America's Bad Medicine: ObamaCare

ObamaCare inevitably will make the US health care system more like the Canadian one, and that's not a good development. The cure rate in our country is well ahead of that in Canada for just about every ailment known to mankind. Eventually, rationing will become the order of the day in American hospitals and physicians' offices. Sarah Palin will oppose such developments, and we need to stand with her.

Consider the following story from Dr. David Gratzer's book The Cure:

"In medical school, I learned the most important lesson not in a classroom but on the way to one. On a cold Canadian morning about a decade ago, late for a class, I cut through a hospital emergency room and came upon dozens of people on stretchers -- waiting, moaning, begging for treatment. Some elderly patients has waited for up to five days in corridors before being admitted to beds. They smelled of urine and sweat. As I navigated past the bodies, I began to question everything I thought I knew about health care -- not only in Canada, but also in the United States. Though I didn't know it then, I had begun a journey into the heart of one of the great policy disasters of modern times." [page 2]

In fact, Barack Obama and Kathleen Sibelius are beginning the same dismal journey -- and they, along with us, will experience the same disaster. That disaster will not occur overnight, but occur it will.[On Saturday and Sunday, I'll have new columns up here -- the first one being about Sarah Palin's support of "Miss California," Carrie Prejean.

What's Wrong with US Healthcare?

There are many things wrong with health care generally in the "advanced" world, including the US.

Because health care (and education is similar) exists outside the realm of competitive choice, there are not good options for people in terms of price and level of care (ranging from awful to outstanding). There are no analogues to the situation where one can link to Dell.com and choose among some tremendous computers . . . at lower prices than in 2007 or 2008. On lawyers.com, you can find lawyers' abilities evaluated by their peers, but there's really nothing similar in medicine.

Health care costs rise dramatically (doubling every 8-9 years), but the health "product" available improves slowly. Mediocre doctors and hospitals "charge" roughly the same prices as excellent ones. It's an absurd situation, where organizations like the AMA do little or nothing to bring about necessary changes.

Hospitals and doctors, most of whom are "average" by definition, don't want to provide more information about outcomes, because doing so would cause many of them to lose business. (The situation is similar in education, where most teachers and schools are "average," but everyone gets paid about the same amount. The truly excellent teachers are out of luck in terms of compensation.)

Doctors and hospitals are extremely hesitant, as Dr. David Gratzer points out in The Cure, to evaluate their counterparts. That means patients -- "customers" -- lack necessary information. So, heath providers get chosen mainly on issues of geography (how close are they?) or personality ("is he/she 'nice?'").

I haven't mentioned the biggest problem, which is that employer and government-financed health care makes health consumers assume that the product is "free" (or close to it). That of course sharply reduces the incentive for patients to make wise choices. When people are spending their own money, they will almost always make better decisions.

Relatedly, when anything is (presented as) "free" (or relatively low cost), people tend to over consume. Many elderly people visit doctors (and even hospitals) as largely a social activity. Have a cold? Hey, go to the emergency room. Lonely? Hey, go see that nice, sympathetic doctor and his friendly nurse. Is your doctor competent? Hey, look he's got a degree up on his wall, right?

A generation ago I had a doctor/friend in Athens, GA. He told me, as he chain-smoked his Camels and talked about his former problems with "substances," that he had been "a C student at the University of Tennessee medical." He was a good guy, but if you needed brain surgery, well, I don't think he was your man.

On costs: If a local bar offered free beer, a lot of people will end up very drunk. If health is essentially perceived as free, medical offices and hospital emergency room will regularly be full. And costs will keep spiraling out of control.

The points I'm raising here are real issues -- important ones. But you'll rarely if ever hear them discussed in the so-called "national debate" about health care. Instead, you're going to hear many proposals -- especially from Obama -- that will make the situation worse.

Medical Horror Stories, Physician Incompetence

Unfortunately, most Americans eventually experience one or more medical horror stories. One problem with American health care is that some (not all, not most, but some) doctors and hospital administrators are embarrassments to their profession. One answer to America's health care problems is to put the bad doctors and the deficient hospitals out of business.

Individuals who don't have health insurance and pay out of their own pockets for health care deserve more choices and better prices. In Dr. Gratzer's case (in a previous column), he was paying out of his own pocket, and was told (sort of) that the price for his wife's surgery was "negotiable." Shortly after that, the hospital's collection agency started dunning him for payment.

