Castonguay Turns

You know that wonderful Hoser healthcare system?  Well, it’s very architect wants to change it:

Back in the 1960s, Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.

The government followed his advice, leading to his modern-day moniker: “the father of Quebec medicare.” Even this title seems modest; Castonguay’s work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast.

Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in “crisis.”

“We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

Castonguay advocates contracting out services to the private sector, going so far as suggesting that public hospitals rent space during off-hours to entrepreneurial doctors. He supports co-pays for patients who want to see physicians. Castonguay, the man who championed public health insurance in Canada, now urges for the legalization of private health insurance.

In America, these ideas may not sound shocking. But in Canada, where the private sector has been shunned for decades, these are extraordinary views, especially coming from Castonguay. It’s as if John Maynard Keynes, resting on his British death bed in 1946, had declared that his faith in government interventionism was misplaced.

What would drive a man like Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care; a system where people in towns like Norwalk, Ontario, participate in lotteries to win appointments with the local family doctor.

Somehow, I rather doubt this will be a part of Sicko II: The Search For More Money.

Guess What?  Socialism Kills People

It’s often been our contention, as vehement critics of socialized medicine and its supporters like Moore, that all government healthcare provides is the same equally shitty service to everyone.  (Except, of course, the wealthy, who can pay for their own treatments.) As usual the Times of London lays it out.

The National Health Service is providing dying cancer patients with drugs that are five times less effective than those available privately and is refusing to treat them if they try to buy medicines themselves.

That’s right, folks.  If you decide to use your own money to pay for the life-saving drugs that your free healthcare system doesn’t provide, you’re shit out of luck on any future treatment.  Their policy is, “Use our substandard care or you’re on your own.” Ah, compassion.

One drug for kidney cancer, routinely available through public health systems in most European countries but not to British patients, can reduce the size of tumours in 31% of patients, compared with just 6% of those prescribed the standard NHS drug.

The growing row over “co-payments” has prompted the government to reconsider the ban. Alan Johnson, the health secretary, has promised a “fundamental rethink” of the policy.

Just not a fundamental rethink of the socialist disaster which created the problem in the first place.

A woman with bowel cancer is fighting for the right to pay for a drug that could extend her life long enough for her to spend Christmas with her grandchildren.

Sheila Norrington, 59, a former NHS medical secretary from Maidstone, Kent, has been told by doctors that if she buys the drug Erbitux, which the health service will not pay for, she will lose her state-funded cancer care. Erbitux is the only drug capable of treating her advanced bowel cancer.

Norrington’s husband, Goff, 61, a former sales manager, said: “We have been told that if we pay for it ourselves we will be thrown off the NHS completely and we will need to pay for everything privately. We are devastated. This is not going to cure my wife, but if it keeps her alive a little bit longer, then we would pay for it.”

The couple say that although they could pay for a few cycles of the drug, which costs about £3,000 a month, they could not pay for all Norrington’s care, including scans, blood tests and consultations.

Goff Norrington added: “We have two young granddaughters and this could make the difference between sitting round the table with them at Christmas or not. We think it is deplorable that patients can get this drug almost anywhere in Europe but we cannot get it in the UK.”

A spokesman for Maidstone and Tunbridge Wells NHS Trust said: “We are governed by Department of Health policy on this issue.”

And why shouldn’t they be?  The government is the one paying for it.  They aren’t concerned with individuals, they’re concerned with doling out their limited resources in the most compassionate and fair manner, which in this case is simply letting people die.

A poll for The Sunday Times shows strong support for allowing co-payment in the National Health Service, with 89% saying that people who buy additional cancer drugs should continue to get free NHS treatment.

Only 5% think allowing co-payment would create a two-tier NHS. Until now this has been the position taken by Alan Johnson, the health secretary.

Ministers had feared that allowing co-payment would upset less well-off patients, but the YouGov poll of nearly 1,800 people shows strong backing across the social spectrum and supporters of all three main parties.

This, of course, begs the question.  If compassionate free government healthcare can’t provide, y’know, actual healthcare to patients, and they are forced to paying massive amounts of money to buy their own treatments, maybe the solution to the problem is less free government healthcare and more private sector solutions.

Wow, paying for healthare.  What a concept!

Dr. Teeth

Remember folks, socialized medicine is a utopian paradise where everyone gets everything they need all the time.

Health service dentists have been forced to go on holiday or spend time on the golf course this month despite millions of patients being denied dental care.

Many have fulfilled their annual work quotas allotted by the National Health Service and have been turning patients away because they are not paid to do extra work. This is despite the fact that more than 7m people in Britain are unable to find an NHS dentist.

Patients have been told they must either pay privately or return in April when the new work year begins. People suffering from toothache have been advised to go to hospital.

This is vastly different from the US, where uninsured people are forced to either pay privately or go to an emergency room.

One In Five Million

You have to wonder if Mikey would ever happen to mention, when he talks about the cost of medicine, something about this:

I was appalled to learn of a colleague’s fate at the hands of a Mahoning County (Ohio) jury in a recent malpractice case. The patient presented with what any prudent physician would deem to be muscular back pain and went on to die of an aortic dissection. Given the patient’s age and sex, the likelihood of such an occurrence would be about two in 10 million.

The likelihood in the presence of back pain would be higher, but given the particulars of the case would still be vanishingly small. Making the diagnosis in a case like this would require a policy of obtaining a CT scan on virtually every case of back pain.

