Government control of health care is puts caring bureaucrats in charge of decisions, not profit-seeking businessmen. But when everything is free for everyone too many dollars are spent unwisely. "But it's free." The misuse of resources requires cutting costs - of course. So how do they cut costs? Not wisely. They can't make the tough decisions so they cut across the board. In many cases they cut medically necessary surgeries.
That's what's proposed in Vancouver, BC, Canada - to cut over 6,000 surgeries over 6 months. And to cover the 2010 Olympics they have to close 1/3 of their operating rooms!
Vancouver patients needing neurosurgery, treatment for vascular diseases and other medically necessary procedures can expect to wait longer for care, NDP health critic Adrian Dix said Monday. Dix said a Vancouver Coastal Health Authority document shows it is considering chopping more than 6,000 surgeries in an effort to make up for a dramatic budgetary shortfall that could reach $200 million.Posted by Ron Hebron at August 20, 2009 06:53 AM | Email This"This hasn't been announced by the health authority ... but these cuts are coming," Dix said, citing figures gleaned from a leaked executive summary of "proposed VCH surgical reductions."
The health authority confirmed the document is genuine, but said it represents ideas only. "It is a planning document. It has not been approved or implemented," said spokeswoman Anna Marie D'Angelo.
Dr. Brian Brodie, president of the BC Medical Association, called the proposed surgical cuts "a nightmare." "Why would you begin your cost-cutting measures on medically necessary surgery? I just can't think of a worse place," Brodie said.
According to the leaked document, Vancouver Coastal -- which oversees the budget for Vancouver General and St. Paul's hospitals, among other health-care facilities -- is looking to close nearly a quarter of its operating rooms starting in September and to cut 6,250 surgeries, including 24 per cent of cases scheduled from September to March and 10 per cent of all medically necessary elective procedures this fiscal year. The plan proposes cutbacks to neurosurgery, ophthalmology, vascular surgery, and 11 other specialized areas. As many of 112 full-time jobs -- including 13 anesthesiologist positions -- would be affected by the reductions, the document says.
"Clearly this will impact the capacity of the health-care system to provide care, not just now but in the future," Dix said.
Further reductions in surgeries are scheduled during the Olympics, when the health authority plans to close approximately a third of its operating rooms.
Two weeks ago, Dix released a Fraser Health Authority draft communications plan listing proposed clinical care cuts, including a 10-per-cent cut in elective surgeries and longer waits for MRI scans.
The move comes after the province acknowledged all health authorities together will be forced to cut staff, limit some services and increase fees to find $360 million in savings during the current fiscal year.
In all, Fraser Health is looking at a $160-million funding shortfall. D'Angelo said Vancouver Coastal's deficit is closer to $90 million -- almost a third of which ($23 million) has already been absorbed through reductions in non-clinical administration efficiencies.
Vancouver Coastal performed 67,000 surgeries last year, an increase of 6,500 surgeries over 2007. "What has now happened is that now our wait times are about 25 per cent lower than the provincial average," D'Angelo said. "We have put a dent in that wait list."
Brodie acknowledged surgical waiting times have dropped significantly in recent years, particularly for patients needing hip and joint replacements. He said the proposed cuts threaten those advancements. "It sounds like we are going backwards here," he said.
Not many, with those ominous pre-existing condition(s) and if so, it's certainly at a price...my comment/question stands.
Posted by: Duffman on August 20, 2009 07:43 AMTravel time.
You could always pay out of your own pocket and sue after the fact in America. In Canada you would have to travel to another country first.
Basically, In America you might hear, "No, we won't pay for that" (Very rare mind you), but you could still get the procedure in most of those cases. In Canada the answer is "No, you can't have it. Period. So you travel to America and pay for it there. Where would you go if the same Denial of service situation occurred in this country? Mexico?
People have made this point before, and I know you are smart enough to have picked up on it. There is a big difference between the kind of recourse you could take with an insurance company verses what you could with the government.
Posted by: eyago on August 20, 2009 07:43 AMbtw: I don't want what Canada has...I want what our Congress has
Posted by: Duffman on August 20, 2009 07:47 AMNot any...Government option
No wonder they did away with the WASL in this state.
Posted by: Rick D. on August 20, 2009 07:49 AMAnd where is the evidence? Exactly how many thousands are effected? And the difference in legal options is?
