Health care protesters have a point

Now we know the enemy in the health-care debate, the really, truly despicable people, the worms who ought to be stuffed back in the dirt they crawled out of. It’s ordinary citizens who have had the temerity to show up at meetings of their representatives in Congress, asking in so many words — "What in the name of heaven are you planning to do with our lives?"

Happy enough to be cheerleaders when Cindy Sheehan and her ragtag followers were out and about calling George W. Bush a mass murderer, Democrats, the left generally, some pretend journalists and a number of big-name commentators are aghast at a lack of respect for the Washington malefactors, fearful that someone will think everyday Americans actually know what they’re talking about and worried about how hard it will be to set the record straight if their critiques are widely circulated.

Nancy Pelosi goes further. She asserts swastikas had been spotted at these protests, as if that is comment enough. Listen, speaker of the House: There are kooks out there. No matter what the event, kooks show up. I have no idea whether someone with a swastika actually was at some health-care protest or two or three, but that would hardly mean what Pelosi implied, that what we have here is just a bunch of neo-Nazis. What we have are people who have been following developments and very well may grasp what is at stake in the rush-job "reform" proposals better than poor Pelosi ever could or even more than some gullible, non-sequitur-plagued, exaggerating writers in big-time media.

Here’s the deal. The Democrats contend health care is a "right," which is to say they think health insurance should be an entitlement provided free if necessary to every single American resident, including people who simply don’t want it and illegal aliens who are likely to be given plenty of opportunity to obtain government handouts without fear of detection. One device to accomplish universal insurance would be a so-called public plan, which is to say a government-run alternative that sooner or later might well be the only show in town, even though all but the very tiniest businesses would be required to either provide health insurance or pay a penalty.

According to the most trustworthy non-partisan people in D.C. — the staff of the Congressional Budget Office — the cost of current Democratic bills would be enormous, at least another trillion dollars over the next decade. This will come on top of the tens of trillions of dollars in unfunded liabilities already owed to Medicare, money that will be due to beneficiaries beyond what will be available from tax revenues or any means other than higher taxes or deficit borrowing. At some point, and not all that much further down the pike, we will have annual, economy-wrecking obligations making this year’s stimulus package and bailout billions look like pipsqueak stuff, and meanwhile count on higher premiums caused by still more mandates on insurance companies.

Something will have to give, and a hint of what that will be is contained in the idea of President Obama to have a Medicare panel making sweeping decisions on fees and advisable care. Severe rationing could eventually become the way of things, no matter what dodges you are told about new efficiencies or preventive health practices doing the money-saving job. Given how much we’ve recently been hearing about how old people really don’t need as much care as they are now getting, I’d say they should keep a keen eye on the formulas Obama and friends have in mind.

The short of it is that while incremental, gradual, market-based reform is certainly needed along with a careful restructuring of Medicare, a really, really big, all-at-once, statist, semi-socialist transition will have even bigger unintended consequences, and ordinary citizens will pay dearly unless their insights can help forestall the hubris.

(Jay Ambrose, formerly Washington director of editorial policy for Scripps Howard newspapers and the editor of dailies in El Paso, Texas, and Denver, is a columnist living in Colorado. He can be reached at SpeaktoJay(at)aol.com.)

51 Responses to "Health care protesters have a point"

  1. jayambrose  August 8, 2009 at 5:46 pm

    I am not sure I have seen a single commenty on the board suffessfully refuting a single thing said by the health protesters. Just name calling, mostly, how awful Hannity is and all the other fallbacks of know-nothing leftists.

  2. neondog  August 8, 2009 at 5:50 pm

    Yo Jay…how well did you prognosticate the banking meltdown? how well did you prognosticate the housing crisis?? (yeah-yeah we know inner city negro’s caused that one). how well did you prognosticate the failures of GM and Chrysler??? Come on Jay tells how you did on the World Trade Center attacks???
    Jay can recall how vehemently you supported the idea of finding WMD in Iraq????

    Jay….you have a history of being wrong…a history of looking the other way when conservatives fail and unquestionably yielding to conservative ideology ….
    Jay…your track record with conservative failures gives you little right to determine the outcome of the current attempts to fix health care.

  3. jayambrose  August 8, 2009 at 5:52 pm

    By the way, what is it that you “experts” believe Obama and the Democrats will actually do to control runaway Medicare expenditures? More preventive care? More electronic records? More careful management of chronic illness? Doing away with some inefficiencies here and there? While all this stuff might have some merit, none of it will solve the problem, and even many supporters of health reform admit as much. Unless you convert Medicare to a very different kind of system overtime, and Obama will not do that, you have to ration, and ration severely, and that is what this legislation begins to do. Check out the duties of the Medicare review board if you do not believe it.

  4. jayambrose  August 8, 2009 at 3:38 pm

    My record on predicting the economic crisis was about the same as 99 percent of the nation’s economists and media commentators.

