vs. Your Health
Medicine really the answer?
The United States has the best healthcare system in the
world. There is no dispute about that. The problem with our
healthcare system is not the quality -- but the cost. But
how do you bring down the cost?
Democrats believe they know the answer: Just get the government
to take it over! But does that REALLY bring down the cost?
Is our government -- who brought us the $435 hammer and the
Bridge to Nowhere -- really the lowest cost provider for
following article is reprinted from the Eden Prairie News, Thursday, November
Who Is Kidding Whom?
By: Carolyn Rebholz, Eden
Rep. Maria Ruud and Rep. John Benson of Minnetonka are proposing “Universal
Health Care for all Minnesotans by 2011.” This is not the answer,
and it is mediocrity at best.
In the past 18 months my husband has been hospitalized several times
in two different facilities for surgical procedures for a life-threatening
condition. His private health insurance was excellent. Upon his final
exit interview after the last procedure on his way to better health,
we visited various caregivers in that facility who had provided superb
assistance. We wanted to thank them for everything. One response to
my husband was “At your age  the lines to receive specialized
care under Universal Health Care would have been so long, you’d
likely be dead.” Thank goodness we have an opportunity for private
The notion that Universal Health Care will provide “high quality
affordable health care” is just another “sounds good” governmental
ploy to control individual choice.
following article is reprinted from the Minneapolis Star Tribune, Monday, October
why we must resist SCHIP expansion
By: Rep. Michele Bachmann (R-MN)
Congress is engaged in a debate about the future of
health care in America and about what should have been
a proposal to extend affordable coverage for low-income
The State Children's Health Insurance Program, or
SCHIP, is set to expire soon. This decade-old program
offers states federal funding to provide health insurance
for children in households that do not qualify for
Medicaid but cannot afford private coverage.
Unfortunately, the program has become politicized,
and Congress recently passed legislation to expand
SCHIP coverage beyond children, beyond U.S. citizens
and beyond those who are truly in need, and, contrary
to the Star Tribune's editorial (Oct. 5), that is where
the problem lies.
According to the U.S. Census Bureau, several million
SCHIP-eligible children are uninsured. Surely, children
in need should have the health insurance promised to
them before SCHIP is expanded further up the income
ladder or before more of the program's limited resources
are used for adults.
Here's my idea: Let's cover the kids first. Let's
focus on children in need who don't have access to
health insurance and fund SCHIP as it was meant to
be. I've publicly supported legislation that would
accomplish these goals and keep SCHIP moving forward
to help those it was intended to help.
But some want to move SCHIP in the wrong direction.
Under the bill passed by Congress and vetoed by the
president, SCHIP dollars could be used to cover childless
adults and more-affluent families -- in some cases,
households earning up to $83,000 per year. It also
changes current law to make it easier for illegal immigrants
to get SCHIP funds.
A Congressional Budget Office study shows that more
than 77 percent of children affected by this expansion
already have personal, private health insurance. So
why create an incentive that pushes kids out of private
insurance into a government-run program, rather than
focusing on low-income, uninsured children?
Worse, this legislation makes SCHIP financially unstable.
In order to appear fiscally sound, it gives children
health insurance for five years, then cuts SCHIP funding
by nearly 80 percent -- a classic bait and switch that
will cause millions of American children to lose their
And what are the taxpayers getting in return? According
to the CBO, the bill will lead to only 800,000 eligible-but-unenrolled
children being enrolled in SCHIP by 2012. The sad fact
is that it would be cheaper to give each of these kids
$72,000 than it would be to enact this bill, and it
would probably show healthier results.
Rather than playing politics with children's health
or scoring points with radio and TV ads, Congress can
show the American people that we are here to solve
problems. I hope that House leaders will do the right
thing and bring up a bill we can all support.
Michele Bachmann, R-Minn., serves in the U.S. House
Healthcare Mandates By State
|Source: Council for Affordable Health Insurance
#2 IN HEALTH
#2 IN HEALTH
If you buy a car, you have a choice. You can buy
an expensive car "fully loaded". Or, if
you're on a tighter budget, you can buy a cheaper
car without all the extras. It's your choice.
With Minnesota healthcare, you do not have a choice.
Minnesota now has the second highest number of health
insurance mandates in the nation -- more than 48 other states. Health coverage in Minnesota
must now include everything from hearing aids to
chiropractic care to hairpieces. The trouble is that,
as you add more mandates, the cost goes up. Add enough
mandates and health insurance becomes unaffordable
Republicans believe that Minnesotans need choice
in healthcare coverage. They believe the free market
is the best way to hold down costs and offer people
the greatest opportunity to select the health care
coverage they want and need.
But the DFL wants to go the other way. They want
to eliminate the free market and have the government
totally take over our healthcare system. But will
that really bring down costs?
following article is reprinted from the Minneapolis Star
Tribune, Thursday, November 16, 2006:
Pawlenty's a conservative? Since when?
By Katherine Kersten, Star
If you think Gov. Tim Pawlenty has a conservative
bone left in his body, read the news reports about
his statements Tuesday at a Minneapolis health care
Pawlenty announced that he would use the machinery
of government -- and a "surplus" of taxpayer
money -- to "start moving toward universal health
coverage." How? First, by "covering the state's
70,000 to 90,000 uninsured children." He proposes
either to expand MinnesotaCare, the state's publicly
subsidized health coverage program, or create a brand
new state program.
How will Pawlenty's proposed new health care entitlement
avoid the pitfalls of other government-driven health
care arrangements, which tend to cost more than expected,
result in rationing, and be hobbled by assembly-line
"Pawlenty didn't outline specifics for expanded
children's coverage," according to the Star Tribune.
How much will this new entitlement cost? Spokesman
Brian McClung says there's "no cost estimate yet."
Pawlenty is vague about what he means by his new goal
of "universal health coverage." But his remarks
on Tuesday suggest that he envisions an expansion of
government control over the financing and delivery
of health care -- hardly a prescription for what ails
It's clear that health care policy needs reform in
this country. The problem isn't quality of care. We've
got the best in the world. The challenge is paying
for that care and ensuring that coverage is as broad
The source of our current difficulty, in part, is
that market forces, which produce the best product
for the best price in other aspects of our lives, have
largely been suspended when it comes to health care.
Government piles requirements and regulations on the
plans that can be offered, while a third-party-payer
system insulates consumers from the real economic impact
of their health care decisions.
If we want to substantially enhance consumer choice
and competition, we'll probably have to rethink the
entire health insurance industry.
The matter is extraordinarily complex, and anyone
who claims to have the whole answer needs to visit
a doctor. But an expansive new benefit, on the taxpayers'
tab, will only make matters worse.
Pawlenty himself recognized this in July 2005 when
he was resisting DFL legislators' attempts to relax
controls on MinnesotaCare spending. Back then, he told
me that Minnesota's state-subsidized health care programs,
already among the most generous in the nation, faced
projected cost increases that could break the bank
in coming years. Left unchecked, he said, health care
spending could require a doubling of state income-tax
revenue every eight years to pay the bill.
Does Pawlenty now want to go down that road? We need
details, Governor, and fast.
