If America adopts Canada's health care system

[a_majoor]

A reason why Williams went to the US for his surgery,might be because he was continuing the feud between him and Harper,and use this as a way to embarass the Federal government.

Since health care is a Provincial responsibility, Danny has lots of explaining to do.

 

[VinceW]

Yes it is,but since Harper still hasn't fulfilled his promise to get"wait time guarantees" done like he promised,Williams might use this move as a way to try and make Harper less popular,by bringing attention to it,or it could be due to the cuts to his Province.

But since I don't know,I'll wait till Williams gets better to explain why he did what he did,
it wouldn't surprise me.

 

[Redeye]

A Provincial responsibility, funded by a Federal transfer payment, and controlled subject to a Federal law.  Whether what Vince suggested was King Danny's play, I'm not sure, but interesting idea at least.

Since health care is a Provincial responsibility, Danny has lots of explaining to do.

 

[a_majoor]

Why let little things like the supreme law of the land get in the way of a good idea?

http://blog.american.com/?p=10601

Why the Healthcare Overhaul Is Almost Surely Unconstitutional

By Douglas Smith
February 18, 2010, 3:36 pm

Given that the Obama Administration recently reaffirmed its commitment to pass healthcare reform, the constitutionality of such legislation is sure to be a subject of continuing debate. Many commentators, for example, doubt the constitutionality of the plan’s “individual mandate,” which would require individuals to purchase health insurance if they do not have it. Such an unprecedented requirement likely exceeds the limited and enumerated powers delegated to Congress under the Constitution. Congress can exercise only those powers that the Constitution expressly delegates to it, and it doubtful that Congress has the authority to require individuals to purchase goods or services. While proponents of the legislation point to the congressional power to regulate interstate commerce, it is difficult to see how requiring individuals to purchase health insurance when they are currently not doing so constitutes regulation of interstate commerce.

However, the proposed legislation raises another, perhaps more compelling, constitutional objection. Requiring individuals to purchase healthcare insurance may violate their constitutional right to individual liberty. Several decisions issued by the Supreme Court hold that individuals have a fundamental right to reject medical treatment. For example, in Cruzan v. Director, Missouri Department of Health, a case involving the right to cease life-sustaining medical treatment, the Supreme Court held that individuals have a “constitutionally protected liberty interest in refusing unwanted medical treatment.” Likewise, in Washington v. Harper, the Court held that prison inmates have a “significant liberty interest” in refusing antipsychotic medication. Indeed, in Parham v. J.R., the Court held that children have a significant liberty interest in refusing medical treatment that they do not want even though their parents request it. Thus, the right to make individual choices regarding medical care is firmly rooted in the Constitution.

By extension, individuals should have a right to reject medical insurance. If individuals have a constitutional right to reject treatment, surely they have the right to reject paying significant sums for insurance. The government could not, for example, force citizens to subscribe to National Review or The Nation. Such a law would plainly violate the right to free speech under the First Amendment. Just as individuals have a right to speak freely themselves and to choose the newspapers or magazines they read, so too they have a right to be free from laws that would require them to purchase materials with which they disagree.

This issue, however, has received relatively little attention given that the attacks on healthcare reform generally come from the right, which has not been as eager to advocate an expansive interpretation of such individual rights. However, the debate over the constitutionality of healthcare reform should not be limited by ideological viewpoints. The sweeping proposals that Congress and the administration continue to pursue despite significant public opposition are bound to raise significant constitutional concerns that deserve serious consideration. Moreover, such concerns only underscore the need to give any proposal careful consideration and not to rush it through Congress without an opportunity for an open and honest debate on the implications of the legislation.

 

[a_majoor]

History 101:

http://cafehayek.com/2010/02/open-letter-to-two-npr-reporters.html

    Ms. Chana Joffe-Walt and Mr. David Kestenbaum
    All Things Considered
    National Public Radio

    Dear Ms. Joffe-Walt and Mr. Kestenbaum:

    Your excellent February 26, 2010, report on the history of how government officials chose the different methods that Medicare has used over the years to determine doctors’ pay is frightening because…

    … in your report, Joe Califano, a chief architect of Medicare, admits that the first method of determining doctors’ pay was chosen for political reasons, namely, to buy doctors’ support for Medicare.

    … you report that Mr. Califano, LBJ, and Congress were genuinely surprised by the rapid cost increases sparked by this first method.

    … you reveal that much of the treatment that Medicare paid for was previously provided free by physicians; that is, Medicare crowded out a sizable chunk of private-sector philanthropy.

    … you tell how attempts to change this first method of paying doctors were deeply influenced by skilled lobbyists working on behalf of doctors.

    … in describing the development of the method currently used for determining doctors’ pay, you (perhaps without realizing it) reveal that this current method is the product of a comically childish labor-theory-of-value analysis – the same sort of analysis that is at the foundation of Marxian economics.

    … your report ends with the admission that, because the current method isn’t working so well, Uncle Sam – 45 years after Medicare was launched – is still searching for a sound method for determining physicians’ pay.

    Given this history, what reason is there to suppose that Obamacare is a good idea?

