If America adopts Canada's health care system

[Redeye]

I don't see a problem with more private capital going into infrastructure.  If I was more wealthy, I'd open an MRI clinic and probably make a fortune in no time, provided I could find someone to staff it, which seems to be as big a choke point as the availability of the machines.  What I worry about, being an avid reader of the UK satirical magazine Private Eye, is that PPP/PFI schemes tend to fail.  They've been the darling of the Labour government (who have used private financing initiatives for everything from the NHS to defence) and the results tend to be less than optimal.

While I saw this LA Times article being batted around by the right wingers on Twitter over the last couple of weeks, I wonder how widespread it will end up - and then what the result will be - if the private system will wind up being essentially incorporated into the single payer system - what I mean is, if all the docs shift to work in private clinics - or a significant proportion thereof, will provincial insurance schemes then wind up directing people to their care?  That, I understand, is what happens with the Shouldice Hospital in Toronto, which is a world leader in hernia treatments.

 

[a_majoor]

The issue with the hybrid systems is they tend to attract the worst of both systems, rather than the best.

What is needed is market incentives, which can easily be put in place by having consumers pay diorectly for their health care (just lioke they pay directly for their bread, dental care etc.). Registered Medical Savings Plans where the consumer keeps any residual monies are a good way to incentivise routine medical care (checkups, minor conditions, vaccinations etc.) since consumers will shop around for where they get the best value for money.

Catastrophy insurance for car crashes, debilitating illness shoudl also be a no brainer, the big problem in the US is tax laws and various regulations by both the Federal and State governments impedes the insurance market and prevents "portable" healthcare. The Federal funding through Medicare/Medicaid also distorts the system by stimulating demand, and causing insurance companies to game the system to get the most money from the Federal system as well.

If doctors and providers are more "private" but still need to deal with complex and inefficient bureaucracies to receive payment, then they will become more efficient at gaming the system to get their payments, which is not the desired outcome.

 

[a_majoor]

See how easy it "could" be?

http://www.technicalbard.com/archives/444

On eHealth and Medical Accounting
Oct 9th, 2009 by Taliesyn in Business, Canadian, Economics, Politics, Provincial
No Comments Comments

Terence Corcoran, in another of his excellent descriptions of the flaws of government bureaucracy, explains better than I can why the eHealth fiasco in Ontario is doomed to fail (as such things have failed elsewhere).  But the best part is this quote from Arnie Aberman:

    It is unlikely that the government will succeed in developing one big EMR project — a better approach is to develop standards for communication between software and then let the market produce many different EMR products. After all, that is the way the financial industry succeeded in automating banking.

I have another idea.  Why don’t we let the banks manage the health care spend?  We need to make the money follow the patient – what better way than to give each consumer a credit card that is only good for health care.  When they get services, they present the card and the hospital or doctor bills to that account (which goes to the state insurer).  That way we can track exactly where the money is going.  And the banks will only charge us 1-2% for the service.  Seems better than trying to build a single monolithic network of a system.

 

[a_majoor]

And what happens when money follows the bureaucrats instead:

http://volokh.com/2009/10/10/fined-for-inadequate-insurance/

Fined for Inadequate Insurance

Jonathan H. Adler • October 10, 2009 9:42 am

Wendy Williams and her husband liked their health insurance plan.  The premium and annual deductibles made sense for them, and a more “gold-plated” plan was not worth the money.  Yet Massachusetts’ health care regulators disagreed, and forced the Williams to pay a $1,000 fine if they wished to keep their insurance plan — a plan they prefer to a comparable state-approved alternative.

It wasn’t always this way.  When the Massachusetts mandate was first adopted, their plan was just fine.  But then the rules changed.  The state no longer accepts their insurance plan, even though they are fully insured and are not imposing their health care costs on other taxpayers.

If the federal government adopts an individual mandate, Ms. Williams fears her experience could soon replay itself nationwide.  She’s right to fear.  Once there is an individual mandate, interest groups will flock to Washington seeking to have their preferred treatment or service incorporated into the requirements for acceptable health care plans.  Over time, the requirements will grow, and the cost of health care plans for many Americans will increase as a result.  Consequently, many individuals who have health care plans that fully meet their needs will suddenly find themselves “underinsured” — and taxed fined as a result.

 

[a_majoor]

The truth emerges for all to see (although many people had seen this through the smokescreen long ago):

http://www.commentarymagazine.com/blogs/index.php/rubin/125022

Taxing Our Patients
Jennifer Rubin - 10.13.2009 - 7:45 AM

As the New York Times reports, there is a jumbo fight brewing among Democrats over just how much they’re going to tax the middle class in the name of health-care reform. Senate Democrats want to tax so-called Cadillac health-care plans to pay for the gargantuan health-care bill, while House Democrats don’t think it’s a good idea to whack middle-class voters, and especially union members. Well, on this one, House Democrats have a point:

In a preliminary estimate, the Congressional Joint Committee on Taxation calculated that absent any such employer efforts, 14 percent of family health policies and 19 percent of individual policies would be hit by the tax in 2013. By 2019, according to the estimate, 37 percent of family policies and 41 percent of individual policies would be affected. Those numbers rise over time in these calculations because although the initial tax threshold would increase with the economy’s overall inflation, premiums would be expected to rise even faster.

The tax really won’t be paid, because employers will start cutting back on health-care benefits, say supporters of the scheme. Turning Cadillac health-care plans into Yugo health-care plans won’t be so easy for unionized employers with collective bargaining obligations. But the idea that the problem will be “solved” by taking away current health-care benefits runs smack into Obama’s promise that we’ll all get to keep the health-care benefits we have. Apparently we won’t.

And let’s suppose all employers cut back so there aren’t so many Cadillac plans out there. Where is the money going to come from to pay for the whole scheme? We were promised, you recall, that this reform was going to save money. Well, not if the tax doesn’t materialize.

You can’t help but marvel at what’s going on here. The Democrats are fighting among themselves on how to tax and slash health-care benefits for their own constituents. Democrats fear doing nothing on health-care reform and that wary voters will punish them for inaction. But once voters catch on to what that action is, they may be very, very upset.

 

[a_majoor]

More on why healtrh care costs are rising rapidly. Note the effect of lessening competition; by implication if the Canadian system allowed and encouraged competition, our costs would go down:

http://reason.com/archives/2009/10/20/health-care-nihilism

In Health Care, Nobody Knows Anything
Two new industry studies reignite the debate about what makes health care so expensive.
Ronald Bailey | October 20, 2009

“Nobody knows anything,” is the famous dictum that screenwriter William Goldman once asserted about Hollywood movie-making. Goldman was saying that movie producers have no clue about whether or not a movie will sell until it hits the theaters. There is no formula for a hit movie.

