Fictions don’t become facts through repetition.
Keep that in mind next time you hear a politician breathlessly decry the horrors of the American health-care system and then explain how he intends to fix it. Some of the most popular talking points in the health-care debate pass as the gospel truth simply because, well, they’re popular — not because they’re true.
Below, I debunk the five most prominent health-care myths:
(1) Forty-seven million Americans do not have health insurance.
This figure comes from the U.S. Census Bureau. What most people don’t know, however, is that the Bureau counts anyone who went without health insurance during any part of the previous year as “uninsured.” So if you weren’t covered for just one day in 2007, you’re one of the 47 million.
That also includes 10.2 million illegal immigrants, and about 14 million people who are eligible for public health-care programs like Medicaid or the State Children’s Health Insurance Program but have yet to enroll. And nearly 10 million of the “uninsured” have household incomes of more than $75,000 — so they can probably afford to buy health insurance but choose not to.
(2) Universal health-care coverage can be achieved via “individual mandate.”
According to the federal census, nearly two-thirds of the uninsured are aged 18 to 34. This makes sense — healthy people aren’t going to pay for expensive insurance they’ll never use.
Those who support an “individual mandate” — like Sen. Hillary Clinton and several governors — believe by legally requiring all Americans to buy health insurance the young and the healthy will increase the size of the risk pool and therefore lower premiums for everyone. As a way to enforce an individual mandate, Mrs. Clinton has suggested garnishing wages.
But many states require insurers to charge everyone the same rate. So young people would end up paying far more in premiums than they should — or could — pay. It’s patently unfair to force people to purchase insurance they can’t afford. Even in Massachusetts, which offers substantial premium subsidies for low-income residents, the government had to exempt a fifth of Bay Staters from the individual mandate because insurance was still so expensive. And, the plan is already $147 million over budget.
The real way to attract young adults into the insurance market is to lower premiums — not to impose draconian sanctions. This can be done by having states reduce costly mandates like coverage of in-vitro fertilization and by allowing people to buy insurance across state lines.
(3) Expensive prescription drugs are a big reason health-care costs increase.
The real price of prescription drugs is actually decreasing. In 2007, inflation rose more than 4 percent, while drug prices increased just 1 percent. So in real terms, drugs were 3 percent cheaper last year than in 2006, on average.
What’s more, drug spending is but a small slice of total health-care spending — less than 11 cents out of every health-care dollar goes to prescription meds.
And drugs actually reduce health-care costs in the long-term. Medicare, for instance, saves $2.06 for every additional dollar it spends on pharmaceutical drugs, according to a paper recently published by the National Bureau for Economic Research. Prescription drugs often obviate the need for expensive surgeries and hospital stays.
(4) Drug importation will save patients a fortune.
At most, according to the Congressional Budget Office, foreign drug importation would save Americans 1 percent over the next decade.
Brand-name drugs are cheaper in foreign countries because their governments impose price controls. Drug-makers can only afford to sell pills at cut-rate, controlled prices in Europe and Canada because Americans pay full price.
If American politicians allow foreign drugs to enter the U.S. market, they’ll in effect import price controls too. Such action will not only create practical problems, like shortages but also deny firms the return on investment necessary to plunge into the next round of research and development into new cures.
It takes nearly $1 billion to bring a new drug to market. Investors are willing to make such a risky investment because the rewards of developing a cure for Non-Hodgkin’s lymphoma, AIDS or diabetes are considerable. If the profit motive vanishes, the miracle cures for which America’s drug industry is responsible would vanish.
(5) The state-run health-care systems in Canada and Europe are better and cheaper than America’s.
People who make this claim usually note that life expectancy is higher in Canada and Europe. But life expectancy is influenced by a number of variables aside from the quality of a country’s health-care system — like diet, genetics, exercise, smoking, pollution and even marital status.
A study published last year in the British medical journal the Lancet suggests America is much better at treating cancer than Europe or Canada. Researchers found Americans have a better survival rate for 13 of the 16 most prominent cancers. An American man has nearly a 20 percent better chance of living for five years after being diagnosed with cancer than his European counterpart.
This study’s findings tell us a lot more about the quality of a health-care system than life expectancy rates do, because the relationship between treatment and outcomes is tighter, clearer and more direct.
Sally C. Pipes is president and chief executive officer of the Pacific Research Institute and author of “Miracle Cure: How to Solve America’s Health-Care Crisis and Why Canada Isn’t the Answer.”