~ Universal Health Care - Call it Socialized
By Lawrence R. Huntoon, MD, PhD
One of the biggest myths being propogated today is the absurd notion that
"people can't see a doctor without having insurance." The truth is office
visits are relatively cheap, well within the means of most people. The problem
is most people don't budget anything for their annual medical care. And,
then when a problem arises, any expense greater than zero "isn't in the budget."
The other problem is that insurance really isn't insurance anymore. It
is pre-paid health care. True insurance is intended to prevent financial
disaster in the face of an unlikely event. Most people, however, have come
to expect first dollar coverage for everything including very common and
likely events like routine doctor office visits. "Covered'' employees don't
realize it's their money going to pay for this "wonderful" non-bargain of
first dollar coverage. It's not a "free" benefit provided by their employer
as most employees believe. These costs are essentially hidden from employees.
Money their employer wastes in purchasing first dollar coverage or inferior
managed care coverage for the employee is money which would have been the
employee's salary to spend as they choose.
The reason most people obtain their health insurance from their employer
is because of tax discrimination. During World War II, our government enacted
wage and price controls. Employers couldn't attract better workers by offering
higher wages, but were allowed to offer health insurance as an untaxed benefit.
Although World War II ended 54 years ago, this same tax discrimination policy
remains in effect today. This atrocious policy discriminates against the
working poor, part-time employees, employees working for small businesses
that don't offer health insurance, and the self-employed. Those who obtain
their health insurance through their employer, purchase their coverage with
pre-tax dollars. On the other hand, those who purchase their health
insurance on their own, purchase it with after-tax dollars
--- a huge difference. In fact, the uninsured actually end up paying what
amounts to a tax penalty for being uninsured.(1) It is estimated that "a
family in the bottom fifth of the income distribution pays about $450 more
in taxes than insured families at the same income level. For families in
the top fifth of the income distribution, the tax penalty is $1,780."(1)
The analysis goes on to say that "on the average, uninsured families pay
about $1,018 more in federal taxes each year because they do not have
employer-provided insurance. Collectively, the uninsured pay about $17.1
billion in extra taxes each year because they do not receive the same tax
break as insured people with similar income. If state and local taxes
are included, the extra taxes paid by the uninsured exceed $19 billion per
Where, we must ask, is the compassion for these overtaxed, hard-working people?
This is clearly a government-created problem. What we don't need is more
government (nationalized health care) to "fix it." What we need is to get
government out of our wallets so people can have their own money needed to
purchase and own their own health insurance. The other thing the pro-socialist
"crisis mongers" fail to tell people is that only one-third of the uninsured
are chronically uninsured.2 For the other two-thirds, it is only a short,
temporary condition, "half of all uninsured spells will last less than
six-months. Three-fourths of them will be insured within 12 months. Only
18 percent of all last for more than two years."(2)
Those who brandish the "crisis" of the uninsured to promote socialized medicine
also often fail to tell people that uninsured doesn't necessarily mean poor.
In fact, the National Center for Policy Analysis (NCPA) tells us that "a
third of the uninsured households earn more than $30,000 a year and 10 percent
earn more than $50,000."(2) That's at least 40 percent of the so-called
"uninsured" that could well afford a $45 office visit or health insurance.(2)
We need to get away from the concept that "someone else," big government
or insurance, needs to take care of our every need.
The other adverse consequence of this tax discrimination is that it led to
cost inflation of medical care. Everyone came to believe that we were spending
"other peoples' money" (OPM). And, when you're spending OPM, the sky is
the limit. Patients have been told that they are getting "free" insurance
from their employer and quite naturally came to expect everything they wanted
or desired, whether of marginal benefit or not, would be "fully covered."
Likewise, the physician who "participated" in insurance and was paid directly
by the insurance company for everything with OPM, had no disincentive to
hold down costs. The patients came to view these "participating" physicians
as "good" and "compassionate" because the physicians would accept their insurance
and the patient would have to pay little or nothing out of pocket, not realizing
that OPM was actually their money all along.
Both patient and participating physician, therefore, contributed to this
disrupted market where both buyer and seller were insulated from costs thus
leading to uncontrollable cost inflation. The problem of cost inflation
was further compounded by the cost of government regulation. Government mandates
increase the costs of health insurance tremendously, and the mandates are
often for things that most people don't want or need. Yet, they are forced
to pay for the "coverage." "These mandated benefits included wigs for bald-headed
women (Minnesota), pastoral marital counseling (Vermont), and community sperm
bank services (Massachusetts).(3) In New York state, most health insurance
premiums doubled as a result of state-mandated community rating.
This has made health insurance especially hard to afford for the young and
healthy who are, in effect, punished by the state for being young and healthy
and for not engaging in unhealthy behavior. State mandates, which were
purportedly instituted to "help" people, have thus had the effect of pricing
many people out of the health insurance market. This, however, is predictably
what happens when we look to big government to "help" us.
Indeed, "universal coverage," nationalized health care, or socialized medicine,
regardless of what you choose to call it, is not the same as medical care.
