OBAMA AND HEALTH CARE
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Obama's Real Goal Is a Complete Government Takeover of Healthcare
- Obama is on record as having stated emphatically, in a 2003 speech at an AFL-CIO event: “I happen to be a proponent of a single-payer, universal health care plan”—i.e., a government-run system. But by 2007, with the White House clearly within his reach, Obama began to make allowances for the increasingly evident fact that a single-payer plan was not politically palatable to a large enough number of American voters. “I don’t think we’re going to be able to eliminate employer coverage immediately,” he said in May 2007. “There’s going to be potentially some transition process. I can envision a decade out, or 15 years out, or 20 years out.” He made similar references to a “transition step” and “a transitional system” on other occasions during the campaign. In the summer of 2008, Obama declared that “if I were designing a system from scratch, I would probably go ahead with a single-payer system,” but acknowledged that from a practical standpoint, such a result could only come about “over time.” Thus Obamacare—i.e., the Affordable Care Act (ACA)—was deliberately designed to be a stepping stone toward total government control of healthcare.
- Deomocratic Congresswoman Jan Schakowsky, speaking to a group of supporters in 2009, proudly and emphatically acknowledged that the primary, long-term purpose of Obamacare was to put private insurers out of business: “The goal of health care reform is not to protect the private health insurance industry. And I am so confident in the superiority of a public health care option ... I know that many of you here today are single-payer advocates and so am I ... This is not a principled fight. This is a fight about strategy for getting there, and I belive we will.”
Making a Fraudulent Case for Healthcare Reform
In July 2009, President Obama and the Democrats began to push aggressively for healthcare reform, seeking to institute a “public option” for a government-run health care plan that would quickly drive all private insurers out of business. As justification for this measure, Obama cited the “crisis” of 46 million Americans allegedly unable to obtain or afford health insurance. But as Sally Pipes explains in her book, The Top Ten Myths of American Health Care, the “46 million” figure cited by Obama was entirely inaccurate:
- First, about 14 million of those uninsured were low-income Americans who were fully eligible for government-assistance programs like Medicare, Medicaid, and SCHIP—but who simply had never gotten around to enrolling in those programs. They could visit a doctor, clinic, or hospital anywhere in the country and enroll in the programs, on the spot, and receive treatment. Those 14 million people could not, by any reasonable standard, be considered “uninsured.”
- Another 10 million of the uninsured were not U.S. citizens; many of them were illegal immigrants.
- And some 28 million of the 46 million uninsured earned more than $50,000 annually—well above the median income nationally. Many of those 28 million were healthy young adults who were not insured by their employers and who chose not to buy insurance on their own because they preferred to use their money for other things. Indeed, Americans aged 19 to 29 represented one of the largest and fastest-growing segments of the uninsured population.
- The demographic groups cited in the paragraphs above were not mutually exclusive; there was some overlap. And indeed some people did “fall through the cracks.” These were mostly people who earned less than $50,000 per year but too much to qualify for government assistance. There were approximately 8 million of these chronically uninsured, and they were indeed in need of assistance.
Obama Lies Repeatedly about His Late Mother's Alleged Health-Insurance Problem
- As Jonathan Toobin reported in Commentary magazine: “During the 2008 campaign and throughout the subsequent debate over his health care legislation, President Obama [repeatedly] used his mother’s experience as a cancer patient fighting to get coverage to pay for treatment for what her insurer said was a pre-existing condition as an emotional argument to sway skeptics. However, a new book by New York Times reporter Janny Scott has revealed this story appears to be a fabrication.... [In fact, the only] dispute concerned a Cigna disability insurance policy[,] and ... her actual health insurer had apparently reimbursed most of her medical expenses without argument. In response to inquiries, 'a White House spokesman chose not to dispute either Ms. Scott’s account or Mr. Obama’s memory, while arguing that Mr. Obama’s broader point remained salient.' In other words, Obama lied in order to make a political point.”
Obamacare's Real Cost Is Three Times Higher Than the President Promised
- In 2009, President Obama promised a joint session of Congress that his healthcare reform legislation would cost “around $900 billion over 10 years.” But in 2012, a Senate Budget Committee analysis (based on Congressional Budget Office estimates and growth rates) found that total spending under the law would be at least $2.6 trillion over ten years.
