Universal healthcare and the first lesson of politics 

Pictured is the Democratic presidential debate candidates in Houston. The appeasement of a ruthlessly progressive primary constituency is proving more alluring than the desire to improve the country by proposing practical solutions, the intended and unintended consequences of which have been thoroughly considered.  Photo by David J. Phillip/AP

Pictured is the Democratic presidential debate candidates in Houston. The appeasement of a ruthlessly progressive primary constituency is proving more alluring than the desire to improve the country by proposing practical solutions, the intended and unintended consequences of which have been thoroughly considered. Photo by David J. Phillip/AP

One thing is very clear following the Democratic presidential debates in Houston last week: Our leaders are far more interested in vying for the nomination than in proposing solutions that will actually help people. The appeasement of a ruthlessly progressive primary constituency is proving more alluring than the desire to improve the country by proposing practical solutions, the intended and unintended consequences of which have been thoroughly considered. The most prominent example of this failure in leadership is the promise of universal healthcare. 

From listening to these candidates, you’d believe that Canada has implemented something remarkably transcendent: A healthcare system in which medical professionals work around the clock for free, all patients receive adequate treatment immediately and a finite quantity of resources is capable of satisfying an infinite number of demands. Predictably, the boundless praise mouthed by our leaders does not correlate with the evidence.   

The average wait time to see a specialist after referral from a general practitioner in Canada is 20 weeks. In order to avoid such dangerous wait times, 323,700 Canadian “medical tourists” traveled to the U.S. last year to receive treatment. Why forgo free healthcare? Aside from the obvious risks of worsening conditions resultant from prolonged waiting, the sitting around in line costs money—$1,924 CND per capita last year ($2.1 billion CND in total). Additionally, the Canadian healthcare system is undersupplied in relation to the U.S. healthcare system: Canada has fewer than 16 CT scanners per million people; America triples that supply. Further, in 2018, Canada could not provide more than three doctors and three beds for every 1,000 residents. 

So why is “free” healthcare so undersupplied and inadequate that Canadians would rather travel to America for more expensive treatment than wait it out up north? Under a universal system, you can only have affordability or quality, not both. If you want treatment with no out-of-pocket expense, then that’s possible provided that you’re willing to sacrifice quality care and immediate availability. If you want quality and immediate care, then you have to pay for it. But this truth is uninteresting to our leaders.  

While universal healthcare may be free up front, the people pay for it with exorbitantly high tax rates and in lost income resultant from extended waiting periods during which they’re unable to work.

As Thomas Sowell aptly explains, “The first lesson of economics is scarcity: There is never enough of anything to satisfy all those who want it. The first lesson of politics is to disregard the first lesson of economics.” 

While universal healthcare may be free up front, the people pay for it with exorbitantly high tax rates and in lost income resultant from extended waiting periods during which they’re unable to work. Further, the eradication of prices produces insatiable demand which cannot be met with adequate supply, resulting in decreased quality of care when the patient’s number is finally called. In other words, folks wait an outrageous amount of time for “free” treatment and it’s subpar when they finally get it. But this is hogwash to our leaders. The voters don’t want to hear why they can’t have something they want. So don’t tell them no. Simply declare commodities rights and then all of the components that make them scarce magically go away. 

While our politicians refuse to, the U.S. healthcare system indulges the laws of supply and demand. This is why our system is of higher quality in relation to Canada and arguably more affordable in some cases. The freedom of market forces to act ensures that those who need healthcare the most receive the best available treatment. Undoubtedly, our system is imperfect. Some Americans do not receive as much as we want for them. But this is true of single-payer systems as well, and to a worse extent. The goal is to evolve a system in which this is the case for as few people as possible.  

If we actually want better quality care at cheaper prices over time, then we have to foster competition within a market-based system designed to incentivize the production of more of what we need, namely more doctors and resources with greater skills and efficiency. You cannot simply declare the product of these inputs a right and expect that it’ll manifest to fulfill this new role. Nationalizing the system and abolishing the private plans of 160 million Americans will not guarantee high quality healthcare for every citizen. It will instead subject them to lower quality of care with less availability under an exhausted system wrought with demand it can’t meet. In other words, this pie in the sky promise will serve only to hurt the very people it’s designed to help. But the first lesson of politics applies: Don’t tell the voters that.  


Kevin Catapano is a weekly columnist for The Daily Campus. He can be reached via email at kevin.catapano@uconn.edu.