Make American medicine American again
By Richard E. Ralston
I am so old that I can remember seeing my doctor wearing a hat. His car pulled up to my parents' tract home in Kansas City on 109th Street. Black bag in hand, he rang the doorbell. He looked down my throat, took my temperature and left a small bottle of pills. Mother gave him five dollars.
No proof of insurance was demanded, and no government forms were completed. The doctor did not have to determine which one of 155,000 ICD-10 codes now required was needed for billing.
Many politicians considered that situation unacceptable and took action to bring it to an end. They have been spectacularly successful.
At that time, American medical care was already being transformed by the rise of employer-paid insurance, to which government tax law gave birth during World War II. The advent of Medicare and Medicaid rapidly expanded the share of medical care directly controlled by government from under 10 percent when they began to 50 percent today.
That has had a huge impact on medical care as government regulates what it pays for in order to restrain costs--unsuccessfully, as the cost of care has risen in tandem with government control.
And now we have Obamacare.
The relatively free system of the 1950s, as well as today's government- dominated system, are often attacked by the claim that all other nations provide government care funded by single-payer medical systems.
But that claim is not true.
Nations such as France, Germany, the Netherlands and Switzerland allow private care. While basic insurance is mandated, it is available from many competing insurance companies, with options to purchase private, supplementary coverage.
Even a single-payer system like the National Health Service (NHS) of the United Kingdom allows private care and private insurance. Remarkably, a significant percentage of physicians employed by the NHS buy it.
Nonetheless, opponents of what remains of private medical care in the United States have to attack it. They cite surveys by the World Health Organization and the Commonwealth Fund, which regularly report the United States far down on the list of quality care.
That ranking is the result of surveys mailed to carefully selected lists of "experts" in each country who are asked to evaluate their nation's care. (The French respondents, unsurprisingly, gave France the highest score.) Respondents were instructed to weight 25 percent of their nation's score on the "fairness" of the system's financing--giving government-funded care higher ranking.
By that standard, the #1 rank in the United States would go to none other than our Department of Veterans Affairs, despite its scandalous spending and waiting lists.
Other studies compare longevity in each country and conclude that longer life is due to government care--even if life was already longer before that care existed. In the United States, traffic deaths, drug and alcohol abuse, shootings by criminals, the death of soldiers in battle, and the number of overweight and diabetic citizens are not taken into consideration.
The bogus claims and arbitrary statistics about other countries, however, are not what drives those who attack American medical care. It is American values they object to.
The best response to the statement that medical care is better for the majority of people everywhere else is: Untrue--but what if it were? "Everywhere else" does not have the Bill of Rights, the U.S. Constitution and the concept of inalienable, individual rights, which should protect each member of society from being sacrificed in the name of some collective "greater good." The United States of America does have these principles, no matter how much the advocates of government domination of medicine wish to ignore them.
American medical care is still the best. But it will not remain the best if we do not fully restore it now and fight to keep it free from ill treatment caused by government.
Richard E. Ralston is executive director of Americans for Free Choice in Medicine, Newport Beach, California. Copyright © 2015 Americans for Free Choice in Medicine. All rights reserved.