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July 30, 2009 - Freedomain Radio - Stefan Molyneux
22:52
1423 True News 47: Healthcare Part Two

Ohhhh Canada!

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Hello everybody, it's Stefan Molyneux from Freedom Aid Radio.
I hope you're doing very well. This is True News, current event clarified, number 47, 29th July 2009.
Healthcare, eh?
Rationing and epic fails from the communist hinterland of Canada's socialized medicine.
So let's start with a pattern I think is really, really, really, really important to understand if you're going to take a stand against this kind of predation.
First thing to understand is, you know, government takeovers of private industry initially works pretty well.
For roughly a generation or so, things are fairly good and then things rapidly descend into the crapper, like a foot into a wood chipper in Fargo.
This can also be called the NASA Syndrome.
Why is this so? I think it's very interesting.
So, for instance, the Canadian government first began to take over in spades the medical system in Saskatchewan in 1961.
Doctors rioted, they went on strike, but they were forced back to work at gunpoint.
Why? Because guns are the only tool that the government fundamentally has.
But for a number of years, the system worked relatively well.
Why, why, why?
I think it's very interesting. Now, make the argument that it is because of the inherited efficiency of a formerly free market system.
So when the government takes over an industry or starts some massive new agency or program, it either generally recruits from the private sector or it inherits private sector workers in the industry that it's taking over.
So most of these workers, they went into that industry specifically to enjoy the risks and rewards of the free market.
So the doctors in Canada who went into healthcare in the 30s, 40s, and 50s did so knowing that it was...
Largely, at least, a free market situation.
They were going to have to be customer-focused, entrepreneurial, driven, provide quality, compete with each other, and so on.
And if they didn't want that, then they would go and become some, you know, ass-toady federal bureaucrat and not go into the largely free market healthcare field.
So, as a result, in the free market industries later taken over by governments, The workers have developed their habits and a commitment to the customer and to quality.
It doesn't immediately end upon socialization.
It's not like when you stop going to the gym, you immediately become, you know, hugely fat and unhealthy and muscles all vanish, right?
It's a slow process of decline.
And I think that's really, really important to understand because it usually takes half a generation or a generation for an entirely new set of workers with far different, quote, values to begin to infest the status system.
This lag is really, really important as to understanding why people are so keen or some people are so keen to socialize particular industries.
Because for them, it's like free market efficiency and state payments.
Boy, it just doesn't get any better than that.
So in the short run for particular people or groups, there's nothing more economically efficient than to inherit the workers' values, organization and structures of a free market environment while having the government pay for everything.
It's beautiful because, I mean, people got great work habits, their customer focus, their inequality, their compete, their, you know, they're dedicated and it doesn't vanish.
You know, some 50 year old guy doesn't just change his work habits because taken over by the government.
He's got relationships with his patients and with his own conscience and his work ethic and so on.
Plus, the free market and the sort of supply and demand price mechanism has allocated things very efficiently in whatever fields, in the medical field here.
It's allocated the doctors, the specialties, where they're located, what they charge and so on, all been allocated very efficiently.
And so when you get rid of the price system by socializing something, it doesn't immediately become chaotic.
It takes a while.
It's like a lens slowly going out of focus.
It takes a while for it to go like, I can't see anything, right?
So like overfeeding an athlete, he doesn't immediately get diabetes.
The healthier he is to begin with, the longer it takes for him to get diabetes.
And initially, it doesn't seem like it's doing him any harm at all, right?
As opposed to some guy who's, you know, 300 pounds or whatever, right?
So people think the system is great to begin with.
It's efficient. It's well allocated because of the former price mechanism.
It's full of really hardworking, dedicated professionals.
And it's all paid for by the government.
It's like, mmm, fantastic.
But it no lasty.
Tragically. The decay, the rot sets in.
As those raised with the discipline and customer focus of the free market, they age and retire, they are replaced by an entirely different kind of slithery animal.
This new breed, they don't face the demands for quality and customer service inherent in a free market, voluntary, competitive environment.
In fact, they've gone into the medical field knowing that they won't have to compete, that the patients won't pay them, that everything's regulated.
They're not entrepreneurs. They're not dedicated to customer focus, because if they are, they won't go into a socialized medical care system, or they'll train here and go to the US, or they go to software or some other entrepreneurial activity.
So as a result, they almost can't help looking upon their, quote, customers with superiority and often thinly veiled contempt.
It's just inevitable. It's the inevitable rot that sets into a violent bureaucratic system.
So after this sort of initial honeymoon period, things get continually worse for the average customer, while those in power, the politicians and so on, who actually control the system, they just don't experience the problems they have created.
Politicians, they create all these systems for other people and then exempt themselves.
They've got their own gold-plated pensions up here in Canada, retirement schemes.
