Canada’s Top Doctors Pan Their Non-Competitive Nationalized System - Obama's Health Rationer-In-Chief Ezekiel Emanuel Blames The Hippocratic Oath For The 'Overuse' Of Medical Care; So Much For Doing No Harm To Your Patients Which Used To Be A Doctor’s Creed

 

http://www.americanissuesproject.org/blogs/columns/archive/2009/08/25/canada-s-top-doctors-pan-their-non-competitive-nationalized-system.aspx

 

By Jim Hoft

On Thursday August 20, Dr. Brian Day, the former President of the Canadian Medical Association dropped a bomb on Obamacare during his interview with Bill O'Reilly. The former top Canadian doctor shed some light on what Americans can expect from a government run health care rationing scheme. The former top doc told Bill O'Reilly that if the democratic health care plan turns out to be anything like the Canadian plan then Americans can expect rationed care, long waiting lists and skyrocketing costs. He didn’t hold back. Here is what Dr. Brian Day said about the Canadian health care system:

Bill O'Reilly: Dr. Day what is the biggest problem with your health care system?

 

Dr. Brian Day: Well, the biggest problem is access. By access we have, in the Canadian system the first line of defense for a sick patient is the family doctor. And, in a population of 33 million Canadians 5 million Canadians do not have a family doctor.

Bill O'Reilly: Is it because the doctors don't get paid as well as doctors get paid as well in the United States? We have 30% more doctors per 100,000. Is it because they are not getting paid as well?

 

Dr. Brian Day: No, we rank 26 out of 28 in the developed countries as far as doctors to population. Its part of the mechanism of rationing that has to happen when you promise to deliver everything and don't have enough resources.

 

Bill O'Reilly: Is that a major problem rationing in Canada? Are people suffering because they cannot get in to see a doctor?

 

Dr. Brian Day: Oh yes. We have over a million people waiting for surgery and probably another million waiting to see their specialist before they get to wait for the surgery.

 

Bill O'Reilly: Obama says if we pass this trillion dollar bill over 10 years that costs will go down in the United States. You're saying that in Canada they have skyrocketed. So, I'm just saying, this is what we're hearing we don't know. Does it seem plausible to you that if Obamacare gets passed our costs are going to come down?

 

Dr. Brian Day: I don't think so.

This is not the first time Dr. Day has spoken out against the Canadian public health care plan. In a May interview Dr. Day said that privatization introduced the necessary component of competition. He added, "I can't think of any one monopoly in any area that is good for the consumer." Several times Dr. Day has recommended competition and more consumer choice. Day told the Canadian Medical Association (CMA) in his Valedictory Address that market principles barely exist in the Canadian system yet the system is subject to normal economic pressures and principles. Dr. Day congratulated the provincial governments that were beginning to understand the need for reform.

Dr. Brian Day is not alone in his criticism of the Canadian health care system. The outgoing president of the CMA, Dr. Robert Ouellet, a private clinic owner/operator like Dr. Day before him, said there's a critical need to make Canada's health-care system patient-centered. In a recent discussion Ouellet mentioned "that competition should be welcomed, not feared." At the CMA's annual convention this August in Saskatoon Ouellet confessed that the vast majority of Canadian doctors understand that their system is broken.

"The physicians of Canada are serving notice that we are tired of the dogmatic, ineffective and faux public/private debate continually derailing any and all attempts to build a health-care system that serves patients."

Even the incoming president of the Canadian Medical Association, Dr. Anne Doig, understands that the Canadian patients were getting less than optimal care. She went a step further telling reporters at the CMA annual meeting, "We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize." Doig added that physicians coming to the annual meeting recognized that changes must be made.

So how does this fit in with the Democratic health care rationing scheme?

Another prominent Canadian physician and senior fellow at the Manhattan Institute, Dr. David Gratzer, spoke on Capital Hill in June about the life-threatening consequences of government-managed care. Dr. Gratzer told Congress that he believes that the most dangerous part of the democratic plan is that "a government-managed system would cripple private insurers by luring Americans into the Washington-run plan." Dr. Gratzer insists that the government would ultimately try to lower health-care costs by rationing care. He said the US system under Obamacare would eventually look like Canada's.