It's a trajedy if it happens to just one person- don't get me wrong! But a few hundred versus 6000 in the next 6-months? And, as has been pointed out in other Obamacare threads, the patient has the option of suing the insurance company. They also have the option of paying for it themselves.
In a government run system, neither is an option.
Posted by: David on August 20, 2009 07:51 AMI've never, during one on one conversations, encountered a Canadian who was pleased with his/her government-sponsored healthcare...or their government's oppressive level of taxation.
My 2003 hip-replacement (due to degeneration from an early-life skiing wreck) was performed by a top-flite, Nova Scotia-born, Canadian/European-educated surgeon who had relocated to America to escape the Canadian healthcare system. More of what we could be looking to see in the future...our best doctors leaving to establish clinics in countries where government is less intrusive and oppressive.
Posted by: Saltherring on August 20, 2009 07:54 AMBottom line: Adjustments and refinements are needed...period!
Posted by: Duffman on August 20, 2009 08:05 AMI did see my dad almost die because the idiots in charge of his HMO couldn't make up their minds which hospital he needed to go to for his lifesaving surgery. Needless to say he got out of the HMO at the first available opportunity. Fast forward several more years and when my father became terminally ill, his non-HMO insurance allowed him access to the best care available, no questions asked.
Just FYI, most of us have no choice about signing up for Medicare, but you do have a choice about the supplement. And having a good supplement makes all the difference as seen in my dad's case.
Posted by: Burdabee on August 20, 2009 08:15 AMDuffman, even if this true, and I don't think it is, why is it okay in your mind that the government take over and deny treatment?
I'm starting to think liberals don't really know what government is.
Posted by: Gary on August 20, 2009 08:29 AMWhat part of "May" don't you understand?
"Thousands of surgeries may be cut in Metro Vancouver due to government underfunding, leaked paper"
This is classic cut the police/fireman (and now surgeries) first budget process crap - I'd bet no surgeries actually be cut.
Posted by: RobertSeattle on August 20, 2009 08:34 AMYou are absolutely correct. However, switching to a government run health care system where a bureaucrat decides what health care you get is not the adjustment we need.
I'll give you an option and you tell me if you would support it since we need adjustments and refinements.
1) Allow individuals to deduct money spent on health insurance from their taxes. Employers can do it now, individuals can't. This would allow employers to stop paying for health insurance, give the money to their employees, and the employees could then go purchase whatever type of health insurance they want.
2) Allow people to form cooperatives to purchase health insurance. It is currently not allowed by the government. The readers of soundpolitics could form a health insurance group and go out shopping for the best policy.
3) Allow companies to sell policies across state lines.
4) Expand access to Health Savings Accounts. You purchase a catastrophic health insurance policy (real health insurance unlike the current definition whereby all your needs are provided), you put money into a tax-free savings account to be used to pay for medical bills. Consumers now shop around for the best deals on health care, they negotiate for better prices because they are paying cash, and they spend less on their health care because they are in charge of paying for it.
Once you implement these reforms, health insurance becomes truly portable since you are buying it, not your employer; it becomes cheaper since there is no large bureaucracy in charge of deciding on payment rates; and it becomes more accessible since anyone can buy themselves an inexpensive policy.
And the best part of it; less government involvement instead of more.
Posted by: Calvin A on August 20, 2009 08:34 AMAre there still people here that deny that the public option is a pathway to single-payer? I've got lots of video by single-payer advocates telling liberal audiences that they have to trick us with the public option to get to single-payer.
Canada's system is, by their own admission, about to collapse. And there are liberals here who want to follow them.
Madness.
Posted by: Gary on August 20, 2009 08:35 AMSound fair?
Posted by: Gary on August 20, 2009 08:43 AM.....or any county (or city) planning or building department, WA State DSHS, Seattle Street Department, King County Parks, public schools, Wa State Legislature, Social Security, public employee unions, HUD, Congress, IRS, King County Elections, Medicare, Seattle Port Commission, WA State Ferries, the entire Obama government.....nothing but ongoing and continual incompetence, scandals, favoritism, waste, bureaucracy, corruption, neopotism, redundancy, fraud and lies. And the Dimocrats want to take over our healthcare?
Posted by: Saltherring on August 20, 2009 08:53 AMHappily engaged trying to change it for the better by exposing the Democrat Party for what it is....a criminal enterprise.
