Why Canadian Premier Seeks Health Care in U.S.

Danny Williams, the premier of the Canadian province of Newfoundland, traveled to the United States earlier this month to undergo heart valve surgery at Mount Sinai Medical Center in Miami. With his trip, Williams joined a long list of Canadians who have decided that they prefer American medicine to their own country’s government-run health system when their lives are on the line.

But just as American hospitals are becoming popular vacation destinations for about 40,000 Canadians a year, California’s Senate is pressing ahead with its effort to make the state’s health care system more like the one in the Great White North. The Senate recently approved a bill sponsored by Mark Leno, D-San Francisco, that would install a government-run, single-payer health system in the Golden State.

Lawmakers should take Williams’ case to heart. Canada’s experience shows that government health care leads to waiting lists, rationing and lower quality of care.

For instance, Canada suffers from a scarcity of physicians. Over the last decade, about 11 percent of doctors trained in Canadian medical schools have come to the United States to practice. Physicians’ salaries are set at artificially low levels by provincial authorities: The average Canadian doctor makes just 42 percent of what an American physician does.

Canadian patients also face wait times for medical procedures. Nearly 700,000 Canadians are on a waiting list for surgery or other treatments.

A Canadian patient has to wait roughly four months for the average surgical or other therapeutic treatment. Wait times were similar a decade ago – even though the government has substantially increased health care spending since then.

Canadians also lack access to advanced medical technology. Compared to other developed countries, Canada ranks 14th out of 25 nations surveyed by the Organization for Economic Co-operation and Development in access to MRIs; 19th of 26 for CT scanners; and eighth out of 21 for mammograms.

Canadian women are nearly a quarter less likely to have had a mammogram than are American women.

Despite these visible shortcomings, many American lawmakers want to emulate Canada’s system. President Obama’s new blueprint for reform would greatly expand Medicaid by adding 15 million Americans to the rolls. Medicaid patients already have trouble finding doctors who will treat them because of low government reimbursements. Nearly a third of physicians nationwide won’t accept new Medicaid patients, according to the Medicare Payment Advisory Commission. Expanding the program will only make matters worse.

Congress would also like to beef up government-run “comparative effectiveness research,” whereby officials evaluate competing drugs to determine which ones are purportedly most effective for the average patient.

Canada employs these reviews ostensibly to make sure that public money is spent wisely. But such reviews just diminish patients’ access to the latest medicines. Publicly insured Canadians have access to half as many drugs as their countrymen with private insurance – and must wait a year longer to gain access to the few new drugs that become available.

America’s health care system merits reform – but not of the government-heavy sort favored by the president and congressional Democrats. Expanding government control over the health care system will diminish outcomes for American patients – as well as the occasional Canadian visitor.

Hospital Managers Worry About Government Targets; 400 Patients Die

From the Telegraph of London: “managers at Mid Staffordshire NHS Foundation Trust stopped providing safe care because they were preoccupied with government targets and cutting costs.”

That’s in an article about a hospital “where at least 400 deaths have been linked to appalling care.”

American health care is not perfect, certainly. But the plans that Congress may foist on the country will only take us further in the wrong direction.

Electronic Health Records Meet Government-Monopoly Health Care

A while back, I noted the Canadian province of Ontario’s negative experience setting up a province-wide Electronic Health Record (EHR) “system” for the entire province.

There’s more news about this fiasco in a recent edition of the Ottawa Citizen.  The government has brought in a “troubleshooter” with loads of experience reining in IT projects that have run off the rails.  With a mix of public and private sector experience, Mr. Raymond Hession has a real job ahead of him.

“eHealth” was started as a result of a commitment that the provincial government made in 2000, to have all Ontarians’ health records online by 2015.  That goal is in doubt, according to the article, because of “shady procurement practices,” the “total absence of a strategic plan,” and consultants “who were running amok.”

Interestingly, the article cites successful adoption of EHR on a small scale: a family-practice group located at the Riverside Campus of The Ottawa Hospital.  This is a fundamental error with government initiatives: Observing success at a local level and believing that by investing taxpayers’ money and government control, politicians and bureaucrats can effectively scale it up to encompass an entire jurisdiction.

It’s a pipe-dream: Ontario has over 12 million residents scattered over a huge land-mass, many of whom are surely none too enthusiastic about the provincial government having control of their health records.

Maybe it’s a good thing that “eHealth” fell under the wheels of incompetence and corruption.

California’s New HMO Regulations

Perhaps the greatest absurdity of California state senator Mark Leno getting his single-payer bill passed in the state senate is that it happened the same month the Department of Managed Health Care announced its new regulations limiting waiting times for HMOs. 

The new regulations will require that telephone calls be returned within 30 minutes; that health professionals be available 24/7; that appointments with general practitioners take place within ten days, or 15 days for specialists.  

There are standards that a single-payer plan could not hope to achieve.  Indeed, California’s current government-run health plans can’t achieve them.

