Why Kulongoski’s Kids Plan will fail.

“Healthy Kids” is an incremental step towards socialized medicine and a future fiscal and healthcare disaster on many levels. Whatever model is adopted for “Healthy Kids” will be the model for complete socialized medicine in Oregon. The current argument among Republicans seems to be simply over how to pay for it (or at least it’s being framed that way). I propose a different approach:

1. Establish what the minimum level of child and prenatal health insurance coverage ought to be.

2. Require every employed Oregonian to provide proof of employer provided health insurance that meets the minimum level or to purchase it from a private provider.

I would suggest a $25 co-pay for physician visits and a $10 co-pay for prescriptions, lab tests and diagnostics. This is inexpensive enough that anyone should be able to afford it. Since most of the cost of health insurance premiums is pre-payment for these types of expenses, this should keep premiums somewhat reasonable. Cover hospital stays 100%.

It’s pretty simple. It provides health insurance for all working Oregonians and keeps health insurance and health insurance administration in the private sector with a minimal amount of bureaucratic intervention/oversight.

There is an opportunity for Republicans to take a Democrat issue and own it in a way that does not increase bureaucracy and taxes and screw up what is, in spite of its few shortfalls, the absolute finest healthcare system in the world. Let’s not screw it up.

Socialized medicine is a disaster everywhere it has been implemented. The combination of bureaucratic inefficiencies, indifference and incompetence, the increasing cost of diagnosis and treatment, an aging population and doctor shortages have turned it into a nightmare for consumers and doctors alike.

I know more about socialized medicine that anyone else you will be speaking with on the issue. I am the only person you will talk to who has literally experienced socialized medicine cradle to grave – an untimely grave. I grew up in Canada. My Father died in Canada. I have two brothers still living in Canada.

The Canadian system – the model socialized medicine advocates most often point to – is now a train wreck.

Forty years ago, when I was a child, the model worked. Everyone got taxpayer provided basic medical services and preventative medicine and it was inexpensive. If your kid broker his arm or you got in a car wreck, you didn’t have to declare bankruptcy to pay your medical bills. If you got cancer or some other horrible disease, you died because there was no cure and little treatment beyond the prescription of opiates for pain relief.

Today, thanks to medical science, most of the things that would have killed us quickly forty years ago are treatable – if found early, but at a tremendous cost. A cancer that would have killed you outright in six months can now be cured – provided you have good health insurance or a couple of hundred thousand dollars. The array of medicines and machinery that has been developed in the last forty years is formidable. Even the cost of “routine” medical care has skyrocketed. The broken arm that cost $120 forty years ago now costs $6000. A routine delivery that cost a couple of hundred dollars is $8000.

The inevitable outcome of rising healthcare costs is rising health insurance cost and/or coverage limits. Canada has attempted to control the cost of its program by limiting coverage and limiting what providers are paid for healthcare services. The result is that the Canadian system has essentially become a system that covers only catastrophic injuries and illnesses and does an absolutely horrible job of it.

Limiting what doctors and hospitals are reimbursed for healthcare has had three deadly outcomes:

First, a shortage of doctors. Why go to medical school for umpteen years if you’re going to wind up making less than a plumber? This is not an exaggeration; in Canada a good plumber makes more than the average doctor. With a limited number of doctors, and an acute shortage of specialists, you wait longer to see a doctor. A lot longer. The wait can range from weeks to months (it’s usually a few days here, but can be the same day if your doctor thinks you need to see a specialist fast). As any doctor will tell you, the longer you wait for treatment of a medical condition, the greater your chances of dying. A doctor in Canada cannot easily emigrate to the United States, so this shortage has evolved slowly, over time. An Oregon doctor not wanting to practice under the deadly nightmare of socialized medicine can easily move to another state – as many already have due to high malpractice insurance costs – quickly leading to a doctor shortage.

