Posted on 11/24/2004 8:34:45 AM PST by quidnunc
What's the defining characteristic of a government health service? It's one word, a word that, in its medical context, doesn't exist south of the border — "waiting," as in "waiting list," "waiting times," waiting, waiting, waiting.
I was sick over the summer and, down in New Hampshire, I went to see the local doctor, who referred me to a specialist. Let's just run through that manoeuvre again, in case it happened too quickly for those accustomed to Quebec levels of treatment: I saw the GP on Tuesday, got referred, saw the specialist Thursday. As is often the case in the U.S., the doctor was Canadian, and indeed came from a long line of Canadian doctors — both his parents practise in Ottawa. Making idle chitchat as his fingers felt his way around my fleshly delights, he explained that "waiting" is built into the concept of a government health service: "If you need surgery," he said, "it's in my interest to get you in and operated on as soon as possible, because that's money for me. The faster it happens, the better my cash flow. But when the government runs the system, every time you get operated on it costs the government money. So it's in their interest to restrict or delay your access. When you look at the overall budgets — salaries, buildings — it's not hard to understand that the level of service you provide to the patient is one of your few discretionary costs. So the incentive is to reduce that."
-snip-
(Excerpt) Read more at westernstandard.ca ...
Is this a Steyn "greatest hit" or is he back at his computer
This is a keeper.
rats, I've been quidnunced again.
Hope somebody fixes this one with the whole article.
Three of the five doctors at the Fargo Synagogue are Canadian. Liberals, mind you, who denigrate America when they can. But they're here practicing medicine, not in Winnipeg.
Neither, it's an article which has been up on the Western Standard sikte for two weeks for subscribers, but just became available for everyone yesterday.
I think Steyn has pre-written some articles for his magazine publishers such as The Western Standard and National Review which dont have to be so topical about current news.
There have been many articles in the WSJ, explaining that socialized medicine in nothing but a triage system that uses delay or denial of service to hold down the costs. The EU members are having a problem now because citizens are seeking and recieving treatment in member states when the wait is too long at home, overloading member states and straining the medical budgets of the home states.
As I have mentioned many times, Dr. Dean instituted socialized medicine in VT and the same results are already apparent. My sister-in-law has been waiting for nine months for back surgery, and in the mean time the doctors just tell her to keep taking her morphine, despite the fact that she works in the school district and does in-home after school daycare. The doctors told her that they would worry about addiction after she has the surgery in December.
I think quidnunc is right. I just got the digital edition of National Review, and his regular "happy warrior" column is in there, but you can tell it was written before he went on hiatus.
Is this hiatus just a well earned vacation? I'm a little concerned that his site say "family and personal reasons". IN my experience that's never good, and does seem to be more than a vacation. Hopefully Mark and his family are OK.
I was talking to a Canadian women visiting the U.S. She had to schedule her return to Canada because of a sheduled doctors appointment or wait another year. If that's not crazy I don't know what is. It's a failed system.
This is what the Clintons had in mind for the rest of us.
The Canadian people are mind numbed robots accepting this crap, lulled into stupor by the utterly corrupt Canuckistan media that parrots the socialist party line.
It's no good only excerpting when the source requires registration, unless you give us your registration, too.
Go to BugMeNot and get a login that will work.
thanks I'm printing that out.
Ask and ye shall receive...
SPUE (Society for the Prevention of Unnecessary Excerpting) to the rescue once again:
What's the defining characteristic of a government health service? It's one word, a word that, in its medical context, doesn't exist south of the border--"waiting," as in "waiting list," "waiting times," waiting, waiting, waiting.I was sick over the summer and, down in New Hampshire, I went to see the local doctor, who referred me to a specialist. Let's just run through that manoeuvre again, in case it happened too quickly for those accustomed to Quebec levels of treatment: I saw the GP on Tuesday, got referred, saw the specialist Thursday. As is often the case in the U.S., the doctor was Canadian, and indeed came from a long line of Canadian doctors--both his parents practise in Ottawa. Making idle chitchat as his fingers felt his way around my fleshly delights, he explained that "waiting" is built into the concept of a government health service: "If you need surgery," he said, "it's in my interest to get you in and operated on as soon as possible, because that's money for me. The faster it happens, the better my cash flow. But when the government runs the system, every time you get operated on it costs the government money. So it's in their interest to restrict or delay your access. When you look at the overall budgets--salaries, buildings--it's not hard to understand that the level of service you provide to the patient is one of your few discretionary costs. So the incentive is to reduce that."
