Monday, April 30, 2007

Problems With Maine's Socialized Medical System

The state of Maine has also attempted to provide "universal coverage" for its residents for many years, with predictably poor results. According to this recent NY Times article, instead of saving money, the program costs continue to explode, and the state officials are considering what sort of cutbacks to implement. Rationing is just one short step away.

Interestingly enough, one of the supporters of the plan is quite explicit about the central problem. She states, "This program needs healthy people who don't get subsidized so it can prosper." In other words, it needs a massive forced redistribution of wealth from one group of citizens to pay for the health care of another group of citizens who otherwise couldn't pay for it themselves.

Yet for some reason, supporters of "universal health care" refuse to call these systems by their real name -- "socialized medicine"! (Via Jason Spears.)

Friday, April 27, 2007

Last Opportunity to Influence 208 Commission

Today was another all-day 208 Commission hearing.

Make your Voice Heard

The most critical issue to a Colorado resident is that the Commission is seeking public comment with regard to important principles and features to evaluate the more than 28 proposals for health care reform that it has received. Watch this blog for summaries and analysis of all 28 proposals over the next few days.

The Commission intends to only evaluate 3 to 5 in detail. To get to this number, it has developed a two step winnowing process. On May 7, the Commission will flush 18 to 20 of the 28 proposals it has received. (From a Commission handout entitled "Major Coverage Strategies of Comprehensive Proposals," the Commission may have already tossed 5 proposals as "not comprehensive.") On May 17-18, the Commission will then review those remaining 8 to 10 proposals, purging all but 3 to 5.

The Commission is seeking public comment by May 12, and wants the public to address two questions:

1) What are the one or two most important features that you feel must be included in any Colorado health care reform? and
2) What is the most important principle that should be considered in any reform effort?

By listed order, the Commission values reform features over principles.

There are two ways to provide comment to the 208 Commission. 1) You may submit a comment in writing by e-mail to Any comment sent to this address will be posted on the Commission website and distributed to all Commissioners for review in advance of the May 17-18 meeting. But the e-mail must be received by May 12.

Alternatively, there are five meetings planned where public comment will be solicited and where you have the opportunity to speak before one or more commissioners. Current public meeting information is not yet up on the website but is supposed to be made available shortly. They still want you to submit written testimony at the time of your oral presentation.

Public Comment Meetings, including dates and locations
  • May 10 Metro Denver, 4 - 7 pm, Wheat Ridge Recreation Center, 4005 Kipling
  • May 10 Glenwood Springs, 4 - 7 pm, City Hall - Council Chambers, 101 W. 8th St, Main level 1st floor
  • May 12 Pueblo, 9 am - Noon, Convention Center, 320 Central Main Street
  • May 12 Durango, 9 am - Noon, Mercy Medical Center, 1010 Three Springs Blvd
  • May 12 Ft. Collins, 1 - 4 pm, Harmony Public Library, 4616 S. Shields Street
Although they will be seeking public comment later in the summer, this is the last opportunity to express your opinion about the most important principle (and features) to be used to select any proposal. This is the time to speak about capitalism v. government control, the individual rights of doctors and other providers v. the needs of some patients, and freedom in medicine and health insurance v. insurance mandates and other instances of government force.

More Commission News

No meeting summaries of any of the prior meetings have been approved by the Commission, are on-line or available to the public. These prior meeting summaries were to have been approved and available today, but were not available due to a "glitch." Chair Bill Lindsay promised that unapproved summaries would be on-line next week at the website.

Governor Ritter has appointed 3 new members to the Commission, two of whom took their places at the Commission meeting today. The new members are Peg Burnette, CFO for Denver Health; Donald Kortz, Chairman of the Board for Fuller & Company, and Lynn Westberg, Director of San Juan Basin Health Department. Ms. Burnette and Ms. Westberg were present today. There are now 27 Commission members.

The Commission also voted to hire a company to "model" the 3 to 5 proposals it selects next month. There were 2 firms considered by the entire Commission: The Lewin Group and Milliman. The Commission voted to accept Lewin's proposal over Milliman's. Their rationale: Lewin had a pre-programmed model designed to run on state samples from national surveys, and it works with lots of state agencies, task forces and commissions on health care reform, whereas Milliman had less government experience, but was experienced with private clients and Medicaid, including long-tem care, and was willing to construct a model for Colorado and include Colorado data. When I asked (during public comment) if there were measured results of Lewin's prior forecasts that would validate the accuracy of its forecasts, the response was that there was no such data because none of the assumptions and proposals that were used in its 18 years of forecasts ever were adopted by a legislative body as modeled. (That says an enormous amount about the various proposals modeled and the legislative process, and why a firm would choose to provide more government than private services in this area.)

