One million Britons are currently waiting for care—400,000 who have waited over a year—and with limited physicians and equipment, 100,000 operations are cancelled every year.
In Sweden, the average wait for heart surgery is 5 months. If a Swede needs a hip replacement, they will most likely wait over a year. In response to budgetary problems and poor fund allocation, surgeries are delayed and treatments are rationed through a triage system. Physicians under socialized health care work much like medics in World War II: Should we treat the guy who’s missing an arm or the guy who’s missing a leg? Because we sure as heck aren’t treating both!
In England and Scotland, the wait for cataract surgery is 8 months, for hip surgery 11 months, and for knee replacement surgery 12 months. Bed shortages are also a problem. Because hospitals are short on midwives and beds, thousands of women give birth outside maternity wards (hallways, office rooms, etc.), while some are turned away altogether because hospitals are at full capacity.
The NHS Information Centre reports that 850,000 diabetics in England, or sixty percent, do not receive proper care. The National Institute for Health and Clinical Excellence (NICE) recommends diabetics have routine checks of cholesterol, body mass, and blood sugar levels, none of which are carried out on a consistent basis.
A study by Glasgow University revealed that 464,000 people in Scotland have died over the past 30 years, due to rationing and long waiting lists. “The vast majority of people—around 250,000—who died due to inadequate or delayed treatment were heart or stroke patients”, the study cited.
Orthodontic treatment in Great Britain is substandard, and is only free for individuals under 18 years old who have a “clear clinical need for treatment”. Because NHS dentists are scarce, children have been known to wait up to four years to get braces.
BBC News reports, “In the east Midlands town of Northhampton 2000 children are waiting for treatment as there are only four dentists who specialize in fitting braces. Not all dentists have the necessary skills to be able to treat cases satisfactorily.” According to the official NHS website, Britons wait an average of 6 to 18 months for orthodontic treatment, of which many receive improper care. Ever wonder why the British are known for having bad teeth?
Waiting lists even apply to orthodontic emergencies, a common one being dental abscesses. If you have a dental abscess, the NHS website recommends not to see a doctor but to control the pain with over-the-counter painkillers. If you have ever had an abscessed tooth you would understand why waiting is not an option.
Arthur Haupt was in excruciating pain. After seeing a dentist for a severe gum infection, the doctor told him he would have to wait three weeks for treatment. But Arthur could not wait this long. As an ex-soldier, he used a barbaric technique he learned in the army to pull out seven of his own teeth.
67-year old Valerie Holsworth also resorted to DIY dentistry to relieve an insufferable toothache. Using beer and whisky as an anesthetic, she fetched a pair of her husband’s pliers and gave her tooth a good yank. Afterwards she told a reporter, “I’m not a masochist but the job needed doing. It is just a matter of tugging and wiggling until the root comes loose.”
Explaining the fallacy of political and economic utopia
Healthy British Socialists
Health care, a right or a commodity?
In 1961, President Ronald Reagan addressed the American Medical Association, warning America about the dangers of socialized health care: “One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it,” but human welfare is “simply an excuse to bring about what [Democrats and liberals] wanted all the time: socialized medicine.”
The question of whether or not to socialize health care is an important, if not the most important, domestic issue under debate. Some view health care as a government entitlement, while others view it as a regular commodity. Some believe government should have total authority over health care; others believe in private competition, with an unfettered market of supply and demand. Health care reform is a controversial subject, one that is complex and emotional, and a barrier among voters and politicians.
Without a doubt, quality health care is paramount to a society’s social and economic well-being. Like other goods and services, health care demands adaptability and a wide range of consumer options. However, health care surpasses general commodities in that it extends life and minimizes physical pain, so the ability to make personal health care decisions is a higher priority.
Someone who is comparing health insurance plans values discretion more so than someone comparing televisions, because a television purchase is not going to determine a person’s overall health and, possibly, their existence. A basic insurance plan may have a high deductible and cover only basic services and procedures, as opposed to a comprehensive plan that has a low deductible and covers specialized services and prescription drugs.
