I'm an independent filmmaker with no ties to the health insurance or health care industry - only a personal concern about American liberty and medical freedom. I've made a number of short films about health care policy - specifically for the internet - and featured on a new website: www.freemarketcure.com.
Michael Moore's new movie Sicko is set to inject a large dose of misinformation and propaganda into our national dialog about health care policy. A case in point is Howard Fineman's column in the June 18 edition of Newsweek. Having just attended a Washington press screening of Sicko, he writes about the increasingly urgent calls for government-run health care:
It would be nice to think that the urgency is the result of outrage at our mediocre infant-mortality and life-expectancy numbers, which are among the worst in the developed world.
The truth, however, is that even if we were to adopt a single-payer system, our infant mortality and life expectancy numbers would still compare unfavorably with Canada and other OECD countries for the simple reason that they have little or nothing to do with the quality of our health care system.
Life expectancy averages are determined by a multitude of factors such as ethnicity, culture, and crime rates. Asians live longer than whites. Whites live longer than blacks. Canada has more Asians than blacks. Infant mortality rates are likewise determined by a host of factors having nothing to do with our health care system. The chief cause of infant mortality is very low birth weight babies. The U.S., for reasons having to do with ethnicity and culture, has more low birth weight babies than Canada and other OECD countries.
According to one observer, Michael Moore has created a love letter to the Canadian system. However, Americans should know that Canada rations health care and that many Canadians wait inordinately long periods of time for urgent medical treatment. The Fraser Institute's annual report "Waiting Your Turn" estimates that Canadians are waiting for nearly 800,000 medical procedures. If the Canadian system was adopted in the U.S. - and you assume one person per treatment - that would translate to nearly 7.3 million Americans. Not 7.3 million Americans theoretically without health care due to a lack of insurance - but 7.3 million Americans who need medical treatment but cannot get it without being on long waiting lists.
How long? In Canada, it depends on the province and the type of treatment. The median wait time for medical treatment in Canada in 2006 was 17.8 weeks. However, this doesn't tell the whole story. It's not hard to find Canadians who have waited months to get an MRI, and years for some types of treatments. There are multiple kinds of waits in the Canadian system: the wait to see a specialist, the wait to get a diagnostic test, the wait to get surgery - and then the wait for rescheduled surgery after one's initial surgical appointment has been cancelled - sometimes multiple times - a routine phenomenon. Waits for orthopedic surgery can be multiple years - and in the case of some elderly Canadians - forever. Waits for things like gastric bypass and sleep apnea treatment are routinely 4-5 years.
My short movie, A Short Course in Brain Surgery, highlights the plight of Lindsay McCreith, a Canadian with a suspected brain tumor who had to wait four months for an MRI. Instead, he crossed the border to the U.S and got it in two days. He then faced another four month wait just to see a specialist in order to schedule surgery which would represent yet another wait. Instead, he had the tumor removed in the U.S. - immediately. It turned out to be early stage brain cancer.
Another short, Two Women, chronicles the sad story of Janice Fraser who, unable to urinate, needed to have a pacemaker-type device implanted to control her bladder. Unfortunately, the hospital arbitrarily rationed the operation by doing only one per month. Janice was number 32 on the list - nearly a three year wait. She ended up waiting so long that she developed life-threatening infections, had to have her bladder removed in an emergency procedure, and will now wear a urine bag for the rest of her life.
The Lemon tells the story of Shirley Healey who was suffering from a near total blockage of her mesenteric artery which feeds blood to the bowels. She was slowly starving and risked death by waiting in Canada. She came to Bellingham, Washington where she got her life-saving operation immediately. The American surgeon who operated said that the Canadian patients are the worst, most dangerous cases he sees - due to the long waits.
In May, the Toronto Star ran a story about an Ontario man with a fist-sized hole in his head - due to an car accident - who had to wait one year for surgery to close it. Indeed, the newspapers of Canada, the UK, Ireland, New Zealand & Australia feature a constant weekly stream of horror stories about their nationalized systems. Two weeks ago, a study was released by doctors at Glasgow University showing that 464,000 deaths had been caused over the last 30 years by the NHS in Scotland and that "the vast majority of people - around 250,000 - who died due to inadequate or delayed treatment were heart or stroke patients".
