Right Thinking From The Left Coast
You will never live if you are looking for the meaning of life - Albert Camus

Coeur d’Leon
by Lee

The Houston Chronicle has a story today about Dr. Bud Frazier, the doctor who put in my father’s artificial heart.  This part of the article really rang true to me.

The Methodist roots help explain an aversion to law and business as chosen professions. Both center, ultimately, on making money. Frazier says he has never sent a bill. He doesn’t know the fees for any of his procedures.

During much of his career, the real money has been in coronary artery bypass surgery, not implanting countless experimental cardiac devices into animals within the bowels of the Texas Heart Institute.

That’s not to say Frazier ignores finances, without which it would be impossible to bring life-saving, but costly, heart devices to market.

“Medicine has to work as a business,” Frazier says. “It’s like what St. Augustine said: ‘We try to live in the city of God, but we must live in the city of man.’ ”

When my dad went into the hospital for the final time he had been sick for 11 years.  During that time he had been able to only work sporadically, in between bouts of illness.  As such, when he went into the hospital he didn’t have any health insurance.  The doctors told us that Dad needed a heart transplant, but that other health issues made him not suitable to be a recipient of a donor heart.  He did, however, qualify for an experimental artificial heart program.  My mom said, “We don’t have any insurance.” Dr. Frazier responded, “I don’t care about your insurance.  We’re going to do everything we can.” And they did.

One day I was having a conversation with him, and he remarked on the fact that our family used to live in the UK.  He mentioned that in the past he had done heart transplants on British people whom their health service had deemed too sick to be healed.  These patients were affluent enough to where they could come to the US and pay out of pocket costs for a transplant.  “It’s a good thing you’re not in the UK right now,"Dr. Frazier said, “because they would have sent your father home to die.” This then evolved into a discussion of the importance of the profit motive for driving medical research. 

As I’ve said a thousand times, it wasn’t just the doctors and nurses who kept my father alive for almost three months, it was the venture capitalists who funded the research done by the engineers who developed the heart.  Venture capitalists can invest in any venture they like, and without a profit motive they will invest their dollars elsewhere.  One day the artificial heart will be a reality, and immediately the Michael Moores of the world will decry the “greed” of the evil corporations who now charge a fee for their product, without realizing (or caring) that over the last 30 years these corporate entities had invested hundreds of millions of dollars in research without seeing so much as a penny in return.

The doctor is truly a great man.

Posted by Lee on 04/29/07 at 08:56 PM (Discuss this in the forums)

Comments


Posted by on 04/29/07 at 10:01 PM from Canada

I just recently saw a new report stating that Canadian healthcare is just as good as US when compared statistically.  And this made me think of my own experiences with Canadian healthcare.

The last city I lived in has a population over 450,000 people with one of the largest and best medical schools in Canada.  However, the 6 years I lived there I couldn’t get a family doctor.  The last report I heard said that at least 10% of the population was without a doctor.  I’d have to go to a walk in clinic.  At walk in clinics the doctor will see you only long enough to write you a prescription.  Emergency rooms at hospitals are for emergencies only, so you have to have heart or lung problems to get prompt service.  Otherwise, you’ll wait 3 – 6 hours for care.  I’ve sat and waited that long with family members before who were too sick to drive themselves.  3 – 6 hours is a long time if you are too sick to move and just puked your guts out.  I did eventually get a family doctor, but he lived 50 Km away and I had no car.  My mom would have to drive me.  The only reason he took me is because I was a patient of his 12 yrs ago when I lived in that town.

I’ve since gotten a car but moved 250Km away from my doctor.  In mid February my back went out.  The pain centered largely around my hips.  I tried to wait it out.  I waited 1 week and the pain got worse, to the point that it felt like I was walking on a 45 degree angle.  I went to the walk in clinic because it was across the street from my mechanic and my car needed a tune up.  The Wednesday I went there was a blizzard, so the clinic was closed, but my mechanic was at work so my car got the tune up and I had to wait.  I waited till Saturday and went to the other walk in clinic (we only have 2 in a town of 50,000 people) and it was closed.  So I went back to the original clinic which had a line up out the door and was about to close (at 2 pm).  So I waited till Monday.  I went at 9:30 am because it opened at 10 am.  I was 5 th in line and had to wait outside for a half hour in -5 degree Celsius weather.  Fortunately it was a sunny day.  I finally got inside at 10 am and had to wait another hour to see the doctor.  The line up was out the door as soon as they opened and they were telling people to come back in 2 – 3 hrs to see the doctor.  The doctor at the walk in clinic referred me back to my family doctor (who’s practice is 250km away) and ordered some X-rays for me.  I had to drive across town for the X-rays, but that only took 20 mins.  Most X-ray places are privately run in Canada.  I called my family doctor who said he’d send me to an Orthopaedic Surgeon, but wait times in his area is about 1 yr.  Even going back to the city I used to live in with the medical school could take 1 yr to see an Orthopaedic Surgeon.  I had to call around my local area and found one that would take me in only 6 weeks.  A real bargain in Canada. 