In another troubling sign, Pawlenty engaged on Tuesday
in pseudo-populist bashing of private companies that
are trying to wade through the current health care
swamp. According to the Star Tribune, "The governor
saved some sharp words for health maintenance organizations":
"'What is the health value of what they do?'
he said. 'How have the outcomes improved? Are we less
obese? Are we less diabetic? Do we have less heart
disease? Do we have less cancer? Are our children more
engaged and active? Do we have less mental health challenge?'"
While the answer to some of these questions is no,
Americans are in fact living longer than ever. And
you've got to have a utopian vision to believe that,
without HMOs, we'd be "less obese" or that
our children would be "more active and engaged."
I remember a Pawlenty who once would have talked for
hours about parental responsibility for childhood obesity
before mentioning a word about government. Now he seems
a distant memory. (Disclosure: I served on Pawlenty's
transition team in 2002.)
There's a lot of talk these days about him as a possible
presidential running mate in 2008. I suggest that Rudy
Giuliani or John McCain hurry up and make him an offer.
Otherwise, Hillary Clinton may beat them to it.
Brase of the Citizen’s Council on Health
Care (CCHC) issued the following press release following
the Governor’s speech (11-14-2006):
to Today's Speech by Governor Tim Pawlenty
St. Paul, Minnesota -- Twila Brase, president of Citizens'
Council on Health Care, provides the following comments-pro
and con-to points made by Governor Tim Pawlenty in
his speech at the Midwest States Health Reform Summit
in Minneapolis. The forum focused on bringing the 2006
Massachusetts universal coverage law and in particular,
its controversial health insurance mandate, to Minnesota.
Governor: We must chart a path toward
CCHC: Universal coverage is a government-directed
initiative, not a consumer-driven initiative. The discussion
should not be about coverage. Coverage is not care.
Many people with insurance coverage, including the
privately and publicly insured in the U.S. and the
entitled in other countries, fight to receive care
every day. Health plans and governments use restrictions,
bureaucracy, and control of dollars to ration patient
access to care.
Governor: I think we should move
to universal coverage. We need to move in steps. We've
been studying diligently the Massachusetts model. We
need to start with covering all kids. That's the logical
next step to universal coverage in Minnesota.
CCHC: A health insurance mandate
is a boon for insurers, a a bad idea for citizens,
and a big step to government-run health care. A mandate
is also unconstitutional. Government forces citizens
to transfer their hard-earned incomes to the pockets
of health plans. In addition, a mandate will not create
universal coverage. As the Governor himself said, Minnesota
requires car insurance, yet 17% of the public has not
complied with the law.
Governor: Television advertising
for pharmaceuticals creates consumer-driven appetites
and should be limited if not temporarily suspended.
CCHC: Government should not limit
citizen access to information on medical treatments.
This is a patient protection issue. Health plans and
government agencies are building data monitoring systems
to direct and control the practice of medicine. If
drug and medical device companies are not allowed to
advertise, how will citizens and patients ever learn
about treatments governments and health plans do not
want doctors to tell them about?
Governor: We need to get to the
point where we don't need to be a Ph.D to figure out
your medical bills.
Governor: We need to incentivize
or require everybody to go to e-prescriptions.
CCHC: Computerization is not problem-free.
Several studies report that electronic prescribing
increases medical errors. A study in the Journal of
the American Medical Association found Computerized
Physician Order Entry (CPOE) added twenty-two new medical
Governor: We need to pay doctors
according to how well they meet recognized standards
of care. We won't use a stick approach. We'll use a
carrot approach. We'll reward doctors who meet the
standards. This system is only going to get more robust.
CCHC: We disagree. This is a big
government stick approach. Anyone who is not "rewarded" is
penalized. They get a stick. There are no carrots,
and increasing robust means increasingly punitive.
This approach also permits government to intrude in
private medical records and interfere with private
Governor: The role of the HMOs is
called into question. Are they just banks? Are they
just underwriters of risk? Or are they true partners.
What is the health value of what they do? If they are
just glorified aggregators of risk that don't meaningfully
improve health, we need to chart a different future.
CCHC: We concur. We have long said
that HMOs are banks that don't have to give the money
back. In fact, they are allowed to write their own
definitions of "medical necessity" and deny
care based on those definitions. It's time for citizens
to "bank" their own dollars, protect their
assets, and keep the dollars they need to get the health
care they want.
Council on Health Care is a non-profit, independent
health care policy organization that supports free-market
ideas in health care.
JUMPS SHIP ON SOCIALIZED MEDICINE
Pawlenty has announed that he now SUPPORTS Socialized Medicine:
"The Republican governor
said he was 'open to' a state law that would try to achieve
universal coverage by requiring that all Minnesotans
have insurance." (Star Tribune 11/15/06).
(Powerline) responds: "So much is wrong
with this proposition. I recoil from the arrogance of
such instruction from public
servants who have forgotten their jobs."
(Captain's Quarters) suggests that "Pawlenty
to drop all of the reasons Republicans voted for him and
address all of the reasons Democrats did not."
•Lady Logician demands: "Governor
WANT MY VOTE BACK!"
moments in Socialized Medicine (Part 4)
A London man fixed
his own front tooth with SuperGlue after failing to find
a National Health Service dentist to do the job
The following article
is reprinted from the London
Daily Mail, Tuesday, November 14, 2006:
Dentist shortage leads man
to superglue own tooth
A man fixed his front tooth with superglue after
failing to find an NHS dentist.
Gordon Cook, 55, has used the bizarre "DIY dentistry" technique
on a loose crown for the last three years - with each
fresh application of glue lasting around two months.
The father of seven, who was erased from his original
dentist's register after moving to a new home in Tranmere,
Merseyside, said he turned to glue after losing hope
of finding a dentist. He said: "I tried to find
a new dentist but they had all gone private.
"A lot of them said they would take me on as
an NHS patient, but only if I agreed to have the loose
crown fixed as a private patient, which would cost
"In the end, I just decided to take matters into
my own hands. I had read somewhere that super glue
was invented for medical use, to bond skin, so I gave
it a go.
"I tried a few different brands but the one I
use now, which is just called Industrial Super Glue,
is the best.
"You can't really taste it but you do have to
be careful not to use too much, in case you glue your
Mr Cook, a security manager, has now found an NHS
dentist and hopes to have the crown fixed professionally.
Councillor Chris Blakeley, chairman of Wirral Council's
social care and health overview and scrutiny committee,
said: "Mr Cook's solution was rather extreme but
he is not alone when it comes to dentistry horror stories.
" People are finding it extremely difficult to find an NHS dentist, and
we are currently gathering evidence to assess the scale of the problem, which
is not unique to this area."
MARIA'S PLAN? SHE WON'T SAY!
The following Ruud mailings were sent out in late October.
Once again, she is careful NOT to use the words "Universal
Healthcare" or "Socialized Medicine" or "Single
Payer". Nowhere in the ads does she tell you what the
final COST of providing you with "free healthcare for
all" will be. Nowhere in the ads does she tell you the
DOWNSIDE of her plan -- government run, government controlled
health care -- lack of choice, long lines, and rationing
She personally called the Eden Prairie News
in August and admitted that she supports "Universal
Healthcare." But, yet, she carefully avoids using
the term in her ads, in her website, in her letters to
the editor. During the debates she failed to use the term
even once. Why?
