The Health-Care Debate from Overseas

by Ronald Rychlak - September 11, 2009

Reprinted with permission.

Knowing that I had spent the summer in England, a fellow law professor recently asked me whether "the Republicans" had hired me to advertise against the president's health-care plan. My response was, "No, but they could have." I would have done it for free.

Watching the health-care debate from the other side of the Atlantic this summer was very interesting. First of all, British doctors do not like having their system held up as an example of what not to do. There were several panel discussions on television and the radio in which doctors defended the British medical plan; the only problem was that they were never very convincing.

My first encounter with the British health-care system came 18 years ago, when I first spent a summer teaching at Cambridge. With two young children, we had a couple of trips to the doctor. All went well, and had I been a resident of the UK, the treatment would have been free. In fact, there was some confusion within the office when we told them that we were Americans and were supposed to pay for the treatment. (We learned this time around that they no longer have any confusion when it comes to charging Americans.)

We lived next door to a nice family, the father of which was in need of a bypass operation. When his time came, I assumed he would have the procedure done for free – but he had already been waiting two years. Since he could not work due to his health, he had lost his job, and he was worried about both his house and his car. I knew right then that there was a serious problem with the British health-care system. (At least twice I've seen Americans go in for a checkup and be directly sent to the hospital for a bypass.)

This summer, swine flu was the big scare in England. One commentator described an easy test to determine whether you had swine flu: Imagine the worst flu symptoms you have ever had; then suppose you were on the street and you saw a £100 bill at your feet. If you decide that it is not worth bending over to pick it up, you have swine flu. That description made it all the more surprising when I heard an advertisement for a £140 swine-flu home-testing kit. I remember thinking that if I suspected I had swine flu, I would certainly see a doctor. That would be doubly true if I could see a doctor for free, and the home kit would cost me about $200.

With so many people concerned about swine flu, the government eventually set up a toll-free phone line to let people call in their symptoms and, assuming the person on the other end of the call confirmed a diagnosis, get a prescription. The demand for this service overwhelmed the phone lines, and the system crashed in the first hour. The really frightening thing, however, was that the disease, in most cases, would be diagnosed and treated at home without the patient ever seeing a doctor.

The hope of health-care reform is that we will be able to reduce costs so that we can increase care. Unfortunately, most government health-care plans don't do a very good job of cutting costs. They may shift around who pays, and they may delay or deny care to some people, but they do not reduce the real cost of health care. (As economist Thomas Sowell said: "The government won't lower the cost of health care; it just won't pay for it.")

Health care, as understood by the Catholic Church, is marked by a spirit of respect that disposes caregivers to deal with patients and their families with compassion and sensitivity to special needs. It is based on the person, not a bureaucracy. It is the very embodiment of the social doctrine of subsidiarity, with important decisions being made by those closest to the situation.

Supporters of health-care reform wonder why there is such discontent with the current proposals, but this idea of decisions being made by governmental officials far removed from the situation is what is really driving these protests. (It also happens to be what people like least about insurance companies and our current system.)

Certainly there are details to be worked out, but if we are trying to reduce costs and provide care to all who need it, why not look at the supply side? We could build more medical schools and produce many more health-care professionals. There are many bright, talented people in the United States who could fill classes in new medical schools. Those people could provide the kind of "hands-on" attention that is in keeping with Catholic teaching, and which we seem to crave. We can do that – or we can emulate the British, which will likely leave us with fewer health-care professionals and more government rationing.

Ronald J. Rychlak is the associate dean and MDLA Professor of Law at the University of Mississippi School of Law. He is the author of Hitler, the War, and the Pope (2000) and Righteous Gentiles (2005).