Folly in Colorado

By Paul Hsieh, M.D.

The Colorado Blue Ribbon Commission on Health Care Reform recently selected four health care reform proposals for eventual consideration by the Colorado legislature. Although they differ in their details, these differences are dwarfed by their fundamental similarity - they all entail a massive increase in government interference in medicine in the name of "universal coverage." All four plans inject government force into the doctor-patient relationship. They include some combination of forcing all residents into a single health program, forcing some or all individuals and/or businesses to purchase a state-approved insurance policy, requiring insurance companies to provide new additional benefits, establishing a new bureaucracy to set payments to the doctors for services they provide, and doubling the Colorado Medicaid population.

These are just disguised forms of socialized medicine. Similar programs already have been tried in states and other countries. They have all failed, resulting only in higher costs and lower quality patient care. The TennCare disaster - Tennessee's failed attempt at "universal coverage" - offers an important lesson for Colorado. In the 1990s, the Tennessee government expanded the state Medicaid program to include people earning up to 300 percent of the federal poverty line, i.e., a middle-class family of four making $55,000 a year. The state also forced insurance companies to offer expensive new benefits and forced employers to either buy health insurance for their employees or else pay into a state fund for the uninsured. Many employers chose the second option, shifting their employees' health costs onto taxpayers.

Because of the new regulations, many insurance companies withdrew from Tennessee, forcing more patients into the state health plan. The Tennessee government initially offered a generous benefits package. Predictably, costs skyrocketed because patients had no incentives to spend prudently. In response, the government attempted to control costs by slashing payments to doctors and hospitals. Hospitals closed and doctors left the state in droves. Many doctors who remained stopped seeing TennCare patients since they lost money on each one. Families with sick children often had to drive long distances to find a doctor who would see them. And they had no alternatives to TennCare because the state regulations had all but destroyed the insurance market.

Ironically, TennCare ended up causing the most harm to the very people it was intended to help - the working poor and rural patients. Nor did TennCare save money. Instead, it nearly bankrupted the state budget. The problems of TennCare are not aberrations that can be fixed with a few minor reforms. They are inherent in any system of government medicine. Under such systems, bureaucrats and politicians decide what care individuals can receive, not doctors and patients. This has long been the case in Canada's "single-payer" socialized medical system, with its infamous waiting lists for critical medical tests and treatments.

For the sake of my patients and myself, I don't want this to happen in Colorado. Socialized medicine is not the cure for Colorado's health care problems. Forcing everyone into a government-run medical program because some people are uninsured would be just as wrong as forcing everyone to live in a government-run housing project because some people are homeless.

Instead, Colorado should adopt free market reforms such as the FAIR Program ("Free-Markets, Affordability & Individual Rights") proposed by Brian Schwartz, Ph.D. Such programs are especially good at providing affordable quality care for the working poor and rural patients. They work precisely because they encourage individual responsibility and they respect the right of the individual to spend his health care dollar according to his best judgment.

Colorado has an opportunity to become a real innovator in health care reform. Instead of recycling failed government programs, we should set an example for the rest of the country by adopting free market solutions. Only the free market can provide Coloradans with the high-quality, affordable health care they need and deserve.

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Incredible bungle: Queensland hospital bureaucrats build TWO unusable operating theatres

HOSPITAL bosses spent $2.5 million building two operating theatres, and then shut them down because doctors said they were unsafe to use. The theatres built for cardiac surgery at Brisbane's Prince Charles Hospital have been out of action for a month while modifications are made. Doctors say it has put a strain on resources, meaning patients are having to wait even longer for operations.

But managers described the situation as "normal" and denied that patients were suffering. They refused to reveal how much the renovation work would cost taxpayers, but said it involved changing benches, a stock room, flooring, airconditioning and electrics [just a few things!] in order to meet workplace health and safety guidelines.

One senior staff member, who can't be named because Queensland Health has banned its staff from speaking out, said the situation was "extremely serious". He said: "The fact is, people needing cardio procedures are dying while we sit here and look at new surgical theatres we can't use because the Government stuffed up building them. "They're boarded up because they are the wrong size and the wrong building materials have been used."

Figures show there are 391 patients on the waiting list for heart operations at the Prince Charles Hospital, of whom 57 have been waiting longer than is considered clinically safe. The theatres were in use for only two months before staff found the range of problems.

Mary Montgomery, district manager for Northside Health Service District, said staff had since been consulted [What an original idea!] about the modifications. "It is normal for any new operating theatre to have an adjustment period in which some refinements and modifications may need to be made," she said. "It is only through using the new theatre that any necessary adjustments can be identified."

Opposition health spokesman John-Paul Langbroek said it was not "normal" to factor an adjustment period into an expensive project. "I can't believe we have credible people saying it's normal to spend $2.5 million on operating theatres and then to find fault with them," he said. "It doesn't happen in private enterprise because businesses would go broke if they ran things like that."

Queensland Health has a history of shutting down its operating theatres. In March, The Sunday Mail reported how theatres at Ipswich, Logan and Redland hospitals were out of action because there were too few staff to run them. Previously, a theatre at the Princess Alexandra Hospital was used as a storeroom for four years. It was opened only after a Sunday Mail report prompted health bosses to take action.

The above story by HANNAH DAVIES appeared in the Brisbane "Sunday Mail" on May 3, 2007

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

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