And Health Care for All...

What great timing. Recently an old friend of mine (Melody) showed up in a post comment and chastised me for being "angry." In her comment, she argued, correctly, that just someone believes in a left-wing idea like "universal health care for all Americans," such person should not be disqualified from the public debate.

Then, on Thursday, 3/16, the Tribune printed an article about how American healthcare is universal alright, universally "mediocre." I couldn't find the article online, but you can get the gist of it here and here. The Tribune made it their "Question of the Day," and 52% of respondents said they do not have confidence in their health care services.

I guess, though, that most Americans should be careful what they wish for. In other words, if you think our healthcare is bad, you should try the "universal health care for all" system like our neighbors to the North.

This week I received an unsolicited email from a local surgeon. He tells the story of a patient of his who has dual US/Canadian citizenship. This patient required surgery. Here is the doctor's account, after I edited it to protect his and the patient's identity:

He used to live in MT where he worked most of his life in ranching. He was born in Canada and decided to retire in Alberta. He went in for an exam with his doctor in Canada because [his condition was impacting his day to day life]. He was told he needed surgery.

This started a process that he called "the negotiations". He called the nearest doctor’s office in both Lethbridge and Medicine Hat. He was told it would be 8 months before he could get in just to be evaluated for surgery. He was told the surgery wait would be 2 years. He called a well known surgery center in Calgary. He got in for an appointment 2 months later. They said he had a significant condition. If he wanted the “experienced” doctor it would be 2 years more to wait. If he wanted the new less experienced surgeon he could have surgery in 8 months. The patient declined that.

It turns out in than Canada a surgeon is allowed to do only so many cases per year and then his or her quota is filled and he or she cant do more. In addition, a Canadian doctor can not charge for covered services outside the system. The patient can’t just pay out of pocket to queue up and the surgeon cant take money from the patient for those services. A two tiered system isn't allowed although it is still tiered as the patients who don't want to go die or grow seriously ill waiting for care are likely to come to the US. This patient was fortunate as he had separate insurance coverage here in the US too (Medicare).

What was really ironic is that the more experienced well known Canadian surgeon was not even routinely practicing in his office in Calgary. The patient said that all 3 OR rooms were empty. Why, I asked? Because the renowned Canadian surgeon has a US VISA and does surgery on Americans at Loma Linda University in California on a routine basis.

So the patient called my office. He had heard of me from one of his friends. He had an appointment and surgery done within 10 days or so. His condition is fully resolved and his prognosis is excellent He is now a very happy person - he doesn't think any part of his care he received with me was mediocre. He shakes his head a lot when he talks about the so called universal coverage. Turns out universal coverage doesn't mean universal care.. one has to wait a bit for the care part to show up.

Which brings me back to a point I have raised many times on this weblog. I do not oppose socialism because I am mean, or because I do not care about my fellow man. I oppose socialism because it doesn't work. People follow incentives.

We will always have poor people; there is no utopia. The question is what system produces the fewest of them? What system gives those on 'the bottom' the best standard of living?

Free market Democracy.