Feeling crankier than usual…

Today, I am feeling crankier than usual…

Friday, I went to see my dentist, because a whole bunch of my teeth are so sensitive now that I could not, in good conscience, delay the visit any more.  My three-branch nerve has always been ‘twitchy’ and as soon as one tooth gets a little sore, it decides to sound all the nerves connected to it, so it makes identifying the culprit difficult, at times.

Which was the case on Friday – so my regular dentist sent me to a dentist who specializes in figuring out exactly these kind of cases.

His receptionist called and set the appointment up for me – it was this morning, Monday, at 8 am.

Just think about it:  I have discomfort, my dentist calls a specialist and I get to see said specialist the next business day.  (They offered me a couple of appointments this week to choose from…)

Some of you might think that spending early Monday morning having my sore teeth intentionally prodded and poked to get a sufficient reaction to single out the ‘bad’ tooth would be enough to make me crankier than usual.  You would be right…

But, what has annoyed me even more than my aching three-branch-nerve is what I heard on the radio on the way:  it now takes about a year for Canadians to see a medical specialist!

Same scenario as the one with the dentist :  your family doctor finds something wrong and wants to send you to a specialist.  The receptionist makes a few calls to get you an appointment.  If you are lucky, you’ll get one – in a year!!!

Of course, this varies from specialist to specialist.

For example, my father had a sports injury and he got in to see a specialist in just 9 weeks!  Of course, by then, he had healed on his own…

My own experience is worse:  I have now been on a waiting list to see a hematologist for over 3 years – and I am beginning to suspect I fell off the end of the list…and, when my specialist doctor (who looks after my particular, serious illness) got sick himself, it took over a year before another doctor would take my care over from him.

(This ‘list’ is a trick to reduce the appearance of waiting times:  once given an appointment, there is a visible amount of ‘waiting time’ which is measured between when the appointment was issued to when you see the doctor.  This ‘waiting time’ is monitored and reported – and ‘efficiency awards’ are issued based on this period of time. So, people get their name put on an unofficial, untracked ‘list’ and when they get to the top, they get assigned an appointment with a short waiting time.  People can be on such a list for years, but this time is not part of the official reports of how long it takes to see a doctor.)

The last time I was walking through one of our hospitals, there were signs posted everywhere that ‘the results of biopsies will be sent back to the referring physicians in 6-8 weeks’.

6 to 8 weeks!!!

For a biopsy  result!!!

That, of course, means that with some forms of cancer, the patient will die (or the disease will advance to an untreatable stage) before the diagnosis is confirmed and before they get on the waiting list for treatment!!!

So, how come I can get to see a dentist right away, but I wait years – if I make it at all – to see a medical specialist?

Could it be that dentistry is only constrained by the free-market while Canadian medical delivery is controlled at every step by the government?

Remember, if you are not the one paying the bill, then you are not the customer!

Yes, that is enough to make a cranky person even crankier…but, that is still not the bit that drives me ‘beyond cranky’.

No, it’s not.

That honour would be reserved for the latest attitudes our southern cousins, in the US, have towards ‘medicine’.

It drives me mad when they – or, especially, US-dwelling Canadian ex-pats, who really ought to know better – tout our Canadian medical system as ‘humane’ and ‘caring’ while turning their noses up at their best-in-the-world medical system.

It’s like ‘nails-on-chalkboard’ to me when I hear them claim our (Canadian) system ‘treats everyone’ while their (American) system will not treat people who don’t have a credit card.  This is simply not true:  there is a law in the US that makes it illegal to turn people away from an emergency room if they don’t have a good enough credit card. There are also free clinics…

In Canada, people have died when they got turned away from the emergency room for not having their government-issued health card on them. And once, while renewing the health card, I saw a guy in the queue there who was on crutches, with his foot backward on his leg.  The emergency room would not treat his complex leg fracture until he went to the main office downtown (far from any hospital) and got his paperwork straightened out…

Oh, here’s a good one:  did you know that some blood tests can only be done in a hospital?  The private clinics simply don’t have the tech for some specialized tests…

Hospitals for adults will not perform these tests on anyone under the age of 16 – there are strict rules.

Hospitals for children will not perform these tests on anyone over the age of 11 who is an out-patient.  Even if the head nurse phones OHIP and begs for an exception – no, not permitted.

In Canada, your kids had better not need any of those tests from when they turn 12 to when they turn 16:  their doctors will simply have to diagnose them without it.  I know – I had been on this merry-go-round with one of my kids!

And yet, the US is not only trying to copy our medicare, the proponents of this feel all righteous and ‘noble’ about it.