Why not obtain a CT scan on every patient with back pain or, for that matter, perform every test known to medical science on every patient who is ill? After all, peoples’ lives are at stake.

There are two reasons. First, nearly every test in medicine is inaccurate. A test that is positive often leads to further testing which, if the test result is in error, is unnecessary. Such testing is sometimes invasive and therefore potentially dangerous, and if the patient is hospitalized unnecessarily there is the additional risk of life-threatening infection. Because of this, the search for extremely unlikely diagnoses would kill more patients than would missing those diagnoses. Researchers at Dartmouth University have shown that more care is often worse care.

The second reason is cost. Embracing this policy would necessitate closing the Pentagon and abandoning public education. As it is, some of my younger colleagues, paralyzed by the fear of being sued, regularly spend $2,000 to diagnose a cold.

Malpractice is defined as a bad outcome resulting from negligence; negligence is defined as other than what a prudent physician would do in similar circumstances. That my colleague acted prudently is beyond dispute. The patient was a victim of fate, not negligence. My colleague was a victim of a process wherein a class of professionals with the morals of a drug dealer hires medical prostitutes to mislead juries in order to win the malpractice lottery. Nationwide, the money being diverted from patient care to service this process is $192 billion per year, approximately 10 percent of the entire cost of health care, enough to pay for all the costs incurred by America’s uninsured more than twice over, and far more than the annual cost of the wars in Iraq and Afghanistan.

I’ve probably said this before, but there is a perception in America that doctors note symptoms, look them up in a great big book and come out with a perfect diagnosis.  It ain’t so.  Medicine is as much art as science, as much instinct as knowledge.  Our bodies are not very good at indicating what’s wrong with them and most physicians have to to act on incomplete knowledge.  When they guess wrong—even when the right guess was a two in ten million shot—they get sued.  And we all pay.  Not only with malpractice premiums but with the cost of unnecessary tests.

But forgot that.  Our expensive healthcare system is entirely the result of evil insurance companies, evil drug companies and evil providers.  Don’t think.  Just feel. That’s it.  $8 for adults.  $4 for children.  Be sure to buy the DVD.

Stacking the Deck

Even the wonderful glorious NHS is apparently not immune to the Law of Unintended Consequences:

Hospitals were last night accused of keeping thousands of seriously ill patients in ambulance ‘holding patterns’ outside accident and emergency units to meet a government pledge that all patients are treated within four hours of admission.

Those affected by ‘patient stacking’ include people with broken limbs or those suffering fits or breathing problems. An Observer investigation has also found that some wait for up to five hours in ambulances because A&E units have refused to admit them until they can guarantee to treat them within the time limit. Apart from the danger posed to patients, the detaining of ambulances means vehicles and trained crew are not available to answer new 999 calls because they are being kept on hospital sites.

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Evidence of patient stacking is revealed in the official ‘turnaround time’ data from seven of England’s 11 regional ambulance services who responded when asked for the figures last week. These show that delays of at least an hour are widespread in the NHS. Figures relating to the past 15 months show that a total of at least 44,000 delays were reported by the seven ambulance services.

In London, there were 14,700 occasions last year when an ambulance took at least an hour from its arrival at one of the capital’s 35 hospitals to hand over a patient and be ready to respond to the next emergency. This figure includes 332 that took more than two hours.

The Department of Health says an ambulance should arrive in 15 minutes and, although it includes time taken to clean and restock a vehicle after a patient has been handed over, ambulance staff say that takes only five or 10 minutes.

‘These figures show there’s a terrible and colossal waste of ambulance resources going on in many parts of the country,’ added Oestreicher, whose union represents about half the 30,000 ambulance personnel in England. ‘The problem is that A&E units aren’t admitting patients who are in the back of ambulances if at all possible if it’s going to compromise the four-hour target that they are set by the government to treat all patients in A&E. They are deliberately keeping patients outside waiting in ambulances.’

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A Department of Health spokeswoman said last night that ‘these statistics are based on only seven out of 11 trusts and measure the time taken to turn around an ambulance for its next emergency, including cleaning and restocking the ambulance ready to go back out on the road. They do not reflect time spent by patients in the ambulance before being admitted to accident and emergency. These figures must be seen in the wider context of the 4.3 million patient journeys undertaken by emergency vehicles in 2006-07.

Just think, Mikey. Ten minutes of setting up your camera in an NHS parking lot and you might have broken a huge story. But then, that would go against your pre-conceived vision of the glories of socialized medicine.

You Are the Future of Healthcare

Yet another dispatch from Britain’s wonderful NHS:

The London Telegraph reported Tuesday that the British government has a “plan to save billions of pounds from the NHS budget.” But it won’t come without enormous pain.

“Instead of going to a hospital or consulting a doctor, patients will be encouraged to carry out ‘self-care’ as the Department of Health tries to meet Treasury targets to curb spending,” the Telegraph explained.

So when is a universal health care system not actually universal? When Britain’s 60-year-old National Health Service can no longer support the weight of its clamoring clientele.

Granted, there should be more self-treatment in developed nations. Emergency rooms and doctors’ offices are often overcrowded with patients who aren’t in need of urgent need but who go anyway because their insurance or government is paying. That type of open access to health care has led to overuse of the system.

The NHS, though, is hoping to cut down on more than frivolous visits. It’s looking for patients with “arthritis, asthma and even heart failure” to treat themselves, the Telegraph said.

