Comments (56)

• Bruce Koerber

  Education and Ethics
  Saturday, March 21, 2009

  Will Natasha Richardson's Accident Destroy Health Care?
  
  What a shock to the psyche of those with wealth! Or are the wealthy so propagandized by the State or by the competitive peer pressure of the "green" or "vegan" or "baby adoption" socialistic idealism of the "rich and famous" that they miss the point?

  Are the wealthy going to find inspiration from this shocking episode to fight to preserve private health care in the United States? Will they either reduce their tourism to Canada or pay for an emergency service that can cross the border if something life-threatening occurs?

  Or will they act "dumb or dumber" and jump on the socialism bandwagon to destroy what is left of an endangered species - private health care!

  I sure hope the wealthy use their resources to educate themselves about classical liberalism and in that manner leave a legacy, a true legacy rather than the plethora of shallow, ephemoral 'showboating' and vain types of legacies. Are the wealthy just airheads who award extortionists like Al Gore the Oscar or are they intelligent enough to recognize that private property and sound money are the foundations of a prosperous and just society?

  Published: March 21, 2009 8:43 AM

• D. Saul Weiner

  Unless and until we learn more, we can only read so much into this one incident. It is possible that Richardson was doomed regardless of the treatment which might have been available.

  The comment about dental care in Germany reminded me that, however bad things were in Communist countries, they were at least able (to some extent) to take advantage of developments in and prices from capitalist countries. As bad as things are in medicine today, and as unfree as the American market is for that matter, the world will not even have this to fall back on when the U.S. health care system becomes completely socialized.

  Published: March 21, 2009 9:37 AM

• Ray Lopez

  It's well known the US subsidizes medical research for the rest of the (socialised) world. It's also well known that the research goes into costly end of life maintenance. In this particular case, perhaps a brain surgery (drilling a hole to relieve pressure) may have worked, but given that you have an hour to diagnose and treat the problem, it would have been chancy. Better to wear a helmet for first time users--cheap and low tech. Great site BTW, allows unregistered users to make comments.

  Published: March 21, 2009 10:06 AM

• prettyskin

  Socialized medicine is purely asinine. So, why are the United States politicians pushing this dead on arrival plan?

  For elitists to be relevant in this world is to impose their views that are mostly peddled by politicians upon unsuspected citizens of the state. Whereby the elitist views are "right" with all disregard to data.

  Published: March 21, 2009 10:24 AM

• Franklin

  The present system in the U.S. is publically subsidized already and far from a private system. Nevertheless, I surmise that few on the "left" believe that there exists "better" healthcare outside the U.S., factoring in the infrastructure, technology, academic and research partnerships, innovation, skill and education of the providers.
  What is at issue is how "access to the care" and so-called "affordability" can be provided to the 300,000,000 residents of the country. (Note, I said "provided," distinct from "made available.")
  And in the provisioning of this care to everyone according to his needs, how and why does this necessarily equate to a pejoration of the "best healthcare in the world"?

  Self proclaimed conservative talk show entertainers decry the threat of collective healthcare, and will argue their point by citing long-lines in Canada or EU.
  This does little (nor should it do anything) to intellectually raise any ire. The leftist response, and fully justifiable, is, "So what. I don't want long lines either; I just want to be able to afford to treat my poor little sick kid, and not see him die. Why do you want only wealthier families to have healthcare? This is not about who gets to buy a fancy car, we're talking about here!"

  A fundamental disagreement is the nature of the service.
  (a) Minarchists may argue, "Nobody should pay a dime for anybody else's insurance, sick kids or not, since healthcare is not a 'public good.'"
  (b) Mainstream republicans and democrats believe it certainly is a public good, "I will ignore your outrageous greed and disregard for sick kids, and simply say that we need a mechanism to fund this public good, much as we fund the roads and the army."

  Excuse the above cardboard characterizations, but responding to (b) with, "Well, you are proposing making our healthcare second rate" is not a thoughtful rebuttal since there is no articulated connection nor deduction. The "left" is not proposing second-rate healthcare at all. They are saying, "We have a pie to slice up; stop throwing all the money at greedy CEOs or at the war machine and use that money to simply provide everybody the same health insurance policy, without changing too much of the current system."

  The challenge for libertarians is to demonstrate how provisioning insurance to "all" is detrimental to healthcare services "for all," including those who "never had it before." The sticking point is often the scarcity of the good (or service). Then the argument follows, "Should only the rich get to buy this service?"
  The long line argument is a frail argument when the choice is "a long line" or "no insurance."
  