Hospitals Barred from Readmitting Patients for 30 Days after Discharge
- Beginning October 1, 2012, hospitals that re-admit patients within 30 days after they were discharged will be required, under an Obamacare provision designed as a cost-cutting measure, to pay stiff fines. These fines could force hospitals to dramatically cut back programs that help the elderly, the poor, and the chronically ill. The Associated Press reports that “about two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates.” Moreover, large teaching hospitals that are affiliated with universities could be impacted most severely by this Obamacare provision, because they are often on the proverbial front lines in treating the elderly, the poor, and people with difficult-to-diagnose maladies who require frequent readmission to the hospital for urgent care.
Obamacare's Steep Cuts to Medicare Will Cost the Lives of Senior Citizens
- According to the Congressional Budget, Obamacare cuts $716 billion from Medicare’s future funding over the next ten years. That will e less money to pay hospitals, doctors, hospice care, dialysis centers and Advantage plans that care for senior citizens.
- Hospitals will have $247 billion less to dedicate to the care of seniors than if the healthcare law had not been enacted.
- These cuts will force hospitals to reduce care, thereby lowering survival rates for elderly patients.
- Obama contends that these Medicare cuts will merely stop the practice of “overpaying” providers. But according to federal data, Medicare already pays hospitals only 91 cents per dollar of care.
- Richard Foster, chief actuary of Medicare and Medicaid Services, has warned Congress that ObamaCare’s cuts in hospital payments could cause 15% of hospitals to stop accepting Medicare.
- Other hospitals will respond to the funding shortfall by reducing nurse care.
- There is historical evidence that these reductions in care are inevitable. As author Betsy McCaughey points out: “When Medicare cut payment rates to hospitals in the Balanced Budget Act of 1997, hospitals hit with the largest reductions in Medicare revenue (over $1,000 per patient) trimmed nursing staff to make ends meet. Eventually, patients at these hospitals had a 6 percent to 8 percent worse chance of surviving a heart attack than patients at hospitals hit less hard by theMedicare cuts, according to the National Bureau of Economic Research. And even the largest cuts to hospitals in 1997 are small compared with what’s coming under Obamacare.... Elderly patients treated at low-spending hospitals get less care and are at higher risk of dying.... [H]eart-attack patients at low-spending hospitals (bottom quintile) are 19 percent more likely to die than patients of the same age at higher-spending hospitals (top quintile). Similarly, patients with pneumonia, congestive heart failure and stroke had [higher] chances of dying at the low-spending hospitals than patients of the same age and illness at hospitals that spend more per senior.”
- In addition to the across-the-board cuts in hospital payments, the Obama administration in 2012 began awarding bonuses to hospitals that spent the least amount of money per senior patient.
The “Death Panel”
- Obamacare calls for the establishment of a Medicare Independent Payment Advisory Board (IPAB), a panel of 15 unelected bureaucrats who will decide which procedures and medications it will authorize for various patients, based on cost considerations and potential benefits for the patient. Like its equivalent in the British healthcare system, the IPAB will give preference to young people over older people, and to healthy people over those with chronic disease.
The Individual Health Care Mandate
- Obamacare requires almost all Americans to buy health insurance. Those who fail to comply will have to pay a penalty. For individuals, that penalty (as of 2016) will be $695 or 2.5% of household income up to $2,085, whichever is higher. Obamacare sets aside $10 billion for the IRS to pay at least 16,000 new agents who will enforce compliance.
The Employer Mandate
- Employers with 50 or more workers must offer their employees federally approved insurance options. Those who fail to comply will have to pay a penalty of $2,000 per worker. Notably, those fines may prove to be less costly than actually offering health insurance, thus many employers are expected to cancel their existing policies and simply pay the penalties instead. The Congressional Budget Office estimates that 14 million workers will be affected by this. Those workers will then turn, largely, to state-based Health Benefits Exchanges.
