Friday, June 12, 2009

How to Destroy a Healthcare System (Part III)

As the rhetoric of the healthcare debate heats up, the quality of American health care is a prominent target. Daily we are hectored with tales of the inadequacy of our medical system. We’re told by the President regularly that we have the most expensive health care system in the world but we are not any healthier for it.

From President Obama on May 18th in New Mexico:

We spend more per capita than any nation on Earth…in some cases we've got worse outcomes. We've got higher infant mortality rates; we've got higher rates of some deadly diseases. That doesn't make sense.

WHO You Gonna Believe?

You’re right Sir, it doesn’t make sense. Do we really believe that we rank 37th in the world behind Cyprus, Morocco, Colombia, Portugal and Costa Rica? That’s what the last World Health Organization (WHO) Report (2000) claims and that’s what supporters of a government run health system proclaim.

There is much to critique in the WHO Report. Thinking people might ask are the measures used defined similarly in all countries, or is it apples and oranges time? On the subject of infant mortality, which is a critical element in calculating life expectancy, the Colombians, ranked ahead of us, would say "confundir la mierda con la pomada". Nevertheless, WHO uses its calculated value of life expectancy, built on faulty assumptions to derive life expectancy as an indicator of health system performance.

An additional reason for the head scratching view of healthcare systems which results from the WHO survey is the heavy weighting of “fairness” of health care distribution in developing rankings. From the Report:

Together, the levels of health and of responsiveness receive a weight of three-eighths of the total. The three distributional measures, which together describe the equity of the system, account for the remaining five-eighths.

Lets review this statement. WHO is not interested in whether your nation's care is good. WHO is most interested in everyone getting the same care, good or bad. Even if WHO could determine accurately the “distribution of healthcare”, a nation with overall stellar care, super stellar at one end of distribution and stellar at the other end, would be penalized! Yes, health tourism in Morocco is booming.

Nations unwilling or unable to invest in healthcare, who sentence all their citizens to the same mediocre care, are revered by the WHO. Commitment to mediocrity, our battle cry! Welcome to the brave new world of socialized medicine.

Infant Mortality

Infant mortality in the US is regularly cited by WHO and others as an indicator of the poor return we get on our health care dollars. The fact is that the US reports on all births more completely than any other nation. A livebirth in the US refers to any infant who on birth shows any evidence of life, including respiration, pulsation of the umbilical cord, or voluntary muscle movement. While there is some state variation for reporting, almost all states mandate reporting for infants greater than 20 weeks gestational age.

From US News and World Report (2006) and Dr. Bernadine Healey:

In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (mean length at 22 weeks gestation) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.

Infant mortality in developed countries is not about healthy babies dying of treatable conditions as in the past. Most of the infants we lose today are born critically ill, and 40 percent die within the first day of life. The major causes are low birth weight and prematurity, and congenital malformations. As Nicholas Eberstadt, a scholar at the American Enterprise Institute, points out, Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in weight at birth.

Form Kramer at al in Pediatric Perinatal Epidemiology in 2002:

The huge disparities in the ratio of fetal to infant deaths less than 750 grams (1.6 lbs) and in the proportion of live births less than 750 grams among these developed countries probably result from differences in birth and death registration practices. International comparisons and rankings of infant mortality should be interpreted with caution.

Infant mortality rankings are not an issue of poor quality of care for the US, they are an issue of our willingness to attempt to support extremely tiny babies and reporting bias. There are disparities in infant outcomes in the US, especially along racial lines, but these have less to do with the healthcare system than societal and cultural factors which the healthcare system has little control over. Our strict definitions of live birth lead to the reporting of thousands of infant deaths annually which are never given a second thought even in Western Europe, the purported mecca of high quality healthcare.

Life Expectancy


Life expectancy in the US is another crude indicator of healthcare system quality frequently cited by critics of American healthcare as emblematic of our deficiencies. While average life expectancy in the US is 78, we still rank behind thirty other countries including Japan, France, Sweden and Hong Kong. What life expectancy as an indicator of quality in healthcare fails to account for are detrimental cultural and societal behaviors which limit life expectancy. US reporting of infant mortality certainly has a negative impact on this number but so do two other vital factors, homicides and car accidents. For 2004, the US homicide rate was 5.9/100,000. The rate was 1.95 in Canada, 1.64 in France and 0.98 in Germany. The US auto fatality rate is also higher. In 2006 the rate was 14.2/100,000 in the US. The rate in Canada was 9.25, in France 7.4, and in Germany 6.19.

