Monday, May 18, 2009

Blame Canada

DEATH OF U.S. HEALTHCAREBy DICK MORRISPublished on on May 12, 2009
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When all of America’s top health insurers and providers met at the White House this week and pledged to save $2 trillion over the next decade in health costs, they were pledging to sabotage our medical care. The blunt truth, which everybody agreed to keep quiet, is that the only way to reduce these costs is to ration healthcare, thereby destroying our system.Here’s why:

• Essential to any cost reduction is a cut in doctors’ fees. Congress is trying to cut Medicare fees by 21 percent. But cuts in fees and doctors’ incomes will just discourage people from entering the profession and those already in it from practicing. The limited number of doctors and nurses in the United States is the key constraint on the availability of healthcare. Our national inventory of 800,000 doctors is growing at only about 1 percent a year (18,000 med school graduates annually minus retirements), while the nurse population is stagnant at 1.4 million. To stretch these limited resources so that they can treat 50 million more people is possible only through the most severe kind of rationing.

• As in Canada, the best way to cut medical costs is to refrain from using the best drugs to treat cancer and other illnesses, thereby economizing at the expense of patients’ lives. Forty-four percent of the drugs approved by the Canadian health authorities for use in their country are not allowed by the healthcare system due to their high cost. As a result, death rates from cancer are 16 percent higher in Canada than in the United States. We will pay for the attempt to save $2 trillion with our lives. (And remember, one cannot opt out of the Canadian system and pay for the medications out of pocket.)• The only real way to save money on the scale projected is to ration healthcare services. Optimists say that this can be achieved by increased use of preventive care. But the Canadian experience indicates that when government — or its satellite private insurance providers — ration healthcare, they cut preventive care first. In Canada, colonoscopies are so rationed that the colon cancer rate is 25 percent higher than in the U.S. (even though Canada has a much smaller proportion of poor people, whose frequently bad diets make them more prone to the disease).