Category: Health

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Repealing Obamacare

It may not matter much in a real election with real people who watch reality TV, believe they are getting a good deal with the Super Jumbo Sized Soft Drink, and hope to win the lottery some day, but the question in mind, for the coming Congressional elections in the fall, is this: which parts of Obamacare are you going to repeal?

I don’t know how most Republican candidates will answer that. They won’t want to. They will not want to go on the record declaring that they will take away insurance for the 5 or 10 million people who now have it who did not have it before. They certainly will try to make it sound like they have a better alternative but even Fox News might occasionally ask a question: what? The answer will be magical thinking: we will find imaginary efficiencies that will produce imaginary care and provide imaginary cost savings for an imaginary future. But, hey, have you seen my new, larger flag lapel pin?

As polls have shown, if you ask the average American if he likes Obamacare, only about 45% say yes. But if you ask them if people should be dropped from their insurance coverage because they develop a serious, expensive illness, or should be denied coverage because they had an illness previously, or if children should be dropped from their parents’ insurance while they are in college or university, a large majority say no. Can the Democrats run on that paradox? If I were a campaign advisor, I’d suggest they start early and hammer their Republican opponents with that question: which provisions of Obamacare will you repeal?

 

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An Epidemic of Diagnoses

You have to distinguish between an epidemic of diagnoses and an epidemic of allergies. Dr. Nicholas Christakis

A recent story out of Sacramento describes the tragedy of the death of Natalie Giorgi, a 13-year-old girl who was allergic to peanuts and inadvertently swallowed a bite of a Rice Krispies square that had “peanut products” in it. Her parents had two EPI-Pens, used them both, then used a third from the camp where their daughter had been staying. Natalie’s father, a physician, couldn’t save her, and neither could the EMS team that arrived by helicopter.

Now the Giorgi’s have gone public because they want to convince a skeptical public that food allergies are real and pose a real threat to public health and safety. They believe most people aren’t already hysterical enough about food allergies. We need to ramp it up.

Now, I don’t know where the Giorgis stand on gun control, or drunk driving, or lightening, but, if we, as a society, were to respond intelligently to genuine threats to health and safety, we might be better off channeling our energies into more productive causes.

Even worse, the remedies proposed most often– declaring schools “peanut free”, for example– may actually be having the opposite effect. In Israel, where peanuts are a popular snack, the rate of peanut allergies among children is about 0.17%. In Britain, where peanuts are less popular, the allergy rate is 2%.

About 150 people die every year in the U.S. due to an allergic reaction. About half are due to peanuts. That’s slightly more than the number of people who die from lightening strikes.

Be it noted: there is a lot of misplaced faith placed in Epi-Pens.

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The Brutality of the American Health Care System

According to a New York Times article [2013-08-03], Michael Shopenn, a man living in Boulder, Colorado, needed a new hip and obtained a rock-bottom price of $13,000 through friends with connections in the industry. Then he tried to arrange the operation at a local hospital: they quoted him $65,000.

That is an unspeakable obscenity.

He chose, instead, to fly to Belgium and have it done in a private hospital there for $13,660. That price included the air fare, surgery, five days in a hospital bed, physical therapy, and the hip itself. The hip came from the same company that offered it to him for that rock bottom $13,000 in the U.S.

How is that possible? America is the greatest country in the universe. All Europeans are lazy, corrupt, and I forget the third one. The American health care system relies on good old capitalism and free market competition to drive prices down give Americans the cheapest health care in the world. The New York Times is lying.

What is the bigger obscenity? That large numbers of Americans continue to believe it, or that doctors and hospital administrators continue to believe that they are good, decent people, with ethics and morals and principles, who do their best to “help” people like Michael Shopenn. They are not like drug dealers, bank robbers, or, God help us, bankers. No, they work very, very hard and deserve to completely ruin your life. Shopenn’s example is a trifling one. I know of cancer patients who were charged $20,000 a day to stay in the hospital after breast surgery.

There is no country in the world where a health care system that charges these rates is sustainable. It is a system designed to deceive Americans into thinking that if they work hard, improve their skills, show up on time, and manage their money wisely, they will be able to retire when they get old.

No, you can’t. You will be robbed of every cent by hospitals and doctors who are unconstrained by morals or laws or regulations. They can charge whatever they want and they do.

The actual cost of manufacturing that hip: about $350. I’m not making this up. And Shopenn was quoted a bargain: many patients pay up to $50,000 or $60,000 for it. Why? Because every agency that handles or distributes or installs the artificial hip takes a huge cut, including the hospital.

There was a time when a man who charged you $13,000 for a device that cost $300 to make was committing “extortion”. I don’t believe for one second that it is not still extortion, and criminal.

But why the hell is the hospital marking up the cost? Why the hell is a hospital in the business of making a profit from a medical device?

Oh. This is America. Cue the anthem. Wave the flag. Get the marching band. Let’s remind the world that we are the greatest country in the universe and anyone who thinks otherwise should go live in North Korea!

It’s the American medical industry that behaves like North Korea. Hospitals are forced by secret agreements to not disclose the price they paid for devices like artificial hips because it would …. er… create competition among the manufacturers. And this is allowed in a Republic that claims to operate on the basic of market competition.

Michael Shopenn didn’t even have to go to India or Indonesia to save money on this operation. He only had to go to Belgium. But the interesting thing about this is that the skills required to safely perform this operation are not worth $65,000. They probably aren’t even worth $13,000. The skill set is not like oil or gold or an automatic transmission: it is something that can be taught to any reasonably intelligent, educated young person in most countries in the world.

Now you should not look at society through the lens of class warfare, but if you did, it would look very much like this: in order to get you to work, in order to make the rich rich, they have to offer you this charade of a “good living”, maybe even health insurance (more likely not), and let you invest in a house and in mutual funds so that when you get old you can retire on your savings. That’s the scam. Once you have actually reached that age, they will take all of the money back through medical costs. Breast cancer? Hip replacement? Heart surgery? It doesn’t matter– you will be charged an incredibly obscene amount of money so the rich can get back all of the money they paid you for your work. God forbid your children should inherit it!

What about insurance? Ah, but that is exactly what the Republicans are working on right now! They will tell you that America cannot afford health care, Medicare, Medicaid, or Social Security. You see, we desperately need that money….. to cut taxes for the rich. Oh– and to buy more F-35 fighters and nuclear submarines. And aircraft carriers, even if a drone from China or Russia or North Korea is going to be able to sink one in the next few years.

No, you couldn’t make that up. Nobody would believe it. But it’s right there in the Republican Party platform and re-election campaigns and policy conferences– that is what they intend to do.

The article about the hip replacement.

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Hurray for Death Panels: I Mean it!

By the Republicans definition, any attempt to prevent people from choosing expensive but ineffective treatments, is a “death panel”.

It is a tribute to how badly outfoxed on public relations the Democrats have been: the public associates “Death Panels” not with congressmen determined to prevent them from accessing health insurance, at a sustainable cost, but with the Democrats who want to provide it. That is an amazing accomplishment.

As far as I can tell, the Republicans greatest concern about health care is the rising costs. It has been rising, rising, rising for fifty years under the Republican system: private insurance. Did I say the Republicans are concerned about these rising costs? Yes they are. They have a solution. Do nothing. As Ross Douthat in the New York Times admits, the conservative solution to the uncontrolled cost of health care is “modest reforms that would help the hardest-pressed among the uninsured”. Isn’t that inspiring? That covers a multitude of nothings.

As the health care industry expands to meet it’s central dynamic: we are a society that looks at itself in the mirror and says, “we believe life is more valuable than money”. Therefore, if someone’s life needs saving, we will spend as much as necessary to save it. The health care industry understands this. There is no reason why they should ever find cheaper, more efficient treatments: it is contrary to their fundamental interests.

It is not contrary to the real interests of the government and the people they represent to place some reasonable controls over how much should be spent on any particular disease or injury. But it’s something all the parties have to agree on or else one particularly stupid or ruthless party can exploit the fact that most people appear to refuse to believe what they see. An unfortunately large percentage of the population can be led to believe that one party can provide all the health care they want and need without bankrupting the country while cutting taxes.

So I’ll bet more than a few rational Republicans — if any are left– regret the choice of the word “death panels”. Because they have attached the phrase to the idea of limiting the relentless increase in health care costs. Because the potential cost of health care is infinite. The last twenty years of astonishing increases have proven it.

Come on, Democrats! Seize the term and turn it on the Republicans! They are the party that doesn’t want you to have affordable health insurance. They are the party of war, of unregulated industry, of tort reform: they are the Drop Dead Party.

The Republican approach will inevitably lead to a system where only the rich can afford proper treatment. By the Republicans definition, any attempt to prevent people from choosing expensive but ineffective treatments, is a “death panel”. Any attempt to limit treatments performed on people who are going to die soon anyway is a “death panel”.

