The Lasik surgery myth

The guy in the audience stood to declare that Lasik surgery shows that if the free market were just allowed to work, it would work in healthcare just like it does everywhere else. Lasik's costs just keep going down.

This is a cherished myth on the right. Because a one-time, walk-in surgery's costs have dropped, they'd like to believe that little Thomas Wilkes' $4,000-a-day factor for hemophilia would also drop. Eventually.

Suppose it did — suppose it dropped 20 percent a year, like Lasik surgery has. By 2009, perhaps Thomas' daily costs for that medication would just be $3,000 a day. Perhaps the Wilkes could afford that. Of course, that medication is just one part of their costs — all together Thomas' treatment costs about $1 million a year.

The fact is that the cost of catastrophic illness and injury under free market conditions would be beyond reach for most of us. We'd just have to hope we didn't get sick or hurt and know that we'd die if we got cancer or were hit by a bus — leaving our children orphaned.

We can't afford to be on our own when it comes to healthcare. We have to pool the risk, and be smart about funding preventive care.

I attended the Northern Colorado Business Journal's Health Care Summit today, mostly to hear "The Great Single-Payer Debate" between Dr. Cory Carroll, a single-payer universal healthcare advocate, and Republican State Senator Shawn Mitchell.

That debate was originally to have been between a Blue Ribbon Commissioner and Dr. Carroll. Weren't the commissioners supposed to keep an open mind about possible solutions?

There were also "healthcare heroes" awards, one of which went to Dr. Glenn Pearson, who was given the award for his work supporting Physicians for a National Health Plan. It is so refreshing that a business journal would recognize Dr. Pearson's work like that. I hope they're not penalized by insurance companies pulling advertising. It was a brave move.

Dr. Carroll, a Health Care for All Colorado supporter, gave a great presentation on why business should support single-payer universal healthcare.

He made the point that as long as there's the 1986 EMTALA law — that's the Emergency Medical Treatment and Active Labor Act — which requires hospitals to care for people in dire need of treatment, that the "free market" really can't work in healthcare. Hospitals would have to be able to turn away victims of car accidents, if they could not pay. Now while that may fit in with the Independence Institute's libertarian values, it's certainly not "What would Jesus do?"

"For a true free market system to succeed, those who cannot pay do not get care," Dr. Carroll said.

This is something those against single-payer universal healthcare play both ways. On the one hand, they complain that government intervention has distorted the market, and that's why it doesn't work. On the other hand, they say that we don't need single-payer, we just need to strengthen the safety net. But not government, I guess. Although anyone from the hospital associations or from charitable organizations will tell you that there's no way that charities can afford to replace the government safety net. Single-payer universal healthcare could, however.

Dr. Carroll included a David Letterman-style top ten reasons why business should support single-payer universal health care. I missed #2, but here are the rest of his reasons:

10. The single-payer system will reduce liability insurance and workers compensation costs for businesses.
9. Single-payer will eliminate the costs and headaches of running a health benefits program — no more annual negotiations with insurance companies.
8. Single-payer will eliminate complaints from employees about the company's health plan.
7. Single-payer will reduce incentives to hire part-time workers.
6. Single-payer will curb medical bankruptcies and free up money for spending on consumer items.
5. Single-payer will reduce the overall costs of covering employees.
4. Single-payer will eliminate retiree benefit costs.
3. Single-payer will reduce absenteeism because the workforce will be healthier.
2. Dunno.
1. Single-payer will allow health care costs to be controlled and predictable, eliminating a major source of business uncertainty and a barrier to planning.

Dr. Carroll also gave the audience a brief history lesson on universal healthcare, with dates that other countries adopted universal health care — the 1800s for Germany — and failed attempts in the U.S.: 1935 for FDR; 1948 for Truman; and 1994 for Clinton.

Sen. Mitchell was smart and funny. He offered the standard criticisms of single-payer universal healthcare — that the U.S. does best for breast cancer and that you might have to wait for a hip replacement in Canada — and managed to make it sound as though the U.S. system was always best and other countries' systems wracked with problems. His foundation seemed to be that yes, primary care was good in those countries, and you were probably happy with your care as long as you didn't need a specialist, but once you needed a specialist you'd be best off flying to the U.S. for care. Which isn't true at all.

All the same, he was personable and funny — and seemed open to learning more about single-payer. He seemed to think that those other countries were moving towards the U.S.'s system, which has no bearing in reality. The Canadian Supreme Court saying that auxiliary health insurance should be legal does not in any way equate to those countries moving more towards our system. People in the rest of the industrialized world mostly assume that Americans have universal healthcare too. Doesn't everyone? Those people who do know — and more will soon, because "SiCKO" will be a hit internationally — feel sorry for us.

Conservatives everywhere are in favor of cost-effective universal healthcare, which means single-payer universal healthcare or a slight modification of it. The U.S. right is the exception that proves the rule on this. What's more, the best of them, if they only had the facts in hand, would surely join their Tory brethren.