  Published: March 21, 2009 10:47 AM

• Stefan

  Speaking as a Canadian:

  The vast majority of my peers appear to believe that the socialized system is the only just way to deliver medical care to all walks of life. They cannot imagine a charitable hospital or anything of that sort because they believe that charity is the function of the state... after all, why do we pay taxes? We've outsourced our charitable goals to an inefficient third-party government machine.

  If you don't have a family doctor... good luck getting one. There is a noticeable shortage. People end up packing walk-in clinics and emergency rooms. Emergency room wait times average around 13 hours in Ontario. Eventually everyone will get some form of care... but since we have no comparative metric, we blindly assume this system is "the best we can do". Result... years for hip replacement, months if not years for an MRI (and they don't even run MRIs 24hours a day with this backlog, as far as I am aware). Also, just wait until you get a referral to a specialist... you may wait months to see a dermatologist.

  Do I detect a lack of a pricing system here? How does the state decide what the priorities are without committee rule? Recipe for shortages and poor service.

  I'm lucky. I'm young. I'm healthy. I know many doctors personally, and can skip the line. Need an MRI?... it will cost me two weeks of waiting and a fine bottle of Scotch. It is a sad state of affairs.

  I think the key point is the following: we can't see how poor people could ever be cared for given the present-day zeitgeist of "me, me, me". Our communities are weak, we don't have local charities of sufficient strength any longer. Can a society demoralized in this fashion support a shift from socialized to free-market care?... not easily... and not likely, I'm afraid.

  Published: March 21, 2009 10:48 AM

• Thank God I'm Not Sick

  A few years ago (it might still be the case) hospitals in Montreal started shutting down operating rooms because there was a shortage of support staff. Instead of paying nurses overtime pay they laid off specialist surgeons because their budget had run out. Of course waiting lists got longer.

  The good news is that the supreme court ruled that the public medical care monopoly violates the charter of rights and freedom, so private practices are now allowed. The new public research hospital that was supposed to be top-of-the-line in Montreal, CHUM, which has been promised for nearly a decade, has not yet broken ground.

  Published: March 21, 2009 10:53 AM

• Ohhh Henry

  The "medical capital" in Quebec has mostly been allocated to the ski chalets and summer cottages of the provincial and federal government politicians and bureaucrats who administer the system.

  Published: March 21, 2009 10:59 AM

• D. Saul Weiner

  "A fundamental disagreement is the nature of the service.
  (a) Minarchists may argue, "Nobody should pay a dime for anybody else's insurance, sick kids or not, since healthcare is not a 'public good.'"
  (b) Mainstream republicans and democrats believe it certainly is a public good, "I will ignore your outrageous greed and disregard for sick kids, and simply say that we need a mechanism to fund this public good, much as we fund the roads and the army.""

  These are not arguments. Saying that we should (or should not) provide something via government because it is (or is not) a public good, is just a circular argument.

  "Speaking as a Canadian:
  The vast majority of my peers appear to believe that the socialized system is the only just way to deliver medical care to all walks of life. They cannot imagine a charitable hospital or anything of that sort because they believe that charity is the function of the state... after all, why do we pay taxes? We've outsourced our charitable goals to an inefficient third-party government machine."

  This is the most tragic aspect of giving functions over to the state. Over time, most people come to believe that they cannot be provided via the free market, simply because that is what they are accustomed to and the alternatives have been displaced.

  Published: March 21, 2009 11:57 AM

• downunder

  We in Australia have a dual system of a mainly Private Health delivery system with the option of Private health Insurance covering Private Hospitalisation and some ancilliary services, and the national public system Medicare, a Taxpayer (levy) funded Universal health System covering the cost (in part or full) of most medical procedures e,g,, consultation, radiography, pathology etc sourced from your choice of private non-government practicioners. The Public Hospitals in my state provide free Medical Services and Hospitalisation for anyone, and are the preferred and usual destination for trauma and emergency patients. They are also widely used by the chronically ill, as well as low income or the the unemployed often by necessity. We don't use the term 'socialised' medicine, and regardless of the many criticisms of our free Public Health Sector shortages and waiting lists, the vast majority want to both retain and improve these Government Services and don't want Medicare dismantled. Private Health Insurance is becoming evermore costly; a very worrying situation for the increasing number of retrenched workers who likely see this Public Health Sector as an additional safetynet. The State Governments also offer various free Services to Welfare or pension recipients at local Community Health Centres. Incidentally, one waits months for appointments to specialists in the private system, but access to private hospitalisation is verymuch quicker_weeks- for none-essential items than the public system which may be 2 years... Many of the private specialists also work in the different sections of the Public Hospitals where the Public patients access their services for free,

  Published: March 21, 2009 12:41 PM

• Mike D.