Some of the self-care that will be expected of patients includes the monitoring of heart activity, blood pressure and lung
capacity using equipment that has been placed in the home.

Patients will be counted on to relate health information to doctors either by phone or computer link. To manage pain, they will administer their own drugs and other treatments.

This isn’t a completely horrid idea as socialized systems can be over-run by people running to their “free” doctor for every sniffle.

Still, if a private company were encouraging “self care”, don’t you think it would be the basis of a hilarious five minute section of Sicko II: The Re-Sickening?

A Small Amount of Choice

The British are trying something interesting—choice:

Elderly people will be given money to pay for their own care as part of a radical shake-up of the welfare system, Alan Johnson, the Health Secretary, will announce today.

The new personal care budgets will give millions of pensioners and younger disabled people the power to decide what kind of care they want and where they buy it.Currently, elderly people are at the mercy of social workers who dictate the services they need to live in their own homes.

Under the new system, which will be introduced next April, older people or their families will set up bank accounts into which councils will pay a monthly sum.

Beneficiaries will be means-tested to assess their needs before they are able to shop around for the best “personal care” packages, which will include help with getting dressed or washed, meals on wheels, cleaning services and cooking.

But wait! Michael Moore said the NHS was wonderful! They certainly don’t need to moving closer to the evil bloodthirsty capitalist monstrosity in the United States. This sounds awfully similar to the HSAs and other voucher programs proposed by evil heartless Republicans who are in the pocket of the for-profit healthcare industry. And we all know that people are way too stupid to decide how to spend their healthcare money.

The world’s falling apart, I tells ya.

GDP and Fingers

From Liz in Canada.

Mr K. and Mr. Lee,
I have been reading part of your site and, while on the whole I found it to be a little one sided, I found one opinion to be rather alarming.  The only mention I have found of this issue on your site is the following quote: “As the baby boomer generation ages, where are we going to get the money and resources to provide unlimited free healthcare?  Is it fair to saddle the current generation with a massive mountain of debt to do so?” While relatively harmless when only taken on its own, I wonder what the effect will be when others of my generation, the one who will have that massive debt, will respond to your quote.  The simple fact is that if not for our parents, who will require massive quantities of health care, we would not exist.  Was it fair to saddle them with the burden of raising us until, in some cases, the very late 20’s?  The current cost of raising a child is approximately 100 thousand dollars.  That does not even take into account the emotional responsibility as well as the difficulties involved in instilling a sense of responsibility and other , for lack of a better word, wantable attributes in another life.  After all this you actually raise the question is it fair to pay for their health care, to keep them comfortable, and to ensure that they feel as little pain as possible?  Perhaps you need to reevaluate your priorities ever so slightly.  By they way I am a canadian who has so far lived in ontario (universal health care) and alberta (more privatized) and I only have this to say: wait times may be high but there are less people missing fingers in ontario. I’ll gladly wait the extra time if it means getting the care i need.

Here’s my response.  My numbers might not be exactly right since I’m at work and wrote this from memory, but the overall theme is correct. Please, if you find more accurate numbers post them in the comments and I will correct what I wrote.

Elizabeth,

Thanks for a reasonably polite question.  Allow me to elaborate.  At the time Social Security was created there were more people paying into it than there were people taking out of it.  Thus there was enough money to finance the thing, plus a little bit left over. Piece of cake.

However, wherever there is a mountain of money laying around, and politicians eager to spend it to show that they’re “doing something,” there will be trouble.  So what the politicians have done is write themselves the world’s biggest IOU.  To put this in basic terms, imagine you had an empty jar on top of your fridge into which you put money for a rainy day.  Then, one day, you see a really cool stereo you want to buy. So you write yourself an IOU, take the money out, and spend it.

Then, when the rainy day comes, you have no money.  In this scenario, however, the only person who suffers is you.  What happened was the government opened the jar, wrote the IOU, then continued to write itself IOUs, to the point that there are currently something like $43,000,000,000 (that’s 43 trillion dollars) in unfunded benefits (i.e. IOUs) that the government has promised the baby boomer generation, who are now hitting retirement age.

Now, if you look at the boomer generation as a whole, they are the wealthiest single demographic in the entire United States.  The vast majority of them have no problem paying for their own medications.  They paid off their mortgages long ago, their children are grown and have college educations and families of their own, they’re doing just fine.  However, they’ve also been paying into the Social Security ponzi scheme their whole life and rightly want to get that money back.  Unfortunately, the government has already pissed it away.

So, how do we come up with $43,000,000,000?  There are one of two ways, we massively decrease benefits or massive increase taxes.  Since the boomer generation will be dead within the next two or three decades, and they are retired and thus not paying into the system any more (only withdrawing from it), they aren’t going to stand for any cuts in benefits.  So the only remaining option is to increase taxes to generate this $43,000,000,000.

To give you an idea of how much money this is, the entire gross domestic product (GDP) of the United States is about $13,000,000,000 a year.  Again, to put this in basic terms, imagine you make $13,000 a year, and you have $43,000 in credit card debt.  How the hell are you going to pay it off?

So, as I initially wrote, is it fair to saddle the current generation, who have no stake yet in social security, with a $43,000,000,000 bill that they had no hand in creating?  If you made $13,000 a year, how would you feel being handed a $43,000 bill that you didn’t create?

