The medicare battle

Earlier this week, steaming mad, I wrote about the new Kock Bros. ad attacking Obama and his meek and mild Obamacare plan.  I think the ad is disingenuous, uses a proven unreliable narrator and is generally all round garbage.

More to the point it completely goes against my experience of the US private medical system.

My piece generated a lot of response and a huge number of reads.  And this comment.  It’s important and also first hand and, I also believe, mistaken.  So I want to look at it in more detail.  First the comment:

Proton Beam Therapy is the 21st Century cutting edge treatment for prostate cancer as well as many others Ian. I had a Radical Prostatectomy surgery for prostate cancer in Kamloops in 2001 which failed. In 2009 after eight years of being told not to seek further treatment but to focus on quality of life I contacted Loma Linda University Medical Center and was accepted as a patient. There were approx. 150 – 160 patients undergoing Proton Therapy at the James M. Slater Proton Center during the period I was there of which the vast majority was being treated for Prostate Cancer and on a few like yourself for brain cancer. Of this group I would say that there were about ten patients who were not US citizens and all but one of the US citizens was was covered by private health insurance. If you did not have insurance Loma Linda did the treatment for cost which was $37,000 US if you had a Social Insurance Number. For foreign nationals such as the Canadians and Australians I met there the cost was $70,000. The Canadian medicare system does not pay for this treatment because there are alternative cheaper radiation treatments available in Canada. The difference is with Proton Radiation the cure rate is higher without side effects such as impotence, incontinence, and bowel problems which are common in Canada. So in Canada we save on the front end by going cheap and then spend money on the side effects for the remainder of the patients life who has to undergo needless misery.

There are problems with the US healthcare system but there are greater problems with the Canadian medicare system. The Koch brothers commercial contain a lot more truth than this blog does about the state of the Canadian medicare system.

If you have a serious healthcare problem you have to be aware that treatment in Canada is inferior if you need cutting edge treatment. It does not usually exist in Canada and never will under Medicare. There is no use arguing about which system is better as we all have our own opinions but the fact that the author went to Loma Linda should give you a big hint. My advice is to get an insured line of credit on your house if possible and use in the case of a catastrophic medical condition or accident. The waiting lists are appalling in Canada and will never be remedied as long as the government prevents private insurers from selling insurance.

My neighbour waited five months after being diagnosed with brain cancer before receiving any treatment. He has since passed on.

First off, proton radiation is not “the cutting edge treatment for prostate cancer.”  Several studies have found no greater efficacy and more side effects for proton radiation therapy than Intensity Modulated Radiation therapy, another fairly new contender.

They do find that proton therapy is far more heavily marketed, probably because the cost of building a proton facility is so steep.

The most recent study was a comparative one from the University of North Carolina that found 34% less gastrointestinal side effects with IMRT than proton therapy.

IMRT is half the cost.  The cure rate was found to be the same as proton therapy

Should proton radiation be a paid treatment for prostate cancer in Canada?  Canada does offer the much cheaper and apparently as effective IMRT treatment.  There’s a facility at VGH, here in Vancouver dedicated to prostate patients.

But it’s not really the debate over which therapy is better and which should enjoy full medicare funding.  It’s who doesn’t have access.

That’s where this commenter leaves me.  He talks about the folks he met when he was at Loma Linda.  Almost all were insured.  But if you’re not insured you don’t get through the door.  That’s my point.

The poster notes that Loma Linda cuts the cost of treatment in half for uninsured patients.  Something tells me they’re still not breaking down the doors to pony up the $37 plus grand.

There are over 40 million uninsured people in the States, most poor without home equity to arrange a loan against.  Why don’t they count in the poster’s story?

I have one more point.  Often when you do get through the door, insurance in hand, you’re cut off.  The US system doesn’t even work for many insured patients and that hasn’t changed in the ten years since I was at Loma Linda.

Can we do better?  Of course.  Anyone can see that.  And I don’t take issue with the number of commenters on this article who point that out.  But remember our system delivers better health outcomes at half the cost, and to all citizens, regardless of income.

We could also do much worse than that.  And the poster’s preference for the US system of private care and private insurers would be a fast road to hell in a handbasket.

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5 Responses to The medicare battle

  1. kootcoot says:

    “remember our system delivers better health outcomes at half the cost, and to all citizens, regardless of income.”

    As does every medical system in the civilized/developed world outside of JesusLand to our south. The fact that the US system costs twice as much per capita or as a percentage of GDP yet totally excludes and leaves out such a large group of citizens is sinful at the least. But we must remember that in the US corporate profits trump all other values.

  2. Pingback: Canadian vs American Health Care- A View From Both Sides! |

  3. Ian says:

    Thanks Richard. Love your blog.

  4. Robert Lynn says:

    Why didn’t you post the rebuttal to the University of North Carolina study? Knowledge is not dangerous.

  5. Leah says:

    Would it be wrong of me to wish that all Canadians who find the American style of healthcare to be better than our own…please…pack up and move down there! Please don’t come back here when your health seriously starts to fail you, as many “snowbirds” do now. Don’t tell me that’s not the case, I work in healthcare and know better.

    If you like it, go for it…stop dismantling our system from the inside out with the help of those whose only interest is making more money, and gaining more control of the population.

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