  I think the analysis is wrong for the following reasons:
  
  Mt Tremblant is only 80 miles north of Montreal. Since the ski patrol called for an ambulance immediately, had the accident been serious (obviously requiring immediate trauma center attention), Natasha Richardson would have arrived at a trauma center in Montreal in about an hour. As it was, she thought she was OK, so the paramedics were sent away.
  
  A person in the US in the same situation, with normal medical coverage, more than an hour away from the nearest trauma center, would have to make the decision of paying $600 for an ambulance, plus $100 ER fee, (or even more for a helicopter) . Most people would wait for serious symptoms to occur, with the same tragic outcome.
  
  I don't think you can blame the PQ health care system for Natasha Richardson's death.
  

  Published: March 21, 2009 1:19 PM

• Jim

  I must be lucky. The dentist I use in Germany has a practice more modern than the one I use in the US. I must admit, I was surprised at first at the level of sophistication and quality of care in general, given that Germany's health care system is more socialized than in the US. At the same time, it must be noted that budget constraints have forced Germans to shoulder an ever increasing share of the direct cost for medical care (via rising quarterly co-pays, in addition to health insurance premiums and other taxes).

  Published: March 21, 2009 2:18 PM

• HM

  I would agree with Mike D. The accident wasn't viewed as being serious enough to require further care. By the time the seriousness was realized, it was too late.

  It is more a case of this person's misfortune and celebrity being exploited for political purposes (the argument against Universal healthcare). Rather pathetic, really.
  

  Published: March 21, 2009 2:25 PM

• Nick E

  I learned all I needed to know about Canadian health care when I lived in south-eastern Michigan for a couple of years, and observed the deluge of Canadians crossing the border to pay for joint replacements and to have medical images read.

  The reason why socialized medicine doesn't work is really quite simple: health services being what they are, people don't spend other people's money on them nearly as judiciously as they spend their own. (See the RAND Health Insurance Experiment for damning empirical evidence.) Subsidizing people's consumption of something they like will cause them to, you know, consume a lot of it. When it becomes clear that the whole scheme is unaffordable, the only options are to (a) skimp on the benefits, (b) skimp on their quality, or (c) both. Most socialized health systems choose option C.

  Health insurance is society's biggest and most hopeless Ponzi scheme. Period.

  Published: March 21, 2009 5:51 PM

• Bruce Koerber

  But don't forget that the perverted idealism of the all of socialistic persons of prominence that are ready to get on their soapbox and cry out for socialized medicine (Universal Health Care) is a gross injustice.

  What will snap them out of their economic ignorance or knock the box out from under their feet? So far it seems verifiable that the socialized health care in Canada is part of the reason for the progression of the injury to the point of the death of the individual.

  The prosperous and just civilization stemming from the principles of classical liberalism deserves to be delivered to the masses by people of prominence and so if the death of Natasha Richardson can bring about that change in their ideology then her soul will rejoice I am sure.

  Published: March 21, 2009 6:03 PM

• Bruce Koerber

  But don't forget that the perverted idealism of all of the socialistic persons of prominence that are ready to get on their soapbox and cry out for socialized medicine (Universal Health Care) is a gross injustice.

  What will snap them out of their economic ignorance or knock the box out from under their feet? So far it seems verifiable that the socialized health care in Canada is part of the reason for the progression of the injury to the point of the death of the individual.

  The merits of the prosperous and just civilization stemming from the principles of classical liberalism deserves to be delivered to the masses by people of prominence and so if the death of Natasha Richardson can bring about that change in their ideology then her soul will rejoice I am sure.

  Published: March 21, 2009 6:07 PM

• Luis Ramirez

  I'm an anesthesiologist who works in Costa Rica, which is considered one rung up on the United States as far as overall "quality" by The World Ministry of Health other wise known as The World Health Organization. With all due respect to my colleagues here at home, how can we be above the most advanced medical scientific and technological country in the world? Even by the WHO´s own standards such a claim is patently absurd, it´s only viable explanation can be based on ideologically orientated propagandistic objectives. Like any other service or product, we need free markets in health care in order for any progress to be made, both technologically and administratively. Only through prices can real needs be known and therefore, addressed. Why should medical services be any different? The United States is the World`s most advanced medical center...the rest of the globe has always relied on that fact.

