The American Spectator

A True Story| 4.7.09 @ 4:23PM

I used to travel frequently to Calgary, Alberta in the mid to late 90s.
A Calgarian suffered a heart attack and was driven by his wife to the emergency room of the nearest hospital.
He was not accepted because it was the "wrong" hospital.
His wife drove him to the next nearest emergency room. He was not accepted for the same reason.
In the end, on the way to a third hospital, he died.
This made headline in the Calgary newpapers.

Other frequent news in the papaers there; new hospital construction in Calgary, while at the same time, existing hospitals had shuttered wings because there were not enough patients. Of course, Ottawa determined all of this; not the Albertan provincial govt.

Lastly, many Canadian doctors now live and work in the USA to escape the Canadian medical system. My Canadian work associate's (a civil engineer) siblings, both MDs, left Canada to live and work in the USA.

Our USA health care system leaves much to be desired, but emulating the Canadian or UK model will lead only to disaster.

E.Patrick Mosman| 4.8.09 @ 7:22AM

Having lived in Europe for over 20 years if you really want horror stories about health services simply live under a government run NHS or simply peruse the English, Canadian or almost any European newspaper to learn the truth. NHS health care is a strictly rationed care depending on age and seriousness of the illness, long waits for tests and economic disasters. it is no wonder that private health care is available to those who can afford it in every country. No doubt some of you are familiar with the term Harley Street physicians in London. They are the prime examples of private, personal care over of the failure of government run health care systems.
And contrary to the economic studies used by proponents of sponsored health care systems NHS are, by most reports, out of control and growing year-by-year. The truth is that there are two health care systems in most, of not all, European countries, one for those with additional private insurance or who can afford to pay and those relegated to the government run For those who can pay there are the Harley Street physicians in the UK, the private clinics with private rooms, no wait for laboratory tests, i.e., X-ray, MRI, CT scans, no wait for elective surgery and no rationing of services. For those ensnared in the government system there are assigned doctors, choice is not option, there are no private or semiprivate rooms, wards only, the wait for tests can be weeks, unless one can pay and then there is no waiting, the wait for elective surgery can eextend for weeks if not months if one is found eligible under the rationing guidelines. Under the rationed care of most state run health care systems older patients, over 65 in some countries , are no longer eligible for transplants or other costly operations and even expensive drug treatments. An alternative readily available and often used by Canadians and Europeans is to seek treatment especially operations in the USA or other countries.
There is no free lunch in any government run service and those who advocate for a government run health care system are either misinformed or pushing a political goal, socialism.

JamesJ| 4.8.09 @ 7:43AM

Where's Dave Mathews? Is he ill? I know he didn't get a job

tabman| 4.8.09 @ 8:16AM

What the article also doesn't mention is the very popular alternatives available in Europe- homeopathy and naturopathy. People have to pay for them, but they are quite widely accepted.

Bob| 4.8.09 @ 11:01AM

There is always bias in an article like this. It is easy to find examples of poor coverage under any system. Do you realize that here in the U.S., because of the financial crisis, tens of thousands of people cannot get help for their cancers? This happens in any system.

But I also notice that no one here seems to talk about Taiwan -- arguably the best national health care system available. They saw the weaknesses of Canada and GB and some of the strengths of the U.S. system and created something new.

It is a weak intellectual argument to criticize a system based upon specific arguments versus overall statistics. You measure the effectiveness of a health care system through statistics like infant mortality, average waiting times, and death rates -- not through one off examples that bloggers seem to use. It's like saying you know someone who just got a promotion and is doing well so the economy must be doing great.

The issue here is competitiveness as a country and it is an economic argument. We currently spend 16% of GDP on health care. Did you know that with current spending, you could hire a personal physician for each person and pay him/her $225,000 annually? We cannot be competitive as a country and build jobs without reducing this cost. Reducing costs means some level of sacrifice. There are always trade-offs.

I don't know the answer, but after studying Taiwan, I do believe there is a middle ground that might be a better answer. The Taiwan system will not work here exactly as they have done, but they have a lot of good ideas.

Open your minds, people.

Bill P| 4.8.09 @ 11:41AM

Well Bob, here's the problem. Almost everyone could use thousands of dollars worth of medical care if it didn't come out of their own pocket. There is simply no way to satisfy this need with a 'free' system - each individual cannot afford to pay his own bill as is. How can we possibly expect each person to pay their fair share of the bill when each is trying to get the very best available medical care when it won't cost him any more that not using any of those services. I myself would mind Lasik surgery and also have a chronic back pain that I'd like fixed. I don't do either because I consider both to be a luxury (that's right, a luxury) that I cannot afford right now. Guess what I'd do if I didn't have to pay for it?

Indiana Alex| 4.8.09 @ 11:44AM

Hmm, infant mortality...

