I believe he is such a good doctor he can diagnose by film.

We need to hear more of this talk of individualism and less of collectivism. More personal responsibility and less of relying on a handout from the government.

We need more of this..

atease

I like this guy!

I loved it all except the first bit about Canada. Sorry to inform you, but our system isn’t all that rationed and our wait times (if that’s what he means by rationing) are only for elective surgery and are comparable to your wait times for the same operations.

We don’t have “death panels” or any other nonsense…everyone who asks gets treatment…if there is any “rationing” its via waiting, not telling old people they can’t get treatment because they are too old, or people with rare disease they can’t get treatments. Hell, if we don’t have a treatment here, we send people to the US and the state pays!

The problem is, for a Canadian free-market libertarian such as myself, that the system works just well enough for most people, most of the time to placate them. They don’t believe real free-market reforms will actually make our mediocre, just ok system immensely better. And often the same kind of FUD we see against our system down south from the Tea Party folks is spread up here in reverse…they seem to think that the ONLY alternative is the incredibly broken US system, and that somehow the government enforced and regulated private health cartel you have is “free-market”.

That lady doesn’t realize that a single payer system like ours is a lateral move, not really and improvement.

And Coburn doesn’t seem to understand that the insidious part of our system is how well it does work.

If it really were about rationing and bread line medicine, we’d have no problem convincing people up here to dump it. But that’s not the case, most Canadians LOVE our system, even to the point that it is called one of our defining characteristics of being Canadian.

Please, please please, debate the pros and cons and extol the merits of the market, but don’t lie about the Canadian single payer system to do it…it makes my efforts that much harder.

The truth works pretty well.

Mike, I appreciate your situation but do you see where the Canadian system is lying to itself? They farm work out to make it seem like they are maintaining a standard. Many national health care plans also farm out work to neighboring countries in order to meet wait times. In the UK, they will bring in a (e.g.) German surgeon to do a bunch of joint replacements in order to clear waiting lists. Those patients have not seen their surgeon ahead of time and will not see him after the operation and local surgeons are left to deal with any complications. This is BAD medicine.

Second, there are no wait times for elective surgery here in the US (beyond that medically necessary, e.g. getting blood pressure or diabetes under control before getting your tummy tuck), so there is no valid comparison.

The challenge here is not in elective surgery or urgent cases. I think we all understand where those things sit in the priority list and almost any type of system can manage them. The challenge is in the gray areas like joint replacements, screening colonoscopies or routine hernia repairs. Who decides the urgency of those procedures? What are the waiting times for recommended, preventive or non-emergent procedures? I think that’s what’s bothering the American in the street.

Here is something that does not get nearly enough ‘press’ in the healthcare systems debate and explains why a national system can work in some places whilst being a failure in others. There is a ‘tripod’ which underlies all medical systems and the legs of that tripod are Access, Cost and Quality. No system, no matter how efficient or well-intended, can maximise all three of those things at the same time. For example, you cannot have unlimited access to world-class care without it costing a fortune. People must decide for themselves where they wants to make sacrifices in their system and that is what is happening at these town hall meetings across America. I get the sense (though I’ve not attended one) that people do not want to sacrifice the quality of the health care they receive in order to reduce costs or increase access.

The government in the US already runs a number of national health systems: Medicare, Medicaid, military medicine, PHS, VA and the county hospital medical system. All of them have significant problems and are faulty in one way or another. I cannot think of a single reason for the American taxpayer to give even more money to their government to start up yet another system BEFORE they prove they can run even one system correctly! It is my personal belief that the way forward in providing health care for indigent and uninsured people is the existing county hospital system. Properly funded, the county system is capable of taking care of the uninsured and under-insured. I know it is because I’ve provided care in the county system in several states.

To clarify my position: I am a surgeon in a socialised health care system. There are very few restrictions on access, the quality is excellent and the cost is moderate (as far as I know). How is this achieved? By having too few workers in the system and underpaying them, and by cutting out the middle man – the insurers and other “healthcare workers” who do not provide any care to patients at all. IMO, there is not nearly enough discussion about cutting the costs of doing business in the American system: tort reform; reducing the number of people who work in the system but do not provide a service to the patient; controlling pharmacy costs, etc.

Regretfully, I am leaving the system I am in after over two decades because I’m tired of being paid in the 10th percentile of my career field. I’m tired of doing my own coding, typing and other administrative tasks. I’m retiring from the military and joining The Machine. I’m going to try out the seemingly greener grass.