  Published: March 21, 2009 11:44 PM

• Timothy foster

  can any one tell me if this is accurate? http://www.freerepublic.com/focus/f-news/2201659/posts
  If so that changes the argument.
  Stefan has the best argument by far (in my opinion)
  "I think the key point is the following: we can't see how poor people could ever be cared for given the present-day zeitgeist of "me, me, me". Our communities are weak, we don't have local charities of sufficient strength any longer. Can a society demoralized in this fashion support a shift from socialized to free-market care?... not easily... and not likely, I'm afraid."
  

  Published: March 22, 2009 1:03 AM

• Timothy foster

  "I am my brothers keeper" means that I will help if the need arises, it is something that the new liberals have forgot and must be reminded of.
  

  Published: March 22, 2009 1:16 AM

• Dan Tappin

  As a Canadian I can attest to what a joke our system is. We have an air ambulance system here but it is pretty much all funded via donations and lotteries.

  We dread having to go to the ER for anything. Pack a lunch and some books because you will wait all day unless you almost dead.

  We once took our infant daughter to our brand new children's hospital and despite being the only ones in the ER at the time we waited 6 hours in a observation room before even seeing a doctor. I would have paid $1000 out of pocket right there and then to see a private doctor but that is against the law. I can however spend the same money on state of the art medical care for our 3 cats and our dog.

  Published: March 22, 2009 2:58 AM

• Artisan

  The article is only partly right. I worked in a large hospital in Hamburg, Germany. Doctors told me they were VERY happy about the luxury they had while doing research there, as compared to situations they experienced in America… It may be different in the old “Democratic Republic” of course, but everyone knows the whole communist-wrecked-country-integration was a mess… which caused the western German social system to collapse anyways.

  
  The trouble is: socialized medicine works for a while VERY well… just like every ponzi scheme.

  The western German dental system is in general technically well equipped. Most machinery is changed every 4 years (not 50 years like in the article). Most famous scam was the gold scam here: doctors got paid gold extra by dental industry to corrupt the market competition even more.

  Most German doctors however sense now that governmental management is a disaster… because they earn less every year and service to patients gets worse. Their former profits were (very well) paid by social democracy… but there’s some way to go from there to understanding that the cost of private medicine is eventually to let poor people die on the sidewalk or treat them at your own responsibility.

  Nevertheless, it used to be the best citizen medical service I found in Europe (I m in a position to compare). 6 Years ago, it would have been exceptional not to have an appointment within the 3 days with any specialist in Germany… and if you wished so you could make 5 appointments with different doctors for the same question – all costs covered by insurance to 100% . Needless to say what an economical nonsense it meant.
  

  Published: March 22, 2009 5:17 AM

• Bastiat79

  The best way I have found here in Canada to argue with the vast majority who supports the public system goes like this:
  - If the system is going to spend $50k on me to cure me of disease X, why not give me $50k and let me choose how I want to be cured. I gain liberty, and nobody loses.
  And then:
  - If insuring me for $50k against disease X costs $100, why not give me $100 and let me choose by which amount I want to be insured against disease X (including publicly owned insurance if I want to). I gain liberty, and nobody loses.

  By stressing that nobody loses, especially "the poor", I usually survive the discussion. At all costs, avoid mixing your arguments against wealth redistribution with your arguments against public health care. Good luck!

  Published: March 22, 2009 7:49 AM

• Jerry Kirkpatrick

  Perhaps there was delay in getting Natasha Richardson proper medical care because she didn't feel the dire need for it, but one doctor friend who used to work in Mammoth Lakes, California, said that 20 years ago the Mammoth hospital had a CT that could diagnose an epidural bleed within a few minutes, not hours. He also said that every major US ski resort that he knew of today has access to a CT within minutes.
  

  Published: March 22, 2009 3:32 PM

• Gil

  "Minarchists may argue, "Nobody should pay a dime for anybody else's insurance, sick kids or not, since healthcare is not a 'public good.'" - Franklin.

  Bingo!

  Published: March 23, 2009 1:23 AM

• Vanmind

  Yes, I wouldn't be too quick to let the Quebec system off the hook. If the institution of socialized medicine had not limited available treatment options, the original attendants might have been able to encourage the patient to get a precautionary CT.

  "Madame, it's only a few minutes away."

  Published: March 23, 2009 1:47 AM

• newson

  ...and the lesson is - free, universal, air-ambulances. so the poor may never die on the ski-slopes.

  Published: March 23, 2009 3:37 AM

• geoih

  Quote from downunder: "The Public Hospitals in my state provide free Medical Services and ..."

  I love it when people say that some service is "free". As if medical treatment (or education or whatever) simply falls from the sky or grows out of the ground and all you have to do is go pick it up.

  This I think is the problem and the point that should be emphasized. It isn't free. Somebody, everybody is paying for it, and there's no accountability. Consequently, it will never work.
  