Do you want to be the politician who tries to explain to the American people that too much health care is provided to people in the last few months of their lives, and that this is making the whole system unsustainable?

Here’s the naked truth: what the U.S., and most western countries need or already have, is something the Republicans have labeled as “death panels”.

As Douthat correctly noted, health care costs rise at astronomical rates. New treatments come on board constantly, new drugs, new techniques, and pharmaceuticals and doctors and hospitals charge enormous sums for these goods and services. Unfortunately, all this new technology has had the opposite effect that it had on computers: medical costs have risen steadily. Why? Really, in a nutshell, because people will pay anything to get better. Anything. Whatever it costs. People will sell everything they own to pay for it because nothing you own matters to you if you’re dead. And the medical industry knows it.

There really as an infinite amount of money we can spend on health care. Unconstrained, it will eventually consume most of the financial resources of the entire nation.

The health care industry also knows that people don’t go shopping around the cheapest cancer surgery, to see if they can get a discount. They don’t turn down an incredibly expensive operation just because they also have cancer and failed kidneys and diabetes and a heart condition, because they are 80 years old, or because they are Republican.

With this logic in place, there is no ceiling on medical expenditures, and eventually it will consume more and more and more of the economy, until it breaks. Or until Republicans, having created an unsustainable system, declare that no system is sustainable and announce their new policy for the uninsured: drop dead.

Most other developed countries simply negotiate what they will pay for particular treatments, which treatments will be available, and how much over-all spending will go into health care. What the Republicans call “death panels” are really nothing more than educated people trying to balance needs against resources, and so far it works pretty well in Europe, Australia, and Canada.

I have no problem accepting a system that declares that it will not spend an infinite amount of money on health care. I have no problem believing that we can still have a pretty good system that provides effective essential treatments for almost every illness. I accept that when I am 80 years old and suffering from all the ailments a typical 80 year old suffers from that I will not be a candidate for a kidney or heart transplant.

The only way to have a sustainable and effective health care system is with death panels.

The essence of the American debate was captured for once and always in this exchange:

Someone reportedly told Inglis, “Keep your government hands off my Medicare.”

“I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,'” Inglis told the Post. “But he wasn’t having any of it.”  Huffington Post

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Acronym Syndrome

A year or so ago, Stockwell Day (a Conservative cabinet minister, in case you’ve forgotten) was defending a number of initiatives by the Harper Government to “strengthen” the criminal justice system. By “strengthen”, he meant “make people suffer more”. When a reporter asked what the reason for this was, considering that the crime rate was actually in decline, Day famously replied that “unreported crime” was on the increase.

I think Day should have set up a website first. “UnreportedCrimes.ca”. Then people could report their unreported crimes and we would have a better idea of the scale of the problem. He should have invented an acronym for it — UCD for “Unreported Crimes Disorder”. He would have sounded more authoritative if he had said, “of course, UCD is way up over last year, and URPCA is also on the increase. (Under Reported Perception of Criminal Activity). He might have added that if a citizen sees any activity take place which is not clearly a known legal activity then it should be treated as an unreported crime. And reported.

The problem is, if he had done this tens years ago, the numbers would still have declined. Because, after all, the rate of crime really is down, if you look at actual facts, so the amount of reported unreported crimes would also likely have declined. Do you see the problem?

Similarly, or not, there is a website for “The Invisible Disabilities Association of Canada”. It’s about two particular “syndromes”– I don’t know what to call it exactly– myofascial and fibromyalgia. Your first clue: myofascial is not in the dictionary. That is because it is not a real word. It is a made-up word.  That means it was just discovered– or just invented.

Now before I go any further, I want to make it clear that I believe it is quite possible that some people in this world, particularly in the affluent developed countries, really do suffer from tiredness, sore muscles, aches, and pains. In fact, it is quite possible that all of us do, to some extent. In fact, it is quite possible that life, in general, sucks. I’m not being flippant– life generally sucks. You make the best of it if you can, but it sucks.

I don’t care about that. I do care about bad science and irrationality, because those things lead to trouble.

So when this website informs me that fibromyalgia is diagnosed when “other illnesses and conditions are ruled out”, I am astounded. Let’s say you meet a person. Are you French? No. Are you British? No. Then you must be Chinese.

Fibromyalgia, we are informed, affects either the upper half of the body, or the bottom half, and can affect the right side or the left side. I am not making this up– check out the website.  [The website is out of business.]