Is this what America needs? If the top Canadian doctors pan their own non-competitive health care rationing system, why would America want to join them? The democrat’s rationed health care plan would be disastrous for America.

 

http://www.werushdaily.com/forums/dittohead-stack-of-stuff/canadian-doctors-our-health-care-system-is-sick

Its interesting to see this article in the Canadian Press Overhauling health-care system tops agenda at annual meeting of Canada's doctors.

Is this finally a tacit admission, or at least a veiled one, that single-payer doesn't work? Hardly, since the current head of the Canadian Medical Association won't let go of the idea, but he is advocating a need for private care being made available.

"The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.

His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."

In other words, Ouellet believes there could be a role for private health-care delivery within the public system.

Ok... an admission that the wait lists exist... and that we can eliminate them while "maintaining universal coverage"... oh I get it... make the system work while maintaining an iron fisted control on the population... Well Sir, if that were possible it would have worked that way in the first place. But providing quality care in a timely fashion has never been what the system was all about has it?

It gets better...

"He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump-sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said."

Soooo... providing quality care to patients was never what the system was about? So much for your "right" to healthcare. Last I checked Dr. Ouellet, the Hippocratic oath you took was "to do no harm"... then based on your statements about the system you support so vehemently, yet needs to be changed while maintaining the very mechanism that breaks it in the first place, is nothing more than an absolute violation of that oath... and harming tens of thousands a year.

The Incoming replacement for Dr. Ouellet, a Dr. Anne Doig stated the following... "'A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable.'"

I see... consolidate everyone's records into the hands of the government, so that "patient-centered" care can then rationed yet again based on a review of the records. So more efficient use of the medical system for younger "more able-bodied" and the same bureaucratic "weeding" of the elderly who generally need greater care. Sounds to me that this looks like the beginnings of what Ezekial Emanual advocated here.. a "Life Years" approach. Pain pill the crap out of the elderly until they're dead.

How did Ezekiel Emanuel put it?... oh yes...

"“When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the …youngest and oldest people get chances that are attenuated…The complete lives system justifies preference to younger people because of priority to the worst off rather than instrumental value.”"

Is it a leap to say that centralized medical records are a prelude to this "Life Years" murder program? Not if the government was involved it isn't, and especially if they're printing the money used to pay the bills.

In Canada, its apparent that the derisive mantra against privatization is to say that "you want an American System here..."

"Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.

"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do.""

I think Dr. Doig, you have a point there... If you compare what is happening in Europe, Great Britain, and in your own country, then compare it to the US... where do these people go when they need quality care and they need it now! They come here to America, I don't ever hear stories about the opposite. What I do hear is about people who go to Europe for some esoteric treatment after they've exhausted all possibilities here.. only to return from Europe knowing they're going to die anyway. The most advanced care is here in the US, and that is due to the privatized system that is absent of Government oppression. That is until now with the Socialists in power here.

You have your model Dr. Doig, its here in the US. Replicate it before the US replicates yours, and then your patients will truly have no where to go.

 

 

http://www.examiner.com/x-2888-World-News-Examiner~y2009m8d17-Canadas-healthcare-system-imploding

 

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Canada's healthcare system 'imploding'

August 17, 7:21 AMWorld News ExaminerCraig Meister

 

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The new president of the Canadian Medical Association, Dr. Anne Doig, has made comments that indicate that Canada's public run healthcare system is running on empty.

 

We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize...We know that there must be change...We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands.

 

These comments come as the outgoing CMA President Dr. Robert Ouellet, is expected to report that Candada's government-run system needs to become more patient-centered.

 

For more info: Overhauling health-care system tops agenda at annual meeting of Canada's doctors

 

The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred.

"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.

"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."

 

 

Subject: The following is a response to a CDT op-ed touting the wonders of Canadian Health Care
Date: Fri, 28 Aug 2009 08:42:00 -0400

 

The following is a response to a Centre Daily Times of State CollegePA op-ed touting the wonders of Canadian Health Care that appeared in today's 8/28/09 edition of the paper.   

