First is the fact that all I ever read or hear about single payer systems is horror stories, particularly coming out of Canada and England.
Second is the fact that there is at least one elephant-in-living-room kind of problem
British and Canadian health care are socialized disasters. Rationed care, deficit spending, primitive equipment and technology, and a lack of consumer choice are just a few atrocities of government-run health care. Canada operates as a single payer health care system"government is the payer, the regulator, the ultimate decider. Rationed treatment and interminable waiting lists kill tens of thousands of people every year. And it only gets worse. 815,000 Canadians are currently waiting for medical care; if the United States had the same health care system almost 8 million Americans would currently be waiting for care.
The Fraser Institute conducts an annual study called Waiting Your Turn: Hospital Waiting Lists in Canada, one of the most comprehensive studies on Canadian waiting lists. Across 12 specialties and 10 provinces, wait times for surgical and therapeutic treatments average 18 weeks; the wait following a general practitioner’s referral exceeds 17 weeks. Two of the worst procedures are neurosurgery (7 months) and orthopedic surgery (10 months). Canadian oncologists recommend cancer patients receive radiation treatment within 3.4 weeks of diagnosis, yet over half wait more than 6 weeks. Waiting lists in Canada are so extravagant that doctors send a third of their patients abroad, most of which receive treatment in the United States.
Patients in Ontario have it rough. The Institute for Clinical Evaluative Studies found that 40 percent of severely disabled patients wait over 13 months for surgery. Delayed treatment leads to prolonged pain and diminished quality of life. Think about having pain in your knee, so severe that you can barely walk, and having to wait a year for a knee replacement. You may be out of work because your job requires physical ability; you may lose relationships because you are confined to your home; and you may become untreatable because your condition has worsened. All of this because the government forces you to wait 12 months for treatment.
Disclaimer: if you live in British Columbia it is recommended that you do not become ill. With a population of 640,000, how many MRI scanners do you suppose Vancouver Island has? On the entire island…one! Even worse, the facility that performs the scans works on bankers’ hours, allowed to perform no more than 3,000 scans a year. Patients wait over a year for a simple diagnostic test. With good reason, BC physicians are outraged. A woman suspected of having an acoustic neuroma, a slow-growing brain tumor, was put on a waiting list after her case was deemed “elective”. For months she waited, wondering if a tumor was growing inside her brain. Her head was a ticking time bomb.
David Gratzer, a Canadian physician and author of the book Code Blue, describes the crisis in BC: “Patients suspected of having multiple sclerosis were also forced to wait. Imagine the sword of MS hanging over your head for a year. In an ironic twist, provincial regulations require that MS patients, in order to receive certain drug therapies, must have the disease confirmed first by an MRI scan.” In his book, Gratzer addresses how Canada’s socialized health care system has affected some of his close friends:
My own views on waiting lists have been darkly coloured by the experiences of a few family friends: a young Winnipeg woman with severe abdominal pain was expected to wait six months for the pain-alleviating gall bladder surgery; a community college teacher from southern Ontario suffered heart trouble and was forced to take a year off work while he waited for bypass surgery; an older woman with severe sleeping problems was put on a two-year waiting list to see a respiratory specialist.
In socialized health care systems, as the need to ration care rises, so does spending. Between 1993 and 2003, despite a 21 percent increase in spending, waiting lists in Canada increased by 70 percent. Free markets adjust to increasing costs through resilience and natural reformation, while socialized markets flood the system with pools of new spending. Bureaucracy thwarts efforts to increase efficiency and productivity, as excess funding is dumped into a bottomless pit. And as Canadian health care proceeds further from pre-socialization, government waste and inefficiency only intensifies.
Patients in Vancouver need MRI scans, they need kidney dialysis, and they need vascular surgery. But wasteful spending and government bureaucracy stand in the way of patients and their health. The province is in a financial crisis. A leaked document from the Vancouver Coastal Health Authority announced they will have to cut 6,250 surgeries and close 25 percent of its operating rooms, due to a plummeting $90 million deficit. Furthermore, a government proposal provoked a plan to downsize staff, increase fees, and limit services and treatment options.
Congressman Mike Rogers’ (R " Michigan), in his opening statement on health care reform, described the inevitable demise of a government-run system:
According to the [National Cancer Intelligence Centre] for the United Kingdom and the Canadian Cancer Registry, here's the trade-off that they picked by having government run health care: If you get prostate cancer you have a less chance of survivability than you do in the United States. And that's the same for skin cancer, breast cancer, bladder cancer, cervical cancer, kidney cancer, ovarian cancer, leukemia and the list goes on and on and on.
The Toronto Star reported a story of a man in Ontario who had a hole in his head the size of a baseball. With severe discomfort, emotionally and physically, he was forced to wait a year for surgery. A movie short, A Short Course in Brain Surgery, recounts the unfortunate event of a Canadian man who, suspected of having a brain tumor, was put on a 4-month waiting list for an MRI scan. Naturally, panicked that the tumor was growing, he crossed the southern border into the United States. Twenty four hours later he got the MRI. On arrival back into Canada, his specialist put him on another 4-month waiting list for neurosurgery. Again he headed south, and had the tumor removed the following day.