Posted by: Saltherring on August 20, 2009 08:57 AMStill waiting on that model of efficiency you can point to, Duffman :)
Posted by: Rick D. on August 20, 2009 09:04 AMExcellent suggestions, but there is one problem. It doesn't turn the American people into slaves to the government which is what this whole fiasco is really about.
Posted by: Jack on August 20, 2009 09:06 AMThanks for the info Ron. [snark]
For those of you wishing to lampoon BC's government run health care....
"Total health spending in British Columbia was $15.7 billion this year, up about four per cent over last year's total of 15.1 billion, according to figures provided by the ministry of health."
What was the year to year increase/decrease in your plan's spending from 2008 to 2009?
Did it meet or beat a 4% increase at 100% coverage?
oh, and don't forget to provide the citation
I'm not surprised. You think Cash for Clunkers is a wonderful success.
Also, isn't securing the border a job the federal government is already charged with?
Posted by: Gary on August 20, 2009 09:44 AMMaybe you don't recall the last time you baited me on Cash for Clunkers, but it was the WSJ that declared it a success in terms of stimulus.
But, I understand you can't address the question I raised, so felt the need to go to the side track.
But if you are interested in comparing BC's 4% 2008 to 2009 expenditure with that in the US, a quick google returns this
between 2000 and 2009 the cost of a family premium provided by an employer rose by 95.2 percent while median income went up by just 17.5 percent. To make matters more galling, workers are getting fewer benefits plus higher deductibles and co-pays for the extra money..
But let's talk about 'Death Panels', Cash for Clunkers, socialism, ... ad nauseum , cuz that will lead us to informed decisions. :-)
Somehow I knew you'd come up with that poor example. The military doesn't operate efficiently, Duffman. Remember about 20 years ago when it was discovered how much the military spent on items like hammers and toilet seats? Also, exactly how large of a chunk of the federal spending is allocated for the military? You don't think there is at least 30% waste there?
Try again. This time one that fits a "model of efficiency" that I asked for.
Posted by: Rick D. on August 20, 2009 10:03 AM
The thrust of the proposal in HR 3200 which includes a Health Care exchange and a Publicly Run option are things that empirical analysis tells me are good. Forbidding the Medicare program from negotiating volume discounts with Big Pharma is not just bad, it is idiotic.
HR 3400 gets no consideration by the Republican leadership, nor conservative bloggers.
At the risk of repeating myself again, my issue is the rate of premium increase greater than inflation and the ever increasing number or uncovered. This is the problem that I want/need addressed, and HR 3200 makes progress towards that.
Posted by: MikeBoyScout on August 20, 2009 10:07 AMEvidence of the results of loosening oversight is beginning to surface. A Department of Defense January 1999 report reveals that defense money is again being wasted on spare parts, as it was in the 1980s. In the report by the DOD Inspector General (IG), AlliedSignal corporation was found to have overcharged the government for spare parts by as much as 618%. The government overpaid on the overall contract with AlliedSignal by 54.5%. The irony is that these parts were bought under the new, much-touted "commercial" price system promoted by the Administration and Congress.
How many private companies could operate under that standard of "efficiency"?
Answer: None for long
Posted by: Rick D. on August 20, 2009 10:14 AMWhy? You said you were for it the way it is. If it needs to be "worked on", then you should be against it.
Hell, even John Jensen is against it.
All organizations are less than optimally efficient.
But Rick, it was not the inefficiency of democratic government run programs that led to the overcharging (and overspending) on Defense programs in the 19080s, and it wasn't private enterprise that sought for it to be resolved.
Ignoring Eisenhower's warning of Military-Industrial complex, the Reagan administration thru money at the military, and the private defense contractors took advantage of it.
And it was public minded civic action groups that got the problem resolved.
There are two points here:
1) Private Enterprise does not guarantee the least costly solutions.
2) Civic governance is an effective means of curtailing abuses of an economic system.
(e.g. In the report by the DOD Inspector General (IG), AlliedSignal corporation was found to have overcharged
The world is not black and white, and neither is our Health Care crisis.
Posted by: MikeBoyScout on August 20, 2009 10:54 AMHAHA. You're only making your case worse with each of these examples, Duffer :)
Posted by: Rick D. on August 20, 2009 10:58 AMOr is it that Americans will be forced to pay for *worse* health care so that illegals can get *better* health care for free?