 

 

If the Canadian health care system is so great, then why, in a CP report, did Dr. Anne Doig, the incoming president of the CMA, say “We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize.  Canadians have to understand that the system that we have right now - if it keeps on going without change - is not sustainable.”  Per the CP report, Dr. Doig says that patients are getting less than optimal care.

 

Dr. Robert Ouellet, the outgoing president of the CMA, has said “There’s a critical need to make Canada’s health care system patient-centered.”

 

This begs an obvious question.   If a health-care system isn’t patient centered, how can it be considered health care?

 

ABC’s John Stossel reports, “In Canada, almost a million citizens are waiting for necessary surgery and more than a million Canadians can’t find a regular doctor. In the small town of Norwood, Ontario, a weekly drawing is held in which a townsperson wins the right to access the town’s one family doctor.”

 

Dr. Brian Day, the former President of the CMA, told Bill O’Reilly that if the democratic health care plan turns out to be anything like the Canadian plan then Americans can expect rationed care, long waiting lists and skyrocketing costs.

 

Another prominent Canadian physician, Dr. David Gratzer, told Congress “A government-managed system would cripple private insurers by luring Americans into the Washington-run plan.” He insists that the government would ultimately try to lower health-care costs by rationing care with the US system under Obamacare eventually looking like Canada’s.

 

If the top Canadian doctors pan their own health care rationing system, why would America want to join them?

 

Gary L. Morella

 

http://online.wsj.com/article/SB10001424052970203706604574374463280098676.html

Obama's Health Rationer-in-Chief

White House health-care adviser Ezekiel Emanuel blames the Hippocratic Oath for the 'overuse' of medical care.

By BETSY MCCAUGHEY

Dr. Ezekiel Emanuel, health adviser to President Barack Obama, is under scrutiny. As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs. Many physicians find that view dangerous, and most Americans are likely to agree.

The health bills being pushed through Congress put important decisions in the hands of presidential appointees like Dr. Emanuel. They will decide what insurance plans cover, how much leeway your doctor will have, and what seniors get under Medicare. Dr. Emanuel, brother of White House Chief of Staff Rahm Emanuel, has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research. He clearly will play a role guiding the White House's health initiative.

[mccaughey]"Principles for Allocation of Scarce Medical Interventions" The Lancet, January 31, 2009

The Reaper Curve: Ezekiel Emanuel used the above chart in a Lancet article to illustrate the ages on which health spending should be focused.

Dr. Emanuel says that health reform will not be pain free, and that the usual recommendations for cutting medical spending (often urged by the president) are mere window dressing. As he wrote in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely 'lipstick' cost control, more for show and public relations than for true change."

True reform, he argues, must include redefining doctors' ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the "overuse" of medical care: "Medical school education and post graduate education emphasize thoroughness," he writes. "This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath's admonition to 'use my power to help the sick to the best of my ability and judgment' as an imperative to do everything for the patient regardless of cost or effect on others."

In numerous writings, Dr. Emanuel chastises physicians for thinking only about their own patient's needs. He describes it as an intractable problem: "Patients were to receive whatever services they needed, regardless of its cost. Reasoning based on cost has been strenuously resisted; it violated the Hippocratic Oath, was associated with rationing, and derided as putting a price on life. . . . Indeed, many physicians were willing to lie to get patients what they needed from insurance companies that were trying to hold down costs." (JAMA, May 16, 2007).

Of course, patients hope their doctors will have that single-minded devotion. But Dr. Emanuel believes doctors should serve two masters, the patient and society, and that medical students should be trained "to provide socially sustainable, cost-effective care." One sign of progress he sees: "the progression in end-of-life care mentality from 'do everything' to more palliative care shows that change in physician norms and practices is possible." (JAMA, June 18, 2008).

"In the next decade every country will face very hard choices about how to allocate scarce medical resources. There is no consensus about what substantive principles should be used to establish priorities for allocations," he wrote in the New England Journal of Medicine, Sept. 19, 2002. Yet Dr. Emanuel writes at length about who should set the rules, who should get care, and who should be at the back of the line.

