heritage foundation – Moral costs of socializedmedicine

Vindy.com News – Youngstown, Ohio – Moral costs of socializedmedicine:

“Anyone who considers Canada’s health system a role model for the U.S. should consider the case of Samuel Golubchuk. His case shows the inevitable collision course between government-controlled health care and the rights of private conscience.”

Typical hack rubbish. My comments are on the Vindy web site below the article…

Health Insurance: It’s Always Something, Isn’t It?

“So long as insurance companies are for profit enterprises, their goal will not be the best health care possible. It will be this — not paying claims. That is the truth of it, because that is how they profit. For real change, we need better, smarter folks elected to represent OUR interests, not just the lobbyists and insurance companies.”

Nice post to add to our “anecdote-off” section, but it also leads to some good posts by Ian Welsh:
On Healthcare and Social Justice:
http://firedoglake.com/2008/01/12/morality-and-health-care-in-the-us-let-the-lazy-buggers-die

If you follow the link to Digg on this one, the Ayn Randers are out in force. It occurs to me that they represent the only philisophical school on the planet that rejects social justice in any way, shape or form. So, how some of them still delude themselves into thinking they are Christians or Jews or aven secular humanists is amazing.

And on why we don’t do something about heathcare (and drug policy and…):
http://firedoglake.com/2007/05/14/hard-and-complicated-arent-synonyms

Cheers,

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Exhausted

From a note on my patient’s chart today:

Dr. _______
Mrs. ________ has exhausted her SNF [Skilled Nursing Facility] coverage. She has used her full 100 days and does not qualify for Medical Assistance [Medicaid]. She would have to privately pay for an SNF and she cannot afford this.

Doctor’s Reply: What can I do about this?

Response: The patient and family are aware and husband says he will hire help but cannot afford private pay at SNF.

An unhealthy health care plan

I only link to mock…An unhealthy health care plan — The Washington Times, America’s Newspaper By Robert Goldberg (vice president of the Center for Medicine in the Public Interest)
Pablo Picasso observed, “To copy others is necessary, but to copy oneself is pathetic.” Is anyone more pathetic than Arnold Relman, the former editor of the New England Journal of Medicine, who continually writes about why America should adopt the Canadian health care system? There is. It’s Arnold Relman himself, writing in Canada about why Canadians shouldn’t abandon the Canadian health care system. In this case, it’s Mr. Relman in the Toronto Globe and Mail opposing the Canadian Medical Association (CMA) proposal to “allow physicians to bill patients (or private insurance plans) for services that are covered by Medicare, and allowing Medicare to purchase covered services from for-profit private facilities.” The goal of the CMA plan is to allow people a chance to get medical care when they need, not when the government sees fit to provide it. Canada has pumped billions of dollars into its system to reduce waiting times for specialty services, cancer care, first-time health visits and emergency rooms.

Here’s the link to the article by Relman. Dr. Relman’s piece speaks for itself.

But according to Health Canada and the independent Frasier Institute the waiting times and shortages have gotten worse.

Please see this previous post to read why you should discount anything from Fraser, and yet recognize that Fraser is a pernicious force to be watched and refuted at every opportunity.

In a recent incident, a child with a brain tumor headed to the states to get a MRI because he would have had to wait four months in Canada. His family paid cash because Health Canada refused to cover the cost. Mr. Relman’s response? He urges Canadians to “avoid exploitation by those who would like to make profits from publicly funded health care. Canadians should not follow Americans down the path to greater privatization.” The kid should die for the greater glory of socialized medicine rather than pay cash and line the pockets of profit hungry docs in America. Groucho Marx once observed, “Who do you believe? Me or your eyes?” Our eyes tell us that here and abroad government run and financed health care stinks.

Welcome to another episode of “Anecdote-Off”, the great justifier of all things wrong in the US sytem if you believe people like this. As I’ve said many times before, if you want to debate this by anecdote, the US loses. Badly.
For waiting times,
go here.

