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Routing

No. 532

January 27, 2005

Health Care in a Free Society

Rebutting the Myths of National Health Insurance

by John C. Goodman

Executive Summary

rationing choices up to local bureaucracies that,

Almost everyone agrees that the U.S. health

for example, fill hospital beds with chronic

care system is in dire need of reform. But there

patients, while acute patients wait for care.

are differing opinions on what kind of reform

Access to health care in single-payer systems is

would be best. Some on the political left would

far from equitable; in fact, it often correlates with

like to see us copy one of the government-run

income--with rich and well-connected citizens

"single-payer" systems that exist in Western

jumping the queue for treatment. Democratic

Europe, Canada, and New Zealand, among other

political pressures (i.e., the need for votes) dictate

places. Proponents of socialized medicine point

the redistribution of health care dollars from the

to other countries as examples of health care sys-

few to the many. In particular, the elderly, racial

tems that are superior to our own. They insist

minorities, and those in rural areas are discrimi-

that government will make health care available

nated against when it comes to expensive treat-

on the basis of need rather than ability to pay.

ments. And patients in countries with national

The rich and poor will have equal access to care.

health insurance usually have less access to criti-

And more serious medical needs will be given pri-

cal medical procedures, modern medical tech-

ority over less serious needs.

nology, and lifesaving drugs than patients in the

Unfortunately, those promises have not been

United States.

borne out by decades of studies and statistics

Far from being accidental byproducts of gov-

from nations with single-payer health care.

ernment-run health care systems that could be

Reports from those governments contradict

solved with the right reforms, these are the nat-

many of the common misperceptions held by

ural and inevitable consequences of placing the

supporters of national health insurance in the

market for health care under the control of

United States. Wherever national health insur-

politicians. The best remedy for all countries'

ance has been tried, rationing by waiting is per-

health care crises is not increasing government

vasive, putting patients at risk and keeping them

power, but increasing patient power instead.

in pain. Single-payer systems tend to leave

_____________________________________________________________________________________________________

John C. Goodman is president of the National Center for Policy Analysis in Dallas, Texas. This paper is adapted

from his book Lives at Risk: Single-Payer National Health Insurance around the World (Rowman &

Littlefield, 2004), coauthored by Gerald L. Musgrave and Devon M. Herrick.