The American health care system has problems, but certain myths cloud the debate about fixing those problems. Sally Pipes, president and CEO of the Pacific Research Institute, rebuts the worst of the myths in a new book. She recently spoke about The Top 10 Myths of American Health Care for the John Locke Foundation’s Shaftesbury Society. She also discussed the topic with Mitch Kokai for Carolina Journal Radio. (Click here to find a station near you or to learn about the weekly CJ Radio podcast.)
Kokai: Because of time constraints, we didn’t get to the top 10 myths, but you did cover some of the top myths [in your presentation]. What are they?
Pipes: Well, I think that we would all agree we want affordable, accessible, quality health care for all Americans, and the goal would be universal coverage. The question is: How do we reach that goal? And I believe in patient-based health-care reform, empowering doctors, and patients encouraging innovation in wonderful drugs and biologics and medical devices. The other vision is let’s increase the role of government in our health care. And today, 47 percent of our health care is in the hands of government, through Medicare, Medicaid, SCHIP, and the VA system. We’re on a path to Medicare for all. And I think part of the reason we’re on that path is because the mainstream media and politicians keep saying we can reach universal coverage if government gets more involved.
And so I have 10 myths that I think people in the mainstream — people on Main Street — need to know what the real facts are. And so I wrote this book, The Top 10 Myths of American Health Care, to let people know what the facts are. So, the top three myths. … The first one is 45.7 million Americans have no health insurance and hence no health care. And of course, that number is a number that comes out of the U.S. Census Bureau. But when you analyze it, because most people, 64 percent of Americans, get their health care through their employer, if you lose your job or you quit your job, your health care is not portable, and it doesn’t go with you. And so you’re uninsured until you get your next job, or you go into the individual market. And so you’re counted as uninsured, even if you’re only out of a job for maybe two months and then you get new health insurance.
But more important, I think it’s important to know that 17 million Americans are earning over $50,000 a year, and they don’t have health insurance. The question is why. It’s because health insurance is expensive because of the many mandates that are on an insurance plan, and it makes it difficult — you can’t offer a catastrophic high-deductible insurance plan. Two-thirds of those 17 million people are young people, the “invincibles,” 18 to 34. Why should they spend $500 a month on health care when nothing is going to happen to them? About 14 million of these people are people who are eligible for existing government programs, such as Medicaid and State Children’s Health Insurance, and they haven’t signed up. Ten million are illegal immigrants. We have about 8 million people that are chronically uninsured for two years or more. Those are the people we need to take care of.
The second myth is we will reach universal coverage if we have an individual and an employer mandate. Hillary Clinton was very much in favor of mandating that people buy health insurance during the campaign. It has not worked in Massachusetts. They still have 2.5 percent uninsured. Costs are out of control. Twenty percent of people had to be — were excluded because insurance was still too expensive. Mandating insurance will not work in this country. It doesn’t work in car insurance; 15 percent of drivers still drive around without car insurance.
And my third myth is that socialized systems — such as the system that exists in Canada, which is where I’m from — are more efficient and cheaper than the American system. And if you look at it, United States spends 16 percent of its gross domestic product on health care. I don’t know whether that number is too much. Perhaps it’s too little. We demand a lot in our health care in this country, and people come from all over the world, from socialized systems, to use it. Canada spends 10 percent of its gross domestic product on health care, a lot less than the United States. But because there’s a lot more demand than supply, we have long waiting lists in Canada. The average wait, from seeing a primary doc to getting treatment by a specialist, is 17.3 weeks. That’s over four months. We have rationed care. People cannot get access to the latest tests, like colonoscopies and mammograms and PSA tests for men, because they’re too expensive. We have lack of access to the latest technology. You know, Canada ranks 13th out of 25 countries within the Organization for Economic Cooperation and Development in CT scans and 19th out of 26 countries in MRIs, and there are only two positron emission tomography machines. You can keep your costs down, but you don’t have access to health care.
Kokai: Having all of these myths in American health care, how does that skew the debate, and how does that hurt efforts to fix the system?
Pipes: Well, you know, President Obama said during the campaign that within the first 100 days he would be reforming health care. We’ve got a stimulus bill of $789 billion. We’ve got a budget, a huge budget. We are doing bailouts to companies and industries. We’re going to be facing amazing, huge tax increases on us, the American people, to fund all of these. But on health care, he has said that he is going to beef up the employer side of health care, have an employer mandate. If an employer doesn’t offer health insurance, they’ll have to pay a payroll tax of about 7 percent, so employees can buy health insurance in a new, government-run insurance plan, which will be part of this new national insurance exchange, which will have private insurers. I think the mandates … will make insurance expensive, crowd out the private sector, ultimately, and we’ll be stuck with a national insurance plan, which is going to result in rationed care. And so I always say President Obama will ration your health care. Where are we going to go? People come from all over the world. Where are Americans going to go to get the finest health care? Let’s change the tax code, allow people to buy insurance across state lines, reform our medical malpractice system, and reduce mandates. And we will have universal choice in health care in this country. Once we have universal choice, we will achieve universal coverage.
Kokai: How likely is it we’re going to get an effective change as opposed to the types of change that you see that don’t look so good?
Pipes: Well, as I say, Mr. Obama said, first 100 days. He set up a lot of infrastructure with the secretary of [Health and Human Services], Kathleen Sebelius, being nominated. Within the CBO, Congressional Budget Office: Doug Elmendorf. Within the OMB [Office of Management and Budget], we have Zeke Emanuel, [White House chief of staff] Rahm Emanuel’s brother. We have Peter Orszag. They all support increasing the role of government in our healthcare. On the congressional side, Sens. Max Baucus and Ted Kennedy and on the House side, Henry Waxman from Los Angeles. So Baucus and Waxman say they’re going to have a bill ready for negotiating by June. And if this gets done and passed, I think we’re going to see this move down to government-run health care in this country. And so I’m fighting very hard. I want doctors to get involved. I want patients and American people to stand up to their congressmen and say, “We don’t want government to be running our health care. It’s not the American way.”
Kokai: If you had a very brief description to give to people of what government-run health care would look like compared to what we have now, what would that be?
Pipes: Well, you know, the polling, the recent polling data shows that 81 percent of Americans like the health care they have. So, you know, we need to focus on those people. And what people have is what they like. We need to also work on those people that aren’t enjoying the health care system and are having trouble getting care. How do we get them the type of care without throwing the baby out with the bathwater? So we need to beef up … the health saving accounts, consumer-driven care, because, as P. J. O’Rourke says, if you think health care is expensive now, just wait until it’s free.