A few months after my wife had her devastating stroke in 1991, I received a notice of delinquency from a primary care physician (billing service I guess) saying that if the payment was not received immediately, it would be subject to collection and that my credit would be damaged, etc.

What was the "delinquent fee? It was $0.07 -- that's right, seven cents. I thought the doctor (Wendy Klein in Springfield, Vermont) and her service had lost their minds. How could any responsible business engage in such atrocious behavior? I never received an explanation. I refused to pay the seven cents.

I've also written about my brother's experience. He was indigent for various reasons, and he went into the emergency room because his blood pressure had dropped and he was faint. He was in the hospital for 30 hours. The diagnosis was "syncope," which means the symptoms he had. Syncope is one step up from a headache.

The first bill I saw was $22,600. There were many bills, all with wildly varying numbers -- making them up as they went along. I never received an explanation for the syncope -- until later, when a non-physician explained to me that what my brother had experienced was a vagus nerve problem. Vagus nerve problems and syncope go together like a horse-and-carriage. No one at the hospital, UPMC (University of Pittsburgh Medical Center) gave any sort of coherent explanation.

My brother's family care doctor (Dr. Catena)? My brother because he had no money received free drugs from Pfizer and others. Pfizer insisted that they had to go to the doctor, assumed to be a responsible individual. The doctor's repeatedly "lost" the pills, meaning occasionally that my brother ran out of them. The doctor didn't give a damn and regarded having to receive and process the pills as an imposition -- i.e., he wasn't getting paid for his activities.

My experience (and I have many others, some perhaps worse, given my wife's condition) is that most people regard what goes on at hospitals as a giant scam, one designed to enrich the people involved (aside from the nurses and the maintenance personnel).

Two months after my wife emerged post-stroke from Dartmouth-Hitchcock Hospital in New Hampshire, she let me know -- she has experessive aphasia -- that she expected to die soon.(That was 18 years ago, and she's fine). It turned out that none of the overpaid boobs at Hitchcock had even given her a prognosis, so she assumed she must be near death.

There is much more about Hitchcock. One guy (neurologist Dr. Williamson) making $330,000-plus a year put her on a Closed Circuit monitoring device . . . and then never checked the monitor. His explanation, "Hey, you know those CC devices cost a lot of money, and we need to keep them operating!" If one were allowed to punch eminent physicians, I would have given that creep, that incompetent, two black eyes. To him, my wife was not a human being; she was a revenue stream.

Yes, some physicians are superb, professionals actually dedicated to making their patients better. However, I look at many doctors, and I see . . . Dr. Williamson . . . with his $300,000 salary (now doubled I'm sure) and his five cent medicine. When I visualize that overpaid egotist, I see a person who's a menace to patients.

As you whould know, UPMC, with its $22,600 bill for my brother, is one step up from a criminal enterprise. In that regard, it's a major supporter of Cong. John Murtha. They have given him more than a quarter-million dollars in exchange for the many millions in earmarks he's given them.

I'm sure UPMC will thrive under socialized medicine. It will provide less care than it already does (if that is physically possible) and still make hefty sums.

I support a more traditional form of medicine not because the current system -- and the physicians who operate under it -- are free from flaws, some of them major, but rather because I believe a private enterprise approach will lead to the best quality care at the most reasonable costs.

Frankly, I wish at least a few more doctors (other than Dr. Gratzer) shared my perspective. Too many physicians -- and too many hospital administrators around the country are embarrassments to their profession. They generate hostility because they falsely assume they can do no wrong.

"First do no harm," and then physicians need to heal themselves.

Obama: Making Health Care Worse

As part of my continuing series on Obama-care, his death-inducing proposals for health care, I previously quoted him on "democratic decisions" about whether patients should live or die. What essentially is Obama's plan for people with catastrophic care needs and those in conditions that appear to be terminal?


As one analyst on FOX News said Saturday morning, Obama essentially is proposing the "European solution," which is to tell very sick people to wait in long lines . . . until many of them die. At that point, they no longer will qualify as a "cost burden" on the health system. Ah, the joys of cost savings!


Am I exaggerating what Barack Obama said in his interview with the NY Times? Read his chilling words for yourself (at the very bottom of this piece).


Don't get me wrong: great as it is compared to other countries', our health system does have some serious flaws. In a capitalist society, efficiency and cost control depend greatly on the amount of information we have from businesses. In health care, alas, we have very little transparency.


