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Wednesday, May 06, 2009
Ed Feulner :: Townhall.com Columnist
A Cure Worse Than the Disease
by Ed Feulner
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Emily Morley got some very bad news in March 2006. Her cancer had spread, the doctor informed the 67-year-old Canadian. She would need to see an oncologist.

Then Morley got some really bad news: She’d have to wait several months before she could get an appointment.

Only after her family raised a ruckus, calling the local paper and starting a petition to demand she get care, did the government get her a specialist. Then, it was more bad news: Morley had only three months to live.

At least she had time to put her affairs in order. “Had her family not intervened,” noted provincial lawmaker Don McMorris, “it is quite likely that Emily Morley may have died before even seeing an oncologist for the first time.”

But that’s how a single-payer, or “universal,” health care system works (so to speak). Even the very ill routinely hurry up and wait.

Alarmingly, Congress is gearing up to “reform” American health care along Canadian lines -- and proponents are trying to take a short-cut to get there. According to former Medicaid director Dennis Smith, proponents of a government-run health system are hoping to enact a bill by by-passing the usual, lengthy bipartisan review process.

The goal of any reform, supposedly, would be to trigger “competition” between government-run health care and currently existing private health insurance plans. Yet, Smith warns, the government will inevitably tilt the playing field to favor its own plan, running private coverage out of business. Americans could be left with a single, government-run health plan à la Canada’s.

So let’s take a look at what such a system means for our northern neighbors.

As Sally Pipes, president of the Pacific Research Institute and a former Canadian citizen, recently told Congress, today some 750,000 Canadians are on a wait-list for medical procedures. Further, 3.2 million (out of a population of 32 million) are waiting for a chance to see their primary-care physician. Once a PCP diagnoses a problem, Canadians must keep on waiting -- 17.3 weeks on average -- before they can see a specialist.

Why? “The Canadian government controls costs by rationing care,” Pipes explained. “Canada ranks 14th out of 25 [Organization for Economic Co-operation and Development] countries in MRI machines, and 19th out of 26 countries in CT scanners.” Long wait times and lack of equipment force many to seek care in the United States.

Take Member of Parliament Belinda Stronach. She strongly supports Canada’s health care system. But where did she go when she was diagnosed with cancer in 2007? To California, where she paid for treatment out-of-pocket. Then there was a mother in Calgary, Alberta, who had to be flown to Great Falls, Mont., to deliver her quadruplets. This relatively small American city had better facilities than any hospital in the wealthy province of Alberta.

Our current system is far from perfect, of course. Millions of Americans lack health insurance, prompting many to put off seeing a doctor until a small, treatable problem has become a larger, more threatening condition.

But the answer isn’t to try and cover everyone through a single-payer system. We’d be better off changing how the federal tax code treats health insurance (which, illogically enough in our 21st century economy, ties it to our jobs). Such a change would foster genuine competition among insurers by allowing Americans to shop for the coverage that suits them best in an open market.

Current policy provides unlimited tax breaks for health coverage provided through employers. Meanwhile, Americans who want to buy their own insurance must do so with after-tax dollars. Few can afford to do that, especially since insurers are more interested in competing for big group coverage (more lives, more money) rather than individual or family-based coverage.

Lawmakers could change this, and even provide vouchers or other forms of direct assistance to help poorer Americans buy private plans they would own and control. This would also make insurance portable when people change jobs.

Maintaining our standard of care is critical. There’s a reason Canadians “fly south” for treatment: Our system, for all its flaws, provides superior quality and access to care. Let’s ensure that policymakers, in their understandable zeal to reform health care, don’t make changes that weaken the entire system.

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About The Author
Dr. Edwin Feulner is president of The Heritage Foundation, a Townhall.com Gold Partner, and co-author of Getting America Right: The True Conservative Values Our Nation Needs Today .
 
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What about the US Government?
We don't have to look at Cnada to see what a US system will be like. Just look at Medicare. I think most of what is wrong here is the result of bad policies and interventions by Congress and their indifference to responsibiity to correct them. We should make them fix Medicare before they do anything else.

I suspect that few know what is wrong. First the government underpays the providers to the tune of $500B. Those shortfalls are transferred to everyone else and ultimately drive up the premiums of health insurance.