Though high costs and excessive insurance premiums are legitimate concerns, individual health and care quality are most consequential. Indeed, the cost of a surgical operation is outweighed by the cost of losing a life because of unfit physicians and outdated equipment. New drugs, cures, and technology enhance quality of life, and most would agree, especially under personal circumstance, good health and longevity transcend financial concerns. However, this is not to say rising costs are inevitable and must be accepted. The problem is, the solutions being advocated are eroded with allegories and misconceptions, and sold to the public on emotion and false pretense.
Healthy Canadian Socialists
British and Canadian health care are socialized disasters. Rationed care, deficit spending, primitive equipment and technology, and a lack of consumer choice are just a few atrocities of government-run health care. Canada operates as a single payer health care system—government is the payer, the regulator, the ultimate decider. Rationed treatment and interminable waiting lists kill tens of thousands of people every year. And it only gets worse. 815,000 Canadians are currently waiting for medical care; if the United States had the same health care system almost 8 million Americans would currently be waiting for care.
The Fraser Institute conducts an annual study called Waiting Your Turn: Hospital Waiting Lists in Canada, one of the most comprehensive studies on Canadian waiting lists. Across 12 specialties and 10 provinces, wait times for surgical and therapeutic treatments average 18 weeks; the wait following a general practitioner’s referral exceeds 17 weeks. Two of the worst procedures are neurosurgery (7 months) and orthopedic surgery (10 months). Canadian oncologists recommend cancer patients receive radiation treatment within 3.4 weeks of diagnosis, yet over half wait more than 6 weeks. Waiting lists in Canada are so extravagant that doctors send a third of their patients abroad, most of which receive treatment in the United States.
Patients in Ontario have it rough. The Institute for Clinical Evaluative Studies found that 40 percent of severely disabled patients wait over 13 months for surgery. Delayed treatment leads to prolonged pain and diminished quality of life. Think about having pain in your knee, so severe that you can barely walk, and having to wait a year for a knee replacement. You may be out of work because your job requires physical ability; you may lose relationships because you are confined to your home; and you may become untreatable because your condition has worsened. All of this because the government forces you to wait 12 months for treatment.
Disclaimer: if you live in British Columbia it is recommended that you do not become ill. With a population of 640,000, how many MRI scanners do you suppose Vancouver Island has? On the entire island…one! Even worse, the facility that performs the scans works on bankers’ hours, allowed to perform no more than 3,000 scans a year. Patients wait over a year for a simple diagnostic test. With good reason, BC physicians are outraged. A woman suspected of having an acoustic neuroma, a slow-growing brain tumor, was put on a waiting list after her case was deemed “elective”. For months she waited, wondering if a tumor was growing inside her brain. Her head was a ticking time bomb.
David Gratzer, a Canadian physician and author of the book Code Blue, describes the crisis in BC: “Patients suspected of having multiple sclerosis were also forced to wait. Imagine the sword of MS hanging over your head for a year. In an ironic twist, provincial regulations require that MS patients, in order to receive certain drug therapies, must have the disease confirmed first by an MRI scan.” In his book, Gratzer addresses how Canada’s socialized health care system has affected some of his close friends:
My own views on waiting lists have been darkly coloured by the experiences of a few family friends: a young Winnipeg woman with severe abdominal pain was expected to wait six months for the pain-alleviating gall bladder surgery; a community college teacher from southern Ontario suffered heart trouble and was forced to take a year off work while he waited for bypass surgery; an older woman with severe sleeping problems was put on a two-year waiting list to see a respiratory specialist.
In socialized health care systems, as the need to ration care rises, so does spending. Between 1993 and 2003, despite a 21 percent increase in spending, waiting lists in Canada increased by 70 percent. Free markets adjust to increasing costs through resilience and natural reformation, while socialized markets flood the system with pools of new spending. Bureaucracy thwarts efforts to increase efficiency and productivity, as excess funding is dumped into a bottomless pit. And as Canadian health care proceeds further from pre-socialization, government waste and inefficiency only intensifies.
Patients in Vancouver need MRI scans, they need kidney dialysis, and they need vascular surgery. But wasteful spending and government bureaucracy stand in the way of patients and their health. The province is in a financial crisis. A leaked document from the Vancouver Coastal Health Authority announced they will have to cut 6,250 surgeries and close 25 percent of its operating rooms, due to a plummeting $90 million deficit. Furthermore, a government proposal provoked a plan to downsize staff, increase fees, and limit services and treatment options.
