National Healthcare: Getting what we ask for – A review of “National Health Care: Catholic Hospitals Rethink Their Stand,” by William J. Cox, “Liguorian,” Vol. 71, No.2, February, 1983, and a Conclusion.
Many uninformed Americans seem to think that a national healthcare plan, “Medicare for all,” will be free, if not from cost then free from worry about getting prompt, first-rate care. They are wrong on both counts. And, as analyzed in an article cited below, this false frame of mind will eventually have a catastrophic outcome if national health care comes to realization. While the potential demand for “free” health care is unlimited, the supply of money to finance and the providers to deliver are finite.
In a Kaiser Family Foundation poll conducted in 2020, one-half of those responding favored a national plan where all Americans would purchase healthcare insurance from the federal plan and the government would oversee delivery of healthcare. (“Public Opinion on Single-Payer, National Health Plan, and Expanding Access to Medicare Coverage,” published October 16, 2020 (at kff.org).) But the respondents’ answers were qualified. A summary of their reservations revealed the following:
71% would favor a national plan if it guaranteed health insurance as a right for all people in the U.S.;
67% would favor a national plan if it eliminated insurance premiums and out-of-pocket costs;
70% of people would oppose a national plan if it led to delays in testing and treatment;
60% would oppose a national plan if it led to paying more in taxes; and
58% would oppose a national plan if it led to the elimination of private health insurance companies.
Medical News Today, “What to know about the history and future of Medicare,” by Mary West, January 28, 2021 (medically reviewed by Shilpa Amin, M.D., CAQ, FAAFP).
Although not directly addressing each of the “ifs” in the investigative summary, the journalist recognized that “a Medicare for All plan would involve complicated logistics and many considerations, including costs (such as increased taxes) and coverages (such as having to wait longer for tests and procedures) and how to encourage healthcare providers to accept Medicare rates.” Id.
While trying to conclude this lengthy opinion, I came upon a magazine article published 40 years ago that has insights pertinent for today. The piece was written less than 20 years after Medicare and Medicaid’s enactment. It was written from the standpoint of the experience of private hospitals in the United States, Catholic ones in particular, but contained observations and statistics generally applicable to all hospitals. Unless noted otherwise, all quotes hereafter are taken from that article: “National Health Care: Catholic Hospitals Rethink Their Stand,” by William J. Cox, “Liguorian Magazine,” Vol. 71, No.2, February, 1983, pp. 24-28.
The Catholic Health Association (CHA), representing Catholic hospitals, was the only group hospital organization to testify before Congress in favor of national health insurance. That was because, in the first stages, “[t]he financial picture for most hospitals improved . . . since Medicare and Medicaid reduced the number of bad debts for medical care.” Also, government regulations that intruded into hospital management were originally “relatively modest.” In fact, the CHA initially thought “an even larger program would be better.” However, by 1980, “sharply rising (and seemingly uncontrollable) health costs, accompanied by costly but largely ineffective government regulations, caused Catholic hospitals to rethink their stand on the national health legislation they had formerly advocated . . .” The change of support was not a retreat from a belief in “the right of every person to necessary health care.” Rather, it reflected their “growing lack of confidence in the schemes then being offered for realizing this goal.” (I.e., government-run control and delivery.)
The effect of the 1965 government programs, as they grew, was to “rapidly” contribute to inflation “while straining federal and state budgets.” Furthermore, “the government’s refusal to pay hospitals for the actual cost of the care they deliver to Medicare and Medicaid patients” was beginning to force some hospitals in less advantaged areas to close their doors. Noted, too, was that “public hospitals are in equally difficult straits.” This is because by 1983 the government had already made health care, and particularly hospitals (public and private), “one of the most regulated sectors in the American economy.” The article’s writer predicted that if government health insurance and oversight of health care were to continue expansion the result would be “more centralized and detailed controls on the supply of physicians, hospitals, and other health services,” including rationing of those services.
Predictable results of poor consequences from universal health care: While a national plan would guarantee health insurance as a right for all people, bureaucracy will increase; cost of delivery will increase; premiums and taxes paid to the government will increase; times waiting for testing and treatment will increase; and administrative restrictions will make it inconvenient, if not impossible, to choose one’s own private doctor or preferred facility for care.
In my opinion, as foreseen decades ago, government takeover of health care insurance and, therefore, its eventual takeover of health care delivery, is a bad idea.
Chip Williams is a Northsider.