Yeah, I’m cranky…

Milton Friedman – Socialized Medicine

Sometimes, we all need a reminder.  Milton Friedman said this in 1978…

Who decides on your medical treatment?

For ever, I have been pointing out the shortcomings of socialized medicine:  what it boils down to is that the one who picks up the tab gets the final say in which treatments gets picked.  And, if that decision is not made by you or your loved ones, but rather by a bureaucrat who does not know you personally, the decisions may not be exactly the ones you might wish…

Thomas Sowell has put this extremely well in his 4-part series:

Whose medical decisions?

Whose medical decisions?, Part II

Whose medical decisions?, Part III

Whose medical decisions?, Part IV

Medicare as means of coercion: as long as I pay your bills, you will obey my rules!

How many people’s parents used to say something equivalent to this:

“As long as you live under my roof, you will obey my rules!”

For those whose parents supported them while they studied in another city, this might be a more familiar version of the expression:

“As long as I pay your bills, you will do as I say!”

It is a rather reasonable expression of the parents’ role: as long as their son or daughter lives under the parents’ roof or as long as the parents are financially responsible (even partially) for the offspring, that offspring (whether chronologically an adult or not) is not truly emancipated.   As long as one is a dependent, one cannot expect to have their independence!

OK – so what if the adult child’s medical costs (say a University or College student) are covered by the parent: would that parent would be within their rights to insist that their son or daughter (adult or not) not indulge in, say, ultimate fighting?

After all, we know that some activities are,  statistically speaking, much more likely to result in higher medical bills than others. So, if someone else is paying a person’s medical bill, that someone else would be justified in putting in some limits on dangerous behaviour.

Right?

So, what about a situation where a group of friends get together to purchase a medical insurance in order to get a ‘group rate’? It is inevitable that not every member of the group will necessarily have a slightly different ‘benefit’ at any given point in time – and most will accept that going into the deal. But…

What if one of these people – let’s call him ‘Bill’ (pun intended) – takes up the hobby of getting a little tipsy and, on a dare, nailing his hand to ‘stuff’. Whenever he does it, Bill gets rushed to a hospital, his hand has to be surgically separated from whatever he had nailed it to this time, Bill then has to get shots… You get the picture. Bill incurs a sizeable bill.

And he does it again.  And again.  And everyone’s group-insurance costs go up!

In this situation, do Bill’s friends have the right to tell him to stop nailing his hand to stuff?

Do they have the right to force him to stop?

The next time he does it, do they have the right to tell him that he is not allowed to use their group insurance to cover the cost of the medical treatment?

Perhaps we can agree that this particular Bill is an idiot. But – where exactly does his right to be an idiot stop and the rights of his friends not to have Bill’s idiocy ruin them financially begin?

Obviously, I picked an extreme example. So, let’s pick another one…

What if, instead of nailing his hand to stuff, Bill chose to get piercings?  It’s sort of similar – just a bit more socially acceptable.  And, what if Bill’s piercings got infected, he needed to be hospitalized, and all that.

And then he got another piercing.

And another.

And they kept on getting infected or having other complications, and Bill’s friend’s medical insurance rates kept rising and rising… Would they have the right to tell him to stop getting any more piercings? Or do they have the right to tell him that any future piercing-related costs will not be covered by the common insurance plan?

All right – what if Bill did stop getting piercings… but one of his existing rings gets caught on something, tears the skin, and Bill has to go to the hospital again. It’s the piercings which are causing the cost to go up – again! Should the group insurance cover it?

And what about if Bill were not an idiot – but his friends were. What if they thought that regular exercise and a good diet was bad for you, because they heard about a lot of athletes getting arthritis? What if these friends believed (truly and honestly) that regular exercise was an unreasonably high-risk behaviour, much like nailing one’s hand to stuff would be. And, what if Bill liked to do yoga – and he pulled something that required medical help…a few times?

Who gets to decide who is ‘the idiot’ and who is ‘reasonable’?

Or what if Bill were a Billie – and she had 16 kids, while nobody else in the group had more than 2: should her choices in fertility affect her friends’ medical rates?

Should only her first 2 births be covered by the group’s insurance?

Or should the whole group be responsible for paying for Billie’s hospital bills if she got into an accident because she was speeding? What about the bills of her 16 kids, who were in the vehicle, too?

Who gets to decide?

Before, or after the treatment?

Would any of your answers change if, instead of choosing to enter into this group insurance arrangement, all the friends were forced into it by law, with no means of opting out? You know, like all Canadians are?

These are not easy answers: I certainly don’t know where the balance lies. All I am trying to do is to make sure that people understand that the ‘benefits’ of being ‘one of a group’ come with the cost of allowing the group some control over one’s behaviour. There is no such thing as a ‘free lunch’ – or a free ‘medical care’!