The fact that the U.S. has a disproportionate number of individuals who die as the result of fatal injuries compared to the other wealthy nations of the world should be considered in any discussion of life expectancy rankings, but rarely is this recognized by those eager to find fault with American medicine. The destruction of inner city communities and mandates for a nation of automobile nomads to drive increasingly more fuel efficient and less safe automobiles does not reflect upon the quality of health care in the U.S. Death in these situations almost universally occurs independently of the condition of health of the individuals who die as a result of these factors.

When authors Robert Ohsfeldt and John Schneider in The Business of Health (2006) adjusted international life expectancy data for these variables, it turns out the US leads the world in life expectancy:


Table 1-5: Mean Life Expectancy at Birth, OECD Countries, Actual and Standardized by OECD Mean Fatal Injury Rates, 1980-99

OECD Nation 5

Actual (Raw) Mean (Does Not Account for Fatal Injuries)

Standardized Mean (Accounts for Fatal Injuries)

United States

75.3

76.9

United Kingdom

75.6

75.7

Switzerland

77.6

76.6

Sweden

77.7

76.1

Norway

77.0

76.3

Netherlands

77.0

75.9

Japan

78.7

76.0

Italy

76.6

75.8

Iceland

78.0

76.1

Germany

75.4

76.1

France

76.6

76.0

Denmark

75.1

76.1

Canada

77.3

76.2

Belgium

75.7

76.0

Austria

75.3

76.0

Australia

76.8

76.0


The President is correct when he reports that Americans experience higher rates of deadly diseases. Specifically, America has high rates of heart disease and diabetes. The cause of this, however, is not the American Healthcare system. It is directly related to the fact that 31% of Americans are obese compared to 14% of Canadians, 13% of Germans and 9% of the French. According to Ron Bailey, science correspondent at Reason Magazine:

Taking all these unhealthy proclivities into consideration, the American health care system is most likely not to blame for our lower life expectancies. Instead, American health care is rescuing enough of us from the consequences of our bad health habits to keep our ranking from being even lower.


Statists interested in further expansion of government power eagerly proclaim that medicine has neglected its responsibilities in wellness and preventative care. Speaking to a crowd in Wisconsin this week the President, when asked about wellness and personal responsibility, immediately redirected the question to the responsibility of employers, government and medicine to keep individuals slim, trim and disease free. The canard of wellness will be used by statists interested in tightening control over the medical sector, which has no ability to influence societal ills created by decades of central planning. This heavy club will also be used to bludgeon other industries (tobacco, food) into submission, all in the name of health and “bending the healthcare cost curve downwards.”

Miracles of American Healthcare and the Mediocrity of a Single Payer System

Cancer

For those genuinely interested in maintaining the best medical system in the world, there are many factors well beyond the control of the healthcare system which determine an individual’s health. While US critics are fond of inaccurately attributing quality deficiencies of our healthcare system, rarely do we hear of the incredible success stories that have resulted from American medicine. It is more likely that we will hear about the wonders of Cuban medicine in mainstream media.

“Cancer” is the word that strikes fear into the heart of all when they sit in a physician’s office. Should it strike more fear for patients in different healthcare systems? Short answer, yes it should.

From an article entitled Socialism and Cancer, written by Dr. David Gratner, a Canadian, in The New Atlantis:

A working group associated with CONCORD (the European NGO Confederation for Relief and Development) recently completed a study comparing five-year cancer survival rates for several malignancies: breast cancer in women, prostate cancer in men, and colon and rectal cancer in both women and men. Combining the efforts of some hundred researchers and drawing data from almost two million cancer patients in thirty-one countries, the study, published in the August 2008 issue of The Lancet Oncology, is groundbreaking.

The CONCORD study finds that the United States leads in the field of breast and prostate cancer. France excelled in treating women’s colorectal cancer and Japan in men’s colorectal cancer. And the United States clearly leads other nations in overall survival. Regrettably, great discrepancies do exist between white and black Americans and among residents of different cities. That said, given a cancer diagnosis, patients overall do better here than anywhere else.