Why does Ruud continue to evade the issue? Ruud says healthcare
is one of her TOP PRIORITIES but yet she has yet to be straight
with the people of Eden Prairie and Minnetonka.
To see a larger version of the ads, click on each of the
Bill Cullen has a better plan. To see the many differences
between Bill Cullen and his opponent, see
following letter is reprinted from the Eden Prairie News
Thursday, October 19, 2006:
By Tim Goodyear, Minnetonka
It was disappointing to learn that Rep. Maria Ruud
has joined those who endorse a universal health care
I am afraid to even imagine how this type of system
would dramatically increase the costs of all of our
health care, as well as decrease quality due to government
bureaucracy. While the government certainly should
play a role in helping those who need assistance, the
vast majority of consumers want more choice and control
over their own health care.
The competition between Target, WalMart, Costco, and
Kmart benefit us all with lower prices and more choices
in consumer goods, and this high level of competition
in the Minnesota health care market would help keep
down costs as well. Profit and nonprofit companies
alike should be allowed to compete in our state so
that we, the consumers, have the most competitive choices
Free, open markets are the best way of providing health
care services, especially when they aren't overly burdened
with government mandates and red tape. Newer innovations
like HSA accounts are great choices that encourage
consumers to become cost conscious, compared to the
outdated third party co-pay plans that have led to
our current high costs.
More competition, freedom, and limited government
will make Minnesota an even better place to live. This
is another reason I heartily support Bill Cullen
for the Minnesota House of Representatives and encourage
you to join me.
VS. RUUD: IN THEIR OWN WORDS
HAS A PLAN . . . .
. . . BUT RUUD REFUSES TO ANSWER
The following are the e-mail responses
from the candidates to a question asked by the Eden Prairie
News (printed 10/5/2006). THE COMMENTS ARE ADDED AND
ARE NOT THE OPINION OF THE CANDIDATE OR THE EDEN PRAIRIE
|Q: How would you address the
health care needs of Minnesotans? What needs to be
done to prevent further increase in cost?
Cullen's Answer: “We must hold
the line on exploding costs by encouraging
the power of the private market. I have a four
First, we must increase competition by eliminating
the laws that restrict the market to a few insurance
Second, we must assure that pricing and quality
metrics are available to consumers so you can
make informed decisions.
Third, we must make health care savings accounts
easily available to consumers.
Fourth, we need tort reform.
My opponent supports universal healthcare. That
will not contain healthcare costs, it will just
increase costs and cause rationing of care.”
Comment: Bill Cullen
is asked a question and he answers it.
How would you address healthcare and bring
down the cost? Here's my four point plan.
Boom, boom, boom, boom. And not only that,
but here's why my opponent's plan is bad.
You learn more about Ruud's plan from
Bill Cullen than you do from Ruud. Isn't
Bill Cullen is asked for a solution and
he delivers. Now read Ruud's evasive response
. . . .
Maria Ruud's Answer: “Rising
healthcare costs are the biggest economic threat
facing Minnesota. Healthcare is also a major
social concern for voters whose families are
either getting squeezed out of adequate health
coverage or losing their coverage completely.
Comment: Ruud wastes
her first two sentences basically telling
us “Yup, we've got a real problem
Access to affordable healthcare for all residents
must be our number one priority. This is not
only the right thing to do but is also part of
the economic package that can make us a much
more competitive state.
Comment: This is the
closest Ruud actually comes to an answer.
Except it really isn't an answer. Who is
going to pay for this? What kind of “economic
package”? What the heck are you talking
Additionally, if the state doesn't aggressively
control escalating health care costs, there won't
be enough money left for education, public safety,
transportation and other issues.”
Comment: Does Ruud
ever answer the question? You decide.
How would she “answer the healthcare
needs of Minnesotans”? We still don't
How would she “prevent further increase
in cost”? We still don't know.
She won't talk about it because she knows
socialized medicine is unpopular. She knows
people don't want long lines, high taxes,
fewer choices, and rationing of care.
She says healthcare is her #1 priority.
Yet, when given the chance to tell us what
she would do, she chooses to be evasive.
Eden Prairie and Minnetonka deserve straight
answers to straight questions. Eden Prairie
and Minnetonka deserve better than Maria
following letter is reprinted from the Eden Prairie News
Thursday, October 5, 2006:
By Bonnie Gasper, Eden Prairie
Rep. Maria Ruud champions her work related to "children's
mental health." She boasted about an award she
received from a lobbyist organization called the National
Alliance on Mental Illness (NAMI-MN) which supports
Minnesota initiatives to screen "early and continuously" children
birth to age 5 for mental illness.
Does Rep. Ruud know or care that NAMI has a serious
conflict of interest? A large portion of its budget
comes from drug companies. According to internal documents
obtained by Mother
Jones magazine; from 1996 to mid-1999, 18 large
pharmaceutical firms gave NAMI a total of $12 million.
NAMI's largest donor was Eli Lilly who delivered over
$1 million in 1999 alone.
NAMI supports mental health screening of children
(for the children, of course) and drug companies support
NAMI because they stand to make billions of dollars
pushing drug therapy on your children as a result of
When the overall positive predictive value of a common
screening tool is a mere 27 percent, you can be certain
millions of children will be falsely diagnosed and
recommended for treatment.
In 2005, Rep. Ron Paul of Texas introduced the "Parental
Consent Act" - a bill forbidding federal funds
being used for any mental-health screening of students
without the express, written, voluntary and informed
consent of their parents. The bill was supported by
Minnesota Reps. Kennedy, Gutknecht and Kline.
NAMI, the organization that Ms. Ruud supports, worked
to defeat this bill. They said that the bill would
harm their "efforts" to screen schoolchildren
for mental illness. As a result, the bill remains stalled
in committee and has not been allowed to come to a
Universal mental health screening simply has no place
in a free or decent society. The notion of federal
bureaucrats screening then ordering potentially millions
of youngsters to take psychotropic drugs strikes an
emotional chord with American parents, who are sick
of relinquishing more and more parental control to
The government does not own our kids, and it has
no constitutional authority to interfere in our family's
intimate health matters. Psychiatric diagnoses are
inherently subjective, and the drugs regularly prescribed
can produce serious side effects; especially in developing
children. The bottom line is that the government is
out of its jurisdiction here.
I don't know a single parent who supports governmental
screening and drugging of children. Ruud shares no "common
ground" on this one.
following letter is reprinted from the Eden Prairie News
Thursday, September 14, 2006:
Ruud's health-care plan
By Allen Bode, Eden Prairie
I'd like to thank the Eden Prairie News for clarifying
Maria Ruud's position on health care. As the paper
explained in a correction on Aug. 31, 2006,
"Ruud supports universal health care."
If government forces employers to pay for universal
health care, it will negatively impact wages and take-home
pay. Consumers will feel the pinch as the price of
goods and services rise to cover these new costs. Small
businesses will be hit especially hard.
