Thursday, July 26, 2007

Lebanon Daily News - When it’s free, health care really costs

Lebanon Daily News - When it’s free, health care really costs

Dismembering a typical philistine, pig-ignorant op-ed (apologies to John Cleese)

When it’s free, health care really costs
Editor:
Lebanon Daily News


The presidential candidates, the media and some local misguided souls have been turning up the rhetoric supporting universal or single-payer health care while cautiously avoiding the truth that such systems are simply socialized medicine.
Part I: Invoke socialism bogey-man. Betrays common ignorance of all right-wingers in not understanding the difference between 'socialized medicine' and single-payer systems. Also fails to understand that in the context of health-care, we all wish to have basic healthcare for ourselves, our families, and, I hope, if one claims some basic humanistic/Christian/Islamic/Jewish/Hindi/Buddhist/whatever qualities, for the 'least among us.' That means poor and lower income and those with previously diagnosed health conditions (for the empathy impaired).

Socialized medicine does not work anywhere.

Part II: Ignore all evidence to contrary of your opinion. Ignore OECD, Commonwealth fund, essentially all scientific literature on the topic.

It never has, and by it’s very structure, it never will. When I use the word “work,” I mean it in the context of providing what we have in the U.S. — the finest health care in the world.

Part II, again. Ignore all overwhelming evidence to the contrary. I'll try to link back to evidence soon.

Hundreds of thousands of people come to our country for their health care every year because what they need is not available where they live.

I don't think some Saudi and UAE princes count as hundreds of thousand. And they come for what is right about American medicine: the high tech, cutting edge care that cannot be BOUGHT elsewhere. That is, they can't jump the line elsewhere, like they can here.

Certainly we have problems in our current system, but the problems are fixable if all the parties in the system will step up to their part of the problem. Some uninformed people cite the insurance companies as the single problem in our health-care system. While insurers certainly are a part of the problem, they are no more of a problem than are the providers themselves. The cost of repairing botched surgeries, medical errors, hospital-based infections, allowing medical providers who have lost their license in another state to be licensed in Pennsylvania, overutilization, underutilization and a general unwillingness to purge their ranks of known, bad providers, contributes as much or more to the cost of health care as does the “greedy” insurance industry, and every honest medical provider knows it. It’s time to stop the blame game and get on with solutions.

I'm an honest medical provider, and the writer is wrong. The litany he lists all need fixed, but will be much easier to fix in a properly funded single payer system. And, sorry, the for-profit system, the same unrestrained, repugnant greed-based system that led to Enron, Tyco, and a two billion dollar surplus for Highmark alone, is by far the biggest problem.

To cite the one-sided propaganda film “SiCKO”as beneficial because it stirs debate on health care is like endorsing communism because it will make our citizens more patriotic. It’s sicko logic.

SICKO showed some of the serious flaws in our system and showed some of the serious benefits to others. That really is the bottom line. I've been following the media coverage closeely, interviews with various experts, MM himself in interviews, etc. There are lots of complaints about what he "left out." Well, it's only a two hour movie and I think it is not his job nor his role to be the healthcare czar and review every nuance of healthcare here and abroad. He had a lot of points to make and he made them very well, very humorously and sometimes heart-breakingly poignantly. If you see it, you'll know that he didn't tell the downsides of universal access in other countries, but, frankly, as we healthcare providers know better than the average viewer, neither did he scratch the surface of the problems so widespread in our "system." But he always says in interviews that of course other systems have problems. Our goal should be to take the best parts of each of those systems and craft an American system better than all the others. But, he makes no bones that this needs to be a single payer system at its core. He seems to have no bone to pick with physicians - he believes the focus of reform should be getting rid of private health insurance as we know it.

I urge everyone to see it. It engenders debate, not just about healthcare, but about who we are as a people. Are we, as Americans, about "me" or "we"? That really is the central question he asks.


For the truth about how socialized medicine does not work, go to http://www.fraserinstitute.ca/ and click on “health.” Several interesting reports are available online, but the report entitled “Paying More, Getting Less” is particularly revealing. The Fraser Institute is an independent Canadian research organization and is the only source of accurate statistics on wait times and the status of their failing system of health care.

The Fraser Institute is as reliable as the Cato Institute, the American Enterprise Institute and every other right-wing "think-tank" From Nick Scala, of Physicians for a National Health Plan ( pnhp.org)

"...data supplied by the Fraser Institute, an ultraconservative PR firm that masquerades as a legitimate research institution. Dr. Robert McMurtry, the Canadian orthopedic surgeon who is a former dean of a Canadian medical school and served on the national waiting times commission tells me that not even the right wing Canadians take them seriously. Their “scientific” method of determining wait times consists of bulk-mailing a list of pro-privatization physicians and asking them how long they think their patients will have to wait to see them. If they return the mailing they are entered in a drawing to win a $2,000 cash prize. It’s pathetic. Unsurprisingly, Fraser comes up with outrageous waiting time estimates (17.8 weeks last year, as I recall), and is quite adept at publicizing them in the American media. Wait times are scientifically measured every year by Statistics Canada (the counterpart to the U.S. Census Bureau). I’m sure most Americans would be surprised at the results of scientific measurement: In 2005, median wait times were 4 weeks for elective surgery, 4 weeks for specialist care, and 3 weeks for diagnostic tests.

http://www.statcan.ca/Daily/English/060131/d060131b.htm

Also, the Canadian Health Services Research Foundation has done a short, scholarly critique of Fraser’s methods and compared them with real studies. (In fact, I think they’re far too kind to Fraser)." (Thanks, Nick!)

If you think health care is expensive now, wait until you see what it costs when it’s free.

Final bit, trot out a really stupid, non-sensical cliche. We spend nearly twice as much per capita as every other western country, and we're supposed to worry about "what it costs when it's free?"

Stan Alekna, Cornwall

Sorry, Stan, but that is a really lame rehashing of right-wing garbage that does not stand up to even mild critical analysis.

Christopher M. Hughes, MD

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