The second deadly outcome of cost control is service rationing. If your hospital can’t charge enough to buy that fancy new MRI machine, there’s going to be a long line for the hospital that did manage to sneak one through the budget process. It takes a certain amount of time to perform an MRI and there are only so many hours in a day and only so many MRI machines. In the United States if there is a shortage of places to get an MRI done, some entrepreneur will open one and charge what the market will bear. In Canada – even if you were allowed to after the extensive bureaucratic permitting and authorization process – it wouldn’t pencil. If the State decides what it will pay for a patient’s use of an MRI – or any other – machine and it’s not enough to cover the cost running the machine, hospitals aren’t going to buy them.

The third deadly outcome is unavailability of service. What if no hospital in your area has an MRI machine? You either get in line for the one 600 miles away or you do what smart and/or wealthy Canadians do – you go to the States.

The stories of Canadians dying while waiting for routine diagnosis, treatment and surgical procedures are not apocryphal. I know, my father died from socialized medicine. His death certificate lists cancer, but that’s not what killed him. In the summer of 1987 my 62 year old father went to his GP for his annual checkup. He was pronounced in excellent physical condition with the exception of a tiny shadow on his x-ray. An appointment was made several weeks in the future for more x-rays. When the x-rays eventually came back an appointment was made several weeks in the future with a specialist. When the specialist reviewed the x-rays he made an appointment several weeks in the future for more diagnostics…etc. The short story is that it was a year before he was diagnosed with cancer and that he died an excruciatingly painful death three months after that. In the United States the diagnostic process my father went through would have taken a month, at worse. In the United States the cancer from which my father died had an 80% survival rate in 1988. I have been told by medical professionals that, given the early discovery of the shadow on the x-ray, my father would have easily been one of the 80%.

Socialized medicine is a great service provider if you are young and healthy. If you break an arm or have a kid you don’t go broke. If, however, you break your arm really badly of your kid has health issues, you’re screwed. If you are old or suffer from a chronic condition – make a will. As bad as the worst HMO is, socialized medicine is a thousand times worse. My youngest brother, who still lives in Vancouver, Canada and earns a middle class income, travels to the US for his health care and pays out of pocket.

According to the Governor’s website there about 117,000 uninsured children in Oregon. Half of these are from families making over $40,000 a year. 16,000 are from families making over $70,000 a year.

Every child deserves access to healthcare. Providing a means by which children can receive the routine and preventative medicine that will provide a lifetime of returns is the obligation of every parent. Unfortunately, some parents shouldn’t be caring for a goldfish, let alone children. As a conservative I abhor most government mandates. There are, however, some circumstances when people simply should not be given a choice. Healthcare for kids is cheap. Parents who choose to purchase consumer goods for themselves instead of healthcare for their children should not have that choice. Mandatory purchase of child and prenatal health insurance by all employed Oregonians with children eliminates this dangerous and irresponsible choice.

According to the Governor’s website there are 567,000 children insured through private insurance. If I am an employer, paying for all or part of an employee’s children’s health insurance, how fast do you think I am going to drop that coverage and shift the burden to the State? Pretty dang quick. “Healthy Kids” in its current form will likely add 500,000 children to the rolls of state sponsored health insurance, not 117,000, and if you think it’s going to be done for $160 of taxpayer money a kid you probably worked on the committee that said the Portland Tram would only cost $6 million.

If you want your medical system run like the DMV, support the current “Healthy Kids” plan. If you think Medicare is an efficient and cost-effective service provider, support the current “Healthy Kids” plan. If you hate your parents, grandparents and children, support the current “Healthy Kids” plan. If you want a system that works for patients and is sustainable in the long run, make a different choice.

In closing I want to address a note to all those misguidedpundits who will assert that socialized medicine, in spite of its worldwide failure, just hasn’t been done right:

Why aren’t you getting your health care in Canada?

A second note to all those “experts” who will spew facts and figures to prove the case that socialized medicine is the greatest thing since sliced bread:

Socialized medicine is like sex or an acid trip. You can study it all you want, but until you’ve experienced it you just don’t know.