SteynOnline

A selection of recent letters on Congress's forthcoming healthcare "reform".

PUBLIC WORKERS’ PRIVATE DEAL
Regarding more Healthcare Hell, UK-style, this London Times article "3,000 NHS staff get private care" cries out for your most acerbic, pithy commentary.   "All the pigs are equal but some pigs are more equal than others...".  These more-equal pigs can oink out the most shameless excuses, too.

Is there anyone naive enough to think the examples listed in the article are all that occurred, and that they won't continue?  Moreover, is there anyone naive enough to think preferential treatment for "Key Personnel", "VIPs" as the norm, doesn't occur regularly in Canada and would also in an America with socialized (aka inevitably rationed) medicine?

David J Crook
Coatesville, Pennsylvania

HMO SWEET HMO
These are old stats, but add to the cost of healthcare
                        
Barry Levy

LEFT TO STARVE
Just a little story from Britain to illustrate the wonders of our nationalised healthcare system.
 From "The Times"

"AN 80-year-old grandmother who doctors identified as terminally ill and left to starve to death has recovered after her outraged daughter intervened. Hazel Fenton, from East Sussex, is alive nine months after medics ruled she had only days to live, withdrew her antibiotics and denied her artificial feeding. The former school matron had been placed on a controversial care plan intended to ease the last days of dying patients.Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying. Deborah Murphy, the national lead nurse for the care pathway, (…) She said 3% of patients placed on the plan recovered."

Jonathan Adjderian

SHATTERED
I assume that you've seen this a billion times already today, but yet another anecdote of the glories of government rationed health care...

Ken Yost
Winnipeg, Manitoba

YOU LIE!
 According to Paul Krugman (hat-tip to James Taranto at the WSJ),
 
"In Britain, the government itself runs the hospitals and employs the doctors. We've all heard scare stories about how that works in practice; these stories are false."
 
Thank goodness, that settles that!
 
Hell adjourned.
 
Marty Brandt
Phoenix, Arizona

DESTROY THE ECONOMY, DON’T FIX THE PROBLEM
So, senator Max has put forward a plan that costs $900,000,000,000 (over 10 years) to ensure that 95% of the country is covered by some  wretched form of medical insurance.  In a country of 304,059,724 people, 5% is 15,202,986 people, or, more than 1/2 of the number of people that the president (now) claims are amongst the uninsured masses.  How can anyone, let alone a member of the "World's Greatest Deliberative Body", not notice that senator Max wants to destroy a significant percentage of the US economy to solve less than 1/2 of the stated problem?

My head hurts.

Greg

BUSINESSES WILL GO BELLY UP
Everybody seems to be missing another critical problem with healthcare reform legislation, that will destroy thousands of businesses.

There is a major, I should say catastrophic, flawed premise in healthcare reform legislation.

The flawed premise is that employers who meet a threshold payroll amount actually make enough money to pay for its employees' insurance.  The amount of a company's payroll has no bearing on whether that company makes a profit.  Thousand of businesses go belly up every year, thousands more break even, and thousands more make little profit.  Mandating these companies on the cusp to pay a large percentage of its employees' premiums will bankrupt companies by the thousands.  Imagine how many jobs will be lost.  Healthcare reform will be a job killer.  After running the numbers, my company will go into the red by $150,000 per year - my employees will lose their jobs when I go bankrupt.

If this nonsense passes we will be bleeding businesses and jobs.

Charles

CAN’T WAIT
Am I reading the Senate Health Care reports correctly?

Individual employees (like myself) will be required to purchase employer provided health care policies at $13,375 per year.

However, the employee contribution will be capped at 13% of wages/salary.

Since I've been employed by the same boss for 30 years, 13% of my salary is about $15,000.

My current employer provided plan costs me $3,000 per year.

So, under the Senate plan, I will get to pay $10,000 more each year for the "Government mandated plan."

Like tens of millions of Americans, I can't wait to sign up.

Dave Holsclaw

HAPPY HEALTHCARE STORY
This past Tuesday my tongue started swelling up and throbbing in pain while at work. By the time I got home the swelling and pain increased. At 7 in the evening I was able to reach my doctor. He was getting ready to leave but said come on down. After examining me he called an ear, nose throat specialist. At 7:45 PM he was also still at work. They consulted by phone and the ENT guy said to send me to the ER. My doctor called ahead, gave me written instructions for the ER and off I went.