If the government were to simply take over health
care, we only need to look at the medical systems in
Canada, Europe and the former Soviet Union. They're
outdated, inefficient and costly, with many procedures
As a recent survivor of major spinal surgery, I was
most fortunate to have been able to select the neurologist,
surgeon and hospital of my choice such that I can again
walk and care for my new granddaughters.
Universal healthcare is not just another costly,
feel good, big government program that doesn't work;
it won't cure what ails our health care system and
will ultimately lead us to join our Canadian friends
who frequently need to leave their country to find
quality physicians and timely treatment for their serious
When Hillary Clinton tried to impose universal healthcare
on America, the only good that came out of it was the
public rebuke. Americans knew then, this plan wasn't
good for them, for patients or their doctors ... and
the citizens of Eden Prairie and Minnetonka know that
it isn't good for them now.
(Editor's note: Bode is vice chair of the
Senate District 42 Republican Party.)
following refers to a "correction" printed
on the editorial page of the Eden Prairie News Thursday,
August 31, 2006:
The August 31 Eden Prairie News contained a curious “correction”:
Ruud supports universal healthcare.
We have discovered that it was Maria Ruud herself
who called the paper and demanded the correction.
Curious fact #1: Maria
Ruud lists Healthcare as one of her three priorities (along
with Education and the Environment). But nowhere
on her campaign website does the word "Universal" appear. She
calls the paper demanding a correction of her position, yet
the term she uses does not appear even once in her literature.
She demands that her position not be mischaracterized, yet
she never mentions it during her debates. Why is that?
This is one of her three priorities and yet she will not
tell us where she stands. What is Maria hiding?
Curious fact #2: Regardless
of the term she uses -- Universal, Single Payer -- it's still
basically the same thing. Government dictated, government
controlled, government mandated medicine. Maria Ruud
wants to socialize our healthcare system. And that
is bad news for Eden Prairie and Minnetonka families!
following letter is reprinted from the Eden Prairie News
Thursday, August 24, 2006:
21st Century Healthcare System
Bill Cullen, Minnetonka resident and candidate
for Representative, House District 42A
There has been a lot of discussion about the health-care
crisis on these pages. This crisis is really a crisis
of cost as the care we receive is outstanding and the
vast majority of Minnesotans have coverage. Today health-care
costs consume 16.2 percent of our gross domestic product,
which is twice the rate of any other country. Health-care
costs continue to grow at almost three times the rate
of inflation. In other words, the problem is huge and
getting worse. Our solution must contain costs without
losing (preferably improving) quality.
The DFL, and my opponent, [Rep.] Maria Ruud, want
tax-supported, single-payer healthcare. This only makes
sense if you believe our government is a low-cost,
high-quality provider capable of providing personalized
care. Other single payer systems have resulted in the
government hiding escalating costs in tax rolls and
rationing services. Do you believe that more government
bloat and control is the prescription for health care?
I believe government should reform our health-care
market to be consumer driven. All HMO providers should
be allowed to sell in Minnesota so we have more competition.
Health savings accounts should be more readily available.
The fees and quality of our providers must be transparent
to the consumer. When consumers are in control of their
own health care, they will make financially wise choices
with regard to procedures, insurance and behaviors.
We should strive to limit government and maximize individual
moments in Socialized Medicine (Part 3)
times in Great Britain
The following article
is reprinted from the Vodka
Pundit , Monday, August 7, 2006:
Posted by Will Collier · 7
With Hillary Clinton a sure thing to run for President,
it's a very safe bet that we'll be hearing plenty
of calls in 2008 for socialized medicine, except
it'll be euphemized as "single payer" government
health insurance. Check out this
story from the UK on how well that's working
out for the Brits:
Hospitals across the country are imposing
minimum waiting times - delaying the treatment of
thousands of patients.
After years of Government targets pushing them
to cut waiting lists, staff are now being warned
against "over-performing" by treating patients
too quickly. The Sunday Telegraph has learned that
at least six trusts have imposed the minimum times.
In March, Patricia Hewitt, the Secretary of State
for Health, offered her apparent blessing for the
minimum waiting times by announcing they would
be "appropriate" in some cases. Amid fears about £1.27
billion of NHS debts, she expressed concern that
some hospitals were so productive "they actually
got ahead of what the NHS could afford".
The Sunday Telegraph has learned of five further
minimum-waiting-time directives. In May, Staffordshire
Moorlands PCT, which funds services at two hospitals
and is more than £5 million in the red, introduced
a 19-week minimum wait for in-patients and 10 weeks
for out-patients. A spokesman said: "These were
the least worst cuts we could make." In March,
Eastbourne Downs PCT, expected to overspend by £7
million this year, ordered a six-month minimum
wait for non-urgent operations. Also in March,
it was revealed that Medway PCT, with a deficit
of £12.4 million, brought in a nine-week
wait for out-patient appointments and 20 weeks
for non-urgent operations.
Doctors are also resigning. One gynæcologist
said that he spent more time doing sudoku puzzles
than treating patients because of the measures.
Since January, West Hertfordshire NHS Trust, with
a deficit of £41 million, has used a 10-week
minimum wait for routine GP referrals to hospital.
Watford and Three Rivers PCT, £13.2 million
in the red, has introduced "demand management":
no in-patient or day case is admitted before five
Oh, yeah, sign me up for that.
following letter is reprinted from the Eden Prairie
News Thursday, August 3, 2006:
sponsored health-care measures
By Maria Ruud, DFL 42A
I would like to thank Angela Erhard for her letter
to the editor in the July 20 Eden Prairie
News regarding affordable health care in Minnesota.
I appreciate her concern about this issue, and agree
with her that this is a worthwhile goal to work toward.
Ms. Erhard specifically inquired about measures I
sponsored to control health care costs in Minnesota.
I was pleased to co-author House File 1635, legislation
that would have allowed individuals and small employers
to purchase affordable health care coverage by joining
existing groups of purchasers. This approach, if enacted,
would have saved small businesses as much as 31 percent
on the cost of health care coverage. No state subsidies
would be involved because the businesses and individuals
would pay full cost, yet still be able to access lower
premiums as part of a larger pool. In addition, I supported
House File 588, a new law that permits health insurers
to sell lower cost policies that are not subject to
burdensome state health insurance mandates which increase
premiums. I look forward to continuing work on health-care
cost containment efforts next session.
In addition, during my first term in the Minnesota
House I was honored to co-author many health-related
pieces of legislation. Some of the topics these bills
dealt with included children's mental health, breast
and cervical cancer treatment, organ donation, lead
poisoning screening, mental health parity in insurance
coverage, prescription drug bulk purchasing, a statewide
smoking ban, MinnesotaCare coverage, and the nursing
shortage. Also, I am proud to be a founding member
of the Mental Health Legislative Caucus which was named
Legislator of the Year for 2005 by the Minnesota Chapter
of the National Alliance of Mental Illness in Minnesota
As a nurse practitioner, I witness on a daily basis the
crucial importance of affordable, quality health care,
and I will continue to support legislative efforts to
see that all Minnesotans receive it.
Ruud represents Minnetonka and part of Eden Prairie and
is seeking re-election.
