Waiting for medical care

Canadian Physician Warns, “Obamacare Rationing Inevitable”

Canadian Physician Warns, “Obamacare Rationing Inevitable”
By Lee Kurisko, MD, www.medibid.com

waiting too long for medical careUnder Obamacare, the federal government will inevitably decide what kinds of care will get funding and who will get it. Comparative clinical effectiveness research is now a reality as a part of the U.S. government reform of the health care system. As a Canadian Physician, I know this research leads to only one thing – rationing.

Imagine the nightmare I experienced as a radiologist in Canada arbitrating who would be scanned and who would be sent to the end of the line. Sometimes I would read a scan and discover the patient had a huge tumor or rampant infection and I had personally sent them to the end of the waiting list when waiting times were as long as 13 months.

Harsh reality caused a complete turn-around in my views, which led me to move with my family from Canada to the U.S. in 2001. I now believe that government has no justifiable role in the delivering of health care. Hippocrates was correct. Health care is a matter entirely between the patient and his doctor. Those in need should be treated with compassion, as they were prior to the government getting involved during World War 2.

It used to be a matter of medical ethics to care for the poor. Government horning its way into such benevolent transactions does not improve them. The involvement of government and other third parties has driven costs sky high and then doctors and hospitals are compelled to accept fees that cannot cover those costs. In the United States, “benevolent” government makes it illegal to perform charity scans in our imaging centers.

I have actually had opponents tell me that an American system of government medicine would not entail rationing. This is pure fantasy. As Thomas Sowell succinctly states, “The key task of any economy is the rational allocation of scarce resources.” We all hold a piece of responsibility for this each time we spend money. We assess price and value to allocate resources efficiently.

In health care systems, when someone else is paying, we do not make rational choices and over-consume medical goods and services. As a diagnostic radiologist reading over 100 imaging cases daily, every hour of every day that I work, I read cases that are discretionary expenses that the patient and physician likely would not have pursued if the patient had to pay themselves. Furthermore, the patient would not have suffered any negative consequence with a “wait and see” approach

In health care, wishing that the laws of supply and demand do not exist does not make them go away. Since we do not restrain our own health care purchases, and since resources are “scarce,” to use Sowell’s terminology, we must be restrained by someone else. Therefore third-party payers limit coverage and deny claims. Restated, they ration.

Rather than sending our money to third parties (government and insurance companies) and then letting them decide how our money is spent, we should hold onto that money and decide for ourselves. Furthermore, this would save the monetary inefficiencies of third-party payment. It does not eliminate the role of insurance. Most types of insurance exist to replace large financial losses for unexpected events. I have used my auto insurance once in thirty years. Auto insurance is cheap. It wouldn’t be if it paid for routine maintenance and oil changes. Perhaps the health care reformers should learn a lesson from this.

We need preventative care, and we’ll all have minor illnesses and injuries that need attention. What we don’t need is someone else telling us what and how we will have access to, simply based on the cost. I want insurance for heart attacks and cancer; not hangnails.

Eventually the nightmare scenarios in Canada will be relived here if action is not taken. Misuse and overuse from the illusion of entitlement out of payment into obligatory health care will always lead to rationing.


Lee Kurisko, MD is a Canadian physician specializing in Diagnostic Imaging and Fellowship trained in Neuroradiology. He is former Medical Director of Diagnostic Imaging for Thunder Bay Regional Hospital in Thunder Bay, Canada. A former believer in the superiority of government delivered healthcare, he no longer holds this view and is an advocate of free markets in health care. He is on the Board of Directors of Consulting Radiologists Ltd. based in Minneapolis. He is Chief Medical Officer of www.medibid.com, an internet portal for buying and selling medical goods and services without the intrusion of third-parties. His book, “Health Reform – The End of the American Revolution?” was released in the summer of 2009.
Contact: Lacey Clifton, meet@medibid.com, 888-855-6334

Dr. Lee Kurisko
Dr. Lee Kurisko

6 responses

Government “programs” have no magic that will reduce the cost of medicine or any other product or service. They just attempt to hide the costs and they are often quite successful at it. After all, it would truly be wonderful if medical care really was free, so the great majority of the general population buy into the argument that somehow the government will provide health care that is better, less costly and “universal”. To the extent that they succeed in hiding the costs, they have created an uncontrollable monster. If the price is thought to be zero, the demand will always be relentless and unmanageable.

Reducing pay for specialty procedures a small percent and increasing pay for primary care a full 25 % would lower health care costs and improve outcomes in one fell swoop

That will probably have a positive effect. Consumers at MediBid.com are looking for good primary care physicians, and are willing to pay fair market rates for good quality care.

I have lived in Asia and Europe and I have never had problems with medical care insurance and access to it at an affordable price until I returned to the U.S. and found it inaccessible. While Obamacare may not be a cure all, it is certainly a vast improvement over what we be stuck with until it fully is implemented in 2014. I found that I had import basic diabetes and blood pressure medications from a Canadian based wholesaler, which was getting its medications from a U.S. licensed facility in Palau. Even with the shipping costs, it still cost about half what I would have been able to pay in the U.S.

Obamacare will not be perfect, nor are the plans I find advertised on American television. I think we all know the supplemental medicare support plan sponsored by AARP, provided via United Health Care. It gives one pause, when the insurance at that company’s home office provides for such high deductibles, that it is basically just like having no insurance whatsoever.

Fortunately, I am covered by spouse’s health insurance plan, but if we relocate back to South Korea, medicare, which I will soon be paying into, will not cover for any medications/health care I receive abroad. Hence, I am considering my options.

Unfortunately obamacare makes a bad problem much worse. I have lived in Canada, Germany, Thailand, Nepal, and the US, and of those Thailand and the US were the best. I had coverage but lacked access in Canada and Germany

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