A back-door path to a government takeover

Amidst all the moving parts of a national healthcare reform package, one simple, but central question must rise above everything else to guide our efforts: Who do we empower to provide the highest quality healthcare — patients and doctors, or the federal government?

With President Obama’s recent endorsement of a “public option,” it appears his answer is “the federal government.” From the editorial page of The Washington Post to candid confessions from a handful of congressional Democrats, the truth is out that a “public option” is nothing more than a back-door path to a government takeover of personal and private healthcare.

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While patient-centered reforms are needed, the average American appreciates that the quality of our healthcare remains the world’s best. Increasing access to this care and lowering costs are important.

However, those with coverage are reliably satisfied with the care they receive. Waiting times are typically short, Americans have access to the most innovative procedures, and we have some of the highest survival rates for critical diseases in the world.

As a physician, I know firsthand that government intervention has a harmful effect on each of these. Yet Democrats are convinced government is the best provider of care. For a glimpse at what a government takeover of our health system would look like, we need only examine how such as system is carried out across the Atlantic Ocean.

In the United Kingdom, the misnamed National Institute for Health and Clinical Excellence (NICE) determines what treatments, procedures and drugs should be made available to patients. (An analogous board, the Comparative Effectiveness Research Council, was created this year in the president’s “stimulus” bill.) The NICE board determines whether a remedy meets its fiscal goals. Comparing cost to potential for survival or cure, the board places a government-endorsed price tag on a patient’s well-being. It is not unusual for an otherwise effective remedy to be judged too expensive. Care is denied or delayed, and the patient is left out.

Take Pamela Smith of Darlington, England. In 2007, Mrs. Smith petitioned the government to pay for the drug Erbitux to treat her bowel cancer. The drug was already widely used here in the United States and deemed by her oncologist as the best treatment to slow the progression of her disease.

Unfortunately for Mrs. Smith, officials from NICE decided that treating her with Erbitux, as suggested by her doctor, was not cost-effective. She was forced to turn to the supplemental healthcare market to purchase her treatment. The government pencil-pushers only relented when it was clear that Erbitux had significantly reduced the size of her tumor. By that point, Mrs. Smith’s life savings had disappeared.

Democrats sell a government option as the ultimate solution to our insufficient level of access. Yet since governments view care in terms of dollars and cents, rather than patients and doctors, they limit care to such a degree that the majority of patients are forced to purchase additional health coverage. In France, for example, 92 percent of patients pay for supplemental health insurance on top of their inadequate federal plan. Even here at home, over 90 percent of people on Medicare, our “public option” for seniors, have some type of extra coverage.

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Proponents of a government takeover disingenuously point to studies asserting that nations abroad have healthier populations. This is dangerously misleading. We must not confuse healthy lifestyles with healthcare outcomes. According to a 2008 study by CONCORD, the European NGO Confederation for Relief and Development, five-year survival rates for breast, colon, rectum, colorectal and prostate cancer are all significantly higher in the United States than the United Kingdom.

The five-year survival rate for breast cancer is 83.9 percent in the U.S. but only 69.7 percent in the U.K. The difference in the rate of survival for prostate cancer patients is a shocking 40.8 percentage points, with a U.S. five-year survival rate of 91.9 percent compared to only 51.1 percent in the U.K.!

Healthcare delivery in America needs serious reform, but these stark differences in survival rates clearly show we must increase access to patient-centered and controlled care, not eliminate it.

Positive health system reform will put patients in charge by empowering them with ownership of their coverage. This way, insurers will have to be accountable to the patient rather than the government or a corporation. An improved system must also include reform of the tax code so that it makes financial sense for all Americans to purchase care. This way we can reach universal access to care without inflexible government mandates and lower quality.

The experiences of our friends in the United Kingdom offer valuable lessons about a government takeover of health care. If we choose not to learn from their mistakes, we will surely be doomed to repeat them.

There is a positive solution: Providing all Americans access to affordable, quality healthcare with patients and their families in control — not the government.


Price, M.D., practiced orthopaedic surgery for over 20 years. He chairs the Republican Study Committee.