Look To Free-market, Not Hillary Clinton, To Fix Health Care System

By Jessica Peck Corry, 10-04-07

Let’s celebrate Hillary Clinton’s fantasy for a moment and assume that her plan to socialize American health care could work.

Let’s visualize for the sake of pleasant conversation that she finds a way to fund her plan with a paltry $110 billion annual taxpayer investment. Let’s suppose that it wouldn’t put small businesses out of business. Let’s suppose that every American (and every illegal immigrant) would be covered.

What would this coverage look like? Now it’s time to take off the blinders. It could be a nightmare for every American facing a catastrophic health care emergency. We need look no further than our neighbors to the north and across the Atlantic to realize why socialized health care is horrific in practice.

For one brief and horrible moment, assume that your child has contracted meningitis. You’re lucky because the disease is detected early and she will survive. Your joy is soon tempered, however, when you realize that she now suffers from one of meningitis’ most devastating potential complications-deafness. 

Your best hope for recovery? Pray that you live on the right side of the border and on right side of the Atlantic.

Regardless of geography, your child’s best shot for regaining her hearing may be a cochlear implant, a surgically-implanted device that stimulates the auditory nerves of the inner ear with electrical impulses that give a user a sense of sound.  The only problem-the devices must be implanted quickly.

A Denver hearing specialist I spoke with emphasized that timing is critical. According to Anne Cosgriff, who previously worked for Cochlear Americas, when a child goes deaf because of meningitis, bone tissue can begin to grow inside the ear that can make implantation problematic. 

“Timing is everything,” she said.  “If the boney material begins to grow, you can still get implantation done but it’s going to be much more difficult. The patient could end up with a longer surgery with more complications, ultimately meaning that (the device) is less likely to work.”

For the vast majority of American children suffering from meningitis-induced deafness, getting the procedure—and getting it done in time—may include a battle with the family’s insurance company. But in the end, according to Cosgriff, the prospects are much better for kids here than they are for their neighbors to the north.

Cochlear has an entire staff devoted to securing coverage by U.S. insurance companies.  In addition, several states are now mandating coverage of the implants.  And for the 15 percent of American families who lack private insurance, the government often picks up the tab.  While the system is imperfect and Medicaid reimbursement rates trail behind actual costs, the situation is improving as public health care advocates coordinate with industry officials to significantly improve reimbursement rates and develop private sector strategies for increasing access.

In Colorado, the Center for Hearing at the Colorado Neurological Institute is working with industry leaders, including Cochlear, to provide cost-free implants to needy families.

Compare this to Canada, where the government runs the show and the private sector has little opportunity - or incentive - to improve access. According to the Hearing Foundation of Canada, the government in Ontario artificially limits supply to 47 cochlear implant procedures a year and hundreds of people forced to wait up to four years for treatment.

In British Columbia, government funding allows for only 25 adults and a fewer number of children to receive an implant annually.  Everyone else is forced onto a waiting list.  In a recent medical article written by Lorne Smith, titled “Canada, Land of Equal Access,”Dr. Sipke Pijl, PhD, director of the Department of Audiology at St. Paul ‘s Hospital in Vancouver, says recent government funding there has translated into shorter wait times - but they still languish at about a year. 

Canadian officials boast that the implants are much cheaper there - with one article saying the average cost is $32,000 - compared with $50,000 or more in the U.S. While Canada’s government health insurance generally covers the cost of the procedures and related costs, including specialist referrals, this means nothing for the hundreds of families languishing on waiting lists. They can only hope they’ve got time to spare in the fight against lifelong deafness.

For most Canadians, access to an American hospital or an American-like health insurance system is just a fantasy.  They must get in the back of the line. They don’t have the financial luxury owned by wealthy Canadians who head to major U.S. cities for implant procedures. They aren’t as lucky as some Canadians who to have access to private health insurance known as “extended benefits” coverage.

For British Columbia’s 4.3 million residents, there is just one medical clinic that administers the implants for adults, and another for children. According to Pijl, who administers the implants in Vancouver, the prospects can be dim for those seeking help.  “Here in B.C., cochlear implants for adults are on kind of a quota system,” Pijl said. The Ministry of Health “will allow us to do 25 implants a year.”

If your child has gone deaf in both ears, the prospects can be even worse. The Canadian government refuses to fund bilateral cochlear implants. According to Pijl, bilateral implants can be essential in aiding hearing recovery. Canadian audiologists are lobbying the government to fund them.  “If I were responsible for a children’s program, I would consider it malpractice not to implant both ears,” Pijl said.