I got to the hospital around 8:30. I was in a bed in the ER by 9. I was seen by a doctor and administered an intravenous pain killer and antibiotics by 9:30, even though in my suffering I was probably kind of a “pain in the you know what” to the staff. Blood was drawn, an IV started, etc for the next couple of hours.

At around 1 AM x-rays were taken of my chest/neck areas. An hour later I got a CATscan of my neck and jaw areas. Shortly thereafter I was brought upstairs and admitted. I was in a room by maybe 3:30 AM.

The next morning my GP and the ENT doc were both there to see me before 8AM. The treatment continued, I slept, stayed overnight and improved. Everyone from the porter to the nurses couldn't have been nicer. My doctor was back early the next morning and I was released a few hours later. That was yesterday, Thursday.

Today, Friday I was able to see the ENT doc at his office for a follow up exam at 10:30, out by 10:50.

I know I'm not complaining. It's taken me longer to register a used car.

Phil Lynch
Hewlett, New York

TWO-HOUR OR TWO-DAY WAITS?
Just wanted to let you know that I work in an emergency room in Pennsylvania.  I've been reading the notes in your healthcare-hell section.  The waiting time goal for my section of the ER is 2 hours,
from check-in to leaving.  We get fairly close.  I get people complaining that they have been waiting too long after less than an hour.  Do you really think that Americans would put up with 2 day waits for emergency-room care?  I get people complaining that the specialists will not come in IMMEDIATELY and will, instead, see them in the morning.  How much patience do you think they would have for a months long wait? Maybe Canadians are more patient.....

Janice
Pennsylvania

BODY BAGS AT THE READY
Hope you are aware of this:

Body bags disrupt Canada's flu-readiness message
Wed Sep 16, 2009 5:41pm EDT

WINNIPEG, Manitoba (Reuters) - The Canadian government sent body bags to some remote Indian reserves as it prepared for the winter flu season, sending a jarring message at odds with its promise that  it's ready for the H1N1 flu. The body bags went to some reserves in Manitoba, the western province in which some remote Indian communities were hard-hit by the flu in the spring, Health Minister Leona Aglukkaq said on Wednesday.

Gloria Gibson
Falls Church, Virginia

PSYCHOLOGICAL PROBLEMS
I thought you might be interested in hearing that wait-times to see a Psychiatrist in the Ottawa area are now 18 months+.  I know because both a child of mine and I are waiting to see one for issues related to Asperger Syndrome.  It might be of further interest to you that though I insisted from the time he was an infant that my first child indeed has Autism, my husband and I were not able to have him diagnosed here in Canada's capital city until he was nine years old, and many of the early windows of opportunity for Autism intervention had long since closed.  I don't know whether to laugh or cry that at one point we were assigned, after waiting a very long time for this appointment, to "the best Pediatric Psychiatrist team at the Children's Hospital of Ontario", or so the advance notice went. Well, of this dynamic duo, the younger doctor could not speak either English or French to save his life, and the older and senior doctor slept through most of the two-hour interview. I had to do most of the talking, and of the three adults in the room, I knew the most about Autism, hands-down;  I had done my homework for years, you see, and I was up-to-date on all of the cutting-edge Autism research, as a growing number of parents who have Autistic children are.  At the end of this interview/appointment, the younger Psychiatrist pushed past his older, still-sleeping colleague, to grab my notes from my hand, which had previously been referred to by this specialist team as "mother's scratchings". It was from my scratchings, and only from these, that they were able to piece together the report that they subsequently added to my son's file.  I went after a copy, which they repeatedly promised me, and which led to further Keystone Cops antics on their part (I was not really ever going to get my own copy). 

I am still astonished to this day.  Only in Canada, you say...?

Anne MacLeod Prado

YES, IT IS A TAX INCREASE
To the esteemed Mr. Steyn,

I would direct your attention to the following AP story on the president's health care "plan" and give you a couple observations.  In this story, ABC discusses the charge that obligatory participation in the plan amounts to a massive tax increase and quotes the president as follows: "What it's saying is, is that we're not going to have other people carrying your burdens for you anymore," said Obama. "Right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase."

My observations:

1. Auto insurance is mandatory only if one owns and operates a vehicle.  One is free to fly, bus, bike, or walk to one's destination, all without the need for auto insurance.  One does not have a similar opportunity with one's health insurance under this plan, except if in some cruel way Obama's notion of choosing to not pay and participate involves euthanasia and the "death panels".

