Wednesday, February 02, 2005

COLUMN -- Canadian health care is a 'paper tiger'

Posted by Craig Westover | 7:17 AM |  

Wednesday Feb. 02, 2005

"Who is Lee Kurisko?"

Patients waiting months for diagnostic imaging at Thunder Bay Regional Hospital might well ask that question.

So, too, might Canadians who recall the CBC news report quoting a heretical Ontario physician saying, "The government should not be in the business of health care."

It might have been asked by the speaker at a University of Minnesota forum on universal health care after he denied an audience member, a former Canadian physician, a five-minute rebuttal to a one-sided presentation.

"Who is Lee Kurisko?"

The cost and quality of health care in the United States is increasingly under fire. Political progressives argue more government is the answer to rising costs and inequality of health care. Often Minnesota progressives look covetously north at Canada's government-run "universal health care" system.

"Physicians' Plan for a Healthy Minnesota," a report released last week by the Minnesota Medical Association is self-described as a "roadmap to provide all Minnesotans with affordable insurance for essential health care services." The MMA report is littered with government mandates and financial subsidies and proposals like taxes on "tobacco, alcohol, snack foods, [and] fast foods."

"Who is Lee Kurisko?"

In 1999 Dr. Lee Kurisko was medical director of Diagnostic Imaging at Thunder Bay Regional Hospital in Ontario, Canada. In 2005, at age 45 and in the prime of his career, he works for Consulting Radiologists Ltd. in Minneapolis.

"When you're working through your residency in Canada," he says, "you're insulated from many of the problems with the system. But when I became ultimately responsible for patient care, I quickly learned that Canadian health care is a paper tiger."

As Kurisko explains the system he worked under, not-for-profit hospitals in Canada don't provide services to generate revenue. They are given a global budget by the government. Their incentive is to manage cost, not provide service.

Due to cost-driven limited availability of systems, patients may wait for services such as CAT scans MRIs for as long as 19 months. It took the Thunder Bay hospital three years to obtain a Rolloscope to aid in reading X-rays; the machine sat idle for another year before a person was hired to load X-ray film.

But equipment is not the only shortage in the Canadian system. Another is doctors. Waits for surgery run into months, sometimes years. For want of primary care, many diagnoses of such treatable ailments as high blood pressure take place only after catastrophic events, such as a stroke.

Ironically, the doctor shortage is planned.

"Doctors are a cost center in the Canadian system," says Kurisko. "Not because of their earnings, but because of the larger costs of admitting people to hospitals and ordering tests."

To control costs, the Canadian government sets quotas for how many doctors can be trained in which fields. In Quebec, older physicians were offered buyouts not to work, despite physician shortages and were actually subpoenaed for emergency-room shifts.

It was those Monty Pythonesque situations and a timely reading of Ayn Rand's classic "Atlas Shrugged" that opened Kurisko's eyes to what was, in effect, an "immoral system."

"I recognized the parallels [between the societal decay in Rand's book and the Canadian system] intellectually," he said, "yet I kept on working long hours and battling the bureaucrats for every piece of equipment. I was Atlas with the world on my shoulders. Emotionally, I felt I could make the system work."

Ultimately, however, like Rand's symbolic Atlas, Lee Kurisko shrugged. "I finally accepted that I had to come to the United States if I were to be free to practice medicine," he said.

Today, Kurisko is applying his skills to the health benefit of Minnesotans and his experience in the Canadian system to our political well-being. He's not shy about speaking out in public forums (he's speaking at the Minnesota Libertarian Party Convention in April).

Kurisko's conversation sparkles with references to individual liberty.

"The common good," he says quoting Rand, "was the claim and justification of every tyranny ever established over men," adding his own observation that "the human rights violations in the Soviet Union were predictable just as escalated loss of liberty is occurring in the Canadian system."

Strong medicine, but just the right vaccination against the deadly and contagious promises of government-run "universal health care."

"Who is Lee Kurisko?"


Coincidently, today, February 2, is the 100th aniversary of Ayn Rand's birth in 1905. Legend has it, that if you go outside and see your shadow and aren't afraid, we might yet remain a free country.

For NOW members interested in understanding what real women's issues are, here are three remarkable women who launched the libertarian movement.

Update: Letters taking excpetion this column are addressed here. A CMA statement on the Canadian Physician shortage is posted here.