Wednesday, August 22, 2007

An unhealthy health care plan

I only link to mock...An unhealthy health care plan -- The Washington Times, America's Newspaper By Robert Goldberg (vice president of the Center for Medicine in the Public Interest)
Pablo Picasso observed, "To copy others is necessary, but to copy oneself is pathetic." Is anyone more pathetic than Arnold Relman, the former editor of the New England Journal of Medicine, who continually writes about why America should adopt the Canadian health care system? There is. It's Arnold Relman himself, writing in Canada about why Canadians shouldn't abandon the Canadian health care system. In this case, it's Mr. Relman in the Toronto Globe and Mail opposing the Canadian Medical Association (CMA) proposal to "allow physicians to bill patients (or private insurance plans) for services that are covered by Medicare, and allowing Medicare to purchase covered services from for-profit private facilities." The goal of the CMA plan is to allow people a chance to get medical care when they need, not when the government sees fit to provide it. Canada has pumped billions of dollars into its system to reduce waiting times for specialty services, cancer care, first-time health visits and emergency rooms.

Here's the link to the article by Relman. Dr. Relman's piece speaks for itself.

But according to Health Canada and the independent Frasier Institute the waiting times and shortages have gotten worse.

Please see this previous post to read why you should discount anything from Fraser, and yet recognize that Fraser is a pernicious force to be watched and refuted at every opportunity.

In a recent incident, a child with a brain tumor headed to the states to get a MRI because he would have had to wait four months in Canada. His family paid cash because Health Canada refused to cover the cost. Mr. Relman's response? He urges Canadians to "avoid exploitation by those who would like to make profits from publicly funded health care. Canadians should not follow Americans down the path to greater privatization." The kid should die for the greater glory of socialized medicine rather than pay cash and line the pockets of profit hungry docs in America. Groucho Marx once observed, "Who do you believe? Me or your eyes?" Our eyes tell us that here and abroad government run and financed health care stinks.

Welcome to another episode of "Anecdote-Off", the great justifier of all things wrong in the US sytem if you believe people like this. As I've said many times before, if you want to debate this by anecdote, the US loses. Badly.
For waiting times,
go here.

Price controls cause shortages of doctors in the UK that in turn are filled by waiving immigration regulations that allow neurologists with bomb-making skills into the National Health Service (NHS).

Good thing we don't allow ferners to practice medicine here.

In the United States, restrictive formularies and cookbook approaches to care have undermined mental health treatment for soldiers returning from Iraq.

Got that backwards.

Medicaid reimbursement levels have increased waiting times and caused millions of children to seek care in emergency rooms.

Because we underfund Medicaid and the economics of reimbursement of course cause providors to scurry for the hills. How is this an argument against single-payer?

Meanwhile SCHIP — 10 years after its enactment — has failed to enroll 3-out-of-5 Medicaid eligible children in private health care plans and access to care has barely increased.

Again, how does this support an argument against universal healthcare? It's an argument against the stupid patch-work non-system we have here in the US, I agree.

Incredibly, Mr. Relman claims that's just a sign free market health care does not work and does not care about people. Enlighten us Arnie, how are the two connected?

Because the patch-work "free market" mess we have here does not work. Clearly Mr. Goldberg has never actually seen patients or been responsible for providing healthcare in this disaster we work in. When funded properly and overseen appropriately and by giving doctors the ability to provide care as they see fit (as opposed to insurers or underfunded goverment programs), a single payer system can not possibly be worse that what we have now. Unless someone puts the Republicans in charge of it. Then, watch out, Brownie will be in charge!

"Physicians in our commercialized, profit-driven system tend to gravitate toward the highly paid specialties, so we now face a major shortage of primary-care doctors." Well, we know how flush the NHS is with well-trained terrorists — I mean family doctors. What about Canada? It turns out the College of Family Physicians of Canada found that 17 percent of Canadians didn't have a family doctor because of a primary care physician shortage. Two million of the Canadians that Mr. Relman wishes to deny free choice of care to have attempted to find a family physician in the past year, but have failed. In the U.S., we have a market-based response to the problem.

