Rich Doctors say Tax Them More to Help Fund the Canadian ‘Obamacare’ System that Makes them Rich

Posted by PITHOCRATES - March 25th, 2012

Week in Review

People distrust rich people.  That’s why they want to tax them more.  Because they have more than enough money.  No matter what they say about earning their money or how they invest their wealth to create jobs.  People don’t want to hear any of this.  For they ‘know’ that these rich fat cats are lying just to keep from having to ‘share’ their wealth.  But whenever a rich guy says ‘tax us rich people more’ everyone hangs on to their every last word.  For if they are talking about raising taxes on the rich then these are not your typical rich.  They’re the good kind.  Like these doctors in Canada (see Tax us more, doctors urge (Are the lawyers listening?) by Michael Babad posted 3/22/2012 on The Globe and Mail).

A group of doctors is taking a page from Warren Buffett’s tax-the-rich call, urging the Canadian and Ontario governments to tax higher-income earners more…

Doctors for Fair Taxation plan to announce their scheme in Toronto this afternoon, calling for additional taxes on people earning more than $100,000. You’d be hit with an additional 1 per cent if you earn between $100,000 and $170,000, 2 per cent if you earn up to $640,000, and 3 per cent for up to $1.85-million. Above that it would be 6 per cent.

“We feel that this is a moral argument,” Dr. Michael Rachlis, who founded the group that so far boasts more than 50 physicians, told The Canadian Press.

“We cannot talk about throwing people out of work and cutting needed programs for people,” said Dr. Rachlis, an associate professor at the University of Toronto.

Wow.  Sounds very selfless, doesn’t it?  These rich guys asking to be taxed more to help their country?  At least on the surface it does.  But the question that begs to be asked is what are they spending so much money on that they have to raise taxes?  And when you learn what that is it puts these doctors into a different light.

Here’s an article from 2010.  About two years ago.  Talking about a budget crisis.  Where spending is out of control.  Spending that the Canadians just can’t sustain.  And where is this out of control spending?  Why, it just happens to be in the industry that pays these doctors.  Canada’s single-payer health care system.  Talk about coincidences.  These doctors asking rich people everywhere to help pay the nation’s bills.  Where the biggest bill is the one that pays these doctors (see Soaring costs force Canada to reassess health model by Claire Sibonney posted 3/31/2010 on Reuters).

Pressured by an aging population and the need to rein in budget deficits, Canada’s provinces are taking tough measures to curb healthcare costs, a trend that could erode the principles of the popular state-funded system.

Ontario, Canada’s most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices and eliminate “incentive fees” to generic drug manufacturers.

British Columbia is replacing block grants to hospitals with fee-for-procedure payments and Quebec has a new flat health tax and a proposal for payments on each medical visit — an idea that critics say is an illegal user fee.

And a few provinces are also experimenting with private funding for procedures such as hip, knee and cataract surgery.

It’s likely just a start as the provinces, responsible for delivering healthcare, cope with the demands of a retiring baby-boom generation. Official figures show that senior citizens will make up 25 percent of the population by 2036.

Proponents of national health care in America blame the private health insurers, the pharmaceuticals and the hospitals for out of control health care costs.  What they say we need is a system like Canada.  Where they put people before profits.  And yet here they are.  The Canadians.  With a health care system suffering from out of control costs.  Which they are trying to fix with higher taxes.  Additional fees.  Even a little Americanization (that is, privatization).  Makes you wonder why we’re going forward with Obamacare while the Canadians are finding that type of a system is unsustainable.  Especially when our retiring baby boomers outnumber their retiring baby boomers. 

Canada, fretting over budget strains, wants to prune its system, while the United States, worrying about an army of uninsured, aims to create a state-backed safety net.

Healthcare in Canada is delivered through a publicly funded system, which covers all “medically necessary” hospital and physician care and curbs the role of private medicine. It ate up about 40 percent of provincial budgets, or some C$183 billion ($174 billion) last year.

Spending has been rising 6 percent a year under a deal that added C$41.3 billion of federal funding over 10 years.

But that deal ends in 2013, and the federal government is unlikely to be as generous in future, especially for one-off projects.

Wow.  Look at that.  Almost half of provincial budgets pay for the ‘free’ health care of Canadians.  Which is causing budget deficits at the provincial level.  And at the national level.  Well, up until 2013, that is.  When the national government is going to address their budget deficits by cutting their health care payments to the provinces.  Increasing the provincial budget deficits in the process.  Leaving the provincial governments to tax and spend more.  Or ration care and cut spending more.  Including doctor pay.  Could this have anything to do with those selfless physicians asking that their government tax the rich more?  Perhaps.

Brian Golden, a professor at University of Toronto’s Rotman School of Business, said provinces are weighing new sources of funding, including “means-testing” and moving toward evidence-based and pay-for-performance models.

“Why are we paying more or the same for cataract surgery when it costs substantially less today than it did 10 years ago? There’s going to be a finer look at what we’re paying for and, more importantly, what we’re getting for it,” he said.