Fibromyalgia consists of general aches and pains and tiredness. That’s good– because if it only affected specific parts of the body in a specific way, you would know when you didn’t have it.

Now, I have no idea how you would know if your aches and pains and tiredness are a syndrome or if they are just aches and pains and tiredness, or if your life sucks and you hate making the effort and you just want to veg out on the couch and you don’t have the courage to get out there and engage the world…. I don’t know. Nobody will ever know.

According to the website:

Generally people with Fibromyalgia state that they hurt all over, especially in the parts that are used the most. Stiffness, especially on waking, sleep disorders, irritable bowel syndrome (see separate sheet), irritable bladder syndrome, premenstrual syndrome, restless leg syndrome, headaches (especially migraines and tension headaches) (see separate sheet), muscle spasms, cold intolerance, TMJ, cognitive difficulties, numbness and tingling in the extremities are some of the symptoms. Other common symptoms include a decreased sense of energy, disturbances of sleep, and varying degrees of anxiety and depression related to patients’ changed physical status.

“Irritable bladder syndrome”? “Numbness and tingling”? “Cold intolerance”?.

Think about how it sounds if you say “I am cold”. Now say, “I have cold intolerance”. Different effect, isn’t it? Now try: “I have cold intolerance syndrome”. I will rush out and get you a blanket.

All of it sounds like the normal wane and flow of everyday physical life. It gets cold, it gets hot. If you move, you use energy, and if you use energy you feel tired, and if you feel tired you want to sleep, and if you feel restless, you have “restless leg syndrome”.

Why? Because a label is a label. Why did you stop going to work? Why do you sit on a couch all day watching TV and eating potato chips? Why are you fat?

If you think you have fibromyalgia, I’m not saying your symptoms are not real. I’m saying that you don’t have something that is left over if nothing else can be diagnosed. I’m saying that you have no way of knowing how tough it is supposed to be to get up in the morning or to get out of the house and engage with the world. You say, I don’t know how real your symptoms are. You don’t know how real my symptoms are. Neither of us knows where the line is between attitude and illness, but I know that any illness that can affect the upper half of the body, or the lower half of the body, or the right side, or the left side, and fails to produce any empirical manifestations, hasn’t earned the right to an acronym.

Your last refuge: you don’t know what it’s like to not want to make the effort. And I admit that we have something pure there.

Of course there is an acronym. Developing an acronym for mythical conditions is essential to selling these conditions to the public. So fibromyalgia becomes “FMS”. I think it is believed that the general public will be more easily convinced of the reality of any condition if it has an acronym, especially if it has the word “disorder” in it.

PTSD. SARS. ADHT. TMJ. MPS.

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Autism and Witchcraft

In his presentation, Wakefield sounded impatient but righteous. He used enough scientific terms — “ataxic,” “histopathological review” and “vaccine excipients” — that those parents who did not feel cowed might have been flattered by his assumption of their scientific fluency. He also tried to defend himself against a few of the charges laid out in The British Medical Journal — offering defenses that did not hold up before the journal’s panel of editors but were perhaps enough to assure an audience of his fans that he did, in fact, have defenses. Some part of Wakefield’s cult status is surely because of his personal charisma, and he spoke with great rhetorical flair. He took off his glasses and put them back on like a gifted actor maximizing a prop. “What happens to me doesn’t matter,” he said at one point. “What happens to these children does matter.”

Andrew Wakefield has had a wildly pervasive influence for a man without the slightest claim to scientific credibility. But he’s a good case study. Scientific truth sometimes seems drastically disadvantaged in our age of the anecdote, the interview on tv, the tears on Oprah. It must be true if you cried.

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No Historians

There are seven members of the conservative bloc on the board, but they are often joined by one of the other three Republicans on crucial votes. There were no historians, sociologists or economists consulted at the meetings, though some members of the conservative bloc held themselves out as experts on certain topics.

NY Times, March 12, 2010.

This is the Texas Board of Education making decisions about text books for millions of students. This is an important decision: these men are entrusted with a serious responsibility. What should our children study in school? How will their perspectives on life be shaped for years to come? How should their education as citizens be guided?

Well, whatever we do, let’s not get an expert on any of the subject areas were are establishing guidelines for. Heavens no.

I wonder if any citizens of Texas realize how close they have come to the 18th century? The only things missing are signs and wonders. Then I wonder if any of them care about how the state is perceived by outsiders. Well, we know the true believers in this movement certainly don’t care. The question is, does Mr. & Mrs. Mainstream care, as they travel through Europe, and identify themselves, and watch people nod and go, “Oh, you’re from there.” Tell me, have you seen any flying saucers lately? Mr. And Mrs. Mainstream reply, “no. Have you tried to open a business lately. Notice how many restrictions there are? How many permits you need? How long it takes to get approvals from the various bureaucracies?”

