Wednesday, September 09, 2009

Health care lessons for America

A Canadian doctor has some very important lessons to teach Americans pondering health care reform, while a local think tank has succinctly presented its health care reform ideas based on principles of individual freedom, personal responsibility, economic freedom, and limited government.

The observations of Lee Kurisko, M.D., were published in his recent article, "What America Needs to Learn from Canadian Medicare," in the Summer 2009 issue of the Journal of American Physicians and Surgeons.

"As a Canadian physician practicing in the U.S.," observes Dr. Kurisko, "I am confident that the systemic problems in American medicine pale in comparison with those of Canada...It is astonishing to discover that some Americans see Canada's system of government-delivered universal health care as a utopian solution to systemic medical services delivery problems in the U.S."

Dr. Kurisko's main points:
  • Central planning does not work - "Stodgy, clunky bureaucracies cannot possibly meet patients’ needs in the way the marketplace does in almost every other economic sector."

  • Price controls do not work - "With insufficient compensation for their time, effort, or investment of capital, doctors had a disincentive to provide services."

  • Whoever controls the dollars is boss [or, as I like to say, "Who pays the piper calls the tune."] - "To paraphrase economist Milton Friedman, in free societies generally people get what they want. In government-controlled societies, people get what a bureaucrat says they may have."

  • Medical care is not a "right" - "A 'right to health care' implies that someone has to provide it. But what of the liberty rights of physicians, nurses, and other medical workers? Or the property rights of taxpayers and entrepreneurs?"

  • People can be persuaded to accept poor care - "Despite their professed individualism, however, Americans quietly accept statist programs like Social Security that have dangerously large unfunded liabilities. They also accept public education and its lackluster results...There is no reason to believe that Americans will not also be seduced and willingly come to embrace more government medicine."

  • There are major similarities between Canadian and American medicine - "Both systems rely on third-party payment with its escalation of demand."

The Freedom Foundation of Minnesota has issued a new report, "Prognosis for National Health Insurance: A Minnesota Perspective." It quantifies the cost to Minnesotans of the $1 trillion health reforms proposed by President Obama and Congress. As an alternative to this massive spending (and debt) increase, the report makes recommendations such as:

  • Provide for individual ownership of insurance policies. The tax deduction that allows employers to purchase your insurance should instead be given to the individual.

  • Better leverage Health Savings Accounts (HSAs) to empower individuals to monitor their health care costs and create incentives for individuals to use on necessary services.

  • Allow interstate purchasing of insurance. Policies in some states are more affordable because they include fewer “bells and whistles”. Consumers should be empowered to decide which benefits they need and what prices they are willing to pay.

  • Reduce the number of mandated benefits insurers must cover, empowering consumers to choose which benefits they need is only effective if insurers are able to fill these needs.

  • Eliminate unnecessary scope-of-practice laws and allow non-physician health care professionals to practice to the extent of their education and training. Retail clinics have shown that increasing the provider pool safely increases competition and access to care and empowers the patient to decide from whom they receive their care.

  • Reform tort liability laws. Defensive medicine needlessly drives up medical costs and creates an adversarial relationship between doctors and patients.

No comments: