Posts tagged with: medicine

From the Jan. 5 Acton News & Commentary. This is an edited excerpt of “Health-Care Counter-Reform,” a longer piece Dr. Condit wrote for the November 2010 issue of the Linacre Quarterly, published by the Catholic Medical Association. For more on this important issue, see the Acton special report on Christians and Health Care. Dr. Condit is also the author of the 2009 Acton monograph, A Prescription for Health Care Reform, available in the Book Shoppe.

Obamacare and the Threat to Human Dignity

By Dr. Donald P. Condit

Since President Obama signed the Patient Protection Act into law in March 2010, the acrimonious debate on this far-reaching legislation has persisted. For many, the concerns over the Obama administration’s health care reform effort are based on both moral and fiscal grounds. Now, with House Republicans scheduling a vote to repeal “Obamacare” in the days ahead, the debate is once again ratcheting up.

Perceived threats to the sanctity of life have been at the heart of moral objections to the new law. Despite a March 2010 executive order elaborating the Patient Protection Act’s “Consistency with Longstanding Restrictions on the Use of Federal Funds for Abortion,” many pro-life advocates fear a judicial order could reverse long-standing Hyde amendment restrictions on the use of federal tax dollars for abortion. Impending Medicare insolvency and the Patient Protection Act’s establishment of an “independent payment advisory board” to address treatment effectiveness and cost suggest bureaucratic restrictions on the horizon for medical care of the elderly and disabled.

The objections made on fiscal grounds are serious. Prior to the 2008 presidential election, Barack Obama voiced concern for 47 million Americans without health insurance. More recently, supporters of this legislation focused on 32 million Americans, with 15 million immigrants and others left out of the equation, yet still requiring care in United States emergency rooms. The Patient Protection Act increases eligibility for Medicaid recipients, yet state budgets are severely strained with their current underfunded medical obligations. Moreover, doctors struggle to provide health-care access to Medicaid patients when reimbursed below the overhead costs of delivering care.

Who Should Pay?

The perception among consumers of third-party responsibility for health, including payment for health-care resource consumption, is the major factor for unsustainable escalation of medical spending in the United States. Yet the Patient Protection Act augments third-party authority and threatens doctor-patient relationship autonomy, by increasing responsibility of government and employers for health care. Patients and physicians will face increasing involvement of third parties in decision making in exam rooms and at the bedside. (more…)

Acton On The AirDr. Donald Condit joined host Drew Mariani on the Relevant Radio Network to discuss the positives aspects of end-of-life planning as well as the troubling issues surrounding end-of-life care under government health care systems. Dr. Condit is an orthopedic surgeon and the author of Acton’s monograph on health care reform, entitled A Prescription for Health Care Reform and available in the Acton Bookshoppe; he has also authored a number of commentaries on health care for Acton and other organizations; his most recent commentary can be read right here. And don’t forget to check out Acton.org’s special section on Christians and Health Care for a wealth of related information.

To listen to Dr. Condit’s 20 minute interview with Drew Mariani, use the audio player below.

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Blog author: kschmiesing
Wednesday, September 22, 2010
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Among the warnings sounded as the Democratic health care reform bill was being debated was that the federal insurance mandate included in the bill—even though not national health care per se—would essentially give the federal government control of the insurance industry. The reason: If everyone is forced to buy insurance, then the government must deem what sort of insurance qualifies as adequate to meet the mandate. This piece of Obamacare promises to turn every medical procedure into a major political fight, with special interest lobbying rather than objective medical expertise being more likely to determine what kind of health care gets covered and what kind doesn’t.

The problem goes beyond ugly politics, however, and into the realm of moral repugnance. The contention has already started, as the Catholic bishops have formally protested the pending inclusion of contraception and sterilization among items that must be covered in every American insurance plan.

Whether one agrees with Catholic morality is beside the point. The point is that this is no way to deal with a major economic sector in a free, pluralist society. Some medical doctors think chiropractors are quacks; some chiropractors think medical doctors are quacks. Some people think marijuana is an excellent pain killer; others think it is an immoral drug. The goods and services that the 300 million people in this country consider to be effective—or objectionable—instances of health care vary, sometimes dramatically, according to geography, culture, religion, and ethnicity. Now a single institution, the national government in the form of the Department of Health and Human Services, is charged with arbitrating which goods and services make the cut and which don’t. Those who lack the political clout to get their preferences included will pay coming and going: their insurance premiums will cover things that they don’t want and they’ll have to pay out of pocket for things that they do.

The variety offered by a medical market is a beautiful thing. Monolithic medicine mandated by a law that most Americans opposed is not.

Blog author: jballor
Tuesday, August 18, 2009
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A great deal has been made in recent weeks about Ronald Reagan‘s critique of nationalized or socialized health care from 1961:


We can go back a bit further, though, and take a look at an intriguing piece from 1848, a dialogue on socialism and the French Revolution and the relationship of socialism to democracy, which includes Alexis de Tocqueville‘s critique of socialism in general.

One interesting note is that Tocqueville identifies one of the traits common to all forms of socialism as “an incessant, vigorous and extreme appeal to the material passions of man,” including the exhortation, “Let us rehabilitate the body.” Reagan’s point of departure in his broadcast is the observation that “one of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project.”