Figuring out health care in America is only slightly more complicated and mysterious than making a hit movie. Fifty million Americans are unable to buy health insurance and premiums have doubled over the past decade. Health care spending in 2009 consumes about $2.5 trillion, more than 17 percent of our gross domestic product. And as spending has skyrocketed, improvements in health outcomes have been real, but modest. What’s going on?

On Saturday, President Barack Obama denounced two new studies, sponsored by the health insurance industry, which found that current health care reform bills in Congress will increase premium prices for consumers. One study, done for the lobbying group America’s Health Insurance Plans by the consultancy PriceWaterhouseCoopers, found that the provisions in the Senate bill sponsored by Sen. Max Baucus (D-Mont.) would add $1,700 a year to the cost of family coverage in 2013 and $600 for a single person. By 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher. A weak individual coverage mandate, coupled with a guarantee issue requirement, no preexisting condition limits, and no rating based on health status would significantly boost insurance premiums.

The Blue Cross Blue Shield Association commissioned a new study by the Oliver Wyman consultancy which also found that guaranteed issue and community rating mandates coupled with a weak individual mandate would drive up premiums by 50 percent for individual policies and 19 percent for small group plans.

“Every time we get close to passing reform, the insurance companies produce these phony studies as a prescription and say, ‘Take one of these, and call us in a decade,’" declared the president. “Well, not this time.”

The president is right that we should always be skeptical of studies that find in favor of the groups that sponsor them. And these two insurance industry-sponsored studies do have their flaws. But the finding that guaranteed issue and community rating mandates increase insurance premium prices has been corroborated by other academic researchers. For example, researchers from MIT, the Brookings Institution, and Brigham Young University reported in a 2008 study published in Forum for Health Economics & Policy that community rating regulations increased premiums for high-deductible policies for individuals by as much as 17 percent and families by as much 33 percent in the nongroup market. In addition, the researchers found that the “guarantee issue regulations that accompany community rating regulations in New Jersey are associated with premium increases of well over 100 percent for individual and family policies.” And as my colleague Peter Suderman recently pointed out, Massachusetts, the one state that combines an individual mandate, community rating, and guaranteed issue, now has the highest premiums for family insurance plans in the country. 

President Obama also denounced the insurance industry malefactors for “making this last-ditch effort to stop reform even as costs continue to rise and our health care dollars continue to be poured into their profits, bonuses, and administrative costs that do nothing to make us healthy—that often actually go toward figuring out how to avoid covering people.” 

Obama is right that administration costs can be quite large. Why would health insurers spend so much money on administration? According to the New England Journal of Medicine, the director of the Office of Management and Budget, Peter Orszag, cites evidence that $830 billion is being spent this year on unnecessary care. That represents about 30 percent of all health care spending. Of course, insurers have a big interest in trying to reduce unnecessary spending, so they hire flocks of administrators to negotiate lower rates and to monitor medical spending charged by doctors and hospital administrators. Government health care programs like Medicare don’t have to negotiate; government agencies just fix prices, which means they fail to combat waste and fraud effectively.

What about those insurance company profits? Back in July, President Obama asserted that health insurance companies are making “record profits.” Not really. The Annenberg Public Policy Center’s FactCheck.org reported, “In general, the health insurance industry did poorly toward the end of 2008 and in the first quarter of 2009, so record profits weren’t likely in the second quarter.” Averaging profits of 3.3 percent, health insurers are the 86th most profitable industry in the U.S., well behind chain restaurants (7.7 percent), electric utilities (6.2 percent), and brewers (18 percent), but ahead of major auto manufacturers (-3.3 percent), resorts and casinos (-8.9 percent), and major airlines (-11 percent).

We’ll pass over the president’s naked attempt to provoke voter envy about the big paychecks of health insurance executives, since taxing them away entirely would not perceptibly lower the costs of health insurance.

So why have health costs, and especially health insurance premiums, skyrocketed since 2000? Let’s look at one plausible theory: market consolidation. In the past two decades, fewer and fewer competitors are exercising more and more monopoly control over health care spending. Case Western Reserve political scientist Joseph White looks at the last time a Democratic administration pushed for health reform. In 1993, recalls White, “costs were expected to quickly hit 14 percent of GDP and rise to 18 percent by the end of the decade.” But that didn’t happen. Why? One plausible story focuses on the rise of health maintenance organizations (HMOs).

The rise of HMOs was enabled by an earlier federal government attempt to rein in health care costs, the Health Maintenance Organization Act of 1973. The idea behind HMOs was that these insurers would control costs by offering a wide array of preventive care to their subscribers. That sounds like a plausible idea until one realizes that people, on average, change insurers every four years or so. An insurer that invested in preventive care was unlikely to reap the cost-saving benefits. Thanks to the spread of HMOs, the 1990s saw the rise in health care expenditures slow down. Why? Chiefly because HMOs fiercely negotiated lower prices from physicians and hospitals. But the era of modest premium price increases didn’t last long.

Hospitals and physicians struck back by beginning to consolidate themselves. As hospital mergers produced local monopolies, they were able to increase their prices substantially. “I find that hospitals increase price by roughly 40 percent following the merger of nearby rivals,” Leemore Dafny, an economist at the Kellogg School of Management at Northwestern University concluded in a 2008 study. Insurers with relatively few patients could not bargain effectively with the new local health monopolies, and so dropped out of those markets. 

According to White, the result of the 1990s orgy of insurer and provider consolidation was that “there were half as many health plans in 2004 as in 1996.” In addition, “in thirty-eight states the largest firm controlled at least one-third of the insurance market; in sixteen states it controlled at least half.” In this analysis, insurers and hospitals have evolved into local oligopolies. One plausible story, it seems, is that an ever more monopolistic health care system has been fueling the recent double digit increases in health care costs.

But then you remember, nobody knows anything when it comes to health care. In 2003, the Federal Trade Commission issued a report that concluded that there was “no valid empirical basis” for the claim that consolidations among hospitals “have accounted for increases on hospital services.” But what about consolidation among insurers? “The insurance industry is congenitally weak in bargaining with supply side of the American health sector,” explained Princeton University health economist Uwe Reinhardt on a recent NPR Money Planet segment. Reinhardt believes that insurers largely dance to the fiscal tune whistled by hospitals and physicians.

 

[a_majoor]

Nothing to worry about...

http://online.wsj.com/article/SB10001424052748704204304574545733826430664.html

Great Moments in Socialized Medicine

If women are discouraged from getting mammograms, as a U.S. government panel recently advised, some will die, but at least others will be spared the discomfort of getting mammograms. There isn't a similar upside to the following decision by Britain's socialized medical system, described by London's Daily Mail:

  Liver cancer sufferers are being condemned to an early death by being denied a new drug on the Health Service, campaigners warn.