Why the difference in cancer care in the American healthcare system? The short answer is better access to screening (preventative care), specialists, medications (expensive chemotherapeutic agents) and technology. Yes, you read that right, we do cancer prevention better than any country on the planet.

Heart Disease

While cancer takes a considerable toll on residents of developed nations, heart disease remains the number one cause of death. There have been multiple developments in the field of cardiology and cardiothoracic surgery over the last several years. Significant advances include the introduction of cholesterol lowering medications, use of aspirin and other medications in the face of heart attack (MI), emergency percutaneous coronary interventions (PCI) for unstable MIs, use of coronary stents and advances in by bypass surgery.
The British Medical Journal in 2006 published “National variations in the provision of cardiac services in the United Kingdom: second report of the British Cardiac Society Working Group, 2005.” The report is notable for several findings:

The UK cardiology workforce has grown significantly over the past five years (fig 4 , table 1 ). This has been most obvious in England (180 new posts advertised and appointed in the past three years), which initially had the fewest cardiologists per million population. Cardiologists are therefore now more equally distributed across the UK; nevertheless, staffing levels remain well below those reported in comparable western European countries and much lower than those recommended by the BCS workforce committee.


An analysis of audit data from the National Pacemaker Database for the period 1998–2002 has shown that the UK as a whole implants far fewer ICDs than most western European countries… Expert commentators have pointed out that these stark differences probably stem from limited access to cardiac catheterisation laboratories or a shortage of appropriately trained electrophysiologists or device specialists in many parts of the UK.


Cardiac resynchronization therapy (CRT) is a complex form of pacemaker therapy that has been shown to improve the morbidity and mortality of selected patients with heart failure. The working group has found evidence of a very patchy uptake of this technology across the UK and believes that this reflects a shortage of the relevant expertise and difficulties in funding. Our first report identified alarmingly low coronary intervention rates in Wales.

Even allowing for the substantial number of patients who reside in North Wales but are referred to England
for treatment, most forms of specialist activity in Wales remain worryingly low. There seem to be two reasons for this. Firstly, there have been difficulties in commissioning. The NSF for CHD has never been adequately funded in Wales and has become aspirational rather than pivotal in healthcare planning. Tertiary cardiac and other specialist services are commissioned nationally by Health Commission Wales; their budget has not been increased in line with the emergence of NICE-approved evidence-based technologies, and the new arrhythmia chapter to the NSF, which was introduced in England more than a year ago, is still to be approved in Wales. Secondly, the consultant cardiology workforce appears to comprise many physicians who have substantial general medical duties and relatively few specialists with skills in coronary intervention and electrophysiology. Unfortunately there seems little prospect of eliminating these inequalities in the near future.

This report should be required reading for misinformed supporters of nationalized health care. While there are some bright spots in the UK’s efforts to upgrade its cardiology services, the report overall is a critical look at a healthcare system struggling to support the cardiac needs of its citizens. For us it might be a look into the future.

Heart Surgery

Surgery remains a mainstay of therapy in severe cases of coronary disease. Most disconcerting is wait times for surgery for bypass cases. It is known that exceeding recommended deadlines for CABG, staged on the basis of a patient’s clinical condition, absolutely affect mortality. While coronary artery bypass surgery is serious business, it is not exempt from efforts by nationalized health care systems to push the envelope for waiting times.

The Canadian Medical Association published in 2008 “The Economic Cost of Wait Times in Canada.” This study evaluated the economic impact of having disabled Canadians wait to receive definitive medical care. Costs were reflected in loss of productivity, support payments and ongoing non-surgical medical care. The impact of just four conditions was examined. The analysis concluded that waits for these conditions cost Canada $14.8 billion in 2007. How long are the waits?

Waits are long. For cardiac patients not treated within the maximum recommended period, the average wait for coronary artery bypass surgery is over 3 months, more than double the maximum recommended wait. The situation for patients requiring an MRI is grave. The maximum recommended wait is 30 days, but the median patient still waits 56 days, while patients who do not get their scan within that maximum recommended period wait an average of 85 days.

From the vaunted Swedish single payer system comes a report published in 2005, in which the median wait times for patients classified as imperative (recommend surgery within 14 days), urgent (recommend surgery within 12 weeks) and routine (recommend surgery within 6 months) were analyzed.