Additionally, Commissioner Linda Gorman noted that Lewin did not generally use administrative costs data that was within the limits of that discussed in the literature, but used their own numbers. So, the Commission, relying on its Evaluation Committee, chose to pick a firm that was government oriented rather than market oriented (where its reputation depends on making accurate forecasts for its private clients) and where the Commission has said there is no ability to measure the accuracy of its forecasts. (By my count, there were only 4 Commissioners who voted for Milliman.)

Just another day at the Commission.

Dr. Paul Hsieh's "Crazy" Letter

A few days ago, my husband Dr. Paul Hsieh published this letter to the editor in the Denver Post:
Health care is not a right, and it is not the proper role of government to provide health care for all citizens. Instead, this should be left to the free market. It is precisely the attempts of the governments of countries like Canada (or states like Tennessee) to attempt to mandate universal coverage which have led to the rationing and waiting lists for vital medical services. Similar problems are already starting to develop in the Massachusetts plan as well. Any plan of government-mandated "universal coverage" is nothing more than socialized medicine, and would be a disaster for Colorado.

Paul S. Hsieh, M.D., Sedalia
In response, Denver Post staff columnist Jim Spencer attacked Dr. Hsieh (without identifying him by name) in his column "Reforming the health of our care":
The craziest letter to the editor that I've read in some time came from a physician who claimed that Coloradans have no right to health care.

Seems the guy not only forgot his Hippocratic oath but also the law.

If you're sick enough or badly injured, they have to treat you at the emergency room regardless of your ability to pay.

The doctor aimed his editorial rant against socialized medicine. But he wrote it because a state blue-ribbon commission is now cobbling together a plan for medical treatment and prescription drugs for Coloradans.
The column then discusses the supposedly noble work of the 208 Commission in determining the proper "private/public mix in the provision of health care."

It's delightful to see that quick letter generating that kind of attention. It shows the power that physicians have when they speak out against socialized medicine. For Dr. Hsieh's more detailed case against socialized medicine in Colorado, read Socialized Medicine in Colorado - An Open Letter to Colorado Physicians.

Tuesday, April 24, 2007

How Does Insurance Spread Costs?

An April 24 article from The Denver Post, titled, "Senate tentatively OKs health-insurance bill," quotes State Senator Bob Hagedorn: "The purpose of health insurance is to spread the cost." Hagedorn is a sponsor of House Bill 1355, which would repeal moderate "ratings flexibility" for employer-paid insurance. Former legislator Mark Hillman, who backed the "ratings flexibility" in 2003, believes that the flexibility enabled more employers to offer insurance.

There is an element of truth to Hagedorn's statement. As I've written: "[P]erhaps it would be helpful to remind ourselves of why people started buying insurance in the first place. It makes sense to insure ourselves against unexpected, high-cost risks such as premature death, a costly disease, the destruction of our home, or a serious car wreck.

"The point of insurance is to get it before we know whether we'll need to make a claim. People pool their premiums, then whoever suffers the harm gets the payout. If everybody has the same risk, then everybody will be willing to pay the same premium. But people at a lower risk won't agree to subsidize somebody with a higher risk. For example, a safe and healthy 25-year-old won't voluntarily pay the same amount for a comparable life-insurance policy as is paid by an older person who has cancer and enjoys drag racing."

So insurance does "spread the cost" in the sense that people voluntarily pool their risks and their premiums. Then the costs of the damage suffered by a few are spread out among all the premium payers. That's the way insurance is supposed to work, and people voluntarily sign up for it.

But that's not the sort of cost-spreading that Hagedorn is talking about. After the federal government pushed most insurance into the high-cost, non-portable employer-pay system via tax distortions, the federal and state governments subjected employer-pay insurance to community ratings and guaranteed issue. The explicit purpose of these measures was to "spread the cost," not by allowing people to voluntarily pool actual risks and (individually adjusted) premiums, but by forcing those with lower risks and costs to subsidize those with higher risks and costs.