    Sincerely,
    Donald J. Boudreaux
    Professor of Economics
    George Mason University
    Fairfax, VA 22030

 

[a_majoor]

Americans quietly adopt America's health care system:

http://mjperry.blogspot.com/2010/03/from-only-200-in-2006-retail-clinics.html

From 200 in 2006, Retail Clinics Now Top 1,200 For First Time Ever; An Amazing 6X Increase in 3 Years

Total Retail Clinics on March 1: 1,205 (up 8 from Feb. 1)
Total Number of States: 40
Total Number of Operators: 71
Total Retailers: 41
Total Hospital Systems: 53

Source: Merchant Medicine

MP: At the end of 2006, there were only 200 retail clinics in the United States. As of March 1, 2010 the number of retail clinics operating surpassed 1,200, which is an amazing 6-fold increase in just over 3 years for the number of convenient, affordable retail clinics operating in the U.S. At the same time that Congress and the President orchestrate a government takeover of America's health care system and capture all of the media attention, a more silent revolution is taking place, as market-based alternatives like convenient, low-cost retail clinics are expanding daily, saving American consumers millions of dollars and putting Americans back in charge of their health care spending.

 

[a_majoor]

The example of National Health is rather chilling....

http://www.dailymail.co.uk/news/article-1255858/Neglected-lazy-nurses-Kane-Gorny-22-dying-thirst-rang-police-beg-water.html

Neglected by 'lazy' nurses, man, 22, dying of thirst rang the police to beg for water

By Emily Andrews
Last updated at 2:19 PM on 06th March 2010
 
A man of 22 died in agony of dehydration after three days in a leading teaching hospital.

Kane Gorny was so desperate for a drink that he rang police to beg for their help.

They arrived on the ward only to be told by doctors that everything was under control.

The next day his mother Rita Cronin found him delirious and he died within hours.

She said nurses had failed to give him vital drugs which controlled fluid levels in his body. 'He was totally dependent on the nurses to help him and they totally betrayed him.'

A coroner has such grave concerns about the case that it has been referred to police.

Sources say they are investigating the possibility of a corporate manslaughter charge against St George's Hospital in Tooting, South London.

Mr Gorny, from Balham, worked for Waitrose and had been a keen footballer and runner until he was diagnosed with a brain tumour the year before his death.

The medication he took caused his bones to weaken and he was admitted to St George's for a hip replacement in May last year. The operation left him immobile and unable to get out of bed.

His 50-year-old mother says that he needed to take drugs three times a day to regulate his hormones. Doctors had told him that without the drugs he would die.
Kane Gorny with his mother Rita while being treated for a brain tumour

Rita said nurses had failed to give her son vital drugs which controlled fluid levels in his body

Although he had stressed to staff how important his medication was, she said, no one gave him the drugs.

She said that two days after his hip operation, while Miss Cronin was at work, he became severely dehydrated but his requests for water were refused.

He became aggressive and nurses called in security guards to restrain him.

After they had left, he rang the police from his bed to demand their help.

Miss Cronin, who is divorced from her son's father Peter, said: 'The police told me he'd said, "Please help me. All I want is a drink and no one is helping me".

'By this time my son was confused due to his lack of medication and I think the nurses just ignored him because they thought he was just being badly behaved.

'They were lazy, careless and hadn't bothered to check his charts and see his medication was essential.'

That evening, Miss Cronin visited him. She said: 'I told Kane to behave himself because I thought he had been causing trouble - and I feel so bad about that now. I thought maybe he was having a bad reaction to the morphine he was on but in fact it was because he had not had his medication.'

The next morning she visited him before going to work. 'He was delirious and his mouth was open,' she said. 'I gave him a drink of Ribena.

'I told three nurses there was something wrong with my son and they said, "He's fine" and walked off. I started to cry and a locum doctor who was there told me not to worry.

'Eventually the ward doctor came round, took one look at Kane and started shouting for help.'

Miss Cronin was asked to leave her son's bedside. 'He died an hour later,' she said. 'I didn't even realise he was dying. I didn't even have a chance to say goodbye.'

The death certificate said Mr Gorny had died because of a 'water deficit' and 'hypernatraemia' - a medical term for dehydration.

His mother added: 'When I went back to the hospital I was told that all the nurses had been offered counselling as they were so traumatised, but nothing was offered to me.

'The whole thing is a disgrace. This hospital has a brilliant reputation and boasts of its excellent standards and safety record.

'But as soon as my son walked into that ward, his death warrant was signed. Of the 32 people who were involved in my son's care, every one made a mistake that ultimately led to his death, from the consultant to the care assistant.

'There has been an internal investigation but St George's never made it public and it was a whitewash-After his death the hospital never phoned me or wrote to me to apologise. How could this happen in the 21st century?'

A Metropolitan Police spokesman said: 'Detectives from the Homicide and Serious Crime Command are investigating the death of Kane Gorny at St George's Hospital after this was referred to us by Westminster Coroner's Court.'

A spokesman for St George's Hospital said: 'We are extremely sorry about the death of Kane Gorny and understand the distress that this has caused to his family.

'A full investigation was carried out and new procedures introduced to ensure that such a case cannot happen in future.

'We have written to the family to explain the actions that have been taken and to answer their concerns about Mr Gorny's care. The family has also been invited to meet with trust staff to discuss the case in detail.'

The tragedy emerged a week after a report into hundreds of deaths at Stafford Hospital revealed the appalling quality of care given by many of the nurses.

This week a task force called on nurses to sign a public pledge that they will treat everyone with compassion and dignity.

Read more: http://www.dailymail.co.uk/news/article-1255858/Neglected-lazy-nurses-Kane-Gorny-22-dying-thirst-rang-police-beg-water.html#ixzz0hWHZWUxv

 

[a_majoor]

Obamacare will be the gift that keeps on giving for the Dems for years to come:

http://www.powerlineblog.com/archives/2010/03/025855.php

These are the good old days

March 17, 2010 Posted by Paul at 8:37 AM

As they got older, my parents noticed to their dismay that their friends talked more and more about their doctors. According to my parents, nearly all of their friends liked their doctors. However, there was always something to complain about -- a personality quirk, a failure to return a call, a long stint in the waiting room, a grouchy billing administrator. Grievances like these tended to dominate the conversations that so annoyed my parents.