So, don’t confuse what i wrote with “You’re a mean heartless poo-poo head because you don’t want to take care of old people.” The issue is a lot bigger and a lot more complex than that.  The problem is that you have fallen for Michael Moore’s schtick—“Anyone who disagrees with me wants to throw old people out into the snow.  Look, they don’t sew fingers back on in America!” This is, as we have demonstrated countless time on the site, complete bullshit.

Is our site one-sided?  Perhaps.  But if so, it is only to act as a counterweight to the one-sided stream of lies and propaganda that have you believing everything that comes out of Michael Moore’s mouth.

So, Elizabeth, you tell me.  Should a recent college graduate, starting his life, be instantly saddled with a tax burden of roughly $35,000 a year for his entire life just to pay for the healthcare of one of the wealthiest groups of people in the country?  You tell me, does that seem “fair” or “compassionate” to you?

It sure doesn’t to me.  Oh, and one final thought:  when your super wonderful awesome magical healthcare system, where everyone has sunshine and rainbows shooting out their assholes, fails to provide you the healthcare you need, you always have the option of crossing the border into the evil, heartless, for-profit United States, as millions of your countrymen do every year, fingers or no fingers.

Elementary Math

It’s amazing how the intelligent, informed, enlightened “fact based community” can flunk simple math by saying that 20 million is equal to 47 million:

In his propagandumentary “SiCKO” that favored the socialist health care systems of Canada, Britain, France and Cuba, Michael Moore made the fantastic claim that almost 50 million Americans are uninsured.

“SiCKO: There are nearly 50 million Americans without health insurance,” quoted Moore’s Web site.

However, the Census Bureau report “Income, Poverty, and Health Insurance Coverage in the United States: 2005,” puts the initial number of uninsured people living in the country at 46.577 million.

A closer look at that report reveals the Census data include 9.487 million people who are “not a citizen.” Subtracting the 10 million non-Americans, the number of uninsured Americans falls to roughly 37 million.

Moore should have paid attention to that fact, since he agrees that being “an American” matters to get health insurance.

“That’s the only preexisting condition that should exist. I am an American. That’s it,” said Moore in footage aired by ABC’s “Nightline” on June 13.

That isn’t the only problem with the numbers currently being used.

If you’ve been to the site since I started posting, you know what’s coming next:

In his film and television appearances, Moore left out quite a bit of information about the uninsured.

On his Web site, Moore claimed the Census Bureau had “underreported” the number of people without health insurance.

But Cheryl Hill Lee, a co-author of the Census Bureau study Moore was citing, told the Business & Media Institute that the data showed the exact opposite of what Moore said.

The Census “underreported” the number of people covered by health insurance – meaning that more people have insurance than the report suggests. The Census also underreported the number of people covered by Medicare and Medicaid.

...

“The number of Americans with no health insurance is continuing to grow as more and more employers say they can’t afford to offer group insurance … People who try to buy insurance on their own often find the price beyond their reach,” said Couric as she introduced a two-part “investigation of the health insurance industry.”

But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326.

One important caveat here. Just because you have the money doesn’t mean you can get insurance. If you have a chronic condition, for example, you’re SOL. My own insurance agent couldn’t insure himself because of an eye condition. And one could argue that, in these cases, government help is the only option to bankruptcy.

However, bottom line:

So what is the true extent of the uninsured “crisis?” The Kaiser Family Foundation, a liberal non-profit frequently quoted by the media, puts the number of uninsured Americans who do not qualify for current government programs and make less than $50,000 a year between 13.9 million and 8.2 million. That is a much smaller figure than the media report.

Kaiser’s 8.2 million figure for the chronically uninsured only includes those uninsured for two years or more.  It is also worth noting, that, 45 percent of uninsured people will be uninsured for less than four months according to the Congressional Budget Office.

That number actually sounds a bit low to me, based on my own experience. But, of course, we’re focusing on insurance, not care. These people are not being tossed out of emergency rooms. They just don’t have an insurance company footing the bills.

NYT’s Numbers on the Dark

Libertarians, conservatives and health-care wonks have been disputing the numbers supporting Michael Moore’s Sicko thesis for some time. But, of course, those objections aren’t real until a Harvard Professor writes about them in the New York Times:

WITH the health care system at the center of the political debate, a lot of scary claims are being thrown around. The dangerous ones are not those that are false; watchdogs in the news media are quick to debunk them. Rather, the dangerous ones are those that are true but don’t mean what people think they mean.

Here are three of the true but misleading statements about health care that politicians and pundits love to use to frighten the public:

STATEMENT 1 The United States has lower life expectancy and higher infant mortality than Canada, which has national health insurance.

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STATEMENT 2 Some 47 million Americans do not have health insurance.

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STATEMENT 3 Health costs are eating up an ever increasing share of American incomes.

HIs refutation of each statement should sound familiar. We’ve been making these refutations on Moorewatch all year long. But it’s nice for the NYT to finally get with the times. Stay tuned for the NYT to be shocked, shocked!, to find that there are long waits for surgery in the UK.

Not all Brits are happy with “Sicko”

"Sicko” recently had its grand opening in England, and I was expecting it to receive quite a fanfare. It seems, however, that a fair number of reviewers are only loving the first half of the movie… y’know, the part where Moore slams the American system. It’s when Moore shines his happy rose-colored light on the British system of health care that has many reviewers all riled up.

