Myths From A Former Pharmacist

I was browsing the Toronto Star website this evening, when I came across this editorial by a former Pharmacist, Murray Rubin, that appeared on June 8th. As I began reading his article (except for the first paragraph), I couldn’t help but wonder if Rubin was going to make provide some logical and well reasoned conclusions on how to best change the health care system in Canada. Unfortunately, Rubin seemed to ignore much of what he had to say himself in his first few paragraphs, and ends up spouting the same old myth that socialist health care proponents continually spout. Here’s my look at his article:

“It was Winston Churchill, the renowned wartime British prime minister, who stated “democracy is a terrible system, but it is the best there is.””

Well, first we have a logical fallacy of appeal to authority. We have no idea if Winston Churchill was an expert on political systems. Sure, he was a Prime Minister of England, and a very popular one at that during WWII, but this by no means suggests that Churchill was an expert on systems other than his own British style of democracy.

Furthermore, what the heck does this have to do with health care anyhow?

“In the field of health care the inadequacy of the democratic system is very apparent. Politicians will not make the decisions to repair a badly flawed system because they are unwilling to fight the status quo encompassing doctors, pharmaceutical companies, and even the public to bring in a system in tune with the technology improvements of the 21st century.

Really? Health care shows the inadequacy of democracy? Rubin fails to prove this assertion. Instead, he points fingers at politicians, doctors and others who are unwilling to fight the status quo.

But this is illogical. This has nothing to do with democracy. Mind you, I would agree with Rubin that the problem primarily lays with politicians and some folk in the health care industry who are afraid to compete and be the best they can be in a free market.

But how this ties in to democracy is beyond me. Rubin fails to define democracy, or even state what IS adequate health care as well.

“Health care is too important an issue to be left solely to politicians.”

Rubin is dead on with this comment! He probably doesn’t realize how dead on he is.

“Politicians are afraid to institute a long-term strategy that will inevitably create turmoil as the new methods of delivering health care are implemented. Their primary interest is in the next election and staying in office.”

Hear hear! At this point, forgiving his first couple of paragraphs that contain illogical fallacies and argument, Rubin is starting to look like a genious.

“The solutions proposed by the Roy Romanow commission are solutions for politicians, with no real change. The politicians’ answer for the improvement of health care is to spend more money.”

Wow. Yes Murray! I’m started to get excited here. Is this really in the Toronto Star??

“Health-care spending in Canada rose from $78.5 billion in 1997 to $121.4 billion in 2003, yet the system is in a steep decline. Waiting lists continue to grow.”

Thank you, Murray for pointing out this fact about health care in Canada. After several years of trying to find a doctor in my town, I’ve only found one that would take me as a patient, four months ago. I know about waiting lists and being in steep decline.

“Dr. Max Gammon, a British physician, studied the relationship between money and health care in the British system of socialized medicine. After an extensive look, Gammon formulated his law, aptly called Gammon’s Law: “In a bureaucratic system, increase in expenditure will be matched by a fall in production.” You cannot overspend your way into better health care.”

Murray! This guy sounds like a libertarian! I cannot believe my eyes, reading this in the Toronto Star! Dr. Gammon is so correct here. And it applies not to just health care, but to any industry where there is bureaucracy.

“But why do we have a problem? Seniors use a disproportionate amount of the health-care budget. The percentage of seniors is increasing quickly and they are living longer. In addition, the great advances in modern medicine use very high technology and are very, very expensive.”

Oh oh… say what, Murray? I’m trying to get my head around this one. In the paragraph above, you just stated the problem. Now you’re asking “why do we have a problem?” and you come up with seniors using a disproportionate amount of the budget? Ummm… well, what did you expect, Murray? Elderly folks usually get sicker more often than younger folks. I mean, wouldn’t alarm bells be going off if younger folks were generally sicker more often than older folks? What am I missing here?

“Between 1994 and 1995, 32,147 hip and knee operations were performed, while between 2001 and 2002, there were 44,792 such operations. A seven-year change of 39 per cent. Today we can perform kidney transplants, liver transplants, install artificial hearts, do bypass operations and use diagnostic equipment, only recently available, like MRIs and CAT scans. These expensive tools will grow in use.”

Awesome, huh? Hey Murray.. care to start guessing at where the greatest technical advancements have been developed? You really don’t think in Government labs, do you? Here in Canada? In our socialist health care system?

And you do realize something about economics too, right? That the more these tools grow in use, the cheaper they will be, right?

“Today we have a major problem with the new drugs that are prescribed by physicians. Most of the drugs are equal to, but no better than, the drugs available 20 years ago. Only one of 18 new drugs on the market yearly is of great significance.”

Well Murray, I really don’t know if your assertion is true or not. But it seems to me that in a free market, only those drugs that really work are the ones people buy. It’s one of those reasons why you don’t see too many Lada dealerships around Toronto anymore. And I’m not sure how this all fits into the stuff about politicians being too scared to make the necessary changes in our health care system. Care to explain?