Can't that be skewed by, oh, people smoking crack while pregnant, chosing not to see a Dr., or dumping a baby in a dumpster, or toilet?

A lot of people like to point to infant mortality as a statistic to show the US healthcare system as a failure.

Perhaps we should also look to statistics of life expectency among inner city minorities?

Bob| 4.8.09 @ 1:08PM

Bill P -- I totally agree with you. If you think I am for a totally national system like Canada and the UK you are wrong. I am for some sort of nationalized basic care -- but this is just for items that we can prove will lower health care costs including seeing a doctor once a year, immunizations, and other simple procedures. I happen to like the current type of insurance coverage for higher levels of testing and other surgeries that may not be necessary. There are some really good ideas in Taiwan like the billing system where immediate transfers are made to the doctors. I think it is important to keep an open mind on these things and not be blinded by ideology.

Indiana -- I totally agree that infant mortality cannot be used uniquely as a measure of the effectiveness of our health care system. However, when a number of these types of measures all show that we don't get what we pay for, I think it identifies a problem.

You are also right that we should look beneath the topline statistics to find out if the problem is skewed. Perhaps that will lead to a different solution in places like inner cities than for the rest of the U.S. What I am against is people who use ideology rather than analysis and objective data to make these kinds of decisions that can determine the quality of life of our progeny.

David Thomas| 4.8.09 @ 2:24PM

Please see relevant comment of 2008 on:

http://davids-home-now.blogspot.com

Cookie| 4.8.09 @ 5:41PM

This is awful!

edree| 4.10.09 @ 9:29AM

Half of the ~ 50 million uninsured in the US are uninsured by CHOICE. the horror stories from around europe are not exceptional but are routine. Comparing the US to the tiny island nation Taiwan is not realistic. The present US system is the envy of the world. Just improve it, not wreck it with unrealistic socialist techniques.

Jayhawk| 4.13.09 @ 4:25PM

Pingback,

I'm impressed that you start out with a "cause" - inefficient and stupid - to end up with the "result" rationing of actual health care. I would have thought one would have wanted to start out with what aspect is "inefficient" or "stupid." At any rate, all private health plans/insurance has some type of rationing. I can't just get any diagnostic procedure done at will.

Since most people seem to like the anecdotes of problems in socialized programs, I'll through in my anecdotes about our wonderful system, as is.

I About a year ago, I visited an emergency room - for an actual emergency. What did I find there? About half a dozen people with non-emergencies, basically because without any other regular physician, it was the place that made the most sense to them.

This has been an increasing problem of using emergency room to replace primary care. This is driven, in part, because "federal law requires that hospitals with emergency departments perform a medical examination on all patients to
determine if a medical emergency exists, regardless of a patient’s ability to pay. That isn't required of any primary care physician." (http://www.wha.org/toolKit/Emergency.pdf) As that article notes, "in Milwaukee County alone, nearly 55% of emergency department
encounters were for primary care services that could have been cared for in more appropriate primary care settings." (Ok, so I strayed from simply anecdotes - sorry)

The net result is what I saw, and a rather costly problem for any hospitals with emergency rooms. Does this really appear to be an "efficient" use of resources to anyone here? That is how our "envy-of-all-the-world" system works in practice.

But maybe it's not only costs that drove them to it. I had to call up 6 different medical groups in my area before I found any group taking on new patients. And to use that new group, I have the privilege of paying an extra $100 a year (regardless of receiving any care) effectively for an access fee. I was starting to think that maybe I should just wait for the emergencies to deal with any medical problems. I haven't been particularly impressed with availability of our "envy-of-the-world" medical care here.

I had routine blood work performed through LabCorp. Total cost initially billed to my health plan (Blue Shield) was $885. Blue Shield paid $110 total (probably much more the norm that I had seen elsewhere in the country), and that ended up being what LabCorp paid. I mentioned this to my physician sister and she said that's standard practice to overbill and then figure on negotiations after the fact. If you don't happen to have the self-serving advocate of Blue Shield or another insurance company looking out for their costs, and individual might pay 880 or 400 or whatever they tire of haggling over. Does this sound like an efficient system? Uh, not really.

As one of the larger medical insurers, Blue Shield does a pretty good job of rationing its care. Basically they say, yes, they will pay for this or no they won't. Like a lot of medical insurers they've taken on the coding system (I think originating from Medicare - definitely one strike against moving to socialized medicine) so that if you have the right "codes" for the procedures and it fits in the right box something can be paid for, otherwise not - or otherwise the same service is paid at a different rate. My father-in-law, also a physician, notes the amount of time gaming the system by the correct coding.

Overall, after having spent over 3 years of my life in other countries (including a year in the UK), I have not been particularly impressed with the socialized medicine I've seen. But I haven't been impressed with what I've seen here either. I also have to admit that I never had any of my colleagues overseas suggest that they wished their country would migrate to our fine system