By Scott W. Atlas, MD
Senior Fellow, Hoover Institution, and Professor, Stanford University Medical Center

Health care reform is a targeted priority of the Administration and the Congress, and there are big problems to solve. Government expenditures for health care are unsustainable and increasing, and health insurance is unaffordable to millions of people. Our current economic debacle has brought to the fore a related but often ignored additional problem: the linkage of health insurance to employment further heightens the impact of job loss among Americans and imposes a debilitating burden on business viability. The debate is not so much about these issues, rather, the question lies in their solutions.

To justify that nationalization is the road to salvation, the key players in American health care are being cast as greedy evil-doers by the Administration – “profit-seeking” drug companies; “nasty, cold-hearted” health insurers; “corrupt, unaccountable” doctors, and the like. But the grandest misconception being proclaimed by those interested in expanding government control over health care is that the American health care system is a failure, inferior to that available in the rest of the developed world. That misrepresentation is naively perpetuated by ill-informed media and furthered by many misguided economists who have accepted the severely flawed WHO report of 2000 without noticing its wide-spread criticism in scholarly journals as agenda-driven, with its embarrassingly large margins of error, problematic data analysis and input, and overt ignoring of any statistical validity. Regardless, many Americans have accepted this distorted analysis; the issues are complicated, and the lure of a government offering to provide everything as if someone else was paying, at this economically vulnerable moment in our history, may prove to be irresistible.

Meanwhile, evidence shows that countries with heavy-handed government run health care have failed to control escalating costs. Even welfare burdened nations like Sweden are introducing privatization as part of their solution in grappling with the economic challenges of health care. Despite this, the Obama Administration and their allies in Congress plan to impose new insurance mandates on individuals and on employers, while determining for Americans the details of that insurance coverage, and dramatically expanding costly government entitlement programs already stressed far beyond sustainability. The plan is filled with naïve fantasies about savings from health IT, but what’s worse, an inexplicable lack of acknowledgment of the dramatic economic failures of our own state-based experiments with similar overreaches (see Hawaii and Massachusetts).

But while those economic failures are fearful to contemplate on a national scale, it may be that the more dangerous consequences of the impending radical transformation of America’s health care system will be far more personal to Americans and their families. An entire herd of elephants in the room are being ignored by those whose minds are already made up and don’t want to be “confused” by facts. Consider what we enjoy right now in America compared to other countries in North America and Western Europe:

• The world’s best survival rates from cancers ranging from rare to common;
• Better availability of screening tests for life-threatening cancers;
• More access to treatment for the most important chronic diseases;
• Widespread and faster access to highly trained specialists, new drugs, and leading medical innovations;
• Far shorter wait times for life-changing surgeries like cataract and hip replacements;
• Significantly shorter delays to receive radiation treatment for cancer;
• Greater access to the most advanced medical technology, like sophisticated imaging, a fundamental part of safer and more effective treatments now in development.
Consider that 80% of Americans say that access to the most advanced tests, drugs, and medical procedures and equipment is “very important” or “absolutely essential” - yet our government’s economic advisors stress limiting their use. And why is it that the same elected officials leading the charge toward nationalized health care immediately wield all their influence to seek out America’s leading physicians and the most sophisticated diagnostic tests and novel therapies behind closed doors, when they or their families need care? Ironically, they themselves ought to be particularly worried, because ultimately we risk an inevitable degradation of physician quality, owing to the impending price (and therefore wage) controls for health care providers and hospitals being contemplated in Congress. Does anyone really believe that the best and brightest will continue to pursue a profession requiring years of rigorous training and sacrifice where in the end government restricts wages and bureaucrats dictate decisions?

With all its flaws, the leadership position of American health care is at serious risk. Americans enjoy unrivalled access to the most advanced medical care in the world, and important facts –published data in leading peer-reviewed journals - point to the superiority of America’s health care. Now is the time for all who value control of their own health decisions, access to highly trained subspecialty doctors of their own choosing, and continued advances in safer, more effective treatments to recognize what they are about to lose. We need creative and bold leadership to stop the inexorable slide to nationalization of health care, proven world-wide to reduce choice, restrict access, and harm patient outcomes. The impending shift of power from patients and their doctors to government bureaucrats under the guise of reducing costs may be the greatest Trojan horse in American history. This would mark the end of health care as we knew it.


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