This is my second post on socialism, from National Review’s latest issue. Avik Roy is the President of the Foundation for Research on Equal Opportunity (FREOPP.org), a non-partisan, non-profit think tank: “It’s worth defining exactly what “socialized medicine” is, and what it is not. ‘Universal coverage,’ a system in which everyone has health insurance, is not necessarily socialized. Switzerland, for example, has a system of universal coverage in which Swiss residents buy private insurance and receive treatment from private physicians and private hospitals. In contrast to the United States, there are no government-run insurers in Switzerland.
“Canada, on the other hand, has socialized, or ‘single-payer,’ health insurance, in which the government is the only meaningful health insurer. But Canadian-style socialized health insurance is still a minor-league version of socialized health care, because single-payer health insurance can — and frequently does — tolerate the existence of privately owned hospitals and physician clinics. The standard-bearer of truly socialized medicine is the United Kingdom. In Britain, as in Canada, health insurance is the province of the government. But, as it is not in Canada, the delivery of health care is also socialized in Britain. That is, a government health-insurance agency pays a government-employed doctor to send Britons to government-owned hospitals.” The whole mess is called the National Health Service, NHS. This is what proponents of government run health care would lead us to believe works so well. They lie. Read on.
“The NHS is no paradise. Open a random edition of a British daily newspaper and you will likely encounter an article about some egregious problem that the NHS has failed to solve. For example: NHS doctors routinely conceal from patients information about innovative new therapies that the NHS doesn’t pay for, so as not to ‘distress, upset or confuse’ them; terminally ill patients are incorrectly classified as ‘close to death’ so as to allow the withdrawal of expensive life support; NHS expert guidelines on the management of high cholesterol were intentionally not revised after becoming out of date, putting patients at serious risk in order to save money; when the government approved an innovative new treatment for blindness in elderly patients, the NHS initially decided to reimburse for the treatment only after patients were already blind in one eye — using the logic that a person blind in one eye can still see, and is therefore not that badly off; while most NHS patients expect to wait five months for a hip operation or knee surgery, leaving them immobile and disabled in the meantime, the actual waiting times are even worse: eleven months for hips and twelve months for knees (compared with a wait of three to four weeks for such procedures in the United States); one in four Britons with cancer is denied treatment with the latest drugs proven to extend life; those who seek to pay for such drugs on their own are expelled from the NHS system for making the government look bad, and are forced to pay for the entirety of their own care for the rest of their lives; and Britons diagnosed with cancer or heart attacks are more likely to die, and more quickly, than citizens of most other developed nations — Britain’s survival rates for these diseases are, according to an OECD survey, ‘little better than [those] of former Communist countries.’
“One ‘success’ of socialized medicine in Britain is that it has proven impervious to reform. In an attempt to reduce lengthy wait times for emergency-room service, Tony Blair’s Labour government introduced a mandate requiring that patients admitted to an NHS emergency room receive treatment within four hours. Some British hospitals responded by instructing their ambulances to drive around town with ailing patients inside, so as to minimize the number of patients technically waiting for care inside the emergency room. This year, the NHS announced plans to abandon the four-hour guarantee.
“American Medicare works in a different way. American Medicare contains few restrictions on specialist care or expensive technologies. The American Medical Association and other doctors’ lobbies, through a secretive group called the “Specialty Society Relative Value Scale Update Committee,” effectively determine how taxpayers pay physicians for Medicare services. These features of Medicare — heavily subsidized premiums and unlimited access — make the program highly popular with seniors. On average, seniors receive more than three dollars in benefits for every dollar they pay into Medicare. But Medicare’s lack of Canadian- or British-style controls has turned the program into an oppressive fiscal burden. Today we spend more on Medicare than we spend on national defense. The program is the biggest driver of our deficits and debt. The Medicare hospital trust fund is already sending out more money than it takes in; according to its trustees, it will run out of other people’s money in 2026. Medicare Advantage highlights socialized medicine’s biggest lie: that ‘Medicare for All’ expands Americans’ health-care ‘rights.’ The Anglo-Canadian version of socialized medicine tramples on individuals’ rights to seek the care and coverage that they want. The U.S. version tramples on Americans’ right to the fruits of their own labor, conscripting them through taxes and debt to fund an unsustainable system.”