North Coast Online

American Health Care

Some perspective on American health care.

Last week, the British Medical Journal ran the triumphant headline "US comes last in international comparison on health care", based on a survey by the US-based Commonwealth Fund. However, the notorious anti-American bias of this publication actually buried the real shock, which was that:

The United Kingdom was ranked first overall, scoring highest on quality, efficiency, and equity.

The other countries in the list are Australia, Canada, Germany and New Zealand. It is crucial to remember that studies like this (using highly aggregated data) tend to compare apples with pears. For example, key health data like infant deaths and live births are recorded differently with the US counting extremely low-weight infants as live births. This led to false accusations on poor US standards regarding infant mortality.

The editors of The Australian Private Doctor recently provided some revealing figures, confirming that socialized NHS style systems ration services not by price but by waiting times:

While only about 5 per cent of Americans have a wait of more than four months for surgery, the figure for Australians, New Zealanders, Canadians and Britons ranges from 23 per cent to 36 percent.

The American system is more expensive because it delivers premium healthcare with high cost technology and pharmaceuticals, as well as super-specialist physicians and treatments. Most of those are rarely elsewhere available. The US also pays for the bulk of clinical research and is pivotal to medical innovation.

Much is made of the 40 million uninsured in the US, but they should really be labelled free-riders – they obtain health care on an emergency basis and others pay (roughly $1000 per year). Even more important, thanks to a range of State and Federal programmes for low-income individuals and families, "The per capita spending rate (on health care) for individuals is the same for those above and below the poverty line."

We have to be careful that in an effort to improve access to health care we don't ruin the really good parts.

Michael Moore -- Dumbing Down Ignorance One Film At A Time

The Instapundit on Michael Moore's evidently autobiographical film, Sicko.

MICHAEL MOORE:  The less you know, the more you like his films!  And vice versa, apparently:

Michael Moore received a standing -- and sustained -- ovation following the screening of his latest documentary, Sicko, at the Cannes Film Festival Saturday. But some critics suggested that in censuring the U.S. health system, Moore was overly generous in his praise of other countries'. At a news conference, Canadian journalists harangued Moore for, as Toronto Star film critic Peter Howell wrote, making "it seem as if Canada's socialized medicine is flawless and that Canadians are satisfied with the status quo." Apparently taken aback by the assault from the Canadian journalists, Moore said, "You Canadians! You used to be so funny! ... You gave us all our best comedians. When did you turn so dark?"

I don't know, maybe  three years on a waiting list for hemorrhoid surgery will do that to you . . . .

But you miss the point, Instapundit.  In Canada, everyone has to wait three years for hemorrhoid surgery (in Cuba it's no doubt much longer.)  But that's the beauty of it to Moore.  Rich people are reduced to scratching their behinds in agony just like the poor.  In fact, if there were ever a better description of socialism, I haven't seen it.

Save The Hospitals

Hints today that the hospital closings required by the Berger Commission may be negotiable.  Those recommendations were a fitting close to the once-promising, but finally-disastrous George Pataki administration.  They assumed that New York health care is already a government-run system that can be dictated from Albany.

While it is perilously close to that "ideal", we're not quite there yet and we consumers of health care should have a say in what hospital we choose just as much as we determine which supermarkets succeed.   Sadly, to me, nothing was mentioned about Millard Fillmore Gates Circle.   The thought of its closing, forcing city residents to compete for attention with even bigger crowds at Buffalo General scares the crap out of me.

If the Berger recommendations are carried out, we'll have witnessed the first evidence of what government-run health care will look like.

Health Care Hypocrites

Wal-Mart's critics often complain that by not providing health care benefits to all its employees, it's unfairly shifting its costs for those left uncovered to us -- the taxpayers.  But now that Wal-Mart's CEO has spoken out in favor of nationalized health care, I'm not hearing what I'd have expected.

After all, now it's proposing that the taxpayers support all of its employees.  Why no outcry?

Competition Would Be Good For Our Health

We all want lower health care costs and a private company is willing to build what amounts to a stand-alone emergency room in the Northtowns.  The Amherst IDA granted them $200,000 in tax breaks but has "reconsidered."

Amherst Industrial Development Agency board members changed their minds Friday on granting tax breaks for a proposed urgent care facility on Niagara Falls Boulevard.

The board, by a 4-0 vote with one abstention, rescinded the nearly $200,000 in tax breaks that it granted last month to Exigence LLC to build a 6,000-square-foot urgent care facility at 2099 Niagara Falls Blvd.

