At the close of the Constitutional Convention in 1787, Dr. James McHenry, a Maryland delegate, followed Benjamin Franklin from Independence Hall. He recorded a question asked by a lady, directed at Dr. Franklin.

The lady asked, "Well Doctor, what have we got? A republic or a monarchy?"

"A republic," replied Dr. Franklin, "if you can keep it."


"The smallest minority on earth is the individual. Those who deny individual rights cannot claim to be defenders of minorities." - Ayn Rand

Sunday, August 23, 2009

Rationed Healthcare

Facts: there are roughly 900,000 patients of all ages waiting for beds in Canada according to the Fraser Institute. Source: International Business Daily.

The reality of National Health Care in Europe and Canada is that care is rationed. The Vancouver Sun reported that the Vancouver Coastal Health Authority is looking to close nearly 25% of its operating rooms and will cut 6,250 surgeries including 24% of cases scheduled from March to September and 10% of all medically necessary elective procedures this fiscal year. (op cit)

The article goes on to quote Dr. Anne Doig, the new president of the Canadian Medical Association who says, "It's clear Canadians are getting less than optimal care. We all agree that the system is imploding. We all agree that things are more precarious than perhaps Canadians realize."

That would not be the model I would want for healthcare in the US.


Opus #6 said...

A young mother gave birth on a pavement outside a hospital after she was told to make her own way there.

Mother-of-three Carmen Blake called her midwife to ask for an ambulance when she went into labour unexpectedly with her fourth child.

But the 27-year-old claims she was refused an ambulance and told to walk the 100m from her house in Leicester to the city’s nearby Royal Infirmary.

America is this the kind of health care that we need? Obama’s government ran health care will be just as bad if not worst than the government ran health care in the UK where this sort ( refused an ambulance ) of treatment happens on a daily basis from what we have heard from over across the pond.

Hazaa Blue-Eyes said...

They somehow think we'll be different. How in the world are we going to be able to add 30-80 million (depending on whose numbers you want to believe) people to the health care system with the same amount of doctors (or less!!)??

You can't. It's just not possible. Someone is going to lose out, or even all of us. For that amount of people, you'll have to meet with a nurse who hands you a bandaid and two asprin before shouting "NEXT!" and giving the next person the same thing, regardless if it's a broken bone, a headache or a woman about to give birth.

LL said...

The better use of money would be to apply scholarships to promising young people who want to be doctors and to address research issues in pressing areas of public health.

I know the people who want a free ride will disagree with me.

Something that many people who don't really understand the benefits available to the poor don't understand is that the poor are covered by healthcare at government expense (Medicaid) and the elderly are covered by Medicare.

I admit there are people who make $50K - $75K a year who are in some distress, but there has to be a rational way to make major medical insurance available to them that is affordable.

The Conservative Lady said...

Obama wants the control and the power. He couldn't care less about stories from Canada and Great Britain. And he couldn't care less about the American people. It's all about HIM.

LL said...

Conservative Lady - after all he did exempt himself from his own healthcare plan...

Canadian Pragmatist said...

"Elective surgery" is the key! We're not a bunch of pansies.

Canadian Pragmatist said...

Our system is imploding... Its not perfect. We need more tax dollars or more cost cutting which the conservatives in power and not giving us.

Even still, no one is considering turning it into the private tyranny in the US for a second.

Opus #6 said...

CP, keep your imploding system. And leave us to ours. We will still take care of your preemies and others you don't have time for.

Seda said...

Fact: There are currently over 40,000,000 Americans who don't have access to basic health care. Millions more have their health care rationed by "pre-existing conditions," exclusions, etc.

Fact: Almost every developed nation in the world does far better than the United States by any health care measurement I know of, at a fraction of the cost.

Among the international community, Canada and Great Britain have some of the worst single-payer plans. For some reason, conservatives always point to them and say, "See? This is socialized medicine. Look at how bad it is." I agree. Let's not copy their system. We'd do far better to look at Germany, France, Japan, or even Cuba, for a good example of what our system could be.

Sure, you'd be paying more taxes, but a lot less to the health insurance plutocrats, with a significant net savings. Do you really want to continue to spend more of your pay onour insane, inefficient, inhumane system, just to spite the government out of some taxes?

Seda said...