In the mean time, I went to see a chiropractor.  Chiropractors are all private.  I called at 9:15 am and was seeing him by 9:45 am the same day.  X-rays were done by him in his office.  Within 1 week of his treatments I was doing better and at least comfortable again.  He also helped me get a few days off work to recover.  It only costs $25/visit and private insurance covers 80% of that up to $500.  That was enough to get me through the rough spot. 

I did go see the Orthopaedic Surgeon who told me my hip is mildly deformed, a condition called Leggs-Perthes.  It’s not a major disorder.  His recommendation is that I walk more and swim, which I’m doing.  However, there’s nothing he can do till the deformity strips the cartilage out of the joint in 20 yrs and I have it replaced.  When I told him I was concerned that I’d wake up every few months barely able to walk and would lose time from work, he just shrugged and said I’d have to live with that.  Of course, I can’t go get a second opinion because as you can see, there are too few doctors.  So, I’m fucked till I get enough money to go to the US.  Fortunately it’s a minor condition and not a real emergency. 

It’s funny how the private profit system responded faster and actually helped my recover whereas the private system just told me to go fuck myself while I waited.  The other irony being that in Canada we are lectured constantly how the single payer system is more compassionate than the evil US profiteering system.

Posted by West Virginia Rebel on 04/29/07 at 10:32 PM from United States

In the meantime, Wal_mart has announced they’re going to have clinics in all of their stores. I’m not sure if I want to be around a bunch of sick people when I’m shopping, but this is why capitalism rules. The market dictates what people want.

Posted by on 04/29/07 at 10:35 PM from United States

I’ve tried to explain to numerous people (oddly enough, nearly all of them Canadians) many times that nobody has a “right” to health care as it is a limited resource and that you just can’t treat it is as if it just falls off a tree like leaves in the fall.

Even after explaining that training doctors and nurses is expensive, requires years, decades in some cases, to train physicians and surgeons, and that equipment and facilities need to be purchased and maintained, their only response is “well, just raise taxes and hire more people”. 

Nor can they fathom the concept that having the government run what is a business from top to bottom is a very bad idea.  Explaining to them that long waiting lists for routine surgery is the inevitable result of socialized medicine, not an exception is met with blank looks.  After all, if you just “raise taxes” and “hire more people” the problems will apparently just solve themselves.  For some strange reason, the fact that there aren’t any more doctors to hire hasn’t entered into their thought process.

Posted by on 04/29/07 at 11:01 PM from Canada

The other problme is unions.  My mom was a nurse for over 20 yrs.  In the mid 90s, they held up a contract because the janitors were represented by the exact same contract as the nurses.  The janitors demanded the same pay as nurses which held up the contract signing, so she went without a raise for several years.

Let’s compare the two:
Nurse = 2 yrs training at a college level (these days it requires a BA), plus continuous training.

Janitor = weekend course on WHIMS and how not to drink industrial solvents.

Nurse = misread a label and someone dies.

Janitor = misread a label and the floors aren’t as shiny.

SO, I also like to bring up the fact that under a private for profit system capitalims, profits, and greeds determine the quality of healthcare.  (Of course, I have to say it this way so Canadians will understand.) Then remind them that politicians now make our medical decisions and they do it for political power and greed.  Then I ask which is better.  That will make a Canadian go blank as well.  It’s kinda like asking a Christian if Jesus can microwave a buritto so hot that even he couldn’t eat it.

Posted by Aussiesmurf on 04/30/07 at 01:42 AM from Australia

Without making a direct comment on the U.S. health system (as I live in Australia), I am reminded of a quote from the West Wing when two characters are talking about asking health companies to provide free or discounted health care to AIDS victims in Africa :

Donna : What’s the problem?  These pills cost about eight cents each!
Josh : The SECOND pill cost eight cents.  The FIRST pill cost eight hundred million dollars.

Posted by on 04/30/07 at 03:36 AM from United Kingdom

Lee, it is great your dad got treated for free by this doctor - but beyond that your point makes no sense.

