Wednesday, February 11, 2009

The Kind of Health Care Obama Wants To Impose on the Nation

Via Modern Commentaries, an article from the Wall Street Journal on what socialized medicine has meant in Canada. Some tidbits:
  • In Ontario, Lindsay McCreith was suffering from headaches and seizures yet faced a four and a half month wait for an MRI scan in January of 2006. Deciding that the wait was untenable, Mr. McCreith did what a lot of Canadians do: He went south, and paid for an MRI scan across the border in Buffalo. The MRI revealed a malignant brain tumor.

    Ontario’s government system still refused to provide timely treatment, offering instead a months-long wait for surgery. In the end, Mr. McCreith returned to Buffalo and paid for surgery that may have saved his life. He’s challenging Ontario’s government-run monopoly health-insurance system, claiming it violates the right to life and security of the person guaranteed by the Canadian Charter of Rights and Freedoms.

  • Shona Holmes, another Ontario court challenger, endured a similarly harrowing struggle. In March of 2005, Ms. Holmes began losing her vision and experienced headaches, anxiety attacks, extreme fatigue and weight gain. Despite an MRI scan showing a brain tumor, Ms. Holmes was told she would have to wait months to see a specialist. In June, her vision deteriorating rapidly, Ms. Holmes went to the Mayo Clinic in Arizona, where she found that immediate surgery was required to prevent permanent vision loss and potentially death. Again, the government system in Ontario required more appointments and more tests along with more wait times. Ms. Holmes returned to the Mayo Clinic and paid for her surgery.

  • On the other side of the country in Alberta, Bill Murray waited in pain for more than a year to see a specialist for his arthritic hip. The specialist recommended a “Birmingham” hip resurfacing surgery (a state-of-the-art procedure that gives better results than basic hip replacement) as the best medical option. But government bureaucrats determined that Mr. Murray, who was 57, was “too old” to enjoy the benefits of this procedure and said no. In the end, he was also denied the opportunity to pay for the procedure himself in Alberta. He’s heading to court claiming a violation of Charter rights as well.
Of course, one might argue that the liberals and leftists who favor socialized medicine are themselves at risk in the same way as ordinary citizens.

But they are not.

In any massive bureaucratic system there are enclaves that provide decent service for people who know how to play the bureaucratic game, who have connections and also have the ability to raise hell if they get poor quality care.

Thus, socialized medicine is really something that they want to impose on us.

In principle, it’s just like forcing people to have a smaller “carbon footprint,” while the liberal elitists are using a massive amount of electricity and jetting around the country in private jets.

Politics in America really has resolved itself into a battle between the liberal New Class that wants to dictate peoples’ lifestyles and ordinary Americans who still hold to the notion that they live in a free country.

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Blogger Matt Wion said...

The Canadian system certainly has its problems. But four questions:

1. France has National health care. Is it so bad? From what I hear - The World Health Organization - France has the best health care in the world.

2. Does Barack Obama favor a socialized system? This is not what his stated policy or public statements call for?

3. It seems justifiable not to trust "any massive bureaucratic system." However, it seems to me that private insurance companies are also massive bureaucracies, no less than states.

4. People suffer from Canada's waits. But don't we suffer here? 47 million uninsured, numerous more not covered for a vast array of procedures, even though they are insured? We can't simply state that Canada has serious problems. Of course it does, but is our system better? We have a ton of problems too!

4:17 PM  
Blogger John McAdams said...

With regard to the "ranking" you posted, you didn't bother to look at the methodology.

Here it is:

In designing the framework for health system performance, WHO broke new methodological ground, employing a technique not previously used for health systems. It compares each country’s system to what the experts estimate to be the upper limit of what can be done with the level of resources available in that country. It also measures what each country’s system has accomplished in comparison with those of other countries.

WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs).

A lot of this simply has nothing to do with the quality of health care.

The "overall level of population health" is more a matter of lifestyle than of the health care system.

