MONTREAL — Some Montreal doctors added a dose of realism Saturday to the fiery debate south of the border that asked if Canada’s “socialized medicine” killed actress Natasha Richardson after she hit her head skiing on Mont Tremblant March 16.
“Canadacare may have killed Natasha,” screamed a headline in the New York Post. “Was Canada’s healthcare the problem?”asked another in the Chicago Tribune. The implication “is totally unjustified,” said Paul Saba, an emergency room doctor at Lachine Hospital and co-president of the Coalition of Physicians for Social Justice. He flatly rejected the notion that a lack of funding for overall public health care contributes to fatal head injuries like the one that claimed the life of Richardson.
Saba stressed he was not commenting specifically about Richardson, but “any patient’s refusal of treatment is crucial” to the outcome. So is not wearing a ski helmet, he added. Richardson, 45, wasn’t wearing a ski helmet when she fell around noon and was walking and talking afterward. She also refused an ambulance that came for her about 45 minutes later. Another ambulance was called about 3 p.m. and she arrived at the Centre Hospitalier Laurentien in Ste. Agathe, 42 kilometres away, nearly four hours after her fall. Two hours afterward she was transferred by ambulance to the trauma centre at Montreal’s Hepital du Sacre-Coeur, 83 kilometres southeast of Ste. Agathe. An article in U.S. newspapers by Cory Franklin, a physician who lives in Wilmette, Ill., took sharp aim at the lack of CT brain scanners in some Quebec hospitals and the lack of helicopter ambulances.
“With prompt diagnosis by CT scan, and surgery to drain the blood, most patients survive,” Franklin wrote. “Could Richardson have received this care? Where it happened in Canada, no. In many American resorts, yes.” But a simple phone call Saturday to the radiology department at the Centre Hospitalier Laurentien revealed that the hospital is in fact equipped with a CT scanner. It was not known, however, whether the device, which can cost $1 million, was used on Richardson. As for the need for a medical helicopter, Saba said that while it would be helpful in longer-range cases, it might not have saved the actress.“You have to do a cost-benefit analysis,” Saba said. “It takes time to get the helicopter’s medical team assembled, get the helicopter to the location of the patient, pack in the patient and fly the helicopter to Montreal.” But Michel Garner, head of the emergency department at Sacre-Coeur, said Mont-Tremblant is a two or two-and-a-half hour drive from Montreal. Ste. Agathe can be an hour’s drive away, he noted. “I’m certain some patients would benefit” from a helicopter system, he said. Paul Brunet, president of the Council for the protection of patients, said the question of whether a medical ambulance would have made a difference was moot. “If she had worn a helmet and accepted to see a doctor would there be any talk of this need for a helicopter?
Disclosure: I was injured in a skiing accident in Breckenridge Co. about 7 weeks ago. I thought I had only tweaked my knee but I hit my head (“had my bell rung”) and came to quickly (around 30 seconds). I have many years of abusing my body through sports and I am no stranger to pain, so I shook it off, collected my gear and finished the run. The next morning I was admitted to a local trauma center where I learned that I had completely severed the ligament (ACL) that runs under the kneecap. How I was able to to finish the run or walk that evening remains a mystery to me. But the staff was more concerned about my head injury… I wasn’t. The health care I received couldn’t have been better or more expensive. I guess the point I am trying to convey is that we all have choices and decisions to make at the time of an injury. I probably (definitely) made the wrong decision, yet I was lucky. Miss Richardson was not so fortunate. And in case you’re wondering, no, I never even considered wearing a helmet.
@ #24
Well I can’t directly speak of Canada – but I have Canadian friends in the Uk, and they say its better than in the Uk.
Now I can speak first hand about the national health service in the Uk and the US system.
And whilst the NHS is by no means perfect. And I certainly wouldn’t suggest it provides the same service as rich people get in the US. It does provide a very good service to the vast majority of people.
I really think the US system is broken. It has the wrong incentives. Its complicated. There are out clauses for insurance companies (and its in their interest to find them) if people actually need health care. And it is _inefficient_. Yeah that’s right, a universal system can be more efficient. Ie it costs people less for the same quality or better of service.
And if you want super high quality expensive health care. You can have that too. And the government will even give you back a good chunk of your taxes.
