August 20, 2009

Is Vancouver in your Healthcare Future?

By J. Robert Smith

The droning sound you hear is President Obama reassuring you that healthcare reform has nothing to do with rationing. Budget limits won't bust your medical care. Keep your family doctor, he says. The doctor-patient relationship is inviolate. No take-a-ticket healthcare for you.

Not so in Vancouver, British Columbia, where a leaked report indicates that the health authority is considering massive cuts in surgeries. The authority needs to do so to offset a $200 million budget shortfall.

As many as 6,000 surgeries could be whacked to balance the budget. Nothing major, of course. Neurological and vascular surgeries, among others. Brains and veins are about on par with breast implants and liposuction. Aren't they?

Vancouver's quandary is a glimpse at America's future, if the President's statist gambit succeeds.

What did President Obama say about bean-counters not interfering with your access to healthcare? About your doctor and you making the decisions? The green eyeshade brigade can't balance their ledgers on your sick back?

The President would protest loudly that Canada isn't the 51^st state. It's a different country with a single-payer system. Can't happen in the United States.

But it can; it does already.

Medicare and veterans' healthcare are cases in point. Reimbursements for a host of procedures and services are determined in Washington. Tugs-of-war between Medicare providers and Congress are annual events.

More often than not, it's the patients who lose out. Take respiratory services, for instance. Medicare reimbursements for home oxygen care have slid markedly over the last ten years. Providers aren't charities; they're for-profit enterprises that need to turn a dollar. After all, they have bills and employees to pay. They need to generate revenue to expand or improve their services.

Declining reimbursements mean a reduction in the availability of services, especially in rural areas where smaller operators have a hard time keeping their heads above water.

Yet the President would respond that most seniors are happy with Medicare -- at least those who don't need home oxygen. And he wants reform that gives Americans choices, which involves a public option -- or not, depending on the day's muddled messaging.

As Americans are learning, the public option championed by the President and the hard left is a backdoor to a single-payer system. Regardless, health care reform, Democrat-style, is a Rube Goldberg contraption. It's weighed down with so many new rules, regulations and powers, Democrats just may as well push for single-payer.

A rule of thumb in politics is that you don't have to own to control. Make the rules of the game and you effectively control outcomes. That's real power, and acquiring more power is at the root of the President's healthcare putsch.

Which leads us back to Vancouver. Call Vancouver another case study in a thickening tome of case studies on the failures of socialized medicine.

Brian Brodie, MD, the President of the BC (British Columbia) Medical Association, "called the proposed surgical cuts ‘a nightmare.'"

"'Why would you begin your cost-cutting measures on medically necessary surgery? I just can't think of a worse place,' Brodie said."

And this:

"According to the leaked document, Vancouver Coastal - which oversees the budget for Vancouver General and St. Paul's hospitals, among other health-care facilities - is looking to close nearly a quarter of its operating rooms starting in September and to cut 6,250 surgeries, including 24 per cent of cases scheduled from September to March and 10 per cent of all medically necessary elective procedures this fiscal year."

If the Democrats manage to ram through healthcare reform, sooner rather than later, it won't be Washington alone that faces a budget crisis; states and localities may well follow suit. Congress does a masterly job off-loading mandates and costs on the states.

The Congressional Budget Office estimates that healthcare reform will cost $1 trillion dollars over the next ten years. Big government programs are notorious for dramatically exceeding initial cost estimates. Medicare is a prime example. Its cost has roughly doubled every four years since 1966.

Rolling 46 million uninsured Americans into health plans will make for a whopper of a bill. Add that bill to the others the President is incurring -- stimulus-lacking stimulus measures, bank and auto bailouts -- means the nation will face a couple of generations of economy-crippling and spirit-sapping debt.

But facts don't count, not when an ideologically driven president wants his legacy. Mr. Obama craves a place in the pantheon of great presidents. He thinks government-run healthcare is his chance. But Washington, Jefferson, Madison, Jackson and Lincoln stood for liberty, the God-given rights of the individual and limited government. Where does Mr. O fit in?