Both Senator Obama and Hillary Clinton have proposed universal or “single payer” healthcare systems, though there is very little difference between the two approaches. Both proposals currently contain some provision for private healthcare, but for how long. Once we are down the road to government run healthcare, how long before a Democratic controlled Congress goes along and passes a true government run system? Four years? Eight? And once in place, it will never be undone. Political Night Train believes we need more light on how other universal healthcare systems are doing and because of a recent posting by a reader, we will run a series of articles that try to get at what the Canadian system offers, or does not offer it’s citizens. Here then is the first, and perhaps one of the best articles we’ve seen. You can read the entire article at http://www.thepost.ohiou.edu/Articles/Opinion/Your%20Turn/2008/02/26/23084/ Your Turn: The real cost of “free healthcare”A letter to the editors Private healthcare does have its problems, but it is hard to argue that it is failing on the whole. With Canada being the main country of comparison for many healthcare arguments, it will be the main focus of comparison for this piece. A widespread myth about healthcare is that Canada’s universal coverage system is superior to the U.S.’s private system in terms of quality of care received. This is a vital dynamic of the healthcare system and claims against quality of care should not be taken lightly. A patient of Canadian healthcare waits 17.7 weeks, on average, for hospital treatment with residents of Saskatchewan waiting an average of 30 weeks. These waiting times are unheard of in America’s private system. In the United States, the occasional story of a death occurring while waiting for an operation, while unfortunate and heart-wrenching, is nothing short of ordinary in countries with socialized medicine. In 1999, Dr. Richard F. Davies, a cardiologist at the University of Ottawa Heart Institute, described to the Canadian Institute for Health Information how delays affected Ontario heart patients scheduled for coronary artery bypass graft surgery. In a single year, for this one operation, the doctor reported, “71 Ontario patients died before surgery, 121 were removed from the list permanently because they had become medically unfit for surgery,” and “44 left the province to have the surgery, many having gone to the United States for the operation.” In short, 192 people either died or became too sick to have surgery before even getting a chance to be operated on. You say you want universal healthcare, like that being proposed by Senator Obama or Hillary? You say the Canadians have universal healthcare and that it’s a great system? Let’s read what the Canadians have to say. The following article is an excellent example of how the elderly are treated at Canadian hospitals. Still want to send your mama or grandpa to a universal healthcare hospital?
By Klaus Rohrich Tuesday, February 26, 2008
Next time you feel like bragging about how great the Canadian healthcare system is you may want to consider what’s routinely done to elderly patients in some of our hospitals. Recently an elderly woman, let’s call her Mary, had a stroke, which affected the left side of her body, meaning that the stroke occurred in the right lobe of her brain. Mary was admitted to hospital in a fairly timely fashion and was quickly diagnosed by competent medical staff, including a neurologist. After the diagnosis she was given an intravenous drip (IV) containing blood thinners and other medications designed to ameliorate the affects of the stroke. She also received a CAT scan, which established that the stroke had caused considerable damage to her brain. The hospital informed the family that there wasn’t much that could be done for Mary and to prepare for the inevitable, even suggesting the withdrawal of the IV. The family was devastated at the prospect of losing Mary and hesitated in following the hospital’s recommendation, reasoning that withholding medication and nourishment was contrary to their belief in the sanctity of life. Here’s where the story gets interesting. It took four days for the neurologist to contact the family regarding Mary’s prognosis, and when he finally did contact them he informed them that he had cancelled plans for Mary to have a speech therapist and physiotherapist. His view of Mary’s prognosis was that the situation was completely hopeless, as a second CAT scan had revealed even more severe damage to the right lobe of Mary’s brain than the first. “There’s nothing else to be done,” the doctor informed the crestfallen family members. Mary, however, had other plans. As she lay in her hospital bed for over three weeks, she slowly began to regain her ability to speak and actually managed to move parts of her left side, starting with the toes on her left foot. Throughout all this time Mary’s family and friends were at the side of her hospital bed caring for her and communicating their love to her. On numerous occasions Mary was able to speak to relatives in Germany in her native German and related the conversation to family members at the hospital in English. She also regained the ability to write—all on her own without help of a therapist. As her speech managed to improve, Mary began to express a desire to eat, as for the entire time that she had been hospitalized the hospital had failed to feed her. When questioned by Mary’s family as to why they hospital refused to give Mary food, the nurses explained that it was a liability issue, as stroke patients were never fed until they had passed a “swallowing test”. Only problem is the person qualified to administer the swallowing test is an itinerant tester that apparently moves from hospital to hospital, covering, it seems, a fairly wide range of territory. According to the hospital, during the three weeks that Mary had been hospitalized this tester had had only one occasion to visit the hospital to administer said swallowing test, but Mary was sleeping and was therefore not tested. It seems highly implausible that a community of over 20,000 people with an ultra-modern hospital wouldn’t have visits from a qualified professional tasked with testing stroke victims more frequently than once every three or four weeks. Much more plausible is the doctor’s view that Mary’s life isn’t worth saving, given the results of the CAT scan, regardless of Mary’s remarkable progress. What happened to Mary under the Canadian government healthcare monopoly is frightening, albeit not unusual, as many other people have related similar stories. What happened to Mary would under any other circumstances be described as an attempt at euthanasia. But here in Canada they call it healthcare.
