The National Health Care Nightmare Ahead

There is a growing consensus that if the American Health Care Act as proposed by the Republicans in the House and wholeheartedly endorsed by President Trump becomes law, the prospect of a single payer government run health care system will be virtually unavoidable.  By refusing to fully repeal Obamacare and institute a viable free market alternative, the inevitable failure of the mélange of Obamacare and Trumpcare will create a clamor for an alternative, which will be national health care.  The high probability of this eventuality is reinforced as many left-wing and progressive groups are giddy over the prospect of their fondest wish coming true.

The overriding strategy of Obama and the Left in passing Obamacare was to so disrupt the private health care insurance market and alter the delivery of health service that there would eventually be an extraordinary level of dissatisfaction by the citizenry.  At that stage, the people would clamor for a solution which would be the Left’s century old dream of domination and control of the populace -- national health care -- as any possible return to a free market based system would be essentially impossible. 

The ascendancy of Donald Trump to the presidency was not only a cataclysmic and traumatic event for the Left but one that could have derailed their well laid plans for national health care.   However, the establishment Republicans have confirmed, through their unwillingness to even attempt to repeal Obamacare and begin reconstituting a free market system, that the Left has succeeded more quickly than they had anticipated and, as an added bonus, they now have an unwitting ally to assume culpability for the failure of both Obamacare and Trumpcare.

Further, the Progressives’ success with the public in a comparatively short timeframe has been remarkable.  In a poll taken in May of 2016, 58% of Americans now favor a single payer government run health care system, while nearly the same percentage want a repeal of Obamacare.  Surprisingly, in the same poll 41% of Republicans favor a single payer plan.

That mindset is apparently also shared by Donald Trump who as recently as the 16th of January 2017 stated that he wanted guaranteed health insurance for everyone paid for by the government, if necessary.  Thus his unquestioned support for the legislation on the table is not a surprise. 

What is the future of the American people under a single payer system?   One need only look across the ocean to the United Kingdom.  Over the past 25 years I have had, until recently, an office in the London area and have observed firsthand the National Health Service in a nation that has 18% of the population and 2.5% of the land area of the United States.  I have watched over the years the never-ending budget crises and incessant degradation of care.

When the government controls the financial purse strings and thus determines policy, and when it pre-ordains salary levels and establishes limitations on care, there is no profit motive.   Accordingly, there is less incentive to enter the field of medicine, resulting a rapidly dwindling supply of doctors and nurses.  Therefore, as demand from an ever growing and aging patient population increases, shortages and rationing are inevitable.

A recent report by the British Medical Association stated that the NHS has reached its breaking point and that “Pressure on all services is rising and care is increasingly being rationed.”  There is a rapidly dwindling supply of nurses and doctors as demand from patients increases.  According to this report, the number of district nurses has declined 60% between 2000 and 2016.  There is a shortage of doctors throughout the system but it is particularly acute in the Accidents and Emergencies departments of the hospitals as they are 3,000 doctors short in this one area alone.  As a result, the NHS is looking at the possibility of conscripting hundreds of doctors from India and Pakistan

A report from the Patients Association found tens of thousands seeking routine surgeries had to wait on the average nearly 5 months and those requiring more major surgery, such as hip replacements, had an average wait time of nearly 4 months.  Another study concluded that around 750 patients a month, one in 28, pass away due to inadequate care such as doctors making the wrong diagnosis, being prescribed the wrong medication or mistaken monitoring of a patient’s condition.

According to an article in Forbes:

Terminally ill patients are incorrectly classified as “close to death” so as to allow the      withdrawal of expensive life support.

NHS doctors routinely conceal from patients information about innovative new therapies that NHS doesn’t pay for, so as not to distress, upset or confuse them.

A quarter of those diagnosed with cancer are barred from receiving the latest drugs proven to extend life; if those people choose to seek those drugs on their own they are banned from any further treatment by the NHS.

