Wednesday, October 23, 2013

Known Knowns and Unknown Unknowns Strike Again

Whenever public officials want to pass one of the many bucks that keep fluttering toward their desks, they go to the propaganda cabinet and drag out their trusty Word Salad Spinners.  Perhaps the most famous example of this defense mechanism was when Defense Secretary Donald Rumsfeld gave his tortured explanation for the debacle in Iraq:
There are known knowns; there are things we know that we know. There are known unknowns; that is to say, there are things that we now know we don't know. But there are also unknown unknowns – there are things we do not know we don't know.
And now that Obama administration flacks are flailing like mad against the fluttering flustercuck that is the Healthcare.Gov website, those trusty word salad spinners are spinning to the fullest extent of the news cycle. Only problem is, the little spinners trying to defend their virtual health insurance Laundromat of a website are a tad unbalanced in their own logic. Their spin is not going at all smoothly. Thumps abound as spittle flies.

The Spinner-in-Chief himself is being forced to clunk along. From his latest heavy duty load cycle:  
Of course, you've probably heard that healthcare.gov the new website where people can apply for health insurance and browse and buy affordable plans in most states, hasn't worked as smoothly as it was supposed to work, (putting it self-servingly and mildly) and the number of people who've visited the site has been overwhelming, (too many towels stuffed in the low capacity delicate cycle?) which has aggravated some of these underlying problems. (the machine was designed only for low-suds detergent!). Despite all that, thousands of people are signing up and saving money as we speak. (Keep feeding the broken machine your quarters and maybe it'll fix itself) Many Americans with a preexisting condition, like Janice, are discovering that they can finally get health insurance like everybody else. (um.... how about those 15 million uninsured people not included in "everybody else." How about the majority of poor and minority women being denied admission to the health insurance washateria?)  

As Ezra Klein points out,
The best news for Obamacare is that almost everyone -- including the Obama administration -- realizes the crucial online portal is currently a disaster. 
That's not a universally held view. Salon's Joan Walsh chides those reporting on the law's failure, arguing that the law's problems "are real, and disturbing, and must be fixed asap," but "the president knows that without my telling him."
Actually, that's been the problem: President Obama didn't know that. Nor did White House chief of staff Denis McDonough. Nor did Health and Human Services Secretary Kathleen Sebelius, who will be testifying to that fact next week.
It would be one thing if Obamacare's problems had been unknowable. But they weren't. Staff at HHS and CMS saw this coming for months. Insurance companies began predicting a mess long ago. But the bad news was shaded and spun as it made its way up the chain of command. The alarming failures seen in the (inadequate) load tests were written off as bugs that would soon be fixed.
Klein says that even staffers who knew about the knowns were terrified to speak out about them. He and other reporters "got a wall of denials" on problems, and the White House seemed to believe its own denials.

This is what happens when the most transparent administration in history has a program in place called Insider Threat. As McClatchy Newspapers revealed last summer, Obama has mandated that all federal government employees spy on each other and report their co-workers for incipient or suspected whistleblowing, or even the voicing of concerns that something in the bureaucracy might not be working correctly. Disgruntlement on the job is listed among the red flags. Those staffers Klein talks about who knew about the unknowns of the Obamacare website were terrified to speak up simply because they're all terrified about losing their jobs for the crime of facing reality and for fear of bursting Obama's sacrosanct bubble.

The Ministry of Fear operating at the very highest levels of the government is seriously hampering the ability of American consumers to shop for health insurance product. Therefore, the president seriously needs to get his act together and give another speech about the need to balance our rights to become victims of health insurance predators with his need to look good. 

22 comments:

James F Traynor said...

This is a typical problem of bureaucracies and one experienced by anyone who has worked within them. Of course some more than others, as exemplified by this current example of snafu (Situation Normal, All Fucked Up). Glitches are inevitable, but are compounded by this kind of nonsense. Nonsense that is except to PR types and your friendly neighborhood sycophant and the three monkeys found in every office, public and private.

opit said...