He was chuckling merrily as he explained this, and I got the feeling he'd said it to many Canadians over the years. Defenders of our system often point out that America spends a higher proportion of its GDP on health care than Canada and yet has lower life expectancy. I'm not sure I quite understand the point they're making. I have employees on both sides of the border. When my assistant in New Hampshire has a doctor's appointment at 9 a.m., she's in his office by 9:07 and back in my office by 11. My assistant in Quebec, living in a jurisdiction with the lowest doctor-patient ratio in the western world, can't get a doctor's appointment, so she goes to her local CLSC at 9 a.m., and waits, and waits and waits and waits all day to be seen.
I doubt Chantal's and my loss of economic activity is factored into those health-care-as-a-proportion-of-GDP costs. In Canada, we accept that if you get something mildly semi-serious, it drags on while you wait to be seen, wait to be diagnosed, wait to be treated. Meanwhile, you're working under par. The default mode of the system is to "control health care costs" by providing less health care. Once it becomes natural to wait six months for an MRI, it's not difficult to persuade you that it's natural to wait 10 months, or 15. Acceptance of the initial concept of "waiting" is what matters.
The other week, I made some remarks about C. difficile in The Chicago Sun-Times and observed that it was caused by inattention to hygiene--"by unionized, unsackable cleaners who don't clean properly; by harassed overstretched hospital staff who don't bother washing their hands as often as they should." Michael Miner, in the city's "alternative weekly," The Chicago Reader, took exception to this, mainly because, in a clean American convalescence home, his mother had contracted C. difficile and died. He has my sympathies. I'm not sure that it's wise to trash my argument purely on personal experience, but, since he brought up his mother, let me bring up my wife.
A few years back, she felt herself beginning to miscarry. Nobody was at home so she called a cab and went to the emergency room at the Royal Victoria. Knowing what "emergency" means in the Quebec system, she grabbed a novel on the way out--an excellent choice, Mr. Standfast by John Buchan, our late Governor General. It's 304 pages, and my wife had the time to read every single one of them before any medical professional saw her. While she was reading, she was bleeding, all over the emergency room floor, the pool of large dark red around her growing bigger and bigger, until eventually a passing cleaner ran her mop over the small lake and delivered a small rebuke to my wife for having the impertinence not to cease bleeding.
Maybe it was just bad luck. Michael Miner at The Chicago Reader got U of T's John Marshall on the phone to assure him that "Canadian medical standards are on average every bit as high as American medical standards. It has nothing to do with the structures of the health care system." Oh, really? If Miner's mother was dissatisfied with her convalescence home, she could always pick another. And don't give me all the fine print about HMOs and co-payers: in the last resort, you or your loved ones can always reach into your billfold and go anywhere you can afford. At the Royal Vic, no matter how many bills you wave around, you still have to bleed all over the floor because they're the only game in town. Universal lack of access. Equality of crap--very literally, as the C. difficile outbreak demonstrates.
Since my wife's experience, the average wait time in Montreal emergency rooms has apparently gone up to 48 hours. So don't pack an overnight bag, take two, and the complete works of John Buchan. The natural consequence of a system built on waiting is that more people do what she did--sit in the hospital, waiting to be seen, bleeding all over the floor until a cleaner (and it's one cleaner per two floors at many Montreal hospitals) wipes it up with a dirty mop and then runs the same mop over the floor in the isolation ward upstairs.
That's the C. difficile story. That's why the fatality rate in Montreal is four times (officially) the North American average. "In many institutions, housekeeping staff has been reduced while nursing workloads have increased," reports Quebec's Clostridium Difficile-Associated Diarrhea Clinical Study Investigators Group. "Compliance with hand hygiene has been shown to decrease as workloads increase . . . Wards and emergency departments have become more crowded, and bed turnover is rapid. This makes containment of C. difficile exceedingly difficult, especially among patients with fecal incontinence." According to Dr. Louise Poirier of the Quebec microbiologists' association, "It's not that easy if you are a nurse and you have six patients. You take your gloves off and you go far away, find a sink, wash your hands, go back, put on another gown. You do that sometimes 20 times in an afternoon."
Hygiene is the number one issue in Canadian hospitals, and a problem with hygiene is the logical consequence of a system built on "waiting." On March 7 last year, Tse Chi Kwai went to Scarborough Grace Hospital and, as is traditional, was left on a gurney in emergency for 12 hours, exposed to hundreds of people. Two days earlier, his mother had died of SARS but, despite displaying to her doctor all the symptoms detailed in the several health alerts on the subject, had cause of death listed as "heart attack." And at Scarborough Grace, even after discovering that Tse's mother had recently died after returning from Hong Kong, Dr. Sandy Finkelstein concluded that, even if Tse was infectious, it was only with TB. Lying next to Tse on that ER gurney hour after hour was Joe Pollack, who was being treated for an irregular heartbeat. He was subsequently sent home but returned on March 16 with symptoms of SARS. He was admitted and isolated, but apparently it never occurred to the hospital to isolate Mrs. Pollack. So she wandered around the wards and infected an 82-year-old man from a Catholic Charismatic group.