Congressman Mike Rogers’ (R – Michigan), in his opening statement on health care reform, described the inevitable demise of a government-run system:
According to the [National Cancer Intelligence Centre] for the United Kingdom and the Canadian Cancer Registry, here's the trade-off that they picked by having government run health care: If you get prostate cancer you have a less chance of survivability than you do in the United States. And that's the same for skin cancer, breast cancer, bladder cancer, cervical cancer, kidney cancer, ovarian cancer, leukemia and the list goes on and on and on.
The Toronto Star reported a story of a man in Ontario who had a hole in his head the size of a baseball. With severe discomfort, emotionally and physically, he was forced to wait a year for surgery. A movie short, A Short Course in Brain Surgery, recounts the unfortunate event of a Canadian man who, suspected of having a brain tumor, was put on a 4-month waiting list for an MRI scan. Naturally, panicked that the tumor was growing, he crossed the southern border into the United States. Twenty four hours later he got the MRI. On arrival back into Canada, his specialist put him on another 4-month waiting list for neurosurgery. Again he headed south, and had the tumor removed the following day.
Another victim of the Canadian health care system was Janice Fraser, who needed surgery for a urinary disease. To control costs, the hospital specializing in her particular surgery performs only one surgery a month. Janice was behind 31 other people, which meant she would have to wait three years. Because her surgery was delayed so long her bladder developed severe infections and had to be removed immediately. As a result, she was forced to wear a urine bag for the rest of her life. Unlike the rare, isolated events in the United States—that the liberal media love to exploit—these horror stories are prevalent in the Canadian health care system. They happen all the time. Rationing is cruel and unfair, and as the “protector of the people”, government is the culprit.
Regulating Life
Health care regulation is the worst form of tax, as it confiscates wealth and prevents effective drugs and treatments—that save lives and allay terminal patients—from entering the market. Regulation isolates competition, limits market activity, and politicizes industries, all of which afflict consumerism and restrict individual liberty. Regulation confines industry and accepts the status quo, by constraining production and discouraging innovation and development. Regulation weakens economies and corrupts society, and in the American health care industry, it disparages industrial progress and escalates costs to unprecedented levels.
Christopher Conover of Duke University noted the social costs of regulation across 47 health care categories. In defining social costs as “the value of the goods and services lost by society resulting from the use of resources to comply with and implement the regulation, and from reductions in output” , Conover estimated that in 2002, health care regulation cost American taxpayers $169 billion. “Spread across all households, health services regulation cost the average household an estimated $1,546 in 2002.” This is more than Americans spent on both gasoline ($165.8 billion) and pharmaceuticals ($162.4 billion).
Government regulates insurance providers by placing restrictions on pricing, administration, and agreement terms. Pricing regulation expels actuarial science by preventing underwriters from assessing premiums based on risk. This may appear equitable, but in fact creates an ethical dilemma, as it forces low-risk customers to subsidize high-risk customers.
To regulate pricing in this way means someone who postpones buying health insurance for 20 years, and is suddenly diagnosed with heart disease, pays the same premiums as a healthy person who has carried insurance their whole life. To compensate for price controls, providers must offset premiums, which denies insurance to low-income and low-risk individuals—because premiums become unaffordable. It’s not compassion, but common sense that shows why this is unfair. In the quest for social justice, in theory, regulators produce a result that is unjust and unmerited.
Government also intervenes in health plans themselves, by mandating coverage for specific benefits. Part of this intrusion on the market lies with crooked constituencies that arouse biased legislation. By using constituencies that supply politicians with generous contributions, lobbyists and advocacy groups indirectly legislate health insurance mandates.
The Council for Affordable Health Insurance found that state governments currently legislate 2,133 mandates, requiring insurers to cover services such as “acupuncture, massage therapists and hair prostheses (wigs).” Not surprisingly, supporters of these mandates, who lobby for heavy regulation, include acupuncturists, massage therapists, and chiropractors.
