Friday, November 16 , 2018, 10:47 am | Fair 67º


Harris Sherline: The Health Care Dilemma, Part III

A look at three government-run plans sheds light on the effectiveness of universal care; the bottom line is, ills remain

How about universal health-care plans in general? How well do they work? Do they deliver as promised, or can they? The two most often mentioned systems are those in England and Canada, although there are others in Germany, Japan, Sweden, Finland and Russia. There are also a couple of well-known programs in the United States, notably in Massachusetts and Oregon, that can be studied to evaluate the actual effectiveness and efficiency of government-run health care.

Harris Sherline
Harris Sherline

So, before jumping off the edge ourselves, doesn’t it make sense that we should evaluate how well some of the other plans are working? Looking at just three — Canada, Oregon and Massachusetts — provides some insight into the track record of government health-care programs.

Assessing Canada’s health-care program, Dick Morris noted the following statistics: “a 16 percent higher cancer death rate in Canada”; “an eight-week wait for radiation therapy for cancer patients”; “42 percent of Canadians die of colon cancer vs. 31 percent in the U.S.”; “cutbacks in diagnostic testing”; “the best methods for chemotherapy are not available”; and “no way out of the system; you can’t even pay for services yourself.”

David Gratzer, a Canadian physician, wrote in The Wall Street Journal on June 9: “Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system. ... Canada’s provincial governments themselves rely on American medicine. Between 2006 and 2008, Ontario sent more than 160 patients to New York and Michigan for emergency neurosurgery. ... Only half of ER patients are treated in a timely manner by national and international standards, according to a government study. The physician shortage is so severe that some towns hold lotteries, with the winners gaining access to the local doc.”

How about Oregon, which established a government-run plan in 1993? On June 9, noted the following, among other observations: “The state’s Health Services Commission (like the title?) has compiled a list of 680 treatments, only 503 of which will be paid for by the Oregon Health Plan. ... Got condition No. 504 ... treatment for lichen planus, a skin rash, is an out-of-pocket expense ... So is therapy for a cracked rib (No. 512), nasal polyps (No. 524), a broken big toe (No. 527) and liver cancer (No. 575). Oregon residents must pay for treatment of all those conditions themselves, along with many other health problems.

“A great many lifesaving procedures that ranked high in 2002 have been relegated to much lower positions in 2009, while procedures only tangentially related to life and death have climbed to the top. ... Treatment for Type I diabetes ... was ranked second in 2002 but demoted to 10th in 2009, even though not providing treatment is a death sentence.”

So, if Oregon didn’t get it quite right, how about Massachusetts, which adopted its own state-mandated health-care plan in 2006?

Michael Tanner, a senior fellow with the Cato Institute, wrote a briefing paper in June, “Massachusetts Miracle or Massachusetts Miserable: What the Failure of the Massachusetts Models Tells Us about Health Care Reform,” in which he observed:

“Although the state has reduced the number of residents without health insurance, 20,000 people remain uninsured. ... Health-care costs continue to rise much faster than the national average. ... New regulations and bureaucracy are limiting consumer choice and adding to health-care costs. ... Program costs have skyrocketed. Despite tax increases, the programs faces huge deficits — with its attendant rationing. ... A shortage of providers, combined with increasing demand, is increasing waiting times to see a physician.”

In the final analysis, national or universal health-care systems, whatever they are called, are invariably forced to resort to rationing of services, by limiting care on the basis of cost, age, the severity of disease or injury, or various other criteria. It’s unavoidable and will happen in the United States if the Obama administration manages to get Congress to pass a health-care bill.

Whatever the result, the simplest way to evaluate President Barack Obama’s health-care plan is to ask your congressional representative and senator if they will be required to participate in the same program as their constituents. If not, why not? And, if not, why should you?

— Harris R. Sherline is a retired CPA and former chairman and CEO of Santa Ynez Valley Hospital who has lived in Santa Barbara County for more than 30 years. He stays active writing opinion columns and his blog,

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