If Obamacare passes, President Obama and the Democrats will become part of, and perhaps dominate, most of these conversations. Every excessive wait, every missed phone call, every postponed appointment will become Obama's fault.

This will be true even if the quality of the doctor-patient relationship does not deteriorate under Obamacare. It is human nature when something goes wrong to romanticize the past, forgetting that the same thing probably went wrong just as often back in the day. And, since most Americans, including the elderly, are reasonably satisfied overall with their health care, it will be easy to romanticize the past. Thus, blaming Obamacare will be the natural response to the ordinary frustrations that, in reality, are part-and-parcel of any doctor-patient relationship.

It is obvious, moreover, that the quality of the doctor-patient relationship for those who now have insurance will decline under Obamacare, and probably sharply. For one thing, Medicare funding is being slashed. The Democrats say that these cuts will be offset entirely by ending fraud, waste, and abuse. In reality, they will be "offset" by a vast increase in irritating events -- long waits, inability to see the doctor of one's choice in a timely manner, etc.

Medicare cuts aside, Obamacare would provide increased medical services for tens of millions of people who presently are uninsured (these people get medical services now, but not to the extent they would under Obamacare). At the same time, the number of providers would not increase. To the contrary, studies purport to show that perhaps one-third, or even more, of all doctors would leave the profession. Frankly, I don't believe these numbers; when doctors threaten to quit practicing, I think they are mostly just talking. My guess is that perhaps 5 percent, and no more than 10, will actually exit.

But even if there is no attrition, it will still be impossible to maintain current service levels for those who now have insurance in the context of a vast increase in total service. Rather, it is inevitable that, if Obamacare becomes law, the medical service level for virtually all Americans will reside somewhere between what it is now for the insured and what it is now for the uninsured.

This, of course, is what left-liberals want; indeed, many of them see such equality as morally imperative. But it is a recipe for endless complaints by those Americans who presently are insured, i.e., the vast majority of Americans.

These complaints won't be confined to the elderly. Old people complain more about their dealings with doctors primarily because they spend so much more time with them. But I've never met a person who likes being blown off by a doctor or sitting for 40 minutes in the waiting room, plus an extra 15 in the examining room before the doctor arrives. Nor have I ever met a person who enjoys hearing his or her aging parents complain about their medical service, especially when the complaint is justified.

In some ways the Democrats' stubborn quest for Obamacare resembles Republicans perseverance with the war in Iraq. At some point, it became clear that the Iraq war was ruining congressional Republicans politically. Yet, they continued to support the effort because they thought it was the right thing to do. Most congressional Democrats, similarly, are supporting Obamacare because they strongly believe in it (some, though, are simply yielding to intense pressure from their leaders).

But there is this key political difference between the Iraq war and Obamacare: the Iraq war eventually wound down and will soon end entirely. Obamacare (unless repealed, which strikes me as something of a pipe dream) is forever. It promises to annoy, if not enrage, millions of people for as long as anyone is around to remember, however imperfectly, what things were like before the Democrats overhauled the health care system.

Maybe the House can adopt a rule deeming these memories forgotten.

 

[a_majoor]

More MD reaction. How many are not openly saying this?

http://hotair.com/archives/2010/04/14/arizona-doctor-goes-galt/

Arizona doctor goes Galt
posted at 10:12 am on April 14, 2010 by Ed Morrissey

Last month, a urologist in Florida told patients that he’d prefer ObamaCare supporters go elsewhere for treatment.  Today, a dermatologist in Arizona warns that he’ll be elsewhere if ObamaCare comes fully into law.  Joseph Scherzer says the penalties for dealing with Medicare patients, along with more top-down government control of health care, will drive him to close his doors:

    While it may be years before most Americans feel the impact of President Obama’s health-care bill, a few patients in Scottsdale, Ariz., got a small taste of life under Obamacare last week when they arrived at their Dermatologist’s office only to see a sign with the following taped to the front door:

    “If you voted for Obamacare, be aware these doors will close before it goes into effect.” The note is signed Joseph M. Scherzer M.D. and includes the following addendum: “****Unless Congress or the Courts repeal the BILL.”

    Scherzer, who attended Albert Einstein College of Medicine in New York, has been a practicing Dermatologist in Scottsdale, Ariz., since 1976. Reached yesterday at his office, Dr. Scherzer, 63, said he plans to stop practicing before 2014 when the bill’s full impact will be felt because he refuses to deal with the headache of increased government involvement in health care. …

    Scherzer said the bill’s emphasis on punitive measures for physicians not following government-prescribed treatment methods under Medicare would increase his anxiety level to the point he would no longer be able to practice medicine. The maximum fine was previously $10,000; under the bill it will now be capped at $50,000. Scherzer said the fine system makes seeing a Medicare patients a difficult and stressful exercise.

    “Doctors have actually committed suicide over these things. There’s no insurance to cover it,” Scherzer said, calling the fine system “tremendously complicated and Frankensteinian.” “It’s absolutely impossible to be certain you’ve complied. I feel like when I see a Medicare patient I have the Sword of Damocles hanging over my head.”

Frankenstein isn’t a bad analogy for ObamaCare. Its piecemeal approach to overhauling health care has already had some frightening and unintended consequences, the most humorous and ironic of which was stripping Congress of its health insurance.  The hidden tax for the middle class, which will cost people in the middle $3.9 billion in 2019 alone, is another.

