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News

New survey finds that Canadian health care system quality is declining

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Map of Canada
Map of Canada

A story about a recent survey on Canada’s universal health care system, from the National Post.

Excerpt:

A new survey on attitudes about the health-care system reveals some interesting responses, confirming that Canadians have widespread misgivings about the system, even while not fully understanding how it works. They also favour using tax incentives to encourage healthier living and eating.

The survey of 2,300 Canadians carried out in April by the consulting firm Deloitte was part of a larger poll covering 12 countries. It is considered accurate to within two percentage points, 95% of the time.

Some of the highlights include:

– Just 5% of respondents gave the system an A grade; 45% giving it a B, 36% a C, 10% a D, and 4% a failing F.

– 33% of Canadians said they understood how the system works, down from 39% in 2009 when Deloitte did a similar survey.

– 69% feel that the system has not improved in the last two years, while there were slightly more who thought it had deteriorated, as opposed to improved, in that period.

– 36% believe that half the money spent on health care is wasted; interestingly, half of those skeptics blame the waste on people failing to take responsibility for their own health.

– 13% reported that they are caring for another person, up from 10% in 2009, a possible sign of the increasing personal burden posed by the aging population. In a third of those cases, the individual is caring for a spouse.

– 55% rated their health as excellent or very good … even though 52% report having been diagnosed with one or more chronic diseases.

– 63% favour some kind of tax-based incentive to encourage more healthy diets and lifestyles.

– About 80% favour expanding medical-school enrollments to increase the supply of doctors.

You can find some more videos describing horror stories in the Canadian system in this previous post.

Everyone agrees that the American health care system is too expensive, but do we at least get better quality outcomes? Let’s see.

How good is the American health care system?

Consider this article from the Hoover Institute at Stanford University.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world. Economists, government officials, insurers, and academics beat the drum for a far larger government role in health care. Much of the public assumes that their arguments are sound because the calls for change are so ubiquitous and the topic so complex. Before we turn to government as the solution, however, we should consider some unheralded facts about America’s health care system.

1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

2. Americans have lower cancer mortality rates than Canadians. Breast cancer mortality in Canada is 9 percent higher than in the United States, prostate cancer is 184 percent higher, and colon cancer among men is about 10 percent higher.

3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.

4. Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate, and colon cancer:

  • Nine out of ten middle-aged American women (89 percent) have had a mammogram, compared to fewer than three-fourths of Canadians (72 percent).
  • Nearly all American women (96 percent) have had a Pap smear, compared to fewer than 90 percent of Canadians.
  • More than half of American men (54 percent) have had a prostatespecific antigen (PSA) test, compared to fewer than one in six Canadians (16 percent).
  • Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with fewer than one in twenty Canadians (5 percent).

5. Lower-income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report “excellent” health (11.7 percent) compared to Canadian seniors (5.8 percent). Conversely, white, young Canadian adults with below-median incomes are 20 percent more likely than lower-income Americans to describe their health as “fair or poor.”

6. Americans spend less time waiting for care than patients in Canada and the United Kingdom. Canadian and British patients wait about twice as long—sometimes more than a year—to see a specialist, have elective surgery such as hip replacements, or get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In Britain, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand, and British adults say their health system needs either “fundamental change” or “complete rebuilding.”

8. Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared with only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.

10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States.

Despite serious challenges, such as escalating costs and care for the uninsured, the U.S. health care system compares favorably to those in other developed countries.

The author of that article is a senior fellow at the Hoover Institution and a professor of radiology and chief of neuroradiology at Stanford University Medical School.

So, we saw that the quality of the U.S. health care system is good, but how can we lower the costs? Is government controlled rationing (like Canada) the answer, or is there another way?

Choice and competition in health care

The Center for Freedom and prosperity seems to have found another way: choice and competition.

Excerpt:

In many ways, America’s health care system is the best in the world. It has state-of-the-art technology and highly-skilled medical professionals. America is also home to most of the cutting-edge medical research in the world. However, there are also important problems, such as the “third-party payer” model where consumers rarely pay the full cost of their own health care. This creates an incentive for both excessive and expensive use of health care, a problem that would be exacerbated by current proposals for greater government control of the health care system.

But the third-party payer problem is not the only reason that health care costs are high. State governments impose health insurance coverage mandates, often for “gold-plated” coverage, that drive up the cost of insurance. These regulations, which are unique to each state, are imposed at the behest of interest groups seeking to increase demand for their services. Combined with protectionist barriers that prevent consumers from buying policies from providers in other states, these mandates have severe unintended consequences:

  • They limit competition in the health insurance market by preventing insurance buyers from shopping across state lines, creating monopolistic and oligopolistic situations in many states;
  • They impose coverage mandates that force health insurance buyers to purchase coverage that they either do not want or cannot afford;
  • They force insurers to use community rating instead of experience rating, which means healthy people are forced to subsidize unhealthy people – to the effect that insurance premiums rise for many buyers and healthy people are driven out of the market.