Mr. Pollack, Mrs. Pollack, the 82-year-old Catholic Charismatic and his wife all died. None of these people went anywhere near Southeast Asia. They were exposed to SARS by the Toronto health care system, as was the 82-year-old's son, who was also unknowingly infected at Scarborough Grace and went on to expose another 500 to SARS at a religious retreat. As I wrote in the National Post at the time, "Only in Canada does the virus owe its grip on the population to the active co-operation of the medical profession. In Toronto, the system that's supposed to protect us from infection instead infected us. They breached the most basic medical principle: first do no harm."
Almost all scandals in Canadian hospitals boil down to the same thing: a decrepit system unable to observe basic rules of hygiene and quarantine. Sometimes it's SARS, sometimes it's C. difficile, sometimes it's hundreds of women going in to the Captain William Jackman Memorial Hospital in Labrador City and being gynecologically examined with unsterilized instruments-and thereby potentially exposed to chlamydia, gonorrhea, hepatitis or HIV. And almost all these crises are due to, in Dr. Marshall's words, "the structures"--a system that ensures sick people wait longer in crowded rooms in dirtier hospitals will, by definition, spread disease.
One day it will be something much worse than C. difficile.
Yeah, but that's extra work. I feel the poster should provide the passwords, etc. if they are going to excerpt from a site requiring registration.
Allow me...
From bugmenot:
email: jvqhstxqgcoheo@mailinator.com
username: buttwipe
If he had not he would have had to wait hours in an American big city emergency room (which are becoming harder and harder for poor people to find as the system breaks down)for the most basic service (forget about seeing a specialist).
Steyn goes for the cheap shot. He paints socialized medicine at its worst while showing ours at its best. The real choice is between socialized medicine which delivers mediocre care to all and ours which delivers the best care in the world to those who can afford it and - increasingly - none at all to the many who can't.
This is an outstanding article. Thanks.
What's the problem 'o Canada? I'm sure your elected and appointed leaders get immediate appointments, convienient times for treatments, and whatever medical treatments they happen to need when they need them. I am also sure that the evil rich people among you also receive the best care available. All you lower class people will just have to wait.
Who cares if some of you little people die while waiting for an operation or if you are in pain because you are unable to access the healthcare system in a timely manner? The point is that your betters in government and business are doing ok. That is what you vote for year after year and you are getting what you have chosen to get. There are only so many government teats to go around and you are not on the list today.
Socialism for you, capitalism for them.
One of the interesting things about the browser Firefox (instead of Internet Explorer) is that it has an "extension" that makes it a lot easier.
The BugMeNot "extension" provides the following function. Just right click anywhere on the excerpt, and it opens a window with the username and password from BugMeNot. This is really really cool.
Holy Kamolie! Just great, so it's easy to not treat patients just by putting them on pain-killers or other drugs, while delaying actual treatment. Dear goodness, socialized medicine can't be allowed to happen in America.
Steyn as usual makes some good points, but yours are as valid. As someone who has worked in the healthcare system in this country for years I can guarantee you that any managed care system is all about denial of service, as much as they can get away with, in any case. The overhead administrative costs are also way out of line. I'm not a big fan of Canadian medicine, as it claimed an early death for both of my parents, but we can't pretend that we have a system that is working much better for many people in our society. Just spend some time in an inner-city hospital, and see what happens to people who cannot afford routine, preventive healthcare. Believe me, when they are diagnosed with advanced disease that could have been prevented if caught earlier on, someone pays, and it's us, in the form of higher taxes, higher healthcare premiums, and welfare for the family members deprived of their breadwinners. In the long run it costs us all more money to have these people uninsured. There has to be an answer somewhere between managed-for-profit care and the Canadian abyss. It is disingenuous to focus only on the worst of socialized medicine.
As we read in the article, Mark Steyn mentioned that he sought treatment for a medical problem this summer. Perhaps the problem is on-going. Hopefully, it will be resolved with a good outcome since he is not dependent on socialized medicine in New Hampshire.
If it is, does society owe you a car, too? Where does this end?
Is it the government's job to provide things to the people or is it the individual's duty to provide for himself? That is the defining question between liberals and conservatives, and I already know how you'd answer.
Your "share-the-misery" socialism has never been all that popular in the US. Since the poor have to wait (according to you) in either system, would not the system that serves the "non-poor" better be the preferred method?
