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Thursday, August 27, 2009


Dear Washington Post Editor:
In his article of August 4 ("For Doctors, Rationing Care is Standard Practice"), infectious-disease Dr. Manoj K. Jain's thesis is that America is "rationing care, just like the Canadians and British, with long wait times." Americans would do well to understand that Dr. Jain is way off base!!! Canadian and British health-care rationing differ in both degree and type from the "rationing" that occurs in the United States.

Dr. Jain shows no appreciateion for the extreme severety of rationing in Canada or Britain as compared with the United States. Dr. Jain does not mention that, in terms of availability of health care technology per 100,000 of population, of the 29 member OECD nations, Canada ranks dead last!!! Dr. Jain does not mention that for Canadians, it is easier to get an MRI for one's dog than for one's self. Nor does he mention that, while 40% of Oregon's hospitals can offer transplant services, in nearby British Columbia the figure ZERO percent. Nor does Dr. Jain mention that while 40% of Oregon hospitals can save your life with coronary balloon angioplasty, only 1 in 10 British Columbia hospitals can. Nor does he mention that, by the Canadian government's own admission, 20-30% of Canadians in queue for coronary bypass surgery have grown too unstable to tolerate the surgery, while waiting. That doesn't count those who have been removed from the queue because they died while waiting. The Canadian and British health care systems are designed to ration health care by preventing the existence of technological equipment, facilities, and specialists. In the United States, on the other hand, what Dr. Jain calls "rationing" relies much more on the very sort of case-by-case evaluation-of-benefit that Dr. Jain actually describes in his article.

Canada's single-payor health care system is a severe disaster for those who are actually sick!!!That is why Canadians spend a billion dollars per year for US health care. Canadian and British health care rationing differs in both degree and type from rationing that occurs in the United States. For Dr. Jain to equate United States and Canadian/British health care rationing shows a fundamental lack of understanding.

2009 "100 Most Outstanding Nurses" Award, Washington, DC
Director, Health Professionals for Meaningful Change

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