With tensions over health care reform reaching critical levels, the coronavirus has shattered proposals for socialized health care. The last major shift in health care came in 2009 with the Affordable Care Act, or Obamacare, which passed Congress with 87% of Democratic support and a single Republican vote in favor. Since then, both sides have bitterly fought over health care in the courts, Congress, and the White House. This political fever surrounding health care is driven by public attitudes — in a January Gallup poll, health care was one of the most important issues to voters, and it was uniquely important among all political parties. With the health care system embattled, the coronavirus has attacked us and thrown our lives into chaos. The United States alone has over a million confirmed cases and thousands of deaths, and there are many more around the globe. This ultimate stress test is teaching us that government-controlled systems of central planning and health care are woefully inadequate at providing care and are subject to political failure.
The lives lost to nationalized and single-payer health care systems amid the coronavirus epidemic have shaken any confidence that government control of health care is a viable path for the future. European-style systems of health care are often held up as models for what “Medicare for All” or similar proposals could look like in the United States. However, these standard-bearers of socialized medicine have fallen short against the coronavirus. First, the United States’ commitment to free enterprise has built a larger and more advanced medical care infrastructure than Germany, Italy, France, or the U.K. This is evident in the availability of intensive care, which has proven to make the difference for the ill in this pandemic. The United States has over 34 “critical care beds” per 100,000 people, dwarfing the 6.6 in the U.K. or the 11.6 in France. The often respected U.K. National Health Service was reported to have only 6,000 ventilators before the pandemic, whereas the United States had 62,000 in hospitals and over 100,000 stockpiled (mostly by hospitals themselves). Hence, the United States stood with more hospitals and equipment per capita than its European counterparts as the virus came. Meanwhile in Europe, the unfortunate mismanagement of health care by socialist health care systems has produced dreadful results: As of May 11, 2020, the United States had substantially fewer deaths per capita than Spain, Italy, France, or the U.K.
This is not to say the American response was perfect; in fact, it left a lot to be desired. Yet, this is not because we do not have enough government involvement with health care, but because we have too much government involvement with health care. The United States’ main failing was testing too little too late. This is largely due to the bureaucracy of the Food and Drug Administration, which initially only allowed the Centers for Disease Control and Prevention to test suspected coronavirus cases and refused to allow private labs and citizens to determine who was infected. The government even told the University of Pittsburgh Medical Center to not develop a test when they asked, because “the federal and state authorities would be able to handle everything.” Disappointingly, those original, “government approved” CDC kits are now suspected to have been faulty. The government eventually ceded control and allowed private labs to begin developing and deploying their own tests in March. Since then, faster, more reliable, and cheaper tests have been developed that now represent over 85% of coronavirus testing. Unlike in the previous metrics, the United States fell behind its European counterparts in testing because the government insisted on monopolizing care even when clinics around the nation stood ready to serve. It is thanks to industry that we are now distributing a greater volume of more effective tests, but it came six weeks too late. Inefficiencies like this are foreshadowing how federal control of health care could play out in times without a pandemic.
Apart from creating inefficient management, mixing politics with the science of health care has proven toxic. With politicized health care, optics and power become the goal, and patients are forgotten. For instance, the coronavirus’s initial spread was catalyzed on the back of misinformation from the Chinese government. Dr. Li Wenliang from the Wuhan province sent a message to fellow medical workers, warning them about the virus and urging them to wear masks after he had fallen ill. He was later summoned to the Public Security Bureau and investigated for “spreading rumors.” The People’s Daily, the official newspaper of the communist party, claimed Li died in February from the virus, and the government censored thousands of messages on social media that called to hold the government responsible. This is the inevitable end when governments, which are political engines, get wrapped up in health care. This pattern holds past the authoritarian government in China. The World Health Organization, an often lauded intergovernmental agency of the United Nations, initially criticized the travel restrictions made by the U.S. and other countries in a misguided move by claiming there was no need to interfere with international trade and travel by limiting movement to and from China. As President Trump announced, the WHO inappropriately handled the virus and put politics above people. Just as government management distorted the availability of critical care beds in Europe and the development of virus testing in the U.S., politics is likewise corrupting information and action in China and the U.N.
It is not government involvement but free-market competition that has proven effective at lowering costs to health care, even within America. It is a common mischaracterization that only the government can facilitate increased access by bargaining for better prices. The free market provides many goods, from cell phone coverage to clothes, to nearly all American consumers at accessible prices. With increased competition, prices drop lower as hospitals and doctors vie for market share. Professor of Health Economics James Robinson from the University of California Berkeley studied health care prices between various hospitals in the U.S. He looked at the cost of different procedures across 27 markets and found that free markets and competition drastically lowered costs. For example, hip replacements cost private insurers 50% more (about $10,000) in consolidated markets with little competition than in competitive free markets. Further, nearly all the price increase in consolidated markets went directly to hospital profits, not to giving better care. Robinson notes that the Affordable Care Act, which increased government control of the health care system, has “encouraged further consolidation” and driven up costs. Thus, it is through competition, not government intervention, that the United States can truly strive to provide affordable care.
Coronavirus has exposed the reality of government-controlled health care. Socialized medicine results in a lack of care and preparation mixed with political roadblocks and posturing that leave our families and friends at risk. Health care is a life-giving industry, and we cannot let the inherent politics of government mislead it. The same bureaucratic structures that stymied the pandemic response in the United States and abroad should not be handed the reins to the whole system. We owe it to ourselves to lead the way in thoughtful, market-based reforms that encourage world-class care and make strides to lower prices that improve access. This is the path to improving our health care system for all and ensuring that we can effectively respond to the next pandemic.
Image by Bill Oxford is licensed under the Unsplash License.