Scherzer is near the normal retirement age anyway, but many specialists continue working in their practices past that time.  What matters here are the incentives and disincentives in play.  If Congress quintupled the penalty cap that the HHS Department can levy on Medicare issues, that provides a disincentive for providers to accept Medicare patients altogether.  In fact, the arbitrary nature of these fines probably accounts for at least some of the existing difficulties that Medicare patients have in finding providers, which is why 25% of Medicare patients purchase Medicare Advantage plans in order to get wider access to providers.

Except, of course, that ObamaCare makes deep cuts in the Medicare Advantage plans to pay for Medicaid expansion.  Oopsie!

Under these circumstances, as well as other disincentives to providers in ObamaCare, we can expect to see large number of doctors in all fields following Scherzer’s example, primarily the most experienced who see early retirement as a much better option than dealing with Uncle Obama’s medical-care directives.  What will that leave?  A less experienced and smaller cadre of providers with increased wait times and miles of red tape for everyone.  Scherzer may be one of the lucky ones, at least until he gets sick himself.

 

[a_majoor]

Obamacare looks pretty familier to us in the Great White North. Our action plan should be to capitalize on Obamacare by overhauling our own system to lower costs and increase accessibility; I would suggest allowing private hospitals to open in Canada to cater to American patients practicing healthcare tourism. We would get lots of business, these hospitals would serve as great teaching/training hospitals for our own medical practitioners (and attract lots more people to join the medical profession, the real crunch point in our system) and the one minimum condition I would add to the program is every one of these private hospitals have a functioning 24/7 emergency ward.

http://healthcare.nationalreview.com/post/?q=Y2U5YjAzMjkxODY1YTViYmNjN2JjNGZjYWY4ZjliNDc=

Obamacare’s Danger Signs 

[Grace-Marie Turner]

Not one of its major programs has gotten started, and already the wheels are starting to come off of Obamacare. The administration’s own actuary reported on Thursday that millions of people could lose their health insurance, that health-care costs will rise faster than they would have if the law hadn’t passed, and that the overhaul will mean that people will have a harder and harder time finding physicians to see them.

The White House is trying to spin the new report from Medicare’s chief actuary Richard Foster as only half bad because it concludes that, while costs will increase, only 23 million people will remain uninsured (instead of 24 million previously estimated).

But looking at the details of Foster’s report shows the many, many danger signs for Obamacare and how many of its promises will be broken:

1. People losing coverage: About 14 million people will lose their employer coverage by 2019, as smaller employers terminate their plans and workers who currently have employer coverage enroll in Medicaid. Half of all seniors on Medicare Advantage could lose their coverage and the extra benefits the plans offer.

2. Huge fines for companies: Businesses will pay $87 billion in penalties in the first five years after the fines trigger in 2014, partly because they can’t afford to offer expensive, government-mandated coverage and partly because some of their employees will apply for taxpayer-subsidized insurance.

3. Higher costs for consumers: Tens of billions of dollars in new fees and excise taxes will be “passed through to health consumers in the form of higher drug and devices prices and higher premiums,” according to Foster. A separate report shows small businesses will be hit hardest.

4. A program created to fail: The new “CLASS Act” long-term-care insurance program will face “a significant risk of failure,” according to Foster. Indeed, he finds, “there is a very serious risk that the problem of adverse selection will make the CLASS program unsustainable.”

5. Spending increases: Under the new law, national health spending will increase by $311 billion over the coming decade. And instead of bending the federal spending curve down, it will move it upward “by a net total of $251 billion” over the next decade.

6. “Free-riders”: An estimated 23 million people will remain uninsured in 2019, roughly 5 million of whom would be undocumented aliens; the remainder would be the 18 million who decline to get coverage and who will pay the penalty.

7. Spending reductions are fiction: Estimated reductions in the growth rate of health spending “may not be fully achievable” because “Medicare productivity adjustments could become unsustainable even within the next ten years, and over time the reductions in the scope of employer-sponsored health insurance could also become an issue.”

8. You can’t keep your doctor: Fifteen percent of all hospitals, nursing homes, and other providers treating Medicare patients could be operating at a loss by 2019, which will “possibly jeopardize access to care for beneficiaries.” Doctors are threatening to drop out of Medicare because cuts in Medicare reimbursement rates mean they can’t even cover their costs.

9. Coverage but no care: A significant portion of those newly eligible for Medicaid will have trouble finding physicians who will see them, and the increased demand for Medicaid services could be difficult to meet.

This is an objective report by administration actuaries that shows this sweeping legislation has serious, serious problems.

And there’s more: Joint Economic Committee Republicans explain in a new report the impact of a rarely mentioned $14.3 billion per year tax on health insurance, effective in 2014. They find this tax will be mostly passed through to consumers in the form of higher premiums for private coverage. It will cost the typical family of four with job-based coverage an additional $1,000 a year in higher premiums and will fall largely, and inequitably, on small businesses and their employees.

States are fighting back. The Florida legislature voted Thursday to place a state constitutional amendment on the ballot that would ban any laws that compel someone to “participate in any health care system.” It requires a 60 percent vote to succeed. The legislation is modeled after the American Legislative Exchange Council’s Freedom of Choice in Health Care Act, which has been introduced or announced in 42 states.

Obamacare is far from settled policy. There are two more federal elections before the major provisions of the law take effect in 2014. Doctors are fighting mad, patients are scared, and companies are starting to realize that the promises of health-care-reform legislation could turn into a huge and costly burden. 

The studies released today only fuel the fires to repeal and replace the health-overhaul law.