They've got their own private parallel medical care system.
They've got access to private schools.
They don't touch the shit that they force us to eat.
Of course not, right? That's for the dregs.
That's for the common voters. Not for them.
They're the leaders. They're the rulers.
Why would they want to subject themselves to the values they impose on everyone else?
You must be kidding. What's the point of power if you're subject to the law?
So you really think that Stephen Hopper, the Canadian Prime Minister, has to sit for 12 hours in an emergency room or has to wait for a year to see a specialist or get an MRI or has any problems whatsoever finding a family doctor.
Of course not. When he recently had a healthcare issue, bam, straight to the front of the queue he went, and then he says, hey, you know, it's a pretty great system.
Why, yes, it is for you, just not for everyone else.
Oh, Canada. The Healthcare Act of 1985 eviscerated the final remnants of the free market system within Canada, made it entirely a government-run enterprise.
Now, Canadians vote for politicians like everyone else, but the unelected and unaccountable bureaucrats are those who actually make the vast majority of decisions about the healthcare system.
They don't get to vote for them, and they advise the politicians.
So, for instance, the way that they tried to control healthcare costs in Canada in the 90s was by hugely cutting back on the amount of medical school enrollees, places available in medical schools.
It works great in terms of controlling costs, although it hasn't actually really done that.
But what happens is the results of which we'll see in a few slides.
Gammons Law, he was a British physician who said in a bureaucratic system, increase in expenditure will be matched by fall in production.
That is inevitable.
We talked about that in the last video.
We'll see it more here.
More money, lower quality every single time.
For example, in Canada between 90 and 99, the average waiting time between a patient being referred by a GP and treatment by a specialist rose from 9.3%.
To 14 weeks, the most current data that I could find.
Waiting time in 2005, almost, well, 17.3 weeks, almost twice what it was 15 years earlier.
Have they been spending more? Absolutely.
Between 96, 97 and 04 and 05, healthcare spending has increased.
And in the last five years, the growth in public health expenditures by all 10 provinces has grown faster than their total revenue growth.
So not only are we spending more money for shittier service, but it's completely unsustainable as it is, which means service is going to be cut even more radically in the future.
Increased amount of spending is absolutely unsustainable, which means it's going to get worse and worse.
Some examples. Do you know?
The Canadian government hires private clinics to get federal employees back to work faster.
Of course, you wouldn't want them to be subject to the socialized healthcare system, so they'll hire private for-fee clinics to deal with their own workers to get them back to work faster.
One, BC is British Columbia.
It's our, like, left-wing, left-coast, west province.
It's our California, but with even more dope...
So one BC notary, not long ago, offered cash to anyone willing to swap his 290th spot on a surgeon's waiting list for something sooner.
Why? Because knee arthritis had him doped on morphine, unable to properly work.
He begged, he pleaded, he bribed.
But no luck. That's illegal.
When former Quebec Premier Bourassa was diagnosed with cancer, he avoided the free socialized healthcare in his own country, like the plague that it is, and instead sought treatment in Cleveland.
And if that doesn't tell you everything that the ruling classes know about socialized medicine, I don't know what will.
BC's MRI weights have grown to nearly a year to get one goddamn MRI. Studies have shown patients are dying on lengthy waiting lists for surgery.
Ah, but you see, in the United States, there are people, tens of millions of people without healthcare, but those are generally young people who say, well, why the hell would I want healthcare when all it's done doing is subsidizing arthritis medication, Viagra, and hip replacements for older people, right?
Because it's ridiculously expensive relative to the health problems needed.
health issues of young people for them to pay as much as they do so they make the rational economic choice to not pay for healthcare that's obscenely expensive relative to their needs because it's all cross-subsidizing those people who have greater issues.
They say, well, there's tens of millions of people without access to doctors.
Well, it's no different in Canada, my friends.
For instance, Ontario is the sort of largest, most populous province.
Only 4.1% of doctors in eastern Ontario are accepting new patients in Canada.
And I can tell you that if you are 55 years old or older with multiple health problems that's going to be time-consuming and could have risks of liability, you're going to be even less likely to get someone.
About 5 million Canadians, or 17% of the population, do not have a family doctor, so they rely on walking clinics and the ER, just like Americans.
Among those doctorless people, nearly 2 million of them, or 38%, have attempted to find a family physician in the past year, but no luck.
The family physician shortage is particularly acute en Quebec, where nearly 29% of the population have not the doctor.
So if you don't have a family physician, it's really hard for you to get referral to a specialist, which means people often have to wait for advanced medical care much longer.
And of course, when you need a specialist in advanced medical care, it's really not good.
By the by, I mean, I've only once in Canada had to get an appointment with a specialist.
It turned out to be nothing. I went to my doctor in February.
