The High Cost of Free Health Care

The U.K.-based Daily Telegraph reports on the growing sentiment to limit health care for both old people and those with unhealthy lifestyles. A survey of doctors is not the same as government policy, of course, but Prime Minister Gordon Brown wants to identify patient “responsibilities” — which is being interpreted as a step toward policies that will penalize those who drink, smoke, and eat too much:

Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives. Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone. …About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.

…Obesity costs the British taxpayer £7 billion a year. Overweight people are more likely to contract diabetes, cancer and heart disease, and to require replacement joints or stomach-stapling operations. Meanwhile, £1.7 billion is spent treating diseases caused by smoking, such as lung cancer, bronchitis and emphysema, with a similar sum spent by the NHS on alcohol problems. Cases of cirrhosis have tripled over the past decade. Among the survey of 870 family and hospital doctors, almost 60 per cent said the NHS could not provide full healthcare to everyone and that some individuals should pay for services. One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.

Investor’s Business Daily comments on this controversy, noting that the denial of health care is a risk once government is in charge of the health care system. Moreover, the editorial explains that government-paid health care actually worsens problems such as obesity because people do not bear the cost when they behave recklessly. Of course, they will bear very steep costs if the government now cuts off health care, but this is an example of using one misguided government policy to try to fix the problems caused by another misguided government policy. Wouldn’t it be preferable to just fix the underlying problem by shifting to a free-market system?

The London Telegraph is reporting that the doctors believe “smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations.” Perhaps the doctors are following the lead of the National Institute for Health and Clinical Excellence, the British agency that provides guidance on public health. In 2005, NICE proposed that the National Health Service use age as a measurement of a patient’s worthiness for treatment.

…For Britons, health care rationing isn’t just a threat. It’s a reality. The Telegraph says roughly one in 10 hospitals — usually those with financial problems — now deny some surgery to smokers and the obese. On a moral level, the doctors have a point: Taxpayers shouldn’t have to subsidize care for those who make poor choices and then expect others to pay for their mistakes. But that’s exactly what universal health care does, and that’s one of its primary flaws. It promises people that they’ll be cared for no matter what they do to themselves. When the consequences of bad behavior are eliminated, there’s a strong incentive to behave badly.

…Proponents of forcing government health care on Americans want voters to believe that none of this can happen here under their plan. But they can’t guarantee it. All that can be known for sure is that the U.S. will follow the same path as Britain. Bureaucrats will ration care, and those who provide it will become civil servants whose performance will more closely resemble that of DMV employees than caring professionals.