hard)copies of this attractive two-color pamphlet are available for 5c each (minimum order $1.00). Price includes shipping. This pamphlet is produced as a public service by the International Society for Individual Liberty. If you would like to receive free literature about ISIL's activities around the world, and receive a sample copy of the FREEDOM NETWORK NEWS newsletter and book catalog, please write: INTERNATIONAL SOCIETY FOR INDIVIDUAL LIBERTY 1800 Market Street, San Francisco, California 94102 USA Tel: (415) 864-0952 Fax: (415) 864-7506