You have to be real poor to qualify for Medicaid. You can't own a house, etc. The folks who are really suffering are the working poor and lower middle class - $20 k to $50 k - and their children - especially if they don't have health insurance through employers.

In this country our primary health care rationing is done through income - a system that is completely unfair and penalizes young families with children most severely. (The elderly have access to Medicare.) Point the finger at imperfections oversees all you want, still nobody in the direction you're pointing wants anything like what we have (except perhaps the ultra-wealthy).

LL said...

Seda: I would like choice in my healthcare plan. I do not want a government monopoly on anything. Healthcare is not a right.

85% of all Americans are satisfied with their healthcare plans.

I agree that the working poor need some sort of option but the worst possible choice is to wipe everyone else out for their sake. Address that issue as "that issue".

Cuba is the worst possible example of a Socialist train wreck. I don't think you want me to go there.

Financially, the best thing that could happen to me would be for the US to go to a single-payer system. I am presently able and willing to build hospitals across the US border in Mexico to deal with health issues that won't be covered under the government plans. I will make a fortune. If you need to see a doctor NOW and you live in a Border State, cross into Mexico and you'll be seen... Like that idea? I have discussed the matter with Goldman Sachs and have financial commitments from them and others to back my program.

Do I want to see a single payer system in America? No. But if they do it, I'll be fine.

Seda said...

Yeah. I'm really lucky. I have a good job with an outstanding plan, one of the best in town. But I'd like choice in my healthcare plan, too. I can't afford any other plan, though, so I don't have any choice about it. Except to not use it.

I'd like to be able to choose my doctor, too. But the one we'd like most isn't in my plan's preferred provider network, so, too bad.

I'd like to be able to choose to divorce Kristin, too, if it would make her happy or she wanted to marry her sweetheart. But then she wouldn't have any insurance. I'm not okay with that.

She can't get on her sweetheart's plan even if she married him, because he's on the "don't get sick" plan. He's a self-employed musician and music teacher. He's got no health insurance at all. He doesn't have any choice about it.

Actually, there are worse examples than Cuba. Uzbekistan, for instance. And I'm under no illusion that Cuban care would be as good as what I have access to. Their health care system, however, works a lot better than ours. Sad but true.

But if you're able to build hospitals, I see your point. When you can already afford any health plan available, changing to single payer doesn't do you any good.

I just benefits the 95% of us who don't have those options.

LL said...

I can't afford to build hospitals but I can certainly put a deal together on a sure thing. It's part of seeing opportunity and making things happen as opposed to working for someone and making things happen for them (which I did when I was younger).

The nice thing about America is that YOU can decide on your career path. Being a self-employed music teacher is a choice. So is being a government drone, building houses or growing peaches. If you grow peaches, you will likely have to put something aside for healthcare whether you self fund it or join an insurance plan. But if you decide to grow peaches (no plan) why should I, as a government drone with a plan have to pay for your career choice?

I don't get it.

Seda said...

Great question. Why should you have to pay for the peach grower’s health care? For that matter, why should you have to pay for the fire protection that saved my house when it caught fire? Why should I have to pay for my coworker’s police protection that recovered his stolen laptop and put the burglar in jail? Why should I, who homeschools, pay for the public schooling of my neighbors’ children?

The way insurance works, is that a large pool of people who don’t need split the cost to pay for those who do. The fact is, you already pay for the obese accountant who suffers from diabetes. The peach grower (who works outside and eats a lot of fruit, so is probably ridiculously healthy anyway) may not add much to the pool paying for the accountant, but it does reduce your share by that much. So the short answer is, to save you money.

Frankly, I would like to live in a society where no one is forced to deal with a crushing burden by themselves. And I’m happy to pay for the benefit of others, just for that privilege.

You say you want choice in your health plan, but, if you’re like me, you don’t really have that choice – you get what your employer can afford and is willing to pay for. A lot of those plans aren’t very good, because a lot of employers are small businesses, and the pool just isn’t that big, and other employers are jerks and will exploit their workers for everything they can get. If you have a health condition that needs care, you are then stuck with that employer – your choice to leave and get new work is truncated by your inability to then get your condition covered. If not, you can choose employer A, B, C, whatever, but the choice is still limited. It’s rather like, with our system, you can choose Pepsi in the red can, the blue can, or the yellow can. If we expanded Medicare to include everyone, on the other hand (unless Congress screwed it up), it’s like you’d get to choose Pepsi, Coke, Sprite, or root beer, all in the red can, properly labeled. I know which choice I’d prefer.

