#67: “Why are hospitals so crowded in America? It’s because capitalist medicine is taking us for a ride.” Hogwash. Hospitals are full because there is a rising demand for hospital beds, due to the combined graying of our society and our terrible health habits, as demonstrated by the obesity and diabetes epidemics we currently suffer.
“FACT: capitalist medicine is inefficient.
FACT: socialist medicine is not.”
It may be juvenile to talk about socialized medicine, but it’s ignorant and naïve to think socialized medicine will solve our problems. And just because you wish something with all your might and WRITE IT IN UPPER CASE doesn’t make it so. In America, socialist medicine is no more efficient than capitalist medicine. If the government were so efficient, why not offer Medicare as an open enrollment insurance (competing against private insurers) and let the consumer decide which is better? If Medicare was so efficient, why were Advantage programs created, whereby Medicare (in order to cut costs) is essentially subcontracting itself out to private insurers?
Do you really think government-run medicine can be more efficient than the private sector? How has it done so far? 45% of US medical expenditures are already spent by the government, through Medicare/Medicaid/VA/SCHIP. Has it proven itself more efficient than the private sector? No. The President’s Council of Economic Advisors recently stated that “nearly 30 % of Medicare’s costs could be saved without adverse health consequences,” implying 30% of Medicare’s spending is a waste, a proportion similar to that suggested for private insurance companies. Liberal pundits proudly assert that Medicare’s administrative costs are only 2-3%, much lower than the private insurance companies. Yet that number belies many hidden costs not attributed to Medicare (as fee collection, fraud investigation) that other government branches undertake on behalf of Medicare. The percentage is also low because Medicare payouts are so high. As the denominator grows, the relative size of the numerator shrinks.
The reason the government (and the private sector) have been unable to rein in expenditures is because the rise in costs is, for the most part, NOT due to company inefficiency. As Americans become older and fatter, healthcare utilization has risen. There’s also a greater array of services, drugs, and technologies available, whose use (and misuse) is fomented by the US fee-for-service healthcare model. Little is done to discourage waste, in the form of unnecessary tests or expensive drugs. Why would healthcare professionals offer unnecessary tests or technologies? Given that these tests offer the professionals reimbursement, additional protection against lawsuits, and greater patient satisfaction (as often the patients demand them), they may ask, why NOT offer them? Would politicians legislating for socialized medicine change this? Given the millions spent in lobbyists by the insurance industry, drug companies, and even professional organizations like the AMA, the answer is no.
So unless we overhaul the entire fee-for-service model, or decide to curb expensive technologies/services/drugs, things won’t change much under socialized medicine.
We will simply be transferring exorbitant healthcare costs from the private to the public sector.
What do we mean when we say the government should provide healthcare? It sounds almost noble to say, let the government pay for universal healthcare. But how does the government pay for this? Payroll taxes? Income taxes? Corporate taxes? Given that the underclass pays few of these taxes (43% of Americans pay no federal income tax at all), “let the government pay for it,” essentially means, “let the corporations/rich/even middle class pay for it.” This, coupled with our fee-for-service model, could prove a costly mix, as more people will be offered more services which they themselves need not worry about paying for. How will you discourage overuse? Costs will continue to skyrocket.
The secret to lowering healthcare costs is not who pays for it, but understanding what we are paying for. Streamlining the system, allowing for greater competition, or even making companies non-profit, could all help reduce costs to a certain extent (and it’s doubtful that making all of medicine government-run could do any better). But until we curb the increased demand for healthcare, and contain the rising supply of services offered, our healthcare costs will continue to rise.