2. Even when auto insurance is required, it is not continuously verified by a large, powerful government agency such as the IRS, whose power will be greatly enlarged under this plan.  This is far more troubling than the PATRIOT Act's library account provisions ever were.

3. When the IRS reviews a transaction for tax liability, it looks at the essential substance of the deal, not the window dressing that people often put up to try to shelter reality.  Let us do the same with the president's plan: an involuntary levy on a citizen's personal finances will be collected by the IRS to help pay for a massive government entitlement program.  Hmmm, sounds like a tax to me.

Of course, Mr. Obama's larger point regarding contribution to the system is perfectly understandable if you view health care as a positive collective right that the government must ensure (or insure, in this case), such as our now long-enshrined right to free government counsel in criminal cases.

Please keep up the good work, Mr. Steyn.  I greatly admire your humorous insight.

Colin MacDonald

STOP THEM RETIRING
If you start from a point of view that Obamacare is at least partially interested in improving access to healthcare (a stretch I admit), isn't one of the unstated assumptions that the doctors and nurses, etc. currently providing healthcare will continue to do so?

Given the recent IBD survey stating many doctors would consider retiring if Obamacare passes, perhaps an amendment should be added to the legislation forbidding healthcare professionals from retiring or quitting unless they have government approval!

I've heard a war was fought in the 1860's to end this sort of employer/employee relationship, but isn't this a logical outcome when someone else has the "right" to another person's output?

Darrell Letourneau

‘PERMISSION’ IS THE KEY WORD
Longtime fan here.  You once posted my query as to the origin and meaning of an old fave expression of your's, "clapped out".  Today I'm writing to comment on a remark you made on the Hugh Hewitt show yesterday, 8/27/09.

But first a little background on my knowledge of the "healthcare" issue.
 
As it happens I am an independent insurance agent, selling life and health insurance, in Florida for over 23 years.  I deal in health insurance only because I have an exclusive gig for the last 11 years catering to self-employed Realtors of the largest real estate brokerage in Florida.  It is their number one and perennial concern so to earn the right to talk about the profitable lines I deal in I must give the utmost in service and advice regarding health insurance.  Otherwise, any other agent at my level in the biz would not answer the phone for health insurance inquiries nor would I. It has become too complex, fraught with liability and unhappiness all around and at the end of all the hassle pays dismally.  Since the demos of the real estate industry are 89% female, average age 56, pre-existing medical conditions are a given and makes my market the second worst for health insurance there is.  The worst are men older than 56. 
 
As it also happens, early in my career I was involved in the lobbying efforts of our state agent's association (not the companies', they can more than take care of themselves) and got up fairly close to the sausage factory of state legislation. Since I'm also a political animal I have kept an ear
to the ground of the politics of "healthcare" issues nationally and in Florida ever since.  The totality of my experience makes me probably one of the state's preeminent practical experts in the trenches of insuring self-employed individuals through both group and private coverage and who is respectfully knowledgeable about the politics of it all.  When I started in the business in 1986 there were approximately 40 carriers offering coverage in Florida but through a series of ham-handed legislated "reforms" and mandated benefits our brilliant politicians have driven out all but five group insurers and only a few more carriers of private coverage that is worth buying. So now everybody pays exorbitant rates with far fewer choices. It's instructive to remember that during that span of 23 years Florida was one of the fastest growing and economically prosperous states and yet insurance companies took a pass on doing business here rather than expose themselves to the unquantifiable risks the politicians imposed on them. It's all about risk to underwriters and if you mandate they cover more and more risks while at the same time restrict their ability to assess them by limiting their underwriting they simply won't take any.  Some day, if you're ever interested, I can give you the full dissertation on how precisely government intervention has ruined the health insurance market in Florida and made it perhaps the least competitive, most expensive and troublesome in the Union.
 
And finally by way of credentials I suffered a heart attack on 7/4/09 necessitating an emergency angioplasty and stent and am now a veteran of actually using the system at a high level.  To the tune of $90,000. I am the 48 year old father of six who has kept very fit for 30 years, races vintage motocross (1978 Suzuki RM400, a monster!), eaten right, don't drink and drug and who has otherwise been a total square for 25 years.  It was the first serious health issue in our family, thank God, and also the first time I ever had to see if my "parachute" (my simplified sales lingo for insurance) would work.  Being self-employed, I carry a high-deductible individual (fully underwritten private plan) HSA plan and it worked precisely as advertised and as I've pitched it for years.  We agents aren't so different from the layman and though I have many clients who have had smooth claims, until we have to pull our own ripcord we too never truly know if it will open.  And it did, beautifully.
 