    You are right that I was wong about there being WMD in Iraq, maybe because I listened to all the assurances of the people who said the weapons were there: Bill Clinton, Hillary Clinton, John Kerry, Ted Kennedy, etc. What I was right about was that Bush did not lie, unless, of course, all those other people just cited also lied.

    I never blamed the problems of cities on inner city blacks. That’s a ploy leftists use to make their opponents sound like racists. Shame.

  5. neondog  August 8, 2009 at 6:33 pm

    Jay? Are you freakin serious?
    Controlling run-a-way Medicare expense?
    If you are you referring to the “socialized” program that supports senioir Americans during their gratest time of need, I believe Sarah Palin has already answered that question for you.

    Now that Sarah has some free time on her hands, she has delved deep into Obama’s health care reform bill and discovered that most of the Medicare savings would come from putting seniors to death.

    As stated on her Face Book page:
    “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.”

    Jay…you sure don’t play “smart-ass” very well…

  6. storky  August 8, 2009 at 10:24 pm

    My record on predicting the economic crisis was about the same as 99 percent of the nation’s economists and media commentators.

    Why would you source stories to media commentators? Why would you not chose more authoritative sources like Nobel prize winning economists, Joseph Stiglitz and Paul Krugman.

    You are right that I was wong about there being WMD in Iraq, maybe because I listened to all the assurances of the people who said the weapons were there: Bill Clinton, Hillary Clinton, John Kerry, Ted Kennedy, etc. What I was right about was that Bush did not lie, unless, of course, all those other people just cited also lied.

    The Bush Administration bypassed normal intelligence channels, made poor assessments, while attributing the conclusions to other organizations. They fabricated evidence and lied about the source. Do you mean to imply that those who were intentionally mislead by liars are as guilty as the liars? By that premise, you are guilty as they are. However, journalists aren’t merely scribes, they are required to test the veracity of claims!
    Meanwhile, gullible media sources discounted and even ridiculed the accurate conclusions of authoritative sources like heads of UN weapon inspection teams, Scott Ritter and Hans Blix.

    You’ve just demonstrated clear cut examples of journalistic malpractice.

  7. gazelle1929  August 9, 2009 at 4:49 pm

    Sarah Palin is apparently channeling Rep. Michele Bachmann, who said in a speech on the floor of the House that Rahm Emmanuel’s brother, identified by Rep. Bachmann as an advisor to the President on health care, has been quoted as saying that there needs to be some form of rationing of medical care.

    From this she concludes that the health care bill does indeed contain this dreaded “death panel.” Such a non sequitur is common fodder for the people on the right who are trying by hook or by crook to defeat this bill.

    Does this “death panel” exist in the legislation currently before the House? I certainly could not find it, but perhaps others might want to look for it.

    It is, at best, disingenuous to say that since an advisor has a certain attitude that that attitude must perforce be in the legislation. If. Rep. Bachmann had found that in the bill, she would have been waving it around for all the world to see and perhaps be horrified by. Since she didn’t do that and since I couldn’t find it, might that not mean that it does not exist and it’s simply more right wing smoke, mirrors, and bullshit?

  8. storky  August 9, 2009 at 10:00 pm

    Keeping up with the news has become a full-time job for those who wish to be accurately informed. It disturbs us that we now have to fact check reporters from what had been trusted news sites.

    Yellow journalism is rampant these days, but there are no consequences for inaccurate or deceptive reporting at least not by the agencies that accept their stories. What ever happened to editorial prerogative? Do editors no longer read submissions before publishing?

    This leaves the reader with few options:
    1) Move on. Find another more trustworthy news source. Acknowledge the fact that the current site’s standards have diminished precipitously and its content is of limited value.
    2) Respond via comments, letters to the editor or complaints to the editorial staff or ombudsman. Hope that your messages reach the publisher and are acted upon.

    I am rapidly approaching the point where I no longer find value here. If the publisher doesn’t think my patronage is necessary to their business plan, then it will be a mutual parting of ways. If, however, the publisher finds my readership valuable and beneficial, then it’s time for the publisher to re-evaluate his team of contributors.

  9. woody188  August 10, 2009 at 12:16 am

    Jay, one of your best pieces ever. Wonder why we don’t see any of the Republican town hall meetings that have been disrupted. I’ve heard they are getting slammed too but I have been unable to find any proof of that. Maybe you could take up that with a follow up to this one, and cover the other big issues like cap-and-steal, fair versus free trade, and how about at least suspending H-1B VISA’s in the meantime?

  10. jayambrose  August 11, 2009 at 3:10 pm

    I have no idea what this guy means? Does anyone here? Does anyone want to try to explain this wacko stuff?

  11. gazelle1929  August 11, 2009 at 10:26 pm

    If it were explicable it would (perhaps) not be wacko. He’s apparently bought into the bullshit that we are going to send all our old people walking onto the ice floes to feed the polar bears that are facing extinction because they can’t hunt seals.

