UNC Healthcare CEO Dr. Bill Roper educated state legislators Dec. 11 about what he called five “myths” of health care at a Joint Legislative Oversight Committee on Health and Human Services meeting held to discuss the future of health care.
Among the so-called myths he attempted to debunk was the notion that “the American health care system is the best in the world” and President Obama’s promise that “if you like your health care the way it is, nothing about it will need to change.”
Roper, who formerly served as head of the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention, argued that, on average, Americans have worse health care outcomes than people in many other countries, that care is too expensive and not of high quality, and that too many Americans go without it.
He also said, despite Obama’s promises to the contrary, in order for America’s new universal health care system to work, current health insurance plans would need to change, even if people liked the way they work now.
In an earlier radio interview on the topic, Roper said ultimately Americans needed to be forced into a single-payer health care system — a single insurance pool run by the government — for the current level of care to remain viable.
Roper said the uninsured aren’t getting all the care they need and that, in the end, that is a “huge cost” to American taxpayers because when people wait too long to seek care they end up with “worse illnesses and worse outcomes.”
Dr. Andrew Foy, a cardiology fellow at the Penn State-Hershey University Medical Center and a contributor to the Ludwig von Mises Institute’s website, rejects the idea that taxpayers should pay for “preventative” care to save money on indigent visits to emergency departments or operating rooms.
“It sounds good, but the data … suggests the opposite — with few exceptions, paying for health maintenance upstream simply increases costs upstream without significantly impacting health downstream,” he wrote in an article for the site.
Roper also argued that Americans, as a whole, spend too much on health care, noting that 17 percent of the national economy is devoted to health care. He said there could be no meaningful health care reform with out the imposition of “cost controls.”
Foy agrees that the health care costs are spiraling out of control, but blames government intervention for the problem and argues that more government intervention is not the solution.
“Prior to the advent of Medicare and Medicaid, individuals paid for the majority of medical goods and services out of their own pocket and utilized health insurance as a rational tool for mitigating financial risk posed by catastrophic events,” Foy wrote in another article. “During this time a real market existed for the vast majority of medical goods and services, and prices were reasonable.”
But after these government programs came into existence, private insurance companies also began covering health care “maintenance” to remain competitive, he said, causing third-party spending on routine medical services to increase and out-of-pocket spending to fall.
The result, he wrote, is “consumers now use many medical services that they would simply reject if they had to pay for them out of pocket — and truthfully, in most cases, they would be none the worse off for rejecting them.”
The final myth Roper wanted to set straight was Obama’s claim that if people liked their health insurance policies the way they were, they wouldn’t need to change.
“We need to change lots of things about how health care is organized and financed and delivered if we’re going to have the ability to create the health care system I’m here calling for,” Roper said.
He didn’t spell out exactly what type of system he was calling for in his presentation to the committee, but he did on an episode of the syndicated radio show The People’s Pharmacy earlier this year.
Under the current American health care system, Roper said, hospitals have to charge people who can pay more money to compensate for those who can’t pay.
He said “a more sensible approach” would be to set up “one insurance scheme for everybody and charge premiums to people who could afford to pay it, and a sliding scale for those who couldn’t. Then [provide] subsidies for those and the bottom of the scale, and then collect the money and pay the bills … that works in other countries.”
The host noted that the system Roper was advocating sounded “suspiciously” like a single-payer system, and Roper confirmed that was what he was describing.
“The problem with that here is it runs counter to our tradition of radical individualism and Americans having great distrust of major government programs,” Roper said.
“None of the reforms that Americans would find reasonable will work unless most if not all of our population is in the system,” he continued. “Unless people can be compelled … and I’ll use the word compelled… to make plans and buy insurance ahead of time then the only people who will buy it are those that have these chronic, serious illnesses, or pre-existing conditions.”
“The question is how do we spread the risk over 310 million people in a way that is fair?”
Foy said if one believes health care is a human right or “public good that should be regulated and allocated in such a way to assure a ‘just’ social distribution,” then single-payer probably is the most reasonable way to accomplish the goal.
“If, on the other hand, one believes that health care is a service, then it makes the most sense for the market to coordinate its allocation and distribution to satisfy consumers’ wants,” Foy said. “This would be a true free market and this model does not exist anywhere in the developed world. In my opinion, it would be the best.”
The difference in the two systems, he said, is that in a free-market system people would regulate their behavior according to what they wanted and needed most. In a government-run, single-payer system, the government would decide which services consumers need.
“There is no reason to believe that health insurance doesn’t work unless everyone is forced to buy into it,” Foy added. “All other private insurance markets work without compulsion as a pre-condition.”
Sara Burrows is a contributor to Carolina Journal.