How the Health Benefits Exchanges Will Work
- Lower-income individuals (those earning between 133% and 400% of the Federal Poverty Level—i.e., $14,403 to $43,320) can qualify for government subsidies to help them purchase insurance through these Exchanges. For a family of four, the corresponding range of subsidy eligibility will be $29,326 to $88,200.
Obamacare Prohibits Insurers from Canceling Policies of Unhealthy People
- Such cancellations have already been illegal for more than a decade, thus the provision is a meaningless public-relations gimmick.
Obamacare Bans Lifetime, Annual, and Dollar-Amount Caps on Benefits
- This ban will eliminate the current option that allows people to select a less-expensive plan with a very reasonable $2 million limit on coverage. Everyone will instead be funneled into costlier plans.
No One Can Be Denied Insurance, or Charged Extra Because of Their Health Risks
- Obamacare requires insurers to approve, at a specified cost, 100% of health insurance applicants, regardless of their health, and regardless of any risky behavior patterns in which they may routinely engage. Within any designated geographic area, for example, a 35-year-old, obese, diabetic alcoholic who shares dirty heroin needles with his friends, cannot be charged any more for insurance than a fit, athletic 35-year-old who lives a clean, substance-free lifestyle.
The Goal Is to Drive Private Insurers out of Business
- The additional burdens that Obamacare places on private insurers, whose profit margins currently stand at a mere 3.4%, are designed to ultimately drive those insurers out of business.
Obamacare Expands Medicaid by 18 Million People
- Obamacare increases Medicaid eligibility to 133% of the Federal Poverty Level, and to childless adults aged 26 and under. This will add some 18 million people to the Medicaid rolls, bringing the total to about 84 million. This expansion of Medicaid will require at least 159 new agencies, boards, and commissions to administer—with the assistance of dozens of already-existing federal bureaus.
Obama Administration Acknowledges that Obamacare Will Raise Health Insurance Premiums
- In 2009, MIT economist Jonathan Gruber, the chief architect of ObamaCare, reviewed a report by the insurance industry contending that health insurance premiums would rise sharply with the passage of the healthcare bill (i.e., the Affordable Care Act). At that time (2009), Gruber argued that the industry report failed to take into account government subsidies that would help moderate-income Americans purchase insurance, or administrative overhead costs which he predicted would “fall enormously” once insurance polices were sold through the anticipated government-regulated marketplaces, or exchanges. “If you literally take the data from the Congressional Budget Office (CBO) you can see that individuals will be saving money in a nongroup market,” he said.
- On September 22, 2010, in an informal discussion regarding the healthcare bill, President Obama likewise contended that “as a consequence of the Affordable Care Act, premiums are going to be lower than they would be otherwise; health care costs overall are going to be lower than they would be otherwise. And that means, by the way, that the deficit is going to be lower than it would be otherwise.”
- But in late 2011 and early 2012, Jonathan Gruber backtracked on his previous analysis. He now told officials in Wisconsin, Minnesota and Colorado the price of insurance premiums would “dramatically increase” under the reforms. In backtracking on his original analysis, Gruber noted that “even after tax credits some individuals are ‘losers,’ in that they pay more than before reform.” “After the application of tax subsidies, 59% of the individual market [in Wisconsin] will experience an average premium increase of 31%,” Gruber estimated. Similarly, Gruber estimated that 32% of Minnesotans would face hikes similar to those in Wisconsin.
- On September 24, 2012, Investor's Business Daily reported the following: “During his first run for president, Barack Obama [repeatedly] made one very specific promise to voters: He would cut health insurance premiums for families by $2,500, and do so in his first term. But it turns out that family premiums have increased by more than $3,000 since Obama's vow, according to the latest annual Kaiser Family Foundation employee health benefits survey. Premiums for employer-provided family coverage rose $3,065—24%—from 2008 to 2012, the Kaiser survey found. Even if you start counting in 2009, premiums have climbed $2,370. What's more, premiums climbed faster in Obama's four years than they did in the previous four under President Bush, the survey data show.
