A couple of weeks ago I lost a very dear friend. Charlie and I met when we were cabin-mates at the UK Naval Academy nearly forty years ago and though our careers had taken each of us in different directions (his into becoming a fast jet jockey and mine into the rather more sedate surface fleet) we had remained friends throughout the years and always stayed in touch. When he left the navy he carried on flying with a defense related organization, about which he shared many stories but only a few intriguing but frustratingly sparse details.
At work about eighteen months ago, having just landed and parked his aircraft, Charlie was walking through the hangar when he was felled by a massive brain haemorrhage. Fortunately he was surrounded by people who knew what to do in such circumstances, and he had been walking through the home hangar of the local the air ambulance, which delivered him to the area accident and emergency (UK National Health Service) hospital within minutes. It took several very anxious days for Charlie to wake up, and even longer to regain the full use of all his faculties, by which time the entire medical staff had become fully conversant with the pleasures and perils of night flying at fifty feet at nearly 600 mph over parts of the world they had never heard of. He probably omitted to mention that he had been a lot younger at the time. However, I am told that one rather ill-informed but 'know-it-all' individual had the temerity to challenge Charlie about the 'below fifty feet' claim and said that he happened to know that the designed limit for that type of aircraft at that speed was above 200 feet. “Ah” said Charlie. “That's the one they reserve for the guy who doesn't suffer from vertigo”.
For the longest time during his recovery the doctors couldn't figure out why Charlie's blood tests always came back with readings that were alarmingly abnormal, and so stubbornly resistant to corrective medication. His wife, who is not a lady easily ignored, insisted on further investigations and eventually, but hopelessly too late, the advanced metastasized prostate cancer was revealed. You see, under a single payer health system such as that found beyond our borders, investigative research and diagnosis beyond the issue immediately at hand, in this case a brain haemorrhage, is not the norm. It incurs an additional and possibly 'uncontrolled' cost on the system.
And making a bad situation worse there is this. During treatment for the cancer Charlie's doctor told him that there was a drug that he felt would be particularly helpful but, because of the very high price of the drug he was unable to prescribe it on a NHS prescription. So, after a family conference regarding what savings and other assets might be gathered together Charlie and his wife went back to the doctor and told him that though the cost of the drug would swallow almost everything they had put aside, they had decided to go ahead and pay for it. To which the doctor replied, "I am so very sorry. When we last spoke I did not know what I must now tell you. I have been informed that if you elect to pay for that drug yourself you will, by definition, be electing to remove yourself from my care, and that of the NHS, and you would have to find and pay for any further treatment privately".
So I ask you to consider whether or not the true story above could possibly be an example of a third party coming between the doctor and the patient, or is it a simple case of rationing brought about by a disproportionate share of healthcare funds being swallowed by administrative costs rather than on patient care? Or is it all of the above? I suspect it is the latter for to provide healthcare services to sixty million UK inhabitants, of which twenty-nine million comprise the working population, over 1.4 million are employed by the National Health Service. A report I saw the other day informed me that the UK NHS is the world's third largest direct employer, after the Chinese army and the National Railway of India. A replication of the UK system in the US, or even a close approximation of it, could easily employ 7 million public pay-roll people without the addition of a single doctor. What a very convenient and reliably compliant electoral power base that would be.
Interviewed on Bill O'Reilly last night Dr. Brian Day, former President of the Canadian Healthcare Association made a number of interesting remarks. Among other things he said that 14% of Canadians do not have a family physician, said that rationing is a major problem in Canada and stated that out of the population that is just one-tenth the size of the United States, they have 1 million people waiting for surgeries, and another 1 million waiting to see a specialist for their condition. He also pointed out that a significant number of Canadians die needlessly because they were unable to get an ambulance to take them to the emergency room. The reason? You need separate insurance for an ambulance ride. See the video at http://209.157.64.201/focus/f-bloggers/2321143/posts
So, at the acceptable risk of being labelled an astroturf mobster I find myself implacably opposed to the various versions of the proposed healthcare reform bill washing around Capitol Hill. I’m opposed not because I believe our healthcare system is just fine and dandy the way it is, but because I believe that the solution to the shortcomings of the system in no way support a wholesale takeover by the government. I am insulted by those who tell me that such a takeover can be achieved without adding to the economic deficit. I am angered by those who would have me accept at face value their assertion that somehow, despite overwhelming international evidence to the contrary, that a couple of hundred politically motivated ideologues are capable of succeeding where the rest of the world has so demonstrably and unarguably failed. And I am enraged by politicians who do not read bills, but who are nevertheless content to rush them into law without giving me and millions of others the chance to consider and comment. That’s not democracy, that’s government by dictat. And they call my objections ‘un-American’? How dare they!
Conservative Americans agree that nobody should be left impoverished and/or homeless just because they got sick. They believe that nobody should have healthcare insurance denied or withdrawn because they fall victim to a disease or major ailment; that’s not insurance. They accept that there are probably some 17 million people who through distressed circumstances have less than adequate access to quality healthcare, and they are anxious for that need to be addressed. And they also recognize that the scourge of unemployment, particularly when it is accelerated and exacerbated by reckless, frivolous and wasteful government spending, adds to the ranks of those that become uninsured.
But they don’t accept that the solution to these and other problems lies in the creation of a bloated, unelected, unaccountable and perpetual bureaucracy. They do believe that someone who is harmed by medical or any other malpractice or incompetence should be properly and fairly compensated, but they don’t believe that the fool who bites into an apple turnover still bubbling from an extended session in the micro-wave should receive hundreds of millions of dollars for their stupidity. So why not tort reform? Could there be a powerful interest group or two at work?
And finally, for those who believe that the defeat and banishment of the current healthcare reform bills will allow them to sleep peacefully once more, I’m afraid I have some disturbing news. The American Recovery and Re-investment Act (HR 1), also known as ‘the stimulus bill’, - the one that nobody bothered to read before it was rushed into law, - contains all the new healthcare rules and information technology infrastructure, together with the necessary funding, for the current administration to achieve a very large part of what they are seeking to enforce through the healthcare reform bills. Don't believe me...................?
For details, go to http://www.rules.house.gov/111/LegText/111_hr1_text.pdf, and read:
Division A, TITLE IX—LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION starting on or about page 129, and,
Division B, TITLE IV—HEALTH INFORMATION TECHNOLOGY starting on or about page 395.
Certainly it creates several new agencies and off-shoots of agencies and czars, and it also mandates the introduction of electronic health records, the better to strip fraud and abuse from the system - and also adjust physician reimbursement rates. There is much there that if used by safe hands there is every expectation that huge financial savings can be won. Unfortunately however, those safe hands are self evidently not available in Washington.
Oh! About Charlie. Well he cheated the cancer, but at way too high a price. He was fifty-eight. He spent his life defending the land that he loved. He leaves a wife and two fine adult sons.
While resting at home after a heavy dose of chemo, he succumbed to a stroke that occurred in almost exactly the same position as his first haemorrhage.
I wonder why they didn’t fix that in the first place. May he rest in peace.
