The Olasky Interview - Sally Pipes

NICK EICHER, HOST: Today is Tuesday, August 11th. Thank you for turning to WORLD Radio to help start your day. 

Good morning. I’m Nick Eicher.

MARY REICHARD, HOST: And I’m Mary Reichard. Coming next on The World and Everything in It: The Olasky Interview. Today, a conversation with health care analyst Sally Pipes. 

She is president of a free-market think tank in California, the Pacific Research Institute. Most recently, she wrote False Premise, False Promise: The Disastrous Reality of Medicare for All.

EICHER: In this excerpt, Pipes talks about some of the current problems facing American healthcare and what other countries’ failures can teach us.

MARVIN OLASKY, EDITOR IN CHIEF: More than 40 percent of physicians say they’re burned out. More than half of doctors point to bureaucratic tasks as a big contributor to burnout. So, doctors seem to want to change something of what we have right now.

SALLY PIPES: Well I think, we don’t have competition of choice. And when Obamacare came into being—which is almost ten years ago now—the whole idea of electronic health records was pushed on doctors. All of the mandates, the regulations, it’s become very burdensome for doctors and doctors don’t like it. I know my own OBGYN retired at the end of January, just couldn’t take it anymore. 

The American Medical Association at their annual meeting: 47 percent of people polled there said they supported single-payer compared to 53 percent who didn’t. But we’re seeing a lot of support among the medical community. And I think many of them don’t realize, they think well, you know that they would have just one person to pay them, that would be the government. And they don’t understand that in Canada where I’m from, each Provincial government is the payer. Doctors are private contractors, and as my cousin who’s an ophthalmologist in Vancouver says, if American doctors that the government’s going to pay you quickly and efficiently and for whatever procedures you do, they should think again. 

And in Canada last year, the average wait from seeing a primary care doctor to getting treatment by a specialist was 20.9 weeks. That’s over 5 months. Which is much greater than the 9.3 week wait back in 1993 when the Fraser Institute started counting these wait times. So you know it’s, the American people, it’s not only the doctors that are going to be upset by what happens. Patients in this country would also face long waits because there would be too much demand, not enough supply and therefore waits would happen. Just like in the UK and in Canada. In the UK this year, to date, over 4 million Brits are on a waiting list under the National Health Service in order to get treatment. It’s a terrible system and care has to be rationed. So the older you are, the less likely you’re going to get timely care.

My own mother died in Canada in Vancouver from metastasized colon cancer. Because when she thought she had a problem and went to her primary care doctor, called the general practitioner in Canada, she had an x-ray and he said you don’t have colon cancer. And I said, you don’t detect colon cancer with an x-ray, you need a colonoscopy. And when she went back to him he said, well I’m sorry but there are too many younger people with issues and so you can’t have a colonoscopy.  

When 6 months later, when she had lost 30 pounds and was hemorrhaging, she went to the hospital in an ambulance, two days in the emergency room, two days in the transit lounge waiting for a bed in a ward. She got her colonoscopy, but died two weeks later from metastasized colon cancer. You can ration care and it harms patients. 

OLASKY: Right. No, I’m sorry to hear that about your mom. And I’ve certainly seen, I’ve done some reporting from Cuba, and I’m not puzzled by the general population wanting Medicare for All. Because if people are told free, people don’t know much about it, that all sounds great. What’s puzzling me still is among physicians. 

PIPES: Well, first of all, the American Medical Association only represents about 20 percent of doctors. With the change in medicine, a lot of women want to have a regular life. And so they want to work a limited number of hours, they want to be able to know what money they’re making. And so a lot of women doctors, particularly primary care docs, support the idea of Medicare for All. They see it as a way to sort of regulate their lives. 

You know we don’t have a free market healthcare system in this country. 50 percent of healthcare is in government, whether it’s through medicaid for our seniors, medicaid for our low income people, the CHIP program for children. So you know, there are problems with the American healthcare system. We need to bring about competition in choice. Because in every other aspect of our lives competition and choice results in more choices, more opportunities. 

OLASKY: Well let me ask about the demand side a little bit. You know if you go back—and I’ve done some writing on the history of welfare and so forth—a lot of anti-poverty programs worked, to a certain extent, when only those who really needed it signed up. We have a demand problem. I know my own mother, her entertainment basically was going to a different doctor most days of the week. How do we deal with that? 

PIPES: Well, your mother’s case is quite common. And particularly in Canada where, because it’s supposedly free, people that were lonely, people that have mental issues would always be booking appointments at the doctor. 

In Canada today, when you call your general practitioner to book an appointment, you can only discuss one issue with your doctor. If you have 3 or 4 health issues you have to book subsequent appointments. But doctors in Canada are seeing around 65 patients a day and therefore, you know, and they can’t get the kinds of tests—whether it’s an MRI, or a PET scan, or a CT scan. And so, so many doctors that I grew up with have quit medicine in Canada because they said I can’t see 65 patients a day, it’s exhausting. 

The Provincial governments don’t have the funding to provide the very latest in equipment and techniques. And you have, if you look at Canada today, there’s 16 MRI machines per million people. The United States the number is 44. But even in a country like Lithuania, you know a former communist country, there are 24 MRI machines per million people. So when the government determines what’s going to be spent, when is the equipment going to be replaced, all of these things, it’s not in the best interest of patients.

REICHARD: That’s Sally Pipes talking to Marvin Olasky. For more excerpts of this interview, look for their Q and A in the August 15th issue of WORLD Magazine.

(Illustration by John Jay Cabuay)

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