- The Investor's Business Daily report added: “And Obamacare will continue to fuel health premium inflation. First, the law piles on new coverage mandates. It requires insurance companies to provide 100% coverage for various types of preventive care, bans lifetime coverage limits, extends parents' coverage to offspring up to 26 years old, and requires plans to meet certain 'medical loss ratios.' Coming up are rules on 'essential standard benefits,' limits on deductibles, bans on annual spending caps, and much more. The experience with state mandates show that they only tend to grow over time, and get more expensive.... Meanwhile, Obamacare's insurance reforms—guaranteed issue and community rating—will likely raise premiums, too. States that have tried these reforms—which forbid insurers from denying coverage based on preexisting conditions or charging the sick more—have seen insurance premiums spiral upward as healthy people leave the market, knowing they are guaranteed coverage when they get sick.”
Early Indicators of Obamacare's Destructive Effects
On October 2, 2012, Forbes magazine reported the following about Obamacare (a.k.a., the Affordable Care Act, or ACA):
- “A key source of the ACA’s projected savings, the CLASS entitlement designed to provide unlimited, lifetime benefits for long-term care, was quickly abandoned. Recognizing that its premiums, $86 billion by 2021, would finance the rest of Obamacare instead of its own costs, Sen. Kent Conrad (D-ND) called CLASS 'a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of,' and vowed to block its inclusion in the Senate bill. Medicare Chief Actuary Richard Foster calculated the program needed to enroll more than 230 million—more than the entire nation’s workforce—to be financially feasible. HHS Secretary Kathleen Sebelius was forced to admit last October that the plan simply wouldn’t work.”
- “The ACA’s medical device tax—on revenues, not just profits—is already destroying high-paying jobs for Americans and moving them overseas. Directly accounting for more than 400,000 high-paying U.S. jobs of the sort our young people seek, these companies are already eliminating jobs because of ACA’s onerous taxes. ACA’s new taxes will cost Boston Scientific more than $100 million a year, so they built a $35 million research center in Ireland instead of the U.S. and announced another $150 million site in China. Stryker of Michigan announced job cuts of 1,000 workers last November 'in advance of the new Medical Device Excise Tax.' CEO Curt Hartman reiterated this month that the tax will force companies to move their operations overseas, eliminating American jobs. Cook Medical of Indiana scrapped plans to open five new plants in the Midwest, while saying 'in reality, we’re not looking at the U.S. to build factories anymore as long as this tax is in place.' CEO Alex Lukianov of San Diego’s NuVasive wrote 'to offset this tax increase, we will be forced to reduce investments in research and development and cut up to 200 planned new jobs next year', and 'as a result of the law, for the first time in our history we are being compelled to consider moving manufacturing, clinical trials and investment in new innovation to more business-friendly countries.' And CEO Mark Waite of Lighthouse Imaging in Maine stated what is obvious to anyone with an understanding of business—'This [tax] will end up making the cost of goods higher, and since most of these medical devices are required, as opposed to being optional, that cost gets passed on to the consumer and the cost of care goes up.'”
- “The Medical Loss Ratio mandate is already forcing insurers out of the market and reducing insurance choices for Americans. Five insurers, including two of the nation’s largest, already decided to stop selling health insurance in Indiana, mainly because of the ACA edict … Ironically, young adults are also seeing their choices disappear, as colleges are dropping low cost, limited coverage plans altogether or pricing students out of health insurance because of these actuarial requirements and the bureaucrat-defined list of 'essential' benefits dictated by ObamaCare.”
- “A repeated series of waivers to the ACA were urgently granted by HHS, in order to prevent widespread loss of coverage and substantial premium increases caused by ObamaCare’s own decrees. More than a thousand waivers to unions, states, and corporations that cover about 4 million people were granted to avoid 'significant increases in premiums or significant decreases in access to health care benefits … needed to meet the annual limit requirement,' wrote John Dicken, Director of Health Care Issues for the GAO in his letter to Congress.”