Concerns about the project’s impact on Millard Fillmore Suburban Hospital, which is tripling the size of its emergency room, along with questions about how it might affect a possible transformation of DeGraff Memorial Hospital in North Tonawanda into an urgent care facility prompted the IDA to reconsider its approval last week.

Another urgent care facility would spur competition, lead to faster emergency room service and actually allow people to compare prices.  Those generally leads to lower consumer costs.  Remember when Buffalo was the 2nd most expensive city in the country to fly to?  The NFTA attracted competition and local airline prices plummeted. 

It's a simple concept. But when it comes to health care, rational thinking goes out the window. 

I hope it gets built despite the IDA's decision.  We need more health care options around here -- not fewer.  That's why the state's decision to close Millard Fillmore Gates Circle and St Joseph are so preposterous.   There's a race around here for our health care dollars and it can only lead to better service; but New York State and its development agencies see competition as something to be avoided and discouraged.

It makes no sense.

Worse Than The Illness

Yes, it is broken, but, please, let's keep her out of the repair shop. 

"Step away from the tools, ma'am."

Between The Sheets

You might think I'd praise a government agency that was watching its expenses, but, um, not in this case.

Cleaners at an NHS hospital with a poor record on superbugs have been told to turn over dirty sheets instead of using fresh ones between patients to save money.

Housekeeping staff at Good Hope Hospital in Sutton Coldfield, have been asked to re-use sheets and pillowcases wherever possible to cut a £500,000 laundry bill.

Posters in the hospital's linen cupboards and on doors into the A&E department remind workers that each item costs 0.275 pence to wash.

Why not just wrap each patient in plastic and skip the whole problem?

Imagine That Buffalo's Hospitals Were Run Like Buffalo's Schools

We'd like to think that if health care were brought under the fair and protective umbrella of the government, that we'd keep what we have now (arguably the best health care in the world) but that the underprivileged would be allowed in out of the rain with us.   It's just that it hasn't worked out like that where it's been tried.

Last night (Easter Monday Public Holiday) at 10:00 we noticed one of our elderly cats couldn't stand up, rang the vets who cheerfully opened up the surgery and by half past the poor old Moppet was being examined by the vet in spotless surroundings. Sadly she had a thrombosis and we had to have her put to sleep as that seemed to be the kindest choice of the options we were given. We brought her home by 11:00
Over in another part of town my eldest son was stricken by severe abdominal pain down on the lower right side. The doctor was rung at 10:00 but of course was unavailable, at 11:30 his mother was still waiting to see if she was to be allowed to take him to hospital that night to be examined.

Says it all about health care doesn't it.

It's all quite fair, of course, but everyone makes do with a lot less.

H.T. to the Adam Smith Institute.

Tell Me How It Would Work

One of the biggest problems in debating with advocates of single-payer health care plans is their lack of details -- in short, how much will it cost?  They're usually quite certain that cutting out insurance company profits and eliminating duplication of services will pay for it, but I'm never convinced that they know what they're talking about.  Arnold Kling agrees.

Jonathan Cohn writes,

French universal health insurance works an awful lot like Medicare does in this country. And that's the great irony of how screwy the debate over health care has become in this country. Conservatives always talk about expanding choice, yet when it comes to the choices Americans prize most -- choice of doctor and hospital -- government-run health care actually delivers that choice better than private health insurance.

Last year, I scaled up the French population to our level, and then created the following table of medical expenditures:

Country	Health Care Spending $ billions
France*	900
U.S.--Medicare	300
U.S.--non-Medicare	1600

*with 300 million people

If Medicare were a country, it would already be way over the top in terms of health care spending. If we were to keep Medicare as it is and then introduce the French level of total spending then we would have to cut spending on the non-Medicare population by roughly 67 percent. Is that what Cohn is talking about? I doubt it. But I can never figure out what single-payer advocates are talking about, because they so often evade the basic issues of how it is supposed to operate.

I really want the advocates of single-payer health care to get into specifics about spending, taxes, methods for compensating health care providers, and all of the other mechanics that need to be worked out if the government is going to take over health care finance. It is irresponsible to just blithely say, "It works in Europe, so it can work here."

Me, too.

Nothing To See Here, Folks. Just Move Along

It may be just dumb luck, but America's (semi) private health care system doesn't seem to suffer from these increasingly common "superbug" outbreaks.  Oh look, they're happening in Canada, too.