" our right to become victims of health insurance predators " And of course that is the next truth to strike home. Ezra had a doctor clear up some of the issues several years ago on one of his personal - no longer available - blogs...though it could have been Pandagon. Staff were more challenged by accounting than by healthcare delivery. That is because between cherrypicking procedures and patients so as to minimize costs, it was an exercise to figure out what was covered by a plethora of deadbeat 'insurers' prior to actually doing any medicine.
To give him due credit, Ezra did extensive research on what was done outside the US and how well it worked. Obama, however, was notorious for spending time with lobbyists while ignoring activists. Likely both knew centralized payment was the only option that made sense.
Not that the battle ever ends. Between lies about Canada's healthcare service experience by the public and constant efforts to 'privatize' ( allow corporate milking of the public purse ).... political activists still follow political efforts to sabotage Medicare.

Zee said...

@Karen and @All--

Secondarily quoting Valerie Jarrett a couple of days ago, Maureen Dowd finally explained to me why ObamaCare is the rolling disaster that it is, along with the rest of The One's administration.

“As Valerie Jarrett told David Remnick in 'The Bridge,' Obama’s 'uncanny' abilities need to be properly engaged, or he disengages. 'He’s been bored to death his whole life,' she said. 'He’s just too talented to do what ordinary people do.'” --Maureen Dowd (My bold emphasis.)

http://www.nytimes.com/2013/10/20/opinion/sunday/cat-on-a-hot-stove.html

My God! That's the answer! We just need to get this poor man's attention with a really, really, REALLY BIG problem worthy of his attention so he'll finally “engage” and maybe save the world without breaking a sweat!

Domestically, ObamaCare, huge unemployment figures, growing poverty, a stagnant economy, “fiscal cliffs,” &etc. not to mention, abroad, the Arab “Spring” (that wasn't) and use of chemical weapons in Syria, just haven't been complex enough to pique the Big Guy's interest, because clearly, he's been bored and disengaged since his first election.

His interest in life seemed briefly to be re-kindled by his election campaign in 2012, but since that time he has gone back to deeply empathizing with Henri, le Chat Noir, who may just be the only living creature who rivals Obama in both his sense of superiority and his boredom with his own existence.

http://www.youtube.com/watch?v=Q34z5dCmC4M&list=PL5EDF5A12BE6394F4&index=2

Please, please, PLEASE, will someone throw this guy a problem worthy of his greatness, before he completes the destruction of this nation owing to his ennui?

Zee said...

@opit--

First let me say that after long soul-searching, both Mrs. Zee and I have come to the conclusion that Canadian-style, single-payer health care insurance is the way to go. It just makes no sense to put a for-profit insurer in charge of one's health care when the insurer “earns” its profit by denying care altogether, or by opting for cheaper, “cookie-cutter” treatments in lieu of more expensive, though possibly better ones. Moreover, it is inhumane to leave a large sector of our population with no health care insurance at all.

Still, it is my understanding that the Canadian health care system has its share of problems. Thanks to good health care insurance, I have never waited more than a week or two (once, in excruciating, crippling pain) for expensive diagnostics ( e.g., MRIs) and treatments (complicated spinal injections), or significant surgeries (one joint fusion and one joint replacement, bilateral hernia repairs, cataract surgeries (both eyes) and one surgery that is best unmentioned, if memory serves).

Apparently that is not the case in Canada, where we hear a great deal here in the U.S. about “wait lists” for significant surgeries, and even for certain advanced diagnostics such as MRIs.

Now, if that's one of the “lies” about Canadian health care that's being spread about down here in the States, then, apparently even the Canadian Supreme Court believed it back in 2005, and further believed that “wait-lists” constituted a serious threat to to the health of some Canadians.

http://www.nytimes.com/2005/06/09/international/americas/09cnd-canada.html

“...in recent years, patients have been forced to wait longer for diagnostic tests and elective surgery [in Canada], while the wealthy and well connected either seek care in the United States or use influence to jump ahead on waiting lists.

The court ruled that the waiting lists had become so long that they violated patients' 'liberty, safety and security' under the Quebec charter, which covers about one-quarter of Canada's population.

'The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients DIE as a result of waiting lists for public health care,' the Supreme Court ruled.”
(My bold and capitalization emphases.)

So, again, I have to ask, “Is the “wait-list problem” a scurrilous lie?” Because if it isn't, I want my fellow American citizens to have a responsive health care system more akin to mine than to the Canadian system.

