Politics and Insights from History

President Obama wants to make sure that every American has health coverage, provided by the government of course. This means universal health care. This idea is not new. Many in Congress have been pushing for socialized medicine for the past two decades, or more. Sweden and Great Britain were two of the first western countries to institute state run health care. They have had government run health care since 1948. Over the decades other nations such as, New Zealand, Australia, Cuba, and Canada have all instituted government run healthcare.
Sweden is often referred as a country that has the most equalization. It’s true, if you believe in equal results rather than equal opportunity. Sweden is the most socialist country in the world. And they have state run health care. Many people look to Sweden as an example for how a healthcare system should be run. After all they provide the best healthcare to all of their citizens. They have equal coverage, equal access, high quality care, a longer life expectancy than in the U.S., and their health care is free.
But if Sweden’s health system is so great, then why are they privatizing parts of it? The reality is their health system is fading. Proponents for universal care point out that Sweden’s experiment with profit driven health care is not working. They are right. But not because competition fails. The reason for its failure is that the bits of privatization in Sweden’s health care system are not truly private. They are still heavily regulated by the government.
Sweden only spends about 8.4% of their GDP (Gross Domestic Product) on their health care. But GDP alone is not a measure of how well a country is performing. Health care in Sweden suffers from increase costs, lack of doctors, and long waiting lines. In a ten year period, 1980-1990, the cost of Sweden’s healthcare rose by 145%. Despite price controls on the cost of drugs, doctor visits, and medical procedures, the cost of healthcare in Sweden is increasing.
Sweden suffers from long waiting lists. Patients stand in long lines to see a doctor. Security guards are common in their clinics to ensure there are no riots. They also refuse to let new people enter if the clinic is full. Patients are denied newer, better medicines because they cost more than the older prescriptions. Patients are denied the option of paying for prescription drugs themselves because it would cause “unequal access”.
Great Britain was one of the first countries of western culture to institute nationalized healthcare. They have had it since 1948. The people there suffer from long lines, denied medical procedures, denied drugs, and inferior equipment. English hospitals are routinely over crowded causing a shortage of beds, which in turn means that patients are turned away. Overcrowded hospitals increase the risk of infections spreading from patient to patient. It is reported that at least 7,000 patients suffer from infections and that 5,000 of those die from them. One of the reasons for overcrowded hospitals is England’s attempt to cut the waiting lines. They have passed reforms to cut back on the time people spend waiting to have surgery or see a specialist. There are many stories about patients not receiving the care they need. Many cancer patients are unable to see a surgeon or receive the medication they need.
And then there’s Canada. Our neighbor to the north. Everyone talks about Canada’s health whether they are pro or con nationalization of health care. Canada spends about 10% of their GDP on health care. We see news reports about how Canadians love their health care system. They’re smiling. They cannot understand us Americans and why we resist such a great system. People only wait 30 minutes at a clinic to see a doctor. They don’t have to pay for the visit or the prescription. They don’t pay for surgery. Canadians do not pay for one cent of their healthcare needs. At least, this is what we are told. And this is what many people believe. The truth is, Canada’s health care is not free. It never was. Canadians do pay for their health care. They just pay for it indirectly through taxes.
At least 22% of all taxes collected go to health care in Canada. Canadians pay an income and sales tax and employer based premiums to generate revenue for their healthcare. In 2005 citizens from Ontario pay 40% of their tax dollars toward healthcare and the figure is on the rise. The costs are borne by the federal and provincial levels in Canada. But lately Canada’s federal government has had to cut back on how much they spend on healthcare. Much of the responsibility is being shifted to the provinces. Of all the industrialized countries that have universal healthcare, Canada spends the most. But it ranks at the bottom for access to healthcare, according to the OECD (Organization for Economic Co-operation and Development). “It is 17th out of 20 for its doctor/patient ratio—only 1.8 doctors per 1,000 citizens, 17th for availability of CAT scanners, and 18th for MRIs.” Here is a table of average wait times:

Wait Time (Weeks) Procedure Waiting For
16.5                                    Time between referral from a general practitioner & treatment
8.5                                      To see a radiation oncologist
5.2                                      For a CT scan
12.4                                    For and MRI
3.2                                      For an ultrasound
20                                       Time between seeing specialist to surgery for hip replacement (after waiting
13 weeks to see the specialist in the first place)

(Houston Kerri, Acces Denied: Canada’s Healthcare System Turns Patients Into Victims, December 2003, The Center For Civic, Family, and Social Progress Policy Perspectives, vol. 10, Issue 6. http://ff.org/centers/ccfsp/pdf/CCSFP-PP-Winter-03.pdf (I put the figures in a table to make them easier to read.)

Canada also suffers from long lines, lack of access to newer and better technology, hospital beds, and prescriptions medication. However, Canada also suffers from a shortage of physicians. Doctors are leaving Canada. They cannot charge more than what the state allows for their services meaning that they are paid the same no matter how many patients they see or the quality of care they provide. Sometimes doctors have to send payment back to the government because they saw more patients than what the government mandated they could tend. As a result, doctors quit caring about their patients’ well-being. There’s no need to. Those physicians who truly want to help people have been prevented from doing so. In the 1990s roughly 10,000 Canadian doctors left the country.
On top of doctors leaving, there are few replacements graduating from medical schools. The Canadian government has put limits on the amount of enrollments for medical schools. Only 1,530 people graduated from Canadian medical schools in 2002. There are not enough doctors to replace those who leave or retire. Ontario alone claims that “nearly 80% of its regional communities are listed by the provincial government as being ‘underserviced’ due to physician shortages”.
Prescription drug coverage in Canada is no better. Drug prices are controlled by the state. Drugs are also approved by the government. This makes it difficult to get newer drugs on the market since in an effort to control cost the government will not approve them. These new drugs may be more effective, but they are also more expensive. Canadians only have access to the drugs allowed by the government. Even if they are willing to pay for the medicine themselves, they are not allowed to buy it. So, many Canadians come to the United States for their medicine. Another problem with mandated drugs by the state is that the government can change a person’s prescription to something more generic and cheaper without consulting the patient or the physician. Many Canadian are hospitalized because of a sudden change in their prescription and the side effects that occur. Drugs are not cheaper in Canada. They appear to be because of price controls, but their prices are higher than what we pay in the United States.