Thus, what Hagedorn is talking about is not really even insurance. It is a combination of insurance, health "insulation" (to use Arnold Kling's term) and coercive wealth transfers.

Though one wouldn't know it from Hagedorn's quote in the Post, there is all the difference in the world between voluntary cost sharing and cost sharing that results from political force.

Medicaid Reforms

Brian Schwartz, Ph.D., gave me permission to post his following comments about Medicaid. Bear in mind that Medicaid is primarily a federal program, so states are limited in how they can reform it. In his proposal to Colorado's 208 Commission, Schwartz focuses on state-level reform. He writes:

"The Denver Post reports on April 19 that 'Colorado's Medicaid program…is among the worst in the nation.' Indeed. My proposal to Colorado's Commission on Healthcare Reform, FAIR: Free-markets, Affordability, and Individual Rights, shows that by the Commission's own standards, Medicaid fails miserably. It inhibits consumer choice, encourages recipients to forgo higher-paying jobs to maintain eligibility, and increases medical expenses for those not enrolled. Says former Maryland state representative John Adams Hurson: 'I am a Democrat, a liberal Democrat, but we can't sustain the current Medicaid program. It’s fiscal madness. It doesn’t guarantee good care, and it’s a budget buster. We need to instill a greater sense of personal responsibility so people understand that this care is not free.'

"The Colorado legislature should convert Medicaid to a consumer-driven program resembling Colorado's Consumer-Directed Attendant Support (CDAS) program -- with insurance vouchers and Health Opportunity Accounts. It should promote responsible consumption with co-payments and premium-sharing, and prevent people from hiding assets to qualify for Medicaid long-term care. Lastly, it should convert Medicaid from a monopolistic pre-paid health entitlement program to a voluntarily-funded charity that, because it must compete for tax dollars, has incentives to improve care and lower costs."

On pages 39 through 46 of his proposal, Schwartz discusses the many ways that Medicaid fails to meet the Commission's own criteria for proposals.

Wednesday, April 18, 2007

How HSAs Help Women (and Men)

In an April 16 blog, John Goodman writes that Steffie Woolhandler produced a forthcoming study claiming that "women are punished by high-deductible, Health Savings Account plans because they have expenses men don't have: mammograms, pap smears, prenatal care, etc." While the study itself was not yet available, an AP story that Goodman cites discusses the study and quotes Woolhandler.

Goodman writes: "A glaring omission in the AP article: most HSA plans make preventive care a first-dollar coverage exception to the high deductible, and/or deposit funds in the HSA so that women can purchase care on their own."

In accordance with the freedom to contract, insurance companies and their customers have the right to mutually agree on a policy that both sides find agreeable. In a truly free market, likely some insurance policies would make "preventive care a first-dollar coverage exception to the high deductible," and some wouldn't. The government's proper role is to protect the right to contract, not force either insurance companies or their customers to accept particular sorts of policies.

My wife and I can attest to the value of HSAs for women. My wife and I were uninsured for several years, and only in recent weeks have we applied for high-deductible insurance in conjunction with an HSA. We simply couldn't afford broader-coverage insurance, at something like $4,000 per year. However, the high-deductible insurance costs us only around $1,600 per year. So, because of HSAs and high-deductible insurance, my wife and I have health insurance, when otherwise we would not. And that is a benefit to one woman whom I care about very much indeed.

The unaffordable, broader-coverage insurance wasn't that broad, anyway. It still required relatively high co-pays. It didn't cover my wife's single most expensive health cost, birth control. And it covered only 80 percent of costs, even after the deductible, without limit. So, for us, the expensive insurance was a terrible deal. (This is not surprising, given that employer-paid insurance is particularly rigged by federal and state controls to force people like my wife and me to subsidize others in the pool.)

Now that we have an HSA, we can purchase birth control with pre-tax money. Thus, my wife will now be spending less on her health care than she would have spent with the more expensive insurance.

Goodman writes that Woolhandler wants "Americans to adopt Canada's healthcare system." But that's not so great for women, Goodman points out: "The organization Cancer Ontario reports an average wait time of more than five months between the first abnormal mammogram and a diagnosis of breast cancer." He cites a Fraser study to the effect that, in Canada, women are forced to wait for treatment, and they have less access to machines such as MRIs, sonograms, and ultrasounds.