  12. jayambrose  August 12, 2009 at 5:46 pm

    I think Palin’s “death panel” comment was stupid, but if you don’t think Obama wants a Medicare panel to control costs, you are ignorant of front page news, as most posters on this board seem to be. For a good, objective account of it, Google “Broder” and “Medicare panel.”

    If you do not believe in Medicare’s runaway expenses,you should not say another single word about health care until you have spent time acquainting yourself with America. Medicare has accounulated unfunded liabilites of almost $40 trillion. Do you know what an unfunded liability is? I thought not.

  13. Dionysis  August 7, 2009 at 11:49 am

    We can always count on people like Mr. Ambrose to engage in the usual dishonesty (or confusion) in his continual efforts to champion the interests of the radical right and the well being of corporate interests.

    Health insurance companies and right-wing front groups bus in hooligans to prevent any debate at all, extending their outrage to basically anything connected with the administration. Many of these people are racists, and the whole lot of them clearly disdain democratic debate, while claiming to be for ‘freedom’ (“we support our freedoms, now shut up”).

    Your smear of what Nancy Pelosi said is based upon your typical ignorance or dishonesty. She did not use the word ‘Swastika’ but did say there were Nazi SS signs at town hall events (here is a link to a photo, since you apparently don’t care to actually see what the facts are):

    http://rawstory.com/blog/2009/08/ss-nazi-sign/

    Very few Democrats have claimed health care is a “right,” although some have. Most take the position that it should be a guarantee (and not a guarantee of free healthcare, only the right of access).

    You and the other insurance industry shills seem fine with allowing the greedy insurance companies to continue to collect premiums and deny payments, which is how they make their obscene profits off of the health of Americans, gleefully buying politicians (including Blue Cross, er, Blue Dog Democrats).

    Basically, it’s the same old ‘I got mine, now screw you’ attitude that has helped to create this abysmal mess we’re in today.

    The Democrats need to grow spines and push reform through, and quite the silly notion that there will be bi-partisanship with these idea-less obstructionist shills.

  14. jayambrose  August 8, 2009 at 5:33 pm

    Americans now have the “right” to access of health care. Are you aware of the 1980s law requiring hopsitals to treat serious illness whether people have momey or insurance? No? Doesn’t surprise me.

  15. storky  August 7, 2009 at 12:13 pm

    It’s ordinary citizens who have had the temerity to show up at meetings of their representatives in Congress”

    It’s not the temerity to show up.  It’s the temerity to disrupt, threaten and intimidate.  It’s the temerity to spout bullshit in service of health insurance lobbyists.  It’s the temerity to displace local citizens and deprive them of their right to be heard and air grievances.

    Don’t defend angry mobs whose misplaced anger is based on misinformation and disinformation.  Correct the record!  Refute the nonsense!

    Fanning the flames is indeed being part of the problem — not the solution!

  16. jayambrose  August 8, 2009 at 2:14 pm

    To call these groups of everyday Americans “mobs” is a lie, although one that the Democrats are apparently using to justify the union thugs now practicing violence against these decent Americans.

  17. Epictetus  August 7, 2009 at 12:42 pm

    Propaganda straight from the right-wing echo chamber.

    If the author actually believes what’s he writes, he needs to do a tiny bit of objective research into the issue. The previous commenters have already listed the obvious fallacies in the original posting.

  18. jayambrose  August 8, 2009 at 3:28 pm

    Not a single fallacy has been noted. Not one. What we have here is mostly gibberish from people who don’t know what they are talking about and sure as anything have not kept up with the news. The only reason I got involved was the slanderous error that Peolosi did not use the word “swastika.” I have now provided a link showing the mistake. I guess I could provide links to language in the legislation, etc., to show how wrong you people are on just about everything else, but at some point you will need to get off your behinds, escape your ideological fantasies, and do your own homework with some sense of objectivity.

  19. SimonSC  August 7, 2009 at 2:42 pm

    So I was just shopping for treatment for my injuries from being hit by a car in New York last week (the “big line items” were a new spleen, repairs to my lacerated lungs and fixing a big puncture wound). I was so glad to be able to shop around and find the lowest cost provider, which turned out to be a new doctor with a degree he said was from Kinshasa’s top medical school. He had good connections in Nigeria for the needed organ, fast and cheap. Think of the money that would have been lost in a socialist system where I would have been rushed straight to a commie-style emergency ward without the chance to shop around and curb costs!

    I think the rush to emulate the American system in every first-world democracy shows that profit-driven, capitalist health care wins hands down.

    (And good job, America, getting those nukes out of Saddam’s hands before they were shipped via Canada to Bin Laden sympathizers in Podunk, ID in their shoe soles! The million dead Iraqis were a price that nation will no doubt celebrate paying. Next job: stop the Obama socialists in the White House before they add ruined medical care to their ransacking of the financial industry!)

