In Canada, rationing health care

The Baltimore Sun ^ | November 17, 2003 | Elena Cherney

[RebelBanker]

TORONTO -- Nurse Donna Riley hurried through the drab halls of St. Michael's Hospital to deliver the bad news.

Eduard Krause, a 71-year-old retired mechanic, had been waiting more than six weeks for heart-bypass surgery. After fasting for 18 hours, he was lying on a gurney, ready to be rolled into the operating room.

Now, he would have to wait a bit longer: An emergency patient had been rushed into surgery, bumping him from the day's schedule.

[RebelBanker]

Good analysis of Canada's socialized medical system, but forgets one critical weakness: Their total dependence on others (mostly us) for new developments.

At the end of the article, the author mentions a debate about whether a life-saving procedure should be done because it does not have a high success rate and it consumes too many resources.

[RebelBanker]

The system still leaves surgeons grappling with questions about how to ration finite resources. On one of the busiest days in recent months, an emergency patient was transferred to St. Michael's with a ruptured valve condition. The survival rate for the procedure, according to the network's data, is just 10 percent to 20 percent. Indeed, the man died a few days after his six-hour surgery.

The procedure is frustrating, Dr. Errett said, because it claims many resources and so seldom succeeds.

"I've met with our group and said, 'Maybe we shouldn't do them at all,' " he said. In the end, the doctors decided to continue doing the procedures.

[Nebullis]

"If you don't wait in a medical system, there's a problem," said Ted Marmor, a health-policy expert at Yale University. The question, he said, "is whether people are waiting inappropriately."

If capacity and demand are matched there is not waiting. What the Canadian government does is utilize capacity at the expense of the patient. The US takes up the critical patient slack. Just as with pharmaceuticals, the Canadian health system depends on its southern neighbor.

[DugwayDuke]

Three comments.

Those who advocate government run health care fail to understand that government will have a budget for health care and that budget will determine the number of a given proceedure that will be done. Rationing is inherent to such a system.

I truly believe that what upsets a lot of liberals is the difference between the levels of health care within the US. Take for example a system where there are two levels of care. Also, for example, a system where there is only one level but that level is less than the lowest of the levels in the first system. I think many liberals would opt for the second system even if everyone is worse off since every one would get equal care.

Third, don't let this article fool you. The priority system described in this artilce works. The problem is that many die waiting for their turn.

[Area51]

My friends up yonder quickly complain about their Medical services and taxes...

But gladly accepted twice the government paid 6 month materity leave.

go figure. :)

[Jim Noble]

. I think many liberals would opt for the second system even if everyone is worse off since every one would get equal care

The very definition of a peasant is someone who does not care that everyone is poor, as long as no one is rich.

[RebelBanker]

The priority system described in this artilce works. The problem is that many die waiting for their turn.

I am afraid I am failing to follow your logic here. If people are dying while waiting their turn, doesn't that show that the system is not working?

As with any resource for which demand exceeds supply, there must be some mechanism for distribution. Under our system, the market, albeit with heavy government interference, decides. Under the Canadian system, the government decides. The critical difference is that the free market system provides an incentive to increase and improve the scarce product or service, whereas the socialist system does not.

[KantianBurke]

"Some patients, such as Krause, said that waiting isn't too bad a price to pay for their free medical treatment."

For the millionth time, ITS NOT FREE YOU DOLT!! YOUR TAXES AND THE TAXES OF YOUR FELLOW CANADIANS ARE PAYING FOR IT! In fact, the healthcare I pay for is technically "cheaper" than yours.

[RebelBanker]

For the millionth time, ITS NOT FREE YOU DOLT!! YOUR TAXES AND THE TAXES OF YOUR FELLOW CANADIANS ARE PAYING FOR IT!

Thanks K.B.! I forgot to emphasize that point. That is unfortunately a typical attitude - "The Government pays for it" means "Free" rather than "My taxes pay for it."

Your Humble Servant...

[Mamzelle]

re: I am afraid I am failing to follow your logic here. If people are dying while waiting their turn, doesn't that show that the system is not working?)))

But they just die one at a time--tough to build a constituency that way.

Orlando has lost its top-tier trauma system. Now if you're in a serious accident, you may well have to spend more time in transport, perhaps losing that critical "golden hour" advantage.

They lost their trauma teams because of insurance difficulties.

Now, is Orlando, a huge city with millions of tourists a year, squawking? Have you heard about it?

That's because disasters happen to individuals, not to large constituencies.

[Eric in the Ozarks]

The long wait story in this paper and others was generated by a Canadian government study of wait times by province. If you think things are slow in Toronto or Montreal, try Nova Scotia, where medical care is almost nonexistent.