Other problems include trying to control independently set salaries for top hospital executives and doctors and rein in spiraling costs for new medical technologies and drugs.

Ontario says healthcare could eat up 70 percent of its budget in 12 years, if all these costs are left unchecked…

The province has introduced legislation that ties hospital chief executive pay with the quality of patient care and says it wants to put more physicians on salary to save money.

In a report released last week, TD Bank said Ontario should consider other proposals to help cut costs, including scaling back drug coverage for affluent seniors and paying doctors according to quality and efficiency of care.

So the power of government inserted into the health care system has done nothing to lower the cost of medical procedures in Canada.  Makes you scratch your head, doesn’t it?  Because the proponents of Obamacare say that’s exactly what the power of government can do.  But in practice it has failed to do what these theorists say it can do.  Cut costs.  Through bureaucratic management.  And ‘turning of the screws’ on the medical device and drug manufacturers.  Despite this very practice NOT working in Canada.  Which means that the proponents of Obamacare think the Canadian bureaucrats simply aren’t smart enough to make their health care system work efficiently.  That the system of government-managed health care is a flawed system when it comes to costs and efficiency.  Or that government-managed health care is not about costs or efficiency.  But about the bureaucracy itself.  The control and power it offers the politicians.  And the votes it can buy them.

“Many of the advances in healthcare and life expectancy are due to the pharmaceutical industry so we should never demonize them,” said U of T’s Golden. “We need to ensure that they maintain a profitable business but our ability to make it very very profitable is constrained right now.”

Scotia Capital’s Webb said one cost-saving idea may be to make patients aware of how much it costs each time they visit a healthcare professional. “(The public) will use the services more wisely if they know how much it’s costing,” she said.

Wait a minute.  To fix the government-managed system they need to make the patients aware of the costs so they can choose wisely?  There’s a name for such a system.  We call it capitalism.  The very thing missing from government-managed health care.  And the very reason why government-managed systems (the Canadian health care system, the American Medicare/Medicaid programs, the UK’s National Health Service, etc.) fail to control costs.  And why Obamacare will fail to control costs.  Because they exclude the one thing that controls costs best from government-managed systems.  Capitalism.  Where people make spending decisions based on cost.  Which will never happen when someone other than the patient pays for the costs for the medical services a patient receives.  For no one ever asks ‘how much’ when they’re not paying the bill.

So when a rich doctor says to tax the rich more is this selfless?  Or selfish?  You decide.

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LESSONS LEARNED #70: ” There is no such thing as ‘consensus’ in science.” -Old Pithy

Posted by PITHOCRATES - June 16th, 2011

State of the Art Medicine – Balancing the Four Humors

Early science was sometimes by consensus.  Arrived at by some guesses that were almost educated.  Early medical science, for example.  The human body was and is a complex thing.  Most of our knowledge was based on the excretions we observed coming from the body.  Someone with a cold had a runny nose.  Someone with a fever sweated.  Someone with an upset tummy vomited.  And, of course, there’s poop and pee.  If you didn’t excrete enough of either there’s probably something wrong with you.  Even today we look at our poop and pee.  For things like blood.  Or other abnormal secretions.  Because that can be a problem.  So the human body is a plethora of excretions.  Or fluids.  Each telling a story.

Early medicine broke these fluids down into 4 basic fluids.  The four humors.  Black bile, yellow bile, phlegm and blood.  A healthy body had the four humors in balance.  A sick body had an imbalance.  Too little of one.  Or too much of another.  So early medicine looked at putting the four humors back into balance.  Either through putting humors into the body.  As in herbs or food.  Or taking humors out of the body.  As in bloodletting or inducing vomiting.  Or applying a poultice.  Out with the bad.  In with the good.

This was state of the art medicine at its time.  They even used it on George Washington in 1799.  The most important man in America.  He was making his rounds on horseback, inspecting his plantation one day in the rain and snow.  Got a bit of a sore throat.  Came in that evening for dinner.  Didn’t change out of his wet clothes so as not to inconvenience his guests.  The next day his throat was worse.  And he had a fever.  He also had trouble swallowing.  Today we’d see our doctor and ask for some antibiotics.  Before antibiotics, though, you tried to balance the four humors.  So they bled Washington.  State of the art medicine back then.  Washington died 6 days later.  Having never recovered from his sore throat.  Despite using what was then the consensus for the finest medical care.  Bleeding.

The Fight against both Smallpox and the Medical Consensus

Interestingly, George Washington was a healthy man.  He lived longer than most Washington men.  Even survived a run in with Smallpox in his youth.  Which makes his death from something starting out as a sore throat sadder still.  Because Smallpox was a killer.  People feared it like the plague.  In time, though, people found a way to make themselves immune to the disease.  By infecting themselves with a little of it.