Consider the following statement by health care expert Dr. David Gratzer (in his superb book The
Cure), speaking of the time a few years when he was a young Canadian-trained physician who'd moved with his wife to the US.


"In 2003, when my wife ruptured a disc in her spine, I set about to find her a neurosurgeon in western New York. Uninsured and uninformed, I resorted to cold-calling neurologists, asking for their opinions on reputable surgeons. Few were willing to speak to a stranger about a colleague's skills.


"Meanwhile, having a choice of two hospitals and on information on either, we selected one at random . . . and then spent a nervous night before the operation at a Hampton Inn, which I had chosen after reviewing detailed reports at www.hotels.com. I found myself musing darkly that for a mundane accommodation decision, we had a surplus of data, whereas for a critical medical decision, we had little or nothing to go on."


Gratzer continues, "The surgery itself required only an inch-long incision, took under half an hour, and resulted in an inscrutable bill for an extraordinary sum. When we called in to inquire, a hospital administrator hinted that the bill was 'negotiable.' Before we could negotiate, however, we started to receive threatening letters from a collection agency." (The Cure, p. 1)


In one sense. Gratzer's story is mind-boggling. At the same time, it's not atypical. It's a lot easier to get details and the quality and price of hotel accommodations than it is to get useful information about health care. There is no real doctors.com or hospitals.com equivalent to hotels.com.


Unlike local grocery stores, pharmacies, and motels, health care operations do not advertise their comparative prices. They also don't provide any useful information about the kind of care patients might receive. If there are low-cost, high quality health alternatives available, you -- and hundreds of millions of other Americans -- have no way of finding out who or where they are.


How do your doctor's charges -- and skills -- compare with those in your area? If you know the answer to that, you qualify as a veritable fount of knowledge. Years ago, my mother had one of the most incompetent family care physicians imaginable. She loved him because as she said, "He's such a nice man." He was a nice man. He was also a health provider much more likely to read People magazine than a medical journal.


Apparently, local and national medical societies like it that way . . . and so apparently do state and federal governments. It allows doctors and hospitals to avoid competing on messy matters like price and quality of service.


Where there is no transparency -- basically, no advertising -- there is no incentive to compete on price. There's also no incentive to provide evidence that not all doctors and hospitals are created equal. What evidence does exist shows that some low-cost hospitals provide superior outcomes to their high-priced counterparts.


Yes, the US government's rules and regulations -- along with rapacious trial lawyers -- are responsible for most of American health care's problems of affordability and availability. But they're not the only culprits. Without transparency, health consumers -- even ones as knowledgeable as Dr. Gratzer -- can't make good decisions.


The end result is that health care in the US costs a great deal more than it should. Where there are no real informed choices, neither efficiency nor capitalism exists. It makes no sense for us to be fully informed about motel choices . . . and totally in the dark about health care options.


Note, the following are Obama's scary comments (in italics) I referred to earlier:

"There's always going to be an asymmetry of information between patient and provider," Obama said. "And part of what I think government can do effectively is to be an honest broker in assessing and evaluating treatment options." In other words, the federal government would be a middle-man, basically usurping a doctor's and patient's determination what treatment is appropriate.

In addition, Obama stated that "the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here." (Note: it should not come as a surprise that people who are sick are big consumers of health care. People who are well don't need it.) The actual percentage cost of end-of-life care is about 30% (according to health expert Dr. John Donaldson).

Obama: Wrecking US Health System

Barack Obama's efforts to "fix" the American health care system are destined to fail. He will be taking the best medical system in the world and making it resemble the poorer quality variety found in other industrialized countries. (Second in a series)

Paul Krugman, far-left economist and columnist for the NY Times says “Americans tend to believe that we have the best health care system in the world. . . . But it isn’t true.” I have news for Dr. Krugman: when it comes to evaluating health care, he’s an idiot.

The problem is that people like Obama and his left-wing colleagues in Congress tend to believe individuals like Krugman. They know that many people in the US (although not as many as they think) lack adequate health insurance, so they assume our country must be doing a poor job treating people. But in contrast with care in other advanced nations, the US is doing an outstanding job.