Price controls cause shortages of doctors in the UK that in turn are filled by waiving immigration regulations that allow neurologists with bomb-making skills into the National Health Service (NHS).

Good thing we don’t allow ferners to practice medicine here.

In the United States, restrictive formularies and cookbook approaches to care have undermined mental health treatment for soldiers returning from Iraq.

Got that backwards.

Medicaid reimbursement levels have increased waiting times and caused millions of children to seek care in emergency rooms.

Because we underfund Medicaid and the economics of reimbursement of course cause providors to scurry for the hills. How is this an argument against single-payer?

Meanwhile SCHIP — 10 years after its enactment — has failed to enroll 3-out-of-5 Medicaid eligible children in private health care plans and access to care has barely increased.

Again, how does this support an argument against universal healthcare? It’s an argument against the stupid patch-work non-system we have here in the US, I agree.

Incredibly, Mr. Relman claims that’s just a sign free market health care does not work and does not care about people. Enlighten us Arnie, how are the two connected?

Because the patch-work “free market” mess we have here does not work. Clearly Mr. Goldberg has never actually seen patients or been responsible for providing healthcare in this disaster we work in. When funded properly and overseen appropriately and by giving doctors the ability to provide care as they see fit (as opposed to insurers or underfunded goverment programs), a single payer system can not possibly be worse that what we have now. Unless someone puts the Republicans in charge of it. Then, watch out, Brownie will be in charge!

“Physicians in our commercialized, profit-driven system tend to gravitate toward the highly paid specialties, so we now face a major shortage of primary-care doctors.” Well, we know how flush the NHS is with well-trained terrorists — I mean family doctors. What about Canada? It turns out the College of Family Physicians of Canada found that 17 percent of Canadians didn’t have a family doctor because of a primary care physician shortage. Two million of the Canadians that Mr. Relman wishes to deny free choice of care to have attempted to find a family physician in the past year, but have failed. In the U.S., we have a market-based response to the problem.

OMG! 17% don’t have a PCP. I’ve got an idea, let’s take insurance away from 1/6 of Candians and underinsure another 1/6 so they can’t afford a PCP visit, and see what happens to that shortage. The free-market will get rid of those whiners!

A rapid expansion of retail health clinics in the United States is taking place in what the Department of Health and Human Services has designated as medically underserved areas. Take MinuteClinics, a division of the drugstore chain CVS, which offers walk-in health care centers for common medical problems such as strep throat, sunburn, mono, flu, ear infections and sinus infections, and offer vaccinations, checkups, etc. People can pay cash or use their regular insurance.

“People can pay cash or use their regular insurance.” Hahahahahahah!

And will Mr. Goldman and his family use this service? Of course not, because they have good insurance.

Most visits are 15 minutes or less with no appointment needed. In many cases, MinuteClinics are often affiliated with local hospital or physician practices, and will refer customers to a primary care doctor if they don’t have one. Additionally, the center generates an electronic medical record that customers and doctors can access through the phone, fax or Internet. There are 200 MinuteClinics across America. Most are in federally designed medically underserved areas providing immediate care, referrals and electronic medical records for about $50 per person. Other private companies are involved in this trend as well and have been joined by the American Academy of Family Physicians in an effort to improve access to health care for millions Americans.

Well, let’s take it a step further and have us (by us, I mean the U.S., our government) fund such a system. And that way, when the patient is referred to a PCP, the patient will be able to actually go to the PCP without choosing between healthcare and something else.

Meanwhile, as the marketplace makes medical care more accessible in America …

…still can’t get that idea that it should be universal rather than just “more accesible”…

Mr. Relman is telling Canadians, “One thing is certain. If medical care and health insurance are allowed to become private businesses… patients with little or no resources do not get the care they need.”

And Mr. Goldberg doesn’t care about those people. Why not just come out and say it?

