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What Can You Do?
A few years ago I was doing an annual physical on ‘Marie,’ a very pleasant 80-year-old woman who was born and raised in Montreal. Her father had died of colon cancer in his early 60s, but she hadn’t had a colonoscopy for several years. They had always been fine, and she was getting older, and she just hadn’t done one for a while. I suggested we recheck, she said she was too old and not in the mood, so we compromised with a Cologuard (a home stool sample that is moderately good at picking up colon cancer). It came back positive.
I immediately referred her to GI, who said they could see her in three weeks. I said that wasn’t good enough, explained the situation, and they scoped her the following Monday. They found colon cancer, I called a surgeon, and had the cancer removed (along with eight inches of her colon) later that week. Total time from stool sample results to cancer surgery: Eight days. Pretty good, but still, one of the 12 lymph nodes they biopsied was positive for cancer. Crap. Metastatic cancer in an 80-year-old woman. What can you do?
Well, in this day and age, you can do a lot. So she undergoes four rounds of chemo. Modern chemo has come a long way, and she didn’t feel sick at all. Although she got tired of driving back and forth to the infusion center 20 minutes away. It resulted in clean scans and apparent resolution of her cancer. That was three years ago. She turns 84 next month. She feels great, and all subsequent testing has shown no evidence of recurrence. All cancer patients are not so fortunate. But sometimes modern medicine really can work miracles. Yahoo! Except.
When I called her after the stool sample to tell her that it was positive and she had a colonoscopy scheduled in three days, I asked if she had any siblings. She said she had a younger brother. I told her to call him, and tell him that now he’s got a father and a sister with colon cancer. He needs to get a colonoscopy done. And if it’s been a while, he needs it to be done right now. Which brings up the ‘except’ part of all this: He still lives close to where they grew up – just outside of Montreal.
He called his doctor, and left a message. The following week they called back and made him an appointment. That took some more time. Then they sent him to a GI doc. I’ve forgotten how long each step took, but it took over a year to actually find the cancer and get it out. By that time, he had widely metastatic disease. They tried chemo, but they use older stuff, and he got very sick on it. And it didn’t work as well. So they tried some other things, that made him sicker, and also didn’t work. He died after a very difficult seven months of treatment, at the age of 81.
Now, to be fair, Marie pays extra to be a member of a concierge practice. Going from a suspicious test result to definitive cancer treatment in eight days is pretty good, even in America, but that’s the advantage of this type of practice.
But first of all, the only way I could move that fast is because I have the resources of the American health care system available to me. And secondly, even in a more typical practice, there’s no way that would take a freakin’ year. In America, when we find a positive cancer marker in a patient with a family history of that very type of cancer, we get on it. Now. Her brother might have survived if he had been in the states. Any state. Anywhere.
I saw Marie today for a recheck, and she told me that her brother had died recently, and told me the story I relayed above. I wasn’t sure what to say. I just said, “I’m really sorry.” Or something like that. What can you say?
She said, “I’m so glad Justin Trudeau won. We need someone to make the Canadian health care system more efficient. It’s already one of the best in the world, but sometimes it’s not as responsive as it could be. You know, all the care my brother got, even the chemo – it didn’t cost him a dime.”
I wanted to respond, “Yeah, but it did cost him his life. Screw the dimes.”
But I didn’t. I still wasn’t sure what to say.
What an odd response. First, she tells me that her brother recently died. Then, she discusses the results of a recent election. Then, she compliments the health care system that killed him.
Dead brother. Politics. Nice job. Huh?
Wow. That just seems like a really odd conversation to me.
This is just another illustration of a phenomenon often discussed here on Ricochet. The basic problem of attempting to convince a leftist of, well, of anything at all. They’ve made up their mind. Or heart. Or something. And reality no longer matters.
With Marie, I didn’t even try. First of all, her brother just died, and to me, it seems disrespectful to discuss politics. Even though, in a socialized medicine system, matters of life and death are more dependent on politics than they are science or ethics. But, still, her brother is dead, and I can’t quite make the jump to politics. It just sounds dirty, to my ear.
And secondly, because if the death of her brother won’t convince her that perhaps socialized medicine is dangerous, then there is certainly nothing I can say that would convince her.
So I just nodded my head sympathetically. What else could I do?
There is a reason that conservatives lose a lot of arguments with leftists. What can you do?
With metastatic cancer in an 80-year-old, there is a lot you can do. Marie is living proof. But leftism is a metastatic disease with no known treatment. It just spreads and spreads, killing its hosts as it goes. And there’s nothing you can do to stop it. Marie is living proof. She still believes in leftism. So would her brother, if he were still living. But he’s not.
This no longer matters, of course, now that non-leftist opinions are categorized as hate speech. We couldn’t debate ideas now even if we wanted to.
But even when we were allowed to discuss ideas and ethics, we often didn’t. Because, well, why? What can you do?
Published in General
Well leftists don’t see individuals. They see race, they see sexual orientation or they see class. Actual human beings have a weird individual. Maybe it would be easier if everyone was just their race or their sexuality but in reality, everyone is a weird individual.
Hence the ubiquitous leftist who loves “the people” but treats individuals like dirt.
Delays are a form of rationing. Promise full service, but delay and delay and delay.
This is by design. Not an accident.
