Thursday, August 28, 2008

Today's Myth: Healthcare Is Free in Canada, Germany, England, France

Here are some useful facts from BigGovHealth.org. This is the ninth myth listed on their page:
Myth: Healthcare Is Free in Canada, Germany, England, France

Fact: People in other health care systems often pay more than Americans do, sometimes in the form of taxes. And they may also incur high costs if they need a drug that is not covered by their health system or want to see a specialist.

In the US, a family of four with an employer-based PPO will have around $15,609 total this year in health care costs. Of this amount, $9442 will be paid by the employer and the employee will contribute $3,492 in premiums and $2,675 on copays, etc. [1] That's about 6 percent of average family income. [2]

In Canada, while the percentage of taxes used to provide health care varies, it is estimated that 22% of taxes collected went to the health system in 2004.[3] Several provinces, including Quebec, Ontario, Alberta, and British Columbia, also charge additional premiums.[4] Canadians also may spend money to receive private treatment for procedures or drugs that are not covered by the government system.

Citizens of the UK pay 11 percent of each pound they make in weekly income between £100 - £670 for the NHS, plus an addition 1 percent of income over £670 a week.[5] Though the copay for drugs is low, many drugs are not covered, often because they not considered cost efficient. And anyone who uses their own money to buy powerful but expensive drugs not paid for by the NHS finds him or herself shut out of the NHS for having gone outside the system.

In Germany, coverage from a public sickness fund currently can range significantly in cost, from around 12.2 to 16.7 percent of income, with the employee paying a bit under half. As of fall 2008, premiums are to be standardized from the federal level and health care experts anticipate that they will be set around 15.5 percent.[6] Private patients can generally expect to pay more than they would in the public system.

In France, employees contribute only to 0.75% of their salaries towards medical care, but also pay a 7.5 percent General Social Contribution, the majority of which is earmarked for the health system. This base coverage reimburses people for the majority of costs for doctors visits and for a portion of the costs of medications.[7] On top of the government coverage, almost all French residents have supplementary coverage from a mutuelle, costing approximately 2.5 percent of salary.[8]

References

[1] "Average 2008 Employee Out-of-Pocket Costs for Family Health Care to Increase 10.5%, According to Milliman Index," Medical News Today, 16 May 2008, http://www.medicalnewstoday.com/articles/107699.php.

[2] Kevin Sack, "Clinton Details Premium Cap in Health Plan," The New York Times, 28 March 2008.

[3] Jay Lehr, "Canadian Health Care is No Model for US: Claims That Canada's Single-Payer Health System Is More Efficient or More Compassionate than Ours Are Just Plain Untrue," Health Care News, 1 June 2004, available at http://www.heartland.org/Article.cfm?artId=15034&CFID=4911814&CFTOKEN=64059852

[4] OECD, "Taxing Wages 2006/2007: Special Feature: Tax Reforms and Tax Burdens," (2008).

[5] OECD, "Taxing Wages 2006/2007: Special Feature: Tax Reforms and Tax Burdens," (2008).

[6] "Beiträge können kräftig steigen," Süddeutsche Zeitung, 7 January 2008, http://www.sueddeutsche.de/wirtschaft/artikel/401/151024/.

[7] David G. Green, Ben Irvine and Ben Cackett, "Health Care in France," Civitas, (2005), http://www.civitas.org.uk/pubs/bb2France.php.

[8] David G. Green, Ben Irvine and Ben Cackett, "Health Care in France," Civitas, (2005), http://www.civitas.org.uk/pubs/bb2France.php.
As always, these sorts of economic facts are tremendously helpful in reinforcing the underlying moral point that health care is not a right. Health care is a commodity that must be created by the thought and work of a rational mind. There is no such thing as a "right" to something that must be produced by another.

When a government attempts to guarantee health care as a "right", it can only do so by violating the actual rights of doctors and other health care providers, who are forced to provide that service on the government's terms and for the government's prices, rather than on their own terms in a free market.

The results we see in Europe and Canada are the result of this idea put into practice.