Hating Government Health Care (Except for the "Loving It" Part)

I first saw this on Paul Krugman’s blog, but you’ve probably already seen a gazillion similar reports:

At a recent town-hall meeting in suburban Simpsonville, a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”

“I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’ ” Inglis recalled. “But he wasn’t having any of it.”

But it's not just folks off the street.  The award for “item I’ve been emailed the most this week” goes to a video of supply side economist Arthur Laffer on CNN.  His unironic proclamation:  “If you like the Post Office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid, and health care done by the government.”  Hm, clearly there is some confusion on this point.

Please consider this a public service announcement.

Medicare is a single-payer health care system, paid for and run entirely by the government.  So we don’t need to wait to see it done by the government because it’s, well, already being done by the government.  How does it stack up?  Well, thanks to a survey by the Commonwealth fund, we can tell you.  For starters, “Medicare beneficiaries are sicker and poorer but report fewer medical bill problems,” which, if you think about it, is quite the trick.  They are much less likely to have their care denied, made unaffordable or, if you prefer, “rationed” (12% for Medicare vs. 26% for employer-based insurance).  They have an easier time finding a doctor (10% report their physician didn’t accept their coverage vs. 17% for employer-based insurance).  Indeed, part of the problem with Medicare’s fiscal outlook isn’t just that health care for all payers has gotten more expensive, it’s that Medicare makes it perhaps too easy for doctors and hospitals to make money hand over fist for specialist care.  Still, the average annual rate of growth for Medicare (8.8%) is less than that for private insurance (9.9%).

But yeah, government-run, government-funded.  We’d keep the government’s hands off of it but, well, they’ve kind of already been there for 44 years.

Oh, but it gets worse, I’m sorry to say.

There’s a health care system operating in the United States that for the past 7 years has beat both Medicare and private insurance in customer satisfaction surveys run by the American Customer Satisfaction Index; a system which the New England Journal of Medicine compared to Medicare on a broad range of health indicators, from preventative care to chronic care to inpatient care to outpatient care, and found it beat Medicare in 12 of 13 categories.  When the American health care system cost $6,300 per person in 2006, this health care system cost only $5,000 per person.  Indeed, when it was suggested that more of the patients using this payer be shifted to private insurance, with all of its supposed advantages, there were howls of protests, a frequent use of the word “betrayal,” and a bald declaration in a Wall Street Journal Op-Ed that, “This plan is as unfair as it is unnecessary.”

This would be the Veterans Health Administration or “the VA” – paid for and operated by the government.

Both of them are substantially more government-controlled and -influenced than any proposal currently in Congress or the White House, since those bills would preserve at least 160 million people in employer-based insurance plans.  Medicare is a single-payer system, supported entirely by tax revenue in a way the public option will not be – a sore spot for progressives and single-payer advocates, but true nevertheless.  The VA is true socialized medicine.  We’re talking full-bore “doctors and hospital staff are government employees,” “track which treatments work and which don’t,” “actually bother to negotiate for bulk prices with Big Pharma without a perusal of Pfizer’s current stock price” socialized medicine.  That’s the system that it would be "betrayal" to migrate folks from.

So we hate government-run insurance.  We do.  Unless we already have it, at which point you’ll have to pry it away from us with a crowbar.

(Photo credit:  Chuckumentary on Flickr.)