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Thursday, December 07, 2006

"A short course on brain surgery" 


Via Glenn, "A short course on brain surgery":



Actually, the video is a short cautionary tale about the pitfalls of Ontario's single-payer healthcare scheme, which preserves the political support for its terrible service by forbidding competition from the private sector. The result? Canadians with money hire consultants who help them get next day medical care in the United States. Would Ontario voters continue to support their single-payer plan if the American system weren't available to release the pressure from at least some of the patients for whom the timeliness of care is a matter of life and death?

The video also exposes another weakness of single-payer systems: they are popular among people with only minor or routine health problems or very acute problems (such as traumatic injury), but can be catastrophic for people who will only be more likely to die or suffer if they do not get access to technology quickly. This is ironic, because the opponents of market-based solutions (such as health savings accounts) often contend that they are a good solution only for the healthy. Perhaps, but as the video demonstrates (and as anybody who is in the industry knows) the same can be said of Ontario's system.

For more on the looming choice between, well, choice and no choice in health care, listen to Glenn and Helen's excellent podcast interview of Dr. David Glatzer, a Canadian physician who has a lot to say about both systems.


15 Comments:

By Blogger skipsailing, at Thu Dec 07, 04:38:00 PM:

This is really interesting. What it really comes down to is rationing. What mechanism is best for rationing scarce resources in the face of unlimited demand?

the Canadian system is an abject failure, that much has been clear for a long time. Our system is hardly unfettered free markets but it is far more responsive to the public.

Further we have to confront emotion vs rationality. To many on the emotional left, doing SOMETHING, even if it has enormous down sides is simply what conscientious people MUST see as right and proper.

Nonsense. The left will proclaim that the right combination of people and policies will make their foolish approach work. It will fail, and miserably too, while making a few folks who are uniquely positioned and very opportunistic a huge amount of money.

Frankly I'm glad we have the Canadian experience so close at hand. It shows us, again and again, just how ineffective the socialists really are.  

By Blogger Gordon Smith, at Thu Dec 07, 05:14:00 PM:

Yeah!

You don't want to be a socialist! I say Stay The Course! Why change when our health care is so great that...

U.S. has second worst newborn death rate in modern world

The World Health Organization ranks the United States' health system 37th in the world, right between Costa Rica and Slovenia.

15.7% of Americans have no health insurance at all.

What are you people so scared of? That we might be able to improve the system enough to actually move towards a healthier society?

Any system in the world will have negatives, but would a single-payer system leave us with a sixth of our population without insurance? Would it make our infant mortality rate worse? Would it send our world ranking south of Slovenia's?

No more knee-jerk talk on health care. The Republican party has had 12 Congressional years + six Presidential years to address the problem and they haven't done shit.

Now you get to choose between staying this disastrous course or trying a new way. Don't let your ideology get in the way of helping your fellow Americans.  

By Blogger William, at Thu Dec 07, 06:27:00 PM:

I think, Screwy, you're concentrating on the shortcomings while neglecting the virtues of our health-care system. Yes, if you're poor, you aren't going to get as much out of it, contributing to the newborn death rate, the low health insurance rate, and, if its done by averages, the WHO's rating.

But if you look at those who can afford it (84.3% of the population, apparently), ours really is the best in the world. Because they get paid, we get the best doctors, because they can make money, we get the best hospitals, the best technology, and all of it fuels a huge healthcare industry which in turn produces the best research and keeps us on the cutting edge of healthcare technology.

So yes, ideally, we want to incorporate that 15.7% without health insurance, but not at the cost the other 84%, who currently do enjoy one of, if not the best, healthcare system in the world.  

By Blogger K. Pablo, at Thu Dec 07, 08:55:00 PM:

$28,000 to have your astrocytoma treated? That's a friggin' BARGAIN.  

By Blogger SR, at Fri Dec 08, 01:49:00 AM:

It is 10 PM. I just finished taking care of an able-bodied 47 year old patient who presented in our emergency room with an incarcerated (stuck) hernia, He is now cured. He had no insurance, and was seen and treated the same day. no questions asked, and no payment anticipated. It frosts me when no-nothings like hoolie disparage the US healthcare system. Everybosy doesn't get everything, but plenty more is available than in Costa Rica. Russia? Don't make me laugh.  

By Blogger Purple Avenger, at Fri Dec 08, 02:28:00 AM:

What are you people so scared of?

BEing forced to wait years for a brain tumor operation? Works for me.  