    They criticised draft guidance that will effectively ban the drug sorafenib--which is routinely used in every other country where it is licensed.

    Trials show the drug, which costs £36,000 [about $60,000] a year, can increase survival by around six months for patients who have run out of options.

    The Government's rationing body, the National Institute for Health and Clinical Excellence (Nice) said the overall cost was "simply too high" to justify the 'benefit to patients'.

Buck up, liver cancer sufferers! "In Britain, the government itself runs the hospitals and employs the doctors," former Enron adviser Paul Krugman assures you. "We've all heard scare stories about how that works in practice; these stories are false."

I wonder how eager Mr Krugman would be to have himself or his family at the mercy of the UK's health system? He is awfully eager to impose it on others in the United States, though.

And just in case we feel smug:

http://www.cbc.ca/canada/toronto/story/2009/09/30/ontario-health-drug-plan-ombudsman851.html

Ont. cancer drug plan almost cruel: watchdog
Last Updated: Wednesday, September 30, 2009 | 11:45 PM ET

CBC News

Ontario's ombudsman has slammed the provincial government for placing a limit on funding for people taking the colorectal cancer drug Avastin, a policy he calls unjust and arbitrary.

Several cancer patients in Ontario have had to pay for Avastin out of their own pockets or stop treatment after they reached an arbitrary limit set by the government, André Marin said in a report released Wednesday.

The government stops funding the drug after 16 two-week treatments, or about eight months, a limit that isn't supported by medical evidence, he said.

"The funding limit flies in the face of the acceptable standard of oncology practice in this province and beyond," Marin said in his report.

"Regrettably, this situation verges on cruelty for those already afflicted by this unrelenting illness."

Of the seven provinces that fund Avastin, only Ontario has a limit on the number of publicly funded treatments, Marin said. That's an arbitrary cutoff that doesn't take into account whether the patient is responding to treatment, he said.

"That's definitely wrong — not only are you giving false hope but you may also be causing more harm than good by cutting someone off," Marin told reporters in Toronto.

'Dumb as bag of hammers'

Marin is calling on the government to review funding for Avastin treatment on a case-by-case basis.

The ministry did not agree to those recommendations, but said it would work with Cancer Care Ontario toward a new compassionate review policy for cancer drugs, Marin said.

But he sharply criticized the proposed change.

"This policy right now ... is as dumb as a bag of hammers," Marin said. "It has nothing to do with compassion."

It requires patients who have been cut off from funding for Avastin to demonstrate they've tried chemotherapy and it didn't work, he said. This presents a "catch-22" situation, Marin said — people who are showing signs of improvement can't receive government funding.

According to government figures, the average length of survival for people who receive Avastin with other chemotherapy is close to 24 months, compared with 15 months without the drug.

About 14 per cent of colorectal cancer sufferers are doing well beyond the 16 cycles of treatment the province will pay for, Marin said. Each treatment comes with a price tag that ranges between $1,500 and $2,000.

According to an estimate in the report, the province spends about $16.7 million a year in funding Avastin treatment. For an additional annual cost of about $9 million, Marin said, the province can continue providing funding for those cancer sufferers.

He questioned why the province considered that amount too steep, given the provincial health budget stands at around $40 billion.
No medical evidence to warrant change: Caplan

But Health Minister David Caplan dismissed suggestions the drug policy was driven by cost considerations.

"First and foremost, the committee to evaluate drugs looks at the clinical evidence and … the scientific evidence that is produced about the safety and effectiveness of therapies and of drugs," he told reporters.

He accused Marin of using inflammatory language and said he would be open to changing the policy if Marin could provide medical evidence to show a change is needed.

Marin's probe was prompted by complaints from patients, as well as a letter from Progressive Conservative Joyce Savoline saying the 16-cycle limit appears arbitrary.

About 22,000 Canadians are diagnosed with colorectal cancer each year —including 8,100 in Ontario.

 

[a_majoor]

Another data point for people thinking about socialized medicine:

http://www.telegraph.co.uk/comment/columnists/simonheffer/6672409/Want-to-fix-the-NHS-Go-private.html

Want to fix the NHS? Go privateWhen a hospital fails in the way that the Basildon and Thurrock Trust has, it should be turned over immediately to a private-sector hit squad to sort it out, writes Simon Heffer.

By Simon Heffer
Published: 7:22PM GMT 27 Nov 2009

Comments 91 | Comment on this article


Put her on Bupa Photo: Getty One of Labour's great triumphs with the National Health Service is that people now go into hospital to die rather than to be cured. It seems to render the whole debate about assisted suicide utterly pointless. Who needs a Dignitas clinic when you can check into a hospital in Basildon and be relatively certain to be taken out in a box?

It is a further achievement of our monitoring, regulating culture that even the monitors and the regulators don't seem to have a clue how bad things are – or they certainly didn't in Basildon. This exposes one of the great pretences of the NHS: that it is there first and foremost for the benefit of patients. It isn't. It exists these days mostly for the benefit of various trade unionists who are fully paid-up members of the Brown clientele, and who earn good money as petty bureaucrats trying to "manage" things that, if they need to be managed at all, could be far better done by fewer people in much more efficient systems.


Ofsted is simply making schools worse The Government and its apparatchiks have been quick to say that the monitoring regime will itself be better monitored (quis custodiet ipsos custodes, as they no longer say in the schools Labour is also wrecking). What they seem slower on the uptake about is how the hospitals can be improved, and people can be prevented from dying unnecessarily in them.

There is a solution, but it would really put out of joint the noses of the clientele. When a hospital fails in the way that the Basildon and Thurrock Trust has, it should be turned over immediately to a private-sector hit squad to sort it out.

This does not mean violating the terms of the 1946 Act that set up the NHS, and depriving people of a health service free at point of use. It means that the people who provide them with that service do not work for the state, but for contractors employed by it. I can understand that this would upset Leftists in all parties – including in the Tory party, whose policy on the NHS is to do everything identically to Labour – but that would be too bad. The maintenance of the ideological purity of the politically motivated should not be put before the lives of those to whom the state has a duty of care: but that is precisely how things are at the moment.

What, indeed, is to stop the Department of Health from selecting the 10 worst-performing hospitals in the country (though getting accurate data by which to measure their iniquity is clearly, for the moment, a problem) and putting them all out to tender to the private sector? Something similar happens with failing schools. They are bad enough: but a failing hospital is a matter of life or death, and demands radical attention.