  Published: March 23, 2009 6:17 AM

• lisa

  I read this article and related comments with some interest. Where are the solutions? Great, if an MRI becomes and income producing item, what good is that to the person that earns 8/hr at McDonalds? They don't have health care benefits, nor the disposable income to purchase the service. I have a dear fiend who left Canada to practice medicine in the US -- he stopped practicing. Do you know why? His patients could often not afford the cost of care, whether it was prescription medication, or a specialist visit. I hear the stories over and over -- I lost my house when I got cancer, I can't afford to buy my cholesterol medication. Did you know that the US has the highest infant mortality rate in the western world? Why -- because the poorest people, women, can't get access to pre-natal care. Shame, before you denigrate another model -- come up with a soluition first -- nobody wins when we point and 'na-na-na-na' at eachother -- find the answer where we all have equal access to care, all the time, with the best equipment, personel, and methods.

  As for Natasha Richardson, perhaps if she had taken the ambulance offered to her right at the the resort at the time when she fell, she might still be with us -- as is often the case our own choices and fate conspire to place us where we least expect to go.

  Published: March 23, 2009 9:36 AM

• Walt D.

  I think we are falling into a common statistical fallacy, used, incidentally, by the LA School District who claim that standardized test scores are rising, contrary to common sense. How do they perform this sleight of hand - they don't count people who drop out! What is the expected waiting time for hip replacement or triple bypass in the US if you don't have insurance?
  
  We also need to compare like with like. A lift ticket at Mammoth Lakes is $83 dollar; at Mont Tremblant it is somewhere between $50 and $55 depending on the exchange rate. Part of this cost differential is due to liability insurance. It is much easier to have a helicopter ready where you have rich customers. At Formula One events, there is a trauma unit on site. We don't have a trauma unit/helicopter at every little league baseball game, just in case someone gets hit on the head.
  
  Incidentally, I'm not a proponent of socialized health care. However, by taking isolated incidents to support our opposition, aren't we using the same tactics as Michael Moore's "Sicko"?

  Published: March 23, 2009 10:36 AM

• Vanmind

  lisa, don't assume that eliminating universal insurance would mean that McDondalds workers would have no insurance at all. Any lack of choice in insurance is another sign of criminal socialist intervention in the market.

  My father and his brother were both doctors born & raised in Canada. After government stole for itself a monopoly in Canadian health care, my uncle moved to America and enjoyed a more satisfying career than my father who stayed behind and grudgingly accepted his coerced, involuntary servitude. This was before the socialist intervention of Medicare/Medicaid ruined American health care and drove costs up to the point that your friend's patients could no longer afford proper treatment or insurance. Those patients of your doctor friend must blame government and the Medicare/Medicaid swindle, because fifty years ago they would have been able to afford treatment/insurance/care.

  On the other side of the coin, recently a good friend of mine returned from living for a few years in America, where he boasted he could get to see a doctor in a day or two at most if he needed (I've lived there too and know this to be true). After getting back to Toronto, he suffered chest pains during a hockey practice and left the ice. With such a shortage of doctors up here, he spent hours in a hospital ER only to have the staff look him over for ten minutes before saying "We don't see anything, but we've booked an appointment for you two weeks from now so we can do a proper workup." They sent him home, but before sunrise the next day his heart arrested and he died.

  My point? Michael Moore is a fraud, and government expects you to die as soon as possible.

  Published: March 23, 2009 11:11 AM

• Vanmind

  Walt, it might be more accurate to compare Mammoth Lakes with Whistler or Banff/Lake Louise. It is likely that lift ticket prices at Mont Tremblant are artificially lower because of the pervasive subsidies coming from Quebec City to all "vital" Quebec industries (Bombardier, Ubisoft, etc.).

  Where does Quebec City get the funds? By extorting Ottawa with cries of "Sovereignty, Sovereignty" (I am for the sovereignty of all provinces but few in Ottawa are; they'd rather steal from everyone and lie about us being one big happy federal family -- a fact that politicians in Quebec City understand quite well).

  Published: March 23, 2009 11:30 AM

• David Spellman

  If Lisa's McDonald's worker cannot afford health care, where does he get the right to force someone else to give it to him?

  We can cry all we want about the things we cannot afford, but when we decide to take them by force, we are criminals.

  It is amazing to hear all the flowery words from mild mannered neighbors justifying theft and coercion. Totalitarianism stalks the land and destroys society whether it is jack booted thugs or soccer moms doing the dirty work.

  Published: March 23, 2009 11:39 AM

• David Spellman

  If Lisa's McDonald's worker cannot afford health care, where does he get the right to force someone else to give it to him?

