By Doug Magill
One of the joys of travel is meeting people. It is especially rewarding to make the acquaintance of those from other countries as it is always interesting to glean different perspectives and perhaps see the world a little differently. It can also be an opportunity to help those from other countries see things a little differently.
On a recent trip to Vermont, to deliver my youngest to his senior year of college at Norwich University, we stopped for the night in Saratoga Springs, New York. A lovely and scenic town just south of the Lake George region, Saratoga Springs is home of the world-famous Saratoga race track as well as Skidmore College.
After walking downtown for dinner I paused to relax for a few moments on the front porch of the Washington Inn, where we were staying. I was joined by three Canadian gentlemen roughly my age. Delightful and gregarious guys, they were brothers who journeyed once per year to gamble at the race track and just spend time together.
Sharing wine and opinions, we let the discussion soon turn to international affairs. There were a few expressions of dismay at President Obama’s mistaken conjecture that Europe is the largest trading partner for the United States, when our neighbors to the north clearly are, and have been for some time.
My new friends were proud of the relationship Canada has with the United States, but were somewhat wary of her power and politics. There were quite a few self-proclamations of liberalism and a number of gentle jokes at the stereotypical consensus thinking that dominates Canada. Mixed in were a few mild jibes at Steven Harper along with Sarah Palin and Dick Cheney.
I asked about Prime Minister Harper and the negative opinion seemed to be primarily based on his apparent personal coldness. No particular concerns about his policies, although there were some indirect comments about a desire to see compassion as a leadership characteristic. The opinions of Cheney and Palin were rehashes of what had been seen on Canadian television which shares many of the same biases, if not more so, of the mainstream liberal American media. Not surprising, no attempt appears to have been made to really understand either person independent of media spin.
Questions were asked about the election and why Romney seemed to be polling so well against Obama. The perceptions of Romney in Canada seem to be negative because of his wealth. So I asked: Why is being successful a negative? After a few moments the best answer seems to be that a rich person couldn’t relate to poor people. I discussed Romney’s background a bit, and his donation of all of the money his father left him to Brigham Young University. Some surprise at the story, apparently in Canada Romney is history-less until his arrival at Bain Capital.
All three gentlemen were successful professionals and were doing well by either country’s standards and there was some resulting consternation because you see, Romney was “rich”. I didn’t get a good explanation of why that was bad or what it meant. Apparently rich means having more than they did and there was some sort of autonomic response that rich equals evil.
I made a few comments about stereotypes and why wealth is a measure of success but not indicative of a man’s character. I also said that as a father I want my children to strive for success, and if riches come their way then that means they have been good at something. I mentioned how many of the wonders of society have been bequeathed by successful people who had used their wealth to better everyone’s world. Examples abounded, and the Canadians admitted that those things were better done by individuals as governments tended not to have much in the way of imagination or artistic sense.
They raised a question about fairness, and why shouldn’t taxes be higher for rich people. After mentioning that the U.S. tax rates are now among the most progressive in the world, I was enjoined in that circular argument about what is fair and who gets to define it. There was a bit of confusion and silence. It was clear that Canada fears the U.S. debt crisis, and is alarmed that no one seems to be taking it seriously. The argument about taxing the rich seems to tap into that anxiety, although the logic of the argument folds like a paper table under the weight of some alcohol.
We talked for a moment about the Buffet rule and why it was a silly exercise in class warfare and would not raise much in the way of revenue. I clarified that overall increasing taxes on the “rich” won’t have a real effect on the out of control spending problem we face. I also asked if they understood subchapter S corporations and why taxing those individuals would have a deleterious effect on the economy and tax revenues. More confusion. Once they understood the problem of small companies paying dividends that were retained in the company for expansion they got it and understood why taxes on small businessmen would be counterproductive.
There was a lingering sense of disappointment, kind of like why weren’t there more lazy rich people that we could just expropriate their money from and solve the debt problem? Statistics are the enemy of smug moralizing and they didn’t like it. I mentioned that screwing the other guy was kind of the theme of the Democratic Party these days and it was not much a clarion call for a better society. Amused sound effects ensued. But no disagreement.
So we talked about the U.S. government having a revenue problem, and that solving it really required spending adjustments and rethinking of the tax code. That seemed to be an acceptable theme, and the conversation turned to health care.