Britons’ survival rates for those diagnosed with cancer or heart attacks are little better than those of the former East European Communist countries.

A recent study conducted by the University College London and Columbia University revealed that nearly ten percent of British patients died in the hospital as compared to 2.5% in the United States.  This disparity is due in great part to post-operative neglect and inadequate care issues.

From a personal standpoint, I have often passed by the Chelsea and Westminster Hospital, considered among the best NHS facilities in the UK, and seen ambulances lined up waiting for the emergency room.  On another occasion, when a business acquaintance fell and broke his arm, he was taken to the Accidents and Emergency room where he waited for over five hours before being seen by a doctor.  And another four hours went by before his arm was x-rayed and placed in a cast.  It was obvious the staff was overworked and the facility understaffed.  Other experiences relayed to me by those I met throughout the United Kingdom over the years were similarly and uniformly appalling.

On the other hand, just four miles from Chelsea and Westminster is the London Bridge Hospital, a private for profit facility wherein there are excellent doctors, numerous staff as well as first-rate private rooms and medical facilities.  This is the two-tier system in the UK.  One for the wealthy and Ruling Class and the other for everyone else.  It would be no different in the United States when it adopts a single payer socialized medicine model.  Regardless of ideology the American elites will take care of themselves.

The degradation of care has already begun in the United States.  After the passage of Obamacare what was a shortage of doctors rapidly evolved into a potential crisis.  Today there is an estimated 30,000 doctor shortage; however, within seven years that shortfall will expand to nearly 100,000.  The adoption of socialized medicine will further exacerbate this crisis.

Funding and cost is another critical factor to consider in any single payer government run system.   Presently 55 million Americans are covered under Medicare at an annual cost of $721 Billion.  Another 71 million are enrolled in Medicaid and CHIP (Children’s Health Insurance Program).  The cost to the Federal Government is $521Billion and another $309 Billion picked up by the states for a total annual expenditure of $830 Billion.

Thus, nearly 200 million Americans are not enrolled in either government plan at present.  With socialized medicine, they would be.  Assuming the current per person expenditures of Medicaid and CHIP, it would cost over $2.3 Trillion per year (assuming the Federal Government picks up all the cost rather than splitting it with the States) to cover these 200 million citizens. 

Therefore, the potential cost to the Federal Government of universal single payer health care in a nation the geographic size and population of the United States would be: $3.8 Trillion per year (while the States save $309 Billion).  The dedicated advocates of socialized medicine claim there would be savings in reduced paperwork and other efficiencies.  However, no government entitlement program in the history of this nation has ever functioned efficiently and with lower than projected costs.  Medicare, which serves less than 17% of the U.S. population, is essentially a single payer program beset with fraud, waste and abuse.  And, as everyone knows, the government run Veterans Administration is a health care debacle.

When looking at entitlement spending, Social Security (the current annual expenditures are $1.1 Trillion) has to be taken into consideration.  Therefore, all the entitlement programs would cost $4.9 Trillion per year.  In 2016 the total revenue to the US Treasury was $3.6 Trillion.  Therefore, the cost of government run health care plus Social Security would create a deficit of $1.3 Trillion before interest, Defense or any other expenditures are taken into consideration (another $1.5 Trillion).   Revenue (taxes) would have to be increased by 90% to cover all the spending.

In a nation the size of the continent of Europe with 325 million people, there is no viable way that single payer government run health care will function without massive expenditures, overwhelming dislocation and mandated rationing.  The United Kingdom, the size of the state of Wyoming with a population of 60 million, constantly careens from crisis to crisis while the vast majority of its citizens unduly suffer.

Single payer health care is not the shiny object in the distance that will magically solve the nation’s health care issues regardless of the glib assurances and portrayals by the Left.   It will be an unmitigated disaster for the nation and its citizens.   The election of Donald Trump and a Republican Congress was not a mandate to accelerate this headlong plunge into oblivion and travail.