The state would pay the private sector to deliver health care to the people through those hospitals. It could be done on three- or five-year rolling contracts, with penalty clauses and scope for immediate termination if the businesses could not do the job properly. This would, of course, entail the providers making a profit, which is what the Leftists claim to hate. But when they cry that "no one should make a profit out of health care", they forget that lots of people already do: from those who work in the NHS to its every supplier – drugs companies, equipment manufacturers, building firms. It is time that preposterous argument was buried once and for all.

It comes down to the point that any politician who willingly allows the present inefficient – and indeed lethal – set of arrangements to pertain will have blood on his or her hands. Does that worry them less than the vested interests of the health service unions? We shall see.

 

[mariomike]

"Palin: Canada should scrap public health care: “Canada needs to dismantle its public health-care system and allow private enterprise to get involved and turn a profit.”:
http://www2.macleans.ca/2009/11/25/palin-canada-should-scrap-public-health-care/

 

[a_majoor]

Health care dynamics (long post, edited to fit):

http://www.zombietime.com/zomblog/?p=1224

Why America Hates Universal Health Care: The Real Reason
Tue, Dec 15, 2009 at 2:41 pm

I watch the debate over health care with amazement. A million words are spoken on the topic with every passing minute, and as far as I can tell no one has ever addressed the real issue that’s upsetting everyone.

So, rather than wait in vain for someone else to finally speak the honest truth about the single-payer system, I’ll just have to do it myself.

• Let’s Get Blunt

America should listen to Dr. Earl Sunderhaus. ASAP. Because he holds the key to the health-care debate.

Who? you might ask. Never heard of him.
   
I hadn’t heard of him either until I saw a brief article last month in the Raleigh News & Observer with the unsubtle headline “Blunt doctor gets in trouble.”

The article detailed the travails of an elderly North Carolina eye doctor named Earl Sunderhaus who opened a 21st-century Pandora’s Box when he poked a patient in the thigh and informed her that she was too fat. Insulted, the patient complained to the state medical board, and now the doctor might lose his license.

But Sunderhaus was not about to back down:

    Sunderhaus notified The News & Observer that he was about to be “screwed” by the medical board. He admitted he told the patient that thick eyeglasses would not cause her to go blind “but her thick thighs and diabetes would.”

    “I poked her thigh to emphasize that diabetes is the leading cause of blindness,” he said Thursday. “People have got to accept criticism without getting their bowels in an uproar.”

He then upped the ante by threatening to counter-sue the medical board.

A follow-up article in the Asheville Citizen-Times gave more details about the eccentric doctor, who has notions that range from the kooky (disband the DEA, compulsory vasectomies) to the enlightened. Turns out Dr. Sunderhaus wasn’t merely poking this one patient in particular, but rather poking an entire nation of patients just like her:

    “They are chastising me for telling her she should lose some weight because it is raising the cost of health care and it is also bad for her children and she is going to end up with diabetes,” Sunderhaus said. “I had to take three days out of my practice and go down to Raleigh, losing income, just because somebody didn’t like that I told her that she was fat.”

    The patient complained that Sunderhaus poked her thigh and told her she was fat, and scolded her as irresponsible for being unemployed and relying on taxpayers to pay for another pregnancy.

    “I told her the thick glasses were not going to blind her, she would go blind because of her thick thighs because diabetes is the No. 1 cause of blindness in this country,” Sunderhaus said.
    …
    Sunderhaus said he feels it is his responsibility as a physician to tell his patients to live healthier lives and that obesity and diabetes are costing the country millions of dollars.
    …
    “Telling this lady that she is fat is the truth, and it’s for her own good health,” Sunderhaus said. “She should be taking better care of herself, and it will be cheaper for us as a society.”

And to drive home his point, he poked the North Carolina Medical Board too,

    “I’m the type of guy who can tell them to stick it up their butt because I am 77 years old, and if they don’t let me practice, I’ll just quit.”

Eccentricities aside, Dr. Sunderhaus has spoken the unspeakable, and by so doing has changed the frame of the health-care debate.

Because millions of Americans are secretly thinking the exact same thing as Dr. Sunderhaus and I: Why should we be forced to pay for the costs of other people’s irresponsibility?

Proponents of the single-payer national health plan can’t understand why anyone would want to oppose the faultless idea of universal health care. It’s completely egalitarian, it’s altruistic, and it’s free, they say. What’s not to like?

• “Free” is an illusion — but that’s not the point

Well, opponents of universal health care have focused on one particular objection to the idea, conclusively demonstrating that it’s not free at all. It’s “free” only in that the government inserts itself as a middleman into the payment system, so that you pay for your health care indirectly in the form of higher taxes to the government which then turns around and gives the money to doctors and hospitals — rather than individuals paying the doctors and hospitals directly. It just looks “free” on the surface. But someone has to pay for the medical care, and under the single-payer concept, that someone is Uncle Sam. But since Uncle Sam gets all his money from American taxpayers … you end up footing the bill anyway, and also footing the bill of a vast new government bureaucracy.

The argument then devolves into the minutiae of which system is more efficient and cost-effective: The current cumbersome HMO system, which still feels overpriced despite the theory that “market dynamics” should keep costs reasonable; or a new system dependent on government red tape, which long experience suggests will be even more cumbersome, less efficient, and ultimately more expensive overall than the flawed free-market system.

And that’s pretty much where the discussion over health care has stalled: If we have to have a middleman unnecessarily taking a cut of our doctor payments, should that middleman be a private company like an HMO — or should it be the government?

To my mind, that question is actually irrelevant. Because there’s a much deeper philosophical objection to “socialized medicine” that is so un-PC that it is rarely if ever voiced in public. And for that reason, the opponents of socialized medicine never even mention the real flaw in the concept that nags the unconscious of most Americans:

Not all ailments are equal.

• Blame: the final taboo

A built-in false assumption with the health-care debate is that sickness is always no-fault sickness. It’s never socially acceptable to assign blame for people’s medical problems — especially blame on the patient.

But I’m not afraid to confess that I’m a judgmental person. And I’m pretty confident that most Americans who oppose socialized medicine share this same judgment: that some people are partly or entirely to blame for their unwellness.

I’m perfectly willing to provide subsidized health care to people who are suffering due to no fault of their own. But in those cases — which, unfortunately, constitute perhaps a majority of all cases — where the unwellness is a consequence of the patient’s own misdeeds, bad habits, or stupid choices, I feel a deep-seated resentment that the rest of us should pick up the tab to fix medical problems that never should have happened in the first place.