It seems to me in comparisons the US likes compare ‘rich people health care’ with that of universal health care systems. Well thats kind of stupid.
What you should compare is the average persons health care. In terms of how much it costs, agains what services are provided in return (personally I’d factor in convenience too – which the US system is not). Then see what you get. With a huge amount of people being uninsured (and yet still costing the economy and health care system) – I think the answers pretty clear.
#34, your glib “sarcasm” is mildly amusing.
It has been shown that automobile insurance creates an increased willingness of people to engage in reckless behavior while driving. I’m only suggesting that it would be interesting to see if there is a similar characteristic in healthcare when there is no perceived cost to the consumer.
@ #31 right on
@ #30 No.
You could look up base jumpers per capita (or just base jumpers by nationality) or something of that sort.
Cos here’s the thing. Most people don’t like being hurt or sick. They get healthcare as a last resort.
So if you have universal health care, people don’t drive faster thinking if I’m in a crash its okay cos its paid for. Nobody thinks that way. Cos people generally don’t want to be in car crashes… and if they do they tend to leave the gene pool rapidly.
Lame article. There are enough good arguments for and against a national health care system. This one is a distraction.
36,
“I’m only suggesting that it would be interesting to see if there is a similar characteristic in healthcare when there is no perceived cost to the consumer.”
First off, people damage their cars all the time and they continue on with life. Most people don’t like being hurt. Especially when they have families and responsibilities. I snowboard, but I’m not an idiot. I wear a helmet and I stay OUT of the terrain park. I have a very demanding tech job that requires my noggin in top shape. I have a young family and I’m the cook for them. I don’t care if I can stay in the hospital for 6 months free of charge. I don’t WANT to because I love NOT being in the hospital.
That being said, I am very happy that if I get hit by a drunk driver on a hit and run crossing the street, I will NOT go bankrupt because of my hospital stay.
36,
“It has been shown that automobile insurance creates an increased willingness of people to engage in reckless behavior while driving.”
So do seat belts, airbags and SUV’s. But that is a factor of stupidity.
#40, who ever said that people behaved rationally? That’s the whole point.
A better example than the silly “people don’t start jumping off cliffs because healthcare is free” one is – if people know the risk of getting a tattoo is infection, are people more or less likely to get one if they know they will be responsible for paying for their treatment or the treatment is provided for free?
It’s just an academic question that I find more interesting than the asinine tag line of “Did Canada’s Socialized Medicine Kill Natasha Richardson?”
All of the biased headlines that have an unspoken point to them does get irritating on both sides of many of these issues. This headline is designed to unspokenly say ‘so, free medicine bad, lets not have it in America.’ Even if you agree with this this isn’t the way to go about it. It’s so easy to argue against, what a waste of time.
I’d rather point to Mark Steyn’s excellent analysis in Imprimus where he looks at the comparison between healthcare in the US vs Canada (www.hillsdale.edu/news/imprimis/archive/issue.asp?year=2008&month=01). Good big picture view.
From the article I enjoyed this blurb which is a small article from a local paper. “A Canadian woman has given birth to extremely rare identical quadruplets. The four girls were born at a U.S. hospital because there was no space available at Canadian neonatal intensive care units. Autumn, Brook, Calissa, and Dahlia are in good condition at Benefice Hospital in Great Falls, Montana. Health officials said they checked every other neonatal intensive care unit in Canada, but none had space. The Jepps, a nurse and a respiratory technician were flown 500 kilometers to the Montana hospital, the closest in the U.S., where the quadruplets were born on Sunday.”
Steyn comments on this article and says there you have Canada’s heathcare system in a nutshell. “After all, you can’t expect a G-7 economy of only 30 million people to be able to offer the same level of neonatal intensive care coverage as a town of 50,000 in remote, rural Montana.”
But what really takes the cake for Steyn, is the 10 month waiting period for a maternity ward.
44,
No. You have universal health care. Primary, emergency, chronic. You don’t get free drugs. While in hospital you don’t pay for your medications though…
43,
Mark Steyn is the Canadian Rush Limbaugh. Conjecture, opinion and false data. He’s the dude that says genocide in civil war is cool since you gotta keep your demographics up.