Some brag that Medicare has low administration costs. That is an indication of negligence more than efficiency. Newt says fraud is estimated to be $85B/yr. Thinkers like Daschle propose Draconian rationing of eldercare, a blunt instrument compared to utilization review which insurance companies use to flag unnecessary procedures.

Dongress also has bad policies to manage the supply of docs and nurses, so bad that they have created shortages of both and importing personnel. Changing these woul;d mean more good jobs for Americans. The more the merrier, as greater supply lowers prices,

Finally, there is the Law that kills ER's. and unintended consequence of a Good Samaritan decree. It is so broadly written that ER's are overrun with sore throats and sniffles nobody pays for, not the patients or the government,

Lots or reforms are needed, but authors often give only one. That won't cut it. Revealing wha a mess Congress has made might make people deman iomprovements and will certainly reduce their faith in government health care.


Healthcare Reform
Real Healthcare Reform: Changing the Incentives and the Rules of the Game; Creating an Electronic Health Record for Every Citizen Who Wants One.

If you have the financial resources of Bill Gates or Warren Buffett you needn’t pay money to a health plan each month, since if you get sick or injured – even very seriously - you have more than enough money to pay all your medical bills yourself.

But those of us with significantly less financial resources must find some other means of dealing with the thousands or even hundreds of thousands of dollars or more of medical expenses that we might incur should a serious illness or injury be our fate.

Enter the concept of “health insurance”.

Large numbers of individuals and/or their employers pay some money each month into one or another big pot called a “health plan”. Those individuals who remain essentially very healthy for many years and then suddenly die or perhaps leave a particular health plan for some other reason – if they have put more money into the pot than was taken out to pay all their medical expenses - wind up helping to pay the medical bills of those members of the health plan who become seriously ill or injured and incur a lot of medical expenses.

Many members of health plans don’t seem to fully understand or perhaps choose to ignore the fact that if they become seriously ill or injured, for the most part their medical bills will be paid by the members of their health plan who have remained healthy. Some Americans believe that healthcare should become a “right” of every American citizen. If a nationalized single payer health plan were enacted, every American citizen who became ill or injured - for whatever reason - and incurred significant medical expenses would for the most part have his or her medical bills paid by all U.S. taxpayers.

Healthcare Reform (Cont)2
For any health plan to work which has a large number of people pooling their money to essentially pay the medical bills of whichever members of the plan become seriously ill or injured, rules must be established as to when and how much money may be taken out of the pot e.g. “legitimate” doctor bills and hospital bills. Equally important is keeping track of the amount of money that is being put into the pot each month in premiums paid by health plan members or their employers. If too much is being paid out in expenses as compared with the amount being received in premiums, the pot will soon become empty and the health plan will go broke.

As previously mentioned, the monthly premiums paid by individuals or their employers go into a health plan’s big pot from which “covered” healthcare expenses are paid. But also from this pot are paid all the health plan’s administrative expenses including what may be big salaries and golden parachutes for CEO’s and other “healthcare executives” – individuals who may be paid to find technicalities of one sort or another in the health plan’s agreements so the health plan can deny or reduce payments, raise premiums, cancel insurance, or in one way or another minimize or exclude “bad risks” from the health plan. All such questionable business practices are done to enable the health plan to make a profit and remain in business.

Currently we are experiencing continual increases in healthcare costs that are unsustainable and which, if unchecked, will soon seriously threaten the future of the entire American economy. Healthcare costs must be controlled, but how? If a healthcare system made up of health plans is going to have a chance of meeting the needs of its health plan members and simultaneously be able to keep costs under control, something very critically important must first occur.

Healthcare Reform 3
It turns out that a lot of illnesses and many injuries are actually preventable.

Although health promotion and disease and injury prevention receive fashionable and socially acceptable lip service, the fact is that most of the participants in what should be more appropriately called our “sickness and injury care system” actually have no significant financial incentive whatsoever to spend any significant time and energy in genuinely promoting health and helping to prevent disease and injury.