 

[a_majoor]

Without comment:

http://www.calgaryherald.com/Carpay+Unrolling+Alberta+health+care+debate+eyeing+toilet+paper/2982259/story.html

Carpay: Unrolling Alberta's health care debate by eyeing toilet paper


By John Carpay, Calgary Herald May 3, 2010

Read more: http://www.calgaryherald.com/Carpay+Unrolling+Alberta+health+care+debate+eyeing+toilet+paper/2982259/story.html#ixzz0n1ahG9Tb


Shortages of toilet paper were a regular occurrence in Poland under communism. As a Canadian teenager visiting friends behind the Iron Curtain in 1984, I found the level of poverty in this “planned economy” shocking.

Waiting lists for even the most basic consumer goods were the inevitable result of replacing prices in a free market with bureaucratic edict. Poland’s central planners were probably highly educated, and they probably did their very best to determine how many rolls of toilet paper should be produced each year, and where and when and how they should be distributed and ultimately “sold” for money that had little real value. But the problem with a planned economy is that no single person — or even a group of people — can acquire all the economic information that is necessary to ensure that everyone gets the goods and services they need, in a timely manner, as cheaply as possible.

Canadians don’t suffer from toilet paper shortages because millions of buyers communicate with multiple sellers and producers through the mechanism of price. Prices transmit information about where resources are most needed.

When it comes to laundry detergent, vegetables, steaks, houses, cars, and thousands of different goods, Canadians benefit from free market competition each day. The same goes for services. Canada’s lawyers, auto mechanics and massage therapists operate freely (more or less), and they price their supply to match consumer demand. There are no shortages of accountants, carpenters and counsellors. Nobody waits for months to see a hairdresser, or to take Fido to the veterinarian. Competition in a free market keeps prices as low as reasonably possible, and quality as high as reasonably possible. Over time, the prices of computers have come down, while their capacity and quality have improved.

Yet, mysteriously, the positive results of the free market — demonstrated anew each day — are instantly forgotten when it comes to health care. People who would otherwise recognize and understand the benefits of supply, demand, prices and competition will suddenly abandon all reason and common sense when the topic is health care.

A large percentage of Canadians actually believe that high-quality, cost-effective and readily available health care will flow magically from the amazing minds of health care bureaucrats who centrally plan the spending of tax dollars.

Alberta Health bureaucrats spend more than $15 billion each year — about $4,000 for every man, woman and child in Alberta. A perfect example of “central planning” was the Stelmach government’s recent reduction of cataract surgery facilities from five to two.

This resulted in ophthalmologists cancelling surgeries and laying off staff. Some expressed discomfort about performing surgeries in different clinics with unfamiliar equipment, while others are worried about higher risks of infection from the government requiring that surgical devices be reused.

In 1984, Poland’s central planners, having legislated supply, demand and prices out of existence, tried to ensure adequate supplies of toilet paper to all people at all times in all parts of the country. It didn’t work. In 2010, Alberta’s health bureaucrats, equally ignoring supply, demand and prices, are trying to ensure adequate supplies of health care to all Albertans at all times. It, too, can’t work, and won’t work.

Regardless of how smart and educated and sincere Alberta Health bureaucrats might be, like the Polish central planners they lack the necessary information that comes from millions of voluntary interactions between buyers and sellers in a market economy.

“Health care should not be a commodity!” is an emotional argument in support of the dysfunctional status quo. But thousands of Albertans now suffer in pain on waiting lists, and people die in overcrowded emergency rooms, precisely because health care is not a commodity.

But what about people who couldn’t afford to pay for health care on the free market? Patients in France, Germany, Denmark, Belgium, Austria and Switzerland have access to public health care regardless of ability to pay, but there are virtually no waiting lists. These countries have found ways for government to fund health care for all, but without ignoring — or trying to abolish — the reality of supply, demand, competition and prices. Their public and private health care systems operate harmoniously side by side. Alberta should follow these examples.

John Carpay is a Calgary lawyer and public policy analyst.

Read more: http://www.calgaryherald.com/Carpay+Unrolling+Alberta+health+care+debate+eyeing+toilet+paper/2982259/story.html#ixzz0n1aKB1li

 

[Edward Campbell]

Every so often the Good Grey Globe’s Jeffrey Simpson gets it exactly right.

First: consider this, reproduced under the Fair Dealing provisions (§29) of the Copyright Act from the Globe and Mail:

http://www.theglobeandmail.com/news/national/british-columbia/hst-backlash-could-prove-to-be-bc-liberals-waterloo/article1585119/

HST backlash could prove to be B.C. Liberals’ Waterloo
After three consecutive election victories, Premier Gordon Campbell is facing his toughest fight ever

Justine Hunter and Ian Bailey

Victoria and Vancouver — From Saturday's Globe and Mail
Saturday, May. 29, 2010

Scott Nelson has impeccable B.C. Liberal credentials: The former mayor of Williams Lake joined the party in 1993 to help Gordon Campbell win the party leadership. He sat on the provincial council. Last year, he sought a nomination to run in the last election as part of the Gordon Campbell team.

This weekend, Mr. Nelson will be out canvassing for signatures on the petition to repeal the harmonized sales tax  – the campaign that threatens to fracture the coalition that has produced Mr. Campbell’s three straight electoral victories.

In the span of one year, the BC Liberals have lost more than a third of their committed voters, largely due to the public backlash over the HST. “This is something that could seriously affect the [Liberal] base,” said pollster Mario Canseco.

In B.C.’s political landscape, it doesn’t take much to tip the balance of power, and those core supporters must be reclaimed – or the HST may prove to be the Liberals’ Waterloo.

“B.C. Liberal members are mad and angry and very disappointed,” said Mr. Nelson, who is still a card-carrying party member. His longtime loyalty to the Premier earned him a personal call from Mr. Campbell, seeking to dissuade him from joining the allied forces against the HST. Mr. Nelson didn’t budge.