Yeah, I'm thinking of going firefox. What I really need, though, is a nice LITTLE browser for my old computer at the beach cottage, which has little RAM and no way of putting more in without a new board. I'm running Netscape 3.x (!)right now, but.....Any suggestions?
Thx
Thank you.
Is Mark Steyn back from vacation? Perhaps he couldn't resist needling Paul Martin and getting in his digs at Carolyn Parrish... We'll find out soon enough if he's proposing new bars to be sung to O Canada. ;-)
That's society's choice.
I already know how you'd answer
No you don't.
I'm on the hospital board in a small, rural, isolated, very Republican county. You'd be surprised at how peoples' beliefs change when its the lives of their friends and relatives which are on the line.
It's not mine and you assume you know where my sympathies lie.
(according to you)
Visit big city hospital rooms in poor areas instead of making snide remarks.
would not the system that serves the "non-poor" better be the preferred method?
That depends on the details of each system. In Canada one poster claims that health care is not mediocre but terrible. My German and French friends tell me that the poor receive much better health care there than they do in our country.
and - increasingly - none at all to the many who can't. Hospitals cannot turn away patients even if they can't.. or won't...pay.
Feeling a little out of sorts since November 2? There's help available (though I don't know if the government will pay for it). BTW, my wife worked for several years at Cook County Hospital in Chicago. Perhaps conservatives are not quite as ignorant as you seem to imagine.
My sympathies to the Canadians for their health system.
They can if they close...and that's what's happening all across the country.
I don't spend time on such foolish generalities. I was replying to you - not conservatives.
There is. But it depends on getting the government totally and completely out of the health care business.
With a pining regret, I recall when I started my first business -- in 1965. Comprehensive small business employee health care was available from Blue Cross/Blue Shield for the princely sum of $28/month -- $50 deductible, without spousal or pregnancy benefits (which were an additional $12 and $6/month, respectively, as I recall).
Consequently, it was no problem to fund health care for one's employees. And we offered the spousal and pregnancy benefits at the employee's expense as options, so that our cost per employee was the same for everybody.
Soon thereafter, the Johnson administration invented Medicare and Medicaid and began to regulate the health care industry -- encouraging, in their wisdom, the training of specialists and discouraging the training of GPs. Costs began a steady escalation, until they started becoming disproportionate and unbearable in the late eighties.
About ten years ago, around the time of Hillarycare, one of LBJ's staff admitted that the whole program had been "a tremendous mistake", which had distorted the market and raised costs across the board.
Nice of him to do so. But it was a little late...
Once again, the U.S. has health care for everyone. Get it through work or school, buy it yourself or go down to welfare and sign up.
Firefox will run in 64 MB of memory.
It is a pretty stripped down browser.
Ah, the cost of insurance strikes again (a contributing factor, not the sole factor). Its a vicious cycle. Keep putting poor inner city people on juries that award hundreds of millions of dollars in malpractice cases and they'll continue to bankrupt the system. Then when the hospital finally gives up and closes its doors, the first one to bitch will be the jury foremen.
The system is breaking down. Educate yourself.
I will never, ever forget a story I heard reported on the CBC (of all places!) a few years ago. I guess it was too much even for them to ignore:
It was winter. An elderly couple somewhere in Canada was exiting a local hospital, after having visited a friend who was a patient there. Being a Canadian government operation, the hospital had not bothered to salt the sidewalk outside the door, and it had become icy. The man slipped and fell on the ice, breaking his hip.
Since they had left via the emergency room entrance, his wife ran back inside the door, expecting that she could get a couple of emergency room employees to run right back outside with a stretcher to retreive her husband and take him inside for treatment.
What a silly old woman she was for thinking that! It turns out that according to The Rules, only an ambulance was allowed to bring in patients for emergency room treatment. The doctors and nurses - whether out of sheer lack of concern for human life or out of fear of losing their jobs, I don't know - absolutely refused to step outside the door, not even to offer him a blanket while he waited. The wife literally had to call 911 and wait for an ambulance to show up and take her husband the five feet inside the emrgency room door (and fill out the proper paperwork, of course), before her husband received treatment.
That is socialized medicine in a nutshell.
thank you...
and God bless SPUE!
Remember, the HMOs were created by congress. Prior to that, the insurance was much better in this country. HMOs are half way between regular medicine and socialized medicine. The best thing to do is Tort Reform, allowing the medical profession to reduce their costs for mal-practice insurance. Tort Reform should also be accompanied by a dedication on the part of the doctors to eliminate doctors guilty of mal-practice. Just those two things would considerably improve health care and lower costs.
If you think this kind of stupidity doesn't occur here you're living in a dream world. It occurs everywhere, in all walks of life. It's human nature. Mercifully, it doesn't occur very often.
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