After being shot by would-beassassin John Hinckley, PresidentRonald Reagan jokingly askedhis emergency medical team if they were"all Republicans." When former PresidentBill Clinton ended up in the operatingroom (OR) for a quadruple coronarybypass in September, Craig Smith, MD, hissurgeon, was a staunch Republican—anda $2000 contributor to President GeorgeW. Bush's reelection campaign toboot. Dr. Smith is chief of cardiothoracicsurgery at Columbia University MedicalCenter and performs more than 350 heartoperations every year. The 1977 CaseWestern Reserve medical school graduateexpects Clinton to make a full recovery.
Although politics play no role in theOR, some health care experts point outthe irony in the speed with which the58-year-old Clinton was diagnosed andtreated. After complaining of chestpains and shortness of breath, Clintonsaw a cardiologist the same day, had anangiogram, was admitted to the hospitalthe following day, and had bypasssurgery 2 days later.
Under the Canadian health care system,which is much like what theAmerican system would look like if theClinton-backed Health Security Act of1994 had passed, the average wait tosee a cardiologist is 24 days, accordingto the Fraser Institute (www.fraserinstitute.ca), a Canada-based public policythink tank. If the patient needs urgentbypass surgery, there's another 15-daywait on top of that. If the surgery is notconsidered urgent, the additional waitaverages 75 days.
And under a single-payer system likeCanada's, it's less likely a patient wouldbe able to opt for a prestigious hospitallike Columbia Presbyterian. Basically,the problem with government-subsidized"free" medical care, some healthcare economists say, is a surge indemand, which usually ends up swampingthe existing system's ability to providecare and the government's abilityto pay for it. The customary answer ishealth care rationing, which translatesinto the long waits that Canadiansexperience. And long waits can be akiller—the Fraser Institute cites severalstudies that show longer waits for treatmentcan result in a higher risk of heartattack and death.