  We can cry all we want about the things we cannot afford, but when we decide to take them by force, we are criminals.

  It is amazing to hear all the flowery words from mild mannered neighbors justifying theft and coercion. Totalitarianism stalks the land and destroys society whether it is jack booted thugs or soccer moms doing the dirty work.

  Published: March 23, 2009 11:40 AM

• Gary Anderson

  Medical care properly viewed is a responsibility - not a right. To posit a right to health care is to posit the right to command another man's labor, another man's wealth. In short to believe that one has a such a right is to elevate the the role of the parasite to a legitimate station in life. (I would say the same for any similar claim such as the right to a highway or the right to a school.) To believe that one has a right to healthcare is to believe that one has a claim on a doctor's or nurse's time. This is the role of master and slave. It is odious and immoral.

  Published: March 23, 2009 4:20 PM

• Walt D.

  I think we are falling into a common statistical fallacy, used, incidentally, by the LA School District who claim that standardized test scores are rising, contrary to common sense. How do they perform this sleight of hand - they don't count people who drop out! What is the expected waiting time for hip replacement or triple bypass in the US if you don't have insurance?
  
  We also need to compare like with like. A lift ticket at Mammoth Lakes is $83 dollar; at Mont Tremblant it is somewhere between $50 and $55 depending on the exchange rate. Part of this cost differential is due to liability insurance. It is much easier to have a helicopter ready where you have rich customers. At Formula One events, there is a trauma unit on site. We don't have a trauma unit/helicopter at every little league baseball game, just in case someone gets hit on the head.
  
  Incidentally, I'm not a proponent of socialized health care. However, by taking isolated incidents to support our opposition, aren't we using the same tactics as Michael Moore's "Sicko"?

  Published: March 23, 2009 9:21 PM

• Walt D.

  Vanmind
  
  Don't ask me why I got reposted out of order. I agree with your observations. I have not skied at Banff or Whistler for a long time. They used to attract international (Japanese) skiiers. (There are plenty of cheaper ski slopes close by). Looking online, their prices are about 20% cheaper than Mammoth. I view this as market segmentation - Mammoth gets the Hollywood crowd. Squaw Valley is cheaper, even though it is an Olympic quality venue.
  
  However, the canard in the Natasha Richardson story is that you need an MRI to diagnose an epidural bleed. A moron like myself could diagnose it from a CT Scan. A competent technician diagnose it from an X-Ray and a paramedic could diagnose and an MD could confirm it once symptom appears.
  
  I remember a "Grey's Anatomy" episode where the doctors portrayed by Kathyrn Heigl diagnosed and treated a similar condition using a cell-phone and a Black and Decker drill!

  Published: March 23, 2009 9:41 PM

• Vanmind

  Well, I don't know much about reading medical scans, but my diagnosis is that anything with Ms. Heigl has my support for best whatever-of-the-year.

  Published: March 23, 2009 11:50 PM

• Ellen

  To David Spellman's comment:
  "If Lisa's McDonald's worker cannot afford health care, where does he get the right to force someone else to give it to him?"

  And if you cannot afford a private company to come and put out your house which is on fire, where do you get the right to force someone else to give it to you?

  You easily expect the fire department to be there, but not health care.

  "If they'd rather die, they had better do it and decrease the surplus population." - Ebenezer Scrooge "A Christmas Carol" by Charles Dickens.
  

  Published: March 25, 2009 10:36 AM

• Gary Ruppert

  The fact is, if you are poor and can't afford health care of health insurance, too bad. You can't make me pay for it, that is immoral. If you couldn't afford it, you should have worked harder or shopped judiciously for a good deal, now you are sick? Up yours, I've got mine covered.

  Published: March 26, 2009 5:47 PM

• Twisted_Colour

  I'm glad I live in Australia, we have the sense to keep retards like you away from managing our socialized health-care system, and our system works.

  Published: March 26, 2009 6:22 PM

• moondancer

  I've lived in England, France, and the US. I would trade our miserable health care system for any in Western Europe.
  As for Canada, I ask everyone I meet from our northern ally if they would trade their socialized medicine for our organized piracy, so far no takers.
  We need less MRI's and helicopters and more integrated health and prevention.

  Published: March 26, 2009 6:40 PM

• Nicholas Gray

  As an Australian, I wish to disown the last commenter. Whilst we do have a hybrid system here, not everyone is doing wheelies about it.
  A minarchic, best-of-all-worlds, solution would be to have healthcare as an option that is available to all who choose to be a citizen. If you pay to be a citizen, or if you perform some community service in lieu of cash, you might get the right to vote for laws affecting public lands, AND get a whole range of 'free' services, like schooling and health care. Perhaps one could also have access to public hostels, so as to hide the homeless away.

