Post lifted from MedGadget
Recently, Gov. Schwarzenegger announced his plan to provide universal coverage for health care and declared a war on physicians. We were shocked and appalled to learn that the Governator actually wants to penalize us, clinical providers, with a 2% gross revenue tax that will hit MDs with high operating costs especially hard. His action comes at a time when we are already experiencing unprecedented levels of loss of economic liberties and an ever increasing regulation of our profession.
Even more alarming is the acceptance with which this plan, and others like it, are supported by many of our fellow physicians, politicians and the media. Supporters of universal health care--i.e. socialized medicine--would have us believe that countries like Canada and Sweden provide superior care under their government controlled system. Furthermore, they would like to shame us for being 'the only advanced country without universal health care.' Yet, where does the world come for its health care? America. Where did Italy's richest politician go to have his pacemaker installed? Ohio. When confronted with examples like this, supporters of universal coverage don't deny the quality of care America provides but argue ours is a broken system that only provides quality care for the privileged. They would have us believe that socialized systems provide an optimal level of care, available 'for free' to the masses, yet they refuse to acknowledge the very real, very significant problems plaguing these systems. Should we ignore the stories of patients who had to flee Canada or Britain to receive their life saving medical treatment? How about nuclear medicine residents from Canada that have to go to the US to be trained in positron emission tomography? Are these isolated incidences? No. They are an inherent pathogen of every government run system.
To further advance our case, we have contacted Mark Steyn, a best selling author, who in his recent book America Alone: The End of the World as We Know It has an interesting description of health care in Canada. Mr. Steyn has given us kind permission to reproduce the passage from his book, and we are very grateful to him for the opportunity to present our readers with a thought provoking prospect of the future that might soon come to these shores.
By Mark Steyn:
In 2004, Debrah Cornthwaite gave birth to twin boys at the Royal Alexandra Hospital in Edmonton. That's in Alberta. Mrs. Cornthwaite had begun the big day by going to her local maternity ward at Langley Memorial Hospital. That's in British Columbia. They told her, yes, your contractions are coming every four minutes, but sorry, we don't have any beds. And, after they'd checked with the bed-availability helpline "BC Bedline," they brought her the further good news that there was not a hospital in the province in which she chould deliver her babies. There followed seven hours of red tape and paperwork. Then, late in the evening, she was driven to the airport and put on a chartered twin-prop to Edmonton. In the course of the flight, the contractions increased to every two and a half minutes--and most Lamaze classes don't teach timing your breathing to turbulence over the Rockies. How many Americans would want to do that on delivery day? You pack your bag and head to your local hospital in Oakland, and they say: Not to worry, we've got a bed for you in Denver.
Euro-Canadian socialized health care is, in essence, subsidized by American taxpayers: since the end of World War Two, Washington has assumed the defense costs of its allies, thereby freeing up those countries to spend their tax revenues on lavish social programs. But, if America follows the Hutton plan and "joins the world," it will reduce its defense expenditures to Euro-Canadian levels. So the next time a tsunami hits Sri-Lanka or Indonesia there will be no carrier groups to divert and save lives. So more people will die, waiting the weeks and weeks it took the sleepytime gals at the United Nations to arrive. Were America to "join the world," it would have to reduce its funding of the UN and other world bodies to European levels. And it might have to scale back its domestic agencies so that they're no longer able to serve in effect as international ones. Which will be tough when some kid in some village on the other side of the world comes down with some weird illness no one's seen before and they want to FedEx the test tube to the Centers for Disease Control in Atlanta to figure out what's going on.
Indeed, even relatively advanced societies admired by the likes of Will Hutton take it as routine that the CDC is a kind of Health Ministry of last resort. When SARS leapt from China to infect Toronto's hospitals in 2003, the principal contribution of the WHO (World Health Organization) was to issue a travel advisory warning visitors to steer clear of Ontario, leaving it to the CDC to provide advanced and practical analysis of the problem. Toronto's mayor, Mel Lastman, had a hard time keeping track of all the aconyms, and in one press conference launched into a bitter attack on the damaging effects of the travel advisory issued by the CDC.
The doctor next to him tried to correct him: "Who," she said. "The CDC," he repeated. "Who," she said. "The CDC," he repeated, wondering why she hadn't heard his answer to the question the first time. This diseased version of the Abbott and Costello routine went on a while longer, before the doc realized she had to spell it out: W-H-O, the World Health Organization. "Oh, yeah. Them, too," said Hizzoner.
Yet under the who's-on-first shtick lay an important truth: if an infection shows up in an Atlanta hospital, no American doctor looks for guidance from a Canadian government agency. But if it shows up in a Toronto hospital, the Ontario health system takes it for granted the best minds of the CDC in Atlanta will be staying late at the office trying to work out what's going on.
The answer to that Canadian doctor's vaudeville feed-- "Who's on first?"-- is America. When something goes awry, in a Sri Lankan beach resort or a Toronto hospital, it's the hyperpower who shows up. America doesn't need to "join the world": it already provides a lot of the world's infrastructure.