The median waiting time for the 5453 patients that underwent CABG was 55 days (interquartile range 21 to 105 days). The median waiting time was 17 (7–39) days for the patients in the imperative group, 82 (49–133) days for the patients in the urgent group, and 100 (67–172) days for the patients in the routine group. A total of 3014 patients (55%) were operated on within the intended waiting time in their respective groups: 46% in the imperative group, 44% in the urgent group, and 77% in the routine group).

The authors, based on delays in surgery for patients at all acuity levels, were able to determine, unfortunately, the increase in deaths related to each month on the waiting list. From a previous analysis of this data the authors reported that “mortality risk increased with time after acceptance by 11% a month.”

There is no wait list for a CABG in the US. When Italian Prime Minister Berlusconi needed heart surgery in 2006, he didn’t use his nationalized health service. He flew to the Cleveland Clinic.

Other Surgeries

In Canada, wait times for surgery and other diagnostic procedures would be incomprehensible to most Americans. The major Canadian wait time metric is 90% wait time. This is the time at which 90% of cases are completed. Each province has set a goal for the 90% wait time for multiple procedures, and also carefully reports the actual 90% wait times for same procedures. The data is horrifying. For example, in the province of Ontario (includes Toronto), the provincial target for wait time for breast cancer surgery is 84 days. Fortunately, most centers achieve this benchmark, but the overall provincial wait time is still 38 days…for breast cancer surgery. While as inadequate as this may seem, it is clear breast cancer surgery has received the attention it deserves, especially when compared with prostate surgery...at least attention by Canadian standards. The provincial target for prostate surgery is a wait of 84 days. The actual overall wait is 89 days!

For overall cancer surgeries, the targeted wait time is 84 days in Ontario. The actual wait time outperforms the benchmark, however. In Ontario the average wait for a cancer surgery is 61 days. That would be two months waiting for a potentially curative surgery living with the fear that your cancer is growing.

Orthopedic surgeries are rarely life saving surgeries, but they have an enormous impact on productivity and quality of life. In Manitoba (Winnipeg), the median wait time for a hip replacement is 14 weeks. Not days, weeks, and that’s the median. At this point another 50% of replacements are still not complete. In New Brunswick the median wait time is 12 months. That would be a dream, however, for natives of Nova Scotia, living the glory of a single payer healthcare, where the 90% wait time for a hip replacement is 540 days. Nineteen months!

Well, it’s nationalized healthcare right. We have to ration services somewhere. Why not start with the aging population? While it might seem insensitive to some that we send early the message to the aging that they have a duty to die, surely a compassionate, government run, single payer system will make certain the children are cared for.

So how about children’s surgical services? The province of Ontario includes several well known Children’s facilities, most notably the Hospital for Sick Children in Toronto. The 90% wait time for all pediatric surgeries in the province is 226 days! When one considers subcategories for more serious surgical conditions, the 90 day wait for neurosurgery is 71 days. The same wait for cardiovascular surgery is 206 days! There are not words to describe what I expect would be the reaction of anyone familiar with medical care, especially pediatric care, if the President told them the truth.

Diagnostic Tests

If the wait times for surgeries make you shudder, consider the fact that most surgical plans are formulated only after proper diagnostic testing is done. How long does it take to get these studies performed in a nationalized healthcare system?

A key imaging study performed regularly and with minimal delay in the US is MRI. In Ontario, the provincial target is a wait of 28 days, the actual wait time is 105 days! Well, maybe MRI is an expensive and overused technology whose value is totally overstated by greedy American hospitals and physicians. Okay, while many will point to the deficiencies of CT in numerous diagnostic areas, maybe the Canadians are just better at it. Surely that would mean easy access as well. The Ontario provincial benchmark for CT wait is 28 days, the actual wait time is 40 days!

So while it may seem that waiting 6-12 months for your hip replacement or 70 days for your child’s neurosurgical procedure is a lifetime, add in the time that has already passed as you waited for the imaging study required prior to a surgical intervention.

The National Health Service in Great Britain is no better. According to the Times (in 2005):

Ms Rachel King, 32, from Erith, Kent, was knocked down by a car in January. She suffered a broken collarbone, five broken ribs, a shoulder blade broken in three places and head injuries. She was in hospital for 17 days. After she suffered dizzy spells and reduced vision, her consultant referred her for an MRI scan. She said that she was appalled to receive the letter from King’s, saying that, because of “heavy demand”, the scan would be delayed.