Your dad was treated because he was a test case, someone they needed to perfect the operation. The moment it works and they don’t treat test cases any more he would not have been treated just like he wouldn’t have been treated in the UK where they are not running these test cases either.

Clearly, having more money in healthcare like the US does means you get better treatment and particularly more research; there is no problem with that, but this only goes to the people that can pay for it - your Dad was just lucky the treatment was still in test stages.

If you really want to talk about healthcare economics the question you have to ask is does the US get better value for money were the federal government spends more per person on healthcare than the UK government does where everyone has access to treatment.

Our systems are really not very different; your government spends lots of money per person, so does ours; just everyone can get it. We then have private medical insurance on top; it just happens your citizens spend more money on private insurance than ours do.

Posted by InsipiD on 04/30/07 at 04:39 AM from United States

Your dad was treated because he was a test case, someone they needed to perfect the operation. The moment it works and they don’t treat test cases any more he would not have been treated just like he wouldn’t have been treated in the UK where they are not running these test cases either.

You obviously didn’t read the post completely.  Most of his praise was for this doctor, known for going above and beyond.  Secondarily, if the decisions about treatments are in the hands of bureaucrats instead of patients, doctors, or even medical researchers then the treatment gets worse.  Finally, taking the profit motive away from healthcare strips it of any need to innovate.

Posted by on 04/30/07 at 05:26 AM from United Kingdom

You obviously didn’t read the post completely.  Most of his praise was for this doctor, known for going above and beyond.  Secondarily, if the decisions about treatments are in the hands of bureaucrats instead of patients, doctors, or even medical researchers then the treatment gets worse.  Finally, taking the profit motive away from healthcare strips it of any need to innovate.

I did, and of course most doctors don’t care about funding - they just want to treat as many people as they can.

But that is not what Lee talked about. His 2nd and 3rd paragraph was about how his dad would have died in the UK and how the American system of corporations/venture capitalists are what makes American healthcare good.

However, drawing an example from his Dad makes little sense when his Dad was treated for free. Perhaps Lee would have a different opinion, more akin to Moore’s maybe, if his Dad was sent away to die because he couldn’t afford the surgery, instead of just being lucky enough to get offered the treatment while it was still in testing.

Look, I have no qualms about saying American health care is better than in the UK, but then you spend about 3-4 times as much money on it, if it wastn’t a hell of a lot better there would be a major problem. The question then is really, would the UK system (which is massivly more efficient) be better or worse than the US system if we spent 3-4 times as much money on it as we presently do?

Posted by InsipiD on 04/30/07 at 08:54 AM from United States

But that is not what Lee talked about. His 2nd and 3rd paragraph was about how his dad would have died in the UK and how the American system of corporations/venture capitalists are what makes American healthcare good.

However, drawing an example from his Dad makes little sense when his Dad was treated for free.

He wasn’t treated for free.  The evil kkkorporations exploited him for medical testing, and the doctor probably recieved more generous payment for that than he would have from insurance.  In some countries, it wouldn’t be possible to receive treatment this way.  Even though there was an ulterior profit motive behind it, if it allowed Lee’s dad to live a while longer and be with his family, then I’m sure they were happy for it.  When the treatment is fully developed and Britons are dying waiting for it, the difference will be clearer.

Posted by Lee on 04/30/07 at 09:13 AM from United States

Your dad was treated because he was a test case, someone they needed to perfect the operation. The moment it works and they don’t treat test cases any more he would not have been treated just like he wouldn’t have been treated in the UK where they are not running these test cases either.

I’ve written on this subject before.  Not one time, ever, was my father denied treatment because of his lack of insurance.  Yes, the family was given a monstrous bill afterwards, but that’s the trade off.  No matter how sick he was, and no matter what his inability to pay, he always got the best medical care available.

Had he qualified for the transplant they would have given it to him, and then worried later about how to pay for it.  As it turned out, because he was a test case in this instance, all his medical bills (about 4 million, if I remember correctly) were paid by the artificial heart company.  But that’s immaterial to the larger point.  When mom first took him to the hospital they had to go to admitting, where she told him he was uninsured.  It wasn’t a problem then.  It wasn’t a problem when they told us he needed a transplant, nor when they said he needed the artificial heart.

So that’s the trade off.  In America they treat you but you get a bill, and might go bankrupt.  In the UK they determine that, in the cause of the common good, your illness is too advanced and they send you home to die, so that those common resources can be used to treat patients with a better prognosis.

Posted by on 04/30/07 at 10:02 AM from United Kingdom

So that’s the trade off.  In America they treat you but you get a bill, and might go bankrupt.  In the UK they determine that, in the cause of the common good, your illness is too advanced and they send you home to die, so that those common resources can be used to treat patients with a better prognosis.