By Blogger TigerHawk, at Fri Dec 08, 07:08:00 AM:

Actually, Screwy poses something of a false choice. Right-wing stormtrooper I may be, but I do think there are any number of things we could do to improve our public health outcomes, which are really quite independent of our health system. That is, most of the statistics that liberals cite in support of socializing medicine are a function of broader social considerations rather than the system we have for rationing hospital care, which is where the money is. We do have some poor health statistics, but we are by a factor of many times the largest of the rich countries cited in such studies, the most geographically dispersed, we have the only meaningful rural poor population, and the most demographically diverse. These factors and others (such as our political reluctance to federalize social questions) contribute far more to our public health results than the payment scheme we use.  

By Anonymous Anonymous, at Fri Dec 08, 09:46:00 AM:

15.7% of Americans have no health insurance at all.

Does that include people who are wealthy enough that they don't need insurance? Or people who don't have insurance because they're illegal immigrants? People who're incarcerated? I'm not saying anything about the desirability of changing our health insurance system, I'm just trying to see whether the number actually means what the original poster is claiming it means.  

By Blogger Gordon Smith, at Fri Dec 08, 10:22:00 AM:

Anony,

Click the link, silly, to find out what the numbers mean. Yeesh.

I'm a younger lower middle class, self-employed guy, and I have a pretty decent health care plan. It helps that I have no dependents and no pre-existing conditions. However, we're thousands of dollars in debt for health care costs. How can this be? Neither of us has gotten spectacularly ill, but we've gone in to get some things checked out - per doctors' recommendations.

Health Care is wildly expensive, health insurance is unavailable to a sixth of the population, and despite all our bells and whistles, our system drives families deep into debt while saddling our employers with the costs of a broken system.

It seems ludicrous to suggest that Staying the Course is a good idea.

I'd like to see all Americans under age 18 insured first. This will lower health care costs for generations as problems are caught earlier and wellness is promoted. Then we can talk about the rest of us.

Ok?  

By Blogger skipsailing, at Fri Dec 08, 10:33:00 AM:

What I find amusing about Screwy's post is this: Like most lefties he has a rote response to most questions. It's like the new definition of knee jerk.

Mention health care and the knee jerk response: X number of Americans without health insurance.

Mention Bombing Iran's nukular facilities and the knee jerk response: It's a police matter, let's investigate stuff, what did the IRanians do to us anyway, it's a culture war.

We should do an experiment to see if we can develop a list of stock responses. We could assign them numbers, that way these guys wouldn't have to bother to write them out, they could just post the number.

For example, if the host posts something critical about socialized medicine Screwy could simply say, "Oh yeah? Well number 14, with a bit of 27 and throw in some 54 right back at ya."

It would be simpler for them and free up lots of time to attend important liberal functions such as Free Mumia rallies and candle light vigils for the harp seal.

Now for a serious question to Screwy. You mention that some 15.7 % of Americans have no health insurance. Here's my question:

So what?  

By Anonymous Anonymous, at Fri Dec 08, 10:36:00 AM:

USA is already marching quickly down the road to socialized medical care. Consider two items: medicare and drug reimbursements. Medicare has severely restricted payments to approx, 10 per cent of true cost driving many physicians away from these patients; and congress hates big pharma and will surely legislate against them. Meanwhile, trial lawyers are getting rich thru excessive jury awards. We have a good system but it needs help.  

By Blogger Purple Avenger, at Fri Dec 08, 12:46:00 PM:

Health Care is wildly expensive

Don't be stupid man -- walk into a hospital, say you're an illegal alien with no documentation, and they'll treat you for free, or direct you to one that will.  

By Anonymous Anonymous, at Fri Dec 08, 07:46:00 PM:

We can always strive to do better in terms of ensuring basic health care to our fellow citizens, but as we seek those improvements, let's not throw the baby out with the bath water. For most of us, the system works. It isn't perfect, but it works. And for those of us who have faced potentially life-threatening diseases such as cancer, it works fast enough to give us our best shot at survival.

And for some people, the care is indeed free. Sitting in an outpatient radiology unit one day, waiting for my MRI appointment, I observed a couple who entered and checked in at the desk. They were asked for their insurance card (as was I, when I checked in). The male half of this pair said "this is a charity case." The receptionist did not blink -- she handed the people some papers to fill out and the patient was treated. Just like me. No hassles.

There are gaps in coverage for sure. But we have the world's best medicine. Let's not screw it up.  

By Anonymous Anonymous, at Sat Dec 09, 12:10:00 AM:

Screwy- get a grip! The U.S. medical system is ranked 37th in the world? Well, then you must have seen that Canada is ranked number 30, between Morocco and Finland.

The second-worst infant mortality rate in the world? Well, the CNN article references a report where the Save the Children organization "ranks 125 nations according to 10 measures of well-being, six for mothers and four for children. The top ten countries? Number nine is Canada. Number ten is the US and UK.  

By Anonymous Anonymous, at Sun Dec 10, 09:08:00 PM:

And AL GORE got his brain from somone called ABBIE NORMAL  

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