The review from the Scotsman starts off with a bang, furiously agreeing with an indicting the American health care system:

FORGET about Kurt Russell’s character in Death Proof, Michael Moore should rename himself Stuntman Mike. With his latest film, Sicko, America’s premiere left-wing polemicist solidifies his reputation as a consummate showman, pulling off some outlandish tricks and making damn sure he leaves us entertained. He may not put his life on the line, but in this examination of America’s healthcare system, he does do what no-one else has dared do on such a broad public platform: he stands up and asks why the wealthiest country in the world doesn’t have a system that provides basic care for the sick of any age, race, class or income level.

It’s a principle that’s so fundamentally sound that it’s impossible rationally to argue against it. Yet a lot of people in America do. The profit-hungry drug companies with their outlandish product mark-ups; the bureaucratic Health Maintenance Organisations (HMOs) responsible for so many insurance policies that fail the patients; the politicians dependent on campaign contributions from the industry - these are just a few of the key players who collectively have a stake in ensuring that the health of the nation doesn’t improve.

But, just as quickly, the review turns when it begins to discuss the second half of the film:

It’s too bad, then, that Moore undermines his own efforts with his excursions abroad to superficially compare and contrast the health systems of other nations with the US. With faux naïvete and specs heavily tinted with rose, he travels to Canada, France, the UK and Cuba to marvel at the utopian dream we’re all living courtesy of our super-duper free health service, which apparently costs us absolutely nothing, is run with clockwork efficiency, has no waiting lists and pays all its cheerful, definitely not-overworked doctors enough to have a flash car and a nice £500,000 home in the middle of London. It’s a land where MRSA doesn’t exist and where “who gets what treatment when” isn’t determined by inefficient hospital trusts that squander millions.

Sure, nobody could seriously want to trade the NHS for an American-style system (Tony Benn says in the film if that happened “there’d be revolution"), but it’s not helpful to suggest to US audiences that it costs nothing and works perfectly. More to the point, you may find yourself slightly peeved that your National Insurance contributions are also providing free emergency treatment for idiotic American Beatles’ fans who throw their back out while doing handstands on the Abbey Road zebra crossing.

The story Moore is telling is powerful and humanistic enough without such embarrassing deviations. If only the compassion he demonstrates for his fellow Americans was matched by an appreciation for their ability to grasp complex issues without all the parlour tricks, he might be on to something.

This article in The Telegraph also takes issue with Moore’s portrait of the British health care system, which it claims it is a state of complete calamity:

This weekend, the film Sicko — an indictment of US healthcare by the American polemicist Michael Moore — opens across Britain. In it, Mr Moore depicts our NHS somewhat simplistically as a haven of kindly efficiency. While his view is a reminder that there is much to be admired in the NHS, particularly by foreigners, it ignores the harsh fact that it is an organisation heavily funded by British taxpayers and frequently failing to provide proper care in return. Too often, wards are going uncleaned, and patients are neglected in the essential basics of washing and feeding. When a nurse of the stature of Justine Whitaker from Lancashire, named Nurse of the Year for her work in cancer care, resigns in despair because the constant burden of form-filling means that some days she doesn’t get to see a single patient, it is evidence of a system in serious trouble… Time and again, Government ministers have promised the public cleaner wards and greater one-to-one care, only to be rocked by yet more scandals. This is not simply a result of demand outstripping natural capability, but of systematic flaws in the operation of the NHS, compounded by fresh blunders. The money in the NHS is often squandered on lunatic Government initiatives, such as the botched rejigging of the junior doctors’ job application procedure, or the terrifyingly incompetent new contract for GPs that has now resulted in an average GP salary of £120,000 a year while permitting 90 per cent of GPs to opt out of providing care at evenings and weekends. These are disasters imposed from the top down, and paid for dearly from the bottom up. It is time that the Government did what it so often promises and so often fails to do, and really put the patient first.

So here’s my question of the day. If the British can clearly see that Moore’s depiction of their own health care system is biased, based on poor data and research and completely misleading… why can they not seem to grasp that Moore’s depiction of the US system might also be biased, based on poor data and research and completely misleading? How can anyone honestly think that Moore could get one half of his movie completely right and the other half completely wrong? How is it not apparent to these viewers and reviewers that if part of something is a deception that the rest of the the thing must also be construed as possibly being deceptive as well?

It boggles the mind, doesn’t it? 

Surplus … Debt… What’s the Difference?

This sort of nonsense drives me crazy. Britain’s NHS is jumping and down about how they are running a surplus this year. Except:

NHS trusts have a £4bn backlog of key maintenance repairs which range from fixing heating to meeting fire safety rules, government figures suggest.
The figure is eight times this year’s much-heralded NHS surplus, which was achieved by making a variety of cuts.

Shadow Health Secretary Andrew Lansley, who obtained the figures, said they showed the surplus was a “sham”.

But the Department of Health said repairs come under a different budget, and have no bearing on the surplus.

“Public health budgets, education and training budgets and now the basic maintenance and upkeep of our hospitals have been laundered to produce this surplus.”

A surplus in the NHS is not a good thing. It means you’re providing less in services than the British public is paying for. To use Michael Moore’s analogy, the government is wallowing in evil evil profit. Governments do this kind of accounting fraud creativity all the time. Look up the history of the Gramm-Hollings Balanced Budget Act sometime and the accounting gymnastic the Democratic Congress used to “comply” with the law.

$8 billion in maintenance people. That’s the sort of thing than can get taken care of when you have an evil for-profit healthcare system.