For U.K. children suffering from Meningitis-induced deafness, the prospects are even bleaker. National waitlists there top five years.  And the deaf aren’t the only ones suffering from the nation’s socialized system. According to an August study released in The Lancet Oncology, English and Scottish cancer patients have some of the lowest survival rates of any country in Europe. While U.S. patients face overall cancer survival rates of 63 percent, just 53 percent of patients in the U.K. and 58 percent in Scotland will survive. 

According to Professor Ian Kunkler, a study researcher and professor at Scotland’s Western General Hospital, waiting lists for chemotherapy are a serious culprit. “We have good evidence that survival for lung cancer has been compromised by long waiting lists for radiotherapy treatment,” Kunkler told the U.K.’s Telegraph newspaper.

Stuart Browning, a free market filmmaker who is emerging as a conservative voice to counter Moore, says there is another obvious source of the disparity. As he told me, less than 40 percent of British cancer patients ever gain access to an oncologist. 

Despite the advantages of America’s imperfect - but clearly superior - health care system, Clinton and others (including liberal filmmaker Michael Moore) continue to perpetuate a national fascination with socialized health care systems. 

In Moore’s recent film documentary titled “Sicko”, he suggests that America has got one of the worst systems in the entire industrialized world.  While he advocates a “Single Payer System” (the government) and Clinton stops short, a key element unites the two and their ideals: the government should ultimately fund coverage, determining supply, demand, and costs for every American.

Moore claims such a system could lead to greater efficiency.  And he’s probably right.  He points out that we spend more money on health care than almost any other nation.  Keeping people alive costs money.  Making sure that children don’t go unnecessarily deaf is expensive.  But it’s an investment Americans are willing to make.

We could all pay less for health care if the government limited access to cutting-edge technology like cochlear implants - or insurance companies stopped insisting that consumers over the age of 50 get colonoscopies. After all, as Browning points out, colonoscopies are only readily accessible in the U.K. to those with a family history of colon cancer.

While Clinton’s plan is deeply flawed, she made a good point on ABC recently when she said Republicans “are in the ‘just say no’ category.”

Where is the GOP leadership today? 

Clinton’s efforts today - coming 15 years after her first effort to socialize medicine got laughed out of Congress - indicates an ideological commitment that Republicans should emulate in their own positions.  It’s tough to argue against flowery terms like “universal coverage,” but no one said that running for president would be easy. 

To improve America’s health care system, we should move toward capitalism - and not away from it. We need a free-market GOP candidate who will take on the most difficult task we face with regard to health care: ensuring that the poorest among us have access to quality care. 

In many cases, allowing for negotiation directly between a doctor and his patients is a good first step.  The market is already acknowledging this opportunity, with private urgent care centers popping up across America - and in the process, providing quality care at a lower cost to the nation’s poor. We need to make health care more friendly to Americans as consumers - and not just as patients.

We should also be moving toward a system where insurance is used for catastrophic emergencies - similar to car insurance, and not for monthly medical needs.  Certainly, doctors and patients could negotiate fair rates for immunizations, x-rays, and other basic health services without ever involving insurance companies.  This is the idea behind health savings accounts, a model that is being adopted by consumers nationwide. 

Unconvinced? Just take a look at less-regulated medical industries, like cosmetic surgery, where quality and innovation have improved dramatically over the past decade while consumer costs have dropped substantially.  This is basic market economics allowed to play out.

For America’s poor or chronically ill, paying a high monthly premium - or a premium at all - may be out of the question.  But for these families, moving beyond Medicaid and toward a totally socialized system will harm them the worst.  Unlike the powerful and wealthy who can simply catch an airplane every time they need access to quality health care, America’s poor would linger on endless waitlists under socialized medicine.

No one can deny that Canadians and Brits in need of health care - who can afford it - come to the United States to receive it. Just last month, Canadian news stations reported that Member of Parliament Belinda Stronach traveled to California last June for her treatment to battle breast cancer. According to her spokesperson, she was referred to a California surgeon by her Toronto physician to treat “later stage” cancer.  What should have been a personal health decision was blown up into an international story - and for good reason. Stronach abandoned the elitist system she has helped perpetuate.

America’s system is imperfect, but instead of throwing the baby out with the bath water, we should work to keep the baby alive.  For those living with serious medical conditions, socialized medicine is a risk they can’t afford to take.  Just imagine it’s your baby we’re talking about.

Part 1: HillaryCare not the prescription

Editor’s note: Jessica Peck Corry’s weekly blogs are part of a new feature on NewWest.Net/Politics called “Diary of a Mad Voter,” a group blog, published in partnership with the Denver Post’s Politics West intended give a glimpse into the hearts and minds of several independent-minded voters and thinkers in the Rocky Mountain West in the ‘08 election cycle. Check back this week at www.newwest.net/madvoter.