I’m speaking specifically of medical problems caused by:

• Obesity
• Cigarette smoking
• Alcohol abuse
• Reckless behavior
• Criminal activity
• Unprotected promiscuous sex
• Use of illicit drugs
• Cultural traditions
• Bad diets

Now, I really don’t care if you overeat, smoke like a chimney, hump like a bunny or forget to lock the safety mechanism on your pistol as you jam it in your waistband. Fine by me. And as a laissez-faire social-libertarian live-and-let-live kind of person, I would never under normal circumstances condemn anyone for any of the behaviors listed above. That is: Until the bill for your stupidity shows up in my mailbox. Then suddenly, I’m forced to care about what you do, because I’m being forced to pay for the consequences.

• Reluctant busybodies

What I don’t like about the very concept of universal health care is that it compels me to become my brother’s keeper and insert myself into the moral decisions of his life. I’d rather grant each person maximum freedom. I’d prefer to let people make whatever choices they want, however stupid or dangerous I may deem those choices to be. Just so long as you take responsibility for your actions, and you reap the consequences and pay for them yourself — hey, be as foolish or hedonistic or selfish or thoughtless as you like. Not my business.

But if the bill for your foolishness shows up in the form of higher taxes on me, then I unwillingly start to care what you do. And, trust me on this, you don’t want me turning my heartless judgmental eye on your foolish lifestyle. Because I’d have no qualms criticizing half the stuff you do.

Do you want that? No. Do I want that? No. And that’s the point. Instituting a single-payer universal health-care system, or even a watered-down version as the government is now proposing, compels me to become a meddlesome busybody in your personal choices. And it will compel you to become a meddlesome busybody in everyone else’s personal choices. It forever douses the beautiful flame of individualism — freedom to act without interference, just so long as you are ready to accept the consequences, whatever they may be.

The attitude of people like Dr. Sunderhaus perhaps offers a way out of this dilemma. Drop the pretense of decorum. If someone has grown obese eating chocolate, the do-gooders would respond by banning chocolate entirely for all of us — to avoid offending the sensibilities of the individual who abused it. Dr. Sunderhaus would just tell the abuser, “Lady, put down that Hershey bar — you’re too fat!” Horrors, horrors!

But if we had a nation of Dr. Sunderhauses, we wouldn’t need socialized medicine. Because each person, at last, would assume complete individual responsibility. And I’d rather that the doctors do the bullying in private to the people who deserve bullying than me being forced to intervene in other people’s private business myself.

Since it’s nearly impossible to sort out who is personally responsible for which ailments, the only logical solution is to let each person pay for their own care, because that way there’s nothing left to argue about. But if we share costs, we share blame, and that’s the origin of resentment and anger that the average American feels about socialized medicine.

Instead of bankrupting the country to pay for foolish people’s foolish decisions, I want to take a giant Sunderhaus finger and poke each American in the thigh and shout: “Shape up!”

 

[a_majoor]

How to get the votes to socialize medicine:

 

[a_majoor]

Jerry Pournelle:

http://www.jerrypournelle.com/view/2009/Q4/view602.html#Friday

Change You Can Believe In, Chicago Style

Today's Wall Street Journal has an editorial worth your attention. There is no better term for the ObamaCare Bill than Despotism. It's all very well for Congressmen and Senators to look out for their states, but this bill is a pure transfer payment from Republicans to Democrats. There is built into the bill a 40% tax on the most comprehensive -- and thus most expensive -- health care plans: But it does not apply to everyone. Longshoremen, for instance, are exempt -- and of course their unions have negotiated some of the most comprehensive healthcare short of what Congress gets. Other lines of work, nearly all heavily unionized, are exempt from the 40% tax (which will pretty well eliminate these plans for those who aren't exempt from the tax). Also, 17 States will be exempt; for the rest it's just too bad. There is no attempt at an explanation for these arbitrary transfers from those taxed to those not taxed. There is no logical reason why some are taxed and some are not. It's simply a set of earmarks, rewards to those supporting the "plan" and punishment for those who don't.

It's exactly what the Constitution was designed to prevent, a despotic transfer of wealth from one group to another.

Change you can believe in.

 

[a_majoor]

And Mark Styen:

http://article.nationalreview.com/print/?q=YjU5OTJmODE4MGM5YmNiZDEyZDU5ZWU3NThhYjdmNGY=

Cross the River, Burn the Bridge
Obamacare is the fast-track to a permanent left-of-center political culture.

By Mark Steyn

Last week, during a bit of banter on Fox News, my colleague Jonah Goldberg reminded me of something I’d all but forgotten. Last September, during his address to Congress on health care, Barack Obama declared: “I am not the first President to take up this cause, but I am determined to be the last.”

Dream on. The monstrous mountain of toxic pustules sprouting from greasy boils metastasizing from malign carbuncles that passed the Senate on Christmas Eve is not the last word in “health” “care,” but the first. It ensures that this is all we’ll be talking about, now and forever.

Government can’t just annex “one-sixth of the U.S. economy” (i.e., the equivalent of annexing the entire British or French economy, or annexing the entire Indian economy twice over) and then just say: “Okay, what’s next? On to cap-and-trade . . . ” Nations that governmentalize health care soon find themselves talking about little else.

In Canada, once the wait times for MRIs and hip surgery start creeping up over two years, the government distracts the citizenry with a Royal Commission appointed to study possible “reforms” which reports back a couple of years later usually with recommendations to “strengthen” the government’s “commitment” to every Canadian’s “right” to health care by renaming the Department of Health the Department of Health Services and abolishing the Agency of Health Administration and replacing it with a new Agency of Administrative Health Operations which would report to a reformed Council of Health Policy Administrative Coordination to be supervised by a streamlined Public Health Operations & Administration Assessment Bureau. This package of “reforms” would cost a mere 12.3 gazillion dollars and usually keeps the lid on the pot until the wait times for MRIs start creeping up over three years.

The other alternative is what the British did earlier this year: They created an exciting new “Patient’s Bill of Rights,” promising every Briton the “right” to hospital treatment within 18 weeks. Believe it or not, that distant deadline shimmering woozily in the languid desert haze can be oddly reassuring if you’ve ever visited a Scottish emergency room on a holiday weekend. And, if the four-and-a-half months go by and you still haven’t been treated, you get your (tax) money back? Ah, no. But there is a free helpline you can call which will give you continuously updated estimates on which month your operation has been rescheduled for. I mention these not as a preview of the horrors to come, but because I’ve come to the bleak conclusion that U.S.-style “health” “reform” is going to be far worse.

