Lack of Health Insurance Is Not the Problem

Steven M. Warshawsky
Both Linda Halderman and Patrick Poole have offered very helpful analyses of the public policy pitfalls that surround "universal coverage" health care proposals, like the one offered last week by Governor Schwarzenegger of California.  All such proposals are built around one central premise:  That all persons living in this country should have health insurance.  Indeed, the "problem" that is repeatedly pointed to in justifying such proposals is the millions of Americans (the numbers vary) who do not have health insurance.

Plainly, both Dr. Halderman and Mr. Poole accept the premise that a lack of health insurance, per se, is the problem.  As Dr. Halderman writes: 

"Achieving a workable solution first requires that we understand the problem.  For 4.8 million uninsured Californians, no further explanation is necessary..." 
Really?

And Mr. Poole writes: 
"The staggering number of uninsured Americans is truly a tragedy, and Gov. Schwarzenegger has his heart in the right place by trying to tackle the problem head-on." 
How so "a tragedy"?

Once the problem is defined in this manner, the solution becomes obvious:  Government-mandated health insurance for all persons.  The debate then moves to the details of such a plan, with some persons favoring a more "command-type" system and other persons favoring a more "free market" system.  But all such plans are inherently socialistic.  And, don't be fooled, all such plans will lead to the type of second-rate health care systems currently found in Britain and Canada. 

Let me offer this counter-intuitive, but I think correct, observation:  The "problem" is not the lack of health insurance.  The problem, if there is one, is a lack of adequate medical care.  And there is no evidence that there is a significant problem in this country with a lack of adequate medical care The vast majority of people living in this country obtain more than adequate medical care.  Very few people in this country are suffering, let alone dying, because they are not getting adequate medical care.  I challenge anyone to prove the contrary. 

Moreover, not everyone who lacks health insurance is suffering from a lack of adequate medical care.  Many uninsured people do not have a need for medical care, others receive it from charity, others simply obtain it by imposing their needs on hospital emergency rooms (a problem that hardly requires implementing a full-blown scheme of socialized medicine to solve).  And just because someone is uninsured today does not mean that they will be uninsured tomorrow. 

I have never -- not once -- seen an article analyzing the "health care crisis" that shows that Americans, as a whole, are suffering from a lack of adequate medical care.  We know that they are not.  On the contrary, Americans are extremely well cared for.  As Dr. Halderman points out, that's one of the reasons why health care in this country is so expensive.  If we want to have the best doctors, the best technology, the most advanced drugs, and the most sophisticated procedures, it is going to cost money.  Lots of it. 

Yes, some people are not able to get the medical care they need.  Query:  How many people, exactly, are we talking about?  What kind of medical care, specifically, aren't they getting? 

I submit that we are not talking about tens of millions of people, and certainly not hundreds of millions.  And we are not talking about the medical care that most people need in their lives:  immunizations, occasional check-ups, occasional emergency room visits, a surgical procedure or two, OB care.  Before we skip gaily down the path to socialized medicine -- inevitably destroying a health care system that works extremely well for most Americans -- we should demand proof of the "problem" that supposedly must be solved.  Surely, the problem has to be something much more serious than a mere lack of insurance.

Once we accept the premise that a lack of health insurance is the problem, indeed is "a tragedy," then some type of "universal coverage" plan is going to be adopted.  And when that happens, Americans -- like the Tennesseans Mr. Poole describes -- will be very unhappy to learn that they have destroyed the best health care system in the world.

Steven M. Warshawsky 
Both Linda Halderman and Patrick Poole have offered very helpful analyses of the public policy pitfalls that surround "universal coverage" health care proposals, like the one offered last week by Governor Schwarzenegger of California.  All such proposals are built around one central premise:  That all persons living in this country should have health insurance.  Indeed, the "problem" that is repeatedly pointed to in justifying such proposals is the millions of Americans (the numbers vary) who do not have health insurance.

Plainly, both Dr. Halderman and Mr. Poole accept the premise that a lack of health insurance, per se, is the problem.  As Dr. Halderman writes: 

"Achieving a workable solution first requires that we understand the problem.  For 4.8 million uninsured Californians, no further explanation is necessary..." 
Really?

And Mr. Poole writes: 
"The staggering number of uninsured Americans is truly a tragedy, and Gov. Schwarzenegger has his heart in the right place by trying to tackle the problem head-on." 
How so "a tragedy"?

Once the problem is defined in this manner, the solution becomes obvious:  Government-mandated health insurance for all persons.  The debate then moves to the details of such a plan, with some persons favoring a more "command-type" system and other persons favoring a more "free market" system.  But all such plans are inherently socialistic.  And, don't be fooled, all such plans will lead to the type of second-rate health care systems currently found in Britain and Canada. 

Let me offer this counter-intuitive, but I think correct, observation:  The "problem" is not the lack of health insurance.  The problem, if there is one, is a lack of adequate medical care.  And there is no evidence that there is a significant problem in this country with a lack of adequate medical care The vast majority of people living in this country obtain more than adequate medical care.  Very few people in this country are suffering, let alone dying, because they are not getting adequate medical care.  I challenge anyone to prove the contrary. 

Moreover, not everyone who lacks health insurance is suffering from a lack of adequate medical care.  Many uninsured people do not have a need for medical care, others receive it from charity, others simply obtain it by imposing their needs on hospital emergency rooms (a problem that hardly requires implementing a full-blown scheme of socialized medicine to solve).  And just because someone is uninsured today does not mean that they will be uninsured tomorrow. 

I have never -- not once -- seen an article analyzing the "health care crisis" that shows that Americans, as a whole, are suffering from a lack of adequate medical care.  We know that they are not.  On the contrary, Americans are extremely well cared for.  As Dr. Halderman points out, that's one of the reasons why health care in this country is so expensive.  If we want to have the best doctors, the best technology, the most advanced drugs, and the most sophisticated procedures, it is going to cost money.  Lots of it. 

Yes, some people are not able to get the medical care they need.  Query:  How many people, exactly, are we talking about?  What kind of medical care, specifically, aren't they getting? 

I submit that we are not talking about tens of millions of people, and certainly not hundreds of millions.  And we are not talking about the medical care that most people need in their lives:  immunizations, occasional check-ups, occasional emergency room visits, a surgical procedure or two, OB care.  Before we skip gaily down the path to socialized medicine -- inevitably destroying a health care system that works extremely well for most Americans -- we should demand proof of the "problem" that supposedly must be solved.  Surely, the problem has to be something much more serious than a mere lack of insurance.

Once we accept the premise that a lack of health insurance is the problem, indeed is "a tragedy," then some type of "universal coverage" plan is going to be adopted.  And when that happens, Americans -- like the Tennesseans Mr. Poole describes -- will be very unhappy to learn that they have destroyed the best health care system in the world.

Steven M. Warshawsky