  Published: March 26, 2009 7:07 PM

• Dave

  "However, because no one can charge medical consumers for anything in Canada, the decision to purchase an MRI machine is purely one of cost. "

  Sir - you are wrong in this.
  http://www2.canada.com/vancouversun/news/westcoastnews/story.html?id=aaf6d061-7672-4020-ab79-987a7e01f2c1
  "Six provinces have privately owned clinics, but only four -- B.C., Alberta, Nova Scotia and Quebec -- have clinics that accept private payments."

  Quebec not only has private, (likely) profit making MRI machines, but they also allow private payments.

  
  

  Published: March 26, 2009 8:02 PM

• Canadian

  It's good that Mr. Anderson will never suffer head trauma, as his own seems to be positioned firmly somewhere up his own back passage.

  Published: March 26, 2009 8:39 PM

• newson

  artisan is right. the early subscribers to the ponzi scheme do very nicely, indeed. systemic breakdown of socialized medicine, although certain, can take a very long time.

  Published: March 26, 2009 11:15 PM

• Ellid

  Natasha Richardson died because she did not wish to visit the hospital until it was too late. For you to take this tragedy and exploit it is vile beyond words.

  Published: March 27, 2009 5:51 AM

• Franklin

  Incorrect, Ellid. She died because she sustained a fatal blow to the head.
  Whether or not she would have been saved is speculation, some of it based in sound judgment, some of it based in ignorance. But both cases represent a guess.
  Temper your holier-than-thou outrage. Every anecdote in life and politics can be trumpeted as defense for, or disgust with, policy. Every time some thug murders another thug in the drug war zones of the inner city, I hear some pretentious buffoon, proposing that he needs to take away _my_ firearm. Exploitation is reality. And there is no clear answer on when it is appropriate and when it is "vile."

  And to Ellen above, Mr. Scrooge minded his own affairs. He was an unpleasant SOB, to be sure. But his comment was a response -- one that adds ambiguity to the issue, another instance where I tire of your and others' holier-than-thou outrage. Ebenezer asked about the _government-operated_ poor houses, funded by taxes of which he paid (and paid dearly -- a helluva lot more than Bob Cratchit). He was told that some of the poor could not go there and that "[they] would RATHER die." [emphasis my own]. That is the point upon which he angrily turned the tables on those who disturbed him.
  And this is the kind of hyperbole that deserved a wise-ass retort. His response befitted the atmospheric situation, the interruption of his day, the draft that the gentlemen ushered into his office.

  I am so sick of the noise; I am sick of the feigned, hypocritical concern; I am sick of the... the bullshit -- the hyperbole that the world will end if Al Gore doesn't tax my mini-van; the hyperbole that the United States will be overrun by terrorists if we don't stay in Iraq; the hyperbole that we will all die if I am not taxed more to help AIG sustain its dysfunction; the hyperbole that someone "will die" if I do not work extra hours so that I can write a larger check to the U.S. Treasury.
  It is so brutally and interminably tiresome.
  Leave me alone, Mr. Scrooge implies. And to which he is correct.
  

  Published: March 27, 2009 9:28 AM

• Jeff Seltzer

  >In Canada, no medical device has the capability of producing an income

  Wrong. Here's a list of MRI clinics (some private) in Quebec: http:\\www.findprivateclinics.ca/Quebec/Diagnostic_Imaging/Radiology/MRI_Scan/lc-11-0-82-0.html

  >the decision to purchase an MRI machine is purely one of cost

  That's how it's done here too. Cost to benefit analysis is key to all such decisions in any health system. If it costs more than it's worth (whether you base worth on "profit" or "health benefit").

  Published: March 27, 2009 11:51 AM

• Enjoy Every Sandwich

  @Franklin: I'm with you. "Bullshit" is the perfect word for the hyperbole that passes for reasoned debate, and the open hostility to critical thinking.

  I suppose it doesn't bother me so much that some people want to create a Nerf world where nobody gets a boo-boo, or even that they believe such a thing to be possible. But I'm past being tired of the fact that they think they're entitled to forcibly extract the means for building their fantasy out of my hide, and the way they caterwaul if anybody dares to use logic or principles to evaluate their schemes.

  I want the terrorists to win; I want to throw the old folks out into the snow to starve; I want to turn our peaceful cities into the wild wild west; I hate babies, kittens, and Western civilization; I'm the battering ram of socialism; on and on and on. And they get really pissed if I don't take these arguments seriously.