[Dick Vomer]

It gets better in Florida..... thank the lawyers..... for those in Central Florida.... ask your referal doctors for the nearest Pediatric Neurosurgeon.... that's the guy that will drill a hole in your child's head if he gets a blood clot in it from getting hit or an accident.... good luck. Now we can only hope that a lawyers kid gets whacked... then watch him sue everybody on the medical food chain as his kid gets airlifted and shipped around without definitive medical care. Sounds cold... tough sh$t.. that's what happened to a friend of mine's kid who had to be shipped due to the fact that no local neurosurgeon would "touch" this kid due to "liability" issues and lack of malpractice insurance coverage with a pediatric waiver for emergencies.

the comment about people dying not constituents is correct..... what will happen is that no life saving heroics will be tried because there's a chance of "failure" or disability..... so if they (the patients) die.... oh well.... bad luck, heh?.... That's what is happening and is going to get worse. Why risk your neck for a lawyer waiting for a bad outcome..... ? If you do 100 craniotomies then a percentage of them will die, a percentage of them will have bad disabilities but a percentage of them will live ...normally.

Now at least all will be equal.. just like libs like... they'll all die. Isn't life just peachy? Thank you Trial Lawyers of America.... and associated liberal parasites.

[Phantom Lord]

I wish I had a link handy to this article, and hope someone can find it. There was a stroy in the Toronto paper (i believe) a couple months ago written by a Canadian who got feed up with his doctor who spent 10 seconds looking at him and his eye problem. The doctor said it was nothing and to go home. He didn't believe him and wanted to see another doctor. The wait to see another doctor for a second opinion was many months. So he called an American hospital, made an appointment for the NEXT DAY and drove down to Michigan and saw the doctor, found out indeed he did have a problem that could have resulted in blindness in WEEKS, had it fixed and drove home the next day.

He said it was the greatest experience he had ever had with medical car.

The title of the article was something like "A Canadian's Experience with American Medical Care"

[Agnes Heep]

"Some patients, such as Krause, said that waiting isn't too bad a price to pay for their free medical treatment."

How about being completely dependent on the United States for your national security because you can't afford your own, because all your resources are tied up in giving crappy "free" health care to the masses? It costs a lot of money to bring a health care system down.

[kanawa]

It irks me to no end when people refer to our healthcare as 'free'.

6 years ago my 16 year old daughter went to the hospital for serious abdominal pains. I was contacted and went to the hospital.
They had examined and tested her. There was no conclusive evidence that it was her appendix that was the problem but the doctor told me that they would operate anyway, 'just in case'.
At this point I asked if she had been check for constipation as she had that problem in the past with similar symptoms. I was treated to a very condescending look and response.
The operation went ahead. the appendix was fine but he removed it anyway because, 'we were there anyway'.

The final diagnosis? She was constipated.

How much of my money did this joker bilk the system for? I should of sued him to retrieve it.

[Voltage]

In Winnipeg Manitoba this week there is an 'emergency' conference of Govt and healthcare officials to see what they can do to stop the exodus of doctors from rural Manitoba towns. Many of them are heading to the USA.

The conference will of course be a failure, but will make good press copy.

[Snowyman]

couple months ago written by a Canadian who got feed up with his doctor who spent 10 seconds looking at him and his eye problem.

Yes I'd like to see the story too. Because the one I remember had a different ending. The guy waited for a couple of hours in ER and had 5 minutes with a doctor who told him he'd be fine. Not satisfied he flew to Baltimore , spent $1000 and got a 3 doctor consultation that lasted an hour and a half . Diagnosis was the same as the ER in Toronto. He also got a smile from the nurse and a cup of tea.

http://www.freerepublic.com/focus/f-news/953106/posts

[Mamzelle]

But the parents of the child disabled or killed by delayed medical care is just one set of parents--

And the day before those parents needed that responsive care--did they give a hoot about the trauma system shutting down? Nope. Won't happen to them. Greedy doctors. Greedy hospitals.

When the trauma systems started being shut down, I thought that there would be enough squawking to face some of these issues. Now I understand that bad results have to impact lots of people at once, not one at a time, for any momentum to develop.

Drive carefully around Sea World. If you or yours is in a wreck, only the lawyers are ready to act...and they don't know how to sew you back together, they only know how to accuse people who try to help...and fail...

[DugwayDuke]

"I am afraid I am failing to follow your logic here. If people are dying while waiting their turn, doesn't that show that the system is not working?"

I'm sorry, I used "liberal speak" there without so noting. In liberal speak, the system works because, sooner or later, everyone on the list gets the threatment. Of course, dying removes you from the list but liberals don't won't to deal with that.

[MainFrame65]

This analysis completely ignores the cost of keeping people sick for extended periods of time. That cost is shared by the patient, his family, his employer, and the entire economy, as the article plainly illustrates but never states. When I was consulting full-time, I hated to waste potentially billable hours in a doctor's or dentist's waiting room. Typically, I lost more billing than I paid for the visit - including the insurance payment. And that is just a few hours, right here in the USA. Other posts have addressed other indirect costs, such as losing good personnel due to inadequate wages.

I believe that the hidden costs of the Canadian health system far exceed the 4% differential in direct costs of health care.