“I suggest that duplicate drugs not be covered by the government drug plans, but that the government give large tax break incentives to drug companies to continue research. Medical research in universities should be funded solely by government. When new discoveries are made by universities, the drug should be licensed to a major drug company.”

Ahhh… now I’m sort of seeing how you’re trying to link something up here.. but still not quite sure about it all though. I have no idea what you mean by “duplicate drugs” and I also have no experience with any government drug plans.

So, are you suggesting a government drug plan that includes me? Cuz… I really don’t want much part of it.

I do agree with tax breaks to drug companies.. But then I agree with tax breaks to everyone. But this thing about “Medical research in universities should be funded solely by government” bewilders me. Are you suggesting Murray, that I should not be allowed to give any of my own money for medical research to a University? Would you care to say why taxpayer money is better than say… Mr. John Molson’s money? You’re getting a bit bizarre here, Murray.

And how excactly do you propose to licence new discoveries to drug manufacturers? The cheapest drug manufacturer? Or the one that has the best quality control? Or.. one of Prime Minister Martin’s friends?

“To make an omelette you have to break an egg. To improve the health-care system you have to find ways to compensate for the higher cost of high-tech health care and an ever- increasing number of seniors without lowering the standards of care.”

Well, I never did expect a pharmacist to know much about logic and false analogies. Especially one writing for the Toronto Star. But I fail to see how making omelettes has anything to do with the health care system. But to be fair to you, your analogy would be better if you had said something like, “To make a better omelette, you have to find ways to keep all your eggs in one basket without breaking any, and without lowering the quality of the omelette.”

Which I’m sure you know is impossible.

“I was a pharmacist before I retired and over the course of my professional life I must have advised thousands of people about their minor ailments, coughs, colds, allergies, hemorrhoids, headaches, etc. That is the bulk of the work done by general practitioners. You cannot lower the fee for general practitioners but you can, over a reasonable period of time, phase out the simple work they do, and replace them with nurse practitioners and pharmacist practitioners at a much lower cost.”

Well Murray. I’ve got news for you. You CAN INDEED lower the fee for general practitioners. In fact, you’re very example shows this. If a bunch of people came to you for advice, and a GP wanted them to come to them instead, they’d have to compete with you, right? And maybe give away some free services or something? Or reduce their bill in a free market system if the Pharmacist was able to treat minor ailments, and the doctor was sitting there all alone in his office, not making any income?

You’re also forgetting that perhaps some GP’s only want to do simpe work and that’s all they’re really good at. Other GP’s want to do more than simple hemorrhoid examinations. You are suggesting that all GP’s are created equal. And this crap, Murray, as I’m sure you already know.

“These people would be the entry into the system and when the problem is beyond their expertise they would send the patient to a general practitioner who would now exist in far fewer numbers and the general practitioner, in turn, would recommend a specialist, if necessary.”

So, what you are saying is you want to remove my choice of whether I discuss my hemorrhoids with a doctor in a private office, or a pharmacist while standing in a line-up with my neighbours around, buying their Paxil, Ritalin, and jock itch medications?

“As they say, the devil is in the details, but a system devised by people can be adjusted by people. The courses of study in the university for these newly enhanced professionals would have to be changed to reflect their new jobs. It is not inconceivable that nurse and pharmacist practitioners could work together based in a drug store setting.”

Hahahahahahahaha. Who are you suggesting devised our present system, Murray? Aliens? Non-people?

And boy, from some strong libertarian quotes above, you’re almost seeming communist on us. We’re going to force people to study subjects in University they have no desire to study? We’re going to tell them what their jobs must be?

“Small remote communities in Nova Scotia on Brier Island and Long Island have shown the way. They were unable to get a local doctor and eventually settled on a nurse practitioner, Kim Lamarche, and paramedics. She works in conjunction with physician Roy Harding in Digby. And to quote Lamarche “they now have the best health care they have ever had.”

You mean.. small remote communities couldn’t depend on so-called universal medical care… that sacred cow in Canada…, just isn’t working in remote communities? And maybe they do have the best they have ever had.. but that still might not be anything to write home about.

Sorry Murray… but boy oh boy am I disappointed. I’d love it if you read the quote you provided one more time:

“In a bureaucratic system, increase in expenditure will be matched by a fall in production.” You cannot overspend your way into better health care.”

It’s about bureaucracy, Murray. And no free choice.

“The question of public vs. private health care is always present. If you have both systems in one country “money talks” and people with money will get better service. If you can lower costs by using less expensive personnel and medicines and increase services, there will be no need for private health care. People do not go to the U.S. for better care, but go for faster care.”

Come on Murray… everyone will get better service, not just a few rich folk. Free enterprise will guarantee this.
I really don’t know if there is better service in the U.S., but ‘faster’ also equates to better, most of the time.

“The changes must come carefully and slowly to create as little dislocation as possible, but if we can save money as easily as we spend it, we all will have a better health-care system.”

Are you sure about this?