Opinion

Bill loves American health care

With President Obama hoping this week’s “bipartisan summit” will move his health-care bill out of the ICU, it’s worth taking a look at a recent high-profile operation — the heart work done on former President Bill Clinton.

Clinton, of course, got the best of care — a cardiac stent (a tiny metal cylinder) coated with a drug to help keep his artery open. Recent studies in the New England Journal of Medicine and elsewhere have shown that these drug-eluting stents are more effective than bare metal ones.

But they cost two-to-four times more — and the technology is relatively new. That combination has left government-run health-care systems slow to adopt them. The disparity between the US and Canada is striking.

Per capita, our neighbors to the north receive only half as many coronary interventions. And only 30 percent of the stents placed in Canada are drug eluting, compared with a whopping 80 percent in the United States.

So a Canadian cardiac patient is less than a quarter as likely as an American to be outfitted with the kind of state-of-the-art stent that Clinton had.

In Canada, land of single-payer health insurance, you’re also less likely to get the stent as soon as the need is clear — especially in western provinces where resources are extremely limited and access is spotty. In Edmonton, Alberta, the wait for a cardiac procedure is routinely three to four months. In many areas of western Canada, less than half of angioplasties and stents are done at the same time as the original angiogram, a big waste of time and resources.

Canada has been attempting to deal with this problem of excess delay and inefficiency by introducing a database-driven system that assigns scores based on urgency. But many American cardiologists shudder at exactly this kind of solution — a federal system for deciding who needs an urgent procedure and who doesn’t. And if you were to think that rationing cardiac care is a way of saving money, you’d be dead wrong. An Austrian study just published found that the cost of waiting dramatically increases the average cost of treatment per patient.

The record of the last half-century is unmistakable: Government-dominated health sectors don’t innovate as fast, and they resist the latest discoveries because they “see” the costs up-front, and are slow to accept the benefits.

Any of the ObamaCare bills would push us in Canada’s direction, with policymakers looking hard to find overly simplistic solutions to justify lower costs for cheaper technologies. Indeed, some US “experts” are already brandishing a single 2008 study, known as the COURAGE trial, that seems to undermine the value of stents.

But ask any of the one million US patients who have received a stent over the last year if they think the capital investment that companies have made on evolving stent technology has been worth it. Perhaps even the former president would agree to the cost/benefit of stenting, even as he’s championing a form of health care that could take that routine option away.

Marc K. Siegel is an internist in New York and a Fox News medical contributor.