I got the referral in April to see a specialist.
The earliest a specialist could see me was December.
It's beyond shocking.
It's beyond shocking that people aren't in revolt about this.
Health officials in one Nova Scotia, that's an eastern province, think of it as a small chip of Ireland but drunker and smelling of cod.
One Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment.
Isn't that just wonderful?
It's so 1984.
To jump across the pond, the National Health Service, the UK monopoly healthcare organization, routinely denies care for treatments that even the most stingy American insurance companies pay for.
People have this fantasy that, oh, my insurance company doesn't cover this, this, this, and this, so we'll go to socialized medicine and everything will be covered.
Nonsense.
Nonsense.
People are routinely denied stuff that all American insurance companies will cover.
And they're in the NHS.
It's called a death sentence.
You simply don't get the treatment and it won't give it to you.
And you have no alternative unless you can afford to go to the States.
Cue jumping.
This is so common.
People say, oh, well, you know, private healthcare is a two-tier healthcare system.
We have a multi-tier healthcare system.
Let's be completely frank about it.
We have, if you know someone, if you're a doctor, if you have political connections, if you can afford to go to the United States, if you, you know, can afford to slither across to some operating under the table private clinic or private doctor, many, many tiers of healthcare, just not available to the general population.
So the guy who's currently president of the Canadian Medical Association decided to jump the queue.
His daughter says, ow, my leg hurts.
He takes her to a doctorate.
He takes her to the emergency room and the initial bone scan indicated a tumor but couldn't reveal whether it was cancerous or not.
This is Dr. Day. The hospital said, he said, we'll do a CT scan, bring her back next week.
He said, to me, it's completely unacceptable.
Sending a mother home for six days not knowing whether her daughter has a malignant or benign bone tumor.
I made the phone call.
I made them do it that day.
Thus bumping someone else.
Of course, right? But this is the zero-sum game of violence.
He admits that he himself used the system when he needed knee surgery.
Jumping. A long queue to get the procedure done within a week by a surgeon who was also his friend.
Isn't that just lovely? Again, bumping someone else without his political connections.
People vote with their Gucci's, right?
Let's have a look at where the doctors end up who are trained in Canada.
Well, they end up in the United States.
18% of new grads left of the United States within a few years of graduating.
Only 14 out of the 507 graduates chose to practice in the remaining and primarily rural areas of southwestern Ontario, where they were trained.
About 10,000 doctors left Canada in the 1990s.
And of course, there's a strong reluctance of medical students to choose specialties and locations where they're most needed, right?
Rural and other areas in the Indian reservations.
Why? Because there's no market incentive.
They don't get paid anymore. So if you're not going to get paid anymore, why do you want to go live in some rat's ass, small town, snow belt place?
Of course not. You want to go live in Toronto or Montreal or Quebec City or Vancouver or wherever.
Some place where it's kind of hip and cool to be a young doctor rather than, you know, freezing your ass off in some snow belt town in northern Ontario.
According to a national poll, four out of five Canadians are unhappy with their socialized healthcare system and believe it's worsened noticeably in just the past five years.
This is what we were talking about earlier.
You get this honeymoon period and then BAM! It goes into the shitter.
Almost half of Manitoba doctors have left the province in the past decade alone.
Waiting, waiting, waiting, waiting.
So, if you socialize stuff, it becomes free, which means that you exchange dollars for hours, days, weeks, months, and years, and instead of being able to go into debt if you need to or applying to charity to get what you want from the medical system if you can't afford it, you end up just not being able to get it at all until some doctor decides to make him or herself available to you, in which case you might be far too late.
So, for instance... More than 5,500 children, some of whom can't hear or see properly, are on a waiting list as long as one year for corrective surgery in Montreal's two pediatric hospitals.
Julia, an 8-year-old girl who likes to draw pictures of models and nice clothing, has been languishing on a waiting list since April of last year to have her tonsils and enlarged adenoids removed.
Her nose is often blocked, she can't sleep at night.
Her mother climbs into bed and props up three pillows to help her breathe better.
In the US, many children in need of electric surgery can get the operation done within weeks or sometimes the very next day.
A recent study showed from 2003 to 2004, 7.5 to 9.4% of patients left the emergency room in one hospital, 8.9 to 11.5% gave up in another one.
It's not like these people were treated, they just gave up because they were waiting too long.
A Canadian healthcare patient on average must wait 17.7 weeks for hospital treatment.
Shocking. Access to medical technology.
U.S. patients have greater access to advanced medical technology than do Canadians.
Units per million people.
Open heart surgery centers, U.S. 3.7, Canada 1.6.
Installed MRI units, U.S. 6.1, Canada 1.8.
Lithotripsy units, 2.1, 0.4 in Canada.