Given the ObamaCare debacle, it's probably naïve of me to hope that the U.S. could do better than Canada, but there it is. (I know, James, I know: I am naïve.)

According to that same NYT article, the Canadian Supreme Court went on to rule that "In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."

Now, if I haven't asked them directly, I have at least from time to time intimated to our two Americans who reside in Canada—Jay-Ottawa and Pearl—that I would like their perspective on how this “experiment” has worked out, if it has been implemented to any degree. But I would like their perspective on the “wait-list problem,” too.

And I would like to know if, and how, Canada is resolving their “wait-list problem,” if there really is one.

James F Traynor said...

The Canadians I've talked to (only three - one is wealthy, one middle class, the last an R.N.) all liked it and couldn't understand why we didn't insist on something akin to it in this country.

Once, years ago, while living in upstate NY, I listened to an interview of U.S. Sen. Al D'Amato (R - what else), during which he stated that Canadians were "forming lines" outside NY hospitals on the borders, refugees from the Canadian Health System. I immediately called these hospitals and all four of them denied the the truth of the senator's statement. One person doubted that he'd said it.

I could go on but it would become, if it has not already, tedious. Don't worry Zee, naiveté does have it's charm.

James F Traynor said...

God, I am becoming tedious.

Zee, I've no doubt that there have or had been having queuing (as the Brits would say) problems with the health system in Canada. In the beginning they were having funding problems but now I understand it's done at the Provincial level. With every national health system there have been problems and always will be. None of them as intractable as the chaos that is ours.

Zee said...

Oh, God. I must be turning into a pansy Progressive.

I “pivoted” from Sardonicky to local news, just found this story in the Albuquerque Journal, and it made me want to retch:

http://www.abqjournal.com/286831/news/group-wants-return-of-sales-tax-on-food.html

“'The group that lobbies for New Mexico cities is backing a proposal to allow local governments to reimpose a sales tax on food, reigniting a fiery political debate.

New Mexico Municipal League Executive Director Bill Fulginiti said Tuesday that the food tax idea has nearly unanimous support from municipal leaders. If approved by state lawmakers during the 2014 legislative session, he said, it would give cities a way to absorb the loss of a big-dollar tax subsidy from the state without having to raise their local base tax rates.

'It seems to solve a whole bunch of problems without winners and losers,' Fulginiti said after testifying before an interim legislative committee in the state Capitol.

But reimposing a tax on food drew opposition from Gov. Susana Martinez, who has vowed to veto any tax increases during her four-year term.

'The governor does not support the reimposition of the food tax,” Martinez spokesman Enrique Knell said Tuesday.'”
(My bold emphasis.)

Now, Gov. Martinez is hiding behind the fig leaf of a knee-jerk negative response by Conservatives to any and all tax increases. What she really thinks about this, I don't know; Martinez supported both Medicaid expansion and the creation of an ObamaCare exchange in New Mexico (as I understand it), so she's clearly less reactionary than many so-called “conservative” Republican governors.

For my own part, I think that one can still call one's self a Conservative and see sales taxes on life's essentials (food, medications, medical treatments, &etc. ) as hopelessly regressive and unfair. "No winners and losers?" One might equally as well tax the air that the poor breath at the same rate as those for the rich.

My vague hope is that there really is a differentiation to be made between today's so-called Conservatives, who are really just cruel Social Darwinists in disguise, and Thinking Conservatives who believe that there is an honest and socially useful balance to be struck—somewhere—between total, “cradle-to-grave care by the government” and an “every man for himself and devil take the hindmost” society.

But as I look at the current polarization of both our nitwit Congress and our hopelessly ill-informed, stupid populace, I despair.

Pearl said...

Zee:
Briefly, to describe Canadian Health Care, there are weaknesses depending on where medical facilities are geographically located, some line ups which are changeable depending on demand and availability of medical personnel, need for more medical equipment again depending on need and availability and some cutbacks depending on costs and who is running the country. BUT, the basics
are there and flexible. There are watchdog organizations who report and keep tabs on where more needs exist and as for Canadians using the facilities of U.S. medical care, that is only done when there is available medical machinery locally in the U.S.(as in Buffalo, etc.) and costs are then covered by the local Canadian province.

