Lifted comment...

...from a post over at White Coat Rants.

http://whitecoatrants.wordpress.com/2008/02/07/canaries-in-the-coal-mine/

(I hope this doesn't constitute plagiarism; I'm giving full credit here!)

Says Michelle:

Americans who complain about US healthcare should try being sick in Canada.

I’m an American who has now lived in Canada for ten years. The newspapers are full of stories of people waiting. Patients wait for days in emergency for a bed because the nursing shortage has resulted in permanent bed closures. Patients wait two years for hip replacement because we don’t have enough orthopedic surgeons or enough operating time.

A woman was diagnosed with recurrence of ovarian cancer and waited three months for surgery.

We have old facilities that are overwhelmed with increasing numbers of ED patients and a newer ED that closes at 8pm. We hold fundraising dinners to buy cardiac monitors. People go to the ED for anything and everything because it’s “free.” Doctors can’t set their fees; the government decides how much to pay them.

The government also runs the nursing homes and decide how many there will be. Are you surprised that we have a shortage of those as well? So patients who don’t need to be in hospital take up beds that are needed for acute cases.

This is a very astute observation and comparison, if you ask me. Requiring free emergency care (ie: tax-funded health care) would make ED staff -- including ED doctors -- government employees. But in light of some laws already handcuffing medical practitioners, that may be a more appealing alternative. At least they'd get paid, right?

EMTALA (Emergency Medical Treatment and Labor Act) mandates hospital and ambulance services for anyone needing treatment regardless of citizenship or ability to pay -- and it makes no provision for reimbursement. With EMTALA in mind, the government is attempting to employ medical professionals anyway, only without pay -- which, in any coherent definition, would make them slaves, no?? Forced work without pay? Hmmm...

EMTALA, by the way, was buried in Omnibus legislation in 1986, when it was passed into law. I wonder how many legislators knew exactly what they were doing to their constituents that pay taxes on incomes earned by treating patients?

Canadian stories such as the ones in Michelle's comment, ED docs' stories from bordertowns in Texas, and the previous article comparing care in London to care in New York, make extremely clear to me that free care, or even one-source payment for care, is not the answer. What is the answer? Stay tuned, as I try to carve out time to work on that one.

Then again, you might be waiting a while for that...