Who's Really 'Sicko'

In Canada, dogs can get a hip replacement in under a week. Humans can wait two to three years

"I haven't seen 'Sicko,' " says Avril Allen about the new Michael Moore documentary, which advocates socialized medicine for the United States. The film, which has been widely viewed on the Internet, and which will officially open in the U.S. and Canada on Friday, has been getting rave reviews. But Ms. Allen, a lawyer, has no plans to watch it. She's just too busy preparing to file suit against Ontario's provincial government about its health-care system next month.

Her client, Lindsay McCreith, would have had to wait for four months just to get an MRI, and then months more to see a neurologist for his malignant brain tumor. Instead, frustrated and ill, the retired auto-body shop owner traveled to Buffalo, N.Y., for a lifesaving surgery. Now he's suing for the right to opt out of Canada's government-run health care, which he considers dangerous. Ms. Allen figures the lawsuit has a fighting chance: In 2005, the Supreme Court of Canada ruled that "access to wait lists is not access to health care," striking down key Quebec laws that prohibited private medicine and private health insurance.

In the U.S., 83 House Democrats voted for a bill in 1993 calling for single-payer health care. That idea collapsed with HillaryCare and since then has existed on the fringes of the debate--winning praise from academics and pressure groups, but remaining largely out of the political discussion. Mr. Moore's documentary intends to change that, exposing millions to his argument that American health care is sick and socialized medicine is the cure.

It's not simply that Mr. Moore is wrong. His grand tour of public health care systems misses the big story: While he prescribes socialism, market-oriented reforms are percolating in cities from Stockholm to Saskatoon. Mr. Moore goes to London, Ontario, where he notes that not a single patient has waited in the hospital emergency room more than 45 minutes. "It's a fabulous system," a woman explains. In Britain, he tours a hospital where patients marvel at their free care. A patient's husband explains: "It's not America." Humorously, Mr. Moore finds a cashier dispensing money to patients (for transportation). In France, a doctor explains the success of the health-care system with the old Marxist axiom: "You pay according to your means, and you receive according to your needs." It's compelling material--I know because, born and raised in Canada, I used to believe in government-run health care. Then I was mugged by reality.

Consider, for instance, Mr. Moore's claim that ERs don't overcrowd in Canada. A Canadian government study recently found that only about half of patients are treated in a timely manner, as defined by local medical and hospital associations. "The research merely confirms anecdotal reports of interminable waits," reported a national newspaper. While people in rural areas seem to fare better, Toronto patients receive care in four hours on average; one in 10 patients waits more than a dozen hours.

This problem hit close to home last year: A relative, living in Winnipeg, nearly died of a strangulated bowel while lying on a stretcher for five hours, writhing in pain. To get the needed ultrasound, he was sent by ambulance to another hospital.

In Britain, the Department of Health recently acknowledged that one in eight patients wait more than a year for surgery. Around the time Mr. Moore was putting the finishing touches on his documentary, a hospital in Sutton Coldfield announced its new money-saving linen policy: Housekeeping will no longer change the bed sheets between patients, just turn them over. France's system failed so spectacularly in the summer heat of 2003 that 13,000 people died, largely of dehydration. Hospitals stopped answering the phones and ambulance attendants told people to fend for themselves.

With such problems, it's not surprising that people are looking for alternatives. Private clinics--some operating in a "gray zone" of the law--are now opening in Canada at a rate of about one per week.

Canadian doctors, once quiet on the issue of private health care, elected Brian Day as president of their national association. Dr. Day is a leading critic of Canadian medicare; he opened a private surgery hospital and then challenged the government to shut it down. "This is a country," Dr. Day said by way of explanation, "in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."

Market reforms are catching on in Britain, too. For six decades, its socialist Labour Party scoffed at the very idea of private medicine, dismissing it as "Americanization." Today Labour favors privatization, promising to triple the number of private-sector surgical procedures provided within two years. The Labour government aspires to give patients a choice of four providers for surgeries, at least one of them private, and recently considered the contracting out of some primary-care services--perhaps even to American companies.