You go bankrupt and who pays the bill then? Who covers all the other liabilities someone who has gone bankrupt has? Sounds like someone *else* is going to have to pay for your treatment because you can’t pay for it, wow - almost like in the UK. Sure, the hospital providing the treatment might have to cover the bill if you go bankrupt, but guess what they have to do then - raise the price for everyone else. So really its just medicine based on the ability to pay with socialism to back it up.

Anyway, you are again making the mistake of not seperating the amount of resources dedicated to health care and the way those resources are provided. The US has more r&d;because you have more money in healthcare and a larger population. The UK with its “socalist” health care system also has masses of r&d;(a lot at universities which is where a lot of r&d;happens in the states as well) as well as leading phramaceutical companies as well. If we spent 3 to 4 times as much on health care in this country, we might have more pioneering research; although in the case of heart transplants, stem cell research and re-generation of a heart - research which is happening in the UK right now - appears to be a better long term solution.

Posted by on 04/30/07 at 10:05 AM from United Kingdom

He wasn’t treated for free.  The evil kkkorporations exploited him for medical testing, and the doctor probably recieved more generous payment for that than he would have from insurance.  In some countries, it wouldn’t be possible to receive treatment this way.  Even though there was an ulterior profit motive behind it, if it allowed Lee’s dad to live a while longer and be with his family, then I’m sure they were happy for it.  When the treatment is fully developed and Britons are dying waiting for it, the difference will be clearer.

People did in every country because they don’t have access to the medical resources that will save their lives. If you think this is not happening in the US, you must live in a cave.

The demand for medicine is practically infinte. The supply is very much finite. However you fund it and however much people spend, people are going to die because there wastn’t enough money for them. The economics of health care is terribly problematic and every system has huge problems - there is certainly no perfect solution; neither the UK or the US is even remotley close to being perfect and both can probably learn a lot from each other.

Posted by on 04/30/07 at 10:25 AM from United States

Hey padders, OT, but what do the Brits think about Prince Harry going to Iraq?
I’ve been reading a little bit here in the states. I’d be curious to know what the sentiment is on your end.

Posted by on 04/30/07 at 12:29 PM from United Kingdom

Hey padders, OT, but what do the Brits think about Prince Harry going to Iraq?
I’ve been reading a little bit here in the states. I’d be curious to know what the sentiment is on your end.

To be honest there are probably as many opinions as people and it’s not really something I care that much about to really give you a fair answer.

I guess people are impressed with his courage, someone who “has it all” risking to go, but there is perhaps the worry that he won’t see action in the same way other troops while at the same time putting the other troops under increased threat (a few deaths are already being linked to him going).

Complicated really. I can’t imagine what the response will be to him getting hurt, killed or worse of all kidnapped, probably something along the lines of the Iranian situation with half wanting to run away and the other half wanting to the nuke the place.

Posted by on 04/30/07 at 02:09 PM from United States

Complicated really. I can’t imagine what the response will be to him getting hurt, killed or worse of all kidnapped, probably something along the lines of the Iranian situation with half wanting to run away and the other half wanting to the nuke the place.

Thanks for the reply. I don’t know if its the snutty press over here intentionally avoiding the story, but the only place that is covering it is the WSJ.
I just saw “The Queen” with Helen Mirren. I never really got the Princess Diana thing so I am always curious as to what our brethern across the pond think.
It sounds like Al Qaeda is organizing hit squads specifically to target and grab Prince Harry. It is complicated.

Posted by on 05/01/07 at 10:53 AM from United States

I’ve tried to explain to numerous people (oddly enough, nearly all of them Canadians) many times that nobody has a “right” to health care as it is a limited resource and that you just can’t treat it is as if it just falls off a tree like leaves in the fall.

That sounds like you support some sort of triage or rationing. 
Actually, whatever your point of view, there is a gatekeeper.  In Canada it is the government, in the US, it’s the insurance companies.  Lose your job and have fun trying to find coverage if you have any health issues at all.  Don’t expect insurance companies to subsidize any experimental studies, either.  They will say no to everything new or controversial right off the bat and it is up to you and the doc’s to fight back and hope they’ll change their mind.
And PLEASE, all you capitalist-free market types,you may get treated without paying, you may get a bill and declare bankruptcy, they may write it off, but don’t make the mistake of thinking that is the end of it.  You didn’t pay, but “someone” will.  I think that someone is you and me.  How much did your insurance premiums go up last year?

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