CT scanning centers, 15.3 in the U.S., 8 in Canada.
Cardiac catheterization centers, 6.6 in the U.S., 2.8 in Canada.
Per million people. This is adjusted for population.
This is a testimonial I found I thought was quite interesting.
On a sub-zero Winnipeg morning in 1997, this fellow writes, I cut across the hospital emergency room to shave a few minutes off my frigid commute.
Swinging open the door, I stepped into a nightmare.
The ER overflowed with elderly people on stretchers waiting for admission.
Some, it turned out, had waited five days.
The air stank with sweat and urine.
Right then, I began to reconsider everything that I thought I knew about Canadian health care.
I soon discovered that the problems went well beyond overcrowded ERs.
Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation, whom we refer to a pain clinic with a three-year wait list.
Or the woman needing a sleep study to diagnose what seemed like sleep apnea, who faced a two-year delay.
Or the woman with breast cancer who needed to wait four months for radiation therapy when the standard of care was four weeks.
Anecdotal but powerful.
Here's something that's really, really astounding about life in a socialized healthcare system.
You cannot find out how good your doctor is.
Isn't that amazing? When I pick up a goddamn candy bar, and by law, every single ingredient has to be listed.
Pick up a cup of yogurt, and they have to tell me how many calories there are.
Car commercials have the incredibly sped up about car loans and stuff which they legally have to put in to make you informed and aware as a consumer.
You hear ads on TV for medications in the US. They have to list every possible side effect, every warning.
You have to be informed as a consumer in everything except what could be the most important goddamn thing in your life, which is how good your doctor is.
Say I get something like prostate cancer.
Well, lord on a stick, I absolutely want to find the very best guy to deal with it.
I pay any price, bear any burden, sell my house, because what am I going to do if I'm dead with a house?
Doesn't do much good to me then, right?
I want to know who the best thing is, but you know, here in Canada, it's illegal to even track store or, heaven forbid, disseminate.
How good doctors are at particular things?
Now, of course, it's known to some people, those in the field know, and they want to reserve those doctors for themselves.
Politicians can very easily find this information out through word of mouth within the medical profession.
But your average person has no idea of the quality Of the doctor that he's being referred to.
Is he any good? Is he crap?
Does he drink? What's his success rate?
What's the percentage relative to the next guy?
And of course they have to keep this information hidden because otherwise people would always want to go to the best doctor and the system would be even more ridiculously exposed as corrupt, false, brutal and dictatorial.
But that's amazing that you can't find out the most important thing when it comes to placing your healthcare in someone's hands.
How good are they relative to everyone else?
What is their success rate for treating what you've got?
I mean, how cowed and broken are we that we are not shocked and appalled by this?
It just continually blows my mind.
It also blows my mind that it doesn't blow people's mind.
And, of course, socialized healthcare systems are parasites of the innovation of the U.S. system.
Up until recently, more than two-thirds of all drug research was conducted in Europe.
Now, after they capped Europe's price that you could charge for drugs, 60% is conducted in the United States.
In the last 10 years, 12 Nobel Prizes in medicine have gone to U.S. scientists working in the U.S., American-born scientists.
Three have gone to foreign scientists working in the U.S., and just seven have gone to researchers Outside the country, right?
It's amazing. Of the six most important recent medical innovations, four have been developed in the U.S., and one was improved and commercialized within the United States.
So five out of the six pretty much came from the United States.
Not from the socialized medicine, because of course there's no innovation, no profit motive.
So, for example...
Increases in life expectancy resulting from better treatment of cardiovascular disease from 1970 to 1990 have been conservatively estimated as bringing benefits worth more than $500 billion a year, and that's just for the United States.
This is stuff that I think was largely developed in the US. I think this is also a bit of an answer to those who've written to me, and thank you for that, saying that technology has something to do with the increase in healthcare costs.
Well, Technology like better treatment of CB disease has resulted in massive benefits to the economy.
That's kind of what I'm talking about.
Yeah, it costs more maybe, but the benefits should be greater.
Otherwise, it would be a malinvestment, right?
So I think this is really, really important.
And I also saw a study that said that over the past 10 or 20 years, only 15% of the increase in healthcare costs can be attributed to people living longer.
And the 760% price increase, only 15%, can be attributed to people aging.
So that's not the answer either. I just sort of wanted to point that out.
The moral, as we come to the end of these hellish, fact-based fairy tales, we almost have to cough up a moral.
And of course, the answer is the same.
The answer is no guns. Stop using violence to, quote, solve healthcare problems.
Stop using violence to protect doctors from competition, to protect them from From having the information about their competence published, I mean, for heaven's sakes, we really need that information.
It's ridiculous. The answer is no guns, not more guns.
Stop using violence to try and solve these problems.
The same thing every single time.
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