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Health

The People Cheering Brian Thompson’s Murder Can’t Have the Medical Utopia That They Want

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9 minute read

Whether private or public, third-party payment for health care is a huge problem.

Evoking a collective scream of despair from socialists and anti-corporate types, police in Pennsylvania arrested Luigi Mangione, a suspect in the murder of UnitedHealthcare CEO Brian Thompson. Thompson, they insist, stood in the way of the sort of health care they think they deserve and shooting him down on the street was some sort of bloody-minded strike for justice.

The assassin’s fans—and the legal system has yet to convict anybody for the crime—are moral degenerates. But they’re also dreaming, if they think insurance executives like Thompson are all that stands between them and their visions of a single-payer medical system that satisfies every desire. While there is a lot wrong with the main way health care is paid for and delivered in the U.S., what the haters want is probably not achievable, and the means many of them prefer would make things worse.

“Unlimited Care…Free of Charge”

“It is an old joke among health policy wonks that what the American people really want from health care reform is unlimited care, from the doctor of their choice, with no wait, free of charge,” Michael Tanner, then of the Cato Institute, quipped in 2017.

The problem, no matter how health care is delivered, is that it requires labor, time, and resources that are available in finite supply. Somebody must decide how to allocate medications, treatments, physicians, and hospital beds, and how to pay for it all. A common assumption in some circles is that Americans ration medicine by price, handing an advantage to the wealthy and sticking it to the poor.

“Today, as everyone knows, health care in the US can be prohibitively expensive even for people who have insurance,” Dylan Scott sniffed this week at Vox.

The alternative, supposedly, is one where health care is “universal,” with bills paid by government so everybody has access to care. Except, most Americans rely on somebody else to pay the bulk of their medical bills just like Canadians, Germans, and Britons. And while there are huge differences among the systems presented as alternatives to the one in the U.S., third-party payers—whether governments or insurance companies—do enormous damage to the provision of health care.

Third-Party Payers, Both Public and Private, Raise Costs

“Contrary to ‘conventional wisdom,’ health insurance—private or otherwise—does not make health care more affordable,” Jeffrey Singer, a surgeon and senior fellow with the Cato Institute, wrote in 2013. “The third party payment system is the principal force behind health care price inflation.”

In the U.S., the dominance of third-party payment, whether Thompson’s UnitedHealthcare, one of its competitors, Medicare, Medicaid, or something else, makes it difficult to know the price for procedures, medicines, and treatments—because there really isn’t one price when third-party payers are involved.

Several years ago, the first Trump administration required hospitals to publish prices for services. My local hospital offers an Excel spreadsheet with wildly varying prices for procedures and services, from different categories of self-pay, Medicare, Medicaid, and negotiated rates for competing insurance plans.

“A colonoscopy might cost you or your insurer a few hundred dollars—or several thousand, depending on which hospital or insurer you use,” NPR’s Julie Appleby pointed out in 2021.

That said, savvy patients paying their own bills can usually get a lower price than that paid by insurance.

“When government, lawyers, or third party insurance is responsible for paying the bills, consumers have no incentive to control costs,” Arthur Laffer, Donna Arduin, and Wayne Winegarden wrote in the 2009 paper, The Prognosis for National Health Insurance. After all, the premium or tax is already paid, right?

Other Countries Struggle With Similar Issues

Concerns about rising costs, demand, and finite resources apply just as much when the payer is the government.

“State health insurance patients are struggling to see their doctors towards the end of every quarter, while privately insured patients get easy access,” Germany’s Deutsche Welle reported in 2018. “The researchers traced the phenomenon to Germany’s ‘budget’ system, which means that state health insurance companies only reimburse the full cost of certain treatments up to a particular number of patients or a particular monetary value.” Budgeting is quarterly, and once it’s exhausted, that’s it.

Last year in the U.K., a Healthwatch report complained: “We’re seeing a two-tier system emerge, where healthcare is accessible only to those who can afford it, with one in seven people who responded to our poll advised to seek private care by NHS [National Health Service] staff.” Britain’s NHS remains popular, but it has long struggled with the demand and expense for cancer care and other expensive treatments.

And Canada’s single-payer system famously relies heavily on long wait times to ration care. “In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment,” the Fraser Institute found last year. “This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.”

You have to wonder what those so furious at Brian Thompson that they would applaud his murder would say about the officials managing systems elsewhere. None of them deliver “unlimited care, from the doctor of their choice, with no wait, free of charge.” Some lack the minimal discipline imposed by what competition exists among insurers in the U.S.

We Need Less Government Involvement in Medicine

“Policymakers need to understand that the key to ‘affordable health care’ is not to increase the role of health insurance in peoples’ lives, but to diminish it,” Cato’s Singer concluded.

My family found that true when we contracted with a primary care practice that refuses insurance. We pay fixed annual fees, which includes exams, laboratory services, and some procedures. My doctor caught my atrial fibrillation when he walked me across his clinic hall on a hunch to run an EKG.

The Surgery Center of Oklahoma famously follows a similar model for much more than primary care. It publishes its prices, which don’t include the overhead and uncertainty of dealing with third-party payers.

Those examples point to a better health care system than what exists in the United States—or in most other countries, for that matter. They’re probably not the whole answer, because it’s unlikely that one approach will suit millions of people with different medical concerns, incomes, and preferences. But making people more, rather than less, responsible for their own health care, and getting government and other third-parties as far out of the matter as possible, is far better than cheering the murder of people who supposedly stand between us and an imaginary medical utopia.

Business

Cutting Red Tape Could Help Solve Canada’s Doctor Crisis

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From the Frontier Centre for Public Policy

By Ian Madsen

Doctors waste millions of hours on useless admin. It’s enough to end Canada’s doctor shortage. Ian Madsen says slashing red tape, not just recruiting, is the fastest fix for the clogged system.

