If you think healthcare is expensive now, just wait until it is free.
— P.J. O’Rourke

That quote appears in my blog header this week because I’ve been keeping an eye on the Single-Payer Health Bill passed a couple of weeks ago by the California legislature and forwarded to Governor Arnold Schwarzenegger. The Terminator vetoed the bill yesterday but, like his namesake, you can expect that “it will be back.”

The bill would have outlawed all private health insurance in California in favor of a state-run, single-payer system that essentially mirrors the socialized programs of countries such as Canada and Great Britain (two links) and, in the words of Gov. Schwarzenegger, “would require an extraordinary redirection of public and private funding by creating a vast new bureaucracy to take over health insurance and medical care for Californians — a serious and expensive mistake.”

Proponents of the bill say it would actually save the state $8 billion a year in administrative costs, while private health insurance interests released a report that shows that that amount is overstated by $3.5 to $5 billion and that these administrative functions are the industry’s primary defense against fraud and abuse. The private insurers are naturally going to respond strongly to these claims, but even their counter-argument suggests that there may still be as much as $3 billion in administrative costs that could be attacked. Nevertheless, the idea that a state-run bureaucracy with no competive pressure will do a better job of ferreting out abuse and redundancies is counter-intuitive, just as the idea of a “single-payer” is a misnomer since the costs are ultimately extracted from all California tax-payers.

Both sides can readily marshall all kinds of statistics and sound-bites to support their positions. If we only had these to go by, it could be a challenge to try to peer into the future to see what the ultimate impact might be. Fortunately, we don’t have to go by expert opinion or suppositions, we can see the results and unintended consequences such as poor quality care, long waiting lists for necessary surgery and an ever-expanding bureaucracy. The problems in Canada – extolled by some for its artificially reduced drug prices – have become so severe that the New York Times recently reported that an average of one private (and therefore illegal) health clinic per week is opening in our socialized neighbor to the north. The clinics are opening in response to demand from citizens willing to pay out of their own pockets to get needed surgery to improve the quality of their lives. As the head of one of these new clinics stated, “This is a country where a dog can get a hip replacement in under a week and in which a human can wait two or three years.”

I’ve written before (such as in the links in the third paragraph above) that this situation ultimately leads to the government making decisions on who should live and die by rationing or even denying care based on its assessment of costs and quality-of-life issues. There’s also evidence, however, that this isn’t the only way socialized medicine can kill you. Amy Ridenour recently noted that “under socialized medicine, public officials administer a single budget and usually ration care among a population whose sole choice is to take whatever therapies the state monopoly provides” and that “politically driven health care jeopardizes patients’ lives,” citing:

• Breast cancer is fatal to 25 percent of its American victims. In Great Britain and New Zealand, both socialized-medicine havens, breast cancer kills 46 percent of women it strikes.
• Prostate cancer proves fatal to 19 percent of its American sufferers. In single-payer Canada, the National Center for Policy Analysis reports, this ailment kills 25 percent of such men and eradicates 57 percent of their British counterparts.
• After major surgery, a 2003 British study found, 2.5 percent of American patients died in the hospital versus nearly 10 percent of similar Britons. Seriously ill U.S. hospital patients die at one-seventh the pace of those in the U.K.
• “In usual circumstances, people over age 75 should not be accepted” for treatment of end-state renal failure, according to New Zealand’s official guidelines. Unfortunately, for older Kiwis, government controls kidney dialysis.
• According to a Populus survey, 98 percent of Britons want to reduce the time between diagnosis and treatment.
• Emily Morely, 57, of Meath Park, Saskatchewan, discovered that cancer had invaded her liver, lungs, pancreas and spine. She also learned she had to wait at least three months to see an oncologist. In Canada, where private medicine is illegal, this could have meant death. However, Mrs. Morely saw a doctor after one month — once her children alerted Canada’s legislature and mounted an international publicity campaign.
• James Tyndale, 54, of Cambridge, England, wanted Velcade to stop his bone-marrow cancer. However, the government’s so-called “postcode lottery” supplied this drug to some cities, but not Cambridge. The British health service finally relented after complaints from the Tories’ shadow health secretary, MP Andrew Lansley.
• Edward Atkinson, 75, of Norfolk, England, was deleted from a government hospital’s hip-replacement-surgery waiting list after he mailed graphic anti-abortion literature to hospital employees. “We exercised our right to decline treatment to him for anything other than life-threatening conditions,” said administrator Ruth May. She claimed her employees objected to Mr. Atkinson’s materials. Despite a member of Parliament’s pleas, Mr. Atkinson still awaits surgery.

Wouldn’t you just love it if your government decided you were too old — or too politically incorrect — to receive life-saving or life-enhancing care?

Update:

My mistake: the bill that Gov. Schwarzenegger vetoed yesterday was a “Wal-Mart” bill similar to the one vetoed by Chicago Mayor Daly earlier this week. Arnold has not officially vetoed the single-payer bill yet, but has written a published op-ed piece in the San Diego Union-Tribune where he stated that he would veto it. He has until September 30 to terminate it.

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