Any Canadians seeking medical coverage in the U.S. would have to be
enormously wealthy as Canadian doctors' salaries are nowhere near the inflated incomes of the U.S. doctors to say nothing of hospital costs, etc. Any attempts to set up U.S. style profit medical facilities in Ontario, have failed miserably and although there is a financial two tier system that I know of in Toronto where some that can afford it can access more rapid care, is allowable by the government, especially when there may be shortages for a
particular illness or procedure but this is strictly controlled.

I am not an expert on all the details of our system, relying on experiences
of friends and family and reports in the news, and any need for improvement here pales in comparison to the giant cracks in the U.S. system. The only thing that should be included is dental care and eyeglass costs but there would have to be more money put into the system which requires a more liberal political party in charge.

Jay can correct anything I say as he is very knowledgeable about Canadian
health care and Wikipedia has a very thorough accounting of the system.
And as I have pointed out in previous discussions, the need for more costly
care for the increasing proportion of the elderly is a financial and space
problem facing many countries.
But we are light years ahead of the U.S. which is an absolute disgrace. We don't have people lining up to choose health care coverage as in Obamacare and not knowing what it will cost them or having to go without due to their inability to pay. To have peace of mind, knowing one will be properly cared for medically when needed, is beyond price. I am happy to pay my taxes for this opportunity, knowing that other residents have the same options.


Valerie Long Tweedie said...

I have a very close friend whose partner has HIV. They live in Vancouver Canada and receive excellent care and no waits for anything.

It is clear why the politicians are demonizing the Canadian system: it is more cost effective and manages to take care of its entire population.

It is the same in Australia. Americans need to stop allowing themselves to be so propagandized.

VLT

Noodge said...

Incredibly slanted article in the NYT today about Conde Nast's decision to eliminate its internship program:

http://www.nytimes.com/2013/10/24/business/media/sued-over-pay-conde-nast-ends-internship-program.html

Apparently a couple of spoil sports decided that the 60-hour weeks for no pay were a little excessive, and decided to sue Conde Nast for back wages. So rather than pay the interns, Conde Nast just decided to eliminate the program.

The article goes on at length about what a terrible thing this is, as so many students will lose the invaluable "foot in the door" opportunity. Included in the ostensibly objective story are gems like: "... lost would be the lessons learned from working at the magazines, and brushing elbows with the magazine world’s most luminous names. Doing research for writers like George Packer, Jane Kramer and Philip Gourevitch. Spotting Graydon Carter or Anna Wintour in the cafeteria. And, for interns at the fashion magazines, fixating endlessly on what to wear. “I have never been better groomed in my life,” Ms. Indvik, 26, said. “I bought designer clothes off eBay and blow dried my hair and steamed my clothes every day.”"

Also: "The Condé Nast internships also drew scions of the rich and famous, including a daughter of Leslie Moonves, president and chief executive of CBS, and a daughter of Arianna Huffington. Not to mention those reality TV darlings Lauren Conrad and Whitney Port, who were interns at Teen Vogue."

And from the Mitt Romney borrow money from your parents school: "For those born of more modest means, the goings were a bit rougher. Ms. Indvik said without her parents’ financial help, she “absolutely” could not have done the internship, which lasted four months and was initially unpaid, but by the end paid a stipend — of $12 a day."

The paper of record cements its position as the paper for well heeled. Can't afford to buy a job? Then you have no business in New York.

Zee said...

@Pearl--

Thanks for taking the time to answer my questions in some detail. I appreciate reports from people who have actually experienced the Canadian system, rather than hearing anecdotal evidence from bloviating politicians and pundits, or trying to read incomprehensible reports from the Simon Fraser Institute.

Zee said...

@Valerie--

Good to hear from you. As always, I value your observations.

Jay - Ottawa said...

@Zee and @NSA

Once upon a time I worked at big hospitals in the USA. Currently a retiree, I am a (very peripheral) volunteer at a Canadian hospital ten minutes from home on foot. Over the past decade my wife and I have had to seek medical attention in both galaxies, Canada and the US, and should that ever happen again I hope we’re in Canada, not the US, whether for a trauma, a slap-in-the-face diagnosis or the slows of a chronic disease.