    Well done America, keep leading the way! U.S.A! U.S.A! U.S.A!

  20. SimonSC  August 8, 2009 at 4:38 pm

    Whoops, correction. I just found out that the Iraq war was to punish Gog and Magog before they could smite Israel during the apocalypse. My goodness… you just can’t make that kind of stuff up…

  21. storky  August 8, 2009 at 5:41 pm

    Simon,

    A friend who just had second surgery to repair a botched surgery to remove a foot spur, has spent weeks of required bed rest unproductively battling her insurance company to properly cover the cost of the second surgery.

    Despite the surgery having been recommended by her in-network physician, pre-approved by the insurance company, on the premises of her in-network hospital and supported by the in-network team of surgical staff, on the scheduled date of the surgery, the in-network anesthesiologist was unavailable. No-one knew until the bills arrived a month later.

    The difference between the cost of the surgery to the patient with in-network anesthesiologist: $5000 vs. ~$24,000 for anesthesiologist out of network — the insurance company currently refuses to cover the procedure on this basis.

  22. jayambrose  August 7, 2009 at 4:36 pm

    You people filing comments time and again get away with murder — you get facts wrong, you are illogical, you set up strawmen, you parade unthinking lefitism as sophistication and more. I read, smile, go on my way. But it really, truly irks me when someone contends that I (Jay Ambrose) did not bother to research whether Pelosi used the word “swastika” and then cites some propagandistic nonsense to refute me. There’s a video, pal! A video! It’s on the Internet. It is not fudged. It is real. Pelosi absolutely uses the word and she uses it in reference to the health care protests. I await an apology I know I will never get . . .

  23. neondesert  August 7, 2009 at 7:12 pm

    A link?

  24. SimonSC  August 7, 2009 at 9:15 pm

    It is my warm personal friendship with many Americans that leads me to post facts on fact-based articles, and my insights on truth-seeking articles.

    However, most of what passes for “debate” on this issue (indeed in much of the American political scene as broadcast in major media) is, from the outside, so painful, so ludicrous, it’s hard to watch. The rest of the first world finished this debate 40 and 50 years ago, and has spent the time since on improving on the theme of universal care.

    As seen from the outside, advocating the existing American system seems so irrational, so mean spirited, so pathological, that one can only either mock it, or step back since the advocate is likely either mentally or educationally challenged or a shill for corporate interests… and debating a fool, as they say…

  25. pondering_it_all  August 7, 2009 at 7:02 pm

    Protesters have a point, but it is the wrong point: It is only necessary to spend more money on health care if we just pay for access to all to the existing system. That means we (us taxpayers) will be putting 30% of those additional healthcare dollars right into the deep pockets of the insurance companies. THAT’s what the insurance companies are paying the Republicans and Blue Dogs for!

    That’s why a non-profit health insurance provider (government-run or not) is necessary: That is the only way we can get access for all at cost, with no additional taxes.

    We already supply health care to the poorest in America, to anybody once they have lost their job and home, and to anybody who shows up at an ER. So extending access to the mainstream health care system isn’t really going to increase our spending of actual provider dollars. It is just going to shift it to a rational system that doesn’t waste 30% of every dollar on insurance company claim obstructers, shareholder gains, and CEO bonuses. Zero-sum game fear mongering about rationing and euthanasia reflects either paranoid fantasy or some sort of paid relationship with the insurance companies.

    And why, why, WHY should the insurance companies be entitled to 30% of our health care dollars when they do NOTHING USEFUL? All they do is take our premiums and deny legitimate claims, obstruct our medical care, and cancel our policies if we have the misfortune to be stuck without a large group membership. That isn’t insurance: It is a con game! Screw the for-profit insurance companies. Their greed has killed the goose that laid them a billion golden eggs. Our ultimate goal should be to cut them right out of the equation.

  26. SimonSC  August 8, 2009 at 4:41 pm

    OK, so why not let Canada do the administrative side, saving you 15% of the total cost? That should be enough to extend care to those who don’t have it and have some left over to improve facilities while maintaining exactly the same expenditure for those already insured.

  27. free liberal  August 8, 2009 at 12:03 am

    Jay Ambrose preaches: U.S. interests require long-term military presence in Iraq in previous op-ed columns.

    Perhaps Mr. Ambrose, we can SAVE a trillion dollars over the next decade by NOT dropping billions of dollars worth of bombs, NOT invading countries, NOT spending billions a month on post-invasion security, NOT rebuilding infrastructure we bombed away months ago, and NOT lavishing foreign aid on political-pet countries as well as payoff-aid for shady countries.

    Perhaps Mr Ambrose, the money saved would not only pay for healthcare for those who have nothing but also post-secondary education for those who are capable and motivated.