The symptoms of a dysfunctional health insurance market – foremost the significant number of uninsured, but also rising costs – are recognized by many legislators. But the problem cannot be solved, as some suggest, by means of increased government regulation. Indeed, government regulation is the cause of most problems in the health insurance market, not the solution.

Restoring a free market health care system would be a daunting task, one that would involve, 1) sweeping reforms to the 45 percent of health care directly financed by government programs, and 2) a complete rewrite of the tax code to remove the distortions that exist in employer-provided health insurance. This paper focuses on the so-called third leg of the stool – policies to remove government barriers and restore competition to the market for individual health insurance.

Reforming the government-financed programs is definitely necessary because there is so much fraud and waste, as there always is with government, when compared to the private sector. Private sector businesses have to turn a profit, so they actually try to prevent fraud and waste.

Here’s a documentary featuring John Stossel that explains the health insurance problem. (And featuring Regina Hertzlinger, too)

Part 1 of 5:

Part 2 of 5:

Part 3 of 5:

Part 4 of 5:

Part 5 of 5:

Choice and competition govern the way we buy things that we want normally, especially when we buy things online. I am pretty happy buying things from online retailers, because I have so many stores to choose from, with lots of product reviews and retailer ratings. I usually like what I buy, because I know that I am buying a good product from a good seller. And if I don’t get a good outcome, I can leave a review of the product, service or seller as a warning for the next person. That helps to encourage producers to make quality products and services Seller rating helps to make sellers care for customers, and to accept returns on items that don’t perform. Maybe we should do that with health care, and just leave health insurance for catastrophic care – like car insurance is for accidents, but not for oil changes.

Polemics

Why do some people not believe in God?

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An analysis of the common causes of atheism. (H/T The Poached Egg)

Excerpt:

Most atheists would have us think they arrived at their view through cool, rational inquiry. But are other factors involved? Consider the candid remarks of contemporary philosopher Thomas Nagel: “I want atheism to be true …. It isn’t just that I don’t believe in God, and, naturally, hope that I’m right about my belief. It’s that I hope there is no God! I don’t want there to be a God; I don’t want the universe to be like that.” Could Nagel’s attitude—albeit in a more subtle form—actually be common among atheists?

[…]The 20th-century ethics philosopher Mortimer Adler (who was baptized quietly at age 81) confessed to rejecting religious commitment for most of his life because it “would require a radical change in my way of life, a basic alteration in the direction of my day-to-day choices as well as in the ultimate objectives to be sought or hoped for …. The simple truth of the matter is that I did not wish to live up to being a genuinely religious person.”

Historian Paul Johnson’s fascinating if disturbing book Intellectuals exposed this pattern in the lives of some of the most celebrated thinkers in the modern period, including Rousseau, Shelley, Marx, Ibsen, Hemingway, Russell, and Sartre. In their private (and often public) lives, these Western intellectual stars were moral wrecks.

[…]As children of the Enlightenment, we tend to heavily emphasize the impact of belief on behavior. But it also works the other way around. Our conduct affects the way we think. On the positive side, as Scripture’s wisdom literature tells us, obedience and humility lead to insight and understanding. Negatively, as we indulge in immoral behavior, our judgment will be skewed.

[…]External factors may also hamper the natural awareness of God and contribute to a descent into atheism. In his book Faith of the Fatherless: The Psychology of Atheism, New York University psychologist Paul Vitz, a onetime atheist, examines the lives of the major atheists of the modern period, including Hobbes, Hume, Voltaire, Feuerbach, Nietzsche, Sartre, Camus, Russell, and Freud. He found they had something in common: a broken relationship with their father. Whether by death, departure, abuse, or some other factor, the father relationships of all these well-known atheists were defective. Vitz also examined the lives of prominent theists during the same period (Pascal, Reid, Burke, Berkeley, Paley, Wilberforce, Kierkegaard, Schleiermacher, Newman, Chesterton, and Bonhoeffer, among others). In every case, he found a good relationship with the father or at least a strong father figure.

One more quick quote on the argument that immorality leads to an atheistic worldview:

“I had motives for not wanting the world to have a meaning; consequently assumed that it had none, and was able without any difficulty to find satisfying reasons for this assumption. The philosopher who finds no meaning in the world is not concerned exclusively with a problem in metaphysics, he is also concerned to prove that there is no valid reason why he personally should not do as he wants to do, or why his friends should not seize political power and govern in the way that they find most advantegous to themselves… For myself, the philosophy of meaningless was essentially an instrument of liberation, sexual and political.” — Aldous Huxley in Ends and Means, 1937

This rejection of morality is widely acknowledged by prominent atheists as being a selling point of atheism. People become atheists because they know that atheism will free them from having to do anything simply because it’s “good”.