The US system is the proud disgrace designed for the well-heeled who can afford extravagant insurance rates to get fast service, lots of tests and the most expensive procedures, whether or not any of that makes medical or financial sense. And if cadillac insurance of the rich has a cap or doesn’t cover this or that, the rich can always pay out of their deep pockets. Money is the magic that makes problems disappear.

The rest of the working population, even at the high end, is forever at risk of bankruptcy within a matter of months because of medical bills. As for the poor, which is a major hunk of the US population, they get screwed here as well as everywhere else. I can recall a mother and father (middle class) breaking down by the bedside of their son, an unconscious, ventilated trauma patient, not because he wasn’t recovering but because the bills were piling up beyond their means.

Princes of the Middle East in need of a special procedure jet to America for care. They can afford to jump to the head of the line. On the other hand, fifty million poor and near poor Americans don’t even have the option of a long wait in line. Because in the US there is no cue for routine care for the impecunious. In extremis, the poor man’s doctor is the doctor of the moment on shift in the ER. Oh yes, Medicaid. Go ahead, slip into its lines and long waits, then get back to us with a report.

Fortunately, the numbers of the poor and near poor in America are diminishing rapidly, thanks to the good work of Obama’s job creators and Bernanke’s nightly printing of money. Sophisticated thinkers like us understand the wisdom behind austerity for the poor and quantitative easing for the rich. From each according to his greed, to each according to his entitlements, as adjusted by the Grand Bargain just around the corner.

That’s not the system in Canada, not even under Stephen Harper, nor in the advanced countries of Europe and Asia. So, you see, America is exceptional once again. Or maybe it should no longer be counted among “The Advanced.” Aside from other standard measures that show that Canadians as a group live longer and stronger than the US population, did you know that Canadian boys and girls are now taller on average than American youth of the same age? Another reason to look up to Canada, eh?

Did I mention yet that, like Pearl, I prefer the Canadian setup over the American, not just because I’m always looking out for Number One but as a simple matter of rough justice for all. ALL!!!

The Black Swan said...

I know I've said this before, but I might as well point it out again. About two years ago I broke my leg. I had no health insurance. The debate was: do I fly to Spain and get surgery there or throw myself at the mercy of the US health care system and hope for charity care? The Spain option would have run me around $12,000 plus airfare and would have included surgery, housing and rehab. My mom, who worked for the hospital wherein I ended up doing surgery, helped me get charity care by being connected. Not that I didn't qualify, I was in school, I was working as a cook, and my yearly income was under $20,000. I had surgery in the US, 5 hours of it, plus 4 days in the hospital and 6 weeks of PT, plus my initial visit to the ER after the injury. All told my bills ran up over $90,000. That's more than 4 years of income. Even I had the only insurance I could have afforded at the time, catastrophic, I still would have owed between $6-8,000 dollars, or nearly 1/2 my yearly income. Not to mention that I was out of work for over 3 months, so my yearly income would have been in the $12-14,000 range.

Health insurance is not health care. And impoverishing everyone who gets sick or injured is not health care.

The ACA takes a horrible system and cements it in place as the only system allowed in this country. The good old USA is very 'advanced' we have taken the sharecropping, rentier society further than any culture in human history. Now if only I could sell my soul to the company store...

Zee said...

@Jay--

Thanks for describing your positive experiences with the Canadian health care system. It gives me more confidence that it would be a good thing to implement here in the U.S.

I'm not sure that I understand your final remark, however:

“ I prefer the Canadian setup over the American, not just because I’m always looking out for Number One but as a simple matter of rough justice for all. ALL!!!”

opit said...

http://www.thetalentshow.org/2005/04/21/health-of-nations/
http://economistsview.typepad.com/economistsview/2007/04/health_care_the_1.html
This one following didn't seem to load. You have to scroll down http://voices.washingtonpost.com/ezra-klein/health_of_nations/

Grist for the mill.
I recall from conversation with Canadian New Democratic Party elders disappointment with dental and pharmaceutical coverage not being included. It was politically impossible to make it happen.

Zee said...