    Mr Ambrose, were you worried about the cost of the twin wars we’ve been forced to finance? The first wars paid for with borrowed money. While I don’t know the answer to this, I do know that many in the “communist healthcare” crowd were/are cheerleaders for military spending.

  28. jayambrose  August 8, 2009 at 2:12 pm

    When you are losing the argument, change the subject — cute tactic, pal, but not really smart, not really convincing, not for anyone alert to such rhetorical tricks.

  29. Nogood  August 8, 2009 at 8:38 am

    “The Democrats need to grow spines and push reform through, and quite the silly notion that there will be bi-partisanship with these idea-less obstructionist shills.”

    My sentiments exactly! Quit trying to be “nice”, fight fire with fire!

    But isn’t it astonishing that so many people can be brain-washed. I guess Hannity, Beck, Lamebrain, and O’Riley have accomplished something in their miserable lives.

  30. griff  August 8, 2009 at 10:52 am

    I wonder if you have any idea what’s in the legislation that you think we should lay down and accept without question. Do you have any idea at all, or is mindless hatred and blind obedience all you have to go on?

    Does anyone have a clue? My guess is that you have no idea, because if you did, you’d have something other than moronic whining to offer. You’re no better than those that you rail against. Brain-washed indeed.

  31. Nogood  August 8, 2009 at 11:30 am

    Hey Griff, since you present yourself as being well versed in this “reform legislation”, step up and enlighten us poor dumb sobs.

  32. griff  August 9, 2009 at 12:55 am

    I actually have posted sections of this bill in comments on other articles, but noone seems to want to talk about what is actually in the bill.

    When someone does, you simply call us liars and obstructioninsts – and worse – and call it a job well done, and then complain that there is no bi-partisanship. So judging from all these comments, your idea of bi-partisanship is the minority going along with whatever the majority wants. Seems we’ve made that mistake before, not long ago (see: George Bush).

    Just because the Democrats offered no resistance to Bush these many years doesn’t necessarily mean the Republicans are required to reciprocate.

    But since you all are the ones defending it so vigorously, why don’t you go ahead and read it and tell us what’s so wonderful about it. Give us a solid reason why this is such a good thing, other than it’s Obama’s baby.

  33. storky  August 8, 2009 at 5:22 pm

    To call these groups of everyday Americans “mobs” is a lie,

    Here are the relevant definitions for mob
    – – – – – –
    1. a disorderly or riotous crowd of people.
    . . .
    7. Sociology. a group of persons stimulating one another to excitement and losing ordinary rational control over their activity.
    – – – – – –
     
    They were disorderly, disrespectful and irrational. Their “arguments” were not based in demonstrable fact or in reason.
     

    Capitol Hill Blue is an independent, non-partisan news site that belongs to no political party and subscribes to no political or philosophical point-of-view. . .

    In Mr. Ambrose’ case: doubtful.

  34. jayambrose  August 8, 2009 at 5:24 pm

    Hell, they were more rational and, by the way, polite than most of those commenting on this board. Are you folks a mob?

  35. jayambrose  August 8, 2009 at 5:42 pm

    That quote from Capitol Hill Blue, by the way, refers to the philosphical neutrality of those who run the site, not the neutrality of those whose columns are on the site. I would guess that just about every columnist out there is expressing some philophical point of view or the other . . . otherwise, why write? I am a classical liberal, now often known as a conservative, and proud of it. I am not a Democrat, although I have voted for Democrats. I am not a Republican, although I have voted for Republicans. I am an independent who happens to think both our national parties are a disgrace.

  36. jayambrose  August 8, 2009 at 5:29 pm

    Most of the world has a worse system than we do, including the socialist systems in Canada and Britain. Universal coverage does not translate into timely, effective care, and one of the things Medicare recipients are catching onto is all the sophisticated talk of late that says we should do as the really smart Europeans do: let the old folks die.

  37. SimonSC  August 8, 2009 at 7:43 pm

    Back up your specious and misleading claim and define “translate”.

    Universal coverage does translate into timely and effective care, or at least it does in my personal experience in Canada, Switzerland and the Netherlands. It also translates, by definition, into medical care for everyone, the lack of which is exactly contrary to either of “timely” or “effective”.

    You have contradicted your own argument.

  38. jayambrose  August 12, 2009 at 5:39 pm

    Here is a story from the liberal New York Times. Now you provide evidence that there are not long lines in England and Canada.

    ——————————————————————————–

    February 13, 2003
    Long Lines Mar Canada’s Low-Cost Health Care
    By CLIFFORD KRAUSS
    During a routine self-examination last May, Shirley Magee found a lump on her breast. Within weeks she had it and some lymph nodes removed. So far so good, until it came to the follow-up therapy.

    Mrs. Magee, a 55-year-old public school secretary, researched her condition on the Internet, and read that optimally, radiation treatment should begin two weeks after surgery. But the local provincial government clearinghouse that manages the waiting time for radiation therapy told her she had to wait until the end of September — nearly three months after her surgery — to begin treatment.

