Natasha Richardson/Canadian healthcare.

First and foremost, my sympathies to Natasha Richardson's family. Regardless of what was or wasn't done, she still lost her life. :-[

But, the question I have that struck out in an article I read was this;

"Our system isn't set up for traumas and doesn't match what's available in other Canadian cities, let alone in the States," Tarek Razek, director of trauma services for the McGill University Health Centre in Montreal, which represents six of the city’s hospitals, told the Associated Press. Montreal and its suburubs, the second largest urban region in Canada, has a population of more than 3.6 million. Richardson was treated in the intensive care unit at Sacre-Couer and it is believed her husband, Liam Neeson, first saw his wife after her fall there sometime Monday night after abruptly leaving a Toronto film set.
http://www.people.com/people/package/article/0,,20266545_20267163,00.html?xid=rss-topheadlines

If the US gravitates towards a national healthcare will we also lose trauma patients?

 

You did see that around 50 thousand people die of this every year, right?

Nationalizing health care will not fix the problem, it will add a tremendous load to an already outdated and dysfunctional system.

In my area, 2 babies died while in the hospital last week, from infections. Even with national healthcare, babies will die.
Infections will happen. Trauma will still happen.

Nationalizing will bring a lot of patients into the systme but will not bring the corresponding amount of healthcare workers to look after them. That might be a problem.
And we haven't even addressed the cost of implementing that system.

For me, that's a big disconnect.

 

Wasn't she flown from Canada to a New York hospital?

Sparrow

 

I thought I heard that paramedics came but were turned away and never saw her and that the problem was not unvailability of health care but that the situation epidural hematoma was not recognized til too late because she felt ok initially as many patients with this problem do. At the present in the US ER's are full of uninsured trauma patients. That is not where the new load will be. Also, for better or worse, I do not think any of the plans under consideration are similar to either the Canadian or British plans. I am sure there will be tradeoffs but I don't think it will be in the trauma care area. Whether or not we have universal health care in the near future there is going to be health care reform (read cost containment) because the current system in the US is breaking the bank and companies cannot support it any longer and are supporting changes.

 

From what I understand listening to the news, she and her companions waived off the first responders and emt's help. Therefore, she did not go to the ER immediately. On CNN a day or so ago, a neurologist called her type of injury, the "talk and die" injury. Someone can appear to be entirely normal after the accident, then in a few hours afterward experience life threatening symptoms when it is basically too late. Apparently, this is what happened here. If she had gone to the ER, had an ER doctor examine her, had a ct scan and x-rays, it would have increased her chances dramatically. She could have been in surgery within an hour or 2, anywhere, and she would most likely have not passed away at such a young age.

 

Amberini: I have a major disconnect with Universal Healthcare.
As Sparrow stated, she was flown from Canada to the US for further healthcare.
If the US healthcare is in shambles, why was she not treated in Canada?
I am by no means, trying to start a debate, I am just curious as why she wasn't treated in Canada?
Was it because of her wealth or the healthcare of the US?

 

Read my above post Toni. She did not accept immediate treatment or observation in an ER. Doesn't matter if it was in Canada or the U.S. By the time she got to a U.S. hospital it was too late. If she had accepted immediate ER treatment, in Canada, it could possibly be an entirely different outcome. This story has nothing to do with socialized healthcare, the pros and cons of it. I'm not starting a debate either. Just stating the facts as I understand them.

 

She or a family member chose US healthcare over Canadian national healthcare.

Toronto: http://www.trauma.org/archive/resour...unnybrook.html
Distance b/w Toronto and Quebec: http://www.timeanddate.com/worldcloc...Fp1=250&p2=189

Distance b/w Quebec and NY: http://www.timeanddate.com/worldcloc...?p1=189&p2=179

It's the same amount of distance, again why take her to NY if Nationa Healthcare is the answer to the US healthcare crisis?

 

She declined immediate help from first responders. Probably cost her..... her life.

 

Of course not! Who would want to debate the relative merits of the Canadian Health Care System in such a tragic situation as Ms. Richardson’s death?

I also wondered why she was transferred to a US hospital. Was it a family decision? Were there medical considerations at play?

BTW, the Canadian system would never, never, never throw someone out of the hospital because they are wealthy or poor.

To clear up some comments on the Canadian system, it is not a nationalized healthcare system. It is a comprehensive and universal healthcare system that has a single payer (provincial governments). The results speak for themselves: lower costs and longer life. It is not a low grade system.

I do not think Canada’s hospitals will ever have the full trauma capabilities of a major US hospital. A good friend of mine used to teach medical students at the University of Windsor, just across the border from Detroit. He told me that he would take his students to the Detroit hospitals to learn trauma care because of the higher rate of trauma victims from car accidents, shootings, etc.