Last month, the Canadian Medical Association (CMA) released a new study showing that last year patients waiting for health care services in just four clinical areas cost Canada’s economy $14.8-billion in lost productivity and health expenses. It is clear that health care rationing and maintaining inappropriate wait times for medical care represent poor public policy. A study released last month by the European-based Health Consumer Powerhouse, comparing Canada’s health system to 29 European countries, ranked us 23rd overall, and last in terms of value for money spent. We can and should do better.
WHY ARE CANADIANS STILL WAITING FOR HEALTH CARE?
Wait lists for medically necessary health care are Canada’s shame, says writer Nadeem Esmail. Canadians are generally proud of their universal access health insurance program, which ostensibly provides access to care regardless of ability to pay. However, as Beverly McLachlin, Chief Justice of the Canadian Supreme Court, says, access to a waiting list is not access to health care. An examination of Canada’s lengthy wait lists can help put that statement in perspective, says Esmail:
- In 2007, wait times for access to health care in Canada reached a new historic high: 18.3 weeks averaged across 12 medical specialties.
- Canadians waited a median of 25 weeks for cataract surgery from the time their general practitioner referred them to a specialist to the time they received treatment.
- Canadians waited a median of 42 weeks for joint replacement.
- This means that those patients who were referred by the their general practitioner for a hip or knee replacement surgery on January 2, only half would have received their treatment by October 23 while half would still be waiting for care.
Consider the personal costs a wait line of that magnitude entails:
- A patient may experience an adverse event while waiting.
- The wait could cause a potentially more difficult surgery and recovery.
- Any wait time entails some amount of pain and suffering, mental anguish, lost leisure, lost productivity at work, and strained personal relationships.
How concerned is the government about the personal costs associated with these lengthy wait times? According to Esmail, not much. Their main goal is to avoid serious negative health consequences rather than minimize waiting and, thus, personal costs all together.Source: Nadeem Esmail, “Why are Canadians Still Waiting for Healthcare?” Fraser Institute, February, 2008.
MORE PRIVATE HEALTH CARE IN CANADA URGED
The architect of Quebec’s now-overburdened public health care system is proposing a strong and controversial remedy that includes further privatization and user fees of up to C$100 (about U.S. $98) for people to see their family doctor.In a 338-page report, former provincial Liberal health minister Claude Castonguay concluded that Quebec can no longer sustain the annual growth in health care costs. The province currently spends about C$24 billion (about U.S. $23.6 billion) annually on health care, or about 40 per cent of its budget.Other recommendations include:
- A new tax, including a “health care deductible” based on income and the number of visits made to a doctor’s office or hospital in a calendar year. Low-income families and children would be exempt.
- Encouraging private-sector involvement in the management of hospitals and medical clinics.
- Lifting a ban that prevents doctors from practicing both in the public system and privately.
- Raising the provincial sales tax by up to one percentage point.
In the report, provocatively titled “Getting Our Money’s Worth,” the working group headed by Castonguay also recommends an overhaul of the Canada Health Act, which “sooner or later must be adapted to today’s realities.”“If nothing is done, at one point we will reach a crisis point … this is why we say it is urgent to act,” Castonguay said. “There’s no miracle solution, there is no simple solution.”Source: Sean Gordon, “More private health care urged: Report for Quebec government proposes fees, health act changes to help overburdened system,” Toronto Star, February 20, 2008.
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