You get what you pay for.
#45, so you have to pay out-of-pocket for medicine to treat an infection?
I can see not giving some overweight sloth free blood pressure medication, but somebody with an infection requiring immediate treatment shouldn’t be paying for it himself under your system. At least it doesn’t make any sense to me that he would.
#46, “You get what you pay for.”
It’s obviously getting paid for, either directly or indirectly.
Now you could look at the free-rider question of “are people taking out more than they are putting in?” Which is something that needs to be determined so that policies can be established for determining what is covered and what isn’t, and how covered treatments get rationed. And I’m not using the word “rationed” as some sort of bogeyman either. In a market system, rationing happens too in effect, it’s just done via the price mechanism.
Didn’t anyone learn from Sonny Bono or Michael Kennedy, put a helmet on. If you ski on a hill with the mass of humanity that can’t control themselves skiing, then you get what you pay for. As a Canadian using our Canadian Medical system, I would rather be covered than be part of the 46 million that don’t south of us.
# 49 John Craft said, “I would rather be covered than be part of the 46 million that don’t south of us.”
You mean like the “Octo” mom and her 8 kids that are covered in CA?
50,
You love that woman don’t you? Are you secretly the father?
#54, no, I guess there is no harm in paying tribute for preferred access.
#10, Stupid Maine
A CT should have been available, and given the “nobody pays” arrangement, mandatory, before she could sign out.
You morans are more than willing to denigrate a whole nation because they don’t have “free market” health care. Yet, at the same time, you want the hospital to force her to have a CT scan?
The lack of CT capability at the initial treatment center appears to be due to appropriate staff and hardware. Same for the ambulance situation. This isn’t 1950….
And this isn’t the US. She had an ambulance there within 15 minutes with well trained medics. The resort also has well trained ski instructors in first aid. She refused initial treatment. The ambulances are extremely well equipped.
While clinic might not have had the necessary neurosurgeons on staff, they were equipped to handle most emergencies. But guess what, if you had a similar injury here, they would also need to move you to a large city for treatment. Montreal has top notch facilities and physicians.
Socialized medicine means the lowest possible standard of care for everybody, regardless of ability to pay. Which sounds fine until you figure out that accountants and MBA’s are making medical decisions.
You couldn’t be more wrong. The medical decisions are made by physicians. Those on the front line treating the patients. The ones that are lacking in medical care are the same as in the US; those far from large urban areas.
I’m on Medicare, and have Medicare “D” drug coverage. The bean counters declare that a certain drug, which works for me, and my personal physician prescribed, and likes, is too expensive,
Write your Congressman and local Legislator. They are in charge of Medicare. You can’t do that with private insurance companies.
#40, The cost is PAIN.
Do you want to be in PAIN?
Do you want to be disabled for life?
No you don’t, so wear a freaking helmet or win the Darwin award.
You know those youtube clips, with moronic people who do stupid shit so they supposedly looks cool or macho or something, they came from America.
#49 yeah, even experts can take a spill, so better safe then sorry.
Here in Sweden we have socialized medicine. It has it’s problems, sure, but so does everything else. If we look at the statistics we Swedes are pretty healthy I believe. It works ok I would say.
Re: #57, thank you Mr. Fusion,
What is overlooked here is that she was rich.
In Canada, poor (or middle class) wait for socialized medicine. Rich people get on a plane and go to the U.S. Which is exactly what happened (eventually).
Canada’s system only works when we have the option of crossing the border and paying for quick, high-quality service.
62,
Richer people in the US fly to India to get better treatment and a tropical vacation. Your healthcare system only works so long as people can pay to get better treatment elsewhere.
Your point that money and extreme money find boundaries pointless and useless has been well documented throughout history.
my 62… I’m obviously referring to 61.
#53 “That is exactly the reason why I am opposed to an across the board universal system. I don’t want the government in some monopsony (sic) position where it gets to dictate what healthcare providers charge for their services because it is the only game in town.”
I do not know about Canada, but this is not how it works in most EU countries.
