So what about the "death panels" we've got now, Sarah?

Mike Madden of Salon asks this question with his recent article, "The 'Death Panels' Are Already Here":

Opponents of reform often seem to skip right past any problems with the current system -- but it's rife with them. A study by the American Medical Association found the biggest insurance companies in the country denied between 2 and 5 percent of claims put in by doctors last year (though the AMA noted that not all the denials were improper). There is no national database of insurance claim denials, though, because private insurance companies aren't required to disclose such stats. Meanwhile, a House Energy and Commerce Committee report in June found that just three insurance companies kicked at least 20,000 people off their rolls between 2003 and 2007 for such reasons as typos on their application paperwork, a preexisting condition or a family member's medical history. People who buy insurance under individual policies, about 6 percent of adults, may be especially vulnerable, but the 63 percent of adults covered by employer-provided insurance aren't immune to difficulty.

Consider that, and then this news release: "New Poll Shows Canadians Overwhelmingly Support Public Health Care: Group says advocates of private system are out of touch with most Canadians".

A comparison of single-payer and multi-payer systems

The United States uses a multi-payer, for-profit health care system, with some elements that are not for profit, such as Medicare. Our system is administered privately, and operates from a market-based view, i.e., that health care is a commodity. Canada, on the other hand, uses a single-payer system that, while still for-profit, is administered publicly, and operates from the assumption that health care is a right. Our system is financially out of control, and incredibly wasteful and complex. Canada's is fairly simple, and far less expensive. Not only that, Canada's system is rated as better by the World Health Organization than is ours.

The recent hearings in Congress on possible reform measures, headed by Senator Max Baucus, have one striking feature: proponents of instituting a single-payer system in the US have not been invited to participate. Thus, protestors, representing organizations such as the California Nurses Association and Physicians for a National Health Care Program, have taken to interrupting the proceedings to make their point.

Below are two graphic representations of just why our system is so expensive and Canada's is so much cheaper, and yet still outperforms ours. These are taken from Neil Davis' book.

Doctor Shortages?

How many doctors does it take to adequately serve 1000 people? The number varies with country, it seems. In 1997, two countries with highly rated health care systems, France (WHO rating 1st) and Germany (WHO rating 25th), had about 3.3 doctors per 1000 population, but Japan, also highly rated by WHO at 10th, had only 2.0 doctors per 1000 population. Similarly, the United Kingdom (WHO rating 18th) and Canada (WHO rating 30th) had 2.1 doctors per thousand. The less-highly rated United States (at 37th place) had an intermediate number of 2.7 doctors per 1000.

More recent data indicate that the number of doctors in the United States has declined to about 2.38 per 1000, but, curiously enough, a report from the Organization of Economic Cooperation and Development states that the number of doctors in Canada has been stable at 2.1 per 1000 for at least 20 years. The number in Alaska is about the same, 2.05 doctors per 1000 population.

Obviously, the quality of medical care in a country does not critically depend on the number of doctors the country has. However a recent report from the Alaska Physician Supply Task Force notes that because of Alaska's size, rural nature, and extremes of weather, the state really needs more doctors than it has. It should have about 10 percent more doctors per 1000 than the United States as a whole, the report recommends. Presumably the same is true for Canada because of its similar geography.

References:
http://www.upi.com/Health_News/2008/07/08/Canadian_doctor_shortage_disputed/UPI-89811215532839/

http://www.hss.state.ak.us/Commissioner/Healthplanning/publications/assets/PSTF-06.pdf

Health Care for Alaskans: An "Informational" Publication

An insert with the above title (minus the weasel quotes) in the Fairbanks Daily News-Miner's Sunday edition appears, at first glance, to be a special medical issues insert created by News-Miner staff. Article bylines read "Staff Report", with the exception of an article on the last page entitled "Certificate of Need hinders health care innovation," which is written by Michael Morrisey and Michael Ciamarra.* It is on the bottom of this last page, and this page alone, that a small notice reads, "Paid for by the Alliance for Healthcare in Alaska, 1275 Sadler Way, Fairbanks, AK 99701," thus revealing that the 8-page newsy-looking insert is in fact a paid advertisement. The staff "reports" are in fact opinion pieces, and are riddled with false and misleading statements.

Articles in this advertisement include:

• "Nation faces crisis due to physician shortage," which falsely claims that physician shortages "will only be exacerbated with universal health care"; and that "It is well documented that many Canadians wait an inordinate amount of time for their much-needed medical and surgical care," and "end up coming to the United States for their treatment".

• "Alaska's healthcare system locked in textbook 'monopoly'," laughably states, "It is important to understand that the health care system in America is second to none." This is flatly false, unless one is extolling its virtues as a money-making machine for insurance and pharmaceutical companies.

• "Competition necessary for industry to flourish," is a summarization of a presentation by Mark J. Botti of the Antitrust Division of the US Department of Justice in February 2007, "Competition in Healthcare and Certificates of Need." It extolls the virtues of competition in health care and argues against the need for Certificates of Need laws.

• "Breaking down 'Certificate of Need'" (subtitled "Program designed to aid patients in health care community now contains flaws, causes more harm than good"), provides a timeline graph of the number of states with CON laws and takes the form of arguments and rebuttals on the CON issue.

• "Certificate of Need hinders health care innovation,", which describes problems in Alabama, Georgia, and North Carolina's CON laws.

Quite clearly, the sponsors of this multipage advertorial want Alaska's Certificate of Need law overturned, as requested by Governor Palin (although this action was NOT recommended by the Alaska Health Care Strategies Planning Council she created to advise her). Unfortunately, the Alliance for Healthcare in Alaska appears willing to promulgate nonsense in order to do it.


*Ciamarra is vice president of the Alabama Policy Institute, a right-wing conservative think tank, described by the U of Alabama College Republicans as "the largest and most influential Conservative think tank in the state of Alabama."