The situation of my wife and me reveals a few more facts. Many women are married, in which case medical bills for women impact the husband just as much. However, judging from the AP story, apparently Woolhandler just looked at male vs. female expenses, without separating out the women whose medical expenses are already pooled with those of men (their husbands). (Whether or not the study mentions this fact, the AP story does not.)

In addition, averages say nothing about individuals. Last year, for example, I suffered a cracked tooth that cost more than all of my wife's medical expenses for the entire year, combined. The AP notes the statistical averages found by Woolhandler: "The median expense for men under 45 in these plans was less than $500, but for women it was more than $1,200... [O]nly a third of insured men in that age group spent more than $1,050 in annual medical costs, while 55 percent of women did." Of course, if women over 45 were included, the median for women would go down, because pregnancy is fairly expensive (and it's also something that often happens within a marriage, in which expenses are shared).

This raises a much broader issue. Why is gender the relevant distinction? To rephrase the statistics cited by the AP, 66 percent of men in the age group and 45 percent of women spent less than "$1,050 in annual medical costs." That's quite an overlap. Obviously, gender is hardly the most important factor in health-care costs. The express intent of forcing everyone into collective pools is to force the less-costly people in the pool to subsidize the more costly people. Woolhandler wants to forcibly confiscate the wealth of some women (and men) in order to subsidize other women (and men). People such as my wife (who approved this line) who neither equate themselves with statistical averages nor approve of egalitarianism, but instead view themselves as individuals, will find such an outcome to be profoundly unjust.

Monday, April 16, 2007

Lin Zinser to Speak on Healthcare

Tomorrow evening, April 17th, Lin Zinser will speak to the Colorado Springs Republican Women about the pernicious influence of government in healthcare and the current proposals for reform. The event is free and open to the public.
Colorado Springs Republican Women

Tuesday - April 17, 2007



PROGRAM: Speaker - Lin Zinser
(see bio to follow)

City Hall
NE Corner of Nevada & Kiowa
Enter at 212 Kiowa (east of original City Hall building)
South side
Academy Room

No Meeting Charge
Open to the public
Need 2 volunteers for refreshments

Speaker Bio:

Lin Zinser practiced law in Denver for 19 years. As an attorney, most
of her work was in business defense litigation. She routinely litigated
cases with medical issues, as well as cases involving insurance issues,
particularly auto, business, disability, and health coverage's. She
received her JD from University of Colorado at Boulder and a B. A. in
Philosophy from Wichita State University.

In 2004, Lin Zinser began bringing speakers to the Denver metro area to
speak on a variety of ethical and political issues. She recently
founded Ideas, Matter, Inc., a non-profit corporation, to further that
effort. Ms. Zinser became concerned with the increasing threat of
socialized medicine in Colorado and nationwide. Freedom and Individual
Rights in Medicine (FIRM) was created as a program of Ideas Matter,
Inc. to serve as a resource, i.e., to educate and inform the public
about the causes of the current condition of health insurance and
health care, as it relates to Colorado.

The Crisis in Colorado Health Care

A state legislated commission was created to look at health care reform
and report to the legislature in November 2007. This brief talk will
quickly identify some of the causes of the current state of health care
and what this commission is doing and why. How do Bill Ritter and
President Bush affect this commission and its plan for Colorado?

God Bless America
Julia A Lindahl
Colorado Springs Republican Women
390-9833 (H) or 494-7129 (C)

Saturday, April 14, 2007

More Problems With Massachusetts

This recent article in the Boston Globe reveals yet more problems with Massachusetts' attempt to guarantee universal health care:
"Health plan may exempt 20% of the uninsured"

By Alice Dembner, Globe Staff -- April 12, 2007

To remove the threat of a public backlash, the state plans to exempt nearly 20 percent of uninsured adults from the state's new requirement that everyone have health insurance.

The proposal, expected to be approved by a state board today, is based on calculations that even the lowest-cost insurance would not be affordable for an estimated 60,000 people with low and moderate incomes who do not qualify for state subsidies. Forcing them to buy insurance or pay a penalty could jeopardize the rest of the state's initiative, officials said...
Because these sorts of government-mandated health plans are detached from the usual market mechanisms, the state is forced to either compromise on "universal" coverage, decrease (i.e., ration) benefits, or raise taxes. In this case, the government is choosing the first "solution" in order not to undermine the political popularity of their program.