COMMENTS: Ms Ruud says she is proud to
be a member of the Mental Health Legislative Caucus. This
caucus is the Minnesota chapter of the national organization
National Alliance on Mental Illness. This organization strives
to add mental illness as another mandated coverage
for all states. Minnesota currently has 62 required
mandates -- more than any other state in the union. Mandated
coverage is another big government solution which will drive
up health care costs.
Ms. Ruud wants government run healthcare. Her own website
20 years in health care have shown me that health care
should be a right, not a privilege.”
Yes, yes. In other words, government run, government rationed
The DFL Platform is even less ambiguous:
“(We support) Nationally
funded, community-based comprehensive and
affordable health care for all.”
Ms. Ruud is also a member of an organization called League
of Women Voters. Among the League's many Left-leaning
action items: They support ILLEGAL immigration, they oppose
requiring a photo ID to help stop voter fraud, they want
to take away your right to conceal and carry a firearm,
they support abortion . . . and they are STRONG advocates
of socialized medicine:
“The League favors a national
health insurance plan financed through general taxes in
place of individual insurance premiums [and] is opposed
to a strictly private market-based model of financing
the health care system. ”Source: League
of Women Voters MN Capitol Letter, May 12, 2006
Socialized medicine, Single payer medicine, Universal
healthcare -- whatever you want to call it -- it's
all the same. Think Hillary Clinton. Think long lines,
long waits, rationed healthcare, lack of choice, lack
of competition, and poor quality for all.
Again, from Ms. Ruud's campaign website:
supported the Minnesota Children's Health Security
This is legislation which will put all Minnesota children
into a new, Universal HealthCare system (ie. Socialized Medicine).
This is the classic first step in bringing socialized medicine
to the general population -- start with children then get
the rest of us into it. Make no mistake about it, this is
Universal Healthcare -- it is a benefits package that does
not require families to pay premiums, co-pays or deductibles. Who
pays for it then?
Once more from her website:
How does Ms. Ruud plan to make health care “affordable”?
By creating a huge new government bureaucracy? By taking it
out of the private sector? That doesn't make it affordable.
That only passes on the costs to someone else.
high quality health care will keep our families healthy,
our businesses competitive and our communities strong.”
moments in Socialized Medicine (Part 2)
In Canada a baby
dies because there aren't enough hospital beds
The following article
is reprinted from the CBC
News , Friday, July 28, 2006:
miscarriage sparks call for resignations
Alberta 's Liberal leader is calling on the head
of the Calgary Health Region to resign because of what
he calls continuing problems in emergency departments,
including a recent miscarriage in a hospital waiting
CEO Jack Davis should resign because emergency rooms
are still overcrowded and not providing the level of
care they should, Kevin Taft said Friday.
"These issues are not getting solved. This is
not getting better," Taft said.
The opposition leader also wants a public inquiry
to be held into hospital operations.
Rose Lundy went to the emergency room at the Peter
Lougheed Centre with abdominal pain last week. Three
months pregnant, she suffered a miscarriage in the
waiting room after staff told her there was a shortage
of beds and she would have to wait.
The Calgary Health Region said it is investigating
Lundy's case, but will not comment on Taft's call for
"Remember this is not a single incident. This
is a pattern that's repeated time and again," Taft
said. "If things aren't corrected, if steps aren't
taken, if new management isn't put in place, it's going
Board chair David Tuer should also consider resigning,
Health Minister Iris Evans was not available for
following letter is reprinted from the Eden Prairie
News Thursday, July 27, 2006:
Needed for “Healthcare Crisis”
In the July 20 edition [letters] of the Eden Prairie
News, Claire O'Connor spoke of the healthcare crisis
and how Rep. [Maria] Ruud is working for high quality
and affordable healthcare for all Minnesotans. However,
I am confused. I have not seen one piece of legislation
that Rep. Ruud has authored that will reduce the cost
of healthcare. Though she proclaims a "healthcare
crisis," Rep. Ruud, a registered nurse and healthcare
professional, has no answer or vision to solve this
Indeed, the DFL party, to which Rep. Ruud belongs,
has voted for restricting commerce and for-profit insurance
companies from doing business in this state. Competition
is what is going to bring healthcare costs down. How
does restricting the commercial environment (and these
nonprofits paying outrageous executive compensation)
reduce healthcare costs?
O'Connor seems to imply that the solution is for the
government to provide our healthcare. Since when has
the government been a low-cost and efficient provider
of anything? Isn't it better to select our own health
care from a competitive market with a wide array of
Angela Erhard is an Eden Prairie resident
there too many healthcare mandates?
According to the Council
for Affordable Health Insurance, Minnesota now has more
health insurance mandates than any other state. Health coverage
in Minnesota must now include everything from hearing aids
to chiropractic care to hairpieces. Kathy Kersten suggests
that, if we want to get control of health care costs, we
need to start offering choice in health insurance.
The following article
is reprinted from the Minneapolis Star-Tribune, Wednesday,
July 26, 2006:
push health insurance rates up and up
Katherine Kersten, Star Tribune
Amy Klobuchar's U.S. Senate campaign has just launched
a new TV ad. In it, she laments that when her daughter
was born, her health care provider had the nerve to
make her leave the hospital after 24 hours, although
the baby was sick and had to stay longer.
That was about 10 years ago. The ad shows that Klobuchar's
daughter is just fine now, and, taking after her mom,
is becoming a bright and spirited young woman.
Klobuchar didn't just sit and fret over her short
hospital stay, according to the ad. She testified before
the Minnesota Legislature and "got one of the
first laws in the country passed guaranteeing new moms
and their babies a 48-hour hospital stay."
Her story hit home with me. I, too, benefited from
a 48-hour hospital stay after one of my children was
born. I won't deny that I was pleased that my health
insurance covered it.
Over the years, our Legislature has heard hundreds
of moving stories like Klobuchar's. As a result, Minnesota
now has more health insurance mandates than almost
any other state -- over 60 and counting. An insurer
selling health coverage to an employer or individual
in Minnesota must now include everything from hearing
aids to chiropractic care to hairpieces.
But there's a catch. While candidate Klobuchar trumpets
her success in creating a health care mandate, she
also frequently decries the high cost of health care
in Minnesota. Could success on the mandate front compound
the cost problem?
The fact is, the cost of all these mandates adds up.
In recent decades we've created a standardized roster
of benefits -- some quite expensive -- that everyone
covered by the mandates must buy, regardless of whether
they need them or want to pay for them. A sizable number
of people are being priced out of the health care market.
Many factors affect the cost of health insurance,
but mandates are one cost-driver.
Merrill Mathews, director of the Council for Affordable
Health Insurance, describes the problem this way: "Coverage
with lots of mandates is like a Cadillac with options," he
says. "It's great if you want it and can afford
it. But if you can't, you have to walk."
State Sen. Brian LeClair, a member of the Senate Health
and Human Services Budget Committee, builds on the
automobile analogy. "We should mandate seat belts.
But should we mandate leather upholstery and four-wheel
drive? When it comes to health care, many people would
find that a standard Buick works for them. What we
need in this state is health insurance flexibility
Take the case of a healthy young single man, just
out of school. He may not want maternity coverage,
mental health benefits or a hearing aid. But in Minnesota,
if he wants health insurance, he has to pay for all
these and more. As a result, he may decide not to buy
health insurance at all.
