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Busting Healthcare Myths

Monday, May 11, 2009

To fix American healthcare, it's important to avoid some common misconceptions.

President Barack Obama has promised to fundamentally change America’s healthcare system. But before he and his team get too far down the field, they would do well to read Sally Pipes’s new book, The Top Ten Myths of American Health Care: A Citizen’s Guide. The book clearly and concisely explains even the most esoteric aspects of the healthcare debate.  

One of the first myths Pipes demolishes is the oft-cited statistic that some 46 million Americans lack health insurance. Of those, 10 million make more than $75,000 a year and almost 18 million make more than $50,000 a year. That means 38 percent of the uninsured likely make enough to afford health insurance but choose not to buy it.

An additional 14 million are, Pipes notes, “fully eligible for generous government assistance programs like Medicare, Medicaid, and SCHIP. The problem is, they’re just not enrolling in these programs.” Pipes wonders, “If 14 million eligibles aren’t availing themselves of taxpayer-funded coverage, then why should we think that a still bigger government healthcare bureaucracy will solve the problem?”

Of course, there are many Americans who legitimately cannot afford insurance and others are paying too much for the coverage they have. President Obama believes the answer is government-provided healthcare. “If I were designing a system from scratch, I would probably go ahead with a single-payer system,” he has said.

Many people think that is the only humane alternative, but Pipes disagrees. “It is government monopoly healthcare that is heartless and uncaring. And the inferior treatments it provides come with a very steep price tag—rationed care, lack of access to tests, with the latest technological equipment, and long waiting lists.”

38 percent of the uninsured likely make enough to afford health insurance but choose not to buy it.

Pipes knows whereof she speaks. She is a Canadian citizen (now living in California) and recounts her experiences under a single-payer system. She illustrates Canada’s cost-cutting measures that deny access to new drugs with a personal anecdote. Her uncle was diagnosed with non-Hodgkin’s lymphoma five years ago. “If he’d lived in America, the miracle drug Rituxan might have saved him,” she writes. “But Rituxan wasn’t approved for use in Canada, and he lost his battle with cancer.”

As Pipes learned firsthand, “To save funds, Canadian health officials routinely delay the approval of new and more expensive drugs.” Of the 100 new drugs launched in the United States from 1997 through 1999, only 43 made it to Canada during that time.

Canada’s waiting lists are infamous—over 800,000 Canadians are on lists for surgery and other necessary treatments. The average wait between a referral from a primary care doctor and treatment by a specialist is 18 weeks. “That’s almost double what doctors consider clinically reasonable,” Pipes points out.

In other government-managed systems, things are not any better. “Sweden’s waiting lists have led some patients to visit veterinarians,” Pipes reveals.

Of the 100 new drugs launched in the United States from 1997 through 1999, only 43 made it to Canada during that time.

Part of the problem is a physician shortage. One out of ten Canadians is seeking a primary care doctor. According to Pipes, “Over the last decade, about 11 percent of physicians trained in Canadian medical schools have moved to the United States.” This is in large part due to a massive pay discrepancy. “The average Canadian doctor earns only 42 percent of what a doctor earns in the United States,” says Pipes.

Pipes concludes her book with potential solutions for our healthcare problems. She points out that most regulations governing healthcare are designed to protect a system with a “disconnect between provider and consumer.” She proposes that individuals be free to shop for insurance across state lines, thus injecting a hefty dose of competition into the insurance market.

Pipes also argues that the tax breaks on healthcare enjoyed by corporations should be extended to individual consumers. As she notes, the current system guarantees that “people wind up with coverage that’s in their employer’s best interest, not theirs.”

The U.S. healthcare system is broken. President Obama promises to fix it. With her new book, Pipes has provided his administration with an admirable toolkit.

Robert Goldberg is vice president of the Center for Medicine in the Public Interest. 

FURTHER READING: Thomas P. Miller outlines President Obama’s plans for healthcare on the pages of The American here. And the Health Policy Consensus Group recently argued that “any health reform proposal to change what needs fixing also must preserve the freedom, innovation, and quality of American medical care that people value.” 

Image by Dianna Ingram/Bergman Group.

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