Friday, May 1, 2009

Universal Health Care

Many Americans like the idea of Universal Health Care at first thought. Many believe that they will save a lot of money and gain greater access to better care. However, after thought, Americans feel anxious when they hear about Universal Health Care because questions start to arise;

How much will it cost in new taxes?
How good will the quality be compared to what I receive now?
How easy will enrollment be, and do I qualify?
Can I keep my Doctor or will I have to find a different one?
Will the Universal Health Care plan cover everything or are their procedures and tests that will have to be paid out of pocket?
Is there a cap to how much will be spent per year from my Universal Health Care plan?

Because clear answers to these questions are avoided by President Obama and its political supporters, let’s review some basic economics to help shed light on the daunting task of Universal Health Care.

Like any other service driven industry there is a balance between cost, availability, and quality. We will look at a couple of scenarios to understand this balance.

The current system of health care, as imperfect as it may be, is driven by a balance of quality and cost. As a result the better quality health care you receive the more it will cost. Because of that, not as many people will be able to get it because it is expensive. In a system that keeps cost as low as it is in the current system and makes it available to everyone will result in a poor quality. Imagine the influx of patients into Primary Care and General Practitioners offices if all the sudden everyone in your area had health insurance. Getting an appointment would become impossible, especially a sick appointment. Appointment times would be shorter to get everyone seen in the same day; many would be seen by some sort of auxiliary staff instead of a physician. These adjustments in the local doctors office is only the tip of the iceberg. Take this system to the hospital setting and imagine the differences in quality of care.

How do you fix the problem with quality but keep it available to as many as possible? Take in more money, or raise cost, to hire more doctors and staff. In order for every American to have access to the quality care that the members of Congress receive now, cost would have to skyrocket significantly.
In conclusion the demise of Universal Health Care would be paved with good intentions, and as much as we mean the best for every American, the fallout would be a poor Health Care System for every American.


  1. This post is a sweeping generalization with no evidence cited other than a vague appeal to common sense. The argument might even be persuasive if health care quality in the United States right now was higher than in countries that already offer universal health care. But while each industrialized country (and except for the US, they ALL offer some form of universal health care) has variations in quality, on most metrics of patient outcomes the United States comes out at or near the bottom, despite spending an average of twice as much.

    Your mickey-mouse model makes the critical assumption that the cost of care derives from its quality. It does not. The cost of health care derives from its (repeated, expensive) delivery - with or without demonstrable benefit to the patient.

  2. Mr. Mason

    I appreciate your comment, however has President Obama been anymore exact or presented any clear evidence? If you find the evidence please provide the links.

  3. What Obama has or has not given in evidence is a little irrelevant to the question of whether you had a valid point in your post. I appreciate the time you clearly spent preparing it, but I think your argument, as logical as it may sound, is based on the flawed proposition that the quality of health care service is necessarily tied to its cost. So long as we assume that, we will continue to accept as unavoidable the rapid increases in the cost of medical care.

    I believe the evidence shows that these cost increases are neither sustainable nor necessary in order to have a working health care system. And I think the best thing we can do is not to simply accept and defend these costs as being the necessary product of having a health system, but to seek solutions that can help us all lead long, healthy and productive lives.

    I invite you to research the comparative spending on health care versus metrics such as life expectancy, infant mortality, and other readily available statistics for industrialized nations. You will find that countries which have already implemented universal health care are enjoying greater quality of care at a much lower cost than we spend here in the United States. To assume that ours is the only nation that can't get it right, or to get hung up on anecdotal tales of long waits or the unavailability of a particular drug is to miss the point entirely. The point is that you can get healthier citizens for a lot less than we're spending right now.

    A friend of mine died Saturday night due to complications arising from a common cold. A frickin' cold. He was diabetic and up until February he couldn't afford his own insulin medication. He finally got the medicine, thanks to a government program for low-income families, but by then his heart was already so weak. He was 50 years old, and he leaves behind a wife and 4 young daughters.

    I was with them yesterday. Saddest thing I ever saw in my life. The funeral is Wednesday.

  4. Mr. Mason
    I am sorry for the loss of your friend, thats tragic. Being a nurse I see these sad happenings often, and my prayers go out to the family.

    I agree that our current Health Care System needs quite a bit of work. However, I point you to Medicare, our current form of government run or Universal Health Care for the Elderly, it is going bankrupt and is failing.

    Medicare is failing because the cost of medication, doctors, nurses, hospitals, advanced imaging, vaccines, lab tests, etc. These technologies and educated staff cost money, a lot of it. Doctors invest more than $250k in education that has been accumulating interest for the 12 years they have been in school, the doctor needs to earn the money to pay back these loans. Hospitals have to purchase expensive equipment, are you aware that one MRI machine can cost as much as 3 Million dollars in the end. Many people don't know this, but it is true, that is why hospitals try to keep them running around the clock. Even then they are expensive because the tech running the MRI machine has been in school for 4 years, and has his own debt.

    Bottom Line, Health Care is expensive. We expect the most advanced and well education physicians with the most skilled staff at the best hospitals working with the best equipment and medication available to provide top notch Health Care. I don't understand how Health Care costs could be fueled by anything other than quality and availability.

  5. Dave, maybe you need to step back a moment and ask why we spend so many millions on equipment, tests, and training, and still have a health care system roughly as good as Cuba's at prolonging life expectancy. What did they figure out that we missed?

    Could it be that the latest, newest, coolest, shiniest bit of equipment isn't really going to make your patients that much healthier? I mean sure, for a few of them, it probably does. But what about the hundreds of thousands of doses of insulin that could have been provided for the same cost as that one MRI machine?

    We're a nation of gadget-lovers, and we almost reflexively opt for the newest thing when it comes along, even as we ignore things that have proven their ability to help people live longer and better lives.

    Trying to prolong that last tiny sliver of life for the richest and oldest fraction of the country is roughly as expensive as giving decent coverage to an entire population of our young and uninsured citizens who could benefit from it the most.