[gmsisko1]

Canada's ObamaCare Precedent
Governments always ration care by making you wait. That can be deadly.

By DAVID GRATZER
Congressional Democrats will soon put forward their legislative proposals for reforming health care. Should they succeed, tens of millions of Americans will potentially be joining a new public insurance program and the federal government will increasingly be involved in treatment decisions.

Not long ago, I would have applauded this type of government expansion. Born and raised in Canada, I once believed that government health care is compassionate and equitable. It is neither.

My views changed in medical school. Yes, everyone in Canada is covered by a "single payer" -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.



Martin Kozlowski
The problems were brought home when a relative had difficulty walking. He was in chronic pain. His doctor suggested a referral to a neurologist; an MRI would need to be done, then possibly a referral to another specialist. The wait would have stretched to roughly a year. If surgery was needed, the wait would be months more. Not wanting to stay confined to his house, he had the surgery done in the U.S., at the Mayo Clinic, and paid for it himself.

Such stories are common. For example, Sylvia de Vries, an Ontario woman, had a 40-pound fluid-filled tumor removed from her abdomen by an American surgeon in 2006. Her Michigan doctor estimated that she was within weeks of dying, but she was still on a wait list for a Canadian specialist.

Indeed, Canada's provincial governments themselves rely on American medicine. Between 2006 and 2008, Ontario sent more than 160 patients to New York and Michigan for emergency neurosurgery -- described by the Globe and Mail newspaper as "broken necks, burst aneurysms and other types of bleeding in or around the brain."

Only half of ER patients are treated in a timely manner by national and international standards, according to a government study. The physician shortage is so severe that some towns hold lotteries, with the winners gaining access to the local doc.

Overall, according to a study published in Lancet Oncology last year, five-year cancer survival rates are higher in the U.S. than those in Canada. Based on data from the Joint Canada/U.S. Survey of Health (done by Statistics Canada and the U.S. National Center for Health Statistics), Americans have greater access to preventive screening tests and have higher treatment rates for chronic illnesses. No wonder: To limit the growth in health spending, governments restrict the supply of health care by rationing it through waiting. The same survey data show, as June and Paul O'Neill note in a paper published in 2007 in the Forum for Health Economics & Policy, that the poor under socialized medicine seem to be less healthy relative to the nonpoor than their American counterparts.

Ironically, as the U.S. is on the verge of rushing toward government health care, Canada is reforming its system in the opposite direction. In 2005, Canada's supreme court struck down key laws in Quebec that established a government monopoly of health services. Claude Castonguay, who headed the Quebec government commission that recommended the creation of its public health-care system in the 1960s, also has second thoughts. Last year, after completing another review, he declared the system in "crisis" and suggested a massive expansion of private services -- even advocating that public hospitals rent facilities to physicians in off-hours.

And the medical establishment? Dr. Brian Day, an orthopedic surgeon, grew increasingly frustrated by government cutbacks that reduced his access to an operating room and increased the number of patients on his hospital waiting list. He built a private hospital in Vancouver in the 1990s. Last year, he completed a term as the president of the Canadian Medical Association and was succeeded by a Quebec radiologist who owns several private clinics.

In Canada, private-sector health care is growing. Dr. Day estimates that 50,000 people are seen at private clinics every year in British Columbia. According to the New York Times, a private clinic opens at a rate of about one a week across the country. Public-private partnerships, once a taboo topic, are embraced by provincial governments.

In the United Kingdom, where socialized medicine was established after World War II through the National Health Service, the present Labour government has introduced a choice in surgeries by allowing patients to choose among facilities, often including private ones. Even in Sweden, the government has turned over services to the private sector.

Americans need to ask a basic question: Why are they rushing into a system of government-dominated health care when the very countries that have experienced it for so long are backing away?

Dr. Gratzer, a physician, is a senior fellow at the Manhattan Institute.

http://online.wsj.com/article/SB124451570546396929.html

[soulvengeance]

So you prefer the current system where some people get no care at all? I'm not saying that government controlled care is great, but surely you don't like the current system.