Someone always has to bear the costs: and the one who bears the costs will want to have a say in how you behave (and incur the cost)!

In the UK, this is the reality: people ARE being denied medical treatment because they are deemed to have too high a body-mass-index (which actually penalizes muscular people, as muscle is heavier than fat), as are smokers or dare to get old. Their treatment them just does not seem cost-effective or fair to the rest of society that has to pay for it….

And, with my own eyes, the last time I went to renew one of my kids’ health cards at the Ontario Ministry of Health office (it is downtown – nearest public parking is about a 10-minute walk from the office), I actually saw a guy there, with a broken leg….trying to get some problem with his health-card straightened out, because the people at the hospital’s emergency room refused to treat him until the problem was straightened out. He offered to pay – but the law forbids the hospital to let him pay first and get reimbursed later…as it forbids the hospital to set one’s broken leg (or provide any treatment – even a triage assessment) until one has a working health card.

Think about it.

Socialized medicare: a true story

BlazingCatfur has been the advocate for his Mom, as he tries to stop our dismal, ironically called ‘health-care’ system, from killing her:

The attentive care of the paramedics was replaced by – nothing.

We waited nearly an hour for a resident to finally stop by and enquire what the matter was. Appallingly, she had no prior knowledge of why my Mother had been admitted. My shock increased after she asked, in all seriousness, if the angioplasty had been a success. I can only assume that the look on my face caused her to retreat and summon the physician on duty. Exhibiting Solomon like wisdom, the attending doctor suggested that a physical examination was in order. She then disappeared with the resident in tow. A nurse was dispatched who informed us that my Mother would have to be undressed for the examination. Since this Angel of Mercy made no offer to assist, I took it upon myself to undress my bedridden mother in a public corridor, in full view of the passing parade of visitors, patients and staff.

Aside:  his mom was bleeding from an incision in her femoral artery, which was not properly closed following an earlier surgery…you know, the very same femoral artery one can bleed to death from within minutes…


Words just fail me!

It is difficult to understand how so many people just don’t ‘get it’:  life-and-death situations cannot be handed over to bureaucrats, who perform a cost-analysis to decide which medical treatment they will approve – and from whose dictum the medical personnel cannot deviate!

This set of procedures is the basis of ‘socialized medicare’ – and it puts bureaucrats and their ‘due process’ above the well-being of any patient and gives the bureaucrats the right to approve – or not – any and every treatment a medical professional (nurse or doctor) deems best for the patient.  It is this ‘submission’ to the ‘process’ (with its inherent delays in treatment) dictated by the bureaucrats which grinds medical professionals down and turns them from motivated people into automatons who just want to punch in, punch out and not get noticed by the bureaucrats for ‘special assessment’ in between…

The bigger an organization is, the more ‘rules’ and procedures’ have to be put into place to ensure that people do not make ‘biased’ decisions which might, potentially, not be in the best long-term interest of the organization.

Unfortunately, this also becomes true when the medical system is ‘bureaucratorized’. And, health-care becomes bureaucratorized when it is run by an organization so large, the patients become statistics instead of individuals:  that is when ‘charts’ become more influential in a person’s medical treatment than the doctor’s opinion does.   It really does not matter if this is a huge private insurance company (with no fear of competition) or some level of government ….except that, it is much, much harder to sue a government if its actions cause the death or crippling of a loved one!

This is the point when bureaucrats have the final word on what resources a doctor may or may not use to treat a patient….and when the patient becomes nothing more than a liability which costs money!

It is no longer the doctors who are allowed to conduct a procedure they think will help their patient, prescribe treatment – however costly – which will save her/his life – now, it is the bureaucrats whom the doctors have to ask permission before initiating a treatment (and who take their time assessing the risk vs. benefit to their careers if they deny treatment).

Instead of the best interest of the patient, it is now the best interest of the medicare system (or individual bureaucrats who control portions of it) which is the priority.  Even if they are willing to pay (oh, that is just wrong!), a patient will be denied ‘unjustifiable treatment’ – you know, when the cost to the system is so great, saving one life is just not justifiable to the taxpayers…

The result when treatment is deemed ‘financially unjustifiable’ is, of course, the death of the patient.  You have GOT to ask yourself just what factors are considered in THAT assessment!

In Britain today, their ‘socialized medicare system’ is more and more costly, and currently contains more bureaucrats who oversee the medical personnel (to ensure they adhere to government-decreed rules of what medical procedures are ‘warranted’ under specific conditions) than they have doctors and nurses combined!

Hat-tip on the video:  Walker

Best wishes to Blazing Catfur and his mom!  Our thoughts are with you!