.Originally posted at Right-Thinking

Capitalism is the Solution

The vast majority of the hate mail we receive from the Moore worshippers are people from Europe who have been fooled by their idol into believing that the only option to the current disastrous US healthcare system is the European socialist model.  This is, of course, completely untrue.  Everyone knows that the old system of employer-provided insurance, in place wince WWII, does not work in today’s world and needs to be ended.  The question is, do we replace it with the socialist model, which is clearly just as bad in many respects and vastly worse in others?  The following article from Reason explains how we can end the ridiculous system we have now without adopting the socialist welfare disaster of Europe and Canada.

Unfortunately, the CED proposals go quickly off the rails when the group recommends that every household receive a fixed-dollar credit sufficient to purchase an approved low-priced quality health plan. This health insurance credit would not be means tested and would be financed by some kind of broadly based tax—perhaps a payroll, value-added or environmental tax. Such taxes, like Social Security and Medicare payroll taxes, are likely to be regressive, which means the poor will pay a larger percentage of their incomes than the rich. In fact, two-thirds of taxpayers paid more in social security and Medicare taxes than they did income taxes.

For example, today every wage-earning American pays a Medicare payroll tax of 2.9 percent. That tax is supposedly divided so that employees and employers each pay 1.45 percent. Of course, employers would give employees the other 1.45 percent if they were not paying the tax, so in reality the employees are paying the whole tax. The same thing goes for the Social Security Ponzi scheme.

The CED proposal is chiefly a ploy to get employers out from under the increasingly heavy burden of buying insurance for their employees. That’s a laudatory goal, but it shouldn’t be done by imposing yet another tax on employees. The good part of the CED proposal is that employees would purchase private health insurance in a competitive market. If households could find a policy for cheaper than the credit, they could pocket the extra money for themselves. The CED argues persuasively that this kind of competition would tend to keep health care costs down.

But why advocate a tax to pay for the credits? One advantage of such a health insurance credit is that it would avoid the administrative and enforcement costs of coercing people to buy insurance. Such enforcement has proved problematic in other insurance markets. For example, although auto insurance is mandatory, more than 14 percent of motorists are uninsured.

However, there is a better way to expand private health insurance and to obtain the benefits of competition as a way to keep medical spending down. First, retain the CED proposal that health insurance be mandatory. But, instead of a new tax, allow employers to hand over the money they currently spend on health insurance to their employees in the form of money wages. Then, in order to create a level playing field, expand the current tax exemption for employer-purchased health benefits to all individuals. Maintaining the tax exemption helps enforce the mandate because taxpayers will have to report annually how much they paid for their health insurance when they pay their taxes.

What about the poor Americans who do not make enough to afford medical insurance? Give them vouchers to buy private medical insurance and pay for the vouchers by abolishing Medicaid. In 2005, the Federal government and the states spent $316 billion on Medicaid to cover around 17 million households. That works out to about $18,500 per household per year. The annual premium for family coverage in 2007 averaged just over $12,000. Due to increased competition, average premiums for the minimum private plans will drop. This means that some money should be left over from Medicare to pay for the currently uninsured poor. There will be some administrative costs involved with determining voucher eligibility, but the health insurance vouchers themselves would essentially be self-enforcing. The experience of Switzerland, in which nearly one-third of the population receives subsidies to purchase private insurance, suggests that very few would fall through the new health insurance safety net.

God bless the free market.

Superbugs

You know that socialist paradise in Britain? It’s killing people:

Nurses who didn’t wash their hands and left patients lying in soiled beds were cited in an official report blaming mismanagement for the deaths of 90 people who contracted a bacterial infection in hospitals in southern England.

“Significant failings” at all levels contributed to infections of more than 1,000 patients at three hospitals, the Healthcare Commission said Thursday.

The patients were infected with Clostridium difficile, or C. diff, which can cause diarrhea, colitis and other intestinal problems, officials said.

...

The report into the spread of the highly contagious bacterium said nurses at three hospitals run by the Maidstone and Tunbridge Wells NHS trust were often too busy to wash their hands and left patients in their own excrement.

....

In recent years, Britain’s superbug infection rates of bacteria like Clostridium difficile and MRSA have skyrocketed. In the 1990s, only five percent of in-hospital blood infections were from MRSA, the deadly bacteria resistant to nearly every available antibiotic. In past years, that figure has jumped to more than 40 percent.

Now, in fairness, these superbugs are popping up in American hospitals as well. It’s partly a result of indiscriminate use of antibiotics and patients refusing to take full doses of said antibiotics that have created these drug-resistant strains.

But it doesn’t help matters when your hospital are understaffed because of funding concerns. Or when nurses are simply turning sheets over between patients to save money.

Socialist Paradise Update, Part XLI

Canadians are coming to America for neonatal care of premature babies. I guess we could be like every other country and let babies who weigh under 500 g just die. That would boost our life expectancy and infant mortality numbers and make sure those Canadians stay put in their socialist paradise.

And on the other side of the world, Australian surgery clinics are shutting down to save money.

The Royal Australasian College of Surgeons accused NSW Health yesterday of using maintenance as an excuse to cut costs by greatly reducing the operating theatre time and intensive care beds needed for elective surgery. It said the number of surgeons leaving the public system had risen because they were fed up with budget constraints.

Mmm. I can’t wait until we get this. Of course, Captain Mike will have lots of money to pay for his own private care. But the rest of slobs can look forward to when these articles are not about foreign countries, but about ours.