Unfortunately, none of the officials seem willing to entertain market-based solutions, such as HSA's (Health Savings Accounts) coupled with free-market catastrophic insurance, a system that has been proven to provide better quality coverage for a lower cost.

Tuesday, April 10, 2007

Socialized Medicine in Colorado -- An Open Letter to Colorado Physicians

Socialized Medicine in Colorado -- An Open Letter to Colorado Physicians
by Paul S. Hsieh, MD;

Dear Colleagues:

My name is Dr. Paul Hsieh, and I am a physician practicing in the south Denver metro area.

I am deeply concerned that socialized medicine may be imposed on Colorado by our state legislature within the next year or so under the guise of "comprehensive health care reform". I'm morally opposed to this because I believe it would be destructive to our medical practices and harmful to our patients. I'd like your help now in speaking out against this ominous prospect.

The political process which could lead to socialized medicine is already underway, but most working physicians I've spoken with have been unaware of it. Hence, I want to sound the alarm before it's too late.

As some of you may know, in June 2006 the Colorado state legislature authorized a special 24-person Commission (called the "208 Commission" after Senate bill SB208) to generate proposals to restructure the health care system in Colorado, and submit them for legislative approval. The Commissioners were chosen by politicians from both political parties. Currently, there are only two doctors on the 208 Commission; the other 22 are representatives of various special interest groups.

The basic premise of the 208 Commission is that the government must guarantee health care for all Coloradoans. During their public meetings, a significant number of the Commissioners have expressed support for some form of socialized medicine. Although they frequently use euphemisms such as "single payer" or "universal mandatory coverage", similar language has been used in other US states and in other countries to justify massive government control of medicine.

Simultaneously, the Colorado Medical Society (CMS) has developed an official position in which they urged that health care in Colorado should be "universal, continuous, portable, and mandatory".

On January 25, 2007, the CMS submitted those "Guiding Principles" to the 208 Commission, portraying them as the consensus of the doctors of Colorado. They have also stated that the "CMS believes, after extensive vetting and a unanimous vote at the 2006 House of Delegates, that the Guiding Principles represent a compelling consensus of Colorado physicians".

When I first learned of this, I was angered and appalled, because that position does not reflect my views or the views of many other physicians that I've spoken with. The CMS does not speak for me on this issue, and I am not part of this "compelling consensus".

I completely oppose any form of socialized medicine, regardless of whether it is called "single payer", "mandatory universal coverage", or anything else, because I believe it would be bad for both patients and doctors. Years of experience in the US and other countries have shown that these programs will hurt patients and even cause their deaths. As costs inevitably spiral upward, bureaucrats will ration medical services. Eventually, physicians will be forced to practice against their best medical judgment. This is a violation of the fundamental rights of both doctors and patients.

As a result, in states like Tennessee (which in 1994 implemented its own version of mandatory universal coverage called TennCare), many doctors find the practice climate intolerable and are either leaving the state or quitting medicine entirely. I do not want that to happen in Colorado. States like Massachusetts and California, which are also attempting to guarantee universal health care for their residents, will soon face similar problems.

Although I agree that there are genuine problems with the current system, more government interference in medicine can only make things worse. One basic principle we all learned in medical school was, "First, do no harm". This applies as well to politics as it does to clinical practice. Most of the problems of the current system have been the result of bad government policies. Adding more government bureaucrats to the mix will only make things worse.

In my opinion, it is not the government's role to guarantee health care for all Coloradoans, any more than it is the government's job to guarantee all citizens a car or a job. It is morally wrong and economically unsustainable. Doctors and patients ought to be able to freely contract for medical services to their mutual benefit without interference from the government. It is precisely the attempts by the governments in Canada and Great Britain (or states like Tennessee) to guarantee universal "cradle-to-grave" coverage that has led to the runaway costs and rapidly deteriorating health care in those places.

I recognize that not everyone will agree with me here, and this is part of my point. This is a very contentious issue amongst doctors. Based on my discussions with numerous physicians, I don't think one can accurately say that there is a "compelling consensus" of the doctors of Colorado.

So if you oppose socialized medicine on the grounds of medical conscience (as I do), then please contact the Colorado Medical Society and the 208 Commission, and let them know where you stand.

