Atlantic Sentinel

Tag: Health Care

  • Progress on Harm Reduction in United States

    Manhattan New York
    Manhattan, New York at night, April 2, 2020 (Unsplash/Peter Olexa)

    A panel of external experts has advised the American Food and Drug Administration (FDA) to approve over-the-counter sales of naloxone nasal spray.

    Naloxone is an affordable and risk-free way to save drug users from an overdose. The spray costs $250 without insurance and prevents deaths from fentanyl, heroin and painkillers. Naloxone has no effect on people who are sober.

    Only 29 states allow pharmacists to sell naloxone without a prescription. Even in the states that allow over-the-counter sales, there isn’t enough of the stuff. A study published in The Lancet estimates that 1,270 more naloxone kits are needed for every 100,000 residents to avoid 80 percent of opioid overdose deaths. (more…)

  • Abolish the NHS

    St Thomas Hospital London England
    St Thomas’ Hospital in London, England, January 31, 2019 (iStock/Ray Lipscombe)

    Ambulance workers and nurses are planning to strike in England and Wales on Monday in what could become the largest walkout in the National Health Service’s history.

    Emergency care will still be provided, but planned operations and outpatient services are being postponed.

    Unions says nurses and paramedics are overworked and underpaid. They are demanding a 5 percent increase in wages over inflation, which is 14 percent. The governments of England and Wales have given an average of 4.75 percent with a guaranteed minimum income of £1,400 per month.

    Health workers deserve a raise, but this won’t solve the NHS’s many other problems. At some point Britain has to accept the NHS is the problem. (more…)

  • How Government Creates Shortages of Doctors

    Westmaas Netherlands doctors office
    Patients wait to see a general practitioner in Westmaas, the Netherlands (LHV)

    Rural France is running out of doctors. Politico Europe reports that 7 out of 68 million French citizens don’t have a referring general practitioner. 30 percent live in a region where access to physicians is poor.

    France is not alone. Small towns in the Netherlands and the United States are also medically underserved.

    Partly the shortage is due to young doctors and nurses preferring to live and work in cities, much like young professionals in general.

    Higher-than-usual burnout rates during the pandemic exacerbated the shortage.

    But government policy also plays a role. All three countries for years kept the supply of doctors low while demand for health care, as a result of longevity and advances in medicine, went up. (more…)

  • American Health Care Is Understaffed, Because It Is Overregulated

    New York ambulance
    Ambulance in Manhattan, New York, October 4, 2017 (Unsplash/Benjamin Voros)

    If coronavirus convinces more people our health-care systems need to be overhauled, it may be one of the few good outcomes of the pandemic.

    In the UK, the government-owned National Health Service has long underperformed relative to its rich-country peers. I wrote here in January that the pandemic has underscored the need for reform. If you subscribe to the Financial Times, also read Camilla Cavendish’s story from April about the hundreds of babies who died in English maternity wards between 2000 and 2019 from lack of care. This in the world’s fifth-largest economy!

    The Netherlands’ mixed public-private system is superior, but the country still has a shortage of nurses. It’s something I investigated for Wynia’s Week in December. What I found was that nursing associations, trade unions and researchers have been sounding the alarm for years, yet hospitals continue to underpay nurses and few give their workers the autonomy and flexibility they ask for. Probably because nursing was historically a part-time profession of unmarried women, and doctors and hospital administrators were historically older and male. That hierarchical culture (which I imagine exists in other countries as well) is hard to change, but it is slowly starting to. If you read Dutch, you can glean examples from my second story on the topic.

    In America, excessive licensing requirements and regulations have kept health care understaffed. Pro-market think tanks like the Cato Institute and Niskanen Center have been trying to draw attention to this. Even Vox, hardly a bastion of libertarianism, acknowledges that American health care is, in some ways, overregulated. (more…)

  • Pandemic Underscores Need for British Health Reform

    Bristol England hospital
    Royal Bristol Infirmary, England (Fotohaus)

    COVID-19 has overwhelmed all health-care systems, but few were as ill prepared as the British.

    The National Health Service (NHS) has almost 100,000 job openings, including close to 40,000 for nurses.

    The pandemic exacerbated the shortages; because doctors and nurses contracted the virus or quit in exhaustion while demand for health care went up.