Please? Those (he, I guess) in favor of HR3200, please explain this.
Posted by: Gary on August 20, 2009 11:01 AMOn point 2) A private company would have spotted this fraud long before your "civic governance" panel did. Probaly at least by a couple of years or more.
You haven't made your case here, mike.
Posted by: Rick D. on August 20, 2009 11:06 AMThe truest statement spoken herein on this subject.
Posted by: Duffman on August 20, 2009 11:10 AMLiberal wordspeak for the truth. : )
Posted by: Jack on August 20, 2009 11:22 AM#54. We now have some Greenpeace bigwig admittnig to the BBC that their claim of the Arctic melting by 2030 is bogus, but they have to appeal to people's emotions. Works very well for some people right here on this board.
He also said that they had to stunt economic growth in the U.S. Sounds just like Congress.
Posted by: Gary on August 20, 2009 12:04 PMAlso, any idea where he came up with his $50k for a foot amputation number? I guess that "works on people's emotions" too, just as with the Greenpeace nonsense.
Posted by: Gary on August 20, 2009 12:48 PMThe only thing they could do, however, is to get on the backs of the states for limiting the companies which can do business in those states.
The Federal Government is authorized to "regulate commerce" between the states. That means they have to ensure there is no "restraint of trade" between them. That restraint is what is keeping people from shopping for the insurance plan which best fits their family's needs.
Posted by: Douglas Aldrich on August 20, 2009 12:54 PMSeriously...my procedure (TKA) total knee replacement was approx. $100K (before insurance modifications)...Whew! sure glad I was covered!
Posted by: Duffman on August 20, 2009 12:55 PMUnfortunately, our "leaders" don't justify what laws they write.
Posted by: Douglas Aldrich on August 20, 2009 01:13 PMWhat the hell has happened to education in this country? Oh yeah, run by the same people who want to take over health care.
"more dynamic"... according to whom?
You want to change Article 1, Section 8? I suggest an Amendment.
Posted by: Gary on August 20, 2009 01:33 PMDuffman- You haven't found a government MOE yet? Perhaps he's with government Larry and Curly. Good luck on the gulf coast.
Posted by: Rick D. on August 20, 2009 02:15 PMBut seriously, I just read a piece linked from Drudge describing how Canadians very frequently get sent across the border by their government to hospitals here to get major surgeries. They say this doesn't demonstrate weakness in the canadian system. But clearly it does--what it shows is that canada as a country does not have the resources to actually provide government-run medical care to everyone. Again, WE are their emergency outlet. This is living proof. Canada lacks basic medical infrastructure, as clearly evidenced by this article. We don't need to send insured people across the border for any care. This IS the best medical care in the world. And hey---the Canadians are depending on us, dontcha know?
Here are two excerpts from the article:
"Agreements between the Detroit hospital and the Ontario Ministry of Health and Long-Term care for heart, imaging tests, bariatric and other services provide access to some services NOT IMMEDIATELY AVAILABLE IN THE PROVINCE, (my caps) said ministry spokesman..."
"Danny Mercado, a leukemia patient from Kitchener, Ontario is cancer-free after getting a bone-marrow transplant...in Detroit. TOLD BY CANADIAN DOCTORS IN 2007 HE COULDN'T HAVE THE PROCEDURE THERE, MERCADO'S FAMILY AND DOCTOR APPEALED (my caps) to Ontario health officials, who agreed to let him have the transplant in Detroit in January 2008".
Where would these Canadians be without us? WE are their safety valve. We know it. They know it all too well. Why can't Canada as a developed nation have the medical infrastructure necessary for its own citizens? We don't have that problem. And this is rather embarrassing for Canada to have to go out of country to do what they claim to be so proud of. May we never be that pathetic.
Some people have been truly taught well (and by "well" I mean "badly") by our government schools.
Posted by: Gary on August 20, 2009 04:04 PMBut if you are interested in comparing BC's 4% 2008 to 2009 expenditure with that in the US, a quick google returns this
between 2000 and 2009 the cost of a family premium provided by an employer rose by 95.2 percent while median income went up by just 17.5 percent. To make matters more galling, workers are getting fewer benefits plus higher deductibles and co-pays for the extra money..