But then, I tend to look at these things pragmatically, rather than ideologically. I don’t really care who provides the services I need, so long as they are as efficient, effective, affordable, honorable, and available as possible. If the government can provide that, fine. If private industry, fine. What I want is a system that works.

BTW, I've been discussing this a bit on my blog, too. Not that common sense will ever go far in this political climate.

LL said...

Seda- The Public Health Service, Centers for Disease Control and other medical programs funded by tax dollars provide for public health issues and I have no problem with them.

The current healthcare bill will force everyone into a government program. We can debate semantics, but Obama himself said that was the plan and it's on video tape. He said differently too.

We all agree that there is a need for healthcare reform. Doctors included. Profit is important if there is to be research into new and better methods of healthcare. The government is essentially bankrupt and has no motive for investment into research. Because of the financial meltdown the US experienced, healthcare will be rationed. It's a financial fact of life. Because there will be a single payer government program, there will be no alternative but to take what you're given, doff your hat and say thank you.

Medicare is bankrupt.

Social Security is bankrupt.

Both Medicare and Social Security are ponzi schemes that presume that the aging population will work forever. But that's not what is happening. So the need for funding outstrips the income. Both systems are broken and insolvent. There's no argument on that account either. Both Democrats and Republicans have been issuing strident warnings.

You're absolutely right - Congress will screw it up.

Seda, in a perfect world a government plan would work fine. But the world we live in is far from that and things could be much worse than they are now.

Seda said...

The current healthcare bill is a mess, and we liberals and conservatives should unite to oppose it. Though not for the reasons you espouse. I've blogged my opposition on my own site.

Healthcare is rationed in our current dysfunctional system - rather radically and completely unfairly.

If I remember the data right, Medicare will go bankrupt in 2012-2016, Social Security in 2032 - if current trends continue. There is time to prevent it (as the strident warnings have been saying), and the solutions aren't that hard, except that we keep blowing them away on partisan bickering and making sure the corporations get all they want regardless of the people. It's too late to save the federal government from bankruptcy, though. The Democrats seemed to understand that until they got elected; now they're just making it worse.

Government doesn't need a perfect world to work fine. It just needs a critical mass of citizens, beaurocrats, and politicians who understand the role of government and how it can excel at certain functions. Don't hold your breath. Most of all three groups, regardless of political affiliation, are clueless - conservatives, however, far more than liberals.

BTW, Ayn Rand was a very astute political observer and analyst. Unfortunately, she didn't understand human behavior and economics very well.

LL said...

Seda - if it was a State Government healthcare program, you'd find that I would be far less opposed than a federal plan. Why? A greater measure of local control, local voices in how it's crafted and how it's managed, greater accountability to politicians who are accessible to the public, etc.

Healthcare has been on the table for a very long time and nobody has come up with an acceptable answer for a national program.

Many of us including me feel that the ability to choose your provider is very important. Devolving to a single payer plan won't work. And you'll have the next administration reversing the laws passed in this one.

I think Rand understood human behavior rather well - in the world there are makers, fakers and takers. She identified them as broad groups in Atlas Shrugged: Looters vs Free Market.

I know they were broadly defined but her purpose was to paint a broad picture.

Seda said...

A state program might work, but all 50 would have to participate, and coordinate so that you kept health care when moving across state lines, etc. It would still need some kind of federal regulation, which, after all, is the role of the feds, as stated in the Constitution.

People have come up with an acceptable answer for a national program, but it gets shot down all the time because politicians make it too complicated, and the corporations flood the media with propaganda.

I agree that the ability to choose my provider is very important. That's why I like the single payer plan. I don't really care that much who pays - the point is to get the provider I want.

The part Rand missed is that we are all makers, fakers, and takers. Left alone, people will not always act in their long term best interest - they will act in a wide variety of ways, sometimes altuistically, sometimes selfishly, sometimes seeking instant gratification knowing they'll pay for it tomorrow, sometimes generously. And each person will act in all of these ways at different times, and to different degrees, changing with mood, circumstance, and many other variables. What comes out of this is that the Free Market provides a great opportunity for Looters. Which is why a regulated market works better.

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