The title of Colin Gunn’s new film comes from a quip by humorist P. J. O’Rourke: “If you think health care is expensive now, wait until it’s free.”
The United States has the highest per capita health care cost in the world, and Gunn asks, “Why is it so expensive?” This documentary is an attempt to answer that question and suggest what we can do about it.
$88 for Gauze Pads
By way of introduction, we meet two individuals who were almost ruined by health care costs. Jeff, a farmer and a pastor, had a daughter born with spina bifida. His cost was $300,000. Roger, a builder, experienced panic attacks and a taste of cilantro in his mouth—symptoms of seizures in the brain. His cost was $70,000.
Neither man, both self-employed, had health insurance to defray those costs. It all had to come out of their own pockets. Why? Because it’s too expensive, says Gunn, adding that he himself pays $20,000 a year to insure his family.
In any other industry, some of what hospitals do to patients would be called price gouging. Gunn found a hospital that charged a patient $88 for a little box of gauze pads that costs about a dollar at your local pharmacy.
There is no “price transparency” at hospitals: the patient has no real idea of what any procedure or medicine will cost. The uninsured, the self-payers, Gunn says, wind up paying the highest costs for everything: “The least able pay the most.”
Digging into history, Gunn finds that health care costs the average American family, just a generation ago, 5 percent of its yearly income. Now it’s 16 percent—with 45 cents of every dollar going to the government.
How Did We Get Here?
“The American [healthcare] system is barely capitalist at all,” he charges—and goes on to prove his point.
When President Franklin Roosevelt froze wages during World War II, employers made it up to their employees by providing company-paid health insurance plans. That was the beginning.
In 1965 the federal government brought in Medicare and Medicaid. HMOs, prepaid health coverage, came along in 1973.
“Hillarycare,” President Clinton’s ambitious stab at a federal takeover of the healthcare industry, was rejected by Congress in 1993; but many of its provisions have found their way, incrementally, into law since then.
And of course the climax, so far, came in 2010 with the passage of the grossly misnamed “Affordable Care Act,” aka Obamacare—an 11 million-word legislative monstrosity with the goal, says Gunn, of creating “single-payer” health care: a euphemism for leaving the federal government as the only payer. Meanwhile, lobbyists and their partners in Congress have continually changed the ground rules so that “crony capitalists” friendly to the Obama regime rake in enormous profits at the American people’s expense.
It’s Even Worse Over There
I was afraid this film would bombard me with facts and figures until I went all glassy-eyed and couldn’t take it in. But Gunn is too good a documentarian to let that happen.
Instead, he shifts his focus to the United Kingdom, where the National Health Service (NHS), aka socialized medicine, reigns supreme. This look at the NHS begins with a visit to the city of Glasgow in Gunn’s own native land of Scotland.
[Editor’s Note: As an aside, in September 2014, Scottish voters narrowly defeated a proposal for Scotland’s independence. Among the major motivations of the independence movement was Parliament’s proposed cuts to the NHS, which is running out of money. Scottish independence leaders advocated a separate NHS for Scotland which would not be cut, but rather increased.]
Obamacare, says Gunn, is already pushing Americans down the same trail of tears already opened by the NHS. The doctor-patient relationship, he charges, has been hurt. Many doctors have chosen to retire early—even though it takes eleven years, on the average, to become a full-fledged doctor: eleven years of working long, hard hours for little or no pay. Obamacare has forced doctors to convert their medical records to an all-electronic system—at an average cost of $50,000 per doctor.
“This law will be remembered,” says Gunn, “for the damage it has done.”
Meanwhile, in Glasgow, “free” healthcare has fostered “a binge-drinking culture” that has lowered the male life expectancy to only fifty-five years, says Gunn. But “the propaganda still works,” and people see the NHS as “free money from the government.” The perception that “no one pays”—the NHS is only “free” in the sense that it’s entirely funded by taxes—has made the NHS something of a sacred cow. “The British people worship it,” says one embittered doctor.
Behind the screen of propaganda, all is not well. The “defects [are] absolutely startling,” a government investigation found. “The most basic standards of [hospital] care were not observed,” and “shocking cases of neglect, almost cruelty,” were found to be rampant among UK hospitals—all against a backdrop of “upbeat, almost relentless propaganda.”
If I remember nothing else about this film, I will never be able to forget its examination of the now-infamous “Liverpool Care Pathway.”
It should have been called the Non-care Pathway, for it established a protocol of systematically removing from hospital patients all food, water, and medicine, subjecting patients to a slow euthanasia—for which participating hospitals received some twelve million pounds from the government for meeting “cost quotas.” Gunn shows us a British newspaper headline that proclaimed that, following the Liverpool Care Pathway, the NHS killed off 130,000 elderly hospital patients in a single year. It would seem that during the heyday of the Pathway, every British hospital patient was a potential Terry Schiavo.
There will be healthcare rationing along those same lines in America under Obamacare, says Gunn, as soon as the government runs out of money. All we need to remember is that the “death panels,” so derided by defenders of Obamacare, will be called “independent advisory boards”—bureaucrats who will decide when a patient is not worthy of continued care.
Not wishing to leave his audience with a case of the horrors, Gunn goes on to present viable alternatives to America’s maimed healthcare system: “The good news is that the antidote is right here before us.”
“Price honesty,” the practice of posting firm prices on the Internet so that the patient knows what he is going to pay before having to make a decision, has already worked out well for some doctors and medical groups. Reported one surprised physician, “Canadians were traveling to Oklahoma City to pay cash for medical procedures.” Canada is another country with more-or-less socialized medicine.
Paying with cash instead of insurance is another part of the antidote, says Gunn. It not only “helps to restore the doctor-patient relationship,” but also eliminates the costly (to both doctor and patient) paperwork required when the government and insurance companies are involved.
Physicians can also promote and encourage “individual responsibility in health.” Says Gunn, “Seventy-five percent of healthcare costs are preventable, because it’s linked to lifestyle choices” like smoking, overeating, not getting enough exercise, etc. As it is, he adds, our current healthcare system “actually subsidizes” bad choices.
Another way to reform the system would be to let families, not the government, take care of elderly members. Gunn, who has eight children with a ninth on the way, quips, “So maybe my super-expensive family will pay off, after all.”
Then there are free volunteer clinics to serve the poor, funded by churches, civil groups, and individual charity. “Use your own funds, your own time, your own efforts to help others.” This is set firmly in the Biblical tradition of voluntarily helping the poor—a moral duty which too many of us have delegated to impersonal government bureaucracies.
Finally, we are introduced to Samaritan Ministries (see their website, http://samaritanministries.org... ), a cost-sharing group whose members make monthly payments for the care they need: “a Biblical, non-insurance approach to health care needs.” “You can trust God with your health care, too,” proclaims the website.
The great thing about this documentary is, it’s never dull. Seasoned with humor, with vintage TV clips from “The Price is Right” and other shows, with here and there a skit serving as a parable, and concentrating on lively interviews with real people, patients and doctors, who have grappled with real problems in the healthcare system and already (some of them) experienced some of the benefits of the alternatives, Gunn’s fast tempo holds the viewers’ interest.