Terry McLaughlin: Government run health care wouldn’t be cheaper, more efficient
July 5, 2017
On June 23, California Assembly Speaker Anthony Rendon tabled SB 562 (single-payer health coverage), calling the bill "woefully incomplete" and noting that there are "potentially fatal flaws in the bill, including the fact it does not address serious issues such as financing, delivery of care or cost controls."
As Democrats in our nation's capital are considering a similar plan, it is worth sharing some compelling information sent to me from a Nevada County resident currently living in New Zealand, in response to last month's column on this subject. The writer informed me that New Zealand's national system covers only medical care. It does not include services such as dental or vision care, and is not entirely free, as many visits require a modest co-pay. In addition, he said, income tax rates are up to 35 percent with no deductions, plus a 15 percent Goods and Services Tax (GST), similar to the Value Added Tax in many European countries. He remarked that a GST or VAT is much more costly to consumers than a straight sales tax.
"We have rationed health care, which means that, for example, the government budgets a certain number of X-rays per year. So doctors are encouraged not to X-ray patients … Many New Zealanders are told they have a sprain only to find out much later that they have a broken bone. Result: the bone has healed (sometimes badly) and it is not uncommon to see a bone re-broken and reset. I have personally met at least five people who have told me the same basic story.
"The patient waiting game is the same story here as in other single-payer systems, such as Canada and England. It can take months or even years to move up the wait list for certain procedures. Specialists are hard to find and referrals hard to get. But if you have cash or private insurance, that puts you at the head of the line, because the doctor can get paid relatively quickly and completely.
"Drugs must be approved by the government, so only certain drugs are available and shortages are not uncommon."
This gentleman explained that although he has a 90-day prescription for a chronic condition, he can purchase only a 30-day supply of the needed medication because the drug is in short supply.
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In an emergency, patients are required to go to the hospital in the district in which they live, even if there is another hospital nearby. These patients are often flown to the mandated hospital via helicopter — and that cost is charged directly to the patient. The flight is not covered by government insurance. Age is also a determinant of the level of care. "Elderly people," he said, "score fewer points for major operations and wait longer or occasionally do not receive a procedure."
It is quite common for legal immigrants deemed too costly to be "weeded out," attested to by the New Zealand Herald's reporting on June 10 that the visa renewal for a blind, disabled five-year-old was denied and she was being deported back to South Africa because "her medical conditions would prove a burden on New Zealand's health system." This, despite Immigration authorities and doctors agreeing that her "life chances would be far better if she were to remain in New Zealand."
Here at home, Bernie Sanders and House Democrats have proposed the "Expanded & Improved Medicare for All Act." In studying this plan, the nonpartisan Urban Institute Health Policy Center determined it would cost taxpayers an additional $32 trillion over the next decade. The Urban-Brookings Tax Policy Center found that the plan would not raise even half of the income needed to pay for itself. Rep. Kevin Yoder (R-Kansas) said, "An across-the-board doubling of (tax) rates would drive the top bracket from 39.6 percent of income to a whopping 79.2 percent. Individuals making $38,000 a year would see their marginal rate grow to 50 percent from the current 25 percent. In return, every American would be forced onto a socialized health care system to receive insurance from central planners in Washington. Every single American who has a private health insurance policy — some 178 million Americans — would immediately be forced off of their current insurance."
Yoder predicts that in addition to overcrowding and long wait times for appointments, doctor shortages would be exacerbated as doctors flee the system rather than accept inadequate reimbursements for their services as set by the government. Already in Nevada County, many doctors no longer accept new Medicare patients because the reimbursements are too small and the waiting time for payments is too long.
New Zealand apparently suffers from a similar malady, as my correspondent indicated that a large number of New Zealand's doctors are foreign-born, and "if you are a doctor or other medical professional type (particularly specialists) and you speak decent English, you can get almost instant citizenship by moving to New Zealand and practicing medicine."
After living for more than six years with rationing and drug shortages from government administered national health care, the gentleman from New Zealand concluded: "The U.S. system has its own set of problems and we need honest debate … But why would we (Americans) ever want to create a massive new bureaucracy to administer a new government-run health-care program? To expect it to be cheaper and more efficient is insanity."
Terry McLaughlin, who lives in Nevada City, writes a twice monthly column for The Union. Write to her at email@example.com.