    Nonessential procedures were delayed. To clear the backlog, and return to the maximum waiting time of eighteen (!) weeks for treatment, the NHS would need an extra 18,000 nurses on top of the 40,000 it is looking to hire anyway. (more…)

  • American Health Care Is Worst in Rich World

    Empire State Building New York
    The Empire State Building in Manhattan, New York behind the light of an emergency vehicle, June 9, 2016 (Unsplash/Dapo Oni)

    America has the worst health-care system of eleven rich nations.

    The Commonwealth Fund, a century-old foundation dedicated to improving health care, places the United States behind Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom in its latest report. The Netherlands and Norway share first place.

    America is the world’s top innovator of new medications and treatments. The best medical schools are in the United States. The country spends relatively more on preventative care than most. But this doesn’t outweigh its poor scores on the Commonwealth Fund’s other criteria: access to care, administrative efficiency, equity and outcomes.

    In practical terms, this means especially low-income Americans don’t get the health care they need, either because it’s too expensive, too complex or both. Preventable deaths, including infant and maternal mortality, are higher in the United States than in other wealthy countries. Life expectancy is lower.

    The Commonwealth Fund’s findings match those of the Euro Health Consumer Index, OECD, Peterson Center on Healthcare and Kaiser Family Foundation. All rank the United States below Australia, Canada and most countries in Europe. (more…)

  • Dutch Should Keep Health Care System They Have

    Leiden Netherlands hospital
    Leiden University Medical Center, the Netherlands (LUMC)

    Nearly all political parties in the Netherlands call for more government in health care.

    The far-left Socialists and Greens would replace private health insurers with public health funds. Labor would keep the insurance companies but take away their power to negotiate prices with health providers. The Christian Democrats and far-right Freedom Party want to end competition between hospitals. Even the center-right VVD believes liberalization has gone too far.

    I’m a member of the VVD, but on this point I disagree. (So I’m glad there are few concrete proposals to reverse liberalizations in the VVD’s manifesto.) The Dutch health-care system is one of the best in the world. In a column for Trouw, I challenge the parties that want to uproot it to point to a better example. If there isn’t one, let’s keep the system we have. (more…)

  • Coronavirus Puts Extra Stress on Russian Economy

    Saint Basil's Cathedral Moscow Russia
    Saint Basil’s Cathedral in Moscow, Russia at night (Unsplash/Ivan Lapyrin)

    The outbreak of coronavirus disease has put an additional stress on the Russian economy. It was already coping with a slump in oil prices.

    Russia has ample reserves to weather the storm, but average Russians could feel the pain. (more…)

  • The American Dream Could Use Some European Inspiration

    Copenhagen Denmark
    Cyclists in Copenhagen, Denmark (iStock/Leo Patrizi)

    One can tell two very different stories about the American economy.

    In one, growth is robust, unemployment is at its lowest in half a century and the stock market is booming. This is the story President Donald Trump likes to tell.

    In the other, two in five Americans would struggle (PDF) to come up with $400 in an emergency. One in three households are classified as “financially fragile“. Annie Lowrey writes in The Atlantic that American families are being “bled dry by landlords, hospital administrators, university bursars and child-care centers.” This is the story Bernie Sanders and the Democrats tell: for millions of Americans on seemingly decent middle incomes, life has become too hard.

    Sanders’ solution is to bring “democratic socialism” to America. He cites European countries like Denmark and Sweden as inspiration. They’re not bad places to imitate — but they have actually moved away from socialism and toward a mix of free markets and the welfare state. It is why they rank among the freest and most competitive (PDF) economies in the world.

    Americans can learn from the Scandinavian experience, if they get the balance right. (more…)

  • Britain’s Health Care Debate Is Broken

    St Thomas Hospital London England
    St Thomas’ Hospital in London, England, January 31, 2019 (iStock/Ray Lipscombe)

    When it was revealed last week that the British government had not ruled out giving American pharmaceutical companies more generous patent rights under a post-Brexit trade agreement with the United States, the opposition Labour Party was up in arms, accusing the ruling Conservatives of putting the National Health Service (NHS) “up for sale”.

    The Conservatives rushed to deny it.

    “The NHS is not on the table,” said Health Secretary Matt Hancock. “We are absolutely resolved that there will be no sale of the NHS, no privatization,” said Prime Minister Boris Johnson.