England learned of this procedure from the Turks.  Lady Mary Wortley Montagu brought the practice (variolation) back from Turkey.  The king volunteered subjects for experimentation in England.  Which proved to be a success.  Even though there was a risk of death (about 1 in 1,000).  And during the procedure people were highly contagious.  Still, it was a whole lot better than dying from the pox.  So the Royal physician inoculated the Royal family.  And the practice slowly spread.  African slaves were doing it, too, and brought the practice to the New World and taught the procedure to the Reverend Cotton MatherEdward Jenner conducted further experiments.  Found a safer way to inoculate using cowpox.  Without the higher death rate.  Or with people being highly contagious during the process.  And the Smallpox vaccination was born.

But the acceptance of inoculation wasn’t easy.  The accepted medical practice did not include such a radical procedure.  Those in medicine belittled the procedure and anyone practicing it.  The medical consensus was that these were just some misguided people playing God who were going to turn people into cows after injecting them with cowpox.  But fear of dying can change minds.  Especially when there is a Smallpox epidemic in your country.  Which there was during the American Revolutionary War.  More soldiers died from Smallpox than were killed in battle.  A lot more.  More than half of the army.  Soldiers inoculated themselves using the puss from the pustules on infected soldiers.  John Adams’ wife, Abigail, inoculated her own children.  The inoculations saved the army.  And many of the cities.  And it was the successful fight against Smallpox that allowed the fight for independence to proceed.  Thanks to those who went against the consensus.

Contagions, not Bad Air, make you Sick

Part of the reason the disease was so contagious was because of poor sanitary conditions.  Soldiers cramped together in barracks.  Or in hospitals.  Crowded cities.  A lot of sick people in contact with a lot of healthy people got a lot of healthy people sick.  Some understood this and tried to stay away from sick people.  But they didn’t really understand germs.  They tried to stay away from sick people so they wouldn’t catch what they had.  By breathing the same air.  Not necessarily the breath they were exhaling.  But the air they were breathing in that made them sick in the first place.

A common medical opinion was that ‘bad’ air caused illness.  Thomas Jefferson believed this.  That’s why he hated leaving Monticello during the summer.  When the tidewater air was ‘bad’.  The coastal towns.  Where the government met.  He hated going to New York, Philadelphia and Washington.  Because they all had ‘bad’ air during the summer.  And that ‘bad’ air could give you malaria.  Of course, it wasn’t the air.  It was the mosquitoes who liked the marshy tidewater areas.  And understanding this was the first step in (almost) eradicating malaria.

Benjamin Franklin didn’t believe in ‘bad’ air.  Well, not the kind other people worried about.  He didn’t believe cold air gave anyone a cold.  Or the flu.  No one knew anything about germs or viruses yet, but he had an open mind.  And constantly questioned things.  He was, after all, America’s greatest scientist.  Why did he not get sick when traveling in the coldest of winters?  Yet he could catch cold in a warm and comfortable room when someone with a cold was in that same room?  The answer was obvious.  Bad air.  Created by the sick person exhaling their sickness into a room with no fresh air.  Whereby he had no choice but to breathe in this same air.  A contagion spread the sickness.  Not cold air.  Sure of this he would forever sleep with the window open.  Even during winter.  Even when sharing a bed with a sick John Adams during a diplomatic mission to discuss possible terms with the British on Staten Island to stop the rebellion.   There was no room at the inn.  So they had to share.  And they discussed Franklin’s theory.  Adams had a cold and wanted to close the window.  Franklin didn’t want to catch Adams’s cold and insisted on leaving the window open.  Adams returned to bed while listening to Franklin opine.  And fell asleep.  With the window open.  He was no sicker in the morning.  And Franklin did not catch his cold.

Before Modern Science there was Consensus and Bad Medicine

Poor sanitary conditions and a lack of understanding of germs killed a lot of people.  During the American Civil War, doctors would go from patient to patient without washing their hands.  After an amputation, they just wiped their saw on their apron before moving on to the next patient.  These were approved medical procedures.  The consensus was that it wasn’t necessary to wash your hands.  Or your saw.  And the result was an epidemic of gangrene.  And high mortality rates in Civil War hospitals.  Louis Pasteur‘s work on the germ theory of disease began to change things.  And Joseph Lister introduced the modern sterile and antiseptic operating room.

We were making progress.  Modern medicine was coming into being.  But we were still doing a lot of questionable things.  Even though it was accepted by the medical community.  Sometimes we just didn’t know any better.  Like giving people heavy doses of toxic mercury.  Then there were things where we should have known better.  Like sticking an ice pick through someone’s eye socket into the brain to sever the connections to and from the prefrontal cortex during the popular lobotomy craze of the early 20th century.  We don’t do these once accepted medical practices anymore. 

Before modern science and modern surgical tools and equipment there was little more than consensus in medicine.  No one knew anything.  So they started by guessing.  And if a guess won a popular vote, it became an accepted medical procedure.  For it was the consensus of the medical community.  Which until real science came along was the best they could do.  Thankfully, today, we have real science.  We no longer have to guess.  Or win popularity contests.  Which has greatly reduced the amount of bad medicine in our lives.  Thanks to those lone voices in the crowd.  The few who dared to go against the consensus.

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