HEALTH CARE

Polly and I just returned from Mayo Clinic and our annual medical review. Among other things, I had an MRI on Thursday morning. The results were up on on my doctor's computer screen by the time I met with him at 4:30 in the afternoon.

That experience highlighted the impact of an email I received tonight linking to a You Tube video entitled "A Short Course in Brain Surgery." It's the story of Lindsey McCreith, a retired New Market, Ontario body shop owner who suffered headaches for some time before having a seizure. His family doctor suspected a brain tumor and counseled him to have an MRI of his head.

In Canada, only the government can pay for health care. And only government makes the appointments. Mr. McCreith was told it would be four months before he could get in for the MRI. He couldn't wait, so he crossed the border to Buffalo, New York and got an MRI within days. Armed with proof that he had a brain tumor the size of a golf ball, Mr. McCreith returned to Ontario only to learn that surgery could not be scheduled for four or five months.

Of course, he could petition the Ministry of Health for emergency consideration. And if they turned him down, he could appeal. But a little inquiry proved that the bureaucratic process would take longer than waiting for the surgical appointment.

So he returned to Buffalo, and within a week had the tumor removed. The doctors told him that if he had waited much longer, he would probably not have survived the year.

It's not a strong endorsement for the Canadian health care system in an election year when candidates in the United States are touting their plans for assuring health care for all Americans.

It's easy enough to give rousing speeches about the great number of Americans who don't have health care insurance. About universal health care. About the escalating costs of medical and hospital services. But just endorsing a goal doesn't get the job done. There has to be a plan, a strategy, based on realistic premises and solid research; a plan which is founded in common sense and sound economic principles.

I haven't heard anyone say that one of the primary causes of the phenomenal rise in the cost of health care is the very fact of widespread health insurance. Economics 101 should teach us that if the right to obtain medical services is separated from the duty to pay for them, the demand for medical services will go up. And when demand goes up, price goes up.

Add in the factor of limited supply. The Liaison Committee on Medical Education, which accredits medical schools, has strict regulations limiting the expansion of medical schools. There are only 125 accredited medical schools in the United States. There were 160,00 medical schools in 1907.

US medical schools graduate about 16,000 doctors each year. That number has been constant for over two decades. There are 20,000 first year residencies available each year. Where do the other doctors come from? Overseas. Pakistan. India. The Middle East. The number of students in American medical schools preparing to become primary care physicians is going down.

Thirty five years ago, I founded the Thomas M. Cooley Law School on the principle that every college graduate who wanted to become a lawyer ought to be given the chance to try. Today Cooley is the largest law school in the United States. Maybe it's time for someone to start a medical school with a similar vision.

Enough for now.