Do Americans Really Want Universal Health Insurance?

A recently released Gallup poll on healthcare was simultaneously right and wrong.  It got statistically correct answers but asked the wrong questions.

Fifty-seven percent of the 1,020 adults polled responded that "the federal government should ensure all Americans have healthcare coverage," presumably insurance.  Despite assigning healthcare responsibility to Washington, 53 percent wanted private insurance rather than government-supplied.  The article shied away from stating an inconvenient truth: what Americans say they want will not achieve what they really want and need.

Most Americans do not distinguish healthcare from health care.  As one word, healthcare refers to a massive system that consumes 18 percent of U.S. GDP.  As two words, health care means medical care, an intimate voluntary commercial service relationship between a patient and a physician.  Americans don't really care about healthcare — they want, whatever they need when they need it.

Common wisdom says that people with insurance get care, and people without don't.  Common wisdom is wrong.  History shows the exact opposite, called the seesaw effect.  As more people are covered by government-run insurance programs, access to care goes down!

Any system where Washington is responsible for ensuring universal coverage won't get Americans what they truly want: timely, quality medical care.

"Democrats have floated a number of different policy ideas to find a way to ensure greater health coverage through the power of the federal government."  After passage of President Obama's signature healthcare legislation, the Affordable Care Act (ACA), he did admit that Obamacare would reform health insurance, not care, as he had promised repeatedly before March 23, 2010.

Medicare (1965), Medicaid (1965), the Emergency Medical Transport and Labor Act (EMTALA, 1986), the Health Insurance Portability and Accountability Act (HIPAA, 1996), and, the ACA (2010) are well known, presumably well intended healthcare acts.  The end result is what we have now.  Timely health care is both unaffordable and unavailable.

Medicare will be insolvent within five years.  People with Medicaid die waiting in line for care, as do our veterans with Tricare, also government-supplied, insurance.  EMTALA created the unfunded mandate that is forcing closure of rural hospitals.  HIPAA failed to make insurance portable and, worse, obstructs communication between health care professionals.  Before the ACA, average maximum wait time to see a primary care physician was 99 days; after the ACA was implemented, the wait increased to 122 days.

If the federal government subsidizes full private coverage for all Americans, the price tag will be even greater than Bernie Sanders's projection for his single-payer system — $40 trillion.  Forty trillion dollars is slightly less than half the combined GDP of all nations on Planet Earth.

If Washington limits its subsidy of private insurance for all, that is effectively single-payer, even if supporters eschew the name.  As has been shown, a U.S. single-payer system will be prohibitively expensive and will restrict rather than expand access to care, as is true in Great Britain and Canada.

There is a fatal flaw to any healthcare system where Washington is responsible and in charge.  Between a third and a half of all U.S. "healthcare" spending produces no care!  Approximately two of the 4.1 trillion dollars expended last year paid for BARRCO — bureaucracy, administration, rules, regulations, compliance, and oversight.  Imagine how much more care Americans could get if those trillions went to patients and providers.

Americans' position on healthcare has been described as complex.  Gallup used the phrase "nuanced view."  The correct descriptor is "misinformed."  Too few are aware of the facts above.

The two questions Gallup asked were, is it a federal responsibility to ensure universal coverage, and do you want government-supplied insurance or private insurance?

Here is what Gallup should have asked.

1. Should the federal government guarantee timely, quality medical care for all Americans?

2.  Are you willing to double (or even triple) your federal tax payment so Washington can subsidize private insurance for all?

Answer #1: For Washington to guarantee timely care for most Americans would enslave some Americans. People would be forced to attend medical or nursing schools and then forced to provide whatever care the government dictates, when, and where.

Answer #2: Americans would assuredly respond, "Hell no!!"

Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award-winning book Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine.

Image via Max Pixel.

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