We were told we had to do it because of the however many millions of uninsured, yet this bill will leave some 25 million Americans uninsured. On the other hand, millions of young fit healthy Americans in their first jobs who currently take the entirely reasonable view that they do not require health insurance at this stage in their lives will be forced to pay for coverage they neither want nor need. On the other other hand, those Americans who’ve done the boring responsible grown-up thing and have health plans Harry Reid determines to be excessively “generous” will be subject to punitive taxes up to 40 percent. On the other other other hand, if you’re the member of a union which enjoys privileged relations with Commissar Reid you’ll be exempt from that 40 percent shakedown. On the other other other other hand, if you’re already enjoying government health care, well, you’re 83 years old and, let’s face it, it’s hardly worth us giving you that surgery for the minimal contribution you make to society, so in the cause of extending government health care to millions of people who don’t currently get it we’re going to ration it for those currently entitled to it.

Looking at the millions of Americans it leaves uninsured, and the millions it leaves with worse treatment and reduced access, and the millions it makes pay significantly more for their current health care, one can only marvel at Harry Reid’s genius: government health care turns out to be all government and no health care. Adding up the zillions of new taxes and bureaucracies and regulations it imposes on the citizenry, one might almost think that was the only point of the exercise.

That’s why I believe America’s belated embrace of government health care is going to be far more expensive and disastrous than the Euro-Canadian models. Whatever one’s philosophical objection to the Canadian health system, it is, broadly, fair: Unless you’re a cabinet minister or a bigtime hockey player, you’ll enjoy the same equality of crappiness and universal lack of access that everybody else does. But, even before it’s up-and-running, Pelosi-Reid-Obamacare is an impenetrable thicket of contradictory boondoggles, shameless payoffs, and arbitrary shakedowns.

That’s why Nebraska’s grotesque zombie senator Ben Nelson is the perfect poster boy for the new arrangements, and not just another so-called Blue Dog Democrat spayed into compliance by a massive cash injection. There is no reason on earth why Nebraska should be the only state in this Union to have every dime of its increased Medicare tab picked up by the 49 others. So either that privilege will be extended to all, or to favored others, or its asymmetry will be balanced by other precisely targeted lollipops hither and yon. Whatever happens, it’s a dagger at the heart of American federalism, just as the bill’s magisterial proclamation that the Independent Medicare Advisory Board can only be abolished by a two-thirds vote of the Senate strikes at one of the most basic principles of a free society — that no parliament can bind its successors.

These details are obnoxious not merely in and of themselves but because they tell us the truth about where we’re headed: Think of the way almost every Big Government project bursts its bodice and winds up bigger and more bloated than its creators allegedly foresaw. In this instance, the stays come pre-loosened, and studded with loopholes. Because the Democrat operators — the Nancy Pelosis and Barney Franks — know that what matters is to get something, anything across the river, and then burn the bridge behind you.

My Republican friends often seem to miss the point in this debate: The so-called “public option” is not Page 3,079, Section (f), Clause VII. The entire bill is a public option — because that’s where it leads, remorselessly. The so-called “death panel” is not Page 2,721, Paragraph 19, Sub-section (d), but again the entire bill — because it inserts the power of the state between you and your doctor, and in effect assumes jurisdiction over your body. As the savvier Dems have always known, once you’ve crossed the Rubicon, you can endlessly re-reform your health reform until the end of time, and all the stuff you didn’t get this go-round will fall into place, and very quickly.

As I’ve been saying for over a year now, “health care” is the fast-track to a permanent left-of-center political culture. The unlovely Democrats on public display in the week before Christmas may seem like just a bunch of jelly-spined opportunists, grubby wardheelers and rapacious kleptocrats, but the smarter ones are showing great strategic clarity. Alas for the rest of us, Euro-style government on a Harry Reid/Chris Dodd/Ben Nelson scale will lead to ruin.

— Mark Steyn, a National Review columnist, is author of America Alone. © 2009 Mark Steyn

 

[Bruce Monkhouse]

I'm sorry we don't have NFL teams up here so we aren't as used to dealing with the complications that arise from being a juiced-up space monkey.....


http://www.edmontonsun.com/sports/othersports/2010/01/20/12549166.html
Brock Lesnar calls Canadian health care system "Third World"

By Neil Springer, QMI Agency

Following Wednesday's announcement of a miraculous recovery from a career-threatening intestinal disorder and a planned return to the octagon, UFC heavyweight champion Brock Lesnar ripped into the Canadian health care system.

Lesnar said the worst part of his ordeal, which led to him being forced to pull out of two heavyweight title defences against Shane Carwin, was getting medical treatment in the Great White North.

"Probably the lowest moment was getting care from Canada," Lesnar said on a UFC conference call Wednesday. "They couldn't do anything for me. It was like I was in a Third World country...I had to get out of there.
"Canadians, don't get me wrong here. I love Canada; (it has) some of the best people and hunting in the world. But I wasn't at the right medical facility."

After being admitted to an undisclosed Canadian hospital, Lesnar realized his needs would not be met. He and his wife, Rena, then made a run for the border.
"The hospital that I was at, it wasn't their fault," Lesnar said. "They had some machinery that wasn't working and couldn't do its job. I needed to have (tests) done, so we went where they could be done.

"I knew that I had to get out of there and my wife saved my life. She got me out of there and drove 100 miles-per-hour to get me down to Bismark, N.D.”
When pressed further, Lesnar declined to name which Canadian medical facility he had been admitted to.

"I'm not going to disclose anything," Lesnar said. "The only reason I'm mentioning this -- and I'm mentioning to the United States of America -- is because President Obama's pushing this healthcare reform and obviously I don't want it. I'm a conservative republican...and I'm speaking of behalf of Americans. I'm speaking on behalf of our doctors in the United States that don't want this to happen.

"We don't need socialistic healthcare in America."

 

[a_majoor]

The problem was in the message. Now I get it:

http://www2.timesdispatch.com/rtd/news/opinion/op_ed/article/ED-HINKLE29B_20100128-182402/320790/

Hinkle: Talking Down to the Public Will Surely Work . . .
A. BARTON HINKLE TIMES-DISPATCH COLUMNIST
Published: January 29, 2010
» 12 Comments | Post a Comment

This is a complex issue, and the longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people.

--Barack Obama, State of the Union.

There's a lot in the bill that people are going to like. It's just a question of understanding it.

--ABC's Cokie Roberts, Dec. 20.

What are the immediate plans for recalibrating the message or intensifying the message to explain better to the American people what you're trying to do?

--Question to White House Press Secretary Robert Gibbs, Jan. 20.

It mighty big of man with nice voice to take blame like that. Him not need to. Head honchos not often take blame. Most times after big screw-up, head honchos say they have "full confidence" in someone who work for them -- right before pushing someone off edge of cliff, or letting someone twist "slowly, slowly" in wind, like tricky Nixon guy did with man who ran FBI.

Man with nice voice not like those other head honchos. Him bring change to Washington already, see?