Small businesses, which employ a significant part
of our state's workforce, are especially hard hit by
"Mandates -- especially mental health, chemical
dependency and maternity coverage -- may add close
to 20 percent to the cost of health insurance here," says
Mike Hickey, state director of the National Federation
of Independent Business. "Small employers won't
offer health insurance if it threatens their financial
Hickey thinks reform is long past due. "We need
to stop three decades of costly mandates," he
says. "Our goal now should be to make health insurance
Ruud supporter says we NEED MariaCare
Maria's appeal, as with many on the Left,
is primarily emotion, not logic. Just get government do it!
Let's let the government take over our health care system.
But is that really the answer? Ruud supporter Claire O'Connor
seems to think so . . .
The following is reprinted from the Eden
Prairie News, Thursday, July 20, 2006
For My Candidate
I am an active, healthy, maturing adult. I've worked
all my life, paid my share of taxes (of course), contributed
to the economy and to society. Though recently retired,
my contributions continue through taxes and through
volunteer work in my community. Now, it seems, I have
to worry about health care for me, my children and
grandchildren. Will it be there when we need it and
will we be able to afford it?
With elections coming up, I wondered which of the
candidates for state representative share my concerns
about health care. Minnesota Republicans' solution
(as I understand it) is to reduce government's role
in protecting health care for me and my family. I don't
know about you, but it seems strange to ask me to vote
for someone who wants not to do the job. Does that
also mean they will take a smaller salary?
[Rep.] Maria Ruud, current representative for my district,
knocked on my door recently. So I asked her how hard
she works to protect health care.
I found out that she is a registered nurse and nurse
practitioner who is very aware of many of the problems
with our health care system. She told me that her experience
has taught her that Minnesotans of all ages must be
able to get the highest quality affordable health care
when they need it. As an elected government representative
she works to rein in costs, improve care for those
with mental illness, help small employers provide health
benefits, ensure protection for children and reduce
the nursing shortage. Maria Ruud gets my vote.
Claire O'Connor is an Eden Prairie resident
Analysis: Claire O'Connor shares one thing
in common with many Maria Ruud supporters: She's a Bush-hating
Leftist. To read about her many other misguided views, see
the following links:
NOW! -- Claire announces that, after living in Canada, “I
know first hand that single payer tax supported health
care is the only way.”Healthcare Now is an organization
pushing for a government takeover of medicine.
anti-War Movement -- Claire goes on an anti-Israel, anti-Bush rant.
•CRM Vet --
Claire declares that with Colin Powell and General Schwartzkopf in charge, “we
will never have elections again.”Yikes!
Designs -- Claire whines that in 2000 her “vote didn't count.”This
is the classic “selected, not elected”myth pushed by many on the
extreme Left. Even though every major news outlet that studied the ballots later
agreed that Bush was indeed the winner, don't confuse Claire's mind with the
This is who Maria counts as her supporters?
Socialized medicine . . . government controlled medicine
. . . rationed medicine. Is that really “the only way?”
moving AWAY from Socialized Medicine (Part 2)
Zeliotis of Quebec was told in 1997 that he would have to
wait a year for a replacement for his painful, arthritic
hip, he did what every Canadian who's been put on a waiting
list does: He got mad.
The following article
is reprinted from the Wall
Street Journal , Monday, June 13, 2005:
REVIEW & OUTLOOK
A landmark ruling exposes Canada's health-care
Let's hope Hillary Clinton and Ted Kennedy were sitting
down when they heard the news of the latest bombshell
Supreme Court ruling. From the Supreme Court of Canada,
that is. That high court issued an opinion last Thursday
saying, in effect, that Canada's vaunted public health-care
system produces intolerable inequality.
Call it the hip that changed health-care history.
When George Zeliotis of Quebec was told in 1997 that
he would have to wait a year for a replacement for
his painful, arthritic hip, he did what every Canadian
who's been put on a waiting list does: He got mad.
He got even madder when he learned it was against the
law to pay for a replacement privately. But instead
of heading south to a hospital in Boston or Cleveland,
as many Canadians already do, he teamed up to file
a lawsuit with Jacques Chaoulli, a Montreal doctor.
The duo lost in two provincial courts before their
win last week.
The court's decision strikes down a Quebec law banning
private medical insurance and is bound to upend similar
laws in other provinces. Canada is the only nation
other than Cuba and North Korea that bans private health
insurance, according to Sally Pipes, head of the Pacific
Research Institute in San Francisco and author of a
recent book on Canada's health-care system.
"Access to a waiting list is not access to health
care," wrote Chief Justice Beverly McLachlin for
the 4-3 Court last week. Canadians wait an average
of 17.9 weeks for surgery and other therapeutic treatments,
according the Vancouver-based Fraser Institute. The
waits would be even longer if Canadians didn't have
access to the U.S. as a medical-care safety valve.
Or, in the case of fortunate elites such as Prime Minister
Paul Martin, if they didn't have access to a small
private market in some non-core medical services. Mr.
Martin's use of a private clinic for his annual checkup
set off a political firestorm last year.
The ruling stops short of declaring the national
health-care system unconstitutional; only three of
the seven judges wanted to go all the way.
But it does say in effect: Deliver better care or
permit the development of a private system. "The
prohibition on obtaining private health insurance might
be constitutional in circumstances where health-care
services are reasonable as to both quality and timeliness," the
ruling reads, but it "is not constitutional where
the public system fails to deliver reasonable services." The
Justices who sit on Canada's Supreme Court, by the
way, aren't a bunch of Scalias of the North. This is
the same court that last year unanimously declared
gay marriage constitutional.
The Canadian ruling ought to be an eye-opener for
the U.S., where "single-payer," government-run
health care is still a holy grail on the political
left and even for some in business (such as the automakers).
This month the California Senate passed a bill that
would create a state-run system of single-payer universal
health care. The Assembly is expected to follow suit.
Someone should make sure the Canadian Supreme Court's
ruling is on Governor Arnold Schwarzenegger's reading
list before he makes a veto decision.
The larger lesson here is that health care isn't
immune from the laws of economics. Politicians can't
wave a wand and provide equal coverage for all merely
by declaring medical care to be a "right," in
the word that is currently popular on the American
There are only two ways to allocate any good or service:
through prices, as is done in a market economy, or
lines dictated by government, as in Canada's system.
The socialist claim is that a single-payer system is
more equal than one based on prices, but last week's
court decision reveals that as an illusion. Or, to
put it another way, Canadian health care is equal only
in its shared scarcity.
When asked whether he was worried about being known
as the man who helped bring down his country's universal
health-care system, Mr. Zeliotis told the Toronto Star, "No
way. I'm the guy saving it." If the Canadian ruling
can open American eyes to the limitations of government-run
health care, Mr. Zeliotis's hip just might end up saving
the U.S. system too.
moving AWAY from Socialized Medicine (Part 1)
The following article
is reprinted from the NY
Times , Thursday, February 23, 2006:
Canada's Slow-Motion Public Health System Falters,
Private Medical Care Is Surging
By: Clifford Krauss
VANCOUVER , British Columbia: The Cambie Surgery Center,
Canada's most prominent private hospital, may be considered
a rogue enterprise.