@All--

I have appreciated the personal observations of Pearl, Valerie, and Jay regarding single-payer health care systems, along with the links provided by “opit” to comparative data on health care performance and “outcomes” between Canada and the U.S., in which the latter usually comes out on the short end of the stick when a cost-benefit analysis is performed.

However, pondering again the significance of Jay's remark,

“ I prefer the Canadian setup over the American, not just because I’m always looking out for Number One but as a simple matter of rough justice for all. ALL!!!”

I realized that if I'm not ruthlessly “looking out for Number One,” well, I am deeply and shamelessly concerned for my own welfare, and that of my loved ones, and insofar as possible, I will do whatever is legally and morally possible to preserve the life and health of myself and my loved ones. I think that's only being human.

Despite my various surgeries, I'm in pretty darned good shape for a man of 63, or, so my GP tells me. I've never faced any serious ailment, yet, e.g., cancer, chronic heart disease, Parkinson's Disease, lupus etc.

Nevertheless, I have known acute, agonizing, indeed crippling, pain that required e-room treatment, advanced diagnostics, heavy, narcotic pain killers, a complicated spinal injection, and two- months-plus of recovery time, and I'm curious to know how I would have fared in Canada vis-à-vis my experience in the U.S.

It appears that none of you out there are Canadian physicians, but I would still appreciate your opinions if you care to venture them. Or, if you happen to know any Canadian doctors, I would appreciate their opinions as to how my treatment would have progressed in Canada versus the U.S.

So here's the story if you care to indulge me:

To be continued:

.

Zee said...

Canadian versus U.S. health care timetables (cont'd)

Two summers ago, I bent over to tie a shoelace in preparation to go to the gym. A white-hot flame of pain shot down from my left lower back all the way down my leg to my left foot. I fell onto the floor into a fetal position, screaming in pain and crying out to my wife that she needed to get me to the emergency room. (In retrospect, we know now to always call for an ambulance, because ambulance “arrivals” always get priority in the U.S.)

Somehow, I crawled to the car with Mrs. Zee's assistance, and she somehow levered me into the back seat. Happily, it was a weekday morning, our nearest e-room isn't far away, and I was seen immediately, after two hospital attendants lifted me out of the back seat and placed me in a wheelchair.

During “intake,” I was in so much agony that the nurse couldn't even get a realistic blood pressure reading from me. (But they did make sure that I was insured; as I was headed for the gym, I had no wallet on me, but I was a “repeat surgical customer” and my wife had her card.)

Moved to an e-room bed, I was seen by a physician's assistant (I thought he was an MD and I'm still pissed about that), given a dose of morphine and a muscle relaxant, then another dose of morphine before they could even get me to X-ray.

X-rays, of course, showed nothing. So I was sent home with a three-day supply of wholly-inadequate, pantywaist pain-killers, and told to “come back if [you] need further treatment.” Like I'm going to go back to the effing e-room to see a PA again.

Zee said...

Canadian versus U.S. health care timetables (conclusion)

Well, by the next day I had an appointment to see a spinal specialist.. On the third day, I was seen, an MRI was ordered up, and I was put on a muscle relaxant (Baclofen) and a real pain-killer, “Oxycodone/APAP 7.5-325Mg, 1-2 tablets every six to eight hours.” (I'm a physical scientist, not a doctor or pharmacist, but I gather that's a good one.)

I was taking 2 tablets every six hours, and while that period's a total blur, the pain was relentless. I couldn't sit, I couldn't lie down and sleep or even pass out, I could only hunch over a kitchen counter and—occasionally—twist my lower back enough to get a slight reduction of the pain while watching the newly-discovered “Western Channel” on Comcast. I rediscovered “Bonanza,” “Wagon Train,” and “Have Gun, Will Travel.” though I barely remember a thing.

When the MRI was in, I went in for another exam and the results. Going in, I asked the nurse for a refill on the Oxycodone prescription. She asked how much I was taking, I told her, and she told me “You must be flying.” I replied, “I'm still in agony. I can't sleep and NO position is . tolerable for more than half an hour,” and the doctor refilled the prescription by the end of the follow-up exam.

Two herniated discs were compressing my sciatic nerve, causing my agony, so I was also scheduled for an X-ray guided spinal injection—which involved going in and touching my sciatic nerve to be sure the injection was in the right place—the next week.