And here’s Tocqueville on socialism in America:

America today is the one country in the world where democracy is totally sovereign. It is, besides, a country where socialist ideas, which you presume to be in accord with democracy, have held least sway, the country where those who support the socialist cause are certainly in the worst position to advance them[.] I personally would not find it inconvenient if they were to go there and propagate their philosophy, but in their own interests, I would advise them not to.

It may well be that ideologically democracy (as Tocqueville conceived it) and socialism are opposed, as Tocqueville claims. But historically they may well be linked. Lord Acton connected “absolute democracy” (something like majoritarian rule) to socialism: “Liberty has not only enemies which it conquers, but perfidious friends, who rob the fruits of its victories: Absolute democracy, socialism.” And once the majority discovers that it can use the power of the State to plunder the wealth of a minority, the road is well-paved toward socialism.

From the UK:

I never for a moment thought that a life could be decided by something as arbitrary as one’s address.

The often-maligned US health care system is by no means a free market for health care services; rather, it is more of a hybrid public/private system. It’s imperfect and in need of reform, to be sure. But heaven help us if that reform takes the form of a governmental takeover of the entire system. How such a “reform” would improve our flawed system is beyond me.

Blog author: mvandermaas
Wednesday, April 30, 2008
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Continuing with my posts highlighting just how wonderful things will be here in the United States when the government finally does its job and takes over the healthcare sector of the economy, I’d like to bring your attention once again to the fabulous success story that is the Canadian health care system:

Last year, the Canadian government issued a series of reports to address the outcry over long wait times for critical tests, procedures and surgeries. Over a two year period:
• Wait times for knee replacements dropped from 440 to 307 days.
• Wait times for hip replacements dropped from 351 to 257 days.
• Wait times for cataract surgeries dropped from 311 to 183 days.
• Wait times for MRIs dropped from 120 to 105 days.
• Wait times for CT scans dropped from 81 to 62 days.
• Wait times for bypass surgeries dropped from 49 to 48 days.

Sure, you might have to wait a couple of months for that lifesaving bypass surgery. But remember: it’s free!

This evening, I attended a showing of Michael Moore’s movie Sicko

I wasn’t expecting much, so maybe it was easy to exceed my expectations. But I was pleasantly surprised that the movie wasn’t far more painful for me to watch. Although certainly not without its flaws, it has something to add. And the movie was well-made, humorous in places, poignant in others– effective and provocative.

Moore is quite critical of insurance companies and HMO’s– and quite complimentary of the health care systems of France, Cuba, Canada, and England. With that combination, you would expect him to be optimistic about the United States moving toward single-payer health care. But his cynicism toward our government– in particular, the often-unsavory relationship between politicians and interest groups– leads him to criticize our system (correctly in many cases) without embracing government as a practical means to his desired end.

Some examples? Early-on, he mentions that Medicare fails to cover a lot of things (although he fails to pile on by talking about the program’s extraordinary expense). And he points to the government’s selective provision of health care to the heroes of 9/11. He also notes that the government provides awesome health care for the detainees at Guantanamo. (He could have bolstered this with the observation that our troops receive health care that is largely illegal in the states– since interest groups have restricted competition from competent providers like physicians’ assistants and nurse practitioners.) Implicitly, he notes the absurdity of restricting trade in pharmaceuticals, health care services, and health insurance. In a word, he isn’t happy with the status quo, but he’s not at all optimistic that our government can or will fix the problem.

The problem with health care– from the point of an economist– is that government is too heavily involved in health care: in addition to the above examples, we could also list Medicare, Medicaid, and most notably, government’s subsidy of health care insurance (as a non-taxed form of compensation).

Because of the subsidy, ironically, those who can afford health care insurance have too much of it. First, by definition, something that is subsidized will be purchased too much (at least in terms of efficiency). Second, imagine how insurance typically operates: it covers rare, catastrophic events. In contrast, health care “insurance” covers everything from allergy shots to cancer. By way of analogy, car insurance of this type would cover everything from door dings and oil changes to severe car accidents. And what would happen to the cost of oil changes, the paperwork associated with oil changes, etc.? We’d have exactly the same sort of mess we have in health care.

With government’s current level of involvement– very far from a market-based system– one can make an argument that a single-payer plan would be an improvement over the status quo. But of course, one can also argue that a single-payer plan would be even worse. A quick look at our education system and the post office indicate that a government-run monopoly is unlikely to deliver decent quality with any kind of efficiency or without special interest politics. This seems to be Moore’s dilemma in the proverbial nutshell.

Sure, there were examples of poor analysis in the movie. For example:
-There was a strange reference to “full employment” in England (when all of Europe struggles with significantly more unemployment than us– due to various employer mandates Moore seems to appreciate);
-He repeats the common reference to U.S. infant mortality rates (vastly oversold since we treat premies different for the purposes of that statistic);
-He repeats the tired canard that schools just need more money (while they already spend more than $10K per student; how much more money do you want to inject into a government-run entity with tremendous monopoly power?); and
-His analysis of other countries seems to miss the important factor that their populations are smaller and more homogeneous than ours.