Much to the contrary. Other than the actual members of a health plan – patients and potential patients - and their employers and perhaps the employees of some health plans, most participants in our sickness and injury care system - because of the way they are paid - have an enormous (if unspoken) financial incentive for massive amounts of disease and injury – much of which is preventable – to continue to occur in America. Strictly from a financial point of view, for those whose incomes come solely from the treatment – not the prevention - of illness and injury, the more illness and injury that occurs, the better. And if the illness or injury is serious and requires perhaps many expensive tests, multiple surgical procedures, and other very complicated prolonged treatment in an intensive care unit, so much the better; just as long as those unfortunate individuals who happen to be ill or injured are “covered” by “good insurance”, i.e. health plans that are reliable bill payers.

This is not to say that there are not some excellent very dedicated and hardworking doctors and other health professionals - although they are paid on a fee for service basis to care for illness and injury – who nevertheless attempt to essentially work themselves out of a job by making health promotion and disease and injury prevention a top priority with their patients.

Healthcare Reform 4
It should also be recognized that some existing health plans – e.g. Kaiser and Group Health - combine insurance, doctors, and hospitals into a single entity in such a way that provides everyone - including all the health plan’s doctors - a real incentive to spend time and effort with patients on health promotion and disease and injury prevention as well as on early diagnosis and treatment.

But unfortunately the above examples represent only a small part of the sickness and injury care system that currently exists throughout America.

For the most part - because of the way they are compensated – the majority of doctors and other professional providers, acute care hospitals and long term care facilities, pharmaceutical manufactures and pharmacists, medical and surgical equipment manufacturers and personal injury and malpractice attorneys - among others - depend mightily on massive amounts of disease and injury occurring in America; and these participants in our sickness and injury care system would be significantly negatively impacted if a lot of the preventable illnesses and injuries were actually prevented. This must be changed.

Unless the incentives and rules are changed to give as many participants as possible a real financial stake in health promotion and disease and injury prevention, in early diagnosis and treatment, and in maximizing health and minimizing disease and injury, healthcare costs in America will never be brought under control. Making appropriate changes in the incentives and the rules of the game is the real task and challenge of “healthcare reform”.

Healthcare Reform 5
What about financial incentives for individual health plan members? Should individuals receive a financial incentive to be healthy? It is well recognized that engaging in regular exercise, abstaining from tobacco, and eating moderately so as to maintain a reasonably normal body weight are all significant factors in helping to promote an individual’s health and wellness. These healthy behaviors can all be confirmed by simple tests performed or ordered in a doctor’s office. Why shouldn’t those individuals who practice these health promoting behaviors and comply with recommended immunization schedules and appropriate preventive screening examinations such as for colon cancer and breast cancer pay significantly less in premiums to their health plan each month than those who don’t?

To really reform healthcare we must find ways – through changes in incentives and the rules of the game - to actually prevent what is preventable, to maximize early diagnosis and treatment, and minimize disease and injury with all its associated cost. We must find ways for participants to be part of our “healthcare system” and not just a part of our “sickness and injury care system”.

Significant changes in the rules of the game for our legal system – tort reform – is also critically important so that the gaming of the system now being done by personal injury and malpractice attorneys and their clients can be ended and so that the exorbitant costs to physicians and other professionals for malpractice insurance can be dramatically reduced.


Healthcare Reform 5
Truly transforming our “sickness and injury care system” into a “healthcare system” by making significant changes in the incentives and the rules of the game may seem to be a formidable task and one that probably has never really been done before on a large scale anywhere in the world. But it is a worthy task and a critically important task for the future of America and its people.

One significant part of this process is developing the capability of creating an electronic health record for every American citizen who wants one. We need a standardized framework that will allow every American citizen to have an individual electronic health record – a computerized medical record - that can be accessed by all the doctors who care for a particular individual, regardless of wherever on the planet the doctors or the patients happen to be. It would be like having your own personal online banking account that only you have the password to, but which you can share with the doctors who are caring for you, wherever you or they may be.

I applaud those who are using their energy and expertise to upgrade our deplorable current paper medical records system and bring medical records in America into the 21st century. Developing a standardized framework for an electronic health record - for every citizen who wants one – created by your doctor with your assistance, with proper security and safeguards - is something that our national government can and should do as a part of healthcare reform.