Consider these prominent atheists:

The idea of political or legal obligation is clear enough… Similarly, the idea of an obligation higher than this, referred to as moral obligation, is clear enough, provided reference to some lawgiver higher…than those of the state is understood. In other words, our moral obligations can…be understood as those that are imposed by God…. But what if this higher-than-human lawgiver is no longer taken into account? Does the concept of moral obligation…still make sense? …The concept of moral obligation [is] unintelligible apart from the idea of God. The words remain but their meaning is gone. (Richard Taylor, Ethics, Faith, and Reason (Englewood Cliffs, N. J.: Prentice-Hall, 1985), p. 83-84)

The position of the modern evolutionist is that humans have an awareness of morality because such an awareness of biological worth. Morality is a biological adaptation no less than are hands and feet and teeth. Considered as a rationally justifiable set of claims about an objective something, ethics is illusory. I appreciate when someone says, ‘Love thy neighbor as thyself,’ they think they are referring above and beyond themselves. Nevertheless, such reference is truly without foundation. Morality is just an aid to survival and reproduction, . . . and any deeper meaning is illusory. (Michael Ruse, “Evolutionary Theory and Christian Ethics,” in The Darwinian Paradigm (London: Routledge, 1989), pp. 262-269).

In a universe of blind physical forces and genetic replication, some people are going to get hurt, other people are going to get lucky, and you won’t find any rhyme or reason in it, or any justice. The universe that we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil and no good, nothing but blind, pitiless indifference… DNA neither knows nor cares. DNA just is. And we dance to its music. (Richard Dawkins)
http://www.simonyi.ox.ac.uk/dawkins/WorldOfDawkins-archive/Dawkins/Work/Articles/1995-05-10nomercy.shtml

And it works in reverse. When I was a young man, one of my reasons for becoming a Christian was precisely because I did not want to be like atheists. I could plainly see the harm they were causing others with their rejection of prescriptive morality, and when I put that together with the cosmological argument and the Big Bang theory, which I learned about in grade 1, the case was sealed. It helped that I had not done anything really wrong at that time, or it would have been harder for me to accept that I was guilty. The more bad stuff you are into, the harder it is to accept that you are wrong, and to turn away from it. Some clean-living atheists are going to have no problem being fair with the evidence. – switching to Christianity would be much easier for them to do.

As for his second point, consider this article that talks about how important fathers are in passing along religious convictions to children.

Excerpt:

In 1994 the Swiss carried out an extra survey that the researchers for our masters in Europe (I write from England) were happy to record. The question was asked to determine whether a person’s religion carried through to the next generation, and if so, why, or if not, why not. The result is dynamite. There is one critical factor. It is overwhelming, and it is this: It is the religious practice of the father of the family that, above all, determines the future attendance at or absence from church of the children.

If both father and mother attend regularly, 33 percent of their children will end up as regular churchgoers, and 41 percent will end up attending irregularly. Only a quarter of their children will end up not practicing at all. If the father is irregular and mother regular, only 3 percent of the children will subsequently become regulars themselves, while a further 59 percent will become irregulars. Thirty-eight percent will be lost.

If the father is non-practicing and mother regular, only 2 percent of children will become regular worshippers, and 37 percent will attend irregularly. Over 60 percent of their children will be lost completely to the church.

Let us look at the figures the other way round. What happens if the father is regular but the mother irregular or non-practicing? Extraordinarily, the percentage of children becoming regular goes up from 33 percent to 38 percent with the irregular mother and to 44 percent with the non-practicing, as if loyalty to father’s commitment grows in proportion to mother’s laxity, indifference, or hostility.

That is why I find it so odd that so many “Christians” insist on voting more and more wealth redistribution from rich to poor. The more that government programs are seen as a replacement from the protecting, providing and moral/spiritual leading that fathers do in the home, the more atheists we are going to be producing. Fathers are vital for passing on spiritual and moral convictions to children. Fathers are the ones who show that setting moral boundaries is a way to love someone – that love is not incompatible with rules. It is very important that young people see that it is loving for a person in authority to set up rules and boundaries – and that there are reasons for those rules. It’s very similar to the way that boys raised by single mothers are aggressively sexually – because they haven’t seen men loving their wives up close, and getting respect and approval for that love. And girls raised fatherless are similar – they haven’t seen men loving their wives up close, so they aren’t in a position to judge men and hold them accountable. The family is needed to model all kinds of good behaviors at a pre-cognitive level.