All of the citizens of Canada, for instance, have "universal coverage."
What they often don't have, however, is the medical care that they need when
they need it. That is why we see Canadians crossing the border into
the United States in droves to obtain the health care that they can't get
when they need it in their own country. Their government rations access to
health care and thus attempts to control costs by making MRI scans, radiation
oncology, bypass surgeries and many other health services largely unavailable
to their own people. Is this the egalitarian's view of compassion and social
We Get More of What the Government
Government programs also breed highly destructive dependence. How destructive?
Well, I once took care of an alcoholic patient who bragged that his government
disability checks allowed him to purchase better quality whiskey than he
could afford to buy when he wasn't considered disabled because of his alcoholism.
The government thus subsidized his alcoholism.
During his hospital stay, I pointed out his government subsidized habit had
damaged his liver, his pancreas and his brain. He was slowly but surely killing
himself with alcohol, bought and paid for by the government. After much
discussion with the patient, I convinced him to give up alcohol, but there
was a problem. Although the patient was willing to give up alcohol, he wasn't
willing to give up the government checks. You see, if he gave up alcohol,
he would lose his disability status, and would have to do something drastic
like work to obtain money. But, he reasoned, why work when the government
will give him the money to spend doing something that he liked to do? This
spontaneous "experiment" in addiction medicine proved one thing beyond a
shadow of a doubt. As powerful as addiction to alcohol is, it pales in
comparison to the addiction to government money.
Yes, we need health care reform, but it needs to be based upon the principles
of individual freedom and individual responsibility. And, there are many
options out there. Most people could purchase a high deductible indemnity
insurance policy at a lower price than they would pay for monthly managed
care premiums. That's right --- a much higher quality of health care at a
lower price! Imagine, having the freedom to choose the doctor or hospital
you want to go to, being able to go to specialists without denials, delays,
and gatekeepers. And, the money saved by purchasing a high-deductible
catastrophic policy could be set aside in a special savings account to pay
for deductibles. The money saved by purchasing a high-deductible policy could
also be used to pay for the insurance premiums.
Medical Savings Accounts (MSAs) allow people to put money aside and take
a tax deduction for keeping and controlling their own money. The
MSA earns interest year after year tax free and if not spent by retirement
age can be converted into a pension fund. Think of all the money you and
your employer have turned over to insurance companies since you started working,
and how much a young worker would have accumulated after 45 years of investment
in a MSA. Those in favor of nationalized health care, of course, don't want
to give you control of your own money. Government elites feel that
they can better spend your money for you. This is the real message that they
don't want you to hear.
And, last but not least, there is charity. No hospital ever turns
any patient away because of lack of funds. Hospitals and the physicians on
call at those hospitals are required by law to treat all patients presenting
to the emergency department irrespective of ability to pay. And we do it
all the time. It's a total myth that you can't come to the hospital because
you "don't have insurance" or "can't pay." Charity is something that should
involve churches, not big government. What big government does, confiscating
money from all, including the minimum wage earner, and redistributing it
based upon some social engineering scheme, isn't charity. It's legalized
plunder. True charity comes from the heart, not from forced "contributions."
Most churches and charitable agencies understand the dependency trap of big
government programs. They understand that it does no good in the long run
to give a man fish for his dinner. This does not help him. To help a man,
you must teach him to fish. The goal should be to help a man back to his
feet so he can support himself and his family, not to trap them in a cycle
of dependency. That is what dignity and self-esteem are all about. That
is what true compassion is all about. The Amish don't have "insurance coverage,"
yet they have existed for centuries via a charitable tradition of voluntarily
sharing others' burdens and medical expenses. This same concept has been
implemented via other churches and religious organizations in conjunction
with MSAs and has been proven by AAPS members like Dr. Alieta Eck and associates
to be a much more affordable alternative to traditional health insurance.
I find it very sad in a country where men and women have died fighting to
preserve our freedom and have died fighting off socialism and communism that
some are now considering socialized medicine as a solution to improving access
to health care.
Lenin once said that "medicine is the keystone in the arch of socialism,''
and I believe those who are promoting "universal coverage" via government-run
and government-controlled medicine know this. What they hope is that the
public won't find out the truth. There is nothing compassionate about socialism.
This is why the AAPS gives a high priority to educating other physicians
and the public about the truth of socialized medicine. That is why AAPS should
be joined and supported by all physicians!
1. Are the uninsured freeloaders? National Center for Policy Analysis, Brief
Analysis No. 120, August 10, 1994.
2. Goodman JC, Musgrave G. Patient Power. Excerpted from: Problem: The rising
number of people who lack health insurance. National Center for Policy Analysis,
3. Printz D. We need MSAs now! Medical Sentinel 1996;1(2):5.
Lawrence R. Huntoon, MD, PhD is president of AAPS and a practicing neurologist
in Jamestown, New York.
Originally published in the Medical Sentinel 2000;5(4):134-136. Copyright
©2000 Association of American Physicians and Surgeons