BRITISH TORIES CLUELESS ABOUT FIXING BRITISH HEALTH CARE
A young Indian MP told me a story about the Communist chief minister of the state of West Bengal, Jyoti Basu. Basu’s policies weren’t always popular, and there would often be large demonstrations and sit-down protests outside his office by the disaffected. Basu’s way of dealing with these outcries was to join them. He would slip unobtrusively into the crowd and eventually be found sitting among the protesters, holding a placard or chanting a slogan denouncing his own follies.
Perhaps Mr Basu’s disconcerting tactics have had a wider press than I realised, because in the past few weeks his approach seems to have caught on among British ministers. The Labour Party chair, Hazel Blears, has joined protests in her constituency aimed at saving the local maternity unit from merger. The Chief Whip, Jacqui Smith, has been trying to defend the status quo at the Alexandra Hospital in Redditch, and — perhaps most bizarrely — the junior health minister, Ivan Lewis, has been doing the same with regard to facilities at the Fairfield Hospital in Bury.
The national policy, of course, is to move some facilities to centres of excellence, which would provide a higher standard of medical care. Inevitably, because this involves shutting down smaller local units, the policy becomes the focus of local campaigning which — in Britain — is usually devoted to stopping something from happening, and exercises our native ingenuity at full stretch in discovering reasons as to why it shouldn’t.
Naysaying can sometimes be costly. A recent report from the Institute for Public Policy Research argued that successful resistance to the closure of some local A&E departments might well compromise patient care and lead to preventable deaths. “If heart attack victims are taken by ambulance past their local hospital to a specialist centre, they will be more likely to survive,” said the IPPR.
Which is why the Government, of which these three are members, supported the policy. Mr Lewis still does, but not in Bury. Ms Blears does, but not in Salford. Ms Smith does, but not in Redditch. Unsurprisingly the public has noticed that the policy seems to be right in general but wrong in all its specific applications. A BBC poll last weekend registered 72 per cent believing that it was hypocritical for ministers to campaign against the local consequences of their own national policies.
So we are at a strange moment in the recent history of the NHS, its strangeness emphasised because just when there ought to be a sharp political debate about its future, the Conservative Party has decided that it too will join the movement against change, and sit Basu-like on the steps.
By 2008 the Government will have raised the proportion of GDP spent on health in this country from 6.5 per cent to more than 9 per cent, and doubled expenditure in real terms. For that money it has managed a significant reduction in waiting times, an improvement in some key health indicators, a huge increase in numbers of NHS employees and a whacking great pay rise for doctors. Such a government funding bonanza couldn’t last, and the rate of growth will now slow substantially.
Last week we were told by Sir Michael Rawlins, head of the National Institute for Health and Clinical Excellence (NICE), that healthcare spending would have to rise above 9.3 per cent of GDP in the future to deal with medical inflation and the ageing population. “It is the elephant in the room, really,” he said. PricewaterhouseCoopers has estimated that there is a tax or an expenditure-cutting crunch coming some time soon if we are to keep up with the desire to maintain or improve health outcomes.
The obvious answer, to judge by yesterday’s news story, is for everyone to get a dog. The even more obvious answer is for everyone to eat properly and take exercise. So we won’t do that. Sections of the Labour Party, looking to its next leader, have begun agitating for a substantial rise in taxes, while simultaneously wanting an end to targets and a reduced reliance on involving the private sector in health. Which will leave us with the GPs’ contract story in spades, whereby we spend lots more money and don’t get much more work.
This should be the cue for the entrance, like a fragrant wind over a stagnant pool, of Mr David Cameron. Yesterday the Conservatives unveiled some of their new thinking on the radical policies needed to deal with the funding gap and get us all looking at health in a different way. Mr Cameron might well have noted that many of Labour’s early failures in health were as a consequence of suggesting, before 1997, that just by changing a policy (in Mr Blair’s case, the internal market), and spending a bit, lots of resource would be made available for patient care. Labour is still paying for that approach.
Mr Cameron must admire the early Blair because he seems hell-bent on repeating the error. First with his absurd Stop the NHS Cuts campaign, in which petitioners can “call on Gordon Brown to stop his mismanagement of the NHS”, and not — note — to provide any extra money, as if this absence of “mismanagement” will magically stop trusts running deficits. And, secondly, with the notion, promulgated yesterday, that all will be well if you just get rid of Labour’s “national top-down” waiting-list and other targets and replace them with Tory health outcome targets, to be called “objectives”, and somehow to be local and bottom-up. The difference is, of course, that everyone in the public sector knows that targets must be hit, while an objective is something you make progress towards. If you can. And if you can’t . . .
As to money: “Tony Blair’s great pledge,” said Mr Cameron, “was to raise health spending in Britain to the European average. Our aim is different — we won’t just concentrate on the money going in, but on what comes out as well.” So nothing about raising money from individuals by extending the scope of charging, which will shift some of the burden away from tax, and which is done in many European countries. Nothing about funding following the patient. Nothing at all, really.
Mr Cameron may well believe that his best chance of power comes from neutralising the fears of a Conservative government, only to be radical once in power. But history suggests that you can only do that if your radicalism goes with the grain of your assault on power. For their own long-term good, and ours, the Tories should be offering what Labour may be too conservative, too hidebound to suggest. They aren’t; and — for all the Basu-like nonsense from his leading colleagues — there still seems to be more chance of radical policies from Gordon Brown than from the Opposition.
Source
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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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