Frontpage Interview’s guest today is Sally Pipes, the president and CEO of the Pacific Research Institute and author of "The Top Ten Myths of American Health Care" (Pacific Research Institute , 2008).
FP: Sally Pipes, welcome to Frontpage Interview.
So what's Obama planning to do in terms of health care?
Pipes: President Obama made a commitment during the campaign last year that health care reform would be a major priority for him. Since becoming President, he has kept that promise to the American people. Recently, he remarked, if we cannot get legislation enacted by the end of the year, it will probably not happen. Hence, he is pushing very hard.
In his speech on June 15 to the annual meeting of the AMA in Chicago, he reiterated his commitment to a “Public Plan.” The four main pillars of his agenda include the public plan, a “play or pay” mandate for employers, a National Insurance Exchange, and Comparative Effectiveness Research.
I see the public plan as the pathway to a single-payer, government-run, “Medicare for All” system for America. All insurance plans—private and the public one, will have to include mandates, guaranteed issue, and community rating which will add to the cost of insurance. The government will probably price the public plan cheaper than the private insurers will be able to offer and, hence, private insurance will be “crowded out” and we will all be covered by the government.
The Congressional Budget Office (CBO) has priced the health care plan introduced by Senator Ted Kennedy at $1 trillion over 10 years. It will probably be a lot more expensive than that and their will still be 17 million uninsured. We will all face increased taxes and rationed care.
FP: One of the greatest myths you have exposed is that insurance, especially government-provided, somehow equals access to quality health care. Can you talk about that a bit?
Pipes: We all know that the government is not efficient at providing any service whether it is the Post Office, the DMV, or repairing a broken escalator at an airport. Today in the U.S., we spend roughly 16 percent of GDP or $2.3 trillion on health care. The President is said this is too much and must be reduced. In a country like Canada where I am from, the government only spends 10 percent of GDP on health care. If they can provide universal coverage much cheaper, why can’t we? The truth is that the Canadian government, the sole provider of health care, spends 10 percent on health care by setting a global budget. The demand for health care exceeds that amount but is not available. As a result, Canadians wait on average 17.3 weeks from seeing a primary care doctor to getting treatment by a specialist. Care is rationed by age and often denied. Madam Chief Justice Beverly McLachlin of the Canadian Supreme Court ruled in June 2005 that the ban on private health care in the province of Quebec was deemed illegal. Because of the long waiting lists for receiving care. As the chief justice said of the decision “Access to a waiting list is not access to health care.”
FP: If Obama achieves his plans, how will they be bad for the country?
Pipes: If President Obama signs a health care reform package based on his four pillars for reform which are included in the Kennedy bill, we will all face rationed care and long waiting lists because government will have to limit spending on health care. Doctors will be paid based on Medicare rates and many will retire from the practice of medicine. The best and brightest students will not enter the profession. Our access to the latest drugs and biologics will be curtailed because under Comparative Effectiveness, a federal health authority will determine which drugs and treatments are cost effective as compared to medically effective. Where will the best doctors (and we as patients) go, if government takes over our health care system?
FP: What lessons did HillaryCare teach us?
Pipes: When the American people realized what HillaryCare was going to do to their health care and the doctor-patient relationship, they stood up and said “No.” A very effective educational campaign was launched by the key players: insurance providers, doctors, and patients. The public understood that they did not want to have government control their health care.
President Obama stated very clearly that he did not want to make the same mistakes on reform as the Clintons did. HillaryCare and its 1330 page package was put together by the Administration and officials in the White House. President Obama decided that he needed support from Congress and left a lot of the lifting up to those in the House and Senate. As there has not been bi-partisan support or even unanimous support within the Democratic Party on several aspects of reform, President Obama has now become more involved in the debate. Former Senator Tom Daschle recently said that he puts the odds at health care reform passing at 50-50.
FP: Tell us what is wrong with the Canadian system.
Pipes: The Canadian health care system has long waits for care—17.3 weeks on average from seeing a primary care specialist to getting treatment by a specialist; 750,000 Canadians are on a waiting list for a procedure, 5 million out of a population of 33 million are waiting to get a primary care doctor, and access to the latest technology is poor relative to other countries. As Dr. Brian Day, immediate past president of the Canadian Medical Association and an orthopaedic surgeon said in an interview in the New York Times “a family can get a hip replacement for the family dog within two weeks while a human being waits over two years.” As Madam Justice Marie Deschamps said “the idea of a single payer system without waiting lists is an oxymoron.”
FP: What are the better alternatives?
Pipes: According to Professor Robert Blendon of Harvard University, a recent poll found 82 percent of Americans were satisfied with their health care. Are we willing to throw out the best health care system in the world because of the eight million Americans out of 46 million who are chronically uninsured for two years or more? People come to the U.S. for care, not just Canadians who are on waiting lists for what they feel is too long but also people from Europe who do not have access to the latest procedures or timely care.
We need to focus on patient-centered solutions to our health care problems. If we empower doctors and patients, we can reduce costs and improve quality of care. If we change the federal tax code so that the tax exclusion that those who have employer provided coverage receive is eliminated, make insurance portable, available across state lines, reduce the over 2000 mandates that insurers face across the country, and introduce medical malpractice reform, we will continue to have the finest medical system in the world.
As P.J. O’Rourke says “If you think that health care is expensive now, just wait until it is free.”
FP: Sally Pipes, thank you for joining Frontpage Interview.