    ”I was supposed to feel lucky I got in so quickly,” said Mrs. Magee, still viscerally annoyed though she has since successfully completed her radiation regime. ”It’s a horrible feeling that something in your body is ticking that you have no control over. If I were a politician’s wife I wouldn’t have had to wait.”

    Long heralded for giving all Canadians free health insurance and paying for almost all medical expenses, the health care system founded in the 1960’s has long been the third rail of Canadian politics; not to be touched by private hands, nor altered by Parliament.

    But growing complaints about long lines for diagnosis and surgery, as well as widespread ”line-jumping” by the affluent and connected, are eroding public confidence in Canada’s national health care system and producing a leading issue for next year’s national elections.

    A recent government study indicated that 4.3 million Canadian adults — or 18 percent of those who saw a doctor in 2001 — reported they had difficulty seeing a doctor or getting a test or surgery done in a timely fashion. Three million Canadians are unable to find a family physician, according to several private studies, producing a situation all the more serious since it is the family doctor who refers patients to specialists and medical testing.

    ”The sky isn’t falling but things are not rosy,” said Dr. Dana W. Hanson, president of the Canadian Medical Association. ”Nevertheless if things are not fixed, the sky may fall.”

    Canada spends $66 billion a year on health care — only the United States, Germany and Switzerland spend more as a proportion of total economic output — but budget cutbacks since the early 1990’s have impeded efforts to keep health care up to date. A recent report by the Senate’s Standing Committee on Social Affairs, Science and Technology indicates that well over 30 percent of the country’s medical imaging devices are obsolete.

    Overworked technology is one reason for the long lines; others include a shortage of nurses and inefficient management of hospital and other health care facilities, according to several studies.

    Waiting times have also increased because an aging population has put more demands on the system, while the current generation of doctors is working fewer hours than the last.

    Waiting can occur at every step of treatment. A study by the conservative Fraser Institute concluded that patients across Canada experienced average waiting times of 16.5 weeks between receiving a referral from a general practitioner and undergoing treatment in 2001-2002, a rate 77 percent longer than in 1993. The recent Senate report noted that waiting times for M.R.I., C.T. and ultrasound scans grew by 40 percent since 1994.

    ”Waiting lists are the hornets’ nests that are jeopardizing the system,” said Dr. Tirone E. David, professor of surgery at the University of Toronto. He noted that Ontario residents needed to wait an average of two months to see a cardiologist unless it was an emergency, queues for angiograms took four to six weeks, and waiting times between initial examination and micro-valve repairs could take as long as six months.

    ”It wasn’t that way 15 years ago,” Dr. David added. ”It does not alter the ultimate outcome, but there’s an anguish and uncertainty when a person feels their life is in a holding pattern for up to a year.”

    Defenders of the Canadian system note that only patients waiting months for nonemergency care, like treatments for cataracts and hernias, skew the waiting time statistics. And they argue that with a life expectancy of 79 years, Canadians still enjoy one of the longest life expectancies in the world, slightly higher than the United States where 41 million people have no health insurance.

    Still, recent polls show that while Canadians want to keep their national system, they are worried about its future effectiveness.

    ”I don’t think there’s a lot of patience among the public for a lot more study,” said Deputy Prime Minister John Manley in a recent interview, noting that his own driver needed to wait a year for hip replacement surgery. ”There’s not a lot of time to deal with it.”

    In response to the growing concerns, Prime Minister Jean Chrétien and the Senate conducted studies of the system that concluded in recent months that shortages of doctors, nurses and diagnostic equipment had caused at least some deterioration of care over the last 10 years.

    Seeking a legacy in his final year in office, Mr. Chrétien agreed last week to spend over $9 billion more over the next three years on programs to improve diagnostic equipment, primary care, drug coverage and home care. But the provincial and territorial premiers say that isn’t nearly enough to alleviate shortages of services, particularly in rural areas.

    The system’s shortfalls have opened the way for tentative but growing moves toward privately managed medical services and user fees in return for quicker service. A hospital in Montreal has begun charging fees for some surgical procedures and renting operating rooms to patients for several hundred dollars an hour. A Vancouver hospital has begun selling full-body C.T. scans for $660.

    In an effort to reduce waiting lists, the provinces of Alberta, Nova Scotia and Ontario have established about 30 private M.R.I. and C.T. clinics, some of which offer nonemergency services to be paid for by private insurance.

    ”With the system cracking at the edges and waiting lists growing, people will eventually say ‘all right, let me pay,’ ” said Dr. Tom McGowan, president of Canadian Radiation Oncology Services, Canada’s first for-profit cancer radiation treatment center, which has treated nearly 2,000 patients since it opened in Toronto two years ago. (Patients still pay nothing at the radiation clinic; Dr. McGowan is paid by the province and receives bonuses if he surpasses productivity targets.)