Accepting money from patients for operations they
would otherwise receive free of charge in a public
hospital is technically prohibited in this country,
even in cases where patients would wait months or even
years in discomfort before receiving treatment.
But no one is about to arrest Dr. Brian Day, who
is president and medical director of the center, or
any of the 120 doctors who work there. Public hospitals
are sending him growing numbers of patients they are
too busy to treat, and his center is advertising that
patients do not have to wait to replace their aching
The country's publicly financed health insurance
system frequently described as the third rail of its
political system and a core value of its national identity
is gradually breaking down. Private clinics are opening
around the country by an estimated one a week, and
private insurance companies are about to find a gold
Dr. Day, for instance, is planning to open more private
hospitals, first in Toronto and Ottawa, then in Montreal,
Calgary and Edmonton. Ontario provincial officials
are already threatening stiff fines. Dr. Day says he
is eager to see them in court.
"We've taken the position that the law is illegal," Dr.
Day, 59, says. "This is a country in which dogs
can get a hip replacement in under a week and in which
humans can wait two to three years."
Dr. Day may be a rebel (he keeps a photograph of
himself with Fidel Castro behind his desk), but he
appears to be on top of a new wave in Canada's health
care future. He is poised to become the president of
the Canadian Medical Association next year, and his
profitable Vancouver hospital is serving as a model
for medical entrepreneurs in several provinces.
Canada remains the only industrialized country that
outlaws privately financed purchases of core medical
services. Prime Minister Stephen Harper and other politicians
remain reluctant to openly propose sweeping changes
even though costs for the national and provincial governments
are exploding and some cancer patients are waiting
months for diagnostic tests and treatment.
But a Supreme Court ruling last June it found that
a Quebec provincial ban on private health insurance
was unconstitutional when patients were suffering and
even dying on waiting lists appears to have become
a turning point for the entire country.
"The prohibition on obtaining private health
insurance is not constitutional where the public system
fails to deliver reasonable services," the court
In response, the Quebec premier, Jean Charest, proposed
this month to allow private hospitals to subcontract
hip, knee and cataract surgery to private clinics when
patients are unable to be treated quickly enough under
the public system. The premiers of British Columbia
and Alberta have suggested they will go much further
to encourage private health services and insurance
in legislation they plan to propose in the next few
Private doctors across the country are not waiting
for changes in the law, figuring provincial governments
will not try to stop them only to face more test cases
in the Supreme Court.
One Vancouver-based company launched a large for-profit
family medical clinic specializing in screening and
preventive medicine here last November. It is planning
to set up three similar clinics in Toronto, Ottawa
and London, Ontario next summer and nine more in several
other cities by the end of 2007. Private diagnostic
clinics offering MRI tests are opening around the country.
Canadian leaders continue to reject the largely market-driven
American system, with its powerful private insurance
companies and 40 million people left uninsured, as
they look to European mixed public-private health insurance
and delivery systems.
"Why are we so afraid to look at mixed health
care delivery models when other states in Europe and
around the world have used them to produce better results
for patients at a lower cost to taxpayers?" the
premier of British Columbia, Gordon Campbell, asked
in a speech two weeks ago.
While proponents of private clinics say they will
shorten waiting lists and quicken service at public
institutions, critics warn that they will drain the
public system of doctors and nurses. Canada has a national
doctor shortage already, with 1.4 million people in
the province of Ontario alone without the services
of a family doctor.
"If anesthetists go to work in a private clinic," Manitoba's
health minister, Tim Sale, argued recently, "the
work that they were doing in the public sector is spread
among fewer and fewer people."
But most Canadians agree that current wait times
are not acceptable.
The median wait time between a referral by a family
doctor and an appointment with a specialist has increased
to 8.3 weeks last year from 3.7 weeks in 1993, according
to a recent study by The Fraser Institute, a conservative
research group. Meanwhile the median wait between appointment
with a specialist and treatment has increased to 9.4
weeks from 5.6 weeks over the same period.
Average wait times between referral by a family doctor
and treatment range from 5.5 weeks for oncology to
40 weeks for orthopedic surgery, according to the study.
Last December, provincial health ministers unveiled
new targets for cutting wait times, including four
weeks for radiation therapy for cancer patients beginning
when doctors consider them ready for treatment and
26 weeks for hip replacements.
But few experts think that will stop the trend toward
Dr. Day's hospital here opened in 1996 with 30 doctors
and three operating rooms, treating mostly police officers,
members of the military and worker's compensation clients,
who are still allowed to seek treatment outside the
public insurance system. It took several years to turn
Today the center is twice its original size and has
yearly revenue of more than $8 million, mostly from
perfectly legal procedures.
Over the last 18 months, the hospital has been under
contract by overburdened local hospitals to perform
knee, spine and gynecological operations on more than
1,000 patients. Since the Supreme Court ruling in June,
it began treating patients unwilling to wait on waiting
lists and willing to pay their own money.
Now Dr. Day says he is considering building a full-service
private hospital somewhere in Canada with a private
medical school attached to it.
"In a free and democratic society where you
can spend money on gambling and alcohol and tobacco," Dr.
Day said, "the state has no business preventing
you and me from spending our own money on health care."
facts and myths
the most persistent myths about the U.S. health care system
is that it does not provide for the poor. Not so, according
to this article by Arnold Kling.
The following article
is reprinted from the TCS
Daily , Thursday, May 5, 2005:
and Spending on Health Care
By Arnold Kling
One of the most persistent myths about the U.S. health
care system is that poor people lack access. While
we allegedly provide luxury health care for the rich,
we do much less than other countries for those in poverty.
However, the data tell a different story.
The government's Medical
Expenditure Panel Survey (MEPS) tabulates health
care spending for a sample of over 35,000 Americans.
One of the variables included in the survey is household
income relative to the poverty line.
When the data for 2002 (the latest survey year available)
are extrapolated to the full noninstitutional population,
one obtains these results for persons below the poverty
Number of Persons: 35.6 million
Total Spending: $106.3 billion
Per Capita Spending: $2,986
Next, look at data on per capita spending
on health care in various countries, as compiled by
In 2002, per capita spending in Canada was
$2,931, in France it was $2,736, in Germany it was
$2,817, and in the United Kingdom it was $2,160. The
United States spends more on the average poor person
than those countries spend on the average person.
In fact, the MEPS data understate spending in the
United States, in part, as it is limited to the noninstitutional
population. Therefore, it excludes nursing home expenditures.
When those are added in, the per capita spending
in the United States on those in poverty will turn
out to be higher.
Still, people who are above the poverty line receive
much more medical care in the United States, right?
Wrong. In the MEPS data, the per capita spending
rate for people above the poverty line is $2,789, essentially
the same as the rate for poor people. (Again, the MEPS
data excludes spending on nursing homes, research and
development, and other categories that show up in countries'
national income accounts.)
As with all aggregate health care data, these statistics
were not designed to answer the most penetrating questions.
Some issues that come to mind are:
1. Do other countries spend much more per capita on
their poor than they do on the average person?
2. Do poor people in the United States consume too
much of the "wrong" health care resources
-- too much acute care and not enough preventive care?