My opposition to nationalized "healthcare" is based far more on philosophical grounds in tune with your's.  You are right, having the government become the sole provider of healthcare renders us all wards of the state and subject to their final approval for any care and, ultimately, oversight of our private lives. It never ceases to amaze me how people who've lived anything beyond the age of 25 haven't learned the age old adage that "he who pays the piper calls the tune".  I personally don't want the government anywhere near my private life or that of my family's.  And too, if I die someday from some arguable want of care denied me by a third party or by my own decisions, so what, I want to die free. I must die in the end and I don't want to do it clinging to and begging an indifferent government. There is a great line in the movie Open Range with Robert Duvall and Kevin Costner. They are in the town bar chatting with some locals about why they don't stand up to the reigning land and cattle baron who ruthlessly runs the town and the law. A good but cowed man whose grown sons he forbids from resisting the tyranny objects they could be killed to which, Costner replies, "Yes, but someday they'll learn there are some things in life that gall a man worse than dying." Precisely so, live free or die, because in the end we all must do the latter but whether we do the former is up to us. But sometimes convincing others requires converging the philosophical with the practical concerns. And this brings me to your remark of yesterday which does it exceedingly well, "And people write to me whenever I say this, oh, no, this insurance plan won't allow you this, and Medicare won't allow you that. In the end, if you stand there and you get out your checkbook, you can have the procedure. And if you need to mortgage your home or sell your car
to do that, you can have that procedure, too."  Your words are almost precisely how I've been illustrating the difference between a government and free system for years but with a little twist.  I tell people, "there is a huge difference between arguing with your insurance company about who is going to pay for something and begging permission for it from a government bureaucrat.  If one of my kids needs a $300,000 brain surgery to save his life I'll move heaven and earth to make it happen but there is no question we can get it done but in a government system if they say no then the answer is no. It is the difference between freedom and servitude".  When I say that word, "permission", you can see the light go on it the hearer's mind.  I've had staunch liberals with their jaws set completely change their demeanor at the word. The idea of asking the same kind of folks down at the DMV, Post Office or just about any type of gov't agency for permission to get your kid that lifesaving surgery galls an American like nothing else on the topic. It boils the whole debate down to the central idea, liberty or servitude, sovereignty or wardship.  Free men exercise free will, wards of the state beg permission.
 
This is the watchword of the healthcare debate we need to deploy in every conversation, Mark, permission. It cuts through all the fog and arcana. People understand the subservience of asking for permission and no self-respecting grown-up, especially American grown-ups, likes doing it.
Especially of their government that is supposed to work for them.  Keep up the great work.
 
Mark Shepler
Jupiter, Florida

SIMPLER, AND CHEAPER
As B. York has noted, we lost 17 million uninsured during Obama’s speech. That's good - in the course of a month's debate, they've miraculously gotten insurance.  Maybe we should just debate another couple months and it'll be fixed.

Taking a cue from Rush Limbaugh, though, I thought I'd run numbers. Obama says 30 million without insurance.  Let's give them the same deal my wife gets through her work.  The insurance costs the hospital about $1100/month ($13,200/year).  It costs us about $300/month.  (It's a lot more insurance than we need, frankly, but my out-of-pocket costs for the insurance are about half what they would be otherwise.)  Give folks that $13,200/year to buy insurance where ever they can get it, the best they can get.  Comes to $396 billion.  Cut out a bit of unemployment insurance, cut a bit of the farm subsidies, cut a bit off student loans & grants, cut a bit out of public housing and get rid of the ACORN subsidy.  Voila!  $396 billion.  No deficit.  No gov't run option.  No nothing.

It's still a dumb idea, but it's a dumb idea that costs less than half of what the President claims his dumb idea will cost.

Eric Verhulst

WINGING IT
Your comment about Obama being the smart kid who thinks he doesn't have to prepare gets at something I've been thinking throughout this entire healthcare debate.  First of all, I think, like some smart guys, Obama is lazy (so obvious from his background as a community organizer).  His laziness is showing in his inability to fully know what is in his and the Democrats' plans.  The laziness becomes a particular problem in that what president - even smart policy wonks like Carter and Clinton - could have the time to read and remember bills that are over a thousand pages? So, like the smart guy you reference, he wings it!  And, given how large his audience of potential critics is, he gets caught constantly not knowing or understanding what he has failed to master, read or given some sufficient time to understand.

Paul Zisserson
Cranston, Rhode Island