“The government in its arrogance has chosen to ignore the overwhelming wishes of people,” he said. “I don’t believe people will forgive Gordon Campbell.”

This week, Mr. Campbell conceded for the first time that the anti-HST petition is likely to be successful, but insisted it would be wrong to try to back out of the deal with Ottawa. His government may be forced to rethink that soon, however: On Friday, the petition’s organizers announced they now have enough signatures – 10 per cent of eligible voters – in all 85 ridings of the province to succeed as a citizen initiative under the B.C. Elections Act.

A posse of Liberal cabinet ministers and backbenchers are meeting behind closed doors with party members in the Interior on Saturday to try to calm the troops. Steve Forseth, an executive member of the party’s Cariboo-Chilcotin Riding Association, says the membership needs to hear a solid plan to dig the party out of this mess. “Those who come out and say recall is not a threat, they need to wake up and smell the coffee,” he said.

The Premier, however, brushed aside the suggestion that he needs to do any special outreach to the Liberal base. “I think we have to go and talk with all British Columbians,” he said. “I certainly intend to go around the province to talk to people about why every British Columbian is going to benefit from this change.”

Brenda Locke once served in Mr. Campbell’s cabinet, but she didn’t rate a personal call from the Premier when she began campaigning against the HST. Her organization, the Massage Therapists Association of BC, was one of several that received assurances from the Liberals during the last election that the HST wasn’t in the cards.

“It definitely was disingenuous,” said Ms. Locke, who hasn’t renewed her party membership. “It’s a challenge for lots of Liberals to understand and feel any kind of comfort level with.”

Mr. Canseco, a vice-president with Angus Reid Public Opinion, said the only demographic where the Liberals have not seen a double-digit drop in support since the last election is among voters with yearly household incomes of $100,000 or more, who tend to shun the New DemocraticParty .
If a substantial portion of the base doesn’t come back, he said, “there will be no rebound.”

Mr. Campbell’s coalition has long been united by the fear of seeing the NDP return to government. The leader of the anti-HST petition, former Social Credit premier Bill Vander Zalm, now says the prospect of another NDP government isn’t looking so scary.

“I don’t think they are doing a whole lot better than the NDP did,” he said. “Our debt has grown, our deficits are bigger than ever, they haven’t been truthful.”

The polls aren’t the only measure of the Liberals’ fortunes. Next month Mr. Campbell will host his annual leader’s dinner, and he’ll need to show he can still pull in a crowd: The $350-a-plate fundraiser for the party usually draws between 1,000 and 1,200 guests.

Party spokesman Chad Pederson said ticket sales are proceeding at their usual pace without any sign that the HST controversy has deterred some attendees. He is confident the spectre of a renewed NDP will continue to unite supporters. He noted that the Liberals are the free-enterprise alternative to the NDP in B.C.

“A free-enterprise vote for any party other than our own shows us from history that an NDP government will be the result,” he said.

The BC Conservative Party, which does not have any members in the legislature, has seen its party membership double in the last year, with most of the influx coming in the last three months, says Dean Skoreyko, a party spokesman. He declined to provide specific numbers.

Conservative-minded voters, including federal Tories, who have supported the provincial Liberals are taking a new look at the B.C. Conservatives because they are questioning the conservative credentials of the Liberals, Mr. Skoreyko said from his home in Vernon. Mr. Campbell’s party has no link to the federal Liberals, and has been seen as a kind of free-enterprise coalition of political interests that includes federal Liberals and former Socreds.

Mr. Skoreyko questions the existence of a solid Liberal base. “I don’t think there is a history or a base that they can rely on to stick through in tough times,” he said. “If you don’t have an ideological pole to dance around, what you have then is factions and nobody has any loyalty.”

It’s been a year since Finance Minister Colin Hansen persuaded his colleagues in the cabinet that the HST was the way to go. Today, he’s still trying to persuade British Columbians he was right, and the polls show a majority don’t agree.

“I believe we could have spent millions of dollars on paid advertising and it would have not have made any difference,” Mr. Hansen said. “We have to get into implementation so that people are experiencing it and realizing this is not as big an impact on their budget as they had been led to believe.”

Justine Hunter

Now consider this:

http://www.theglobeandmail.com/news/national/british-columbia/hst-backlash-could-prove-to-be-bc-liberals-waterloo/article1585119/

We can’t afford to live in health-care denial
The public has been blissfully ignorant that budgets are growing at an unsustainable pace

Jeffrey Simpson

Sudden crises, such as hurricanes or the Greek debt crisis, produce fast reactions. Slowly worsening problems, however, are often left to fester until they become a crisis, by which time remedial action is painful and sometimes too late.

For some years now, we’ve had a slowly worsening problem of financing health care. Many people, including university health-care “experts” who dominated a lot of public debate about the issue, denied the existence of a problem. The Romanow Commission of 2002 ignored the challenge entirely. Politicians knew a problem was emerging, but were scared to talk about it, fearing public reaction. A few lonely voices tried to alert readers or listeners to the looming problem, but they were derided. The public was blissfully ignorant that health-care budgets were growing at an unsustainable pace.

Unsustainable, that is, provided we didn’t want governments to pay for health care’s higher costs with more borrowing. We could easily pay these higher bills with more taxes, but they would be politically explosive, as premiers who imposed health-care premiums discovered. Or, we could pay by curtailing other programs, which is what’s been happening by stealth to every provincial budget in Canada. Warning signs that this was occurring have been around for a long time, but they were ignored.