Healthcare Reform 6
If done well, electronic health records will be transformational in helping doctors efficiently and effectively care for patients and will save an enormous amount of time, effort, and money which is currently wasted on needless and frequently inaccurate duplication. And having an accurate electronic health record for an individual will also facilitate appropriate health promotion and disease and injury prevention for that individual. Like the telephone and the computer, someday we will all wonder how we ever got along without individual electronic health records.

All this requires action, not just words. Now is the time for Americans and their leaders and doctors and other health professionals to step up to the plate and begin the process of transforming our “American Sickness and Injury Care System” into an “American Healthcare System” that is worthy of our great country.

Robert Westafer M.D.

Canadian legislator goes to UCLA for

cancer treatment

http://chealth.canoe.ca/channel_health_news_details.asp?new s_id=27564&news_channel_id=136&channel_id=136

"'Onetime Conservative MP Belinda Stronach travelled to the United States for treatment. "Stronach ... opposed opening up the Canadian health-care system to any private side, but when she was diagnosed with breast cancer in June 2007, she came to UCLA and had her breast cancer surgery done and paid for it out of pocket,' Pipes said during the hearings on Tuesday."


And then there are all the cancer patients in England who are denied medication because it's too expensive... The NHS just cannot afford to buy them.


Actually, Feulner is exactly correct!

"A Cure Worse Than the Disease."

The "cure" is DEADLIER than the Disease.






Free healthcare
Most of the people that I know very much want this "free" healthcare. When I try to explain rationing to them, their eyes glaze over. The dumbing down process has worked.

Obama and refatstew view
It's never worked before and no one who has it will support it, but it will work this time. Find one European in support of Universal Healthcare.

A better solution is to curb large insurance companies and make them competitive. In the market now insurance companies want and are encouraging high rates. This creates a barrier to entry and they don't even have to pay the high rate because big insurance negotiates the rates. If the government helped to create a more free system by lowering the barriers of entry then I am happy because it's always about the barrier of entry.

Again philosophically speaking allowing power all in one place has never been a good idea. If you can find a historical example that proves otherwise let me know.

Free Market Solution
So it took you (refatsew) how many long winded posts to say the entire thing will be paid for by upgrading our record system? Improvements in efficiency are welcome but it is not the Federal Governments responsibility to ensure that everyone is insured. The current "employer" model needs to be gutted and we need to move to an individualized competitive, market driven, system that will encourage lower prices and better quality through that "evil" concept known as capitalism.

Socialized Medicine In England
From the Times of London

"The late Eileen Fahey, for instance, dying of cancer, was put onto a mixed geriatric ward where confused people wandered about without supervision. One man with dementia regularly masturbated at the nurses’ station and tried to get into women patients’ beds; he was a threat to them all but staff took no notice, according to her daughter Maureen. Other patients have to give answers to intimate questions in the hearing of other patients. One deaf old man was repeatedly asked when he last had an e*ecti*n, until tears ran down his cheeks.

A former midwife described eloquently on Radio 4 the indignities of being in a 24-bed mixed-sex ward, stripped of all dignity and intimidated. Bedlam was the word she used, and it applies even more accurately to the secure psychiatric mixed ward in London endured by Susan Craig last year, after a breakdown. She suffered regular sexual harassment, with mentally ill men groping her and exposing themselves. The nurses disbelieved her and told her husband she was “flaunting herself”.

Welcome to free health care, and worth every penny.

Most everyone supports Healthcare Reform

Only Liberals support Rationed Healthcare.

No more scare stories
The fact is that health care *is already being rationed* in the US. 47 million people are without insurance of any kind, many dropped off the rolls for one reason or another. Before you start pointing the camera towards Canada, how about pointing it to the US where many will *not even be on a waiting list* to see an oncologist because they simply have no access. I am not looking for *free care*. I am looking to be able to pay the same as everyone else, or "equal access." I have no problem with so called private insurance competing with some government system. Besides, I consider it unethical and unbiblical that it be guaranteed that private industry can reap a profit off the backs of the sick. The GOP is hanging themselves in the noose over this issue, as many Christians who are fed up with empty GOP promises of reform and have done nothing but talk about it (like everything else they stand for). If you love Obama, you will continue on with these pointless scare stories, as many of us who voted for Obama have already heard them. Instead, propose real solutions.

