Friday, July 27, 2007

A Canadian Doctor Talks About Socialized Medicine

He said it, not me. Well, all right, I've said most of it, too. But here's how he starts:

I was once a believer in socialized medicine.

Nice. =)

Government researchers now note that more than 1.5 million Ontarians (or 12% of that province's population) can't find family physicians. Health officials in one Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment.

These problems are not unique to Canada — they characterize all government-run health care systems.

Health care by lottery. Bet you didn't hear about that in Sicko, did you?

Because the U.S. is so much wealthier than other countries, it isn't unreasonable for it to spend more on health care. Take America's high spending on research and development. M.D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does. (emphasis mine--Darren)

Do I need to add to that?

The Canucks and the British aren't stupid. They didn't set out for their health care systems to be as screwed up as they are. If there were a way to avoid it, I'm sure they'd have avoided it. But they haven't. The problems they haveare entirely predictable, they're what socialism has wrought.

Anyway, our doctor-author ends with a statement that Adam Smith would probably agree with:

America is right to seek a model for delivering good health care at good prices, but we should be looking not to Canada, but close to home — in the other four-fifths or so of our economy. From telecommunications to retail, deregulation and market competition have driven prices down and quality and productivity up. Health care is long overdue for the same prescription.

Hear hear.


Ellen K said...

One thing that I have failed to see addressed was how HMO's were offered up as the Great Compromise that would lower costs. Instead it set up an entire private bureaucracy that sets up more hurdles to care than opens doors. Back when my daughter was born, in 1982, an office visit to the pediatrician was around $50. Now that is just the copay for an office visit, with every fee under the sun tacked on top. Doctors incorporated to protect themselves legally. The awards given out on malpractice suits have made it almost impossible to find an OB/GYN in some areas. My mother's doctor was originally from Canada and left there because his income was so limited that he couldn't pay back college loans and was working two other jobs. He said if a Democrat gets elected here, he will leave for Costa Rico or Brazil. I know kids who did very well on their MCat's who are not going to medical school because it's not worth it. They can make more and have a more stable life by doing research or bioengineering. What good will that do when everyone has a GP but nobody knows how to do the hard stuff?

steph said...

If Sicko is the start of a new reality here in the States I will be taking my family and moving to a small deserted island in the South Pacific. Government run anything is Not A Good Idea.

Anonymous said...

And I am glad about that statistic regarding MD Anderson -- a dear friend from church is there now, undergoing testing in advance of chemo/radiation for a quick-spreading cancer. He and his wife are in their early 30s have darling little girl.

Prayers are welcome and needed.

allenm said...

HMOs were supposed to be the answer to the medical "tragedy of the commons" that was developing. Of course, like all attempts to regulate a commons you end up with increasingly influential and well-paid cadre who are supposed to regulate the commons for the benefit of all and end up seeing to their own concerns.

The bureaucracy has to burgeon because you can't plan for every eventuality and the only resource to throw at any problem is more personnel. And the problems develop continuously so formerly simple policies mutate over time into complex and intricate horrors that are meant to provide the official answer to every problem, can't and in the end become problems in their own right.

In fact, the American medical system is already socialized to a considerable degree. You can see that in the similarities to overtly socialized medical systems. Costs rise continuously, either without an increase in value or in excess of the value received. Professionals have both their decision-making scope circumscribed and their earning-power diminished. Administrative costs balloon as the displaced decision-making power creates demand for more administrative personnel. An increasingly large share of the budget goes to administrative overhead at the expense of the organization's mission. Rationing starts to occur and with it a class of people who are above any rules about rationing.

The solution to the problem of lots of big HMOs isn't to be found in the creation of a single, sea-to-shining-sea HMO. But try telling that to someone who thinks they'll be getting something for nothing.

Ellen K said...

It's funny, but people really don't get how much their medical results are controlled by healthcare companies right now. I have had someone from an HMO, to which I no longer belong, change my prescription. They didn't change it to a generic, but actually changed it to another medication entirely. I also had to argue to get my son the meds he needed when he was bitten by a spider and went into celluitis. The HMO balked until I told them that I would be happy to wait until he was so bad that I had to take him to the emergency room. Then they paid for the meds. But people should not have to go to that length. It IS what will happen under a nationalized plan. Those who think they will be getting the same level of care need to think if they want what amounts to basic care in our inner city public hospitals, because that is what we will get.