[gmsisko1]

So you prefer the current system where some people get no care at all? I'm not saying that government controlled care is great, but surely you don't like the current system.

Really? Who gets no care at all? Anyone who needs medical attention can get it. No one is denied medical attention.

Too many people spend alot of money on beer every week, but go without health care. There is no such thing as a perfect system. Life is not fair.
The government is not always the answer.

If you want health insurance, work for a company that provides it, or buy a policy. We already have a failing medi care, and medi cade program. No country in the world has done it right. Why will we be better?

[soulvengeance]

Really? Who gets no care at all? Anyone who needs medical attention can get it. No one is denied medical attention.

Too many people spend alot of money on beer every week, but go without health care. There is no such thing as a perfect system. Life is not fair.
The government is not always the answer.

If you want health insurance, work for a company that provides it, or buy a policy. We already have a failing medi care, and medi cade program. No country in the world has done it right. Why will we be better?

Well, what do you propose to fix it then? Just leave it the way it is? The only thing you can say is life isn't fair? I mean, we're dumping money into a war, so it's not like money is an issue.

[Koggit]

uhh okay what does canada have to do with anything?

has obama ever once said he wants to nationalize healthcare?

i wish he would, but no, he hasn't. his talk has been more about modifications to medicare/caid and offering a federal (self-sufficient) insurance plan to force the corrupt HMOs to start providing health care instead of running 80% margins and spending a fifth on lobbying... the only applicable 'precedent' is the fact that the threat alone has caused HMOs to tighten their game a bit.

wsj has been shit for about 5 yrs now

[sonicfreak5]

So you prefer the current system where some people get no care at all? I'm not saying that government controlled care is great, but surely you don't like the current system.

i know this sounds ignorant. im gonna go to college get a fucking job and get healthcare. this issue is just pissing me off i can't take it anymore. Current System>Universal Healthcare. Alright so let's screw all of the nations people, rather then the one's who don't work. Our nation can't handle universal care. We are to big.

[Msut77]

Really? Who gets no care at all? Anyone who needs medical attention can get it. No one is denied medical attention.

People can get seen in an emergency room in many cases which happens to be nowhere near the same thing.

Too many people spend alot of money on beer every week, but go without health care. There is no such thing as a perfect system. Life is not fair.
The government is not always the answer.

Are all your posts going to be like the above stream of consciousness drivel?

If you want health insurance, work for a company that provides it, or buy a policy. We already have a failing medi care, and medi cade program. No country in the world has done it right. Why will we be better?

Lot of countries have done it "better" defined here as "providing coverage for all while spending a fuckton less". Even if that was not the case this is America and despite the last few years I still have faith in it.

[soulvengeance]

i know this sounds ignorant. im gonna go to college get a fucking job and get healthcare. this issue is just pissing me off i can't take it anymore. Current System>Universal Healthcare. Alright so let's screw all of the nations people, rather then the one's who don't work. Our nation can't handle universal care. We are to big.

Well, I don't disagree that a full on socialized healthcare system probably won't work, but I think the public/private mix might be the answer though. I mean, I know people don't want the government to make the decision for you, but if your under an HMO, someone still has to approve you to get certain things done anyway. This guy's paycheck is probably reliant on if you get the operation or not, so would you rather have that instead?

[Koggit]

there are two problems with "just buy it or get it through your employer"

(1) HMOs are ripping your employer off if they aren't ripping you off. their profit margins are absolutely ridiculous, and the little that they aren't giving their CEOs are going to (a) lobbying efforts to keep their cartel legal & protected and (b) to the executives that are best able to deny healthcare to their policy holders (read: keep their profit margins astronomical)

(2) preexisting conditions and accidents. the need for healthcare reform isn't about getting allergy pills or treated for the flu or whatever, it's about falling off your roof or getting cancer. peoples lives, not only the sick but their family as well, get completely ruined due to uninsured accidents or conditions that were diagnosed when uninsured. you're talking millions of dollars in some situations, and of course you can't get insurance for it after-the-fact, so you're talking about spending the rest of your life in debt and dying with debt to give to your children and grandchildren.


though i'm a bit biased since i have extensive experience with issue #2... most people will never really know how dire reform really is. luckily, we'll get it soon regardless.