  Published: March 27, 2009 12:33 PM

• Francesca

  "The fact is, if you are poor and can't afford health care of [sic] health insurance, too bad. You can't make me pay for it, that is immoral. If you couldn't afford it, you should have worked harder or shopped judiciously for a good deal, now you are sick? Up yours, I've got mine covered."
  [I take it this is sarcasm. But I call bull$#it.]

  Has no one here been to an ER in the US? B/c at the entrance there is always a huge sign in multiple languages saying NO ONE will be turned away b/c of an inability to pay. There is also indigent care and things like Medicaid. NO ONE in the US (legally or illegally) dies from lack of treatment. Canadians die on waiting lists, or apparently due to mentally retarded French Canadian paramedics. The image of a dying child due to lack of insurance is a Michael Moore petty emotional blackmail that just won't die apparently.

  Published: March 27, 2009 4:22 PM

• Albert

  There is also no sign on the ER that says that if you don't have insurance, and we treat you, that you might lose your entire life savings because you WILL ultimately be expected to pay for it out of your own pocket.

  Published: March 28, 2009 11:11 AM

• DavidStein

  The death of Ms Richardson is sad and tragic, but all the more so because the real lessons that could save future lives are obscured with the debate about helmets or her initial refusal of care, neither of which is relevant to the larger picture.

  People living too far from Montreal need to be airlifted immediately to prevent needless mortality from treatable neurological emergencies. Ms. Richardson suffered brain death from increased intracranial pressure (ICP) secondary to an epidural hematoma. However, there are other common causes of increased ICP from hemorrhaging unrelated to trauma. Hypertensive strokes, ruptured aneurysms, arteriovenous malformations, and anticoagulant therapy can all cause bleeding sufficient to increase ICP, which diminishes blood flow and oxygen to the brain and later herniates the brain through the openings at the base of the skull, destroying the brain stem producing brain death.

  It would help prevent head trauma if skiers wore helmets, but that does not solve the problem of other common neurological emergencies that require immediate neurosurgical intervention to reduce increased ICP. Quebec has two airplanes but no helicopter for medical emergencies. Helicopters can land and takeoff where planes cannot, and do not require investing in expensive helipads, as erroneously suggested by a representative from Centre Hospitalier Laurentien.

  The delay from Ms Richardson’s initial refusal of care—a misjudgment possibly resulting from the injury itself—did not have to be fatal. When she left Mont Tremblant, her Glasgow rating (12/15) documents she was disoriented and confused but responsive and treatable. Other patients with epidural hematomas who were unconscious and treated promptly have recovered. The only way to have stabilized her was neurosurgical intervention to reduce ICP, but the possibility of this treatment was delayed for almost four hours even after medics arrived. Had she been evacuated by helicopter, she would likely be alive today. Anyone who lives too far outside of Montreal and has a stroke, aneurysm, or car accident could meet the same fate needlessly in the absence of swift medical airlift.
  

  Published: March 29, 2009 1:22 AM

• newson

  albert says:
  "There is also no sign on the ER that says that if you don't have insurance, and we treat you, that you might lose your entire life savings because you WILL ultimately be expected to pay for it out of your own pocket."

  what? so you'd die rather to keep your savings? or feel someone else's savings are less precious than yours?

  Published: March 29, 2009 1:50 AM

• ehmoran

  Personally, when it gets close to my time or I can crawl, I'm going to the woods with a gun and bowie knife, find a grizzly bear den, kick the bear in the nuts, and have it out. I might even pour gasoline on him and light him on fire. If you see a burning bear running out of the woods, you'll know who WON.

  As said in Legend on the Fall: "It was a good death."

  Published: March 29, 2009 1:59 AM

• Gil

  "Has no one here been to an ER in the US? B/c at the entrance there is always a huge sign in multiple languages saying NO ONE will be turned away b/c of an inability to pay." - Francesca

  But who picks up the tab? The U.S. government? Could the hopital sustain itself without government intervention?

  Published: March 29, 2009 3:39 AM

• Craig

  "A person in the US in the same situation, with normal medical coverage, more than an hour away from the nearest trauma center, would have to make the decision of paying $600 for an ambulance, plus $100 ER fee, (or even more for a helicopter) . "

  Well, no. The ambulance or the helicopter would be summoned and you'd likely get on it unless you were in such good shape that you could refuse (as Ms. Richardson might well have done). It's true that later on the huge bill might be a huge financial problem.

  But that doesn't change the author's point that the medical infrastructure in the U.S. is vastly superior for the reasons she stated.

  Published: April 1, 2009 7:42 PM