Sanjay Gupta, Superstar

You remember Sanjay Gupta?  He was CNN’s medical correspondent for a long time.  When he had the temerity to disagree with Michael Moore, he was pilloried by the Moore-ons and Moore apologists like PZ Myers. They could not believe that a member of the MSM would dispute the vileness of America’s healthcare system.  We blogged on the Moore-Gupta dust-up here, here, here and here.  For disputing Moore, Gupta was called a tool of the system.  This quote, from revere, is typical:

Gupta was badly roughed up and had he any testicles prior to the interview would have found them gone after it. Given his track record, he actually had nothing to lose. I’m not a violent or blood thirsty kind of person, but even I have to admit it can be entertaining to watch someone beat up in public.

One can disagree with Gupta, although the links above document, very throughly, that Gupta was right and Moore was wrong.  But the personal attacks and slagging of Gupta was typical of the Cult of Personality that has built up around our favorite documentary film-maker.  And no doubt they played some role in his decision to withdraw his name as a nominee for Surgeon General (to be fair, many liberals loudly supported his nomination).

Ignored in the fracas and character assassination was that Gupta is a skilled neurosurgeon who has saved and improved lives. While covering the Iraq War, he rolled up his sleeves and operated on both military and civilian casualties.

He’s done it again:

After doctors and nurses from a Belgian medical team left a field hospital Friday night because of security concerns, Dr. Sanjay Gupta, CNN’s chief medical correspondent, was the only doctor to help 25 earthquake victims, CNN said Saturday.

The network said Belgian Chief Coordinator Geert Gijs, a doctor who was at the hospital with 60 Belgian medical personnel, told CNN that he decided to pull the team out for the night.

Gupta stayed all night at the hospital with other CNN staffers, security personnel and at least one Haitian nurse who had refused to leave, CNN said.
“I’ve never been in a situation like this. This is quite ridiculous,” Gupta said. He monitored patients’ vital signs, gave them pain-killers, continued intravenous drips and stabilized three new patients in critical condition, CNN reported.

This, my friends, is making a difference.

Cold Water on the Cuban Myth

It’s a rare month that doesn’t go by without yet another demonstration of why Michael Moore was so totally wrong on Cuba’s healthcare system.  Here‘s the latest:

Twenty-six patients at Cuba’s largest hospital for the mentally ill died this week during a cold snap, the government said Friday.
Human rights leaders cited negligence and a lack of resources as factors in the deaths, and the Health Ministry launched an investigation that it said could lead to criminal proceedings.

A Health Ministry communique read on state television blamed “prolonged low temperatures that fell to 38 degrees Fahrenheit (4 Celsius) in Boyeros,” the neighborhood where Havana’s Psychiatric Hospital is located.

It said most of the deaths were from natural causes such as old age, respiratory infections and complications from chronic diseases including cancer and cardiovascular problems.

The statement came in response to reports from the independent Cuban Commission on Human Rights that at least 24 mental patients died of hypothermia this week, and that the hospital did not do enough to protect them from the cold because of problems such as faulty windows.

Commission head Elizardo Sanchez said that so many patients dying of hypothermia was “absurd in a tropical country” and claimed the deaths could have been prevented if the government had granted long-standing requests from international aid groups to tour Cuba’s medical facilities, including the capital’s 2,500-bed mental hospital.

But it’s universal healthcare!  And it’s free!

When P.J. O’Rourke visited East Germany, he marveled that communism could make a poor country out of Germans.  I have to stand back in awe of a system that has people freeze to death in Cuba of all places.  The Cubans are, as usual, blaming the US-led embargo.  But you don’t need fancy imports and trade to keep people warm at night. Is the embargo so onerous that their wonderful healthcare system can not procure a few blankets or seal a few windows?  How does this happen?

Smiles For Socialism

For people who oppose socialized medicine, Britain’s NHS is the gift that keeps on giving.  And for genuine Brits, it’s a nightmare:

Like so many young women, Amy King always took great pride in her appearance.

Standing in front of the mirror to check her make-up before a night out, the 21-year-old would always try a smile - friends told her they loved the way it lit up her face.

Eight weeks ago, all that changed. The student from Plymouth was admitted to hospital where, in a single operation, she had every tooth in her mouth removed.

Amy, whose dental problems were caused by untreated gum disease, does not go out any more. And when she looks in the mirror she hardly recognises the face staring back at her.

...

While Amy’s experience is an extreme one, it highlights growing concerns about the state of the nation’s dental health.

Last week, statistics obtained by the Liberal Democrats revealed that the number of people having teeth extracted in hospital has risen by one third in the past four years.

More than 175,000 Britons had their teeth removed under general anaesthetic in 2007/08, up 40,000 on the 2003/04 figure.

The number of children having teeth out has shot up, too. But more pertinent is the fact that the rate of these extractions gathered pace after a deeply controversial contract for NHS dentists was introduced in April 2006.