But him right. Him not explain health care good. Use too many big words. Say too many compound-complex sentences. Confuse American people. American people not want that. American people want simple explanation. Simpler the better.

Me feel kind of sorry. It must really get on nerves for man with nice voice and people on his side, like lady on TV and cheerleaders in White House press pool. Why can't lamebrain American people get idea through thick skulls? Them not know how to make choices in own best interests! Need enlightened leaders to make choices for them. (Enlightened = smart. Me look this up in thing called "dictionary." Dictionary good! Try sometime!)

Want example? Take mammogram fight. (Mammogram is thing where doctor squish tender woman part really hard and take picture. Owie!) Last year U.S. Preventive Services Task Force say women not need mammogram until age 50. Say squishing younger women not very clinically effective, so not save many lives. Say sometimes "false positives" scare women. This not good. Smart people must protect silly women, make sure they not get scared!

Experts say, from cruising altitude of 32,000 feet saving 12,000 lives over course of 10 years just not worth it. Country should not waste money like that. (Can hardly see someone from that far up anyway.) But crazy right-wing TeaParty people go around saying things like: Well, if it my life or my daughter's life, maybe me feel different. Maybe me should be one to decide to get squished or not. This just show crazy right-wing Tea-Party people always thinking about themselves.

There so many things man with nice voice need to explain gooder. Like, if some people still need health insurance, why not just give them insurance voucher, like housing voucher or food stamps? Why put entire U.S. medical system in Cuisinart and set on Liquefy?

How come House bill create 111 new boards, commissions, and programs? How come, if point is to give insurance, House bill raise big chunk of revenue by fining people without insurance? How that help anyone? This seem crazy to knuckle-dragging trailer-park people, who not know no better. And how come Medicaid and Medicare not doing the job? Isn't that what they for? And if they not do job, then why should people think even bigger program will?

Many American people too stupid to see answers to questions like these, even though they totally obvious.

Man with nice voice also need to explain why it so bad that U.S. spend more on health care than other countries. U.S. spend more on clothes and iPods, too. People in U.S. have more what called "discretionary income." Only spend small share of paycheck on food and rent, so lots left over. Old man want to get knee fixed, why stop him? Him want to buy big new tender woman parts to make hot young trophy wife even hotter, what wrong with that? Seem kind of silly, sure. But man with nice voice need to point out where in Constitution it say White House get to make that call for him.

Stupid American people have strange mad love for Constitution. Crazy right-wing Tea-Party people always making big fat deal out of it. Want to know where it say Congress can make people buy insurance. Freaky house speaker think that Constitution business nonsense. "Are you serious?" she want to know. Crazy right-wing Tea-Party people dead serious. Say government that can make you buy insurance can make you do anything, anything at all. Some even ask what crazy right-wing president and Congress with that kind of power might do. Me not like to think about that!

Whole issue make brain hurt. Good thing man with nice voice in charge. Him have right ideas. Just need to try new angle, that all. Talk slower. Talk louder. Use small words. Treat American people like kid who got held back in elementary school. That bound to work eventually.

The spirit of liberty is the spirit which is not too sure that it is right.

--Judge Learned Hand.

-------------------------------------------------------------------------------

Contact A. Barton Hinkle at (804) 649-6627 or bhinkle@timesdispatch.com.

 

[a_majoor]

Another vote of confidence for Canadian style health care [/sarcasm]. If Obamacare ever passes, where will people like Preimier Williams go for their health care?

http://www.theglobeandmail.com/news/politics/danny-williams-to-undergo-heart-surgery-in-us/article1452524/

Danny Williams travels to U.S. for heart surgery

Newfoundland Premier leaves province for undisclosed location south of the border

Globe and Mail Update
Published on Monday, Feb. 01, 2010 6:28PM EST

Last updated on Tuesday, Feb. 02, 2010 7:44AM EST


The heart and soul of Newfoundland politics is in for repair – and it's not in his home province or even in Canada, for that matter.

Newfoundland Premier Danny Williams is scheduled for heart surgery in the United States, a move that throws into question his province's and his nation's health-care system.

A source confirmed to The Globe and Mail late Monday that Mr. Williams has left St. John's for an undisclosed destination in the U.S. to have heart surgery later in the week.

The 59-year-old Conservative left Monday morning, spokeswoman Elizabeth Matthews said, without disclosing his location. While some of his critics were tight-lipped Monday night, the online public questioned his exodus – why the care he needed was not available in Canada, or whether he preferred treatment in the U.S.

His departure for a U.S. hospital is being met with both sympathy and anger as few details have emerged.

The severity of Mr. Williams's condition is not publicly known, however he was reportedly not overly concerned about his health, as he told close friends his greatest regret was the possibility of missing his Tuesday night hockey outings.

The remaining details are expected to be revealed at a news conference today by Deputy Premier Kathy Dunderdale.

At risk is the already tarnished image of the province's health-care system, which has suffered in recent years.

In October 2008, Mr. Williams apologized for a string of breast cancer test mix-ups. And though he demoted health minister Ross Wiseman last July, he also defended his record, saying there was no other member of his government he'd have rather had lead the portfolio at the time.

The current Minister of Health and Community Services, Jerome Kennedy, declined an interview request last night.

Even Mr. Williams' harshest critics reserved judgment and comments on the matter until more details are revealed, citing the sensitive nature of health troubles.

Newfoundland's Liberal Opposition Leader Yvonne Jones declined to respond to the news, but said she will have something to say this morning after Ms. Dunderdale's public comment on behalf of Mr. Williams.

The medical community was just as reserved.

“It's hard to comment on something that's a personal health issue,” said Robert Bell, chief executive officer of University Health Network, one of Canada's largest groups of hospitals.

However, he added, there could be good reason for Mr. Williams to have the operation in the United States if he has a complex heart condition that requires special expertise.

Rob Ritter, chief executive officer of the Newfoundland and Labrador Medical Association, was also conservative in his comments.

“I don't know if it's something that can be done in Newfoundland or can be done in Canada,” he said.

Even Stephen Harper, known for his battles with the Premier, had only positive words for him last night.

“On behalf of the Prime Minister of Canada, we wish Premier Williams good health and a quick recovery,” wrote Mr. Harper's spokesperson Dimitri Soudas in an e-mail.

Health Minister Leona Aglukkaq declined comment without giving a reason and the federal Liberal party withheld their words, saying there was not enough information to go on.

As far as missing his hockey games goes, Mr. Williams is said to be as driven and competitive on the ice as he has proven to be in politics since the leader of the provincial Progressive Conservatives first rose to national attention with a stunning victory in the fall 2003 election.