Ah, That Island Paradise

I was innocently basking in the wonderful sight of Cuba’s UN delegation flouncing out of the room because Bush said some mean wotten things about Pappa Fidel, when Reason brings this nonsense to my attention. It’s a long scientific paper (and behind a firewall in any case) but the abstract is something that will make Michael Moore drool. We’ll be sure to see him crowing about this soon.

Cuba’s economic crisis of 1989–2000…

Whoa whoa whoa! Wait a minute. Wait a minute. Wait a minute. Economic crisis of 1989-2000? An eleven year economic crisis?! That’s impossible on the Island Paradise. Note the year it started. 1989. The year communism fell and Fidel stopping getting handouts from the Commies. So, in a very real sense, they have been in an economic crisis since 1959.

Anyway, resuming our discussion:

Cuba’s economic crisis of 1989–2000 resulted in reduced energy intake, increased physical activity, and sustained population-wide weight loss.

Most people call that “starvation”, but I’ll let them stick to the technical terms.

The crisis reduced per capita daily energy intake from 2,899 calories to 1,863 calories. During the crisis period, the proportion of physically active adults increased from 30% to 67%, and a 1.5-unit shift in the body mass index distribution was observed, along with a change in the distribution of body mass index categories. The prevalence of obesity declined from 14% to 7%, the prevalence of overweight increased 1%, and the prevalence of normal weight increased 4%.

Add the numbers to see what they’ve left out—the population of underweight people increased at least 2%. As a commenter at Reason pointed out, the Jews lost a lot of weight during the Holocaust, too. I would add that so did the Ukranians during Stalin, the Irish during the Potato Famine, Africans during various civil wars, Cambodians under Pol Pot and . . . Christ, I can’t go on with this. You get the idea.

During 1997–2002, there were declines in deaths attributed to diabetes (51%), coronary heart disease (35%), stroke (20%), and all causes (18%).

Of course, we always believe numbers that come out of Communist countries. Like the way the Soviets used to claim they had suburbs. Granted, some of those suburbs consisted of log cabins and mud huts, but ... they were suburbs! Those people were below the urb. In many cases, six feet below it.

Not reported? How much of an increase there was in death by suicide and starvation. Note carefully that the overall death rate dropped less than the death rate from stroke, heart disease and cancer - so something must have increased. For most people, you’ve got to live a while before you get a stroke, heart disease or cancer. I have no doubt that the millions of Africans murdered during the Congo War had decreased rates of stroke, heart disease and cancer as well.

An outbreak of neuropathy and a modest increase in the all-cause death rate among the elderly were also observed.

Hmm. So just one decade of this back-breaking-labor-and-starvation plan has already shorted and worsened the lives of Cuba’s seniors. That’s nice.

These results suggest that population-wide measures designed to reduce energy stores, without affecting nutritional sufficiency [!!], may lead to declines in diabetes and cardiovascular disease prevalence and mortality.

So there you have it. Michael Moore was right. Cuba has pointed the way! All we need to do is reduce ourselves to such abject total poverty that our 15-year-old daughters are prostitutes. We need to all quit our computer jobs and go to manual labor (all except Mikey of course. Every Golgafrinchan paradise needs documentary film makers). We need to all get the food literally ripped out of our hands ... and we’ll all be healthier!

I think Michael, for opening the discussion of how wonderful Cuba’s healthcare system is, deserves, at minimum, a Nobel Prize. I’ll see if they have a category for fatuous self-importance.

I’m going to go off on a tangent here, but one I think is critical to how we think about socialized medicine. If we get MikeyMooreCare, forced diets will be coming, one way or another.

45 million. 17 million. It’s All Good

Mark Steyn breaks down the 45 million uninsured:

So, out of 45 million uninsured Americans, 9 million aren’t American, 9 million are insured, 18 million are young and healthy. And the rest of these poor helpless waifs trapped in Uninsured Hell waiting for Hillary to rescue them are, in fact, wealthier than the general population. According to the Census Bureau’s August 2006 report on “Income, Poverty and Health Insurance Coverage,” 37 percent of those without health insurance – that’s 17 million people – come from households earning more than $50,000. Nineteen percent – 8.7 million people – of those downtrodden paupers crushed by the brutal inequities of capitalism come from households earning more than $75,000.

In other words, if they fall off the roof, they can write a check. Indeed, the so-called “explosion” of the uninsured has been driven entirely by wealthy households opting out of health insurance. In the decade after 1995 – i.e., since the last round of coercive health reform – the proportion of the uninsured earning less than $25,000 has fallen by 20 percent, and the proportion earning more than 75 grand has increased by 155 percent.

Steyn is being a bit glib. Several of these groups overlap. There are millions of uninsured poor and middle class people.

But his general point is correct. I’ve read the Census report on the number of uninsured. They freely admit that the numbers have larger error bars and that only half of the “uninsured” are uninsured for more than six months. I myself, bouncing from great academia insurance to great academia insurance, have been “uninsured” twice in the last five years—for a couple of days. The universal coverage crowd just takes the worst number and claims that every single person in that group is scrabbling around for healthcare.

I wonder if the DVD of Sicko! will include an interview tih some 25 year-old making $100k a year who has decide to go uninsured. Don’t hold your breath.

Get Me Outta Here!

I hate to pick on someone who has cancer. But when you support a system that denies people the privilege of getting what your wealth allows you to get, you’re relevant:

Liberal MP Belinda Stronach, who is battling breast cancer, travelled to California last June for an operation that was recommended as part of her treatment, says a report.