[Ikohn4ever]

i have a pre-existing condition and in the state of Pa they don't have to cover it ever, so even though I have insurance I am still SOL. There needs to be a better system then what we have now, I know he can't make it any worse.

[Jimbo Slice]

i know this sounds ignorant. im gonna go to college get a fucking job and get healthcare. this issue is just pissing me off i can't take it anymore. Current System>Universal Healthcare. Alright so let's screw all of the nations people, rather then the one's who don't work. Our nation can't handle universal care. We are to big.

You're right, that does sound ignorant. I just graduated college, but I'm unable to get a job because I have to finish my student teaching to be licensed as a teacher in the state of Pennsylvania.

The job market is also absolute shit, I'm having trouble finding work at even something like a summer camp. I'm a cumme laude student with good professional references and a ton of experience in classrooms and the field. As I have stated though, I do not yet have my license.

Unfortunately, my back hurts all the time, my teeth could definitely used to be checked and a need a stronger prescription of my glasses. Where am I suppsoed to get the money for this? My mom does the best she can doing nursing and helping me out, and I am eternally grateful for her whenever she can afford to help me. However, in this instance it is just WAY too expensive to get all of these things checked out. The only time I've been to the doctor in the last 3-4 years is to get a physical and get shots that are required in order to enroll in college and obtain state clearances.

I'm chomping at the bit for non-private healthcare. I could really, really use it.

Really? Who gets no care at all? Anyone who needs medical attention can get it. No one is denied medical attention.

Have you ever seen how expensive this can get? Unfortunately, free clinics are often unable to provide the care patients are looking for.

[irideabike]

i'm all for some kind of government healthcare. As long as that healthcare is paid for by the individual receiving it, and not me giving even more of my paycheck to the bottom feeders of society.

[HowStern]

i know this sounds ignorant. im gonna go to college get a fucking job and get healthcare. this issue is just pissing me off i can't take it anymore. Current System>Universal Healthcare. Alright so let's screw all of the nations people, rather then the one's who don't work. Our nation can't handle universal care. We are to big.

It sounds ignorant because it is. You never know when you will be out of work or why. Elderly people living on fixed incomes who can't afford care. Come off it. I love how people refer to people who can't afford healthcare as bottom feeders.

England gets along just fine and their ratio of doctors to people is much lower than ours AND their health care is publicly funded. While allowing people to private doctors if they so wish to pay.

[fullmetalfan720]

I got an idea. How about we lower people who can't afford health care's taxes so they can actually afford it, if they want it? If we have nationalized health care, everyone will just have to wait to get treatments, and there will be health care rationing.

[homeland]

i'm all for some kind of government healthcare. As long as that healthcare is paid for by the individual receiving it, and not me giving even more of my paycheck to the bottom feeders of society.

We live in a capitalistic country. There will always be bottom feeders. Not everyone can be the CEO. There's only so many managers, so many dept heads.

Edited by homeland, 10 June 2009 - 02:51 PM.

[irideabike]

I got an idea. How about we lower people who can't afford health care's taxes so they can actually afford it, if they want it? If we have nationalized health care, everyone will just have to wait to get treatments, and there will be health care rationing.

The lowest 38% of Americans don't pay income taxes as it is.

[fullmetalfan720]

The lowest 38% of Americans don't pay income taxes as it is.

Maybe they don't after all the tax rebates, but money is still taken out of their check every month for taxes. I would like to see the idea that Capitalizt came up with in one of the threads a while back implemented. No taxes on the first $20,000 you make and a flat 20% tax on everything over that.