The injection took effect over the following two months, by which time I was back to the gym.

So here's my extended question:

From the e-room to seeing a spinal specialist, two days. From seeing the specialist to getting an MRI, one week. From the MRI to the spinal injection, another week.

During all this time, and during the following month, I lived on 2 Oxycodone every six hours, tapering off to zero during the following month. I'm told that Oxycodone is addictive, but I had no problem giving it up.

In Canada, would this “timetable” have been similar for me, or would I have lived on Oxycodone for longer periods between seeing the various specialists? Would I even have been prescribed Oxycodone, which was barely up to the task of suppressing my pain, as opposed to some weak-sister pain killer?

I don't know if you have any answers to these questions, or know anyone who might be able to. But, unlike Jay, to some extent, I am “looking out for Number One,” and I really am curious to know the answer.

Pearl said...


Zee: I just read your report of your agonizing situation. It sounds like you got needed care but you don't
mention what this cost you despite your medical coverage and whether you had to pay for the medications required. Emergencies in Canada I hope get quality care but are not charged and any medications are a fraction of the cost of those in he States. The only hold up I heard of was of a man who lived in a distant rural area of Ontario where they did not have local medical care due to the difficulty of finding doctors to set up shop in such outlying areas and he had to be taken to a hospital several hours away.
However he chose to live there knowing the shortages which are similar in the U.S. As far as the quality of care from doctors, here as in the U.S., depends on the doctor some of whom are better than others and I have had some problems in the past with doctors for various problems, but no worse
than in the States. Canadian doctors are not required to take out insurance in case of patient complaints, but are forwarded to a medical association which investigates the complaints. This also depends on who are on these
boards as to how they conclude. This allows doctors to not be burdened with huge costs for this insurance coverage which has hamstrung many American physicians.

Remember also, that in Canada, if one has a health card that all legal
residents receive, no questions are ever asked about insurance coverage or how they will cover the costs and all people as a result receive for the most part, equal quality of care since doctors do not know the wealth or lack of of their patients. Of course there are snafus in any health care system. In a post some time back, I reported on the excellent immediate care my daughter received after an agonizing colitis attack as well as other surgery.
Strangely enough, the physician who supervised her colonoscopy after the
colitis attack had a report on the front page of the Toronto Star not long afterward for negligence in a particular case and was suspended until further investigations. She saw someone else for another recent colonoscopy which assured her that all was well and nothing had been missed by the former physician. Remember any doctor you see may have been in the bottom half of his class! Good luck to you and your family via health matters.




Zee said...

@Pearl--

Thanks to Mrs. Zee's impeccable record-keeping, we should still have the statements for my Summer, 2011 healthcare saga.

I just have to wait for a time when she's patient enough to point out to me where they are, and I will get back to you then with the total cost for my "experience." Because it certainly wasn't "free."

Also, it's worse than just worrying about having a doctor in the lower half of her/his class. As George Carlin once said:

"Have you ever thought about the world's worst doctor? Process of elimination, somewhere out there is the world's worst doctor. And someone has an appointment with him tomorrow!"

http://tvtropes.org/pmwiki/
pmwiki.php/Funny/GeorgeCarlin

Could be yours, could be mine.

Valerie Long Tweedie said...

That is a good point, Pearl.

When I left the States close to six years ago, I had great health insurance through the State because I was a teacher. My friends in the same school district say that the insurance coverage has eroded considerably since I left. While the district still pays close to $800 per teacher each month, the insurance has higher deductibles and doesn't cover as much. While my 40,000 surgery was almost totally covered (I think I paid a total of $300), my friend had a surgery costing a similar amount a year and a half ago and came away owing $7000 that his insurance didn't cover. So even if Zee didn't have to pay anything at the time, he might if he had the same surgery today.

The only place Australia has problems is in their emergency rooms in terms of wait times. And like Canada - all is pretty much paid for. We carry private insurance but that is only so I can have a private room, see a chiropractor, etc. All basic health needs are paid for through the government.

Strangely, while the cost of living is a fair bit higher, my taxes - considering the health care provided for all - aren't that much higher than they were in the States. But then again, Australia isn't spending its bounty on expensive wars. We do our bit but you will notice we are only minimally involved.

VLT