Progress Illinois

The fight to pass to meaningful health care reform in Washington will ultimately depend on persuading moderate Democrats such as Reps. Melissa Bean and Bill Foster while also enlisting strong support for a public option from progressive members like Phil Hare.  Nonetheless, we're going to continue to keep an eye on how the Republican delegation frames this fight (and affects public opinion) on the local airwaves here in Illinois.

During an appearance on Fox Chicago Sunday last weekend, Rep. Peter Roskam argued that a public plan will lead to a "Canadian-style system if we go in this direction." Rep. Mark Kirk -- the author of a GOP alternative to President Obama's preferred plan -- issued a similar warning on WLS' Don Wade and Roma last Thursday, suggesting that the nation couldn't afford to pay for a comprehensive overhaul and that care will be restricted when the government inevitably "runs out of money."  Kirk also compares outcomes in the United Kingdom and Canada with America's current system and says the U.S. scores better on one crucial metric. Listen here:

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KIRK: But now that I’ve spent four solid months on this, there’s even one more important issue, which is: Is the system generating a greater chance for you to life or die when you’re really sick? Looking at cancer survival rates, according to The Lancet … you have a 54 percent chance of surviving cancer in the U.K., and you have a 63 percent chance in the U.S. We have huge delays for medical care in Canada and the U.S. and many due die in the wait. And if we socialize medicine -- many Canadians when they are denied care, they come here. But if we socialize medicine in the U.S., where do we go?

This type of criticisms mirror those made by the giant insurance companies ( who, for obvious reasons, are committed to protecting the status quo). For instance, in an email sent to all of its customers yesterday, Blue Cross and Blue Shield of Illinois warned that a new government-run health insurance plan would "severely damage the current employer-based system" and "cause employers to lose any ability to manage the costs of coverage."

But when deriding the reform principles favored by Democrats, Kirk, Roskam, and the insurers omit some crucial details.

For one, none of the major Democratic proposals resemble anything like the systems in Britain (which employs most doctors) or Canada (where the government insures everybody directly).  If the Democratic Congress passes health care legislation, it will be a hybrid system where private insurers will (theoretically) compete with a public plan.

Secondly, Kirk's emphasis on waiting times is misleading. While it's true that people in nations like Canada, France, and the Netherlands do wait longer than Americans for non-elective surgeries, there’s little evidence suggesting that those delays lead to less effective care. All people in those countries have affordable access to a specialist, too. Meanwhile, in America, our waiting times are hidden and our "rationing" is class-based. Ezra Klein dug into the statistics about 18 months ago:

In just the past year, a full 25 percent of us didn't visit the doctor when sick because we couldn't afford it. Twenty-three percent skipped a test, treatment, or follow-up recommended by a doctor. Another 23 percent didn't fill a prescription. No other country is even close to this sort of income-based rationing. In Canada, only 4 percent skipped a doctor's visit, and only 5 percent skipped care. In the U.K., those numbers are 2 percent and 3 percent. Few of our countrymen are waiting for the care they need, that much is true. But that doesn't mean they're getting it quickly. Rather, about a quarter of us aren't getting it at all.

Kirk's emphasis on cancer survival rates is also a convenient talking point, but it's not the most enlightening metric by which to judge the U.S. system. Writing in the Boston Globe this weekend, Jonathan Cohn points out that America's unparalleled success at treating cancer is partly a product of the "unparalleled amount of government-funded research in the U.S." (emphasis added).  Any health reform bill that passes Congress won't limit that funding.

Cohn also points out that the U.S. does not compare as well in its treatment of other life-or-death ailments. He highlights data measuring “potential years of lives lost," which are compiled by specialists in an effort to measure how well health care systems perform. The results here in America aren't so stellar:

In a 2003 ranking of 20 advanced countries, the US finished 16th when it came to “mortality amenable to healthcare,” another statistic that strives to capture the impact of a health system. The Dutch were 11th and the French were fifth. These statistics are necessarily crude; diet, culture, and many other factors inevitably affect the results. But, taken together, they make it awfully hard to argue that care in these countries is somehow inferior. If anything, the opposite would seem to be true.