And I suppose that other viewers– perhaps most who would see Moore’s film– could see a call for bringing socialized medicine to the U.S. in Moore’s work. But a more nuanced reading of the film points to an idealistic but laudable desire that our health care system would be something better– without holding out much hope that our politicians will be able to deliver us closer to that outcome.

— Also see Dr. Don Condit’s Acton Commentary: What’s Wacko about Sicko? – Ed.

Don Surber thinks so, and it’s hard to argue his point when you see stories like this:

Sorry about the wait for that angioplasty...

Sorry about the wait for that angioplasty...


More than 400 Canadians in the full throes of a heart attack or other cardiac emergency have been sent to the United States because no hospital can provide the lifesaving care they require here.

Most of the heart patients who have been sent south since 2003 typically show up in Ontario hospitals, where they are given clot-busting drugs. If those drugs fail to open their clogged arteries, the scramble to locate angioplasty in the United States begins…

…While other provinces have sent patients out of country – British Columbia has sent 75 pregnant women or their babies to Washington State since February, 2007 – nowhere is the problem as acute as in Ontario.

At least 188 neurosurgery patients and 421 emergency cardiac patients have been sent to the United States from Ontario since the 2003-2004 fiscal year to Feb. 21 this year. Add to that 25 women with high-risk pregnancies sent south of the border in 2007.

Although Queen’s Park says it is ensuring patients receive emergency care when they need it, Progressive Conservative health critic Elizabeth Witmer says it reflects poor planning.

That is particularly the case with neurosurgery, she said, noting that four reports since 2003 have predicted a looming shortage.

“This province and the number of people going outside for care – it’s increasing in every area,” Ms. Witmer said.

“I definitely believe that it is very bad planning. …We’re simply unable to meet the demand, but we don’t even know what the demand is.”

Read that last line again: “We’re simply unable to meet the demand, but we don’t even know what the demand is.”

Well, that’s a confidence builder.

The Canadian system is supposedly one of the main models upon which the coming American health care revolution will be based. And yet this wondrous Canadian system seems to be more and more incapable of providing relatively common medical procedures to Canadian citizens, even in Canada’s most populous province. Because the system is controlled by a bureaucracy, it doesn’t respond to market pressures (goodness knows that most of the time, bureaucracies barely respond to political pressure) and in fact can’t even figure out what the market is demanding. All of this results in the Canadian government relying on the supposedly inferior US system to provide lifesaving care in many instances. No wonder 3 out of 4 Canadians live within easy driving distance of the US border.

So what happens if we decide to go down the path toward single-payer health care in the US? You’d have to be a fool to think that we could try the same thing that the Europeans and Canadians have done and get different results. No, in the long run, we’ll experience the same sorts of inefficiencies, quality and supply problems that plague the government systems, and yes, more Canadians will die, because the safety net that currently exists for the Canadian system here in the United States will be gone.

More: Check out the video after the jump… (more…)

As a person with a strong family history of cancer, this story warmed my heart. Oh wait, did I say “warmed my heart”? What I meant to say was “chilled me to the bone“:

Created 60 years ago as a cornerstone of the British welfare state, the National Health Service is devoted to the principle of free medical care for everyone. But recently it has been wrestling with a problem its founders never anticipated: how to handle patients with complex illnesses who want to pay for parts of their treatment while receiving the rest free from the health service…

…One such case was Debbie Hirst’s. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist’s support, she decided last year to try to pay the $120,000 cost herself, while continuing with the rest of her publicly financed treatment.

By December, she had raised $20,000 and was preparing to sell her house to raise more. But then the government, which had tacitly allowed such arrangements before, put its foot down. Mrs. Hirst heard the news from her doctor.

“He looked at me and said: ‘I’m so sorry, Debbie. I’ve had my wrists slapped from the people upstairs, and I can no longer offer you that service,’ ” Mrs. Hirst said in an interview.

“I said, ‘Where does that leave me?’ He said, ‘If you pay for Avastin, you’ll have to pay for everything’ ” — in other words, for all her cancer treatment, far more than she could afford.

Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones…

…in a final irony, Mrs. Hirst was told early this month that her cancer had spread and that her condition had deteriorated so much that she could have the Avastin after all — paid for by the health service. In other words, a system that forbade her to buy the medicine earlier was now saying that she was so sick she could have it at public expense.

Mrs. Hirst is pleased, but up to a point. Avastin is not a cure, but a way to extend her life, perhaps only by several months, and she has missed valuable time. “It may be too bloody late,” she said.

I’m simply thrilled that so many people are so keen on introducing this system to the United States.

It’s a shame that the marvel of government-controlled health care hasn’t been implemented in the US yet:

Seriously ill patients are being kept in ambulances outside hospitals for hours so NHS trusts do not miss Government targets.
Thousands of people a year are having to wait outside accident and emergency departments because trusts will not let them in until they can treat them within four hours, in line with a Labour pledge.

What a fool I’ve been to oppose this massive improvement in standards of care. Hat tip to The Corner for pointing this one out.