"The distribution of the health system’s financial burden within the population" likewise has nothing to do with the quality of health care. This implies that if you finance the system out of "soak the rich" taxes, the quality of health care is better than if most of the population pays.

But that doesn't follow. Extremely high-quality health care may be financed in ways you don't like.

"The experts estimate to be the upper limit of what can be done with the level of resources available in that country" is absurdly subjective.

Look . . . the document you linked to is more ideological than scientific. It just doesn't deal with the quality of health care.

It deals with whether the health care system matches the policy preferences of the bureaucrats who put it together.

Want to know something about actual quality?

Compare prostate cancer survival rates in the U.S. and the U.K.

On your other points: Obama once said he wanted a "single payer system" (government controls all the money, and thus all health care).

In the campaign he didn't admit that, but his proposal is designed to result in the dumping of almost everybody in a government controlled system.

Don't trust insurance companies?

There are many of them, and if (say) employees at Marquette find themselves getting poor coverage, Marquette can get a new one.

Indeed, each employee gets to choose from four different plans.

As for the "47 million uninsured," a lot of these people are simply between jobs and choose not to pay for their own insurance.

Several million are eligible to Medicaid and don't bother to apply.

I think universal coverage is a good idea. But not under a system controlled by government.

11:35 PM  
Blogger Matt Wion said...

Good points. And in fact Britain has a number of problems with its system. However, most studies concluded that the United States has a lower life-expectancy, more heart disease, and a higher infant mortality rate, than Europe, Japan, and Canada for instance. These facts are part of the ranking that puts us a 38th. Although, I’m not totally convinced by the rankings either, there are some methodologically debatable criteria. Still, percentage of the populace covered, life expectancy, infant mortality, diabetes, heart disease, cancers, these are part of the rankings, and I think very important to consider.

There is a fine ABC documentary in our library that I use when I teach medical ethics, on this matter. Much better, for example than Sicko. The best thing to do with buffoons like Michael Moore is ignore him!

But I get digress. I'm not sure myself that single payer is the way to go. I'm open to that, but not committed. Of course one can have heath care funded by single payer, but hospitals still run by private interests, so even then it need not be totally run by the government.

It's quite true that the problem with a centralized health care system is that it eliminates options, which may be disturbing.

On the other hand, private insurance gets away with too much. The list of pre-existig conditions for which people can be denied health care boggles the mind! And the number of procedures that the health insurance companies can deny even to the fully insured is appalling.

Of course, I'm sure you don't deny these injustices. Your point seems to be rather, that a nationalized system would be even more unjust.

Perhaps so. I think the matter is worth empirical study and debate.

As for Obama. I recall him saying he favored single payer. But he has appeared to change his mind. What he appears to favor now is regulating private insurance by a Health Care oversight committe or something along those lines. Also, he appears to want to offer a public plan IN ADDITION TO RATHER THAN AS A REPLACEMENT OF private plans.

Of course the complaint of "

1:07 AM  
Blogger Tom said...

Personally I think the solution is to do away with tying health insurance to employment. Realistically, most employers don't offer more than 1 or 2 choices (and usually those are just different choices from the same insurance company), and health care costs rise so quickly that if employees were complaining about the health care coverage, the employer would be more likely to (a) switch based purely on cost to itself or (b) drop coverage altogether than get a plan that actually provides better coverage for the employees.

Then, the idea of "family" coverage needs to go away. A married couple, 22 years old, should not be paying as much as a married couple with 4 kids. Pay per number of people.

Then, health insurance needs to have premiums based on risk like life insurance, taking into account smoking, obesity, or other risk factors, especially the ones based on choices (but not age, which happens to everyone).

Then, something needs to be done about ER's being flooded with poor people with routine ailments. Huge waste of resources - something that could cost a $100 office visit + $20 prescription instead costs upwards of $1,000 for the ER visit. ER's, after all, can't legally turn anyone away currently. I would change that so that ER's can deny non-serious (with more specific rules of course) cases, although there are other solutions. The money that hospitals waste on those cases will be saved, meaning the hospital can charge everybody less for its services.

8:30 AM  

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