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The Honolulu Advertiser
Posted on: Sunday, November 23, 2008

COMMENTARY
Con: U.S. needs system of innovation, choice

By Devon Herrick

Hawaii news photo - The Honolulu Advertiser
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TOMORROW

Hawai'i's healthcare system is in jeopardy because of reimbursement policies, rising costs and the need to reform the medical malpractice system.

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As a new Congress begins to look at healthcare insurance options, some of the members are already discussing proposals for a single-payer, universal healthcare plan.

That's not the best solution. Senators and representatives would be much better off focusing on healthcare solutions that effectively bring down healthcare costs, expand access to quality care and reward patients for shopping around.

Advocates of single-payer health plans want the U.S. government to be the only entity that pays for healthcare: With Uncle Sam picking up the tab, proponents predict healthcare spending would be reduced, administrative burdens would be eliminated and doctors would be free to practice as they wish.

Do they really believe that adding another major program to the federal government would actually eliminate administrative headaches and make it easier for doctors? We need only to look to our neighbors to the north, in Canada, for a clear view of what we could expect under a single-payer system.

The biggest problem is the wait — for office visits, diagnostic tests, lab work, even surgeries.

There are only so many doctors and so much medical equipment in Canada. That means that most patients can't get the help they need when they need it. At any given time, nearly 750,000 Canadians are waiting for a medical procedure. According to a report by the Commonwealth Fund, 42 percent of Canadians with chronic illnesses said they had to wait more than two months to see a specialist. Another major problem faced by those in a single-payer system is the health risk that is faced by participants.

A recent study by the Fraser Institute indicates that much of the health technology in Canada is aging and outdated. Such equipment has a higher risk of failing, may be less accurate, and may not provide the most up-to-date medical readings. As consumers, all we want is healthcare that is reasonably priced, of high quality and that is convenient — without having to wait months on end for needed surgery.

Many of us already have had experiences with limited access to healthcare — through HMOs. Such plans tried to control health costs by controlling which doctors patients could see, limiting the specialists that one can visit, and reducing the options that were available.

It didn't catch on because few Americans like limited healthcare options. We want to make our own choices, based on what's best for our health and our wallet.

Instead of wasting time on a system that limits our choices, creates long waiting times and has the potential to jeopardize our health, the United States should opt for a system of innovation and choice.

The best reform would liberate doctors to meet patient needs in innovative ways, free patients to become smart shoppers, and allow a competitive medical marketplace to allocate resources, while raising quality and lowering cost in the process. Mandates should be avoided in favor of making more options available through consumer-driven health plans. Most such plans include the expansion of health savings accounts to encourage greater participation. Patients with health savings accounts are significantly more likely to talk to their doctor about treatment costs and options, track their healthcare payouts and estimate future expenses.

So, would you rather make your own choices on medical care and cost options or delegate the quality, cost and timing of your care to the federal government? Now is not the time to move ahead with proposals for single-payer, universal healthcare. Nor is next year or the year after that. Instead, Congress should act now to let American consumers — not federal bureaucrats — make their healthcare decisions. When we force medical providers to compete on price, we're all much better off.

Devon Herrick is a senior fellow specializing in healthcare economics at the free-market oriented National Center for Policy Analysis (www.ncpa.org).