ABUSE
and corruption abound in the health care "industry".
Let's examine this "business/government" relationship as a whole, beginning with FDAs and Wall Streets beloved bedmate, Big Pharma.
Next, let's examine the fatal affection of Big Pharma for our med schools, an undying love that systematically seduces potentially fine practioners into becoming unwitting drug dealers that lure entire nations, cradle to grave, into drug addiction and drug dependency.

After closely examining just exactly what we've been paying for with our hard earned dollars for entire lifetimes...only then should we discuss how to best fund, if at all, an atrocity that would make Hitler blush.
Mr Feulner nailed it..."A Cure Worse Than The Disease"!

quit repeasting the LIE
The lie ststing "47 million people in the US don't have insurance". Of those 47 million, 12-17 million are in the US ILLEGALLY. Of the remaing, more than 20 million are young, healthy people with CHOSING NOT to have insurance. Of the remaing 10 to 15 million, more than a million CHOSE TO PAY for medical care themselves, prefering not to deal with insurance companies. Of the remaing, why should I pay for the lazy and inept to get a socialistic "equal outcome". There is no right to this, only and equal start.

healthcare
If we quit eating food that is bad for us, we will not be needing healthcare. It has been proven that if you are obese you need a doctor. If you are slim and beautiful you are healthy. quit stuffing food down your face and you won't need a doctor.

The above is some quote by "MeMe" Roth and the liberal left who want to tell us what we can and cannot eat and then say that if we are fat then we get sick.

I got news for them. I am 5'2" weigh 97 pounds and am sicker than my friend who is 400 pounds. I have several autoimmune diseases. She never gets sick. But she was denied a job because "obese people cost employers more money in healthcare" How? She never gets sick!!

Ironic, Philip
. . . accusing the writer of posting scare stories and immediately responding with the bogus scare statistic of 47 million without health insurance (or without health care, as it is often dishonestly put) A following poster answered that, but I'd like to add that my post about hospital conditions in England were not designed to frighten, but to inform. That's the reality of English health care. True, some places are better, but too many are like I described.
Government controlled health care is frightening for one simple reason-- ever tried to fire an incompetent public employee with union status and some seniority? This is not a situation I want our health care system to be under.

Fear Mongering
You are giving an example of an extreme case in
Canada, you are not giving examples of very
similar situations here in the US, if you do
not have insurance.

I have a sister and a best friend who live within 25 miles of the Canadian border. They
have related all sorts of stories about Canadian
health services, some bad, the vast majority
great. I have college friends who live in
Europe - France and the Netherlands. They
wouldn't switch for anything.

I have a daughter and a husband who experienced socialized medicine first hand,
one in Japan and one in Singapore. They
were amazed with the speed and the cost.

and Jackie: "If we quit eating food that is bad for us, we will not be needing healthcare. It has been proven that if you are obese you need a doctor. If you are slim and beautiful you are healthy. quit stuffing food down your face and you won't need a doctor."

This is a ridiculous statement. It only lessens your chance of the need of healthcare.
It is no insurance policy. In fact, last decade when I and my friends were in our 50's,
every single person that I knew well who died
was a health nut. They represented 7 people. Six died of some form of cancer
(one complicated with childhood diabetes) and
one died from an automobile accident, after
spending nearly 5 months in a hospital in a
coma.



Health Care?
But it's FREE. Ah yes, I believe there are many things I thought were FREE, and what a shock. Some how, some where, some one pays the bill.
In America it will be you the tax payer after a small 50% deduction for handling fees.
Some one will determine if you deserve any care, based upon a non medical persons evaluation of your age, your worth to the community in case you don't survive, versus the cost. You really do not want government care, with all of your medical care on a nice computer base, for employers to check on you before or during your employement.
Total government control of your health plan, really great if you are a moron.
When the expense for your care becomes impractical, guess what care you will get.
Euthenasia anyone.
Cost/versus value to society
But its FREE.

Phillip
Private insurance "competing" against a government insurance? How do you suppose that will work?

