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Title: Blog by Novelist William S. Frankl, MD

Archive for June, 2010

Canada’s Health Care System in Crisis

Sunday, June 20th, 2010

Those Americans who favor a single-payer health care system have often considered Canada a great success in providing quality health care while controlling costs. Canadians are now questioning both, especially the cost. The provinces, which contribute a significant portion of those costs, are considering ending some services and curtailing others, because ballooning costs have exposed the present system to be unsustainable.

Under pressured from an aging population and the urgent requirement to control increasing budget deficits, Canada’s provinces are promulgating tough measures to curb health care costs, which could erode the principles of the state-funded system:

1.Ontario began a fierce battle with drug companies and pharmacies when it said it would cut generic drug prices by 50% and eliminate “incentive fees” to generic drug manufacturers.

2.British Columbia is doing away with block grants to hospitals and replacing them with fee-for-procedure payments.

3.Quebec has established a flat health tax and has proposed instituting a payment program for each medical visit.

4. Several provinces are now experimenting with private funding for hip, knee, cataract, and other surgical procedures.

And since senior citizens will make up 25% of the population by 2036, there will likely be more changes as the provinces, responsible for delivering health care, deal with their demands.

Is the current system unsustainable? The system has long wait times and high rationing hurdles for expensive services, those most likely to be used by the elderly. Costs have increased well above inflation, at 6% a year. Canada’s system has trouble with instituting new technologies and treatments while coping with arbitrary allocations made by the political process. Thus, the care for seniors will likely be hardest hit in this looming financial crisis.

Source: Ed Morrissey, “Canada reconsidering health care model in face of soaring costs,” HotAir.com, June 1, 2010; and Claire Sibonney, “Soaring costs force Canada to reassess health model,” Reuters, May 31, 2010.

How ObamaCare Impacts Doctors

Sunday, June 20th, 2010

Many doctors expect ObamaCare to be a disaster for them.  The bill will reinforce the worst features of the present third-party payment provisions in both the public and  private sectors, further compromising the professional independence and integrity of the medical profession, according to Robert E. Moffit, director of the Center for Health Policy Studies at the Heritage Foundation.

Under ObamaCare, approximately 18 million of the 34 million who would receive insurance over the next 10 years would be placed in Medicaid, a welfare program administered and funded by both the federal government and the states. According to Moffit this will displace many private health insurance programs, and increase government control over health care financing and delivery.

In addition to existing payment rules, regulations and guidelines,ObamaCare creates many new federal agencies, boards and commissions. Health care reform should be designed to restore the doctor-patient relationship, where doctors would be the key decision makers in the delivery of care, and patients would be the key decision makers in the financing of care.  This cannot occur until patients control health care dollars and decisions, and third party insurance programs are directly accountable to those who pay the health care bills.

Source: Robert E. Moffit, “ObamaCare and its Impact on Doctors,” Physicians News Digest,
June 14, 2010


The Alien in the White House

Saturday, June 12th, 2010

Dorothy Rabinowitz, a member of the Wall Street Editorial Board has written a most insightful opinion piece on June 9th, in the Wall Street Journal which describes the deep division that exists between the American people and President Obama and his Administration. He is indeed an “alien” in the White House. Unlike most of us, President Obama dismisses the notion that America is better or even luckier than other nations. He loathes the idea that Americans tend to think of themselves as special among the peoples of the Earth, considering this as ignorance and ethnocentrism. President Obama considers himself a multiculturalist –– a citizen of the world, first, and only secondarily President of the United States. He looks upon cosmopolitanism as morally and intellectually superior to patriotism, and apologizes for America’s supposed depredations, despite the enormous blood, treasure, political and cultural gifts America has given to the world since its founding. Obama is seriously disconnected from this country, which is a looming tragedy for us as well as him.

I’m providing a link to the full article.

Not Presidential

Wednesday, June 9th, 2010

Yesterday morning, while being interviewed on “Good Morning America,” President Obama was asked about how involved he was with the on-going problems related to the oil spill in the Gulf of Mexico. He indicated he was very involved, and that he was speaking everyday to many people in order to know  “whose ass to kick.” This was a crude statement, even more crude than the “boot on the neck of BP” attributed to Interior Secretary Salazar.
I guess this is the kind of language used in the political back rooms of Chicago. Should it be used in Washington? On national television? Is that the language our children should be encouraged to use?

Obamacare and the Constitution

Monday, June 7th, 2010

There are aspects of Obamacare that have been identified as unconstitutional, according to an
editorial by Greg Scandlan: “Read the Fine Print,” in Investor’s Business Daily, May 19, 2010.

1.The individual mandate requires the uninsured to buy a plan. This is the most likely place for legal objections to begin.
2. Another provision likely to be disputed as regards its constitutionality is the expansion of Medicaid that forces states to increase spending on that program.

But even if one or both were stricken, the bulk of Obamacare would remain. However, as Scandlan indicates, due to a little-known legal concept the entire law could unravel if a single part lay outside the Constitution. He notes: “Apparently there was no ‘severability’ clause written into this law, which shows how amateurish the process was. Virtually every bill I’ve ever read includes a provision that if any part of the law is ruled unconstitutional the rest of the law will remain intact. Not this one.  That will likely mean that the entire law will be thrown out if a part of it is found to violate the Constitution.”

Some Constitutional scholars don’t have much confidence that the courts will overturn the law.  But, Ronald Trowbridge, a senior fellow at the Texas Public Policy Foundation, says there is still hope. “Consensus holds that it will take two years for the constitutional challenge to progress through the federal district court, then the appellate court, and finally the Supreme Court,” he wrote on Andrew Breitbart’s BigGovernment.com blog.  “In the meantime, it is possible that an injunction from the district or appellate courts could put the entire bill on hold until the injunction is lifted or the case finally resolved.”  One can only hope.


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