For example, 10 years ago, in 2000, the Conference Board of Canada did a report about health care in British Columbia. It said “expenditures on other programs, which include social services, education, police and economic development will need to be reduced” if the rhythm of health-care spending continued.

The board warned that the health budget, then about $8-billion in 2000, would hit $16-billion by 2020. The Conference Board got it wrong. B.C.’s health-care budget will be $16-billion in 2012-2013, eight years early.

Almost all of B.C. Premier Gordon Campbell’s budgets have touted the need to make the province the best-educated place in Canada. A very laudable and important objective, to be sure. Except that from 2000 to 2010, the province’s higher education budget grew by 36 per cent and the health-care budget by 84 per cent.

In this year’s budget, health care is going up $447-million, the last instalment of a three-year rise of $2-billion. To pay for this, the government is diverting all kinds of revenue into the system: all the extra money from the controversial harmonized sales tax, the tobacco tax, health-care premiums and $167-million from the provincial lottery, plus of course general tax revenues and $3.6-billion in health transfers from Ottawa.

While B.C.’s health-care budget jumps by $2-billion over three years, what about other spending? Adjusted for inflation, the following departmental budgets are falling: universities, children and family development, citizens’ services, K-12 education, forests, housing and social development, public safety, justice, tourism and culture. This profile of one budget rising while all others shrink is precisely what the Conference Board told British Columbians in 2000 they could expect.

Every area of B.C. public spending, except transportation, is falling while the health-care budget soars. The same pattern is reproduced in every province of Canada, and no provincial government has had the courage to try to change it.

This week, TD Economics produced a report about health-care in Ontario, recommending 10 steps to slow down the rate of increase. Quite aptly, the report observed, “it is quite likely that Ontarians have not come to grips with the potential risk to their future quality of life from the health-care Pac-Man.” For “Ontarians” substitute “British Columbians” and people in every province.

The Ontario government is floating a complete myth, presumably to comfort people and sugarcoat the raw numbers of what really lies ahead for the province. It promises to reduce health-care spending to 3 per cent increases within three years. This has never been done and, as TD Economics showed, cannot be done, given population growth, aging and the increasing use of the system.

Instead, health-care spending is likely to stay on the track of 6- to 7-per-cent yearly increases, compared to 4-per-cent increases in government revenues. Under that very hopeful scenario (Ontario will be lucky to see a 4 per cent increase in revenues), TD Economics says that in 2030, 80 per cent of the province’s budget will be devoted to health care. That prediction jibes with the one made by Ontario Finance Minister Dwight Duncan that if nothing changes, 70 per cent of the budget will go to health care by 2022.

What to do? The first and indispensable step is for politicians of every stripe to recognize publicly that the problem is becoming a crisis of public finance. If they don’t talk about the problem, citizens won’t pay attention.

The trouble is that politicians are scared of us and the powerful interest groups that will rally against change. Even the TD Economics recommendations, which don’t go far enough to solve the problem but are nonetheless useful starting points for discussion, would scare the wits out of most politicians.

We remain, alas, far from the “adult conversation” about health care that former Bank of Canada governor David Dodge correctly said Canada needs.

I don’t know what frightens me more: the venality of politicians, especially those on the political left for whom no lie is ever too large, or the stupidity, coupled with plain old fashioned greed, of the overwhelming majority of Canadian voters. They want their “free” health care; hell’s bells they demand their “free” health care but they are too bloody thick to appreciate that the HST is absolutely necessary to raise the money to pay for it. Jesus wept!

 

[mariomike]

This is an ambulance bill from San Francisco.:
http://www.flickr.com/photos/subvert/333397249/

( S.F. Giants Stadium to San Francisco General Hospital:  $1,339.23 USD )
They even charged her $75.00 to turn the red lights on!
"You want lights with your saline drip?" 

That ride, with the ( very basic ) trimmings listed, and many more not listed, would have cost her $45.00 in Toronto.

The lady who received the bill had this to say:
"Getting to the hospital in the United States - $1,339.23
Getting to the hospital in Canada - $48
Not bleeding to death on the bridge - priceless
Thank you United States, for teaching me the financial worth of my life."

Here's a 'nuther:
"The AMR charged me $2100 for the 11 mile trip and all they gave me was O2!":
http://answers.yahoo.com/question/index?qid=20090227154120AAXhdbk

Comments:
"Same thing happened to me and it was less than a mile and 3,000. They did nothing for me, just brought be to the ER. Sorry but I had to suck it up and pay it."

"You should not have gotten on the abmulance ( sic ) if you didn't want to pay for it."

"let you have your seizure at work"

"Must I pay for a $1,261 Ambulance Bill, if I was forced by police to take the ambulance?
I was tazered, and then forced to take an ambulance to the hospital,":
http://answers.yahoo.com/question/index?qid=20090909161618AAJxR73

 

[PPCLI Guy]

Six weeks ago my wife had a roller blading accident, and was admitted to George Washington University Hospital in DC.  She was taken there in an ambulance, received trauma care, had a Cat scan and other x-rays, and spent a night in hospital (just as she would have back home).  She a minor cut to her chin, deeply bruised legs, and a fractured vertebra. 

The bill?  $26,000.

My so called gold-plated insurance seems prepared to pay less than half of it.  Although the rest will be paid by a combination of PSHCP and GOC funds, the fact remains that if I was an American citizen, I would be trying to scrape together over 13 K right now.

Quite happy to pay my taxes, including the GST (that should in my mind have remained at 7%).

My 26K worth.

Dave

 

[Infanteer]

Chasing bad policies with more money isn't a good way to come about a solution to the problem.  Unfortunately, politicians seem unable to come up with good solutions whether they have the money or not.