Some state-mandated benefits are nonessential, while others are downright absurd: two states mandate coverage for naturopaths (specialized herb treatments and prescriptions); seven states mandate coverage for in vitro fertilization; forty states mandate treatments for alcoholism, 27 states for drug addiction, and 29 states for mental illnesses. Because someone spends his life snorting cocaine and chugging Jack Daniels should a healthy, responsible person finance his recovery? Elective government-mandated services and treatments such as these inflate premiums for everyone, even those with basic, high deductible plans.
In the 1960s there were only a handful of government-mandated benefits. And now, there are thousands. It is no wonder health care costs have skyrocketed over the past few decades. Mandated benefits may make insurance policies more comprehensive, but also more expensive, at an expense that is rarely beneficial.
They force providers to cover benefits that are usually paid out-of-pocket, many of which are discretionary and unrelated to health quality. Not to mention, individuals under certain state regulations might have to pay for services that return no benefit. After all, would most women support a government mandate that forced cable and satellite providers to include in their TV packages ESPN, ESPN2, ESPN Classic, ESPN News, Fox Sports, the Golf channel, and the NFL network?
The FDA: Part 2
Rampant bribery partly explains the FDA’s illogical drug approval process. There are countless instances of where FDA officials have received bribes from lobbyists and pharmaceutical companies. The late 1980s is known to have multiple cases of drug manufacturers submitting fraudulent records, where FDA employees received gratuities in exchange for preferential treatment. In 1989, a series of generic drug scandals posted the mark for the FDA’s cozy relationship with the pharmaceutical industry. Ironically, it wasn’t the government that exposed the scandal, but the pharmaceutical company Mylan, who suspected corruption in the rapid approval of only certain manufacturers.
Despite so much corruption in the drug approval process, the FDA refuses to act. Republican U.S. representative Joe Barton of Texas, member of the House Energy and Commerce Committee, released a report describing the FDA’s debarment (or lack thereof) process:
More than 15 years ago, Congress passed a law to let the FDA kick out companies and individuals from the drug industry convicted of crimes related to the FDA approval process…This staff report shows in great detail the record of weaknesses in FDA’s ability and authority to carry out its duties and to protect its own integrity. When it comes to excluding the worst of the worst—convicted felons—FDA’s debarment process seems to be non-existent. It is inexcusable that the FDA can’t quickly debar convicted felons.
The FDA’s debarment list shows they have only used their debarment authority 9 times in over 15 years, during which from 2003-2005 alone, staff investigators found 40 convicted criminals. Even isolated cases where debarments did occur, the FDA delayed proceedings, sometimes for years at a time. Skewed, inconsistent rules allow the FDA to only debar generic manufacturers, while ignoring all corporations associated with brand-name drugs. Furthermore, the FDA cannot debar employees of medical device companies who are convicted of crimes that involve the FDA regulatory process. This is unbelievable. How are we supposed to reduce corruption in the drug industry when the FDA, our “provider” and “protector”, overlooks—and participates in—bribery and political favoritism?
This is not all to say a regulatory organization over the drug industry has no benefit, but the FDA has certainly harmed more than it has helped. It may be true that if the FDA prevented a deadly drug from entering the market, lives would be saved; however, statistics show that more terminal patients have died because they were denied access to unapproved medications. It may sound cruel to say drug companies should be able to release drugs to the market without a screening process, but telling a terminally patient he cannot take a drug that might save his life or improve his quality of life is even worse.
Hypothetically, Pfizer releases a drug to the market that on release kills twenty patients. Obviously this is horrible, but however “evil” you think pharmaceutical companies are, they will not continue to sell a drug that is killing its customers. The drug would be recalled immediately. And you don’t have to look at it in a moral context: in continuing to sell a fatal drug, Pfizer would risk a horrible public image and millions of dollars in litigation.
Now, twenty dead patients in itself might justify an extensive drug approval process. But if Pfizer’s drug caused zero fatalities, and within the next decade saves tens of thousands of lives, is the FDA still the benevolent guardian we perceive it to be? This may sound extreme, and maybe implausible, but there is no denying, FDA regulation hinders medicinal development. And with the drugs previously discussed, delaying or refusing lifesaving drugs, from an organization that is known for corruption, is an act of genocide.