OMG! 17% don't have a PCP. I've got an idea, let's take insurance away from 1/6 of Candians and underinsure another 1/6 so they can't afford a PCP visit, and see what happens to that shortage. The free-market will get rid of those whiners!

A rapid expansion of retail health clinics in the United States is taking place in what the Department of Health and Human Services has designated as medically underserved areas. Take MinuteClinics, a division of the drugstore chain CVS, which offers walk-in health care centers for common medical problems such as strep throat, sunburn, mono, flu, ear infections and sinus infections, and offer vaccinations, checkups, etc. People can pay cash or use their regular insurance.

"People can pay cash or use their regular insurance." Hahahahahahah!

And will Mr. Goldman and his family use this service? Of course not, because they have good insurance.

Most visits are 15 minutes or less with no appointment needed. In many cases, MinuteClinics are often affiliated with local hospital or physician practices, and will refer customers to a primary care doctor if they don't have one. Additionally, the center generates an electronic medical record that customers and doctors can access through the phone, fax or Internet. There are 200 MinuteClinics across America. Most are in federally designed medically underserved areas providing immediate care, referrals and electronic medical records for about $50 per person. Other private companies are involved in this trend as well and have been joined by the American Academy of Family Physicians in an effort to improve access to health care for millions Americans.

Well, let's take it a step further and have us (by us, I mean the U.S., our government) fund such a system. And that way, when the patient is referred to a PCP, the patient will be able to actually go to the PCP without choosing between healthcare and something else.

Meanwhile, as the marketplace makes medical care more accessible in America ...

...still can't get that idea that it should be universal rather than just "more accesible"...

Mr. Relman is telling Canadians, "One thing is certain. If medical care and health insurance are allowed to become private businesses... patients with little or no resources do not get the care they need."

And Mr. Goldberg doesn't care about those people. Why not just come out and say it?

What did Santayana say about fanaticism? It consists of redoubling your efforts when you have forgotten your aim.

Pot, meet kettle... And as John Kenneth Galbraith said, "The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness."

Fighting against medical choices that are available elsewhere in the world is a sure sign that ideological zeal has transcended compassion or the Hippocratic oath.

Uh, he's fighting for medical choice, not against it. He's advocating for compassion, not against it. And if Mr. Goldberg thinks physicians anywhere in the world compromise the spirit of Hippocrates (put the well-being of the patient above all else) more than we do in America, he is as out of touch as the rest of his piece confirms.

Mr. Relman, once a great scholar, should be pitied, not scorned.

It's Dr. Relman, and he doesn't need Goldberg's pity.
read more digg story

Sphere: Related Content

2 comments:

Anonymous said...

it's a shame that both you and the columnist you desire to mock are so enamored of ad hominem arguments. if you could both discipline yourselves to drop them, the debate would be better off. I happen to agree with you on some points - like the ridiculousness of anecdotal argument to reach decisions affecting hundreds of millions - but your heavy use of ad hominem tactics like affixing pejorative labels to human beings, "guilt by association" and questioning people's motives overshadowns the data you present and frankly makes me question whether you are subconsciously insecure about the objective support for your own argument.

Christopher M. Hughes, MD said...

Fair enough, I suppose, but here are the only things I wrote that could be considered even remotely 'ad hominem':

"Clearly Mr. Goldberg has never actually seen patients or been responsible for providing healthcare in this disaster we work in. "

"And will Mr. Goldman and his family use this service? Of course not, because they have good insurance."

"And Mr. Goldberg doesn't care about those people. Why not just come out and say it?"

And at the end, I said I thought he was out of touch based on his column. I didn't call him fat or stupid or unpatriotic or anything terrible, I don't think. My comments were based uppon his writing, I think.

I do try to stick with the arguments, but I will confess his commentary was dripping with derision for an admirable man, Dr. Relman, with whom he disagrees. So maybe I reflected that back a bit, but I wasn't nasty, I don't think.

Cheers,