Why Universal Healthcare Is Doomed to Failure in America

The reason can be summed up in one word – mindset. The case of Charlie Gard may be a classic example of the difference between the American mindset and the mindset in UK.

Charlie Gard, an 11-month-old infant with a rare genetic condition and brain damage, is considered terminal by doctors in the UK. They want to disconnect life-support. Charlie’s parents have already fought with the doctors and gone to court. They have lost.

According to a report at Fox News, “Parents in Britain do not have the absolute right to make decisions for their children. It is normal for courts to intervene when parents and doctors disagree on the treatment of a child. The rights of the child take primacy, with the courts weighing issues such as whether a child is suffering and how much benefit a proposed treatment might produce.”

That is in stark contrast with the American system which sees death as the enemy to be conquered at any cost in terms of suffering or money. With that mindset, universal healthcare would soon eat up the entire economy.

As medical science continues to improve, we will be seeing more options costing more money with diminishing returns. I do not want to be the one deciding how much a human life is worth. Nor do I want to be the one deciding which person should die so that another can live. However, I do want to be in the conversation.

Consider the cost of end-of-life care. In 2010, CBS News updated a story it originally reported in 2009. “Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives. That’s more than the budget for the Department of Homeland Security, or the Department of Education. And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked.”

In that same CBS News article, Dr. Elliott Fisher, a researcher at the Dartmouth Institute for Health Policy, studied Medicare records for patients in the last two months of their lives. According to Dr. Fisher, “I think 30 percent of hospital stays in the United States are probably unnecessary given what our research looks like.” Patients were admitted to the hospital so that doctors and hospitals could get paid for a higher volume of patients. Efficiency is the key. If you are being compensated for hospital admissions and doing procedures, then having patients concentrated in hospitals makes sense.

How much are we willing to pay for a sick child? What about an aging adult? Who decides? In the Los Angeles Times, Soumya Karlamangla reported “one child’s medical expenses in 2014 totaled $21 million — a bill covered entirely by Medi-Cal, the state’s version of Medicaid.” Would that expense have been covered in the UK? Or, would the doctors and courts have decided, as in the case of Charlie Gard, that the procedures were not worth the benefit?

Whether we are talking about dying children or seniors, we are being faced with tough decisions. Which conditions should be treated? Which treatments should be covered? How much should we spend?

I frequently see the idea that Americans should have universal health coverage like most first world countries. Before we can do that we must change the American mindset. Death is part of life. Death is not the enemy. There are limits to how much we can spend. Once we adopt that mindset, we can begin the process of facing the tough decisions.