Archives for June 27, 2008

Texas Senators both choose to screw docs

Update: I appear to have been drawn in by polemics from a group not prone to them.  See Health Care BS for details.

Both Texas Senators (both Republicans).  I’m reproducing the email I got today from TMA after the break.

Thanks for nothing, Senators.

[Read more…]

New Grad Advice 2008

Shadowfax started a nice thread, and the impressive 10/10 added to it today, a list of advice for new EM grads. Read their advice, but here’s mine:

  1. Lease, don’t buy. Way more than half of new grads change jobs within two years. I know, it’ll never happen to you, but here’s the thing: I was you. I got my ‘dream job’, bought a beautiful home in a perfect neighborhood. I sold and moved in 10 months. It’s a really nice way to lose a lot of money. It can happen to you.
  2. Be humble. True, you’re at the absolute top of your game, you know the best literature on every subject, and can intubate with your off hand in the dark, blindfolded. Your new colleagues have been practicing EM for a very long time, and while they’d be interested in your incremental knowledge of the state-of-the-art, they’re not itching for you to enlighten them. Open your ears, listen, and learn. (Use your filter: there’s a pony in there somewhere). [Read more…]

Canadian Healthcare Author Writes a new Ending

Investors Business Daily:

Canadian Health Care We So Envy Lies In Ruins, Its Architect Admits

By DAVID GRATZER | Posted Wednesday, June 25, 2008 4:30 PM PT

As this presidential campaign continues, the candidates’ comments about health care will continue to include stories of their own experiences and anecdotes of people across the country: the uninsured woman in Ohio, the diabetic in Detroit, the overworked doctor in Orlando, to name a few.

But no one will mention Claude Castonguay — perhaps not surprising because this statesman isn’t an American and hasn’t held office in over three decades.

Castonguay’s evolving view of Canadian health care, however, should weigh heavily on how the candidates think about the issue in this country.

Back in the 1960s, Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.

The government followed his advice, leading to his modern-day moniker: “the father of Quebec medicare.” Even this title seems modest; Castonguay’s work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast.

Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in “crisis.”

“We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

Castonguay advocates contracting out services to the private sector, going so far as suggesting that public hospitals rent space during off-hours to entrepreneurial doctors. He supports co-pays for patients who want to see physicians. Castonguay, the man who championed public health insurance in Canada, now urges for the legalization of private health insurance.

In America, these ideas may not sound shocking. But in Canada, where the private sector has been shunned for decades, these are extraordinary views, especially coming from Castonguay. It’s as if John Maynard Keynes, resting on his British death bed in 1946, had declared that his faith in government interventionism was misplaced.

What would drive a man like Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care; a system where people in towns like Norwalk, Ontario, participate in lotteries to win appointments with the local family doctor.

Years ago, Canadians touted their health care system as the best in the world; today, Canadian health care stands in ruinous shape.

This had to be hard for him, and I respect any man who can see his life’s’ work not working as intended, and trying to change it, though this seems a weak start.

It reminds me of the 80’s Soviet Union farms.  5 year plans and Communist Agriculture consistently resulted in inadequate crops and food shortages.  In desperation farmers were allowed a small plot of land to grow food, the sale of which they got to keep the proceeds from.  Guess what sector of their farm economy was most productive?  This is now proposed for medicine in Canada.

I’m sorry for Canadians, and at the same time unsurprised.  Now, can we learn from others?