Universal winners and losers

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The Canadian experience confirms that government monopoly health care, though billed as "universal," has trouble delivering the goods. Nevertheless, similar schemes being advanced in America find favor with Big Labor, with good reason.

Under government monopoly health care, almost everyone in America's hospitals, except the physicians and the executives, would be forced to join a union, just like our public schools.

In Canada, unions are the only significant obstacle to shattering the government health monopoly, which according to a 2005 Supreme Court ruling is a blatant violation of Canadians' human rights. Nurse union bosses love the government health monopoly because it cements their power — even though there is a shortage of nurses in Canada, and nurses (like doctors) would get better pay and benefits through private health care. But the big winners are non-medical workers.

A 2002 study showed that workers such as painters and payroll clerks in Vancouver's main hospital earned better than 30 percent more than their unionized counterparts in the city's hotels — dollars that should have gone to improving doctors' salaries to prevent them from fleeing to America. That's one reason for the long, often deadly, waiting times for diagnosis and treatment in Canada. Similar woes would attend such a system in the United States, where every politician seems to favor some kind of big government approach.

In Sacramento, where labor unions have a powerful hold on the California legislature, state Sen. Sheila Kuehl just re-introduced S.B.840. This bill would outlaw private health insurance and throw every Californian into a government-run health insurance scheme, and also take over hospitals' budgets. A state bureaucracy would decide whether a hospital could add a new operating room or MRI machine.

In Washington, Sen. Ted Kennedy and Rep. Pete Stark have long advocated "Medicare for All." This would gradually open Medicare to Americans under 65 by moving more people from both ends of the spectrum, children and aging Baby Boomers, into this already fiscally teetering program. Presumably, future reforms would continue to attack Americans from both demographic ends, until only 33-year olds are left in private health care, before they too fall into the government's grasp.

Another prelude for a complete government takeover, and favored by the unions, is to over-regulate health insurers, hospitals and doctors, layering on more bureaucracy every year. Costs go up, patient satisfaction goes down, and the interest groups are forced to invest even more resources in lobbying and squabbling amongst each other for government preferences, instead of improving health care.

Regulation of health insurance, for instance, is especially masterful. Politicians have created an overly expensive private insurance system that actually subsidizes Medicare and Medicaid patients, whom hospitals and doctors would otherwise be increasingly unwilling to accept, while blaming insurers for excessive greed! "Single payer" health care is in retreat — but politicians refuse to accept the people's verdict and continue to tender schemes that would benefit public-sector unions. More than two-thirds of Swiss voters recently rejected a proposal to kill its competitive market for health insurance. In 2002, almost four out of five Oregon voters also rejected government monopoly.

The unions represent over one-third of public-sector employees, much more than their paltry 7 percent share of private-sector workers, according to the latest figures from the Bureau of Labor statistics. But flush with funds and power, in some cases they have been able to elect the very people with whom they negotiate. The House of Representatives recently handed them a huge break by passing the Orwellian Employee Free Choice Act, which would eliminate secret ballots for union certification.

Government monopoly health care would eliminate the prompt service and high quality Americans have come to expect. But regardless of performance, unions would benefit from it. No wonder Big Labor wants the government to take over health care.

John R. Graham is director of health care studies for the Pacific Research Institute and co-author of "What States Can Do to Reform Health Care: A Free-Market Primer."