 

[a_majoor]

From Forbes. Canadian style health care comes to America:

http://www.forbes.com/2010/12/15/fda-avastin-breast-cancer-opinions-contributors-sally-pipes_print.html

The Fatal Move From The FDA
Sally C. Pipes, 12.16.10, 10:00 AM ET

On Dec. 17 the Food and Drug Administration is expected to take the radical step of revoking approval for an advanced drug in the treatment of one of the country's most deadly diseases.

Avastin, an advanced treatment for late-stage breast cancer, made it through the FDA approval process back in 2008. But over the summer, an advisory commission at the agency determined that the drug wasn't providing sufficient benefits to patients and recommended that the full FDA board retroactively rescind that stamp of approval.

The FDA has until Dec. 17 to make that recommendation official. If it does, the effects on breast cancer patients will be devastating. Some 17,500 American women are prescribed Avastin every year. Many will face shorter, more painful lives because of the FDA's decisions.

Despite all evidence to the contrary, the advisory committee claims its recommendation had nothing to do with Avastin's cost. The FDA's top brass will doubtlessly take the same line and claim that its decision to ratify that recommendation was based solely on the drug's medical efficiency.

The truth is that Avastin is expensive. A year-long supply for breast cancer treatment costs upwards of $80,000.

However, many American women are getting something priceless in return for those dollars: life and vitality. In one clinical trial, nearly 50% of patients receiving Avastin witnessed their tumors shrink. Another study found that patients receiving the drug in conjunction with chemotherapy lived "progression-free" twice as long as patients without it.

What's more, for a select group of "super responders," Avastin can improve life span by years. That can mean years of extra time for, say, a mother to attend her son's soccer games, for a daughter to vacation with her husband, or for a grandmother to watch her grandchildren grow up.

However, if the FDA revokes Avastin's approval, public insurance programs like Medicaid and Medicare could decide to refuse coverage of the treatment. Many private insurers would likely do the same. Indeed, several major insurance companies--including Regence and HSCS--have already reacted to the FDA Avastin debate by restricting coverage for the drug in the treatment of breast cancer.

Of course, doctors would still be able to prescribe the drug "off label." But because patients wouldn't have coverage, the only ones that could still use Avastin would be the small minority that can afford to pay its full price out-of-pocket.

Both the Susan G. Komen Foundation and the Ovarian Cancer National Alliance have sent letters to the FDA urging it not to revoke approval. They rightly believe that treatment decisions should remain exclusively in the hands of individual patients and their doctors. After all, those are the people best positioned to weigh costs and benefits and decide which course of treatment is best.

Government drug rationing isn't going to stop at Avastin. The Obama administration hasn't been shy about expressing its affections for the practice. None other than the head of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick, has said that "it's not a question of whether we will ration health care," but "whether we will ration with our eyes open."

Every year about 40,000 American women die from breast cancer. Avastin is the last hope for many not to meet that fate. While the drug is costly, it often provides immense benefits to patients. The FDA shouldn't revoke the drug's approval.

Sally C. Pipes is president and CEO of the Pacific Research Institute. Her latest book, The Truth About Obamacare (Regnery 2010), was just released.

 

[a_majoor]

Irony:

http://www.outsidethebeltway.com/a-cuban-hospital-is-no-place-to-be-sick/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+OTB+%28Outside+The+Beltway+|+OTB%29

Michael Moore’s Sicko was banned in Cuba:

    The revelation, contained in a confidential US embassy cable released by WikiLeaks, is surprising, given that the film attempted to discredit the US healthcare system by highlighting what it claimed was the excellence of the Cuban system…

    Castro’s government apparently went on to ban the film because, the leaked cable claims, it “knows the film is a myth and does not want to risk a popular backlash by showing to Cubans facilities that are clearly not available to the vast majority of them.” …

    But according to the FSHP, the only way a Cuban can get access to the hospital [featured in the film] is through a bribe or contacts inside the hospital administration. “Cubans are reportedly very resentful that the best hospital in Havana is ‘off-limits’ to them,” the memo reveals.

I’m shocked — shocked — that a Michael Moore film would misrepresent the truth to make a political point!

UPDATE (James Joyner):  Via Glenn Greenwald, I see that Michael Moore is actively refuting this report.

    [T]he entire nation of Cuba was shown the film on national television on April 25, 2008! The Cubans embraced the film so much so it became one of those rare American movies that received a theatrical distribution in Cuba. I personally ensured that a 35mm print got to the Film Institute in Havana. Screenings of ‘Sicko’ were set up in towns all across the country. In Havana, ‘Sicko’ screened at the famed Yara Theater.

Later in the article, he provides quite a number of hyperlinks which demonstrate either that the film was widely shown in Cuba or the Cuban government really, really wants people to think it was.  The former strikes me as more plausible.

Of course "widely shown" in a place like Cuba means widely shown to people the government is willing to show it to, so take the distribution with a few grains of salt.

 

[The Bread Guy]

Besides, if Cuban health care is so great, why are volunteers collecting old hospital equipment to send there?  I guess Mike never got to deal with that question, eh?

 

[Nemo888]

Tools are just that, tools. Cuba has better outcomes than the American system with no tools. Just saying. The American system is much more broken than the Cuban one from a statistical outcome point of view. The America system of social Darwinism only does well for the top tier, not the average citizen. (Unless social Darwinism is your thing. Then it is working great.)

 

[Brad Sallows]

To what statistical outcomes do you refer?  I assume you are already acquainted with the incidental reasons why measures of infant mortality and life expectancy are skewed and useless and have some other pertinent measurements in mind?