Another victim of the Canadian health care system was Janice Fraser, who needed surgery for a urinary disease. To control costs, the hospital specializing in her particular surgery performs only one surgery a month. Janice was behind 31 other people, which meant she would have to wait three years. Because her surgery was delayed so long her bladder developed severe infections and had to be removed immediately. As a result, she was forced to wear a urine bag for the rest of her life. Unlike the rare, isolated events in the United States"that the liberal media love to exploit"these horror stories are prevalent in the Canadian health care system. They happen all the time. Rationing is cruel and unfair, and as the “protector of the people”, government is the culprit.
The New York Times
March 24, 2010, 9:00 pm
House of Anger
By TIMOTHY EGAN
Unfairly or not, the defining images of opposition to health care reform may end up being those rage-filled partisans with spittle on their lips. Whether the outbursts came from inside Congress " the “baby killer” shout of Rep. Randy Neugebauer, and his colleagues who cheered on hecklers " or outside, where protesters hurled vile names against elected representatives, they are powerful and lasting scenes of a democracy gasping for dignity.
Now, ask yourself a question: can you imagine Ronald Reagan anywhere in those pictures? Or anywhere in those politics? Reagan was all about sunny optimism, and at times bipartisan bonhomie. In him, the American people saw their better half.
The Republican Party has taken some of the worst elements of Tea Party anger and incorporated them into its own identity.
Compare that to the closing days of a week that will soon be chiseled into the larger American story. One Democrat, Rep. Ciro Rodriguez, said he was called a “wetback” by Tea Party hecklers at a meeting a few days before the vote. Black members of Congress say they were spat on, and called racial epithets. Bricks were thrown through the office windows of two other Democrats. And now, the inevitable death threats.
From the leader of the opposition, at least, was expected a level of decorum. But instead, Rep. John Boehner, the Republican who wants to be the next speaker of the House, predicted “Armageddon,” and shouted “Hell, no!,” his perma-tan turning crimson in rage.
Most of these vignettes are isolated incidents " a few crazies going off in a vein-popping binge. But the Republican Party now has taken some of the worst elements of Tea Party anger and incorporated them into its own identity. They are ticked off, red-faced, frothing " and these are the men in suits.
In trying to explain his intemperate shout over a bill that in fact explicitly outlaws using public funds for abortion, Congressman Neugebauer said he was representing the views of people back home in Texas, as expressed in town hall meetings. By this logic, he’d throw his popcorn on somebody’s head if enough people did it in movie theaters in his district.
“Let’s beat the other side to a pulp!” Rep. Steve King, Republican of Iowa, shouted to the last stand of Tea Partiers on Sunday night. “Let’s chase them down! There’s going to be a reckoning.”
Indeed there will. But as the party of the hissy fit, Republicans are playing with fire.
On Monday morning, most Americans awoke with some relief that the epic battle was over. Then, they tried to figure out what health care overhaul would mean to them. They found out that insurance companies would no longer be allowed to drop people if they get sick. They saw that older children could stay on their insurance through age 26. And the elderly, the most consistent voting block, discovered that the new law would gradually end a prescription drug donut hole that causes many of them to cut their pills in half to get through a month.
No death panels. No socialized public option. No forcing people to change doctors or providers. And the most contentious part of the new law " requiring nearly everyone to get health coverage or pay a fine " does not kick in until 2014.
Little wonder then, as the focus turned away from legislators cutting deals to a new law of the land that tries to help average people, the polls showed public sentiment starting to shift. Armageddon was nowhere to be seen.
The stock market ticked up Monday and Tuesday, continuing an upward run of more than 40 percent in the broader S&P index since Obama became president, including the best first year of the market for any president since Franklin Roosevelt. (The shares of some big insurance stocks fell).
A USA Today/Gallup poll showed a plurality now favored the new law " yes, favored. After months of Republicans saying Democrats were going against the will of the people, a plurality " 49 to 40 percent " said passing the bill was “a good thing,” the poll found.
Of course, public sentiment is a fickle thing. And no one can predict whether health care overhaul will work for most Americans, or add to the distrust people already have for the ruling and business classes.
But it’s always better to be building something than destroying it. John McCain had a positive campaign slogan in 2008 " “Country First.” This week, he vowed “no cooperation for the rest of the year.” This is an adolescent living in the shell of a former statesman.
He took his position, he said, using the same justification as the Texan who yelled “baby killer,” because “the American people are very angry.”
Having welcomed Tea Party rage into their home, and vowing repeal, the Republicans have made a dangerous bargain. First, they are tying their fate to a fringe, one that includes a small faction of overt racists and unstable people. The Quinnipiac poll this week found only 13 percent of Americans say they are part of the Tea Party movement.
But consider the policy positions. Do Republicans really want to campaign in favor of insurance companies’ right to drop people when they get sick? Do they really want to knock the 25-year-old graduate student, living on Top Ramen and hope, off his parents’ health care? Are they going to deny tax credits for small businesses?
It was the ancient Greeks who gave us a sense of what Republicans will be living with under this pact with rage. Many people are afraid of the dark, the saying goes. But the real tragedy is those who are afraid of the light.
http://opinionator.blogs.nytimes.com/2010/03/24/house-of-anger/?pagemode=print
Most of the revenue would come from higher Medicare taxes on about 1 million individuals earning more than $200,000 and about 4 million couples filing jointly who make more than $250,000.
http://www.businessweek.com/news/2010-03-22/new-taxes-for-health-care-help-obama-spread-the-wealth-around-.html