Which is exactly WHY the plans in Congress should be avoided. Please see this summary which tells the facts:
Even without the Medicare prescription drug benefit, Medicare's per-patient costs have risen far more than the total per-patient costs of all health care in America apart from Medicare and Medicaid: 4 percent more since 2000, 14 percent more since 1990, 12 percent more since 1980, and 34 percent more since 1970.
So Government run healthcare has been INCREASING in price even FASTER than private! In fact, in your little "factoid", private premiums may be up 95%, Medicare and Medicaid would be nearly 100%. Higher rate.
So tell me Mike, how does nationalizing health insurance LOWER costs? To reduce the costs borne by the Government, we cannot just lower the rate of growth in health insurance? We must REDUCE - in absolute dollars - the amount spent on insurance. Even Obama has said we cannot add deficit spending to cover health insurance - so how does it work?
How do you go from a situation where 35% of the population have Government-funded insurance (whose costs are growing faster than the private sector), and move to a situation where 50% or more of the population have Government-funded insurance. And you pay less total dollars?
Is somehow adding another 40-50 million people to the Government plan going to cut the cost of insurance for all those people by more than 40% per person?
Tell us Mike, how do you save money? Because right now the Government insurance programs cost more than private insurance.
Posted by: Shanghai Dan on August 21, 2009 07:50 AMYou're wrong. You can pay for care out-of-pocket, just like in America. (In your post, you claimed that you could only pay out of pocket in this country.)
Hospitals and doctors are still privately ran in Canada, and most other countries that have universal health care.
Dan, So Government run healthcare has been INCREASING in price even FASTER than private!
Not true.
Let's break down this claim: Medicare's per-patient costs have risen far more than the total per-patient costs of all health care in America apart from Medicare and Medicaid.
Do you know what group in America is apart from Medicare and Medicaid? Those without insurance. This paper is being dishonest. It is pretending that those without insurance are part of our health care framework when they are in fact apart from it. We are keeping costs down in the private sector by denying people access to full health care. That is not an accomplishment, it is a failure. This paper is praising the growth in uninsured Americans -- it's a disgusting and dishonest thing to write.
So, why don't we compare those who have private insurance vs. those with Medicare? Medicare has had substantially less cost growth than the private insurance sector.
Costs are not growing greater than the private health care sector. I hope you don't use this claim in the future, Dan. It is really unfortunate that we have so many uninsured folks in this country. Whether the government should get involved is a political difference, but the facts aren't.
It's beside the point, though. No one -- NO ONE -- is proposing an expansion of Medicare. No one is proposing to make everyone get government health care for free. The public option is NOT government-funded insurance -- it is policy holder-funded like any other insurance company.
Posted by: John Jensen on August 22, 2009 07:09 PMDo you know what group in America is apart from Medicare and Medicaid? Those without insurance.
BZZZT. Wrong, but thanks for playing! I am apart from Medicare and Medicaid; I have my own insurance. I assume you're apart from Medicare and Medicaid, too...
The article states that if you look at just Medicare/Medicaid, then look at just non-Medicare/non-Medicaid. The latter - private insurance - is growing at a slower rate.
How you can get your conclusion is pretty shocking; I don't know how you can twist it to be those without insurance!
Additionally, we know that Medicare has higher administrative costs than private insurance. Facts, John, facts. I know, difficult things to accept because they fly in the face of your pre-conceived notions, but facts nevertheless.
No one -- NO ONE -- is proposing an expansion of Medicare.
That's right; they are proposing a massive expansion of Medicaid, which is even more broke than Medicare.
No one is proposing to make everyone get government health care for free.
Correct. Just drop the "for free" part and you'd also be correct. Not a single private insurance plan is identified as being qualified under HR 3200. Only Medicare and Medicaid are listed as acceptable.
The public option is NOT government-funded insurance
A large portion of it is; buying into the public option plan requires taxes/premiums paid to the Government, which then doles out the money.
And if you choose to self-insure (have insurance from overseas, or are independently wealthy) you must pay taxes to the Government to fund insurance for others.
And of course, if you don't have insurance now, and show you meet some as-yet-defined criteria to get free insurance, then you get free Government-funded insurance.
it is policy holder-funded like any other insurance company.
Really? Can you point to the place n HR 3200 that defines it as such? Is that how Medicaid operates?
Conversely, do those who choose to self-insure have to pay Blue Cross or Kaiser for health insurance anyway?
Posted by: Shanghai Dan on August 23, 2009 10:32 AM