Even a one line e-mail like, "I oppose universal, mandatory coverage or any other form of socialized medicine, because it will be bad for me and my patients", could have a tremendous impact.

To contact the relevant members of the CMS and the 208 Commission go to: or send mail to

The CMS is speaking in your name on this issue, so if you disagree with their position (or if you believe that their position should not be portrayed as the physician "consensus"), then they need to know. The CMS has requested feedback from doctors including those who disagree with their current position, so I urge you to take them up on this.

The 208 Commission is a public body, and has also asked for input from all citizens of Colorado. So if you want to protect your right to practice good medicine and protect your patients' best interests, they need to hear from you before they submit their proposals to the state legislature for a vote.

For further information about this issue, one excellent resource is the website, a non-profit group of Coloradoans devoted to freedom and individual rights in medicine. I especially recommend their article, "Health Care is Not a Right" by Dr. Leonard Peikoff. If you wish to stay informed on this topic, I also encourage you to sign up for their mailing list or read their blog.

Also, please feel free to forward this open letter to any other Colorado physicians that may be interested. A copy of this letter is also available online at:

Paul S. Hsieh, MD

Disclaimer: I am neither a Republican nor a Democrat, but an independent voter. My objections to socialized medicine are unrelated to party politics.



I've listed some references for those who want more information. These are optional resources for those who want to learn more about these topics, but not required reading. (I do not necessarily endorse every item in full):

"Health Care is Not a Right" (HTML format or PDF format):
[Online essay] This brilliant essay was written by Dr. Leonard Peikoff, a philosophy PhD living in Colorado Springs. The original version was written in the 1990's after Hillary Clinton proposed her infamous national health care plan, and has been updated by Lin Zinser and Dr. Peikoff for 2007. He argues that a "right" to health care does not exist and that any attempt to create one necessarily leads to disaster, because it runs antithetical to the genuine rights that were recognized and codified in the Constitution by the American Founding Fathers.

"A Short Course in Brain Surgery":
[Video] This astounding 5-minute video tells the story of an Ontario man with a brain tumor who couldn't get the care he needed under the Canadian system because the waiting lists for an MRI scan and for a neurosurgeon were too long. Fortunately, he was able to get appropriate treatment in Buffalo, NY.

"Health Insurance in the United States"
[Online article] This informative article covers the development of the U.S. health insurance system and its growth in the twentieth century, including the development of Medicare and Medicaid. It also examines the role of government policy in setting the stage for nationalized health care.

"The History of Health Care Costs and Health Insurance":
[Online article] This report was written by Linda Gorman, who is a health-care economist at the Independence Institute in Golden, CO. In this article, she covers the history of spiraling health care costs and government control of medical care, and shows how bad laws and other government interference in medicine have led to the current problems. She also offers some positive market-based alternatives to socialized medicine which have been proven to simultaneously increase patient outcomes and decrease costs, including Health Savings Accounts (HSA's), insurance deregulations, etc.

"Your Doctor Is Not In: Healthy Skepticism About National Health Care":
[Book] This book by Jane Orient, MD, is an illuminating and provocative analysis of the immorality and impracticality of government interference in medicine in general, and single-payer systems in particular. Dr. Orient is the Executive Director of the Association of American Physicians and Surgeons.

"The Cure: How Capitalism Can Save American Health Care":
[Book] This book was written by Dr. David Gratzer, a physician who has practiced in both the US and Canada, and has first-hand experience with the pros and cons of both countries' medical systems. His documentation of the long waiting lists in Canada and the higher mortality rates for treatable conditions is chilling. He also provides excellent historical background on how health insurance became linked to employee benefits as a result of bad IRS policies, with all the resultant problems. His basic conclusion is that capitalism, not socialism, is the way to address the problems. He offers a number of practical, concrete proposals to fix our current problems, all of which are based on decreasing government interference in medicine.

Podcast interview of Dr. David Gratzer at
[Podcast] A 30 minute interview by Glenn Reynolds of with Dr. Gratzer on the problems and solutions to America's health care problems.