You can order Jim Spiegel’s book “The Making of an Atheist” here from Amazon:

And you can also read a sample chapter for free here.

News

V-22 Osprey gets rave reviews from deployed US Marines

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Here’s a photo of the V-22 Osprey – it can change from a helicopter to a plane:

V-22 Osprey Joint Service Aircraft
V-22 Osprey Joint Service Aircraft

Here’s a quick run-down on what the V-22 Osprey can do.

Excerpt:

The V-22 is a tiltrotor aircraft, taking off and landing like a helicopter, but, once airborne, its engine nacelles can be rotated to convert the aircraft to a turboprop airplane capable of high-speed, high-altitude flight.

It can carry 24 combat troops, or up to 20,000 pounds of internal or external cargo, at twice the speed of a helicopter. It includes cross-coupled transmissions so either engine can power the rotors if one engine fails.

The rotors can fold and the wing rotate so the aircraft can be stored aboard an aircraft carrier.

[…]The Osprey has two, large, three-bladed rotors that rotate in opposite directions and produce lift. Because the rotors turn in opposite directions, there is no need for a tail rotor to provide stability as in a helicopter. The wing tilts the rotors between airplane and helicopter modes and generates lift in the airplane mode. The Osprey can convert smoothly from helicopter mode to airplane mode in as few as 12 seconds.

The major advantages of the Osprey over a helicopter are:

  • Longer range – The Osprey can fly from 270 to 580 miles (453 to 933 km).
  • Higher speed – The Osprey’s top speed is 315 mph (507 kph), which is twice as fast as a helicopter’s top speed.
  • Increased cargo capacity – The Osprey can carry 20,000 pounds (4,536 kg) of cargo or 24 troops.

The advantage of the Osprey over an airplane is that it can take off, hover and land like a helicopter. This makes is more versatile than an airplane for such missions as moving troops to remote areas, especially those without landing strips, or conducting long-range rescue operations at sea.

The Hill has battlefield reports about the performance of the USMC V-22 Osprey tiltrotor aircraft.

Excerpt:

Military and industry officials rave about the V-22 tiltrotor’s performance in Afghanistan but know they need to show the aircraft is worth its high price tag.

The Marine Corps are flying V-22 Ospreys in theater and “it’s more effective than we expected,” Maj. Gen. Jon Davis, Second Marine Corps Air Wing commander, told reporters here recently. “We have only scratched the surface with this aircraft. … “We’re doing things with the V-22 we did not plan to do.”

The V-22 takes off vertically but can fly like a plane, allowing it to travel faster than traditional helicopters. The military is using the craft to haul teams of Marines, special operators, combat rescue personnel and cargo.

But there are questions in defense circles about whether — after years of technical delays and cost spikes —such glowing reviews will be enough to avoid future cuts as White House, Pentagon and congressional officials look for ways to trim the annual Defense budget.

Despite rave reviews from war fighters, the program is among the most expensive at the Pentagon.

Each Osprey has a flyaway cost of $65 million. The Pentagon already has spent over $30 billion on the V-22 program, according to the Congressional Research Service.

But some people would rather cut the V-22 than cut Obamacare:

Liberal lawmakers often come after the Osprey initiative when looking for places to trim Pentagon spending.

Last month, Rep. Lynn Woolsey (D-Calif.) offered an amendment to a Pentagon policy bill that would have directed the department to spend no monies on the program in 2012.

Woolsey dubbed the program a “boondoggle” for the “military-industrial complex.” Terminating the program would save more than $12 billion over 10 years, and $2.5 billion in 2012 alone, she claimed.

The House overwhelmingly defeated her amendment, but not before Woolsey said the aircraft has gotten “mediocre marks” from independent auditors and “underperformed across the board.” There are reports the V-22 has struggled in “high-threat environments,” she said.

She also said it has failed to “prove its worth” operationally and has had a number of major crashes. But Davis says it has proven its value, citing the fleet’s strong record in a rugged war theater.

Program officials and advocates are ready to fight back as Washington continues talking about an era of federal spending cuts.

Their embryonic message, as Davis put it: “Why would we terminate something that works?”

Marine Corps and Bell-Boeing officials also say to avoid budget cuts or a reduced buy, they will have to show critics like Woolsey that the fleet is reliable.

Right now, the Osprey’s closely monitored reliability rate in Afghanistan is around 73 percent, according to program officials.

Davis wants to push that figure to 80 percent, saying that would make the V-22 among the military’s most reliable aircraft.

I love the V-22 Osprey. It is a force multiplier, in my opinion. And can you imagine that some people wanted to cancel it just because of some difficulties they had early on in testing?

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