Obamacare: The Biggest Tax Hike in American History
- On June 28, 2012, the Supreme Court upheld the constitutionality of Obamacare, particularly its core provision—the so-called “individual mandate” under which most Americans would be required to buy health care insurance with at least the minimum amount of coverage stipulated by the federal government or pay a fine. Although the Obama administration had tried to characterize the individual mandate as a legitimate exercise of congressional power under the separate Commerce Clause of the Constitution, the Court's opinion rejected that approach and opted to call the fine, imposed on individuals who decide not to buy health insurance despite the mandate, a tax—within the taxing authority of Congress. As Chief Justice John Roberts wrote, that “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
- Obamacare will force small businesses with more than 50 employees to buy “qualifying” health insurance. If they fail to do so, they will be required to pay a tax of up to $2,000 per employee.
- In September 2012, the Congressional Budget Office released a report estimating that 6 million people would be subject to the Obamacare “individual mandate” tax, which would cost them approximately $7 billion in taxes per year. According to the Washington Examiner, most of those 6 million are in the middle class (with incomes below “$60,000 for individuals and $123,000 for families of four). In 2008, Obama pledged that “no family making less than $250,000 a year will see any form of tax increase—not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”
- The individual mandate is just one of many new taxes imposed by Obamacare. According to an analysis by the nonpartisan Congressional Budget Office, Obamacare as a whole constitutes the largest tax hike in American history—and it affects mostly people in the middle class.
Obamacare's Massive Taxes on the Middle Class
Forbes.com identifies the following 7 taxes that Obamacare will impose on people earning less than $250,000 per year:
- Individual Mandate Excise Tax: “Starting in 2014, anyone not buying 'qualifying' health insurance must pay an income tax surtax. It goes up each year until 2016 and beyond when a couple would pay a tax of the higher of $1,360 or 2.5% of adjusted gross income.”
- Over-The-Counter Drugs Trap: “Since Jan. 1, 2011, employees with health savings accounts, flexible spending accounts, or health reimbursement accounts have no longer been able to use pre-tax funds stashed in these accounts to buy over-the-counter medicines for allergy relief and the like without a doctor’s prescription (there’s an exception for insulin).”
- Healthcare Flexible Spending Account Cap: “Starting Jan. 1, 2013, employees will face a $2,500 cap on the amount of pre-tax salary deferrals they can make into a healthcare flexible spending account. There is no cap under current law.”
- Medical Itemized Deduction Hurdle: “Starting Jan. 1, 2013, taxpayers who face high medical expenses will only be allowed a deduction for expenses to the extent they exceed 10% of adjusted gross income, up from 7.5% now. Taxpayers 65 and older can still use the old 7.5% threshold through 2016.
- Health Savings Account Withdrawal Penalty: “Since Jan. 1, 2011, taxpayers who withdraw money from health savings accounts for non-medical expenses before age 65 face a 20% penalty, up from 10% before.”
- Indoor Tanning Services Tax: “Since July 1, 2010, folks using indoor tanning salons face a new 10% excise tax.”
- Cadillac Health Insurance Plan Tax: “Starting in 2018, there will be a new 40% excise tax on taxpayers who are covered by high-cost health insurance plans (with premiums at or above $10,200 for a single or $27,500 for a family). Insurers or employers who are self-insured will pay the tax, but it is expected to trickle down to mean higher costs for consumers.
Obamacare Will Raise Self-Employment Tax Rate
- The healthcare reform bill will raise self-employment tax from 2.9% in 2012 to 3.8% in 2013. This increase, coupled with the rise in the top marginal income-tax rates described above, would raise the marginal income-tax rate on small business profits from its current level of approximately 38%, to about 43% in 2013. This would be devastating to small employers, most of whom have thin profit margins. According to Fox News, “A company with $1 million in profits facing a higher tax rate of 5 percentage points will be saddled with another $50,000 in taxes.”
Obamacare Medical Device Tax
- This 2.3% tax will take effect in 2013 and will affect companies that manufacture devices such as prosthetic limbs, pacemakers, and operating tables. Expected to bring in $20 billion in annual revenues, this tax will be levied on gross sales and thus must be paid even by companies that do not earn a profit in a given fiscal year. The medical-device industry employs 409,000 Americans in 12,000 plants nationwide; many of these incur losses for several years before they are able to turn a profit.
