Tuesday, April 27, 2004

A huge headline on the front of a recent issue of the New York Times Magazine said more than was intended: “Now are we ready to talk about health care?” Inside was an article with the same title by Sen. Hillary Clinton.

The casual arrogance of that question is staggering. We talked endlessly about Hillary’s proposed government-run medical system a decade ago and decided against it for many reasons. Now this rerun of the same issues proceeds as if the question is whether the rest of us are “ready” to talk about such things.

Mrs. Clinton, New York Democrat, parades the usual litany of reasons for the government to run the medical system, beginning with “soaring health costs and millions of uninsured.” But not only does she offer nothing to actually cut costs, she declares “our mental health delivery system is underfinanced.”

In other words, she wants to spend more money on shrinks. Can you imagine what will happen to costs of unverifiable diseases and unverifiable cures provide blank checks to be paid by the taxpayers? “Universal health care” is a lovely phrase with political resonance in some quarters. But what does it mean concretely?

First of all, since people differ in what they want, nothing can be “universal” without being mandatory. In other words, we are talking about forcing people to belong to whatever program the politicians and bureaucrats come up with, regardless of what the people themselves might prefer.

As for health, it is the end result of many things — diet, exercise, genetics, lifestyle — most of which are beyond the scope of government. What the government can control — doctors, hospitals, medicines — are only part of the equation.

What the lovely phrase “universal health care” boils down to is politicians and bureaucrats forcing people to get their medical treatment and pharmaceutical drugs the way the politicians and bureaucrats decide.

Somehow, the notion seems to be insinuated the government can do it cheaper and better. But name three things the government does cheaper and better than private individuals and organizations. It would be no trick at all to name dozens of things the government does worse and at higher costs.

How will it be cheaper to manage hospitals, doctors and pharmaceutical drugs, when it will take an army of bureaucrats and tons of red tape to do so? Economists say there is no free lunch. There is no free red tape either.

Whatever charming visions may be conjured up by political rhetoric, what matters are the hard realities of government-run medical systems. Such systems have existed in many countries. Why not look at what happens in those countries?

How many of those who gush about “universal health care” know that the countries which have it also have waiting times to get treated that are several times as long as people in America wait to see a specialist or get an operation?

Waiting not only means longer suffering, it can also mean a treatable disease can become untreatable — or even fatal — because of the delay.

Britain has had a government-run medical system for about half a century, so it might be a good source of facts — for those interested in facts, instead of political rhetoric.

A feature article in London’s Daily Mail referred to “our filthy hospitals.” The distinguished British magazine the Economist likewise commented on the dirtiness of these hospitals.

Why? British hospitals are so tied up in government rules and union contracts that a nurse has no authority to order the janitorial staff to mop the floor after a patient has vomited. If the nurse wants the floor mopped any time soon, she must stop caring for patients and find a mop to clean it up herself.

Working for a government-run medical system is apparently not all that attractive to Britons who might go into the medical profession. Many of the doctors in Britain are from Third World countries whose medical schools often are substandard.

These are just some of the problems that go with government-run medical systems, whether in Britain or in other countries around the world. But what are mere facts compared to a lovely phrase like “universal health care”?

Thomas Sowell is a nationally syndicated columnist.

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