Sunday, September 12, 2010

The Myth of Obamacare: Healthcare Reform vs. Insurance Reform and Lessons Learned from Our Neighbors across the Atlantic and Pacific

To hear Obamacare supporters and some folks who are just ignorant of the law itself tout the new healthcare law as healthcare reform only infuriates those of us who know what it truly is: it may be referred to as health insurance reform (although, reform in a positive sense is not what the law does at all) but the law is certainly not reform of the healthcare industry.

The law's provisions deal exclusively with health insurance: the mandate to purchase insurance, the requirement that insurance providers cover pre-existing conditions, new regulations mandating that employers provide health insurance or pay a fine--the list continues. The law, however, does not address the immediate and worsening crises within the healthcare industry itself: exponentially-increasing costs for healthcare goods and services; the shortage of qualified doctors and nurses to meet the growing demand of the American population, especially as baby boomers retire; the lack of portability of insurance coverage across state lines; barriers to entry and stifled competition for the emergence of new insurance carriers willing to compete for consumers; the lack of standardization and centralization of medical records; and the roadblocks to implementing new technologies for patient records and streamlining treatments.

Most believe this watered-down takeover of the health insurance industry is only a first step towards a government-run, single-payer system. If so, we could learn much from other countries dealing with the consequences of government-run, single-payer care.

I recently visited Sydney, Australia earlier this year and had the opportunity to witness a session of the New South Wales Parliament, the state legislative body governing Australia's largest state and most populous city. The main issue being debated: access to healthcare. Australia has a hybrid public-private healthcare system. Free healthcare is guaranteed for all 20 million Australians through a government-run scheme, but private healthcare facilities are also allowed to operate, and Australians can patronize these physicians and facilities at their own expense.

The parliamentary session was led by Premier (similar to the governor of a U.S. state) Kristina Keneally of Australia's leftist Labor Party, who acknowledged the federal government had not followed through on its promises to the states regarding healthcare funding, and as a result, New South Wales was experiencing critical shortages of hospital beds, vaccines, and medical equipment, along with complaints from citizens about long wait times for procedures and appointments. Leaders of Australia's right-leaning Liberal Party in the Parliament argued for decentralization of healthcare decision-making and allowing individual states and cities to allocate budget dollars for healthcare, shifting decision-making to doctors, nurses, and hospital administrators rather than bureaucrats in Canberra, Australia's capital city.

Keneally, alarmed that New South Wales residents may be inclined to support some of these common-sense policies in light of the failure of the leftist, federal leadership on the issue, immediately accused her political opponents of favoring--wait for it--privatization. She also said that New South Wales "would not return to the big business, privatization schemes of the Howard government." John Howard was the former prime minister, a conservative member of the Liberal Party and the favorite boogeyman of Australia's left since he lost his last election. Sound familiar?

The session quickly turned cantankerous as members of parliament shouted each other down and personally attacked one another over this extremely intense and volatile issue. The barrister had to quiet down the legislators several times for being out of line.

I find it ironic and revealing that the disastrous realities of centralized, government-run healthcare in Australia , Canada, and the United Kingdom are largely ignored by the U.S. media, but incite fierce debate in those countries over whether policy should move towards privatization and local control. The United Kingdom has already taken the first step: under Conservative Prime Minister David Cameron, Britain's National Health Service will be downsized with most authority and decision-making devolved to the level of town councils and similar bodies.

Even in Australia, healthcare was a major issue in their most recent elections a few weeks ago. Labor lost their majority in the federal parliament and suffered major losses in New South Wales, home to Sydney and Australia's most populous state, a left-leaning bellweather for the entire country. Pundits down-under are now predicting that Keneally will lose her premiership in the upcoming state spring elections and that the conservative Liberal Party may gain control of the New South Wales Parliament for the first time in decades.

The irony of all ironies is that as Europeans move away from their socialized healthcare schemes to patient-centered healthcare with an emphasis on choice and access, the United States, long the world's leading bastion of individual freedom and liberty, will be moving further away from its own ideals and towards the failed trends of European social democracies.

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