I got the sense that there was a general feeling of superiority concerning the Canadian health care system, but as the conversation deepened that turned to discomfort. Once I cleared up the distinction between lacking health insurance and receiving health care the sense of moral superiority crept in concerning Canada’s single-payer system. I mentioned that competition actually worked in health care and gave a few examples, and why shouldn’t that work in insurance as well? Well, because. Probing deeper there was a sense that profiting by insurance companies was wrong and so they should be eliminated.
The main role of insurance companies was to assess risk I explained, and there clearly was a difference in risk between my healthy college athlete and the older Canadian in front of me drinking and smoking. While that was accepted there was a sense that everyone should be treated the same because it was fairer. Why was it fairer I asked, for my sons who are healthy and active to pay more for health insurance than they should when older people who didn’t take care of themselves paid less than they should? Well, because. Why shouldn’t my sons be able to shop for and choose a health insurance plan that suited them and didn’t have a lot of the extraneous coverage mandated by politicians without regard for what was really needed in the health insurance marketplace? No real answer.
We finally got around to talking about single-payer systems and achieved consensus that they worked well when one was healthy. When sickness happened lots of Canadians head south and my companions acknowledged that. And, they agreed that privatization is creeping into Canadian health care because of a recent ruling in Quebec that opined that the right to health care wasn’t a requirement to wait for treatment.
I became passionate when I talked about my prostate cancer experience, and why I was able to select a treatment that gave me the best chance of having a normal life: proton therapy. When faced with having to deal with that under Obamacare, I explained what would happen when control was vested n the Independent Payment Advisory Board (IPAB).
The Canadians didn’t understand what the IPAB was. Fifteen unelected bureaucrats, only a minority of whom can be involved in the delivery of health care, will decide what is best practice and dictate (yes, that’s the right word) what care will be provided and what it will cost.
In my case the big boys: the Cleveland Clinics and the Johns Hopkins of the world will whisper that their practices are best and that is what will become the standard. Surgery, with all of its side effects and follow up surgeries and the inability to function as an independent adult and man will be what is mandated for prostate cancer. Assuming that it is detected as the IPAB will continue the recent decisions of Medicare to reduce testing for prostate cancer and breast cancer.
Which has led, by the way, to an increase in patient mortality in England and Europe for prostate cancer, as they don’t test the way we do in the United States currently. And the Europeans decide to wait longer before treatment leading to a much higher incidence of death attributable to this deadly disease.
Under Obamacare innovation will dwindle, and patient concerns – such as which methodology provides the least risk of impotence and incontinence in my case – will not be a factor. Ever.
And, by the way, the IPAB can only be overruled by Congress.
I clarified that the mandating of free preventative care and the addition of millions of new insured patients to the health care insurance system would increase demand without any concomitant increase in the supply of doctors or facilities. The law of supply and demand not having been repealed by the autocrats in the Obama administration means that there will be longer waiting times. And, Medicare being the primary means of delivery to the poor will be squeezed even more and cost concerns alone will dictate treatment options. The poor will receive worse health care than before. As will seniors with the reduction in payments for Medicare Advantage and the theft of $700 billion from Medicare to pay for free services to the people soon to be enrolled.
So I explained that we are facing a diminution of innovation, a mandated reduction in payments, and we are soon to deal with a forced march into a multi-tiered health care system in which the poor, whom my Canadian friends were so overtly concerned about, would suffer the most.
People like me with potentially lots of life ahead would be sitting in front of them impotent and incontinent and unable to do anything about it.
We were finishing the wine at that point and decided to call it a night. All of the Canadians acknowledged that they hadn’t known or thought of any of the things I had addressed with them and realized it they were serious concerns.
I feel that they, like so many people that want to think of themselves as liberals, genuinely wish to be seen as compassionate and fair (particularly with other people’s money). But they don’t take the time to research and think through the consequences, preferring to analyze by what they think are aphorisms. When faced with results rather than intentions they become confused and unsure of what to do.
Best to leave it to tomorrow, when the hangover will prevent real thought that leads to contrary conclusions.
The greater the ignorance the greater the dogmatism. Sir William Osler
Doug Magill is a prostate cancer survivor as well as a freelance writer and voice-over talent. He can be reached at Doug@MagillMedia.net