"You can't avoid these questions," Dr. Emanuel said in an Aug. 16 Washington Post interview. "We had a big controversy in the United States when there was a limited number of dialysis machines. In Seattle, they appointed what they called a 'God committee' to choose who should get it, and that committee was eventually abandoned. Society ended up paying the whole bill for dialysis instead of having people make those decisions."

Dr. Emanuel argues that to make such decisions, the focus cannot be only on the worth of the individual. He proposes adding the communitarian perspective to ensure that medical resources will be allocated in a way that keeps society going: "Substantively, it suggests services that promote the continuation of the polity—those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations—are to be socially guaranteed as basic. Covering services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic, and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia." (Hastings Center Report, November-December, 1996)

In the Lancet, Jan. 31, 2009, Dr. Emanuel and co-authors presented a "complete lives system" for the allocation of very scarce resources, such as kidneys, vaccines, dialysis machines, intensive care beds, and others. "One maximizing strategy involves saving the most individual lives, and it has motivated policies on allocation of influenza vaccines and responses to bioterrorism. . . . Other things being equal, we should always save five lives rather than one.

"However, other things are rarely equal—whether to save one 20-year-old, who might live another 60 years, if saved, or three 70-year-olds, who could only live for another 10 years each—is unclear." In fact, Dr. Emanuel makes a clear choice: "When implemented, the complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get changes that are attenuated (see Dr. Emanuel's chart nearby).

Dr. Emanuel concedes that his plan appears to discriminate against older people, but he explains: "Unlike allocation by sex or race, allocation by age is not invidious discrimination. . . . Treating 65 year olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not."

The youngest are also put at the back of the line: "Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. . . . As the legal philosopher Ronald Dworkin argues, 'It is terrible when an infant dies, but worse, most people think, when a three-year-old dies and worse still when an adolescent does,' this argument is supported by empirical surveys." (thelancet.com, Jan. 31, 2009).

To reduce health-insurance costs, Dr. Emanuel argues that insurance companies should pay for new treatments only when the evidence demonstrates that the drug will work for most patients. He says the "major contributor" to rapid increases in health spending is "the constant introduction of new medical technologies, including new drugs, devices, and procedures. . . . With very few exceptions, both public and private insurers in the United States cover and pay for any beneficial new technology without considering its cost. . . ." He writes that one drug "used to treat metastatic colon cancer, extends medial survival for an additional two to five months, at a cost of approximately $50,000 for an average course of therapy." (JAMA, June 13, 2007).

Medians, of course, obscure the individual cases where the drug significantly extended or saved a life. Dr. Emanuel says the United States should erect a decision-making body similar to the United Kingdom's rationing body—the National Institute for Health and Clinical Excellence (NICE)—to slow the adoption of new medications and set limits on how much will be paid to lengthen a life.

Dr. Emanuel's assessment of American medical care is summed up in a Nov. 23, 2008, Washington Post op-ed he co-authored: "The United States is No. 1 in only one sense: the amount we shell out for health care. We have the most expensive system in the world per capita, but we lag behind many developed nations on virtually every health statistic you can name."

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McCaughey

Associated Press

 

McCaughey

This is untrue, though sadly it's parroted at town-hall meetings across the country. Moreover, it's an odd factual error coming from an oncologist. According to an August 2009 report from the National Bureau of Economic Research, patients diagnosed with cancer in the U.S. have a better chance of surviving the disease than anywhere else. The World Health Organization also rates the U.S. No. 1 out of 191 countries for responsiveness to the needs and choices of the individual patient. That attention to the individual is imperiled by Dr. Emanuel's views.

Dr. Emanuel has fought for a government takeover of health care for over a decade. In 1993, he urged that President Bill Clinton impose a wage and price freeze on health care to force parties to the table. "The desire to be rid of the freeze will do much to concentrate the mind," he wrote with another author in a Feb. 8, 1993, Washington Post op-ed. Now he recommends arm-twisting Chicago style. "Every favor to a constituency should be linked to support for the health-care reform agenda," he wrote last Nov. 16 in the Health Care Watch Blog. "If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration's health-reform effort."

Is this what Americans want?

Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.