Canada's 'universal' health care

We finally have good operating understanding of "universal" health care: somewhere in the universe there may be a place for you to get treatment. And if you are lucky enough to live near the United States before Hillary Care II takes hold, you may even get treated.

Canada welcomes the birth of the newest set of quadruplets born to proud Canadian parents. Karen and J.P. Jepp. However, the Jepp quads will be eligible to run for the presidency of the United States when they reach the age of 35, having been born in Benefis Hospital in Great Falls, Montana, 325 miles from their home in Calgary, capital of the Canadian oil industry.

The precious gift of American citizenship comes to the Jepp Quads because there were no hospital facilities anywhere in Canada able to handle 4 neonatal intensive care babies. Not in Calgary, a city of over a million people, the wealthiest in Canada, or anywhere else in Canada. Local officials looked. However, Great Falls, a city of well under one hundred thousand people, apparently had no problem with unusual demand for such facilities.

As Don Surber points out, the United States functions as Canada's back-up medical system, enabling it to run with less investment in facilities. America's evil, heartless private medical care system saved the day. In any capital-intensive field, whether it be electric power generation or medicine, gearing up for peak demand costs a lot of money. California discovered this a few years ago when it started to experience rolling blackouts in the wake of bungled partial deregulation of power.

America spends significantly more on medical care than Canada. Socialized medicine advocates frequently claim that this shows we are getting a bad deal: less care for more money. But the fact is that illegal alien mothers walk into hospital emergency rooms and give birth to babies requiring intensive neonatal care costing hundreds of thousands of dollars on a regular basis, and it makes no headlines. We do not send them over the border to Canada or Mexico and use their medical systems as a back-up, even when the mother might be a citizen of that country. We treat them, and pick-up the bill, too, without so much as a citizenship check or a call to immigration officials.

Steven M. Warshawsky demonstrates today on AT that there is no such thing as "free" medical care. Having the government pay means having other people pay your medical bills, and that leads to endless demand, which leads to rationing, which leads to insufficient capacity to handle peak demands, like, say, the birth of quadruplets. If and when Hillary Care II comes, of course there will be no back-up capacity available for Americans (unless you believe Michael Moore and think Cuba's medical system can provide anything to anyone).

Canada's vaunted socialized medical system depends on America for more than peak capacity back-up, of course. When was the last time you heard about a new drug being developed by a Canadian pharmaceutical company? Under the price control system in Canada it makes no sense to develop drugs there. Canada lets the United States bear the major burden of drug development (and so does the rest of the world). Our high drug prices and federal research subsidize the world's medical R&D.

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Australian patients going private in emergency

MORE patients are turning to private hospitals for emergency treatment as pressure on public hospitals mounts and queues to see GPs lengthen. Although there are only a handful of private hospitals in each state with emergency departments -- which usually charge between $150 and $200 per visit -- many say they are busier than ever, with patient numbers rising 10 per cent or more in the past three years. In one case, numbers rose by nearly 30 per cent in five years. The increases are evident in the "graveyard shift" from 10pm to 6am, when many better-off patients are willing to pay extra to avoid having to wait for hours in a public emergency department while staff attend to more urgent cases.

The Howard Government's report on public hospitals, published last month, found patient numbers at public emergency departments were soaring. The percentage of patients seen within recommended times fell in five of the eight jurisdictions. At the same time, GPs are abandoning after-hours services, with more than half referring patients to a deputising service or emergency departments. Although 24-hour GP clinics were common 10 years ago, a clampdown in the late 1990s on the Medicare rebates they could charge reduced profitability, and many folded or cut their hours.

Andrew Singer, president of the Australasian College for Emergency Medicine, said the increase in private emergency patients was caused by the combination of difficult access to after-hours GP services and the problems people experienced when they attended public emergency departments. "In the main, private hospitals provide a pretty good service -- there's usually a lot less waiting, and you usually get a reasonably experienced doctor, if not a specialist-level doctor," Dr Singer said. "Patients tend to prefer it, if they can afford it. "I know people who work in private emergency departments, and a lot of them think things are getting busier these days," he said. "The reality is that all EDs are getting busier."

A spokeswoman for Brisbane's Greenslopes Private Hospital -- the biggest private hospital in the nation, with 580 beds -- said its emergency attendances had risen 10 per cent in 2004-05 on the previous year. They rose a further 8 per cent in 2005-06, and a further 5 per cent in 2006-07. The spokeswoman said the latest increase would have been even higher had the figure not been artificially lowered by a change in the contracting arrangements for military veterans, which meant fewer received free treatment at the hospital.

A spokeswoman for Melbourne's 530-bed Epworth Hospital said it was "certainly seeing more patients", and that annual numbers had jumped from about 22,000 in 2002 to about 29,000 this year. And patient numbers at the emergency departments of the John Flynn Private Hospital on the Queensland Gold Coast and the Hobart Private Hospital have risen by about 10 per cent in the past three years. Numbers at Perth's St John of God, Murdoch Hospital have risen by more than 20 per cent, from 20,540 in 2004-05 to 24,898 in 2006-07, although numbers at its sister hospital in Ballarat, Victoris, have climbed only slightly.

Leon Clark, chief executive of the 452-bed Sydney Adventist Hospital on Sydney's upper north shore, said although numbers of emergency patients had remained stable over the past three years at about 20,000 patients annually, the doctors were much busier because patients coming in had more complex care needs. "Our staff are much busier than they were three years ago because of the increased complexity," Dr Clark said.

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