• Health Care – What Are You NOT Hearing?

The lawyers and legal minds holding the joystick of politics in America’s White House and Congress, are afraid to make a move. The administration and legislature are staying away from confronting their friends, and former classmates, in the legal profession.

America is holding fast on its resistance to health care reform. The double talk and confusion from Washington is abundant, however the leadership is unwilling to implement changes that could dramatically reduce health care costs such as those that could easily be acted on pertaining to tort reform. We are provided claims such as those from the “nonpartisan” Congressional Budget Office report that malpractice litigation represents only 2% of health-care costs. This one is very “misleading,” since lawyers have always made up the majority of representatives sitting in Congress. It also purposely ignores the real costs burdened onto physicians, and the costly “actions” they take to protect themselves from being financially wiped out. Insurance premiums are just the beginning of the overhead. Defensive medicine has nothing to do with health care, but with doctors protecting themselves, and there is almost no viable measurement on the hundreds of millions that this truly mounts to.

You could extrapolate some numbers such as the 83% of doctors in Massachusetts who order tests they know are unnecessary in order to minimize their potential liabilities. When doctors already pay up to $250,000 per year in malpractice insurance, it is understandable that protecting themselves as much as they can, comes naturally. This is defensive medicine, … not the good kind, but the expensive kind. These tests are not preventive care defending patients against future illness. These defensive actions come from doctors protecting themselves against lawyers of the ambulance chasing kind. While some doctors can be accused of offensive medicine by ordering extra, not wholly necessary tests, don’t believe for a moment that there can be no agreement on what constitutes defensive medicine. You might also ask yourself on average, and in their general population, would you trust more of the doctor, or would you trust more of the lawyers?

Federal tort reform must be implemented, such as bringing under control the size of verdicts handed down by the courts, as well as placing serious caps on noneconomic and punitive damages. It is also critical that the fees taken by law firms in all such cases be reviewed and percentages controlled and capped. Let’s not submit to the bromide that lawyers are society’s first line of defense against private or civil wrongs. That claim is a virtuous and finespun abstraction on justice, no matter how much we wish it to be a truism. We have been witness to enough abuse of the legal system by lawyers over the past twenty years. It is time to close the open season trial lawyers have enjoyed on the medical profession, and bring the enormous judgments into the realm of reasonableness.

Obama refuses to support limits on liability. Does he really want reform of the medical care system? His words are delivered emphatically, but they are vacuous. He seems incapable of taking a specific stand against his friends and financial supporters in the legal profession. Congress is right behind him from both sides of the isle. Neither Democrats nor Republicans seem willing to launch a determined heads-on confrontation with the waste, although some of the reticence can be explained by the fact that the Democratic party took $47 million in contributions last year from the its benefactors in the legal profession. The lip service we are subjected to is easily dispensed, but accomplishes little. The White House and Congress would demonstrate more honesty if they would only pick a side, … address health care needs of taxpayers OR admit to supporting the very financially supportive legal profession.

There is much to be fixed before you ever get to a complete overhaul of the health care system. When there is a dearth of will to implement partial corrections, or controls, pertaining to waste and abuse in the existing system structure, there can be little hope for serious reform other than pursuit of ideological doctrine. Tort reform would be a start, though only a start, on the long road to an improved and sustainable system.

The American public is right to be suspicious of leadership that will not take immediate and specific action that would reduce an estimated $200 billion dollars from the Nation’s annual medical bill. How can taxpayers not be apprehensive of a program whose point person, Secretary Kathleen Sebelius, previously led the Kansas Trial Lawyers Association? This is more assurance that “change,” is not coming.

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• CANADA’S BREAKING HEALTH CARE SYSTEM

The past year has seen much made by American media, including the film Sicko, of the supposedly superior Canadian medical system. Before the new White House resident rushes off to implement a national health care system based on the Canadian model, examine its realities. The Canadian health care system is breaking just when it is about to be tested with unprecedented pressure from a wave of aging boomers.

One of the benefits of being a Canadian resident is that you get a Medicare card. This magic access card opens doctors’ offices as well hospital emergency room care, at no cost to you. The No Cost factor is appealing and it is misleading. God help you if you require an operation that necessitates an operating room. Wait six months to a year, or two, unless you’re actually dying, … well actually, that’s not quite right either, some people die waiting. The waiting is a very real impediment to long term health since patients are impacted by irreversible damage from progressing deterioration. If that isn’t enough, add the onset of depression while painkillers become a daily staple of patient diets, and you have a health care system in the midst of cardiac infarction.

What could have gone so wrong? Why is there a new term called “health-care rationing” if the system is so enviable? Isn’t rationing a concept that suggests capitulation?

There is an abundance of strategic thinking for fixes that range from preventative care as in don’t smoke or you’ll get sick and take up a hospital bed, or doctor retention, meaning, pay these guys more or they’ll move to the U.S. The system is breaking because its promise is under funded and many using its services don’t contribute a dime to its costs.

Canadian taxpayers should ask themselves why so many of the new condos and skyscrapers that have clogged up their major cities in the past decade are over 50% empty. Look over a major city skyline between eleven o’clock and midnight, and count lit apartments in recently build structures. In some cases vacancy is 75%. The taxpayers should ask the question, then listen for answers. There are multitudes of well-documented methods of abusing the system that all Canadian politicians ignore, nevertheless as it relates to Canada’s medical care failure, a vacant condo provides some insight. That vacancy is both an address and a ticket to free medical care through abuse of the Canadian immigration service by foreign residents. If you’re a foreign student at a local university, you are even invited to apply for a Medical Care Card after on 3 months of residency. How easy is that? You can also use one of a long list of scams being promoted under the “new-would-be-entrepreneurs” programs where a small investment, quickly returned once you’re in, gets you in the Canadian system which has no effective method of tracking what you do or don’t do. Some retail businesses seem to have new owners every few months. You can almost set your calendar to the cycling.

Too many “visitors” of the past decade have been shown to be opportunists. Canada has little control of who enters or when. The acquisition of Canadian landed immigrant status or residency, and all of the rights vested therein is an abused process and the abuse is rampant.

Without reviewing all the possibilities, and the vast impact on the rest of the Canadian social or economic fabric, it remains that too many who pay no Canadian income taxes, show up when it is time to get medical attention. The new breed of “pretend Canadians” who pay no taxes, are not the only ones to abuse the system for health and other reasons. Canada doesn’t tax those who have slid assets to offshore tax havens to end their tax paying days. These expatriates temporarily move, but come back when the doctor needs a visit. The answer to the problem is simple, but it would take the enactment of a few bills by Parliament, and Canada finds such a step a virtual impossibility when it is saddled with a minority government that has no will. The nation with the world’s most open immigration system not only has the most liberal policies, but those lax policies are being exploited, and the taxpayers are the ones hurting.

So here’s a suggestion for when there is a majority government in Canada:
Place a surtax on all foreign owned real estate, commercial and residential, using a double digit multiple of the current tax levies based on the assessed mill rate, and transfer that revenue to the medical care system of each Province. A drop in real estate values will result? Not likely, but Canadians can wish.

While America builds its new medical care system, it should ignore the vaunting politicians North of the border, and talk to the taxpayers. They’ll be easy to find. Look in the long tail of any line-up.

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