As far as I know, the US is not considering a Canadian styled healthcare system. I would not worry about loss of trauma care facilities. If there is a demand for it and if you are willing to pay for it, it will exist.

Joe

 

Pluto:
I agree with that 100%.
I hope they make helmets mandatory for all ski slope sports.
Also, employ a nearby helio. for emergencies.

Wobble:
I guess we'll probably never know why she was transferred from Canada to NY.
Toronto has a major trauma center, maybe they wanted her closer to home and chose NY?

Honestly, why do you think " do not think Canada’s hospitals will ever have the full trauma capabilities of a major US hospital."?
I am honestly curious.

 

It is not as if there is one kind of universal health care. All over Europe and Japan as well as Canada are universal health care systems that are completely different from one another just as a US system, should we ever get one, would be completely different from all of them. If you read about them, you find that in each case, as each country decided to to go to universal care, they built on the system already in place in that country, and that is why they are all so different.

The problem with US care is not that there are not fabulous clinics in the US, of course there are. The problem is, they are not available to everyone. THe trauma centers are in fact one of the few parts that are available to everyone in the US. It's the rest of the care that is not. The uninsured either cannot access it or if they do, they end up in bankruptcy from it which is not good for their creditors or them or the country. In some cases, even the insured end up in bankruptcy due to a major illness in the family. But putting aside whether we should or should not go to a universal system in the US, the fact is at present that the health care spending in the US is more than 16% of the gross domestic product and rising. The economy simply cannot support this much longer. In Europe it is 10-12%. Yet stats show the infant mortality rate in the US is much worse than in most developed countries. The following figures are for deaths per thousand in live births and children under 5.

63 United States 6.3 7.8
164 New Caledonia 6.1 8.7
165 Cyprus 5.9 6.9
166 Brunei 5.5 6.7
167 Channel Islands (Jersey and Guernsey) 5.2 6.2
168 Cuba 5.1 6.5
169 New Zealand 5.0 6.4
170 Portugal 5.0 6.6
171 Italy 5.0 6.1
172 Ireland 4.9 6.2
173 Canada 4.8 5.9
174 United Kingdom 4.8 6.0
175 Slovenia 4.8 6.4
176 Israel 4.7 5.7
177 Netherlands 4.7 5.9
178 Luxembourg 4.5 6.6
179 Australia 4.4 5.6
180 Austria 4.4 5.4
181 Denmark 4.4 5.8
182 Germany 4.3 5.4
183 Spain 4.2 5.3
184 France 4.2 5.2
185 Belgium 4.2 5.3
186 Korea, South 4.1 4.8
187 Switzerland 4.1 5.1
188 Czech Republic 3.8 4.8
189 Finland 3.7 4.7
190 Hong Kong 3.7 4.7
191 Norway 3.3 4.4
192 Sweden 3.2 4.0
193 Japan 3.2 4.2
194 Singapore 3.0 4.1
195 Iceland 2.9 3.9

So while the US has some of the most extraordinary health care facilities in the world, overall it does not do that well for the whole population.

Be that as it may, whether we choose a universal care system or not, there will be things done to contain costs or health care costs in the US, if the present system is not constrained, will bankrupt the country. So I think we can know that whether or not we get universal health care, we will have our benefits trimmed. If we get universal health care, we will all blame the government health care for that. If we don't, I don't know who we will blame but we'll find someone. The truth is, we are in a pickle and we have to sort it out which we will. We always do.

 

I personally think the family knew she was dying and they flew her home to be with family. :'(

 

June; I agree. A large part of the blame is that of illegals. Trust me, I lived 17 miles from an AZ border town from 2006-2008. I had to take my then 11 year daughter in for a broken wrist and the other then 8 year old for an appy, the wait was over 6 hours long and I asked the head nurse what the hold up was. She shook her head, but said they can not turn the illegals away. Another thing that amazes me is that people, even with insurance, clog the system with simple stuff such as the flu, ect. I understand it can be deadly for the elderly, but a lot of people expect a common fix and thus costs go up and valuable time is wasted.

 

And part of it is that when I had my last mri(s) to look for another acoustic neuroma, the bill was $3700 (of which my part was about $800). In Japan I think they cost $25 (seriously). It was a one hour procedure but somebody had to pay for that big fancy machine and the radiologist's school loans. It's not wrong, it's just how the system evolved here. We'll sort it out. But we'll all gripe (including me) along the way and then when we get it sorted out pretty soon it will seem like it was always that way and we will wonder why we worried so much. Have faith.

