How Government Rations Health Care

How Government Rations Health Care
November 1, 2001


Currently, a Statewide Health Care Insurance Plan Task Force is meeting in Arizona with the goal of expanding existing benefits in the Arizona Health Care Cost Containment System (AHCCCS), the state’s health care plan for low-income residents.

One of the task force’s members, Rep. Linda Binder, told reporters that when she was a child in England, she "never knew growing up what it was to be denied care." However, modeling Arizona's health care system on the British ideal of universal government coverage may teach local taxpayers exactly what it is like to be denied care.


Free ... When You Can Get It

The National Health Service is a government-run organization that aims to provide the best possible health care to all citizens of the United Kingdom, free of charge at the time of service. To some extent, the NHS meets its goal. The United Kingdom does have a high standard of care, and medical care is free at the point of purchase. Of course, calling the care “free” requires overlooking the enormous tax burden borne by citizens to pay for this.

Moreover, the laws of market economics do not cease to hold for the health care industry in the UK just because government provides the service. By achieving its first two goals—care that is both high-quality and free when delivered—the NHS has also succeeded in causing demand for care to far outstrip the capacity of the system to supply it.

To accommodate the demand, the NHS has had to ration care. Care may be free of charge at time of service, but that time of service might not come in the same year one might think it should. NHS guidelines currently allow inpatients to wait 18 months for hospital tests or treatment. The waiting list to be admitted to a hospital tops 1 million people, and over 40,000 of those have been on that waiting list for over one year.

NHS patients are expected to wait 26 weeks to see a specialist after they have been referred to that specialist by their general practitioner—whom they also had to wait to see. In January 2001, there were 180,000 people waiting to see consultants. Dr. Liam Fox, former opposition leader on health issues in Parliament, explained that this number essentially represents the number of people waiting to be added to the waiting list for care.

The waiting lists are not likely to get shorter any time soon. A recent poll to which two-thirds of UK doctors responded found that 80 percent of them would consider leaving the health field if the NHS remains as it is.

The official NHS Web site praises a particular hospital at which patients need only wait 18 weeks for treatment of back problems. That hospital had reduced its wait time from 89 weeks. The Web site also lauds hospitals that are beginning to allow patients to schedule appointments to see specialists according to what’s convenience for the patient, rather than according to the hospitals' arbitrary choice of appointment times.

Even in Sweden—that paradigm of socialist utopia—residents outside of Stockholm wait up to two years for hip surgery.

On the bright side, all of this waiting is free of charge ... even at the time of disservice.


Quality Can’t Compare

In the United States, over half of all patients receiving arthritis medication are receiving the newest and highest-quality pharmaceuticals. In Britain, only 15 percent of arthritis patients can claim that privilege.

Restricted access to high-quality pharmaceuticals is a problem that plagues not only Britain's single-payer medical plan, but health care in other countries as well. Like their British counterparts, only 15 percent of German arthritis patients get the latest medications. From 1995 to 1997, pharmacies in Portugal, Italy, and Greece failed to carry over half of the new medications surveyed. Pharmacies in Belgium, France, and the Netherlands lacked over one-third.

These statistics come from countries that have had years to perfect their socialized medicine programs. However, even the United States can be a source of statistics on socialized medicine. Medicare denies more claims for medical necessity than the private sector does.

What evidence is there that expanding Arizona’s state government health programs will lead to results any better than these? Universal health care has a long history, and that history teaches only one lesson: It will not work.


Logan Elia is a research assistant at the Phoenix, Arizona-based Goldwater Institute for Public Policy.