Healthcare needs politicians with backbones

| October 31, 2013

Marc Landryby Marc Landry, News and Observer, October 30, 2013.

Two friends of mine had joint-replacement surgeries this year. One is a 60-year-old retired Canadian who had a hip replaced. The other is a 61-year-old American who had to stop working because of her knee, which she had replaced.

When the Canadian government worker retired last year, he kept the health insurance he always had. His monthly premium is $58, and his former employer continues to pay it.

When the American could no longer work because of her knee, she lost her job and benefits and was all but uninsurable. Fortunately, her husband is a retired state worker, and she is covered under his policy. Her monthly premium is $630.

Both of my friends saw their primary care physicians and were directed to orthopedic surgeons. The American had a strong financial incentive to select a surgeon within her insurer’s network, and her doctor was happy to make a referral, which she accepted.

The Canadian searched the website of the College of Physicians and Surgeons and other sites that rate surgeons and chose an experienced surgeon without being limited to any network or hospital affiliation. Both the Canadian and the American were able to see their surgeons within a few weeks.

The American was given no say in the type or manufacturer of the artificial knee. Her surgeon decided for her. His choices were likely limited by the FDA, which protects domestic manufacturers that enjoy a profitable oligopoly.

The Canadian was encouraged to research replacement hips because some use metals while others use ceramics, and each has its pros and cons. There are many manufacturers, and the patient made the choice.

Both the Canadian and the American were able to schedule their operations within weeks, and both operations were in general hospitals where each patient had a private room. Both received post-operative care by way of physical therapy and follow-up visits to their surgeons, and they have recovered from their operations and gained mobility.

The Canadian had no co-pays, deductibles, co-insurance or any other out-of-pocket expense of any kind. The insurer paid for the operation and the follow-up care.

The American asked for detailed bills from all providers and was blessed with a blizzard of paper from the surgeon, hospital, anesthetist, physiotherapist and health insurer. She paid approximately $6,500 out of pocket for the surgery and continues to pay $52 co-pays for every visit to the physiotherapist.

Both of my friends got needed medical care in a timely manner, but the American did so only because she had $6,500 in the bank. Otherwise, she would have had to bear the pain while she was saving up or would have had to borrow the money. In the United States, we spend almost twice as much per capita on health care as do the Canadians, and our health outcomes mirror the experience of my two friends.

Americans with insurance and money in the bank get excellent care but are left poorer from the experience. Nearly 2 million Americans will go bankrupt this year because of unpaid medical bills. More Americans go bankrupt because of medical bills than any other type of debt.

Americans have every right to be proud of our “American Know How,” and in many ways the American way of doing things is the envy of the world.

Not so with the American way of delivering health care. Our system is bloated with inefficiencies and crushing administrative costs, and Obamacare is just another boon to insurance companies.

The Canadian health care system is known as Medicare and, in many ways, it is like our own Medicare system. Although I label myself a conservative, I have come to believe that we should expand our Medicare system until all Americans are covered and provided a level of medical care on par with the best offered in any other country.

We should not let American hubris stand in the way of doing what is right for all Americans. In order to get there, we will need politicians with backbone. I am not very optimistic.

 

Category: NC SPIN Perspectives - Opinions from NC Leaders & Organizations

Comments (3)

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  1. Norm Kelly says:

    Part of the reason so much money is spent on healthcare in the US is because of issues that are not covered in Obamacare – also known as socialized medicine part 1.
    Tort reform was/is not addressed in Obamacare. Too many tests & procedures are done in our country in an attempt to avoid a law suit.
    Government oversight is another problem that is only made worse under Obamacare. Government regulations cover just about every aspect of health care delivery for medicare/medicaid, including limiting the amount that can be charged for a procedure. Many times the amount of ‘reimbursement’ has no relation to the actual cost of the medical devices, drugs, doctors, hospital resources involved in a given procedure. How will forcing MORE government involvement in the process help it work better?
    The author mentions, very briefly, the FDA involvement in all of this. Too many times it can be shown that the FDA doesn’t do it’s job correctly. Too many times it can be demonstrated that the FDA handles certain drugs wrong, preventing good medicines from getting to patients or allowing bad drugs to get to patients. The approval process for new drugs or drug updates takes months to years longer under the FDA than in most other countries in the world.
    Local Control of health care is eliminated under Obamacare. My state has virtually NO say in how any part of health care delivery and health insurance markets proceed. Even if NC was stupid enough to expand medicare, thinking the feds could pay 90-100% of the cost forever, it wouldn’t change the fact that the central planners are in complete control. Remember the ‘if you like it you can keep it’ lie? Turns out some unelected official decided that this would NOT be allowed. My state has no say in this matter. My state can’t grandfather in a plan that I like. I am NOT allowed to make my own choices. Under Obamacare, the feds/central planners decide what’s good for me. Like forcing me to pay for maternity benefits. Not only am I male and incapable of birthing, my wife is beyond conception age. We CAN NOT have kids at our age, but if I were to buy insurance on the ‘open market’, I would be forced by some faceless federal agency to pay for maternity benefits. If I were to be added to my wife’s employer plan, we would be FORCED to carry maternity benefits. No questions, no choices. This is not simply outrageous, it’s completely stupid. There is no other description for it.
    I am NOT allowed to buy health insurance across state lines. The politicians decide FOR ME what my plan MUST cover. I have been removed from the choice aspect of my insurance coverage. How does forcing me to pay for benefits I CAN NEVER use help keep my premiums down? If I want a high-deductible plan with limited options attached to it, simply because I can afford it and because I don’t need maternity benefits, why can’t I get that coverage? Simple. Because some do-gooder, feel good, want-to-control-my-life politician in the central planning organization decided for me. This actually doesn’t do me any good. This doesn’t make me feel good, and definitely should not make the politician feel good. I want to control my life, not somebody I’ve never met. I have no idea how well that stupid politician has managed their own life, why would I want them managing so much of my life?
    Attempting to provide medical care coverage for uninsured people does not, should not, require that I am FORCED to give control of MY medical future to the central planners. The biggest difference between Canada, the US, and other socialized medicine countries, seems to be the idea of ‘local control’. Canada appears to have implemented it on a provincial level. How have the Demoncrats in Washington implemented it? Simple. They took complete control. And left the majority of decisions to an APPOINTED POLITICAL position to take control of MY LIFE.
    So, the conclusion is, my life is no longer my life. My life has become the community’s life. I am no longer in control. I will be subjugated to the community, forced to work for someone else’s benefit. I will be forced to support someone else’s life choices without choice of my own. My choice is taken away from me in order to make someone else’s choice possible.
    Socialism can be shown to work when selective, individual cases are brought forth. Socialism can NOT be shown to work when the entire system is taken into account. The best, most efficient, economic choice can be demonstrated to be lightly regulated capitalism. Socialism collapses under it’s own weight. Socialism dies when the central planners run out of ‘other people’s money’. Is $17TRILLION considered ‘run out of’ money? Some would think so. But the socialists are not deterred. They don’t even want to slow down at all, their only plan is to accelerate implementation of socialism. Without proof that it works, ignoring proof that it is guaranteed to fail.
    Yet people like the author of this post want me to also ignore the truth, ignore facts, bury my head in the sand, just like a good liberal/socialist should do. Facts be damned, socialism will move forward!

  2. Richard Bunce says:

    You act as if someone did not pay the rest of the bill in the Canadian case. Your friend paid as did all his friends and fellow countrymen.

  3. TP Wohlford says:

    The speed at which Canadians receive care varies greatly from place to place, as recent Canadian studies show. As a former resident of metro Detroit, where I saw many Canadians come for timely care, I can attest that things change over time too.

    In fact, there is no “Canadian” system. What they do there is to break the thing up by provinces, a variation of our Medicare/Medicaid idea. Because, they think, having one program for 100 million people is too big to manage.

    Which brings me to my point — managing something that is 4% of the world’s economy hasn’t exactly been done before by the American government. In fact, the last time any government tried to do something this big was the centrally-planed economy of the USSR — and most of us remember how that turned out.