Thursday, March 15, 2007

Waiting for Trudot

I have a friend, spending his winter in Florida, whose back is giving him substantial grief. He sends this note regarding a close encounter, occasioned by his ailment, of the rude kind:
I was introduced to a Canadian at a cocktail party by a neighbor who thought we might have something in common, as the poor fellow also has a bad back.

Indeed he did. He said the pain was so bad he could not dress himself or drive a car; he went on to say he was going to have surgery. I asked where, and he named a huge city in his home Province. So I asked the obvious question - how long do you have to wait?

At this point he suddenly became rude and angry, telling me that he was waiting 11 months, but it was free, and he was sick and tired of "stupid Americans" who did not understand how good Canada's health system was. (That's not word for word, but very close). I was taken aback by his attitude, but recovered after a couple of seconds and told him that I found him ignorant, supercilious, and insipid. I then informed him that if he were twenty years younger, I would knock him on his ass and he could get his broken nose fixed for free sometime in 2009.
This prompted a chuckle and a few thoughts.

A) Canada's health care system works so well that the "stupid" Supreme Court of Canada has declared such "wait times" unconstitutional. Yell at them.

B) Rationing, which is exactly what this guy's 11 month wait is, produces skewed statistics from which he probably takes comfort. I'm sure he felt smugly superior when he read that Canadian coronary bypass operations are cheaper than those in the US for statistically identical outcomes. One question not addressed by that study, however, is; How many Canadians died while on a waiting list? Of a certainty, including them would change the "outcome" calculations. If you have to ration heart surgery, as does Canada, the sickest people will die before they ever get to the operating room. Darwinian socialism at work.

C) Apparently this Canadian considers his time, and specifically his time spent as an invalid in severe pain, to be without value. That's heroic of him. However, I don't want his socialist martyrdom to be the standard for my health care, or anybody else's. It should be noted that he does expect his fellow Canadians to gladly accept his judgments on this.

D) Apparently, he considers insurance paid for through exorbitant taxation to be "free." Why, then, does he not advocate that Canada provide "free" car insurance? Well, maybe he does. So...

E) Would he be happy if Canada did provide free car insurance, but for 5 months he had to drive a car on the 401 with an accident-damaged drive shaft his Government-of-Canada-employed physician mechanic tells him might fail catastrophically at any moment? If he is not happy with that scenario, why not? It would, after all, be "free" ... unless he felt compelled to rent a car from a private enterprise in the mean time.

F) Would he feel differently if he had prostate cancer and had to wait more than a month for critical radiation treatments?

... or died because he could not receive timely cardiac catheterization? (this link contains links to many other TOC posts on Canada's health care system)

... or had to fly 500 miles to give birth while having contractions every 4 minutes?

G) If he's tired of "stupid Americans" asking obvious questions, WTF is he doing in Florida where he is exposed to such mental anguish that he feels compelled to insult a stranger? I mean, Cuba is even warmer, is a popular Canadian vacation destination, and has a health care philosophy even more advanced than Canada's. I'll admit Cuba is less able to execute at present, but it's only a matter of time until Canada achieves the same level. It goes from 11 months to "never." Check the UK.

H) At least when he gets home he can commiserate with his countrymen who are waiting for knee replacement surgery. The wait has become so long for these operations that Canada's Government health-care Czars are considering a little privatization - Ontario mulls private knee operations
The Ontario government is reviewing a proposal that would pay a private hospital to perform 1,500 knee replacement operations -- a move that comes as the province struggles to reduce lengthy queues where some patients wait as long as one year for surgery.

...The Ontario government has been working feverishly to reduce some of the lengthier queues. Although progress has been made -- waits for knee replacement, for example, have dropped by 18.9 per cent or 83 days since August/September 2005 -- queues remain staggeringly long.

Specifically, 90 per cent of patients requiring knee replacements had them done in just under a year -- within 357 days -- according to Ontario figures for October and November of 2006.
Indeed, "stupid Americans" don't "get" Canadian health care. It's a good thing we don't - in either sense.

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