What did Santayana say about fanaticism? It consists of redoubling your efforts when you have forgotten your aim.

Pot, meet kettle… And as John Kenneth Galbraith said, “The modern conservative is engaged in one of man’s oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.”

Fighting against medical choices that are available elsewhere in the world is a sure sign that ideological zeal has transcended compassion or the Hippocratic oath.

Uh, he’s fighting for medical choice, not against it. He’s advocating for compassion, not against it. And if Mr. Goldberg thinks physicians anywhere in the world compromise the spirit of Hippocrates (put the well-being of the patient above all else) more than we do in America, he is as out of touch as the rest of his piece confirms.

Mr. Relman, once a great scholar, should be pitied, not scorned.

It’s Dr. Relman, and he doesn’t need Goldberg’s pity.
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Costly ‘affordable’ health care — The Washington Times, America’s Newspaper

Costly ‘affordable’ health care — The Washington Times, America’s Newspaper:

“John Stossel is right.”

When an editorial starts out like this, and it’s from the Rev. Moon’s Times, you know it’s going to be dead on true, don’t you?

Healthcare policy by anecdote- isn’t that what Michael Moore is accused of all of the time?

UPDATE: I contacted an ICU director in Brussels regarding this article. His response:

This is simply wrong – and worrisome if published in the Washington Times
(hopefully not the Washington Post)!

As stated, we have here one of the best health care systems in the world.
Much better than socialistic systems like in the UK or in Scandinavia or even
the Netherlands.

Maybe his grandfather became deaf because of an aminoside administration, but
the antibiotic choice was not restricted by costs !

Maybe it is a case of malpractice – I do not know, these can happen anywhere
– but it is not related to a limitation in health care costs.

The Reality-Based Community: Rationing health care

The Reality-Based Community: Rationing health care:
Rationing health care
Posted by Mark Kleiman

“All this, let’s recall, with the Chancellor breathing down the neck of the boss of the medical area on behalf of a full professor at the university that owns the hospital. So my experience with the system was probably about as good as it gets except for corporate executives using places like the Mayo Clinic or family members of people on the boards of directors of hospitals. (Apparently it’s generally understood that if you stump up enough in the way of contributions to get on the board of the hospital, you’re entitled to priority care; that’s how not-for-profit hospitals raise capital.) It was only later that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments. The process is designed to get very sick or prosperous patients to pay to jump the queue. I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero. “

Amy Ridenour’s National Center Blog: Universal Health Care: Universally Bad

Amy Ridenour’s National Center Blog: Universal Health Care: Universally Bad

I think trying to bring the most horror stories to the table is not a fruitful way to move the debate on single-payer vs. the status quo forward. Besides, the horror stories attributed to other nation’s systems are trivial compared to the stories about our own. On top of this, once you add the population based problems with our system, there really is no comparison.

I say this as a physician who has always looked favorably on single-payer after a medical school experience in England. Yes, that system had lots of problems, but nowhere near as pervasive nor unfair as our own. As the years have gone by, I have seen so many heart breaking (and infuriating!) situations with our own system, my view has gone from simply favorable to my current view: it is really not acceptable to maintain the status quo.

I am not alone. I am involved in organized medicine on the state level. When I started in 2002 in this capacity, I think the current was then 10-1 (or 2) against single payer. i think that is now perhaps 10 to 3 or 4. Now, mind you, these are leading physicians in my state. These are those who used to be very reliably against anything that smacked of single payer.

I think there are many currents that are drawing physicians along. The injustice of the system that we see every day wears us down. The waste in a system managed by not-for-profit-in-name-only insurers and the true for-profit health plans, pharmaceutical and equipment companies and on and on is unconscionable. The loss of control over the patient-physician relationship could not possibly be worse under the most draconian socialized system, let alone a simple single-payer system. The pay differential among specialists is causing strain. The cost of the system is clearly becoming unsustainable.

There are more, but you get the idea.

Cheers,