Read the whole thing.  The system in Britain is basically denying people routine care but paying for massive expensive procedures.  So Amy couldn’t get any help until they needed to yank out every last tooth.

Yes, the Law of Unintended Consequences rears its ugly head again.

The NHS’s Latest Hits

Mike, what news is there from the wonderful UK healthcare system?  Glad you asked:

The full extent of the horrific conditions at an NHS hospital where hundreds may have died because of ‘appalling’ care was laid bare yesterday.

Dehydrated patients were forced to drink out of flower vases, while others were left in soiled linen on filthy wards.

Relatives of patients who died at Staffordshire General Hospital told how they were so worried by the standard of care they slept in chairs on the wards.

The ‘shocking’ catalogue of failures was released yesterday after an independent investigation by the Healthcare Commission.

It found Government waiting time targets and a bid to win foundation status were pursued at the expense of patient safety over a three-year period at Mid-Staffordshire NHS Trust.

The commission’s report - revealed in yesterday’s Daily Mail - said at least 400 deaths could not be explained, although it is feared up to 1,200 patients may have died needlessly.

This is just stunning.

Among the findings of the report were:

Receptionists carrying out initial checks on patients;

Two clinical decision units - one unstaffed - used as ‘dumping grounds’ for A&E patients to avoid missing waiting targets;

Nurses who turned off heart monitors because they didn’t understand how to use them;

Delayed operations, with some patients having surgery cancelled four days in a row and left without food, drink or medication;

Vital equipment such as heart defibrilators was not working;

A savings target of £10million met at the expense of 150 posts, including nurses.

I will grant that this is not typical of the NHS system.  But it is something that you will get when you essentially take the consumer completely out of the loop.

But let’s look at the good side—at least the kept costs down.

Explosively Good Medicine

Meet the doctor.

NHS doctor Bilal Abdulla, who tried to blow up a London nightclub and Glasgow airport, will serve a minimum of 32 years after a judge condemned his “murderous intent” to maim and kill.

Mr Justice Mackay told Bilal Abdulla, 29, he was a “ very dangerous man” who posed a high risk to the British public

He said he had no doubt that Abdulla and his accomplice Kafeel Ahmed, 28, who died a month after the attacks, were planning to “kill innocent civilians on an indiscriminate basis.”

Both men shared equal responsibility, he added, but they may have had “external encouragement.”

Abdulla, a junior doctor from Iraq, and Ahmed, a PhD student from India, tried to set off two car bombs outside the Tiger Tiger night club in London’s West End and when they failed to go off drove a burning Jeep into Glasgow airport in June last year.

The judge said the nails added to the London bombs demonstrated Abdulla’s deadly intent and the car had been parked next to a the glass wall of the nightclub for maximum effect.

He said: “Your murderous intent was best shown by the obstructing of the safety mechanisms on two of the cylinders and by the 800-plus nails in one car and 1,000 in the second, designed to do nothing else but constitute a deadly form of shrapnel to maim, injure and kill.

“The club represented everything that you and Ahmed held in contempt and despised about Western culture - drink, association between the sexes, and music.”

Michael Moore fans will be thrilled to know that Dr. Abdulla’s medical care was provided free by the British government.

Hawaii Bye Bye

It’s hard times for the kiddies in Hawaii.

Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.

Gov. Linda Lingle’s administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

“People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. “I don’t believe that was the intent of the program.”

What?  How can this be?  You mean that when the government provides something for free it provides an incentive for people to take advantage of the system?  My God, who could have ever dreamed of such a thing!

State health officials argued that most of the children enrolled in the universal child care program previously had private health insurance, indicating that it was helping those who didn’t need it.

This is why universal health insurance is such a bad idea.  It encourages people to do things that they normally wouldn’t (and shouldn’t) do.

Update Here’s a quote, generally attributed to Alexander Fraser Tytler which so perfectly predicts and illustrates this dynamic.

“A democracy is always temporary in nature; it simply cannot exist as a permanent form of government. A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury. From that moment on, the majority always votes for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy, which is always followed by a dictatorship.”

The average age of the world’s greatest civilizations from the beginning of history has been about 200 years. During those 200 years, these nations always progressed through the following sequence:

• From bondage to spiritual faith;
• From spiritual faith to great courage;
• From courage to liberty;
• From liberty to abundance;
• From abundance to complacency;
• From complacency to apathy;
• From apathy to dependence;
• From dependence back into bondage.

This is why I’m a Libertarian, and why the less government we have in our lives the better.  Nobody will listen, though.  They’ll keep on looking at the ample teat of government as a place to suckle for free, always expecting other people to pay for things they should be doing themselves.  When you remove the incentive for responsible behavior you end up with citizens behaving irresponsibly.

Which, I’m sure, would NEVER happen in Michael Moore’s fantasy healthcare utopia, would it?