[JolietJake]

Just out of curiosity, what exactly is it that makes Canadians have to wait so long? I'm guessing funding has a lot to with that, but who knows. We're in a good position though, we can examine the programs of other countries and learn why they have problems, then make sure we do what we can to avoid those problems.

[Ruined]

Bottom line is that the government rarely does anything right/well. If they play a larger role in healthcare, my educated guess is that healthcare for most will go down the toilet.

Either get a job and get premium healthcare, or prove that you are disabled & cannot work and get Medicaid/Medicare. Problem solved, and while the current system has problems its much better than universal healthcare.

[irideabike]

Just out of curiosity, what exactly is it that makes Canadians have to wait so long? I'm guessing funding has a lot to with that, but who knows. We're in a good position though, we can examine the programs of other countries and learn why they have problems, then make sure we do what we can to avoid those problems.

crappy doctor to patient ratio (which we already are facing in the US without government provided healthcare. the wait times we face in the US would sky rocket with every person deciding to go to the doctor for any little thing they can think of because its free.)

[HowStern]

crappy doctor to patient ratio (which we already are facing in the US without government provided healthcare. the wait times we face in the US would sky rocket with every person deciding to go to the doctor for any little thing they can think of because its free.)

This is BS. Have you had to go to the ER anytime recently? The wait times are insane. Know why? Because that's where everyone who doesn't have insurance goes for every teency tiny little thing because it's free. If these people had insurance it would clear wait times up for the real emergencies.
We don't have a crappy doctor to patient ratio. We have one of the best in the world.
Know who has better than us? Cuba. Want to go there for treatment? Because I don't.

[irideabike]

This is BS. Have you had to go to the ER anytime recently? The wait times are insane. Know why? Because that's where everyone who doesn't have insurance goes for every teency tiny little thing because it's free. If these people had insurance it would clear wait times up for the real emergencies.
We don't have a crappy doctor to patient ratio. We have one of the best in the world.
Know who has better than us? Cuba. Want to go there for treatment? Because I don't.

Ya, I have gone to the ER recently. Considering it is located about 500 feet away from where I work.

[Koggit]

how does that even make sense

[evanft]

Ya, I have gone to the ER recently. Considering it is located about 500 feet away from where I work.

Good job actually trying to answer his points.

[Koggit]

but seriously how does working near an ER mean you've been there recently

[irideabike]

when you work in a hospital, you tend to float around a lot.

Good job actually trying to answer his points.

The amount of patient to doctor ratio doesn't matter much to this argument right now, considering my post said that the number would rise. So the numbers he posted would be completely changed, because that study wasn't the amount of people to doctor ratio, it was the amount of patient to doctor ratio. The number of "patients to doctor" ratio would rise significantly with the increase of 45~50 million new "patients".

Edited by perdition(troy, 10 June 2009 - 06:25 PM.

[JolietJake]

You're wonderful at avoiding actually answering a question perdition.

There was a discussion on the last episode of Real Time about health care. It was mentioned that in many other countries, doctors were less motivated by money than in the US. I don't know how true that is, but from my own experiences, it does seem that some doctors are more interested in money than actually caring for their patients.

[irideabike]

What do you want me to say to answer his question? That I personally believe our healthcare system is in better shape then Britain's and base it on a study that is biased in America's favor in relation to the fact it only considers the patient to doctor ratio rather than the doctor to population ratio?

[Msut77]

but seriously how does working near an ER mean you've been there recently

He was there recently, mopping the floors but still...

[HowStern]

Also, National Geographic had an article recently about how the doctor supply in the U.S. is growing (and declining in other nations) because doctors from all over usually end up deciding to come here to practice. Hence the increase in foreign doctors.
Not to mention hospitals have been cutting staff due to being ripped off by Insurance Co.'s and not being to able support payroll.
With healthcare reform there is a chance the tax funded dollars would increase money to support more staffing. Increasing doctor to pop. ratio even more.
Obama has also made it clear no one will force you to use this healthcare. You can stay private.