Other European countries follow this same path. In Sweden, after the latest privatizations, the government will contract out some 80% of Stockholm's primary care and 40% of total health services, including Stockholm's largest hospital. Beginning before the election of the new conservative chancellor, Germany enhanced insurance competition and turned state enterprises over to the private sector (including the majority of public hospitals). Even in Slovakia, a former Marxist country, privatizations are actively debated.

Under the weight of demographic shifts and strained by the limits of command-and-control economics, government-run health systems have turned out to be less than utopian. The stories are the same: dirty hospitals, poor standards and difficulty accessing modern drugs and tests. Admittedly, the recent market reforms are gradual and controversial. But facts are facts, the reforms are real, and they represent a major trend in health care. What does Mr. Moore's documentary say about that? Nothing.

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Australia: Public hospitals "too busy" -- turn away 48-year-old heart attack victim -- who dies for want of attention

As a relatively young man he might well have survived if promptly given anti-clotting agents etc.

A MAN died after besieged Gold Coast and northern NSW hospitals turned away ambulances yesterday. The man, 48, from NSW, is believed to have suffered a heart attack at Currumbin yesterday morning. Tweed Heads Hospital would not accept the man and he was taken by ambulance to Gold Coast Hospital where he died, according to a Queensland Health spokesman. "He went into cardiac arrest soon after he arrived at Gold Coast and died in the emergency department," the spokesman said.

A NSW Health spokesman confirmed the Tweed Heads Hospital was on "bypass" but said the manager was unaware of an ambulance being turned away with an emergency patient on board. A Queensland Ambulance Service spokeswoman said ambulance officers contacted the Tweed Heads hospital twice but were turned away. "We were advised that the hospital was on redirect and unable to accept the patient," she said.

Several regional hospitals were turning away ambulances yesterday, including Gold Coast, Logan, Pindara, John Flynn, Allamanda, Tweed Heads and Murwillumbah. "The (Queensland) Government has been putting its head in the sand for far too long over the bypass situation," one ambulance officer said.

A Gold Coast Hospital spokeswoman said the hospital had been on bypass or "redirect" between 1pm and 3.30pm yesterday. She said the winter flu season was adding to pressure on hospitals.

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A deadbeat State health system in Tasmania

THE giant $1.3-billion Health Department has delayed paying its bills, including $69 owed to a Burnie couple struggling to survive on disability pensions. Tom Browne said he had $40 to last him the next two weeks and could not believe the department had not paid him the refund for driving his son to Hobart to see a neurosurgeon. "It just peeves me off, they don't look out for the little people anymore," he said. "To me it's a lot of money and I need the money more than they do."

Health Minister Lara Giddings revealed yesterday that her department had delayed the payment of bills because of the "tight financial problems we are in". "We do need every dollar we can get," she said. "Firm control is indeed needed to ensure that we remain within our budget. "We must all live within our budgets."

Mr Browne said he had been out of pocket for a month, having spent $80 on petrol to drive his adult son to Hobart and back. The $69 refund appeared in his bank account yesterday afternoon, hours after a question about its whereabouts from Tasmanian Greens leader Peg Putt to State Parliament. Ms Putt welcomed the payment, which she said had come after she embarrassed the Government about its "extraordinary penny-pinching".

She said three weeks after the Brownes had applied for their public transport refund, a public servant had told them about a memo circulating. She said it read: "Due to budget restraints and the end of the financial year, we are currently holding payments past the due dates."

Department deputy secretary at shared services Simon Barnsley said at June 21, Tasmania's three public hospitals owed $10.7 million to creditors. He said since then $4.7 million worth of accounts had been paid to meet all accounts outstanding more than 30 days. He said payments would continue through until June 30, in line with "standard cash management practice". "At the Royal Hobart Hospital the outstanding amount was $4.7 million -- or 1.8 per cent of budget," he said. "$3.1 million was owed at the Launceston General Hospital, or 2.2 per cent of budget -- and at the North West Regional the total outstanding was $2 million or two per cent of budget."

Ms Giddings said the department did not have a "bottomless pit" of money to tap into and there were no extra funds available. "We have to live within our budgets, and it is a problem," she said.

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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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