The new regulations are a result of years of negotiations between HMOs, the government, and self-styled “consumer advocates”, who lobby for laws and regulation friendly to trial lawyers.  Indeed, Anthony Wright, ED of Health Access California, the “statewide health care consumer advocacy coalition” is actually listed on the DMHC’s press release as “sponsor of the original 2002 law.”  (Can you imagine the outrage if Pfizer or Eli Lilly were listed on a government press release as “sponsor” of a law concerning prescription drugs?)  According to Cindy Ehnes, Director of the DMHC, “Californians are literally sick of having to wait weeks to see a doctor.”

Well, I’m sure they are.  But what of the poor Califorians enrolled in Medi-Cal, our Medicaid program? Only 11 percent of cardiologists in Los Angeles accepted Medicaid patients, and the highest accepting specialty was dermatologists: 58 percent.

Lengthy waits for medical services, as doled out by government bureaucrats, are characteristic of so-called “universal” health care.  In my home country of Canada, we don’t measure waiting times in days, but in months – over four months, to be precise, according to The Fraser Institute’s 2009 annual survey of waiting lists for twelve specialties in each of Canada’s ten provinces.

Read more here.

More On The Premier of Newfoundland’s Heart Surgery

I think this story will have a long life.  One major question, yet unanswered, is: “Who is paying for this surgery?,”  although the fact that his doctors at home referred him suggests that the provincial health plan will pay.

If Mr. Williams is paying himself, he has a real political problem, because he’s violated the so-called “social solidarity” of government monopoly over people’s access to medical services.

If the Newfoundland health plan is paying for it, it’s even worse.  People will want to know if every Newfoundlander has the same claim to go the U.S. on the taxpayers’ tab.  Periodically, provincial health plans have to contract with U.S. providers because waiting lists just get too long at home.   Also, when Canadians go to the U.S. and pay out-of-pocket for specialized care, there have been cases where they made claims, and even lawsuits, against their provincial health plans to reimburse them.

I hope that the Canadian media will keep kicking at this issue.

The Latest Canadian Politician to Get Care in USA

Top Canadian Coming to USA for Surgery

The top politician in Newfoundland and Labrador, a Canadian province (one of those places where health care is a “right” to be funded by taxes) is having heart surgery . . . in the United States.

Said his deputy, “It was never an option offered to him to have this procedure done in this province.”

What is the Health Care Debate Really About?

Hint: It’s not about health care.

Ask yourself this question: What is the one health system characteristic every developed country has, except the United States?

If you answered: Every other country has made health care a right, you’re wrong. Citizens of Canada have no right to any particular health care service. They have no right to a CT scan or open heart surgery. They don’t even have a right to a place in line. The 100^th Canadian waiting for heart surgery isn’t entitled to the 100^th surgery.

If you answered: Every other country guarantees essential care to all its citizens, you’re wrong. Citizens of Canada and Britain are routinely denied prompt access to basic health care.

If you answered: Every other country guarantees access to care, regardless of ability to pay, you’re wrong again. In Britain people routinely go to the private sector and pay out-of-pocket for care they cannot get from the state. Canadians come to this country. In both cases, lack of ability to pay is a barrier to care.

If you answered: Other countries make primary care more accessible because there is no barrier of money, you’re wrong once more. Americans get more primary care than Europeans. Even uninsured Americans get as much or more primary care as Canadians get.
Continue Reading at the John Goodman blog.

Single-Payer Writ Small

A blogging friend of mine writes about a case of single-payer health care write small. In this case, it’s a union health plan that obscures the cost of treatment, leaving patients with little up-front costs. Not surprisingly, there’s a lot of dysfunction, including people signing up for appointments and not showing, and overuse of the emergency room.

Bureaucrats and Health Care are a Deadly Mixture

A news story out of Nova Scotia should bring wisdom and understanding to even the most dense and power hungry politicians in Washington.

An 81-year old Canadian man began to have chest pains. His 83-year old wife called the local hospital and was told to drive her husband to the hospital or call 911. As his wife did not drive, he drove himself. As Canada’s CNEWS reported, Smale said his mother, who doesn’t drive and has had two heart valve replacements, went inside the hospital to get help because her husband was unable to walk on his own due to the pain.

She was told by hospital staff that they couldn’t come out and she should bring him in herself or call 911, Smale said.

Staff called paramedics who were stationed across the street from the hospital, which describes itself online as a full service, acute care community facility.

Staff apparently also told Smale’s mother she would have to pay for the ambulance trip, he said.

Paramedics arrived shortly after the call and took Smale’s father into the hospital.

The Smale case is only one story in the massive problem created by the Canadian health care bureaucracy.

WORLDmag.com reported, “Mrs Smale was told that government hospital policy prevented doctors or nurses from going outside to see the 81-year-old man in the car.” Once Nationalized Healthcare is brought down upon the people of a nation, the people are at the mercy of the bureaucrats and politicians. Normal human functions such as logic, compassion, and common sense become rare commodities among those who work in bureaucracies.

Read the entire column here.