Walter Williams is my second favorite active economist, just behind Thomas Sowell. (I also like John Lott, Robert P. Murphy and Jennifer Roback Morse – see my blogroll for links) In a recent article, Williams takes a look at how well Sweden’s single-payer, socialized health-care system is working out for its customers. The productive Swedish taxpayer forks over a lot of money to the government. What do they get in return?

First, what is socialized medicine? (which we are moving toward, since porkulus passed)

1. Producers pay huge amounts of taxes to the government .
2. Low-achievers pay nothing, since they have no income.
3. When you want treatment, you have to get in line behind everyone else – especially behind special interest groups, such as people wanting sex-changes.
4. The taxation is compulsory, the treatment of patients is at the government’s discretion.

Williams begins his article by evaluating the UK’s National Health Service:

A recent study by David Green and Laura Casper, “Delay, Denial and Dilution,” written for the London-based Institute of Economic Affairs, concludes that the NHS health care services are just about the worst in the developed world. The head of the World Health Organization calculated that Britain has as many as 25,000 unnecessary cancer deaths a year because of under-provision of care. Twelve percent of specialists surveyed admitted refusing kidney dialysis to patients suffering from kidney failure because of limits on cash. Waiting lists for medical treatment have become so long that there are now “waiting lists” for the waiting list.

And then there’s Canada single-payer socialized system:

…after a Canadian has been referred to a specialist, the waiting list for gynecological surgery is four to 12 weeks, cataract removal 12 to 18 weeks, tonsillectomy three to 36 weeks and neurosurgery five to 30 weeks. Toronto-area hospitals, concerned about lawsuits, ask patients to sign a legal release accepting that while delays in treatment may jeopardize their health, they nevertheless hold the hospital blameless. Canadians have an option Britainers don’t: close proximity of American hospitals. In fact, the Canadian government spends over $1 billion each year for Canadians to receive medical treatment in our country.

The article cites Sven R. Larson, who recently completed the book “Lesson from Sweden’s Universal Health System: Tales from the Health-care Crypt,” published in the Journal of American Physicians and Surgeons (Spring 2008). The first thing about socialized health care is that you don’t pay for treatment like you shop at Wal-Mart. The government takes your money and makes sure that everyone is treated equally, regardless of each individual’s earned income and lifestyle choices.

Mr. D., a Gothenburg multiple sclerosis patient, was prescribed a new drug. His doctor’s request was denied because the drug was 33 percent more expensive than the older medicine. Mr. D. offered to pay for the medicine himself but was prevented from doing so. The bureaucrats said it would set a bad precedent and lead to unequal access to medicine.

When health care is free for consumers, demand increases. Doctors and drug companies stop producing since the government won’t let them make a profit. Since the government is the single-payer, then the only way to stop the shortage is to ration medical services, often based on leftist victim ideology. Socialists don’t trust you to make your own decisions about how you earn income or how you spend it.

Here’s a bit more from the article:

Malmo, with its 280,000 residents, is Sweden’s third-largest city. To see a physician, a patient must go to one of two local clinics before they can see a specialist. The clinics have security guards to keep patients from getting unruly as they wait hours to see a doctor. The guards also prevent new patients from entering the clinic when the waiting room is considered full. Uppsala, a city with 200,000 people, has only one specialist in mammography. Sweden’s National Cancer Foundation reports that in a few years most Swedish women will not have access to mammography.

Wow, that smacks of fascism! But that is where socialism inevitably leads. In Canada, you can’t even buy your own drugs and treatment, even if the government puts you on a waiting list (dying list?), or if it won’t pay for treatment at all. Private purchases of health care or medical drugs are illegal in Canada. (except for Quebec, oddly enough, because of a recent court decision).

The problem with a system in which low-risk producers pay for the services, but don’t use them while high-risk victims use the services, but don’t pay for them, is that there is no incentive for people to be healthy. As people act more and more recklessly, the government steps in and starts controlling their lives in order to reduce costs. Fascism.

Socialized medicine redistributes wealth in order to equalize the outcomes of good lifestyle choices and poor lifestyle choices. The more that lifestyles are equalized, the less personal responsibility there is among the citizens. Eventually, the government takes control of people’s lives to reduce costs. This article shows how it’s happening in Canada, as they try to ban trans fats:

A mammoth government program is a poor excuse for further encroachment on people’s lives–maybe fewer government entitlements would encourage smarter and healthier habits. If the ban is the sword of the nanny-state crusader, surely the health-care system represents his shield.

Freedom means deciding how much security to want, based on your own free choices and the risks you assume.

A useful podcast on health care and government, featuring Sally C. Pipes on the Dennis Prager show is here. For a good explanation of supply, demand and shortages, see this Von Mises Institute article.

UPDATE: Saw this UK Telegraph story on a single NHS hospital (H/T Stop the ACLU):

NHS managers were yesterday accused of putting targets and cost-cutting ahead of patients as a report into at Mid-Staffordshire Hospitals trust found up to 1,200 people may have died needlessly due to “appalling standards of care” at a single hospital.

…Last night patient groups voiced concern that managers who should have spotted failings at the trust but did not raise the alarm have been promoted to key jobs in the NHS and health care regulation.

…The investigation into care between 2005 and 2008 found overstretched and poorly trained nurses who turned off equipment because they did not know how to work it, newly qualified doctors left to care for patients recovering from surgery at night, patients left for hours in soiled bedclothes and reception staff expected to judge the seriousness of the condition of patients arriving at Accident and Emergency.

Doctors were diverted from seriously ill patients to treat ones with minor problems to make the trust look better because it was in danger of breaching the Government’s four-hour waiting time target.