    The episode was emblematic of the British health care debate: Labour mischaracterizes any proposed change as a step toward privatization while the Conservatives, rather than make the case for choice and competition, try to convince voters they care about the NHS even more. (more…)

  • The Best Argument Against Medicare-for-All Is Not Cost

    Elizabeth Warren
    Democratic senator Elizabeth Warren of Massachusetts visits a high school in Des Moines, Iowa, October 21 (Phil Roeder)

    It’s worth asking how expensive nationalizing health insurance in the United States would be. I’ve told you before that cost estimates range from 13 to 21 percent of GDP, a difference of $1.7 trillion, or two-and-a-half times the Pentagon budget.

    Senator Elizabeth Warren puts her plan at the low end of spectrum, about $2 trillion per year (which would still mean a 50-percent increase in federal spending). Even journalists broadly sympathetic to Medicare-for-all doubt that’s realistic.

    I doubt it’s going to convince anyone. Medicare-for-all’s proponents are unlikely to change their minds even if they find out the cost isn’t manageable. Americans who oppose nationalizing health insurance are unlikely to come around even if it is.

    The questions most Americans will be asking are:

    • Would I pay more or less under Medicare-for-all?
    • Would my health care get better or worse? (more…)

  • Who Pays for Medicare-for-All?

    Elizabeth Warren
    Democratic senator Elizabeth Warren of Massachusetts visits a high school in Des Moines, Iowa, October 21 (Phil Roeder)

    Replacing private health insurance with a single-payer, government-run system is hugely unpopular in the United States, but that hasn’t convinced two of the Democrats’ three top-polling presidential candidates — Bernie Sanders and Elizabeth Warren — to back away from it.

    In the most recent televised debate, Warren, who is polling neck and neck with former vice president Joe Biden, couldn’t say how much “Medicare-for-all” would cost or who would pay for it. She has since promised to release a detailed plan.

    Sanders, to his credit, admitted it would require tax increases. But by how much, and for whom, he didn’t say.

    He can’t. Nationalizing health insurance for 327 million Americans is such a huge and complex undertaking that nobody knows how much it would cost.

    Which calls into question the wisdom of doing it at all. (more…)

  • Democrats Back Away from Abolishing Private Health Insurance

    Kamala Harris
    Democratic senator Kamala Harris of California listens during a meeting in Los Angeles, April 21, 2017 (Office of Senator Kamala Harris)

    Good news: Democratic presidential candidates are coming to their senses on health care.

    Senators Cory Booker, Kirstin Gillibrand and Kamala Harris have all backed away from abolishing private health insurance in favor of Medicare-for-all.

    Even Senator Elizabeth Warren has given herself wiggle room, saying “there are a lot of different pathways” to achieving universal coverage.

    The exception is Bernie Sanders, the author of Medicare-for-all and a self-declared democratic socialist. (more…)

  • Democrats Are Not Talking to Swing Voters

    Bernie Sanders
    Vermont senator Bernie Sanders gives a speech in Manchester, New Hampshire, October 30, 2015 (Michael Vadon)

    Imagine you’re an American swing voter and you listened Tuesday and Wednesday night to the twenty Democrats vying for their party’s presidential nomination. What did you hear?

    • Three of the four highest-polling candidates want to abolish private health insurance and replace it with a single government program.
    • Virtually all candidates would decriminalize illegal entry into the United States and all of them praised immigration.
    • Many would give free health care to undocumented immigrants.
    • Some, like Bernie Sanders, would even give them a free college education.

    This is not a winning program. (more…)

  • Abolishing Private Health Insurance Is Bad Policy for Democrats

    Kamala Harris
    Democratic senator Kamala Harris of California listens during a meeting in Los Angeles, April 21, 2017 (Office of Senator Kamala Harris)

    Four of the Democrats running for their party’s presidential nomination committed to replacing private health insurance with a government-run system in debates this week: Senators Kamala Harris of California, Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts as well as Mayor Bill de Blasio of New York.

    Harris later maintained she had misheard the question and supports Medicare-for-all with supplemental private insurance.

    She, as well as Sanders and Warren, stand a real chance of becoming the nominee (de Blasio is a long shot), so it’s worth pointing out why abolishing private health insurance is such bad policy for Democrats. (more…)