Obamacare Investment Surtax
- “Also taking effect in 2013,” says a Fox News report, “this tax increase captures those few small business owners not covered by the self-employment tax hike: owners of Subchapter-S corporations and limited partners. These owners are currently exempt from self-employment tax, mostly because they are investors rather than proprietors. But Obamacare sweeps them into the IRS net too, forcing them to pay the 3.8 percentage point tax as an 'investor surtax.' This will make it far more difficult for investors to raise money to start up small firms. An investor is going to need to see even greater small business profit projections to overcome this higher 'hurdle rate' of taxes. Not only does a small business owner have to give his investor a strong return on his investment, he now has to do it with a giant tax mill around his neck.”
The Many Failures of Socialized Medicine Around the World
Socialized healthcare systems around the world are invariably beset by serious problems such as rationing of care and medicines; the unavailability of cutting-edge drugs; long waiting lists; and the existence of a bureaucracy determining who merits treatment and who does not. Below is a brief overview of three socialized healthcare systems in other countries.
The British System
In July 1948, England established a National Health Service (NHS) that extended government-administered health insurance to all legal residents of the country. Within two years, more than half a million Britons were on waiting lists for hospitalization, surgery, and other forms of care, and some 40,000 hospital beds were taken out of service because of a nationwide nurse shortage. By 1960 the country's hospital shortage had become so acute that hospitals routinely denied admission to the elderly and the chronically ill, who, once admitted, would have been difficult to discharge because their condition was so fragile.
- In British industrial centers, it was not uncommon for individual doctors to be responsible for the care of as many as 4,000 registered patients each. In many cases, these doctors were able to give each patient only three minutes of their time per visit.
- During the decades since then, the situation has not improved. As of 2008, more than a million Britons in need of medical care were on waiting lists for hospital admission. Another 200,000 were trying to get onto such waiting lists.
- According to the BBC, British patients face an average wait time of 8 months for cataract surgery; 11 months for a hip replacement; 12 months for a knee replacement; 5 months for slipped-disc surgery; and 5 months for a hernia repair.
- In many cases, the condition of patients with diseases that were curable at the time of diagnosis degrades to the point of incurability by the time treatment finally becomes available; other patients become too weak to undergo whatever surgical procedures had originally been recommended for them.
- Each year the NHS cancels approximately 100,000 scheduled operations.
- Most British hospitals are, by American standards, of poor quality. Up to 40% of NHS patients are undernourished during their hospital stays.
- The NHS bases its funding decisions on the recommendations of the quasi-governmental National Institute for Clinical Evaluation and Excellence (NICE), a panel that determines which patients merit preference over others in terms of the treatments for which they are eligible, medications they may be given, and how soon they may have access to a doctor. Because of cost considerations, NICE gives preference to young people over older people, and to healthy people over those with chronic disease or with destructive habits such as smoking or alcoholism. NICE is also explicitly tasked with limiting people’s access to many of the latest and most effective drugs, again basing its decisions on what it considers to be most “cost-effective.”
- In recent years, many native Britons have traveled to other countries to undergo major operations that doctors in their homeland lacked the time to perform. As of October 2008, more than 70,000 of these so-called “health tourists” had procured treatment in at least four-dozen other nations.
The Canadian System
- Canada has operated a system of socialized medicine since the early 1970s. During this period, the country has experienced a severe nationwide doctor shortage. For example, more than 1.5 million residents of Ontario (or 12% of that province’s population) cannot find family physicians who have time to accept any new patients. Some provinces actually hold lotteries where a few fortunate winners are granted access to medical care that they otherwise would be unable to obtain.
- Between 1998 and 2008, approximately 11% of physicians who had been trained in Canadian medical schools relocated to the United States—mainly due to financial considerations. Because doctors’ salaries in Canada are negotiated, set, and paid for by provincial governments and are held down by cost-conscious budget analysts, the average Canadian doctor earns only 42% as much as his or her American counterpart.
- Of Canada’s approximately 34 million people, at least 800,000 are currently on waiting lists for surgery and other necessary medical treatments.
- Between 1997 and 2006, the median wait time between a referral from a primary-care doctor for treatment by a specialist increased from 9 weeks to more than 18 weeks.