Since then, Mr. Williams – a Rhodes scholar and wealthy lawyer who made millions in cable television – has won two provincial elections and his popularity with the electorate of Newfoundland and Labrador, always high, has been said lately to ride at the 80 per cent mark.

One survey named him, by far, the most popular premier in Canada.

His latest battle – before the unsuspected heart problems – was over New Brunswick's plans to sell off its provincial energy provider to Hydro Quebec, an act that Mr. Williams claimed would threaten the energy sovereignty of the entire East Coast.

and via Instapundit:

UPDATE: Reader Geoff Coghlin writes:


I’m a Canadian in Australia, and a great fan of your blog.

The premier heading south is not new. The Canadian political elite has long headed to the US for medical services while – with straight faces – extolling the virtues of socialized medicine for everyone else. And US hospitals are always used to back up a system in Canada that can’t meet demand.

It prompts the question: If the US adopts Obamacare, how will the Canadian health care system survive?

 

[Edward Campbell]

Another vote of confidence for Canadian style health care [/sarcasm]. If Obamacare ever passes, where will people like Preimier Williams go for their health care?
...

Singapore (if they are fortunate enough (rich enough) to qualify for permanent residency), Malaysia, India and China: thousands, yes thousands, five or ten a day, almost every day of the year,* already do so for e.g. joint/hip replacements, organ transplants, heart surgery, post-stroke treatment, and, and, and ... and the flow is increasing, steadily, and not just amongst Asian born Canadians either.


-----
* According to a report I read several months ago (cannot remember where) which said that day-after-day, month in and month out, two or three people left Vancouver and three or four or more left Toronto every single day bound for medical tourism destinations in Asia. India has been the most popular but both Malaysia and China are catching up. I, personally, found brochures for one service planted in an Ottawa medical waiting room and there were posters in the Asian travel agency window just a few doors away.

 

[observor 69]

And  more opinion from the medical community:

http://www.theglobeandmail.com/news/politics/williams-could-have-had-surgery-in-canada-cardiac-experts-say/article1454023/

Williams could have had surgery in Canada, cardiac experts say

Steven Chase and Lisa Priest

Ottawa and Toronto — From Wednesday's Globe and Mail
Published on Tuesday, Feb. 02, 2010 9:50PM EST

Fellow politicians are loath to criticize Danny Williams's decision to forgo Canada's medicare system and pay for heart surgery in the U.S., but cardiac experts insist the Newfoundland Premier could easily have received top-notch care in this country instead.

Mr. Williams, thus far a staunch champion of medicare, has reignited debate about the adequacy of Canada's single-payer system and given opponents of health-care reform in the U.S. ammunition to vindicate their claims.

Arvind Koshal, a prominent Alberta cardiac surgeon, said virtually all heart procedures available in the U.S. are provided in Canada and he thinks Mr. Williams is sending the wrong message by travelling across the border for surgery.

“The optics are very poor, especially for people who are proponents of the Canadian health-care system,” said Dr. Koshal, director of development and external affairs at the Mazankowski Alberta Heart Institute in Edmonton. “It also says if you can buy your way out, then you can go to the U.S. and get it done right away.”

Mr. Williams's office is tight-lipped on the Premier's medical trip, refusing to disclose the location of his treatment or what procedures he will undergo this week. They said he is leaving Newfoundland because the treatment was not available in his home province, but refused to say if Mr. Williams could have been treated elsewhere in Canada.

Wilbert Keon, a heart surgery pioneer in Ottawa and a Conservative senator, said there's “no question” Mr. Williams could have been cared for in Canadian facilities.
“He's going to have to admit that when he recovers and has to face you guys,” he said.

Mr. Williams could get emergency surgery “tonight or tomorrow” in Canada and urgent procedures performed “in a couple of days,” Dr. Keon said. Elective procedures – medically-required but not an emergency – could take weeks.

But the Ottawa doctor doesn't begrudge the Newfoundland Premier for heading south for health care. “If he can afford to pay for that, who can deny somebody the right to drive a Mercedes as opposed to a Honda?”

Dr. Keon said he thinks one reason Canadians might favour U.S. hospitals is their more luxurious facilities.

“If for example he came to the Ottawa Heart Institute he would be in a little private room where there's just a chair for his wife to sit on and his family [would] have to stand around the end of the bed. He goes to one of the American luxury institutions and he gets a suite for his wife and family and so forth.”

Mr. Williams's trip became fodder for opponents of President Barack Obama's proposed reform of the U.S. health care system, which is aimed at extending coverage to most of the country's 47 million uninsured. Although the latest version of Mr. Obama's plan does not include a state-run health plan for Americans under 65, the U.S. right has warned further government involvement in the American system would lead to “Canadian-style” rationing and wait times.

The Newfoundland Premier's move sheds “light once again on the shortcomings of his nation's single-payer system,” charged Americans for Prosperity (AFP), a libertarian advocacy group founded by billionaire oilman David Koch.

Brian Day, a past president of the Canadian Medical Association, said he doesn't begrudge Mr. Williams for paying for care, but wants more private-sector incentives in Canada's health-care system to eradicate waitlists. “It was urgent enough for [Mr. Williams] to be worried about it and if you're worried about [health] you should have the right to do something about it.”

Canada's political class, from St. John's to Victoria, had only sympathy for Mr. Williams as he faces serious surgery.

“I don't think we should read more into this than the fact that Danny Williams, unfortunately, is going to have to have a significant operation,” B.C. premier Gordon Campbell told reporters.

One exception was former Prime Minister's Office director of communications Kory Teneycke who attacked Mr. Williams as a hypocrite for accepting U.S. medical care after his 2008 campaign against Mr. Harper where he warned the federal leader was a threat to medicare. “It's a clear case of hypocrisy,” Mr. Teneycke said. He no longer works for the government and said Ottawa clearly wants to take the “high road” in this instance. “That doesn't prevent others from pointing out the hypocrisy.”

With reports from Konrad Yakabuski, Karen Howlett, Rod Mickleburgh and Dawn Walton

 

[Redeye]

Where will they go?  To hospitals in Canada, like Premier Williams could have, according to a variety of sources.

Ironic that King Danny, who's in the past been a strong defender of universal healthcare, is being held up by the rabid right in the US, before anyone even knows why he went to the US.

Another vote of confidence for Canadian style health care [/sarcasm]. If Obamacare ever passes, where will people like Preimier Williams go for their health care?

http://www.theglobeandmail.com/news/politics/danny-williams-to-undergo-heart-surgery-in-us/article1452524/

and via Instapundit:

 

[VinceW]

A reason why Williams went to the US for his surgery,might be because he was continuing the feud between him and Harper,and use this as a way to embarass the Federal government.