    The Ontario provincial government allowed Dr. McGowan to open his night clinic after it was forced to send 1,650 cancer patients to the United States for radiation treatments during a 25-month period in 2000 and 2001 because of waiting lists that were up to 16 weeks long.

    Dr. McGowan said the emergency, which cost the province $20 million in travel costs, was not rooted in a shortage of equipment nor staff but inefficient public management. Whatever the reasons, his patients are quick to tell horror stories about their waits for diagnostic tests and treatment.

    ”Your worst fear is it is going to grow while you are waiting,” said Pat McMeekin, a 53-year-old hospital clerical worker, recalling the two months she had to wait between a mammogram and the first of two biopsies confirming she had breast cancer last summer. ”When you have something, you want to take care of it and be done with it.”

    Photo: Dr. Tom McGowan is president of Canadian Radiation Oncology Services, Canada’s first cancer treatment center run as a business. (Lana Slezic for The New York Times) Chart: ”A CLOSER LOOK — Universal Health Care’s Downside” Under Canada’s national health care system, patients have seen increased waiting times between referral and treatment, according to the Fraser Institute, which espouses free market solutions to social problems. Graph tracks median wait between referral and treatment, in weeks for: Orthopedic surgery Plastic surgery Ophthalmology Neurosurgery Gynecology Head and neck medicine Cardiovascular surgery Urology Internal medicine General surgery Radiation oncology Medical oncology KEY Graph tracks increase since ’93

    Copyright 2009 The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Back to Top

  39. jayambrose  August 8, 2009 at 5:37 pm

    And by the way, I never said the Democrats want health insurance free for everyone, although you might note than even the very, very, very rich get Medicare at very, very, very low cost. The Democrats actually have quite a record of giving things away to the rich. FDR knew the rich did not need Social Security but figured the Republicans would keep their hands off of it if he gave it to everyone. It was a lesson the Democrats learned well.

  40. SimonSC  August 8, 2009 at 7:44 pm

    Pointing out your own miserable track record as a journalist is hardly “rhetorical”. Perhaps it wouldn’t be admissible in a criminal trial, but it seems a fair argument.

  41. jayambrose  August 8, 2009 at 10:03 pm

    It is a lousy argument of the kind your parents should have warned you about when you were a kid — two wrongs don’t make a right. Assume it is true that the Iraq war will cost more than health care reforms in the their first 10 years and did not accomplish anything (I think it accomplished a hell of a lot). Assume that it was a waste of money. Does that fact somehow mean it is OK to waste other money? Or does it mean that someone who was for the war should be for health reform even though he thinks it would be an outrageous waste that could help sink the economy? What you have here is a logical fallacy of a kind leftists generally bathe in, but on top of that, a simple act of changing the subject when you are out of arguments.

  42. SimonSC  August 8, 2009 at 10:42 pm

    Again: do the math. Adopting only Canadian-style administration, without reducing *existing* expenditures overall, would leave enough money from the savings to provide universal coverage at the current average covered level of care.

    I think what is being pointed out is that the same crowd tended to be pro-Wall St., pro-Iraq war and anti-universal health care. The track record on all three issues is one of propaganda and fudged numbers.

  43. storky  August 8, 2009 at 9:47 pm

    “you will need to get off your behinds, escape your ideological fantasies, and do your own homework with some sense of objectivity.”

    Actually, as a “journalist,” isn’t it YOUR job to do YOUR homework? Provide accurate information evidenced by quoted passages of the proposed legislation. When people claim government will decide who will live and who will die, I think such claims should be accompanied by a reference to a specific section and paragraph within the bill in question.

    When readers are required to fact check the journalists, that is unacceptable. Furthermore, when the journalist starts to insult readers, that’s when the readers can rightfully demand disciplinary action against said journalist.

  44. gazelle1929  August 9, 2009 at 4:18 pm

    You say not a single fallacy has been noted in your column above. I have not read the comments below, and I am posting this around 4 PM Eastern time on Sunday, August 9.

    This is what you said in your column:

    “Happy enough to be cheerleaders when Cindy Sheehan and her ragtag followers were out and about calling George W. Bush a mass murderer, Democrats, the left generally, some pretend journalists and a number of big-name commentators are aghast at a lack of respect for the Washington malefactors, fearful that someone will think everyday Americans actually know what they’re talking about and worried about how hard it will be to set the record straight if their critiques are widely circulated.”

    Being out and about calling Bush a mass murderer, etc., is not the same as going into a meeting where Congresscritters and Senators are trying to give information and receive feedback and disrupt the meeting so that there is no exchange of information and views. Cindy Sheehan came to prominence for standing by the side of the road to Bush’s ranch in Texas and holding up a sign decrying the war that took her son’s life.