Doctors spend more time on paperwork than on patients and that’s fueling Canada’s health care wait lists

Canada doesn’t just lack doctors—it squanders the ones it has. Mountains of paperwork and pointless admin chew up tens of millions of physician hours every year, time that could erase the so-called shortage and slash wait lists if freed for patient care.

Recruiting more doctors helps, but the fastest cure for our sick system is cutting the bureaucracy that strangles the ones already here.

The Canadian Medical Association found that unnecessary non-patient work consumes millions of hours annually. That’s the equivalent of 50.5 million patient visits, enough to give every Canadian at least one appointment and likely erase the physician shortage. Meanwhile, the Canadian Institute for Health Information estimates more than six million Canadians don’t even have a family doctor. That’s roughly one in six of us.

And it’s not just patients who feel the shortage—doctors themselves are paying the price. Endless forms don’t just waste time; they drive doctors out of the profession. Burned out and frustrated, many cut their hours or leave entirely. And the foreign doctors that health authorities are trying to recruit? They might think twice once they discover how much time Canadian physicians spend on paperwork that adds nothing to patient care.

But freeing doctors from forms isn’t as simple as shredding them. Someone has to build systems that reduce, rather than add to, the workload. And that’s where things get tricky. Trimming red tape usually means more Information Technology (IT), and big software projects have a well-earned reputation for spiralling in cost.

Bent Flyvbjerg, the global guru of project disasters, and his colleagues examined more than 5,000 IT projects in a 2022 study. They found outcomes didn’t follow a neat bell curve but a “power-law” distribution, meaning costs don’t just rise steadily, they explode in a fat tail of nasty surprises as variables multiply.

Oxford University and McKinsey offered equally bleak news. Their joint study concluded: “On average, large IT projects run 45 per cent over budget and seven per cent over time while delivering 56 per cent less value than predicted.” If that sounds familiar, it should. Canada’s Phoenix federal payroll fiasco—the payroll software introduced by Ottawa that left tens of thousands of federal workers underpaid or unpaid—is a cautionary tale etched into the national memory.

The lesson isn’t to avoid technology, but to get it right. Canada can’t sidestep the digital route. The question is whether we adapt what others have built or design our own. One option is borrowing from the U.S. or U.K., where electronic health record (EHR) systems (the digital patient files used by doctors and hospitals) are already in place. Both countries have had headaches with their systems, thanks to legal and regulatory differences. But there are signs of progress.

The U.K. is experimenting with artificial intelligence to lighten the administrative load, and a joint U.K.-U.S. study gives a glimpse of what’s possible:

“… AI technologies such as Robotic Process Automation (RPA), predictive analytics, and Natural Language Processing (NLP) are transforming health care administration. RPA and AI-driven software applications are revolutionizing health care administration by automating routine tasks such as appointment scheduling, billing, and documentation. By handling repetitive, rule-based tasks with speed and accuracy, these technologies minimize errors, reduce administrative burden, and enhance overall operational efficiency.”

For patients, that could mean fewer missed referrals, faster follow-up calls and less time waiting for paperwork to clear before treatment. Still, even the best tools come with limits. Systems differ, and customization will drive up costs. But medicine is medicine, and AI tools can bridge more gaps than you might think.

Run the math. If each “freed” patient visit is worth just $20—a conservative figure for the value of a basic appointment—the payoff could hit $1 billion in a single year.

Updating costs would continue, but that’s still cheap compared to the human and financial toll of endless wait lists. Cost-sharing between provinces, Ottawa, municipalities and even doctors themselves could spread the risk. Competitive bidding, with honest budgets and realistic timelines, is non-negotiable if we want to dodge another Phoenix-sized fiasco.

The alternative—clinging to our current dysfunctional patchwork of physician information systems—isn’t really an option. It means more frustrated doctors walking away, fewer new ones coming in, and Canadians left to languish on wait lists that grow ever longer.

And that’s not health care—it’s managed decline.

Ian Madsen is a senior policy analyst at the Frontier Centre for Public Policy.

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Addictions

BC premier admits decriminalizing drugs was ‘not the right policy’

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From LifeSiteNews

By Anthony Murdoch

Premier David Eby acknowledged that British Columbia’s liberal policy on hard drugs ‘became was a permissive structure that … resulted in really unhappy consequences.’

The Premier of Canada’s most drug-permissive province admitted that allowing the decriminalization of hard drugs in British Columbia via a federal pilot program was a mistake.

Speaking at a luncheon organized by the Urban Development Institute last week in Vancouver, British Columbia, Premier David Eby said, “I was wrong … it was not the right policy.”

Eby said that allowing hard drug users not to be fined for possession was “not the right policy.

“What it became was a permissive structure that … resulted in really unhappy consequences,” he noted, as captured by Western Standard’s Jarryd Jäger.

LifeSiteNews reported that the British Columbia government decided to stop a so-called “safe supply” free drug program in light of a report revealing many of the hard drugs distributed via pharmacies were resold on the black market.

Last year, the Liberal government was forced to end a three-year drug decriminalizing experiment, the brainchild of former Prime Minister Justin Trudeau’s government, in British Columbia that allowed people to have small amounts of cocaine and other hard drugs. However, public complaints about social disorder went through the roof during the experiment.

This is not the first time that Eby has admitted he was wrong.

Trudeau’s loose drug initiatives were deemed such a disaster in British Columbia that Eby’s government asked Trudeau to re-criminalize narcotic use in public spaces, a request that was granted.

Records show that the Liberal government has spent approximately $820 million from 2017 to 2022 on its Canadian Drugs and Substances Strategy. However, even Canada’s own Department of Health in a 2023 report admitted that the Liberals’ drug program only had “minimal” results.

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