What added insult to injury was the handwritten note on the bottom, which read: “If you want to go privately call 0845 6080991 for prices.”


When she did, the telephone was answered by King’s College Self Pay, who said that the cost of such a scan was £983, and she could have the procedure in a couple of weeks.


“It’s insulting” she said. “I was absolutely distraught. I need reassurance that the damage isn’t permanent. All I want is to know if it is going to get better.


“I still have falls, and I can’t return to work or drive. I’ve never signed on the dole in my life but I have had to now.”


King’s College Hospital said in a statement that it recognised that an 80-week wait for scans was unacceptable. It had recently received funds to expand its services, with the aim of getting waiting times down to 26 weeks by next March.


Ms King’s case is the starkest example yet of widespread delays in diagnostic tests across the health service. One in five trusts has waiting times of more than a year for MRI scans, and two in five have waits of more than six months.


A quarter of trusts said that 25 per cent or more of their scanning capacity was not used but lack of staff and resources prevent increased usage.


From the Telegraph:

An ex-serviceman is being left to go blind in one eye before the National Health Service will consider treating him for a condition affecting 250,000 people in the UK. Leslie Howard, 76, noticed problems with his right eye in November and was diagnosed with wet age-related macular degeneration (AMD) two months ago.

His sight could be saved by a course of treatment involving new drugs which could cost more than £6,000 a year.
But the local Primary Care Trust has told him it will only considering funding in his case once he has gone blind in one eye and developed wet AMD in the other.

A study sponsored by the Canadian Medical Association reports on the hidden cost of wait times:

Wait times in just 4 areas — joint replacement, sight restoration, cardiac bypass surgery and MRI scans — cost Canada $14.8 billion last year and lowered government revenues by $4.4 billion during the same period. The data, from a study done for the CMA by the Centre for Spatial Economics, were released in Toronto during a Jan. 15 speech by President Brian Day. “Our estimates are extremely conservative,” Day said. “Moreover, they do not include the costs, short and long term, of the deterioration that occurs while waiting. As an orthopedic surgeon, I have seen patients develop chronic and severe, irreversible damage, addiction to painkillers, and depression. And it need not happen.” Day looked back at the causes of today’s problems and ahead to potential solutions. He said causes range from decisions to cut medical school enrollment in the early 1990s to “self-serving” moves to protect the status quo.

Day also said Canada has fallen to 24th among OECD countries in physicians per capita, after ranking fourth in 1970. “How many of you have a doctor who is 50 or older? Who do you think will look after you when you are older and need medical attention?” Just to reach the OECD average of 3 physicians/1000 people, said Day, Canada would need to add 26 000 physicians, or more than 10 years’ output from its medical schools, at once. “It is not our role as physicians to passively accept the prolonged suffering of patients,” Day concluded. “We want to manage patients, not wait lists.”

The Canadians dedicate significant time and resources to trending and documenting waiting times in their medical system. While we all will be subjected to rationing and waiting periods that severely impact our health and welfare as we leap to a single payer system, the upside is that there will be more of the jobs created which the President makes best...government jobs. Armies of government agents charged with reporting on and examining time management in US healthcare will be put to work.

Medical Research


Stated simply, the United States puts more money into medical research than any nation on the planet. From Tyler Cowen in the NY Times in 2006:

In real terms, spending on American biomedical research and development (R&D) has doubled since 1994. By 2003, spending was up to $94.3 billion (there is no comparable number for Europe), with 57 percent of that coming from private industry. The National Institutes of Health’s current annual research budget is $28 billion, All European Union governments, in contrast, spent $3.7 billion in 2000, and since that time, Europe has not narrowed the research and development gap. America spends more on research and development over all and on drugs in particular, even though the United States has a smaller population than the core European Union countries. From 1989 to 2002, four times as much money was invested in private biotechnology companies in America than in Europe.

The 2009 NIH Budget alone is $40.9 billion. The pharmaceutical industry spent an additional $40 billion on R&D last year. America produces more than half of the health care technology products purchased globally. The Canadian 2009 budget allocates $5.1 (US) billion for all science and technology research. The Canadian Institute for Healthcare Research (CIHR) is budgeted $917 million for research this year. In Canada there are minimal contributions from the private sector given government regulation of the healthcare market. The UK through the Office of Strategic Coordination of Healthcare Research (OSCHR) has budgeted $2.75 (US) billion on medical research. US GDP is (was) 9.4 times larger than Canada’s and 5.3 times bigger than the UK’s.

