- The Washington Times - Saturday, November 13, 2004


By Sally Pipes

Pacific Research Institute, $14.95, 219 pages


I am a great fan of publisher Wiley’s series of “Dummy” books (billed as “a reference for the rest of us”). Whether the “Dummy” focus is on World War II, gardening, baking, or understanding wines, the Wiley books boil down the essence of the topic into easily understandable bits and pieces. There is nothing pejorative about writing on the “dummy” level. Instead it is an enviable skill to do so. Indeed, I believe all of us who write for the general public on any topic can learn from this series: no matter how complex the topic is, you can write about it clearly and simply if you try.

We have long needed a “dummy” book on the very complicated and mysterious topics of health care costs, health insurance and access to affordable drugs. I do not believe Wiley has done such a book. And they now do not need to, because Sally C. Pipes, President of the Pacific Research Institute, has written “Miracle Cure: How to Solve America’s Health Care Crisis and Why Canada Isn’t the Answer.”

Ms. Pipes well understands that for most Americans access to health care and inexpensive drugs are considered an entitlement. While we do not expect our employer or the government to pay for other essentials like food, clothing and shelter, many of us simply assume that because we need medical care and drugs to stay healthy and alive, we deserve them at little or no cost. With most employers providing or subsidizing employee health insurance plans, the cost of drugs, hospital and physician services is not closely connected to what consumers pay for them. This disconnect is now causing a crisis, threatening availability of patient care resources and pharmaceuticals that save lives and prevent suffering.

Sally Pipes is in a unique position to take on this subject. She is a former Canadian who grew up under a single-payer health care system—and she is all too familiar with the serious limitations and negative consequences of government-financed medical care. As she watched the encroachment of Big Government on the U.S. health system, she became alarmed—and decided to define the problem and set out her solutions in a clear, understandable way.

Like all of us, Ms. Pipes wants all Americans to have access to quality and affordable health care. But unlike many of today’s politicians, she sees government intrusion into health care matters as the problem rather than the solution. Ms. Pipes’ native land, Canada, with its “free” medical care and drugs, may sound like the answer to our problems. But she paints a stark picture of reality in Canada, with long waits for even essential medical care and rationing of pharmaceuticals to the point that sick Canadians scurry across the border to get new medicines in the U.S. that are not available in Canada.

What is Sally Pipe’s prescription for our ailing health care system?

—Educate the public about the reality that health care spending is under 6% of the total income of most Americans—an amount equal to discretionary spending for dining out, entertainment and the like. Similarly, even seniors pay only 3% of their income on drugs. These are not unreasonable percentages for essential services. Consumers must shed the illusion that health care, unlike everything else in life, should be “free.”

—Health insurance should not be regarded as an “entitlement” from government or employers to pay for every aspect of medical care. (A few years back, one of my staff members complained that our health insurance was inadequate because it did not cover the cost of eyeglasses.) Instead, health insurance coverage (purchased by consumers with pre-tax dollars) should be used to pay catastrophic health bills—not routine doctor visits for checkups or treatment for minor ailments

—There should be a financial reconnection between the patient and the provider of medical care, through the establishment of HSAs (health savings accounts). The HSA account would be untaxed money used for routine medical expenses—at the discretion of the patient. Unspent money could be carried over until the next year. If patients are spending their own money, they will choose their doctors wisely and be prudent about incurring medical bills. These out of pocket medical expenses would be paid directly to the physician upon receipt of service—as it should be.

—Efforts to reform medical malpractice laws that currently encourage lawsuit abuse against doctors and hospitals should be embraced by politicians across the political spectrum.

If the recommendations in “Miracle Cure” were applied across the board, our health care crisis would fade. Our medical care system—fueled by patient choice and an unimpeded relationship between physician and patient—would flourish. The elephant in the kitchen causing the current crisis is Big Government, and instead of trying to work around that elephant, Ms. Pipes calls for diminishing its size and presence. Let the free market and competition provide the incentives that will give us the end result we want: access for all Americans to good, affordable health care.

Elizabeth Whelan is president of the New York City-based American Council on Science and Health.

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