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Commentary

The Dangers of Undermining Patient Choice: Lessons from Europe and Canada
Institute for Policy Innovation, Galen Institute, International Policy Network, 10-18-06

Debate over whether the U.S. should adopt a single–payer health care system will intensify if the Democrats take back Congress tomorrow and the issue will play an even greater role leading up to the 2008 presidential election contest. But before anyone jumps to conclude that countries with single–payer systems have discovered a magic bullet for offering affordable health care, they should read this collection of essays compiled by three free–market think tanks.

The U.S. is once again embarking on a national debate over health care reform, one that will engage both the states and Congress and will likely infl uence the outcome of the 2008 presidential campaign.

The debate will include both facts and faith–especially faith on the part of some people that somewhere, somehow, someone has fi gured out how to create a government–run health care system that actually works. It is an act of faith because a well–functioning government run health care system has never actually existed. Regardless of the country–Great Britain, France, Italy, Sweden or Canada—they all face limited funding, rationed care, and restricted choices. All of them.

But that fact has done little to diminish the hope that it can be done successfully, if only the U.S. will try. Given the prevalence of the faith in government–run health care, the Institute for Policy Innovation, the Galen Institute, and the International Policy Network asked a number of economists and health policy experts from Europe and Canada to write brief chapters on issues facing their countries’ health systems. Th e papers are off ered in this publication and also were presented during briefings in Washington, D.C., in the fall of 2006.

What these experts expose are governments often obsessed with micromanaging the health care system: imposing price controls, limiting access to prescription drugs, hindering research and innovation, and cutting government health care budgets. And the result is millions of patients facing long waiting lines, going untreated, or treated with old and outdated technologies–all because of the heavy hand of government in micromanaging health care.

Not everything about these countries' health care systems is bad, of course. Some elements work well. They do try to achieve universal coverage, and, of course, they spend less money than we do in the U.S. But they also get less. Access to the newest technologies and latest therapies, especially drug therapies, is limited. Doctors may be very well trained, but health facilities can look like those of a less–developed country. And express government approval is often required if a patient needs therapy that is outside the norm. Moreover, fiscal pressures are building. Shifting from a market–based health care system to a government–run system may seem harmless for a while because the new system lives off the old capital infusions. But as government constrains spending, capital infusions decline and the infrastructure begins to deteriorate. And what should be a private investment decision based on the likely needs of patients—Does a hospital need a new CT scanner or PT scanner?—becomes a political decision because someone has to allocate limited government funds, which means someone wins and someone loses.



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