By every relevant measure, the U.S. has the best health care system of any developed country. Doubt that? Well, consider the following points from Dr. Gratzer’s marvelous book The Cure:

Women with breast cancer in Europe are four times as likely as women in the U.S. to be diagnosed after the tumor has spread and thus are much less likely to survive the disease; for example, the survival rate for first-stage breast cancer in the US is 97% but only 78% in Great Britain;
Cancer patients in the U.S. have much higher survival rates than their European counterparts. US doctors and hospitals catch 70% of prostate cancers in the, while their British counterparts catch only 58%; Germany and France are better than Britain but well behind the US; and,
The US consistently beats Europe in survival rates for cancer – with the American survival rate for leukemia being 50%, while Europe’s average rate is 35%.

The statistics are similar with heart disease and stroke. On both, the US is well ahead of Canada and Europe. Our system dramatically outperforms the care provided in the national health systems. The second and third best systems are Canada and Australia. The worst performers are Great Britain and New Zealand.

A friend wrote me yesterday saying that Germany and Switzerland had good health system. Small, relatively homogeneous countries (Switzerland, the Scandinavian nations) aren’t really comparable to large, diverse countries like the US.

As for Germany, Dr. David Gratzer doesn’t give it high marks.

He says, “If French health care appears shaky, the house of German health care sinks on its own unsustainable foundation. ‘The German health care system is facing bankruptcy on an unprecedented level,’ states The Lancet, the prestigious British medical journal. Faced with rising pressures, the German government has to various methods of cost containment, such as global spending caps [e.g., “you can spend this and no more”]. One colorful result: large-scale doctor strikes.

Gratzer adds about Germany, “Some say the quality of care suffers. ‘Not even half the patients who have suffered a heart attack are treated according to the medical state-of-the-art,’ observes Ulla Schmidt [former federal minister for health and social security]. ‘Health care for women – especially precautions against breast care – is so bad that it results in unnecessary amputations and late diagnosis.’”

The government-dominated health systems Obama and his political allies are holding up as models for us . . . aren’t systems we want to imitate. Yes, we pay more for health care than other advanced countries, but we also get much more.

(Note: I'm not saying the US health system can't be improved, and later in this series I'll give some ideas on how to do so. What I am saying is that Obama's efforts will harm the system much more than they will help it.)

Democrats Disastrous Health Care Plans

“I serve as a blank screen on which people of vastly different political stripes project their own views.” - Obama

"The smell of urine and sweat." (Dr. David Gratzer in The Cure)

[Note: Cristi Adkins' fine piece )scroll down) on "How You Can Stop Obamamania" got reprinted in the Canada Free Press: http://canadafreepress.com/index.php/article/4081]


You may have heard from Democrats during the primaries what a great plan they have for universal health care. They generally compared US health care unfavorably with the national health plans in countries like Canada, Great Britain, and Germany. The last things they wanted you to know about were the deficiencies of a government-dominated health care systems.The following material is from David Gratzer's book The Cure: How Capitalism Can Save American Health Care. I urge you to read this explosive study of Canadian and American health systems.

Gratzer is a medical doctor certified in both Canada and the US and currently works and writes in New York City. His book is a compelling read.

In it he says, "In medical school, I learned my most important lesson not in a classroom, but on the way to one. On a cold Canadian morning about a decade ago, late for a class, I cut through a hospital emergency room and came upon dozens of people on stretchers -- waiting, moaning, begging for treatment. Some elderly patients had waited for up to five days in corridors before being admitted to beds. They smelled of urine and sweat. As I navigated past the bodies, I began to question everything I thought I knew about health care -- not only in Canada, but also in the United States. Though I didn't know it then, I had begun a journey into the heart of one of the great policy disasters of modern times."

Gratzer points out that he had grown up in Canada believing its "system was better than America's, with its uneven quality and absurdly high cost."

After he entered medical school, however, his view of Canada's universal health care began to change. He says, "The more I was exposed to the system, the more familiar I became with the shortcomings of government-run health care. I trained in emergency rooms that were chronically, chaotically, dangerously overcrowded, not only in my hometown of Winnipeg, but all across Canada. I met a middle-aged man with sleep problems who was booked for an appointment with a specialist three years later; a man with pain following a simple hernia repair who was referred to a pain clinic with a two-year wait list; a woman with breast cancer who was asked to wait four more months before starting the life-saving radiation therapy. According to the government's own statistics, some 1.2 million Canadians couldn't get a family doctor."

What would I recommend to John McCain and other GOP candidates? Please read the above material verbatim to audiences who might have been attracted to the Democrats' false promise of "free health care." In this life, alas, nothing is free. Everything comes at a cost. one that, in this case, is much too high.

(More to follow on Wednesday. Your Comments are welcome)