One may argue the role of government support for scientific research of any sort, but the national commitments to medical research based on public funding alone are clear. As a percentage of GDP the US government spends four times as much as Canada and the UK on medical research. This does not include private funding for medical research, which at least doubles health research spending in America, dwarfing the commitments of other nations to research. Much as we militarily support the survival of the “great” European democracies, so do we support advances in their healthcare.

Quality Conclusions

While many have noted the so called “poor performance” of American health care with regard to the strawmen of infant mortality and life expectancy, what is rarely noted is that social and political experimentation in this nation over the last fifty years has created a Tower of Babel, not only linguistically but culturally. Health care is saddled with government mandated multilingual requirements and the need to support expensive interpreting services. We have an enslaved underclass in our inner cities who generations ago abdicated personal responsibility in favor of the snake oil peddled by statists who still find believers in the promise of a government sponsored utopia. We are bending under the weight of an illegal alien population lured here by open borders policies supported by politicians on both sides of the aisle.

The real wonder is that the American healthcare system functions at all. The fact that we achieve what we do is nothing short of miraculous, and is a tribute to the amazing men and women who are committed to health care service in all its facets.

“Worse outcomes” Mr. President? Compared to who? The President views a takeover of healthcare as one more brick in the wall of massive government expansion and central planning. The President assured us yesterday in Green Bay that he has no interest in a government run healthcare system. This would be the same President who now appoints the Board for Chrysler, GM and AIG.

The question is not what the motives of a statist President and liberal Congress are, those are clear. The President and the rubber stamp statists in the Congress tell us American medicine is in crisis, we have to reform now! Deja vu all over again...the banking industry, the housing industry, the auto industry. Next up, medicine and energy. Remember the battle cry of Rahm Emmanuel, "Never let a good crisis go to waste." The Alinsky corollary is to never miss an oppoortunity to create a good crisis. Team Obama is actively making the case that, despite the well meaning intentions of some, American medicine is failing the citizenry on all fronts.

The question is not what tactics the White House will employ in attempting a complete governement take over of healthcare. They will lie as they will diminish the amazing acheivements of Amercian medicine. They will ignore the terrible results of failing or failed governement run healthcare sytems across the globe. They will demean the benefits of capitalism and free markets which has made this country the greatest example of freedom and liberty the world has ever known. They will resort to the tactics which have successfully overwhlemed our nation and suckered a majority of Americans into believing they live in a hopelessly mediocre and greedy country whose success, if any, has been built on the exploitation of its citizenry.

Once again the President and Congress, creating an atmosphere of fear and chaos, will attempt to convince the American people that more government is the answer. We witnessed the President demanding "stimulus" legislation earlier in the year that "could not wait." In fact, the President, promising to be the most transparent President of all time, didn't even give legislators 24 hours to read a 1000 page spending bill! Americans and Congress yielded to our flim flam Presdient. The President, speaking about healthcare, has stated several times over the last week,"If we don't get it done this year, we're not going to get it done." Who says so? Why the rush? The rush is designed to prevent any reasoned discussion of the issues.

So the strategy in the White House is clear here. The important question is have Americans learned anything over the last year? Will Americans wake up and recognize what the President offers in trade for our current healthcare system? If we are willing to scratch beyond the rhetoric and look, we have clear previews. At home Medicare, Medicaid, SCHIP, Tricare and the VA are the 50% of our healthcare system the government currently operates. The government side of the house, if it were a business, would be bankrupt…much like Social Security. We only have to look across our border to see the full effects of government run healthcare.

Is this what we want as Americans? Do we want to wait a year for an MRI scan when we are experiencing dizzy spells and blurry vision 2 weeks after a car accident? Our healthcare system is imperfect but, when objectively examined, is the best healthcare system on the planet. There is a role for government in our health care system but history here and abroad demonstrates that it needs to be defined and limited. The current level of involvement has been devastating to our country, has destroyed the health care systems of other Western nations and has led to a stampede of nationalized health care systems trying to restore the private options they outlawed.

The reform required for American healthcare is not a government takeover, it is government divestment.

Wake Up America!!!!

Quaere Verum

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