"Universal Health Care -- Call It Socialized Medicine":
[Online essay] Lawrence Huntoon, MD, PhD, discusses why "universal health care" is synonymous with "socialized medicine". He also observes:
Indeed, "universal coverage," nationalized health care, or socialized medicine, regardless of what you choose to call it, is not the same as medical care. All of the citizens of Canada, for instance, have "universal coverage." What they often don't have, however, is the medical care that they need when they need it. That is why we see Canadians crossing the border into the United States in droves to obtain the health care that they can't get when they need it in their own country. Their government rations access to health care and thus attempts to control costs by making MRI scans, radiation oncology, bypass surgeries and many other health services largely unavailable to their own people.
Dr. Huntoon is a former president of the Association of American Physicians and Surgeons, and is a practicing neurologist in New York state.

"Universal Health Care's Dirty Little Secret":
[Online article] Trying to provide universal coverage doesn't actually result in better care, just rationing.

"No 'Crisis' of Uninsured":
[Online article] Rocky Mountain News columnist Mike Rosen debunks the myth that there is a "vast army of people... who are permanently unable to obtain health insurance".

"Why Are Health Costs Rising?":
[Online article] A nice short analysis on why health care costs have risen so much. Again, the basic problem is government interference in normal market mechanisms. As anyone who has bought a cell phone or a DVD player recently knows, the natural course of the marketplace is higher quality goods for lower prices over time. Even in the medical field, this has been the pattern in LASIK and cosmetic surgery, i.e., in the types of medical care where patients pay for themselves and are therefore incentivized to be prudent shoppers.

"Colorado Medical Socialism":
[Online article] A strong critique of the CMS position on universal mandatory health care by Boulder Weekly writer Ari Armstrong.

There is no health care crisis in Colorado:
From Lin Zinser's 3/28/2007, "Report on the 208 Commission" (scroll down to her "second point"). She notes, "According to Colorado voters there is no crisis of health care in Colorado. According to Colorado voters polled in December 2006 for the Denver-Metro Chamber of Commerce, 77% of Colorado voters believe their own health care is good or excellent and 60% believe the quality of health care in Colorado as a whole is good or excellent. More to the point, only 7% describe the situation in Colorado health care as a crisis."

Problems with Tennessee's universal health care system, TennCare [online articles]:
"The Price of Seduction"
(A devastating criticism of TennCare from family practice physician, Dr. Sydney Smith.)
"Tennessee: Lesson for California"
"TennCare: A model for how American socialized medicine will fail"

Problems with Massachusetts' universal health care system [online articles] :
"Universal Healthcare Boondoggle"
"Universal Health Care: Proceed with Caution"
"Intensive Care for RomneyCare"
"Bad Medicine: What's Wrong With RomneyCare"

Problems with California's proposed universal health care system [online articles] :
"One Step Forward, Ten Steps Back: How California Will Make Health Care Much More Expensive"
"Schwarzenegger's Folly"
(Analysis by John Stossel, co-anchor of ABC News' "20/20".)

Freedom and Individual Rights in Medicine:
[Organization] From their website:
Freedom and Individual Rights in Medicine (FIRM) promotes the philosophy of individual rights, personal responsibility, and free market economics in health care. FIRM holds that the only moral and practical way to obtain medical care is that of individuals choosing and paying for their own medical care in a capitalist free market. Federal and state regulations and entitlements, we maintain, are the two most important factors in driving up medical costs. They have created the crisis we face today.
I encourage all physicians interested in staying informed on these issues to sign up for their mailing list. FIRM also runs a weblog.

The Colorado Medical Society and some key officers:
Alfred Gilchrist (Executive Director):
Chet Seward (Director of Health Care Policy):
Lynn Parry, MD (President):
David Downs, MD (President-Elect):
Mark Laitos, MD:
Ben Vernon, MD:

The 208 Commission official website:
The full list of the 208 Commissioners and the publicly available e-mail addresses:
William N. Lindsay III, Chairman:
Erik Ammidown:
Elisabeth Arenales:
Clarke Becker: unknown
Carrie Besnette:
David Downs, MD:
Steve Erkenbrack: unknown
Lisa Esgar:
Linda Gorman:
Julia Greene:
Allan Jensen:
Grant Jones:
Donna Marshall:
Pam Nicholson:
Ralph Pollock:
David Rivera: unknown
Arnold Salazar:
Mark Simon:
Dan Stenersen: unknown
Steven Summer:
Mark Wallace: unknown
Joan Weber: unknown
Barbara Yondorf:
Peg Burnette:
Donald Kortz:
Lynn Westberg:

[This letter was slightly edited on 4/17/2007. -- PSH]