As P.J. O’Rourke said “If you think health care is expensive now, wait till you see what it costs once it’s ‘free’ “
Before everyone gives up hope for the future, I wish they would investigate the consumer-driven health care movement. It has been nurtured by Regina Herzlinger, my favorite health care financing author and a sometimes contributor to the Manhattan Institute.
She recently coauthored a piece for Harvard Business Review “Preparing Hospitals for the Next Pandemic“:
She has been advocating for years for health insurance to be deductible for individuals. Companies can deduct it but not individuals. She also wants companies to give employees cash with which to buy their own insurance.
And she is fanatical in her support for doctors as being the heart and soul of health care, that we need to respect them and leave them alone to do what they do best.
The government is overwhelming us in this area. But a movement to elevate consumers in this economic sector could right that imbalance.
I wonder if it might have been better to save the brother, if Dr B had somehow been able to. Especially if the brother was not also a leftist.
I was reminded of a quotation:
And sometimes when someone is in pain is when they most need messages.
Ouch
My uncle from Canada used to berate American medicine and brag on the wonderful Canadian health care system.
Fast forward to point where he has angina so bad he gets chest pain if he even thinks of walking around. At that time he calls me for advice. Canada was not doing any bypass surgery at that time since studies did not show any increase in longevity, although it did show a tremendous improvement in quality of life ( this was before angioplasty). So his question to me was ” how do I get surgery in the US?” I told him he would need to come up with the cash since he couldn’t get insurance as this was a pre existing condition. Eventually, years later he did get treatment in Canada, but he was miserable for a number of years.
Nobody worships their health care service like the Brits. It’s their real national religion.
I’ve said for 50 years that health care is a black hole into which you can pour any amount of money.
For some reason the responses of Dr. Bastiat’s patient made me think of the Monty Python segment “Liver Organ Transplant” in their movie, The Meaning of Life. This nice lady seems to have imbibed the idea of her small significance in the vast cosmos, and the insignificance of all human life. She would, if asked, happily donate her liver on the spot, even though she was using it.
Then I thought of Candide emerging from the rubble of Lisbon with Prof Pangloss pronouncing this the ‘best of all possible worlds”
Then I thought of Erasmus’ Encomium Moriae.
I guess my mind goes off half cocked too much.
Damn Doc. Why did you have to remind me of my colonoscopy coming up next week? With the weird pills I need to drink with 3 gallons of water so I can sit on the stool for 6 hours. But you are right about the U.S. docs. They know what they doing and get it done fast.
But leftism is a metastatic disease with no known treatment. It just spreads and spreads, killing its hosts as it goes. And there’s nothing you can do to stop it. Marie is living proof. She still believes in leftism. So would her brother, if he were still living. But he’s not.
I’m not even qualified to be a Love Doctor ™, but this must be a tough one to grapple with. She’s already bought-in to that system. She completely misses the difference between her treatment here, and what her brother received in Canada. 8 days. 1 year. That’s the difference between her being alive and his death, and his death was very likely preventable.
Nothing’s free. Last I heard, they had taxes in Canada. And you get what you pay for, which is less access, slower response times, with a correspondingly higher negative result rate.
You might be able to avoid cancer. You can’t avoid your government.
I’m married to a Canadian, and used to live in Vermont, very close to the border. Anecdotally, the length of time it takes to get scheduled and seen for anything in Canada strikes me as being almost catastrophic. Last year, I wound up getting referred for a brain MRI (nothing negative came out of it, apparently my brain does not contain a tiny evil twin of myself, pulling levers on my brain controls and snickering as he does so), but the time between the referral and the MRI was a week or two.
From what I understand, that’s almost impossible in Canada – and not because people are evil or heartless, or toothy chowderheads like Trudeau. It’s just the system they’ve bought into, and the results will inevitably be deaths or other negative health impacts, impacts that are avoidable.
I don’t have a fix, other than these types of stories, stories which break the narrative in half over its knee and casually discards the remnants.
Simply poetic…demoralizing, but poetic
You can’t avoid a leftist government. Because it is involved in every aspect of your life.
A smaller, constrained government, though – ideally you could go days or weeks without giving it a second thought. You would think about government only when you entered it’s sphere. Which would be small.
Sound like a fairly tale? Read American History.
Or put another way: You may not be interested in a leftist government. But a leftist government is interested in you.
Not as dramatic as a cancer diagnosis, but perhaps easier for a person to grasp is the time required for a routine office visit. Mark Styne used to comment that he had employees in the United States and employees in Canada. A doctors office visit for any of the US employees meant the employee would be away for at most a couple of hours. But a doctors office visit for a Canadian employee took the employee away for a minimum of half a day, and sometimes all day, while the employee waited in various lines at the clinic.
Some people are immune to good advice. – Saul Goodman
We have 4 times as many MRI scanners per capita as the Canucks.
Very, very, very few people pay high enough premiums to sustain even Medicare without taxpayer funding. Perhaps no one does.
I went to medical school in Toledo, Ohio in the early 90’s. At the time, Canada had 3 MRI machines in the whole country.
We had 3 in Toledo.
Limit their free time and you limit their time to get uppity about anything. Worked for the soviets too.
Arguably, that’s why Natasha Richardson died after a skiing accident in Canada.
Because there were 3 MRIs in Toledo?
No, because there were maybe still only 3 in all of Canada, at the time of her skiing accident. The true problem wasn’t discovered until she was airlifted to a hospital in New York City, by which time it was too late.
In our defense, we’re hoarders.
I believe in having spares of anything valuable.