...

“Belinda had one of her later-stage operations in California, after referral from her personal physicians in Toronto. Prior to this, Belinda had surgery and treatment in Toronto, and continues to receive follow-up treatment there,” said MacEachern.

...

“In fact, Belinda thinks very highly of the Canadian health-care system, and uses it when needed for herself and her children, as do all Canadians. As well, her family has clearly demonstrated that support,” MacEachern told the Star.

Well, of course the system is good . . . until you get really sick. Read the comments, which are expressing sympathy for her and describing this as a personal matter. I agree, it is. I agree, she should seek out the best care she can get. I don’t have any issue whatsoever with Ms. Stronach doing whatever she can to battle her breast cancer.

My issue is not with her at all. It’s with the Moore-ons and socialists. If we had a Candian-style system in this country, Belinda Stronach might be dead. And no matter how liberal she is, I think she—I think everyone—should have the opportunity to seek out the best care they can get without the government looking over their shoulder worrying that it’s not cost-effective. Yes, some people, like Ms. Stronach, will get better care than the rest of us. But that will happen no matter what system do we have. Which would you rather play a bigger role in the quality of care you get: your money or your political connections?

(PS - I’ll post on Hillarycare II: The Search of the Whitehouse soon.)

One more reason you don’t want the government providing your health care

Because they can’t even sell sex right.

The Federal Government of the United States can not run a bordello and make money.

One cathouse. Just one. Not “one in every state”. Not “one whether you think you need it or not”. Just one single legal bawdy-house with an already-established customer base.

And they couldn’t keep it out of the red.

Now, this is just my opinion, but if your money-handling skills are so poor that you can’t even make a profit selling sex, then you have absolutely no business getting involved in more complicated financial areas.

OK, so you think that the Fed running the Mustang Ranch isn’t really comparable to a giant, plodding bureaucratic division running the health of every man, woman and child in America?  Is this a little better?

DNA backlog piles up for FBI

The FBI has fallen behind in processing DNA from nearly 200,000 convicted criminals — 85% of all samples it has collected since 2001 — Justice Department records show.

The backlog, which expands monthly, means most of the biological samples the bureau collects have not been stored in the national DNA database and used to solve crimes. DNA from 34,000 convicts has been added to the database since 2001, resulting in 600 matches to unsolved crimes, according to statistics furnished by the Justice Department to the Senate Judiciary Committee. At the same rate, the unloaded samples could help solve an additional 3,200 crimes.

The backlog expanded by about 80,000 samples in 2006, when a law took effect requiring that all federal convicts, rather than just violent felons, submit DNA samples. A new law requiring DNA to be taken from about 500,000 federal arrestees and detainees could swell the backlog. Rules for implementing that law are due early next year, according to Office of Management and Budget documents.

How does this pertain to Special Magic Free Universal Health Care For All?  Testing.  How many blood tests have you had in the last 6 years?  Are you willing to trust your health to a government that has a backlog of six freaking years for one small segment of the population (i.e. criminals)?  How in the name of anything can we expect that adding over 300 million people will go more smoothly?  Feds require certification for everything, so you can’t tell me they’ll just punt it off to local, third-party labs.  That will be expensive, plus not everyone will be able to be certified right away, if ever.  Now what?  We all just sit around, while some building full of bureaucrats “prioritize” who gets test results first?  How is that different from Kaiser, or Humana, or Anthem?  At least the companies have some tiny motivation to provide service.

The government has none.  If you make them your only option, you will get crapped on at every turn and you will have absolutely no recourse and nowhere to turn.  If it ends up, as we all know it will, a tangled mess of complexity and incompetence, you will have absolutely no recourse and nowhere to turn.

Say no to government-provided health care.  It’s the healthiest thing you can do.

Hat tip: Drumwaster.

The US Sucks - We’ll Prove It!

John Stossel tears apart a recent “study” that showed the US system is inferior to everyone else.

But while the U.S. lost points for not having national health insurance, the authors added, “[I]f insured, patients in the U.S. have rapid access to specialized health care services.” That’s an understatement. Insured Americans have almost immediate access to cutting-edge procedures performed by some of the best-trained doctors. It’s why our outcomes for such diseases as prostate and breast cancer are markedly better than in Canada’s and Britain’s socialized systems. The Commonwealth Fund doesn’t mention that.

I’ll add that uninsured Americans often have access to cutting-edge medicine as well. My dad treats gunshot and car crash victims who are often insured but get astonishing care, surviving injuries that would have killed them just ten years ago. Recently, a disabled friend of mine, who is uninsurable, came down with a serious illness. Not only did he get outstanding healthcare but hospital social workers are helping him acquire retroactive Medicaid.

The Commonwealth Fund’s study has other problems. It was based on telephone interviews with patients and doctors. So it grades nations on people’s perceptions without controlling for their expectations. Yet patients who live in a country with long waits for medical care and bureaucratic inefficiency may have low expectations.

More ridiculous is the arbitrary way the Commonwealth Fund assigns weight to each of its measures. The proportion of patients who say they got infected at a hospital counts about the same in the “quality” measure as the proportion of doctors who use automated computer systems to remind them to tell patients their test results. Those things aren’t equal in my book.

Read the whole thing. It’s ridiculous for anyone to cite this “study” to prove the US healthcare system stinks.

Which, of course, makes it perfect fodder for the Moore-ons who love anything that sounds factual but isn’t.