And the European says, “and how’s your health care?”

 

 

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No Health Care for You!

Health Care
When will Americans finally begin to realize that there is not a single component of the health care industry that benefits from preventing illness? Are you listening, America? THE MEDICAL INDUSTRY DOES NOT BENEFIT BY KEEPING YOU WELL. This is the fundamental, inevitable flaw in a for-profit health care system: the system profits by keeping you ill.

So it is in the interests of the health care system that you are obese, that you don’t exercise, that you smoke, that you drink, that you watch television, that you biggie-size your meals, that you don’t know what’s in the food you eat, that there is radiation and asbestos, that there are wars and civil disturbances, accidents and sickness.

Sure, the health care reforms just passed by Congress will help lots of people. But some Republicans– not very many of them, obviously– and many Democrats are also right that real reform has to start with the entire system which currently focuses on treatment rather than prevention.

Just one example: the makers of Crestor, a cholesterol medication, are crowing that a recent study concluded that healthy people who take Crestor every day (at more than $3.50 a pop) are 50% less likely to have a heart attack than healthy people taking a placebo. Wow. Let’s get all the healthy people on this drug! Now!

A well-paid doctor who received money from AstraZeneca, says, would you let your patient walk out of your office without signing up? Hell no! The only problem: well, only a very small number of healthy people have heart attacks. Only about 1 in 500. So a 50% reduction translates into a difference of 1 in a 1000, of which a large majority will survive the heart attack anyway. But the cost of providing 1000 people with Crestor for a year is over $1 million. Good deal? Then add in the fact that some cholesterol drugs have now been implicated in causing type 2 diabetes. They know that at the time they signed everyone up to a drug you will never be able to stop taking once you get started on it.

The alternative: walk more, eat more vegetables and less fatty foods.

Thinking of treating somebody like an object? Don’t do it. It sends a bad message that will not be quickly forgotten.

The drug cartels are battling it out in Mexico for… what? For routes into the U.S. In theory, of course, there are no routes. The U.S. government spends $13 billion a year ensuring that there are no routes. Actually it’s more than that: think of all the people incarcerated for drug offenses, or offenses related to drug use.

The idea that America cannot “afford” the health care bill is ridiculous. To believe it, you have to assume that all or most uncovered medical conditions are not treated. That, of course, is not true. They are often treated in emergency wards, and they may be treated– in a different form– later in life in a chronic care facility, but there will be treatment and it will cost somebody and it will have an impact on the economy.

What universal health care coverage does is apply some rationality to the cost of health care. When you think about it, insurance is a marvelous concept. Since nobody knows who will ever get a disease or serious illness, why not commit, in advance, to pool our resources and treat everyone? When John McCain insists that the Republicans will campaign in November on repealing it– he’s dreaming. Since the Republicans have no alternative, his campaign will consist of “we will take away your health care”. About that for a slogan!

Even the Republicans are probably not that stupid. They will probably have to come up with some kind of weird alternative plan. The problem is, there is no alternative. They will come up with something that sounds like an alternative, but is really a variation of what the Democrats just passed, but with something that looks more “free enterprise” in it.

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Pandemic!

You would think we all would have learned about hysterical over-reactions from the hysteria surrounding SARS in in 2003, and the even more over the top hysteria over Avian flu in 2006.

But then, many people don’t think it was an over-reaction. Many people believe we were almost swept by a deadly virus that could have killed … well…. I have no idea. I have no idea how many people many people think it might have killed. Nobody will say. Nobody will say because if they did say, they would quoted frequently when we find out that the real numbers are not quite anything like the predicted numbers, or the monumental solemnity with which Peter Mansbridge intones the phrase “pandemic”.

All we know is that SARS actually killed about 774 people world wide. Avian flu? When is the last time you saw a headline on that? Right– way before Michael Jackson died.

Now you may think that 774 is a big number. And it is– by all means. That’s a lot of death. It may sound rather clinical to observe, however, that compared to a number of other causes, it’s not really a very high number. Car accidents? Cancer? Homicide? Starvation? Every year about 4,000-5000 people die from seasonal flu alone in Canada, and about 40,000 to 50,000 in the U.S. When is the last time you saw twenty headlines in a row about those deaths? Why? Don’t they matter?