- A study entitled Waiting Your Turn: Hospital Waiting Lists in Canada, conducted by the Vancouver-based Fraser Institute, reports that Canadian health care patients must wait, on average, 17.7 weeks for admission to a hospital.
- In a 1999 address to to the Canadian Institute for Health Information, Dr. Richard F. Davies, a cardiologist at the University of Ottawa Heart Institute, described how delays in treatment affected heart patients scheduled for coronary artery bypass graft surgery. Specifically, Davies noted that in a single year, “71 Ontario patients died before [being able to undergo this] surgery, 121 were removed from the [waiting] list permanently because they had become medically unfit for surgery,” and 44 left the province to have the surgery performed elsewhere—usually in the United States.
- In a 2004 article in the journal Health Affairs, researcher Robert Blendon and colleagues reported that in Canada, the average wait time for a 65-year-old man requiring a routine hip replacement was more than six months. By contrast, 86% of American hospital administrators reported that the average wait time for such a procedure in the U.S. was less than three weeks.
- In a July 2004 study, Fraser Institute researchers compared the health care systems of 28 industrialized countries belonging to the Organization for Economic Cooperation and Development (OECD). They found that while Canada spent more money on health care than any of the other countries in the sample, it ranked, on average, 24th in terms of such indicators as access to physicians, quality of medical equipment, and key health outcomes. Notably, before the government first took control of Canada's health care system in the early 1970s, the nation ranked second in terms of these same indicators.
- In August 2006, Canadian doctors elected Brian Day president of their national association. A former socialist who counts Fidel Castro as a personal acquaintance, Day has nevertheless become perhaps the most vocal critic of Canadian public health care. He opened his own private surgery center as a remedy for the long waiting lists and then challenged the government to shut him down. “This is a country in which dogs can get a hip replacement in under a week,” Day fumed to the New York Times, “and in which humans can wait two to three years.”
The Cuban System
- Leftists revere Communist Cuba for numerous reasons, not the least of which is the government-run, universal health care system that was put in place by Fidel Castro. Many of these admirers—among the more notable of whom is the filmmaker Michael Moore—form their impressions of the Cuban health care system from its tourist hospitals, which are, by any standards, clean, well staffed, and of excellent quality. Indeed Cuba, in an effort to attract wealthy foreign tourists who might be willing to spend their money on health care services, has pioneered the practice of so-called “health tourism” through agencies such as Servimed, which markets Cuban medical services abroad.
- But hospitals for ordinary Cubans possess a dearth of even the most basic medicines and medical equipment. They have virtually no access to antibiotics, insulin, heart drugs, sphygmomanometers to measure blood pressure, sterile gloves, clean water, syringes, soap, or disinfectants.
- Cuban hospitals typically feature unsanitary conditions. Hospital gowns, linens, and towels must be provided and cleaned by the patients' families. Poor sanitation is extended to the medical instruments handled by doctors and nurses; often these items are not properly sterilized and they remain soiled with traces of tissue and blood after their use. Syringes are frequently used to inject multiple patients without any sterilization, and “disposable” gloves are likewise used and reused. Consequently, infectious diseases are commonplace in the Cuban hospital population.
- Cuba's health care system is a disaster not only for patients but also for physicians. Because of the meager salaries paid to Cuban doctors—on the average 400 pesos per month (equivalent to $20 U.S.)—many have quit the profession to seek jobs in the only industry that offers them any degree of economic opportunity: the Cuban tourism industry. Former doctors in Cuba can commonly be found driving dilapidated taxis, acting as tour guides, or even working in family inns as waiters or cooks. Those who choose to remain in the medical profession work long hours in dismal conditions.
- It is noteworthy that in the pre-Castro years of the 1950s, the Cuban population as a whole had access to good medical care through association clinics which predated the American concept of health maintenance organizations (HMOs) by decades, as well as through private clinics. At that time, the Cuban medical system ranked among the best in the world; its ratio of one physician per 960 patients was rated 10th by the World Health Organization. In addition, Cuba had Latin America's lowest infant-mortality rate, comparable to Canada's and better than those of France, Japan, and Italy.
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