Socialized Medicine in America

If there were an award given for the worst health policy exaggeration of 2011, it might well go to Newt Gingrich, Mitt Romney, Rick Perry, and a chorus of others who call the Affordable Care Act “a government takeover of health care.”

They make this charge to capture votes from a constituency that fears what life would be like if we had “socialized medicine.” 

The problem with the rhetoric is this.  It isn't true.  If you look at who pays the bill, the United States already has socialized medicine. We just get less for our money than practically anyone else in the world.

According new data from the Organisation for Economic Cooperation and Development (OECD), no other country spends close to what our government alone does on health care.  Right now, the total government share of our annual per capita health care bill is around $6,000, or over 70% of the total. 

Norway is next most expensive, but its total per capita bill is $5,352.  The government share is $4,501.  In Denmark, the government pays only $3,696 annually, and in the United Kingdom, our poster child for socialized medicine, it pays just $2,933.

There are more relevant comparisons to make, too.  According to OECD, the Canadian government’s share of its annual health care bill is 71% - exactly what ours comes to when you add in all our government costs (the OECD does not in its data reporting, which makes our government share – though still second-highest among the nations – look artificially small).  Health care costs much less in Canada than it does here, however.  The Canadian government spends only about half ($3,080 per capita) as much as ours on health care.

What are we getting for all this government spending?  Fewer doctor visits, shorter hospital stays, and less access to mental health care.

We get an average of 3.9 visits to doctors each year here, compared to 7.7 in Germany, 5.5 in the United Kingdom, and 5.5 in Canada.  People in Italy, Switzerland, and Denmark also get more doctor visits than we do.

Our average length of stay for an acute care hospital visit is 5.4 days.  In Canada, they get 7.7 days, in Germany and Switzerland, they get 7.5 days, and in the United Kingdom, they get 6.8.

And we share 2 psychiatric care beds for every 10,000 people.  Canada has 4, Germany has 5, Denmark and the United Kingdom have 6, and Switzerland has 10.

Perhaps we need less health care because we’re healthier in America. 

Only 16% of our population smokes every day, the same percentage as in Canada.  This compares favorably to Norway, Germany, and the United Kingdom, where over 20% of the population are daily smokers.

And while we consume almost 9 liters of alcohol per person per year, citizens of Germany, the United Kingdom, Switzerland, and Denmark all consume far more alcohol than we do.

But if we take better care of ourselves, have shorter hospital stays, and fewer doctor visits, shouldn’t our overall cost of care be lower, not higher, than other countries’? 

Could we be paying for quality?

We have access to a lot of medical technology, but not so much more as to explain why the cost of care is so high here.  For example, we have more MRI machines than any other country in the world, but countries like Greece, Iceland, Korea, and Finland are all beginning to catch up with us. 

And we are in a tight competition with this same set of countries in the availability of other technology.  We have less radiation therapy equipment available to our population than Iceland, fewer mammogram machines than Greece, and not as many CT Scanners as Korea. 

Of course, we don’t usually compare our health care to that in Iceland, Korea, Finland and Greece – and we shouldn’t.  Iceland’s annual total per capita health care expenditure is $3,538, Finland’s is $3,226, Greece’s is around $3,000, and Korea’s is $1,879.

So why is socialized medicine such a mess in America? 

It isn’t, and won’t ever be, on account of the Affordable Care Act’s phantom “government takeover.” 

It’s more likely because politicians pretend that private insurers play a bigger role in financing health care than they do, and give them too much power over transactions between patients and providers.   

And – unlike other countries with socialized medicine – it’s because we treat health care more as a commodity off which private businesses should profit than a public service we all need.

That’s what exaggerating politicians are really defending.

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