Canadian Hands

At one point, during the promotional period for Sicko, Michael Moore said something to the effect of, “Do you think you could find anyone in Canada who would trade their healthcare system for ours?” (If you can remember the exact quote please post a link or, if you’re a fellow poster, put it as an update.) At any rate, recently there was a debate held over universal healthcare, and one of the panelists arguing in favor of it was Paul Krugman, liberal economist and New York Times columnist.  Here’s a portion of an exchange from the debate.

PAUL KRUGMAN
And private insurance? That’s the thing, I— Actually, can I just —I wanted to ask a question. And—

JOHN DONVAN [MODERATOR]
Please—please do—

PAUL KRUGMAN
—and I wanted to ask, actually two questions, to the audience. First, how many Canadians, would Canadians in the room please raise your hands. [ONE PERSON APPLAUDS, LAUGHTER]

JOHN DONVAN
We have about seven hands going up—

PAUL KRUGMAN
Okay, not as many as I thought. Okay, of those of you who are not on the panel who are Canadians,, how many of you think you have a terrible health care system. [PAUSE] One, two—

JOHN DONVAN
We see—almost all of the same hands going up. [LAUGHTER]

PAUL KRUGMAN
Bad move on my part. [APPLAUSE]

Remember, folks, Canada is a utopia where everyone gets all the super awesome magical unicorn healthcare they need, and only evil rich corporations pay for it.

Once Again, Capitalism Saves the World

When Michael Moore wants to drop a few pounds he usually just pays someone to use Photoshop to stick his head on the body of a smaller fat guy.  Other than that he pays hundreds of thousands of dollars to go to the world’s most exclusive fat farm resorts.  However, if you’re a nurse in the socialist medical utopia of the UK, you just let the taxpayers pick up the bill.

Overweight nurses are to get personal trainers and high street vouchers to encourage them to lose weight.

More than 200 NHS staff are being equipped with pedometers and offered motivational fitness coaches to help them slim down.

They have been promised £20 of high street store vouchers if they manage to keep the weight off during the year-long pilot.

But here comes the best part.  Are you ready?  Make sure you’re sitting down, because this is awesome.

The £250,000 scheme at Birmingham East and North Primary Care Trust is being run by American healthcare company Humana, which wants to roll the programme out across Britain.

That’s right, folks!  The compassionate, free governmental fantasyland of the UK is turning to an evil, greedy, for-profit, heartless capitalist American company to get their lard-ass nurses to drop weight. 

My God, it’s almost as if socialism doesn’t work, and the free market provides solutions that government either cannot or will not!  Who could have ever imagined such a thing?

Dead Baby Jokes

You know that wonderful medical utopia in the UK, where everyone gets all the super duper magical free healthcare they could ever need, and it’s paid for by fairies and unicorns?  Well, it’s killing babies.

A devastating report on the state of Britain’s maternity services has concluded that they put the lives of women and their babies at risk.

The first national inquiry into maternity care by the Healthcare Commission, the NHS watchdog, has revealed a critical shortage of midwives, obstetricians absent from wards, a lack of beds and poor continuity of care. These have contributed to high death rates in some units and threaten the long-term health of mothers and their babies in others.

The inquiry, which is the largest ever carried out, involved all 150 NHS maternity units in England. It was triggered by separate full-scale investigations conducted at three trusts where mothers and babies died, which revealed failings indicative of a national pattern.

The three trusts were Northwick Park Hospital in Harrow, where 10 mothers died between 2002 and 2005, New Cross in Wolverhampton, where three babies died in two months in 2003, and Ashford & St Peters in Surrey, where there was a series of serious incidents in 2000 and 2001.

The Healthcare Commission said the root cause of poor performance was weak leadership by managers and medical staff. Many trusts were critically short of midwives, with numbers ranging from 40 per 1,000 births in the best-staffed trusts to 25 per 1,000 in the worst.

Only two-thirds of trusts had a consultant present on their wards for 40 hours a week – the basic safety standard laid down by the Royal College of Obstetricians. The study also revealed a five-fold variation in the number of consultants among trusts, from 3.3 to 0.6 per 1,000 births. In some trusts this meant consultants were present on the wards for just 10 hours a week.

More than £660m was paid out by NHS trusts in the three years to 2007 in negligence cases for obstetric claims – enough to hire 1,000 extra consultant obstetricians. Maternity services account for one in 10 requests to the Healthcare Commission to investigate particular trusts. Today’s report, which included surveys of 5,000 staff and 26,000 mothers, says nine out of 10 mothers rated their care as good. But it said there were “significant weaknesses”, with wide variations in standards between trusts. Many of the problems identified in earlier investigations were widespread, suggesting that NHS trusts are not giving maternity services priority. Sir Ian Kennedy, chairman of the commission, said: “I don’t ever again want to be reading another report into high death rates at a maternity unit.”

It’s worth noting that this report comes from The Independent, one of Britain’s leftie papers.  Ah, socialism.  Guaranteeing the same equal level of misery and shitty treatment for everyone.  (Except of course the rich, who can avoid the whole socialist disaster altogether by paying for private care themselves.)

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.

...

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.’

...

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.

...

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

...

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?