The "Crisis" Looks a Lot Like State-Run Medicine

The USAToday published a front-page story today arguing that a health care "crisis" looks a lot like Houston, Texas.  I would argue, from their descriptions, that a health care "crisis" looks exactly like state-run medicine.

Ijeoma Onye awoke one day last month short of
breath, her head pounding. Her daughter, Ebere Hawkins, drove her 45
minutes from Katy, Texas, to Ben Taub General Hospital, where people
without health insurance pay little or nothing for treatment.

Onye, 62, waited four hours to be seen. Still,
going to the emergency room was faster than getting an appointment. For
that, "you have to wait months," Hawkins says....

The huge number of uninsured residents here means that health officials
must make tough decisions every day about who gets treated and when.
"Does this mean rationing? You bet it does," says Kenneth Mattox, chief
of staff at Ben Taub, the Houston area's pre-eminent trauma care
facility.

The article goes on and on like this.  The problem is delays and queuing in facilities that provide free care.   And the difference between this and state-run health care is what exactly?  When a product or service is free, people will tend to over-consume the supply, with rationing taking place via queuing rather than price.  This is how every state-run supply system works, from food in the Soviet Union to health care in Canada.  And by the way, exactly how upset should I be about people receiving an extraordinarily valuable and costly service for free but having to wait a while to get it?

This article is actually a great rebuttal of the inherent message in
the health care debate that "uninsured" means "denied health care."  In
fact, it is clear that even in the spot USAToday picked out as the worst in
the country, the uninsured are in fact getting health care.  It is tedious with long waits, but there are no examples in the long article of people going without.  Yes some people consume less than they might if it was free and convenient, but that is just the rationing at work.  Anyone who says that rationing goes away in a state-run system is bald-faced lying to you.

Remember that national health care does not eliminate queuing and waits for the poor -- it just institutionalizes these waits for the rest of us.   Universal Health Care is equivalent to a Great Society housing program where everyone, rich and poor, have to give up their house and move into a crappy public apartment block.

Postscript: By the way, I am sympathetic to certain hospital administrators who have a "crisis" on their hands because the mass of uninsured show up in their emergency rooms.  That, however, is a problem manageable far short of government-run health care.  They want to blame diversions of critical patients away from over-crowded emergency rooms on the "uninsured" but it is really a function of their own faulty triage.

Update: Michael Moore will soon argue that its better in Cuba.  Hah! That is funny.  If people really want to believe this, then it is another reason is is way past time to open up our relations to Cuba, so people can see for themselves what a lying sack of poop this filmmaker is.

  • http://www.dagen.net/blog/ Damon Gentry

    The best analogy I've heard about government provided health care is this:

    Imagine if your local hospital, pharmacy, or and clinic were run and operated like your local DMV. Now, compare the vast difference in difficulty between issuing a driver's license and the process to observe, test, diagnose, and treat health problems.

  • tk

    Many of the politicians that are arguing for a change to the heath care system aren’t proposing government run health care, they are talking about offering government run insurance.
    What’s wrong with that? I have a problem with the fact that the insurance companies are making hundreds of millions of dollars in profits off of us and we have a huge block of uninsured citizens. It’s a disgrace to this country.
    You can still pay extra for your premium health insurance if you’d like but if the government can offer some basic insurance for an affordable price, what’s wrong with that?

  • Reformed Republican

    And how do you think the government will pay for this basic insurance? Through taxes. What do you think will happen when the costs start to skyrocket? Loss of freedom as the government starts prohibiting unhealthy behaviors such as drinking, smoking, overeating, etc. Perhaps mandatory exercise and nutrition requirements.

    The government will refuse to allow certain treatments that are deemed to costly. The goverment will also begin to fix prices that physicians can charge, leaving them with two options: refuse to accept government insurance, or lose money treating patients.

    I can go on, but I think you see the picture. Government provided insurance is not free, and health care will be worse for everyone except for very few at the bottom.

  • dearieme

    Whatever you do, chaps, don't copy us in Britain. You'd live to regret it. Or very possibly not.

  • DKH

    tk, the problem with the government offering basic insurance for an affordable price is that the government doesn't always keep its revenue high enough to cover its costs. Why charge more and lose customers when you can just ask Congress for another check?

    This is an issue at state level now with programs like Medicaid. The government can charge each person less than they have to pay out, on average. Since not everyone qualifies for Medicaid, this is not as visible of an issue. (As a side note, I believe some state legislatures have passed laws requiring Medicaid programs to at least cover costs, but I don't know specifically. The issue exists, though.)

    But if health insurance is widely available from the government under such conditions, customers will be drawn away existing health insurance companies toward the government plans. Then we have the same issue as always with socialized medicine, in which there is overconsumption due to the fact that costs are understated.

  • Dan

    An example from my childhood:
    In Milwaukee, where I grew up, there is music festival held each year called Summerfest. Basically, for a fairly nominal ticket price, you get admission to 8-10 stages with club-level acts (funded mostly through beer sales). Each night there is also a headliner which plays at an ampitheater adjacent to the festival grounds.

    Originally the headliner act was also included in the festival admission. This meant that for extrememly popular headliners, people would have to queue, sometimes for days, in order to get into the ampitheatre. Due to the many problems this caused, they went to a separate ticket system.
    They did however, retain a few sections of seats that were available with a festival admission.

    Now there are basically three ways to get into the show. You can either take your chances in the festival queue, or you can buy a ticket in advance which guarantees a better seat that you can get by queueing, although you still have a shorter queue to buy the ticket. The third method is to buy a ticket from a broker, and pay a premium over the ticket price, effectively paying someone else to spend the time in queue for you.

    In the case of a public/private heathcare system, you will get the same phenomena. The poor would have to queue for a limited supply of lower quality resources. The midle class would end up with longer lines than they currently experience, at a higher cost than they used to pay, for the same level of service. The rich, however would still be able to pay a premium to get immediate access to whatever services they decide they need.

    Oh, and by the way, since they went to the separate ticket model, the quality of headlining acts has improved tremendously. Thus the people who get in on the festival seats get a better show than they would have under the old first-come, first-served model

  • Methinks

    "In the case of a public/private heathcare system, you will get the same phenomena. The poor would have to queue for a limited supply of lower quality resources. The midle class would end up with longer lines than they currently experience, at a higher cost than they used to pay, for the same level of service. The rich, however would still be able to pay a premium to get immediate access to whatever services they decide they need."

    Dan has described the current healthcare system in Europe and Canada. Often, there are wait lists to get onto wait lists. Needless to say, people die on these lists. My uncle in Canada has been on a wait list for two years for non-elective surgery.