 

Another thing.......

I understand that doctors have to make a living here in the U.S. Most are not on salary. They have an awesome responsibility to us, their patients. They do hold our life in their hands. When you have to "go in", you in effect give your life to the doctor. I understand that they have to pay for their education, malpractice insurance, etc.
After my experience this past June of 2008, I wonder what is too much. Don't get me wrong, I appreciate the doctors' experience, their knowledge. My surgeon............ 12 grand for 8 hours of actual surgery (2 surgeries total), in addition to the hospital's charges. My pulmonologist, $200 everytime she stepped in my hospital room......... I don't quite know how that equates to their lifestyle, how it relates to me..... maybe he did 3 surgeries in one day............. anyway I'm rambling. I know healthcare is very expensive in the U.S. I wonder if it has to be that expensive....... how much of that doctor's bill went to his new Lincoln.......... his "toys".......... I don't begrudge their lifestyle..... Did I say I was rambling??? Yeah, I am. Healthcare is probably the most crucial topic in the U.S right now, alongside the economic problems........... I thank God that I have very good healthcare insurance or I would be in bankruptcy right now. 150 grand for my summer experience............. don't want to do that again, ever.

So, what's best.......... whatever ya got. I'm just thankful for the system I have here. I know, I've been rambling.

 

Agreed to both.

My 13 year old has to get her 4 wisdom teeth extracted. Without insurance, $2k, we have insurace, it's going to cost $600.
Now why it doesn't fall under medical is beyond me. Anyway, point is, she has Raynauds (circulation problem) and they couldn't get a vein for an IV.
So, I had to reschedule for an anatheisologist (sp) who is coming to the Oral sugeon's office.
Now the Oral surgeon doesn't have hospital priviledges, so, the ana. comes in the "under the table" at the Oral surgeon's office.
Trust me, I went rounds with billing with why I couldn't claim this on my taxes.
So, for him to come in and put her under for 20 minutes is going to cost us an additional $500.

 

I agree with Mya46 that it was a family decision to bring her to the US. I feel they wanted her to be seen by friends and family, especially her mother, before she passed. It was my understanding that she was already on life support before the transport and I just felt it might be easier to bring a person back into the states before they are deceased rather than after. Just my thoughts and I know I would have prefered for my daughter or parent have a visit from loved ones.

 

I'm not sure there is a good answer to the healthcare situation ANYWHERE. Now, if we could go back 50 years where people weren't so lawsuit happy and we actually appreciated what others did for us, then malpractice insurance wouldn't be so damn high- doctors wouldn't be required to see so many patients to make their "quota" (especially those that belong to the bigger groups). Doctors would go into the profession to actually take care of patients and not make the all mighty dollar and achieve prestige through their status.

I cringe when I hear reports that "if she was seen earlier, then she might still be alive" when referring to Miss Richardson. That might be the case, but can you imagine how that makes the family feel. It's too late for the what if's and what might have beens. It won't bring back this Mom/Daughter/Wife to her family.

I will say, with her status- it is more likely that the doctors would have been more thorough with her exam even if she came in prior to developing head trauma symptoms.... but I'm just going to address the system that I have worked in and even encountered as a patient.

When I worked ER, sometimes it would be crowded as can be. Patients were treated, not as they walked in the door- but on importance/significance of injury. Now, this is just theoretically speaking.... and not taking in consideration that Miss Richardson was a celebrity, but if the ER was packed and a patient came in with no symptoms and just reported that they fell down (they would not be a high priority). They would have to present with symptoms of vomiting/level of conscious change/severe headache (not something she initially presented with). We would take in patients that presented with chest pain, difficulty breathing first.
There is a good chance that a person would not come up and complain that they were having a headache once already being told to wait, so by the time she would be seen (if there was a back up in ER (which is most often the common case these days)- then her chances would not have been that great regarding survival. You also have to take into consideration what level of a hospital the patient is seen at. Some hospitals have to transfer brain injury patients to a level 1 trauma/brain hospital where there is a 24 hour neurosurgeon always available (that wasn't the case in the hospital that I worked at when I worked ER).... so even more time before the problem would have been treated.

I wish there were some good answers, the only thing I can say is be as proactive as you can with your healthcare and your families healthcare. And if possible, never leave a loved one in the hospital alone. Unfortunately we now live in the days of understaffing and insurance regulations (even on the good physicians we have left).

 

""And if possible, never leave a loved one in the hospital alone"" gulp : : In my case, I am it, there would be no one to look after me......... oh well........ opening my folder and working on my Will.

Sparrow