Both private and public hospitals exist. Public hospitals charge according to your means; if you are poor you pay almost nothing, if you are rich you pay the full cost of treatment, almost on par with the private sector. The equivalent of the IRS gives you a certificate which indicates in what percentage band you belong, it is very difficult to game the system
Public hospitals offer good service although usually it is rather crowded and there are waiting lines for some types of treatments. Doctors decide if someone needs urgent care and if it must jump the cue. From what I read, the waiting period (with the exception of transplants) is not unreasonably long.
The rich people have an incentive to go to the private hospitals; since they will also pay in the public hospitals, why endure the crowds. Also, private hospitals have better building facilities and usually more hi tech equipment.
Star doctors prefer to work for private hospitals and the ambience is better.
On the other hand, public hospitals have much better standards of nursing care; local nursing staff prefers to work for the government because of the better benefits and pay. The nurses at the private hospitals are mostly foreigners from Eastern Europe, SE Asia and Africa. They are good but they do not stay long enough to become efficient at their work and there are language problems, especially with older patients.
Personally, I have not been treated as a patient in a public hospital since when I broke my leg when I was 8 years old (circa 1979). I am very well off and I prefer to go to private hospitals. I do know how public hospitals are, because I have my parents and other family members who use them and I value their opinion. They are happy with the care they get.
Actually my mother pays full price in public hospitals but she likes and trusts the doctors and staff there and so she continues to use public health care. When my father had to have a (non threatening) heart operation (clogged arteries), the waiting period was 3-4 weeks which I find reasonable.
Since public hospitals compete with the private hospitals for patients, the private hospitals cannot increase their prices too much because their customers might defect.
I understand that I pay taxes which fund the hospitals which I do not use but I do not mind; it’s comforting to know that if I lose everything, I will still be covered.
Furthermore, public hospitals promote preventive medicine. Since check ups are free (even for the rich), people go to their annual check ups. This catches many ailments before they get worse.
All these bullshit post when the answer is obvious: No, her inability to ski did.
Constantine said:
“Both private and public hospitals exist. Public hospitals charge according to your means; if you are poor you pay almost nothing, if you are rich you pay the full cost of treatment, almost on par with the private sector.”
“The rich people have an incentive to go to the private hospitals; since they will also pay in the public hospitals, why endure the crowds.”
I like this provision. My understanding of the Canadian system (from Wikipedia) is that “Coverage is universal for qualifying Canadian residents, regardless of income level.”
This forces everyone to pay for the health coverage of even the rich who could obviously afford their own health care.
An individual’s view of the U.S health care system is dependent on their current situation.
If you are healthy and working, it is somewhat expensive but great for you. It may be very expensive for your family however since many employers do not (for even a reasonable fee) cover family members anymore, just you.
If you are rich, it is expensive but great.
If you (or a family member) have a pre-existing condition and are not eligible for insurance at any price or are not employed, or are employed but one of you family members is sick, or are self employed and cannot afford health insurance, you are royally screwed. You might be able to get life saving treatment at an emergency room, but probably not until you were sick enough to really need it.
Maybe my expectations are high but really we should be able to do better than this!
#64, “Public hospitals charge according to your means; if you are poor you pay almost nothing, if you are rich you pay the full cost of treatment, almost on par with the private sector. The equivalent of the IRS gives you a certificate which indicates in what percentage band you belong, it is very difficult to game the system”
How lovely, means testing for a service that is supposed to be this “basic human right.” No wonder the rich seek alternative sources of treatment – if they are paying for it anyway (again, since they already paid taxes), might as well get more than the baseline.
—–
And on a side note, do people even know how to properly use [sic] these days? If you are quoting something while leaving intact grammatical or spelling mistakes, you note it with a [sic] so that people know you didn’t make the mistake yourself. You don’t use it because you disagree with a word that is chosen to characterize something. Or maybe you need to open a dictionary if you think I meant to use the word “monopoly.”
Not really picking on you; I just see it a lot these days on the Internet, when it’s not appropriate.
# 66 Steve S said, “Maybe my expectations are high but really we should be able to do better than this!”
Sure, just gather like minded individuals and chip into a pool to pay for members medical expenses. Done.
Another insurance company and AMA take on how bad government medical care would be. Their opposition is similar to how our banking crisis was created. The greedy unwilling to diminish their greed.
#5 – [Where ya been Jäger? – ed.]
Been hooked on another online drug… gaming. 😉