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The Truth about Government Run Healthcare Systems

October 20, 2023 By Richard C. Young

By Axstokes @ Shutterstock.com

At the Cato Institute, Michael F. Cannon explains the truth about the differences between government run and private healthcare systems. He writes:

With Health Care Quality Week upon us, a few reminders are in order. First, the U.S. health sector improves health care quality around the world. Even so, government intervention reduces quality here at home. And making quality health care universal requires reforms that let individuals make their own health decisions.

The U.S. health sector leads all other nations in medical innovation. Those quality improvements make health care more universal around the world—even in countries that supposedly already had universal health care.

Consider sofosbuvir (brand name: Sovaldi), an “almost universal cure of chronic hepatitis C” with cure rates of 84–96 percent. One study found sofosbuvir reduces all‐​cause mortality among hepatitis C patients by a whopping 50 percent.

Before the U.S. health sector introduced sofosbuvir in 2014, hepatitis‑C patients around the world suffered and died for want of a cure. Since 2014, the U.S. health sector has been filling that gap in every nation’s health system.

Even so, a high degree of government control relative to other developed nations suppresses quality here at home.

Organisation for Economic Cooperation and Development (OECD) data show that in the United States, government directly or indirectly controls 85 percent of health spending. That’s the 8th-highest share among OECD nations. It’s higher than Canada (71 percent) and the United Kingdom (82 percent)—which have explicitly socialized health systems—and just two percentage points behind highest‐​ranking Germany. As a share of GDP, compulsory health spending in the United States (14 percent) exceeds total health spending in every other OECD nation (highest: 13 percent).

Government uses that control to encourage low‐​quality health insurance that makes the problem of preexisting conditions worse.

The average worker changes jobs 13 times by age 56. In Recovery: A Guide to Reforming the U.S. Health Sector, I provide data showing that patients with employer‐​sponsored coverage who are in poor health are significantly more likely to end up uninsured—i.e., with a preexisting condition—than similar patients who purchase coverage themselves.

Still, 55 percent of U.S. residents continue to enroll in low‐​quality coverage that vanishes when they change jobs. Why? If workers don’t purchase employer‐​sponsored health insurance, government penalizes them with lower after‐​tax earnings.

Meanwhile, government health programs literally pay producers not to improve quality.

For at least two decades, the Medicare Payment Advisory Commission has warned that in traditional Medicare, “providers are paid even more when quality is worse, such as when complications occur as the result of error.” One study found that when patients experience post‐​operative complications, Medicare ends up doubling hospitals’ net revenues from $1,880 to $3,629. Medicare rules reward private insurers for skimping on care to the sick.

Medicare’s quality‐​improvement efforts consistently fail to improve quality. A study of Medicare’s Hospital Value‐​Based Purchasing program found that “in no subgroups of hospitals was HVBP associated with better outcomes, including poor performers at baseline.” Medicare’s attempt to reduce unnecessary hospital readmissions likewise had zero effect on patient outcomes.

To reward all dimensions of quality, consumers must be free to make their own health decisions.

Read more here.

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Richard C. Young
Richard C. Young
Richard C. Young is the editor of Young's World Money Forecast, and a contributing editor to both Richardcyoung.com and Youngresearch.com.
Richard C. Young
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