Judging from the press, it seems that English-speaking countries are congenitally unable to run nationalized health care systems. Maybe that's why more thoughtful advocates of single-payer laud the French and German systems whose newspapers most Americans can't read. Apparently, Mr. Moore has not been as thoughtful. He may not have considered that anyone with a computer and an internet connection can use Google News Search to quickly determine that his version of the Canadian system is not even close to reality.
These are not isolated anecdotes. Indeed, they are the result of the systematic rationing of health care by the Canadian government via global hospital budgets, technology budgets and the intentional limitation on the number of practicing specialists. However, many advocates of government-run medicine deny that waiting for health care in Canada is a problem.
Defenders of the Canadian system tend to fall into three groups:
- Those who deny that Canadians wait too long.
- Those who admit it and blame it on under-funding
- Those who think that waiting is not a bad thing
Those who deny that waiting is a problem in Canada include Ezra Klein of The American Prospect who minimizes the effects of waiting this way:
... there is no rationing or waiting lists for non-elective or emergency procedures.
Well, no there aren't. But, just because a surgery is termed elective doesn't mean it's not urgent. In fact, all cancer surgeries are considered elective in Canada. And - unless you're having a heart attack, a bypass operation is considered elective - even if the blockage approaches 100% - even if you're a ticking time bomb - even if an American doctor would consider it an emergency.
All of the patients in my films - a man with a cancerous brain tumor, a women whose bladder had ceased functioning, a women who was slowly starving to death due to a blocked mesoenteric artery - were waiting for elective surgery. In 2003, Diane Gorsuch of Manitoba died while waiting more than two years for elective cardiac bypass surgery. But, of course, it's in the interest of single-payer advocates to mislead Americans and make them think that Canadians only endure long waits for varicose vein treatment and lap band procedures.
Klein also plays down Canadian waiting this way:
Oh, and the "hordes of Canadians rushing across the border for care thing"? Mostly myth.
Well, its not difficult to see why. Canadians have already paid high taxes for national health insurance. They don't have health care savings because they've been subjected to two decades of government propaganda that tells them they don't need it. - And, they don't have private insurance because it's outlawed - and many of them are old, afraid to travel for surgery, fear they may lose their place in the queue or be thought of as "un-Canadian".
Then, there are those who admit that Canadians suffer and wait long periods of time for medical care - but who blame this merely on underfunding - not on the system itself. Groups like Physicians for a National Health Program, who take this stance, like to have it both ways. They lament high U.S. health care spending while they praise low Canadian spending - all the while blaming underfunding for the constant stream of horror stories in the Canadian press.
And finally there are those who seem to think that suffering and waiting is a good thing as long as everyone suffers equally. Academics like Pat and Hugh Armstrong who have written a book praising and defending the Canadian health care system say that "waiting lists are an indication of strong demand for high quality health care."
Undeterred by reports of long waits and suffering in countries where nationalized health insurance has been implemented, the advocates of government-run medicine point to 45 million Americans without health insurance as proof that the market has failed and that government-run medicine is the answer.
However, the so-called "crisis of the uninsured" is anything but. As I show in my short film Uninsured in America, the vast majority of the uninsured are people who choose to go without coverage. Seventeen million of the uninsured reside in households making more than $50,000 a year. Fourteen million people without coverage are eligible for Medicaid or SCHIP, but haven't signed up. Throw in millions of illegal immigrants who don't buy insurance and millions of people who are uninsured only for short periods of time and we've got a non-crisis of politically exaggerated proportions. Moreover, millions of people who are unwilling to pay for their own medical care have figured out that it's free-for-the-taking at any hospital emergency room.
Consider this: across Canada, thousands of baby boomers and the elderly often wait years for knee and hip replacements; often in great pain while taking powerful narcotics. However, a dog in Canada can get a joint replacement operation at a veterinary hospital done in a matter of weeks. The real danger of adopting a system like the one in Canada is not just long waits for medical treatment. Americans would pay much higher taxes and lose important liberties while turning over personal life-and-death decisions to government bureaucrats.
U.S. Think Tanks
Think Tanks Abroad