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MUNK Debateа–Аjune 7, 2010 Rudyard Griffiths: I'd Like You to Join

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MUNK Debateа–Аjune 7, 2010 Rudyard Griffiths: I'd Like You to Join MUNK DEBATE – JUNE 7, 2010 Rudyard Griffiths: I’d like you to join me in welcoming our pro debaters, Senator William Frist and Dr. David Gratzer. Bill and David, come on out. William Frist is a nationally recognized heart and transplant surgeon, and a former majority leader of the U.S. Senate. Many of you will have seen him on television in the immediate aftermath of the Haiti earthquake, delivering primary care to the wounded and critically ill. Healthcare runs deep in the Frist family. His brother is currently operating the world’s largest health facilities company, a multibillion dollar enterprise in the United States with 173 hospitals and 107 surgery centres in 20 states. He is currently a professor of business and medicine at Vanderbilt University. David Gratzer, a practicing physician in both Canada and the United States, is a graduate of the University of Manitoba with post graduate medical training at the University of Toronto. He works here in the city of Toronto with patients suffering from severe mood disorders and he’s published widely in academic press. More important to us, he’s also a best selling author, a winner of the Donner Book Prize and a fellow at the prestigious Manhattan Institute in New York City. I think it is safe to say he is one of a few but true cross­border healthcare experts. Let’s get our second team of debaters onto the stage, our con debaters, Governor Howard Dean and Dr. Robert Bell. Howard Dean is the former Democratic National Committee Chairman, a presidential candidate ­­ none of this will forget that campaign ­­ a six­term governor of Vermont and he’s a physician to boot. This is one talented guy. He’s distinguished himself as one of America’s most effective and innovative campaigners for social justice issues including universal healthcare, and a sign of his commitment to tonight’s debate is that when weather cancelled his flight from Vermont he drove all the way from Burlington to be here this evening. Dr. Robert Bell is known to many in this hall. He is the President and CEO of the University Health Network, which is Canada’s largest research hospital encompassing Princess Margaret Hospital, Toronto General Hospital, and Toronto Western Hospital. An internationally recognized orthopedic surgeon, a clinician, a scientist and an educator, Dr. Bell has helped revolutionize cancer care in Ontario and achieved reductions in wait times that are the envy of many of his peers in other provinces. I’d also like to add that as a sitting CEO and hospital administrator we thank him personally for participating in this very public discussion. So, down to business. I’m going to call on Senator Bill Frist for his opening statement. WF: Thank you Rudyard. It’s an honour to be here tonight and I think the real goal here is to see the contrast, for you to learn, for us to have fun, so thank you for that opportunity. I’m speaking to the 83% of you who are willing to change your minds, not the other 17%. You know, it’s been a fascinating year in the United States. President Barack Obama pulled off what most Americans thought would be impossible. That was to propose, to help legislate and ultimately pass a healthcare bill against great odds and in a very partisan way, which is unusual for big social legislation in America. He also managed to pass a bill that extends coverage towards the Canadian ideal of universal coverage. Historically this has been a very real defect in our system. In the past sixty years, presidents and others had tried to change it. The one thing it did not do was lower the cost of healthcare. We’ll come back to that, because both you in Canada and we in the United States absolutely must address it, or at least lower the cost curve, the growth of healthcare over time. That bill does nothing, or does very little in that regard. Throughout the year long debate, however, Canada was placed out there as an option, as a model of the single­payer, centralized control position. What is important, and hopefully tonight you’ll understand why, is that the model of a single­payer system was totally rejected by the president of the United States, by the Democratic and the Republican leaders in the United States Congress, by the Democratic and the Republican leaders in the United States Senate and by the American people. Why? It was rejected because if you get sick you want to be in America. We’ll come back to expectations, but part of what’s in the American psyche is not to have politicians ­­ and you’ve got a couple of former politicians up here ­­ or bureaucrats somewhere else coming in and limiting in some way what kind of healthcare you can have for your daughter who is dying of leukemia. Just that whole concept of having somebody else up there controlling a single spigot of resources that dictates convenience or whether you can get to the best specialist, is simply something with which the American psyche is not comfortable. Reviewing Canadian press coverage you get a pretty dismal picture of America and again, I’m not going to change that, especially with the 17%. I think you are probably going to stick with what you believe. But I do want you to understand a little bit about how a pluralistic system works and that it is rich and robust and that is has benefits and advantages. Our system is part socialized ­­ our veterans’ system – and is single­payer for a large number of people through Medicare. I’ll come back and explain our Medicare and Medicaid in a little bit. If you’re really sick, we are the undisputed leader in biomedical research. We have a robust arsenal of prescription drugs as part of our Medicare plan. We have the best diagnostic and treatment technology in the world. And the good thing about it for the overwhelming majority of people is that it can be delivered more conveniently and with more certainty in the United States when you need it. A quick primer on American healthcare: we’ve got a system that has about 42 million people on Medicare which is a single­payer system run out of Washington D.C., with lots of price controls. We have a Medicaid system that has 47 million people. It’s for low­income people and not as complete as it should be. The new legislation adds another 16 million people to that over the next nine years. We have socialized healthcare in our system of veterans’ administration. And then we have 170 million people out there who get private healthcare insurance through private plans. The uninsured in America we’ll come back to later. Today there are 46 million uninsured, 30 million are hardcore, completely uninsured. Now, it’s important to note that about 15 million of that 46 million make more than $55,000­60,000 a year and simply choose not to have healthcare insurance. If they need it they’ll go out and buy it. My life as a heart and lung transplant surgeon really introduces the single most important thing that would be lost if we went to a single­payer system and that is our capacity to innovate. Our capacity to innovate is funded in large part because of this environment that is out there, an environment in which we do spend more on our healthcare and in which we have a for­profit motive. It is a virtue, not a vice. In America we just simply put a high value on innovation and it is part of that American spirit and that vibrant private sector makes it happen. What’s the evidence? Better innovation, better technology, 18 of the last 25 Nobel laureates, 32 U.S. companies have developed half of all major new medicines introduced worldwide and Americans played a key role in 80% of the most important medical advances over the last 30 years. We’ll come back and we’ll talk more about innovation and technology. In America today you have access to the highest technology, the greatest biomedical research in the world. RG: Senator Frist that was exactly six minutes on the nose. Your years in the Senate have put you in good stead. I’m now going to call on Bob Bell for his opening comments. RB: Thank you Rudyard. Let me take a moment to thank the Munk Debates and the Aurea Foundation for the opportunity to represent the hometown team in this debate. A big thank you to Senator Frist and Governor Dean for entertaining us so well at the Peter Munk Cardiac Centre today and thanks to Dr. Gratzer for making this trip home to Toronto, even though, David, you’re clearly here to argue the wrong side of this debate. Arguing against getting sick south of the border begins not with medical statistics but rather by comparing bankruptcies in our two countries. Americans are nearly three times as likely to become bankrupt as Canadians and the reason is medical bankruptcy. David Himmelstein wrote in the American Journal of Medicine in 2009 that 62% of American bankruptcies were caused by an inability to pay medical bills. Surprisingly, he found that three quarters of medical debtors had health insurance that proved inadequate to pay the bills in the face of a serious illness. Nearly all medical statistics show better health outcomes in Canada. Johns Hopkins is an esteemed medical university in Baltimore and their statisticians have compared national health results in our two countries using Organization for Economic Cooperation and Development data.
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