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How Nasty Things Spread
Sun-Times columnist Mark Steyn has some interesting ideas about health care. Back in Chicago late last Sunday night after two and a half weeks away, I opened the Sun-Times to read the Kerry endorsement, then spotted the Mark Steyn column a few pages on. Steyn, his usual cocksure self, was ridiculing John Kerry's position on medical issues. "So this is no time to vote for Europhile delusions," he wrote. "The Continental health and welfare systems John Kerry so admires are, in fact, part of the reason those societies are dying." Steyn, a Canadian who lives in New Hampshire, sneers with the best. "As for Canada, yes, under socialized health care, prescription drugs are cheaper, medical treatment's cheaper, life is cheaper," he went on. "After much stonewalling, the Province of Quebec's Health Department announced this week that in the last year some 600 Quebecers had died from C. difficile, a bacterium acquired in hospital. In other words, if, say, Bill Clinton had gone for his heart bypass to the Royal Victoria Hospital in Montreal, he would have had the surgery, woken up the next day swimming in diarrhea and then died. It's a bacterium caused by inattention to hygiene -- by unionized, unsackable cleaners who don't clean properly; by harassed overstretched hospital staff who don't bother washing their hands as often as they should. So 600 people have been killed by the filthy squalor of disease-ridden government hospitals. That's the official number. Unofficially, if you're over 65, the hospitals will save face and attribute your death at their hands to 'old age' or some such and then 'lose' the relevant medical records. Quebec's health system is a lot less healthy than, for example, Iraq's." This interested me enormously. At the beginning of October I'd never heard of Clostridium difficile -- or "C diff," as nurses call it. But then my mother in Saint Louis contracted the infection -- in a clean, cheery Lutheran convalescent home far from the squalor of socialized medicine -- and died. My sister, who lives in Vancouver and isn't an ardent foe of Canada's health system, arrived in Saint Louis with a packet of information on C. difficile, including an alarming article on the Quebec outbreak published just that morning, October 22, in Canada's National Post. Dr. John Marshall, a professor of surgery at the University of Toronto whose study of C. difficile was about to be released, told the Post that overuse of antibiotics was destroying the natural defenses elderly patients had against the infection. He predicted that his research could lead to what the Post called a "watershed change" in the use of antibiotics in intensive-care units. Nowhere in the article did Marshall or anyone else suggest that the rash of deadly C. difficile cases could be blamed on socialized medicine. Moreover, a second article provided by my sister reported the claim of an infection-control specialist in Montreal that the "epidemic strain" of C. difficile plaguing his city had shown up earlier in the U.S. and probably originated there. So was Steyn drawing on facts, intuition, or ideological shamelessness? I e-mailed him and got a prompt response from his representative, Tiffany Cole. "Why is there such a lack of hygiene in Quebec and Canadian hospitals?" Cole e-mailed me back. "Mark wrote on this once before in relation to the fact that Toronto was the only North American city to get a SARS outbreak. . . . Mark also adds, if you're gynecologically inclined, you may also wish to look into the women in Labrador who contracted chlamydia from their hospitals. Mark's contention is that basic hygiene becomes a problem in government run health systems." I called Doctor Marshall and began reading Steyn's column to him. "That's absolute hogwash!" he declared before I'd finished. "Canadian medical standards are on average every bit as high as American medical standards. It has nothing to do with the structures of the health-care system." I read him Steyn's conclusion: "One thousand Americans are killed in 18 months in Iraq, and it's a quagmire. One thousand Quebecers are killed by insufficient hand-washing in their filthy, decrepit health care system, and kindly progressive Americans can't wait to bring it south of the border. If one has to die for a cause, bringing liberty to the Middle East is a nobler venture and a better bet than government health care." "That's the most outrageous, raving poppycock I've ever heard," said Marshall. "Infection-control procedures do play a role, but I'd wager there's no significant difference between Canadian and U.S. hospitals. That is just so far over-the-top it's almost not worthy of commentary. I have a sense this is a man whose thought processes are a little bit out of control." Tiffany Cole told me, "Mark has lived under the very different health systems of Canada, the UK and the US and he knows which he prefers." But one can live under the American system in different ways. I suppose what you think of it depends on whether it shields you or grinds you down. My mother was too sick to be told that the cheery convalescent home she'd been brought to wanted to kick her out because she wasn't convalescing and therefore Medicare was about to stop paying the bills. To keep her where she was, we children promised to pay for her care out of our own pockets. |