Take it out of the health insurance realm. My town used to have several very fine private campgrounds. They provided nice parking places with trees, electric/water/sewer hook-ups, tour information, etc. They charged a little bit more than AAA campgrounds in the Lower 48, which when you consider the higher cost of living here in AK makes sense. Somebody complained at the local visitor's center and viola, the city and then the state opened campgrounds close to town. The cost of a full hookup at the private campgrounds was $15 a night, but you got showers and tour information as well as the water/sewer/electric. The public campgrounds are just dumping stations with parking spots, but they were only charging $8 a night. Guess what the tourists chose? Yes, the $8 camp site. Forget that the average stay of the camping tourist who stayed at the private campground was twice as long as those at the public campground (a story I did showed that the public campground tourists were woefully unaware of the activities in our town). Forget that the public campground tourist polled as significantly less satisfied with their visit to Fairbanks than the private campground tourists did. Forget that the state and local governments subsidized the $8 campsite to the tune of $25 a night (when the private campground could make a profit at $15 a night). Camping in our commmunity was considered too expensive, so gov't stepped in. All but one of those private campgrounds has closed in bankruptcy. Private companies cannot compete against gov't-subsidized programs. It's not a level playing field. The real costs are hidden by the subsidy.

Tammy
I have a friend who is from England. She reports that they routinely "pull the plug" on patients who score too lowly on the Glascow Coma Scale, sometimes within just a day or two of the head injury that put them in the coma. My friend works at a nursing home that has a short-term care wing for people transitioning from a rehabilitation center to home. She says that better than half the patients she helps transition to home would never have lived long enough to wake up from their comas in England. Carolyn's mum came to the US for cancer treatment she was denied in England because she was past an age limit. She's doing fine today.

I also live in the nearest modern city from the AK-Canadian border. It is a well-known fact among health care professionals locally that 25 percent of our patients are Canadians, paying out of pocket for care they maybe can get back home, but have been told they'll have to wait an unacceptable amount of time. One of my coworkers is a Canadian (well, actually, she's become an American citizen now) nurse who originally came to this country for shoulder surgery she couldn't get at home (as a psych nurse, she was told she didn't need pain-free use of her shoulder).

I think you don't really know that many people who have had anything to do with the Canadian Health Care system. I know quite a few who think it's terrific. They're all Americans who have been told by somebody else how terrific the Canadian system is, but they've never actually experienced it themselves. I know a few who changed their minds after they did.

The benefits of no health insurance
My husband's union health insurance is self-funded, so in order to keep costs down, they provide the members with a report of health care costs charged to the fund. Last year they provided a comprehensive report of the last 10 years. A noted trend was that people used to go to the doctor for trivial things -- colds (which doctors can't do anything about), mild sprains, sunburn, sore throats, etc. Then the union started sending out these reports and showing how much premiums were going up due to this trivial use. People have started to cut back and premiums aren't going up. In fact, last year they actually were reduced by 2%.

When people don't have insurance, they tend to take better care of themselves (this has been well-documented by doctors) and they tend not to run to the doctor for trivial things.

I have a few friends who have high deductible policies that cover preventative care at low-cost regardless of whether the deductible has been paid. They report they use the preventative care and hardly anything else unless they break a bone or need surgery. Those with low deductibles tend to go to the doctor for silly things that they don't need to go to the doctor for.

Having insurance tends to drive up medical costs and medical use, which drives up health insurance costs.

Call a Canadian
Want to know what universal single-payer health care is really like? Rationed? High taxes? Worry free?

Instead of listening to "experts" from the health insurance industry, lobbyists, the government, or even Michael Moore, why not call an average Canadian and find out for yourself?

Substitute your area code for a Canadian one listed below and call your own phone number. Introduce yourself and ask the person at the end of the line what they think about their health care system. Ask about their own experience. The service, the price, the choice, whatever.

Then make up your mind if single-payer universal health care is a good idea for the USA.

Canadian Area Codes:
709 Atlantic Time plus a half hour

506 and 902 Atlantic Time

819, 418, 581, 450, 613, 514, 438, 343, 416, 647, 905, 289, 705, 519, 226, 807 Eastern Time

204, 306 Central Time

867, 780, 587, 403, 587 Mountain Time

250, 778, 604 Pacific Time
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