Single-payer health care in Canada, the U.K. and the U.S.

You have to empathize with doctors who would like to see a single-payer system in the U.S., to cut down on paperwork and multiple treatment authorizations. But interestingly, respected non-profits like the Mayo Clinic, singled out as models by President Obama, and many medical specialty groups, oppose a Single Payer system. Why would this be?

Our current system is more complex and expensive than it needs to be. And single-payer health care plans often work well for a while. But eventually the problems now seen in the UK and Canada become serious. Acute care still seems to be good in these countries in most cases. Though there have been cases of ambulances lined up, waiting to take patients into Emergency in the U.K. Routine preventative care is good in the city. Dental care in the UK is abysmal (it's an exception to single payer in Canada). Those with chronic conditions often wait for months for an appointment in both Canada and the UK. Cancer survival rates are higher in the U.S. This is one indication of more timely care and more treatment options in the U.S.

Cost-Cutting in Canada (sometimes at the expense of the U.S.)

In Canada, those "with connections" get seen by doctors much sooner than ordinary people, just like in Marxist countries. Urban dwellers get much better care than rural folks. In some smaller towns in Canada, there is a lottery system for doctor visits. I believe that there is no private care option in Canada (though it is now under consideration) and many Canadians come to the U.S. for treatment of serious conditions.

I once attended a meeting in which Canadian regulators explained their extortion program for getting American companies to do some of their research in Canada in exchange for reasonable drug prices. Canada is one of the few countries in the world with "mandatory licensing", which means that they will force innovative companies to disclose information necessary for another company to produce their new drug if the government doesn't like the price the innovator company wants to charge for the drug.

No wonder Canadian companies do not develop new pharmaceutical products. The reason new drugs are so much cheaper in Canada than in the US is mostly that Canadians do not consider it in their national interest to help companies recoup the hundreds of millions of dollars it takes to get a new product registered because they do not have a pharmaceutical research industry themselves. Canada is no less advanced than Sweden, but Swedish companies develop pharmaceuticals (though American consumers still pay for most of their research costs). Since the U.S. now supports most medical innovation in the world, new therapies which are more expensive when first introduced will be squelched if single-payer health care becomes the default system in the U.S.

The company I worked for opened a Canadian subsidiary and had Canadian sites for clinical trials so that they would be allowed to make a little money in Canada rather than turning their product information over to a generic manufacturer. Canadian doctors were notorious for not providing all the data required by the protocol of the study in which they were involved. They knew that they were in demand by American companies for political reasons - not because of the quality of their participation in studies.

Freedom and Fairness in the UK

The UK has a private health care system for the elite in addition to national health care, but no crossover between private and national health care is allowed. In the UK, a woman who had the audacity to pay for a cancer treatment not covered by national health care was punished for getting "unfair" treatment by cancellation of all her other national health care benefits. People are not allowed to spend their own money for better care if they are in the public system.

Some people think dogs get better medical care than people in the U.K. Don't know about that, but they probably get more timely care.

However, some Brits now go on "medical holidays" for health care in other countries. That way, they can get the care they want without getting their health care coverage cancelled back home. A few Americans are also starting to go on medical holidays abroad in countries moving toward capitalism, like India (still taking advantage of technologies developed in the U.S., usually) because of lower cost. But usually not because care is unavailable to them here. And not because they will be denied future medical care for going outside "the system" in the U.S.

Single-payer in the U.S.

The federal and state governments already pay for a big percentage of American health care. To get a feel for how things might change with a uniform single-payer system, it might be good to review results for Medicare, Medicaid, the VA and military medicine. Medicare is vastly more expensive than it was intended to be. Not Surprising. Other government-sponsored medical systems are characterized by inefficient and inconsistent care.

Single-payer proposals in the U.S. would change things in a drastic manner. The two things which scared me the most about single-payer HillaryCare when the Democrats tried to ram it through years ago were (1) the proposals that health care professional who treated both private and public patients would be criminals and (2) Hillary Clinton's remark to a nurse that if she had wanted a good-paying job, she should have gone into another line of work. (Law, maybe). Wage controls for all medical professionals seemed, how do you say it, unconstitutional to me. I do not want the vast majority of doctors and nurses in the U.S. dependent upon the government. And we don't need doctor strikes.

During her later presidential campaign, Hillary made a point of shadowing a nurse for a day during her "listening tour" as a gesture of humility after her earlier statement which suggested that nurses did not deserve a good salary. She also became more supportive of nurse's unions.

If a huge country like the United States adopts a single-payer system, all sorts of unintended consequences will occur. They will occur much faster than in smaller, less diverse countries.

The bill now being rushed through Congress is a messy first step toward a single payer system. The bill under consideration empowers dozens of federal bureaucracies to regulate the provision of health care. A federal bureaucracy is the closest thing to "forever" in American government. Why not let the states experiment with plans to work toward universal coverage and insurance reform? Why not consider Medical Savings Accounts which would lead to more true competition and less bureaucratic hassling of physicians by insurance companies?

Plans for rationing health care in the U.S. are already under consideration. If a single-payer system is adopted in our country, which provides a kind of foreign aid by paying for research for the whole world, medical progress will be also be slowed down tremendously. There is a place for federal funding for basic research in government institutions, universities, etc. Private companies are more effective at the boring, tedious work it takes to bring an innovation to market.