The bureaucracy that surrounds the FDA is malignant, a cancer to American health care, as it disrupts medical progress and euthanizes the terminally ill. The FDA denies and prolongs the approval of lifesaving medications; it keeps new medical equipment, such as bone screws, joint replacements, and healing products, off the market; and it uses its political authority to manipulate the industry, by arbitrarily picking winners and losers. Most importantly, the FDA inhibits patients’ rights to freely choose treatments and restricts insurers and physicians from doing what they do best: progressing health and saving lives.
The FDA: Part 1
The Food and Drug Administration (FDA) not only neglects American health care but prevents breakthrough drugs from reaching the market. It is an industrial barricade, with patients on one side and pharmaceutical companies on the other. The FDA discourages research and development by putting pharmaceutical companies through an exhausting drug approval process, a system that is iniquitous and sometimes even fraudulent. Heightened regulation and extended clinical testing delay new drugs from entering the market, so much that the average time for FDA approval nearly doubled from 8.1 years in the 1960s to 15.2 years by the 1990s.
Expenditures have also doubled, much due to indirect costs aroused by wayward FDA procedures. Pharmaceutical companies currently spend $800 million to introduce a new drug to the market, which multiplies as Congress further expands FDA authority. Moreover, less than one-third of all FDA-approved drugs recover their development costs. The FDA condemns progress and censors the production of lifesaving medications. You don’t have to sympathize with pharmaceutical companies to understand why this is a problem. FDA authority has increased so much that in 2002-04 a whopping 58 new drugs received FDA approval, a 47 percent decline since the 1996-98 period.
FDA reviewers are trained to be risk-averse, so much that FDA Commissioner Alexander Schmidt admitted, “In all our FDA history, we are unable to find a single instance where a Congressional committee investigated the failure of the FDA to approve a new drug. But the times when hearings have been held to criticize our approval of a new drug have been so frequent that we have not been able to count them.” Strict regulatory oversight intimidates reviewers in their approval of new drugs, delaying or refusing altogether, drugs that reduce pain and save lives. With an overwhelming bureaucracy that dictates behavior, Schmidt asserted, “the message to FDA staff could not be clearer.”
Henry Miller worked 15 years for the FDA and served as a founding director of the FDA’s Office of Biotechnology. Now he is one of the FDA’s most vocal critics. Miller’s frustration with bureaucracy, and the political red tape that prolong drug approvals, gave him much distaste for the organization. Following his resignation, he expressed his discontent: “In spite of increasingly more powerful and precise technologies for drug discovery, purification and production, during the past twenty years development costs have skyrocketed. The trends are ominous: The length of clinical testing for the average drug is increasing, fewer drugs are being approved, and the number of applications to FDA by industry for marketing approval has been decreasing for more than a decade.” Miller observed FDA politics firsthand, and watched idly while corruption shielded the public from drugs that could potentially save thousands of lives.
The FDA has a fatal track record. In August 2007, the D.C. Circuit Court of Appeals reversed a previous ruling that restricted a patient’s right to take investigational, FDA-unapproved drugs. The leukemia drug Gleevac passed its first phase of testing in 1998—ruling that it was both safe and effective—and when physicians requested the drug for treatment in June 2001, the FDA denied their request. The clinical trials display the success Gleevac has had on leukemia patients: 80 percent of the test subjects are still alive today. Despite conclusive evidence, Gleevac did not gain approval until March 2003, after 3,600 patients had been denied the drug, many of which died in waiting.
The FDA has delayed many other cancer drugs, leaving thousands of cancer victims to die every year. Ronald Trowbridge and Steven Walker report the FDA’s deadly pattern in the Wall Street Journal:
"The American Cancer Society reports that some 550,000 cancer patients die annually, making the number of cancer deaths from 1997 to 2005 about 4.8 million. Over that same period, the FDA reports granting individual access to an investigational drug to not more than 650 people per year for all diseases and drugs—a pathetic, even cruel, pittance. A few thousand more patients managed to gain access by enrolling in relatively small clinical trials or exceedingly rare expanded access programs."