    According to the wiki article on this womand:

    “Sheehan and other military families met with Pres. Bush in June 2004 at Fort Lewis, near Tacoma, Washington, nearly three months after her son’s death. In a June 24, 2004 interview with the Vacaville Reporter published soon after the meeting, she stated, ‘We haven’t been happy with the way the war has been handled. The President has changed his reasons for being over there every time a reason is proven false or an objective reached.’ She also stated that Pres. Bush was ‘… sincere about wanting freedom for the Iraqis… I know he’s sorry and feels some pain for our loss. And I know he’s a man of faith.'”

    Now does that sound as though she got in Bush’s face and screamed at him to prevent him from voicing his views? Hardly.

    You are, I believe, wrong to make a comparison between Cindy Sheehan’s peace movement and the disgraceful mobs that have prevented meaningful dialog. My advice to all members of the Congress is to continue to hold these meetings, to put a good faith effort into creating and maintaining communication, and to allow the public to make its own conclusions about the actions of those who would cause mob rule to squelch communication.

  45. jayambrose  August 11, 2009 at 3:16 pm

    Look, pal, I did my homework, and have provided evidence of same. You and the other ignorance-spouting posters on this board have done no such thing. You just say information is wrong when it isn’t and actually seem to think you have made a point. Give me some hard facts I got wrong. You have none. All you have is blather and the capacity to call names.

  46. jayambrose  August 11, 2009 at 3:21 pm

    Are you a complete ninny, or what? Yes, she met with Bush, and then, LATER, went around calling him a “serial killer,” among other things. It is all documented, and for you to cite something irrelevant to the column’s point shows, among other things, you don’t even read the daily headlines.

    I know, the Internet is a great toy for know-nothings, but not a one of you has been able to answer my rebuttals.

  47. storky  August 10, 2009 at 9:15 am

    If its relevant to this discussion, why not post sections of the bill here? Again, enlighten us.

  48. griff  August 10, 2009 at 10:53 am

    Repost from previous comments…

    Section 163 modifies the Social Security Act (Section 1173)to allow the government real-time or near real-time access to an individual financial’s records and accounts.

    2(B): be authorative, permitting no additions or constraints for electronic transactions, including companion guides.

    2(D): enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card.

    3(C): enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;

    Gee, a national healthcare ID card that contains or allows access to an individual’s financial status and information? The government deducting from your accounts if they deem you worthy of treatment? Sounds like freedom to me.

    Section 223:

    (f) LIMITATIONS ON REVIEW. – There shall be no administrative or judicial review of a payment rate or methodology established under this section or section 224.

    Once this law is in place there will be no review? Why would anyone support a law that can’t be reviewed?

  49. gazelle1929  August 10, 2009 at 11:32 am

    Your preamble says:

    “Section 163 modifies the Social Security Act (Section 1173)to allow the government real-time or near real-time access to an individual financial’s (sic) records and accounts.”

    I believe you have totally misinterpreted this section. Section 2(D), which you quoted accurately, does not authorize the Government to investigate a person’s financial records. Rather, it requires that the Secretary of HHS set up a program where an individual’s insurance can be checked to ensure that he has insurance coverage for a particular service. This inadroitly phrased section boils down to the same thing many insurance coverages have today, namely preferred provider discounts. “Financial responsibility” does not refer to a person’s credit rating or credit worthiness, but instead refers to whether a person has the proper insurance coverage.

    3(C), cited above, refers to using EFT to pay claims to providers, not to collect money from the patient.

    Section 223, from which you extracted one paragraph, sets up a system for providing rates for services provided, which would be standard payments made to providers of services. Here’s a possible example:

    Suturing a wound:

    $50 for setup plus $5 per stitch.

    Note I am just making this up off the top of my head, but that’s the sort of thing that would be on a list like that.

    The Secretary could set these rates, and they would be final and binding on providers. The paragraph you cited applies ONLY to this one section and not to the law in general. It’s there so that providers know what they can expect to be paid and so there will be no pissing and moaning about whether they should be paid $55 for the setup tray and $5.50 per stitch.

    In conclusion, I looked over the entire section and find nothing authorizing the Secretary or anyone else to search for an individual patient’s financial records. And your implication that the total health care law cannot be reviewed is completely without merit.

  50. griff  August 10, 2009 at 1:09 pm

    I don’t see how giving the government real-time access to “financial records and accounts” can be anything but a bad thing. This is a door I don’t think the government should be opening. It’s one thing for a private insurance company, bound by privacy laws, to have access, but wholly another to have the government snooping around. And what of 2(B)?

    I think your interpretation of 3(C) is flawed. Where do you think the money to pay the providers comes from, if not collecting from the patient, as this entire section relates to? And what if you have too much money in your account? Will you pay more for the same service as opposed to someone with lesser means?

    You are right though, it looks a though I imply that the whole law is unreviewable. I thought the actual excerpt from the bill was sufficient enough to explain the sections it refers to.

Comments are closed.