June 24, 2007


Out of America: The US health-care system can work brilliantly, as the recent experience of our correspondent shows. But in a country where 44 million people have no medical insurance, the pressure for change is building (Rupert Cornwell, 24 June 2007, Independent)

Whisper it not to the assembled Democratic presidential candidates, and breathe not a word to Michael Moore, whose new film Sicko hits US movie screens this week. I have just had my first direct encounter with the much reviled US health-care system - and I won't hear a word said against it.

During my regular annual check-up with my GP in April, I mentioned that something was causing severe nerve pains in my leg. He recommended I see an orthopaedic surgeon (in the very same building). The appointment was a week later, and came with an on-the-spot X-ray, which revealed nothing special.

On his instructions I had an MRI scan a few days later, which revealed the problem even to my ignorant eye: a badly herniated, or "slipped", disc that was pressing against the spinal cord and causing the pain.

The specialist prescribed a week's course of steroids, but they made no difference. Surgery, he told me, was the only realistic answer. After the standard pre-op tests, he performed the operation at a very efficient, very friendly and very comfortable local hospital, where I spent a night before being discharged the next day. The whole process, from initial visit to the GP to the surgery itself, took about nine weeks.

The operation seems to have been a total success, and my entire "hospital experience", as they say here, was "very positive". Everything should be paid for by the insurance company - the consultations, the scan, the surgery, the night in hospital. If this is a lousy health-care system, I wonder, what on earth is a good one like?

...how about all the Lefties who want to re-make our health care system in the image of Canada and Britain go to those places for their own care?

Posted by Orrin Judd at June 24, 2007 8:57 AM

And Moore to Cuba for his.

Posted by: Genecis at June 24, 2007 10:24 AM

The poor already have free health care and yeah, I know it's too expensive because they use ER and taxi-cabs to get there, but if we would return to neighborhood clinics, it would be cheaper and they'd get better care.

In their usual heavy handed way, the left want to keep the "poor" riled up, so they can demand what's not in their own self interest while keeping the heat on the guilt-ridden middle class who haven't a clue as the what's going on.

Leftist elites, like themselves, don't care who pays for their excellent health care as long as it's not they.

Posted by: erp at June 24, 2007 10:42 AM

The VA's medical system, often maligned, sometimes unfairly, has served me admirably. They depend primarily on Nurse Practitioners as the first line of care, with MD's as consultants and second level diagnosics. Whatever we end up with nationally in the future, the number of Nurse Practioners will have to be exponentially increased and that could make neighborhood clinics more feasible.

Of interest, the only VA Hospital in NH no longer performs surgery on site but outsources such to Regional hub VA's and most often to local hospitals.

What is given away free is taken freely and there's no question services will necessarily be rationed. A new system of triage for services will have to evolve beyond the current one of wealth, which has worked well for those of us better off. A problem is, how does one explain triage to those denied.

Posted by: Genecis at June 24, 2007 11:07 AM

Genesis, as oj frequently opines, we have plenty of money. The problem is we're spending it on maintenance of the bureaucracy instead of on medical care. Nurse practitioners may be one of the solutions. but I think there would be plenty of very bright young people who will be glad to pledge a stint in the clinic for help with their medical school fees. We have so many options, it really is exciting.

What's really scary is this kind of thinking.

Posted by: erp at June 24, 2007 11:56 AM

"The problem is we're spending it on maintenance of the bureaucracy instead of on medical care."

The problem is actually in doing paperwork and unnecessary scans and tests to prevent a mal-practice suit.

5 years ago, an ob-gyn who has never had a mal-practice law suit told me, his malpractice insurance premium was $200k. How many $100k did he have to make in order to pay the premium?

A dentist told me the way mal-practice premium is accessed, e.g. in 1990, you had treated 10 patients, you paid premiums for 10 patitents; in 1991, you treated 10 more patients, you paid premiums for those 10 patients, plus the premiums of those patients you've treated in 1990, in case they sued you. The premiums pile on and on like a pyramid.

I wonder if we can sue a doctor for mal-practice under universal health care, and who is going to pay for the damages? Right now, we can't sue federal or state officials or employees for incompetence. Under UC, a doctor is a state employee. The govt. is picking up the tab for whatever judgment against the doctor (if he can be sued). That means you and me, the govt.'s deep pocket, will be paying. Won't that be fun?

Posted by: ic at June 24, 2007 12:23 PM

Well ERP that same problem exists in the public school systems. And yes IC, insurance costs are killing the doctors, I know one who quit his practice because of them. The same problem extends to the ski industry, restaurants, bars and next will be the dry cleaners. Between the lobbyists for the insurance industry and the legal profession the squeeze on our netDP must be enormous.

Posted by: Genecis at June 24, 2007 1:40 PM

You can thank your favorite lib for the state of our public schools and legal system. Their biggest supporters are the teachers unions and the trial lawyers.

Posted by: erp at June 24, 2007 3:41 PM