3. Do poor people in other countries require less
health care than poor people in America? Are they healthier
to begin with?
I suspect that the answer to (1) is "no," but
that the answers to (2) and (3) are "yes." People
who tend to make bad choices about how to care for
themselves and how to spend money also tend to be poor.
Taking this propensity to make bad choices as given,
the poor need to spend more to achieve a given level
of health. I believe that this effect is stronger in
the United States than it is in other countries.
I suspect that severe substance abuse plays a big
role in poverty, poor health, and mortality. My guess
is that if substance abusers were excluded from the
international statistics on health outcomes, the standing
of the United States would improve considerably. If
this is true, it still begs the question of whether
our public health policies are inferior to those of
other countries in the area of substance abuse.
I think it would be foolish to conclude that the United
States does as well or better than other countries
in providing health care to the poor. What the data
do suggest, however, is that poor people in America
do not suffer from a lack of total health care resources.
No Easy Answers
If the United States does not lag in spending on health
care for the poor, then this undermines one of the
arguments for adopting a more European or Canadian
style health care system. Our challenge is not to redirect
resources toward the poor but to come up with better
approaches for improving public health.
In Medicaid, we already have the sort of state-funded
health care system for the poor that other countries
provide for everyone. It is difficult to see how expanding
that system to the middle class (as Howard Dean, among
others, has proposed) will make the poor better off.
I believe that there are genuine problems with our
health care system. Studies and anecdotal evidence
suggest that the uninsured and the poor receive inferior
care. But I do not believe that there are any easy
answers. In particular, I fail to see how any fair-minded
individual could conclude that we ought to increase
government's role in health care finance. If the poor
under Medicaid are not as well cared for as the rest
of us under private systems, then government-funded
health care would seem to be part of the problem, not
moments in Socialized Medicine (Part 1)
As British socialized
medicine continues to fail, the demand for "health tourism" grows
The following article
is reprinted from the UK
Guardian, Tuesday, February 1, 2005:
patient George Marshall
in hospital in India.
This UK patient
avoided the NHS list and flew to India for a heart
Is health tourism the future?
By: Randeep Ramesh in Bangalore
Three months ago George Marshall fretted about the
choice offered by his doctor in Britain. Diagnosed
with coronary heart disease, the violin repairer from
Bradford was told he could either wait up to six months
for a heart bypass operation on the National Health
Service or pay £19,000 to go under the scalpel
In the end, Mr Marshall chose to outsource his operation
to India. Last month he flew 5,000 miles to the southern
Indian city of Bangalore where surgeons at the Wockhardt
hospital and heart institute took a piece of vein from
his arm to repair the thinning arteries of his heart.
The cost was £4,800, including the flight.
"Everyone's been really great here. I have been
in the NHS and gone private in Britain in the past,
but I can say that the care and facilities in India
are easily comparable," says Mr Marshall, sitting
in hospital-blue pyjamas. "I'd have no problem
The 73-year-old found the hospital in Bangalore after
a few hours surfing the internet. Mr Marshall decided
to come after an email conversation with Wockhardt's
vice-president and a chat with other "medical
tourists" from Britain who had undergone surgery
in the hospital.
"Once I knew others had come I thought, why
not? In Europe hospitals in Germany and Belgium would
do the operation for less than doctors in Britain.
But Europe was still more expensive than here. And
the staff speak English in India."
With patients such as Mr Marshall willing to travel
across the globe to get treatment sooner or more cheaply
than they could at home, Indian hospital groups see
a huge market for their services.
A study by the Confederation of Indian Industry (CII),
and McKinsey consultants estimated "medical tourism" could
be worth 100bn rupees (£1.21bn) by 2012. Last
year some 150,000 foreigners visited India for treatment,
with the number rising by 15% a year, says Zakariah
Ahmed, an analyst who helped compile the report,
With a large pool of highly trained doctors and low
treatment prices, healthcare aims to replicate the
Indian software sector's success. Built on acres of
land, often gifted to companies at peppercorn rents
from Indian local authorities eager to promote business,
the new, sleek medical centres of excellence offer
developed world treatment at developing world prices.
A number of private hospitals also offer packages
designed to attract wealthy foreign patients, with
airport-to-hospital bed car service, in-room internet
access and private chefs. Another trend is to combine
surgery in India with a yoga holiday or trip to the
Many say that it is not just cost but competency
that is India's selling point. Naresh Trehan, who earned
$2m (£1.06m) a year as a heart surgeon in Manhattan
but returned to start Escorts hospital group in India,
said that his hospital in Delhi completed 4,200 heart
operations last year.
"That is more than anyone else in the world.
The death rate for coronary bypass patients at Escorts
is 0.8% and the infection rate is 0.3%. This is well
below the first-world averages of 1.2% for the death
rate and 1% for infections," says Dr Trehan. "Nobody
questions the capability of an Indian doctor, because
there isn't a big hospital in the United States or
Britain where there isn't an Indian doctor working."
Most foreign patients who come to the subcontinent
are from other developing countries in Africa, south-east
Asia and the Middle East where western-trained doctors
and western-quality hospitals are either hard to find
or prohibitively expensive.
Hospital administrators accept that many prospective
patients from the west are put off because images of
India tend to focus on poverty and on the less than
hygienic living conditions of most people.
Mr Marshall had never visited the subcontinent before
and only been out of Britain twice before, to Australia
and Egypt, on holiday. He readily admits that he did
not tell his daughter what he was planning to do until
two days before coming, for fear of her "reaction".
What little Mr Marshall knew about the country was
not favourable and at first he was shocked by the organised
chaos of India. "There are so many people here.
When I was in the car coming from the airport we got
stuck in really heavy traffic. It was hot, there were
horns going off and people shouting. I thought, 'Oh
hell, I've made a mistake.'"
But once in his airconditioned room, with cable television
and a personalised nursing service, the 73-year-old
says that his stay has been "pretty relaxing.
I go for a walk in the morning when it is cool but
really I don't have to deal with what's outside".
How many patients will come from Britain ultimately
will depend on the NHS, which has begun sending patients
for treatment to Europe to cope with its backlog of
cases. At present the NHS restricts referrals to hospitals
within three hours' flying time - but Indian hospitals
say this barrier will eventually be lifted.
"It is inevitable. In the west you have rising
healthcare costs and an ageing population," says
Habil Khoraiwallah, chairman of Wockhardt, who plans
to open five hospitals in India next year, including
a new 350-bed hospital in Bangalore. "People are
already discovering the benefits themselves. Governments
But campaigners say while the private medical industry
is getting tax breaks and other incentives, the public
healthcare system in India is falling apart. The country
has less than one hospital bed per 1,000 people, compared
with more than seven in first world countries. There
are just four doctors in India for every 10,000 people,
compared with 18 in Britain.
"The poor in India have no access to healthcare
because it is either too expensive or not available.
We have doctors but they are busy treating the rich
in India," says Ravi Duggal, a researcher at Cehat,
a health thinktank based in Mumbai. "Now we have
another trend. For years we have been providing doctors
to the western world. Now they are coming back and
serving foreign patients at home."
What treatment costs
Heart bypass UK: £15,000
Hip replacement UK: £9,000
Cataract operation UK: £2,900