The Great Debate

Michael Goldfarb serves as a GlobalPost correspondent in the United Kingdom, where this article first appeared.

In America, the health care debate is about to come to a boil. President Barack Obama has put pressure on both houses of Congress to pass versions of his flagship domestic legislative program prior to their August recess.

Good luck.

Opponents are filling the airwaves with the usual litany of lies, damned lies and statistics about socialized medicine and the twin nightmare of bureaucratically rationed health care and high taxes amongst allies like Britain, France and Germany. So here is a brief overview of health care in some of Europe’s biggest economies: Britain’s National Health Service is paid for out of a social security tax. Services are free at the point of provision. No co-pay, no reimbursement. The budget last year was 90 billion pounds (about $148 billion). That makes the average cost per person about 1,500 pounds ($2,463).

The NHS is big — huge, in fact. With 1.5 million employees it is one of the largest employers in the world. Only China’s People’s Liberation Army, India’s state railways and good old Wal-Mart employ more folks. Sixty percent of the NHS budget goes toward salaries.

The French system is run on a compulsory purchase of insurance through the workplace. The insurance cost is based on how much a worker earns. Low-income workers pay nothing. The average contribution per person is about $4,000. The government sets fees for services and negotiates the price of drugs with pharmaceutical companies. (See related GlobalPost story “Why French doctors still make house calls.”)

– Peter J. Pitts is president of the Center for Medicine in the Public Interest and a former FDA associate commissioner. The views expressed are his own. –

When it comes to healthcare reform, as Aldous Huxley said, “Facts do not cease to exist because they are ignored.”

Three of the most common “urban myths” of American healthcare are that:
1. The lower life expectancy in the U.S. “proves” the total inadequacy of our system;
2. There are 47 million uninsured Americans — proving the inequity of our system; and
3. We spend “too much” on health care — proving the wastefulness of our system.

– Brian Lee Crowley is the founding president of Atlantic Institute for Market Studies (AIMS), a public policy think tank in Canada (pictured left) and Valentin Petkantchin is director of research at the Paris-and Brussels-based Institut économique Molinari. The views expressed are their own. –

President Barack Obama’s package of heathcare reforms – mandatory health insurance, public health option and increased federal government financing – is being sold as preserving independent high quality care and choice for patients while keeping down costs. Taxpayers and patients in both Canada and France know better.

Unfortunately, our experience is that once the government gets its nose in the healthcare tent, not only is spending not contained, but health care professionals lose their freedom to practice. Left with few choices, patients face shortages and waiting lists.

–- Diana Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute. The views expressed are her own. –-

President Barack Obama has repeatedly said “First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan. Nobody is talking about taking that away from you.”

But America’s Affordable Health Choices Act of 2009, the bill under discussion in the House of Representatives, would result in the demise of private health insurance in America.

— Peter J. Pitts is president of the Center for Medicine in the Public Interest and a former FDA associate commissioner. The views expressed are his own. —

On Tuesday, House Democrats released the Affordable Health Choices Act of 2009, their comprehensive health reform package. As expected, the proposal to create a brand new government insurance program designed to directly compete with private plans is getting a great deal of attention.

An important power of this “public option” has yet to receive much scrutiny, though. The secretary of Health and Human Services will be given the authority to “negotiate” prescription drug prices for the public option.

– James Pethokoukis is a Reuters columnist. The views expressed are his own —

You have to admire the confidence. “Don’t bet against us,” said President Barack Obama on Monday about the chances for healthcare reform. “We are going to get it done.” Not only that, Obama repeated his pledge that his plan “will not add to the deficit over the next decade.”

Sunny optimism may reign at the White House, but things are a bit gloomier over on Capitol Hill. An August deadline to get a bill passed looks likely to be broken. More delays mean lost momentum and rising odds that debate over the bill could linger into the tumult of the 2010 congressional election year.

– James Pethokoukis is a Reuters columnist. The views expressed are his own —

The playbook is getting pretty thin for the Obama White House and congressional Democrats. One big idea they had to pay for healthcare reform was by capping itemized tax deductions for upper-income taxpayers. But the charities and nonprofits who benefit from these deductions screamed to Capitol Hill, so that approach was shelved. Time for Plan B.

Then congressional Democrats considered removing or capping the tax-advantaged status of job-based healthcare benefits. These untaxed benefits mean workers pay very little of their healthcare expenses out of their own pockets, which, in turn, means they aren’t motivated to act like true, cost-conscious consumers.

— Peter J. Pitts is president of the Center for Medicine in the Public Interest and a former FDA associate commissioner. The views expressed are his own. –

On Thursday, as part of the Department of Homeland Security funding bill, the Senate voted to make us less secure by allowing Americans to purchase prescription drugs from Canada over the Internet. The measure is now headed to conference, where House and Senate lawmakers will hammer out a final piece of legislation.

When he introduced the measure to his fellow Senators, Louisiana Republican David Vitter described it as a “re-importation amendment.” And over the next few weeks, as lawmakers deliberate on this, you’re likely to hear that phrase quite a bit. Supporters of foreign drug importation believe that such wording makes this policy more palatable to the American public.

– Darrell West is vice president and director of governance studies at the Brookings Institution and the author of Digital Medicine: Health Care in the Internet Era. The views expressed are his own. —

It is not the first time Washington has been disconnected from the general public, but recent discussions over healthcare reform reveal a D.C. establishment fixated on arguments not central to the general public.

The air waves are filled with clashing claims over the so-called public option whereby Medicare would be expanded to include more Americans. Proponents claim this is the best way to cover most Americans currently without coverage and drive down costs by creating competition for private insurance companies.

– Peter Morici is a professor at the Smith School of Business, University of Maryland School, and the former Chief Economist at the U.S. International Trade Commission. The views expressed are his own. –

America’s healthcare system is broken, but President Obama inspires little confidence with his fix.

Healthcare absorbs 18 percent of GDP—about 50 percent more than in other wealthy countries. Prices are too high and are a terrible burden on jobs creation.