The problem is that every few years– on schedule, it seems– the media whip us all into a frenzy over some new virus that supposedly is going to decimate the population and destroy our civilization. Do you recall Legionnaire’s Disease? SARS, of course. Avian flu. With the notable exception of the AIDS virus, none of these actually had much of impact beyond the usual seasonal swell of flu deaths. SARS is reported to have been “contained”. What on earth does that mean? Sports and other events were cancelled; anyone with a temperature was quarantined; nurses wore masks; thermal scanners were installed at airports. Did any of this actually have any effect on the spread of SARS? I don’t believe it.

I’m not sure yet about getting vaccinated myself.

Fear drives bad politics. When people are willing to wait in line for eight hours to get a flu shot, you know that they will not countenance a government that says “the media are exaggerating the problem– there’s really not much the government can or should do to prevent the spread of H1N1”. The government knows that it better look like it’s doing something. The media know that the government knows that it better look like it’s doing something. Both of them want to feel important, so we have the sober Peter Mansbridge solemnly intoning that “Canadians are concerned”– as if he had some hotline to the brains of 30 million people– that not enough vaccine is available for every Canadian.

Do Vaccinations matter? A fascinating article from the Atlantic Monthly.

And an even more fascinating article in Wired which draws the opposite conclusion.

Which is more persuasive? Right now, I lean towards the Wired article because one of it’s main points is that the public has a foolish tendency to ignore the science and go with their feelings. It was the government– not the scientists– that announced that vaccines would no longer use thimerosal even though it was safe, so that the vaccines would be safer. They might have also announced that they were making witchcraft illegal, not because there are witches, but because we will all be less likely to suffer from magic spells.

Bill on SARS.

Now this one tops them all: the CBC is doing an online poll to ask viewers what story Wendy Mesley should cover tonight. One of her possible topics is this: can the public be trusted in a pandemic? I am not kidding. (Unfortunately, it is winning.)

What the hell is that supposed to mean? That the government should not compel people to get vaccinated?

 

The contemptible CBC: my wife and I have watched the CBC national news for about 15 years now. I used to think they were reasonably sober and serious and comprehensive, aside from occasional hysterics about SARS or Princess Diana… I don’t know– maybe they never were. We want some Canadian news, so I was reluctant to switch exclusively to McNeil-Lehrer but maybe it’s time. I was disgusted with their coverage of the SARS crisis back in 2003 and I am even more disgusted with their coverage of H1N1 now. The CBC has gone absolutely hysterically over the top this time.

From Wikipedia: As of 22 April, all Canadian SARS cases were believed to be directly or indirectly traceable to the originally identified carriers. SARS was not loose in the community at large in Canada, although a few infected persons had broken quarantine and moved among the general population. No new cases had originated outside hospitals for 20 days

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Canadian Tire and 9/11

I never knew this before, but during the 9/11 crisis, when thousands of airlines passengers were stranded in Gander, Newfoundland, the local Canadian Tire Store, with approval from head office, instructed their clerks to ask if any customer was one of the “airplane people”. If they were, the clerks were instructed to allow them to take whatever they needed without cost.

We drove past that Canadian Tire on our way to Trinity Bay from Twillingate. Across the road is a Walmart. Most of the “airplane people” were American, but the Walmart charged their usual prices for everything– they actually had more of what the passengers needed because all of the luggage was sealed in the planes and inaccessible.

Canadian Tire, when it ran out of sleeping bags and such, bought $10,000 worth of goods from Walmart and gave it away to the passengers.

Let’s not be tacky and notice how the grateful Americans have repaid us by slandering our health care system.

Well, probably not the ones who stayed in Gander, Newfoundland.

About that Canadian Health Care System– if you are an American and you have heard the ridiculous attacks, you should consider this one thing alone: there has not been a single federal politician in any recent election in Canada who has dared to advocate dismantling it. Not a single one. If Canadians were even remotely unhappy with our system, would you not expect at least a few daring rogues to run on a platform of making our system more like America’s?

Then consider this: Canadians, inundated with American media, have a deep familiarity with both systems. Most Americans have virtually no familiarity with the Canadian, or British, or French systems . I am eternally impressed with those citizens standing up at those town hall meetings with remarkable confidence in their own experiences and knowledge, of which there seems to us, very little, to let all Americans know just what should be done with the health care system, and don’t you dare require us to support anything we didn’t choose, even though they expect Americans to support every war– and there’s been a pile of them– whether they chose it or not.