Alternatively, skiers should wear helmets. Helmets for everyone is quite a bit cheaper than CAT scans, helicopter ambulances, and neurosurgery for everyone.
Which may or may not have prevented this. Of course, it could have happened while not skiing as well. Should everyone wear helmets all the time?
Making a statistical argument on a sample size of one is not very useful. The valid question is this: How many Canadians per 100,000 die of subdural hematomas vs. how many Americans per 100,000?
I have no idea what the answer is and a day job which doesn’t involve researching this issue.
This is a perfect illustration of what happens in a universal care system. You get a well run, highly efficient general practitioner service but a poor and stodgy hospital service.
I’m all for the ounce of prevention/pound of cure philosophy but I also subscribe to the dictum of Shit Happens. For all those possibilities that accidents sometimes happen the former Boy Scout in me salutes 3 fingers and says, “Be Prepared”.
Sure, Jim, and if the major criterion here is economy, they could just have made her comfortable at the resort and let her die. That would be cheaper still, and certainly not inhumane by the standards of, say, 1950s medicine.
What’s overlooked in your little Stalinist calculus of death is that Natasha Richardson and Liam Neeson are wealthy. They could easily have afforded to pay for the air transport to a top-notch trauma center that would have saved her life. And I don’t doubt that they would have, gladly.
But she didn’t have that choice, because nasty people such as yourself in Canada decided it wasn’t her business to decide how much of her own wealth to spend on saving her life. It was the government’s job to decide what her life was worth — and they did, and it wasn’t worth the price of a helicopter ride. Too bad, Tasha. After all, statistically speaking, it was probably a reasonable choice. Why spend the money on saving one woman, when there are so many more socially useful places it could be spent? Bailing out you friends at Goldman Sachs, for example? Or some cool neato techno “green energy” boondoggles that, oddly enough, private investors haven’t been panting to buy into, the sods.
Now, interestingly, back here in the evil expensive US, my daughter suffered a very similar injury — a fall while in the mountains. No, she wasn’t wearing a helmet. One rarely does while merely walking about. But she hit her head and became altered. Just like Richardson. It was a two hours’ drive to the hospital down windy roads. Just like Richardson.
But fortunately, here in the US, you have choices. My choice was to call the FD, and they offered me the choice of a helicopter ride to the hospital. It landed on the mountain road, and she was in the ER getting a CAT scan of her head 40 minutes after the accident, instead of 3 hours, like Richardson. Problem solved.
The 20 minute helicopter ride cost me $2,000, and I paid it gladly. What’s a daughter’s life worth? I’m glad I had the choice. I’m sorry Liam Neeson didn’t have a similar choice, because dickheads decided he shouldn’t — for the greater good, of course.
I disagree with the characterization of “poor and stodgy hospital service.” Generally, I’ve found Canadian health care to provide excellent service – once you get into the treatment system! The shortcoming of the Canadian system is that we’ve pared down capacity to reduce costs. That works well much of the time, but as anybody who’s been to a grocery store knows, the average size of a line-up doesn’t reflect the way that lines tend to vary between 1-2 people most of the time, then suddenly jump to a line-up of 8 people in a matter of a minute.
I’m not sure how many Americans are aware of this, but there’s been a push among a lot of Canadians to create a parallel private health care system in Canada for a number of years. The idea is that if you want to pay to access health care faster than the public system permits, go for it – it would even take some pressure off the public system. Needless to say, this doesn’t go over well with the left wingers who regard universal public health care as the sine qua non of Canadian identity.
I have no idea what the answer is and a day job which doesn’t involve researching this issue.
If you don’t have the time to figure it out, why did you waste time posting the comment? I mean, your statisical argument discussion is not valid either, because it doesn’t consider the numerous means in which the damage occurs. The question posed in the NY Post is more along the line of, how many hospital’s have CT scanning equipment? If a Canadian hospital doesn’t have a CT scanning equipment, as the article suggest, then the only way to know if the cause of death was a subdural hematoma (had she died in Canda) is via autopsy or guess.
Making a statistical argument on a sample size of one is not very useful.
Neither is manufacturing straw men. I made no statistical argument.
Leland – my point is we’re arguing about the wrong thing here. One individual case proves nothing. I am sure that, here in the US, some number of hematomas are missed.
The valid question from a policy point of view is whether or not Canadian hospitals miss more hematomas (in particular) or emergency health problems (in general) then US hospitals?
I don’t have those numbers. Nor is Canadian care the only “socialized” medical system. In France, for example, one can buy private medical insurance and go to private hospitals or rely on the public insurance system.
Rand: The helicopter, CAT scan and neurosurgeon might not have saved her either. Falls can happen anywhere, but most of us don’t plan ahead to make sure we’re always in cellphone range, near a suitable helicopter landing area, and within chopper range of a trauma center. Some risks have to remain risks, but given the accident rate in skiing, putting on a helmet is cheap insurance.
It will be interesting to see if the ski area makes helmets mandatory. A Dartmouth student died after an accident in a beginner skiing class. Her parents sued the college, and one of the results is that all Dartmouth students now must wear helmets in skiing classes. Note: our Dartmouth Hitchcock Medical Center is a regional trauma center, with helicopter ambulances and CAT scan machines galore, but they couldn’t save this particular girl; a $60 helmet would have.
Carl: Ms. Richardson was free to travel with her own helicopter, CAT scan machine, and neurosurgeon; if she ever considered the idea, she wisely dismissed it as a poor use of resources, because the odds of her (or any one person) needing them were vanishingly small.
You aren’t asking for Canada to let her pay for those things, you’re asking for Canada to pay for them, and let her defray the expense a bit if they end up helping her. That’s a very different matter.
My brain bleed anecdote: A radiologist friend was doing some research for a paper, involving CAT scans of brain abnormalities. To have a “control” illustration for the paper he scanned his own head. When he examined the scan he was astonished to see a potentially fatal brain aneurism that might blow at any moment. He immediately scheduled surgery, and is fine today.
This happy accident may have saved his life. But that doesn’t mean that all of us should have our heads scanned every month, just in case. And Ms. Richardson’s sad demise does not mean that every town of 9,000 in Canada should get a CAT scan machine and access to a helicopter ambulance.
The availability of helicopters and CT scanners is the issue here – whether health care is socialized, private, or some mix is not the issue. If you are in a rural area in the USA when you suffer a head injury that requires immediate attention, if there isn’t a helicopter or CT Scanner immediately available, your ability to pay for one, and the health care system’s willingness to let you go private doesn’t really matter.
You’re really arguing that private companies will have a better distribution of expensive and occasionally life-saving equipment than public services will. You cite Canada’s desire for economy as a reason to think that. But private companies have a much greater incentive to think about the overall economic impact of their choices. The rap on government is that it is wasteful and inefficient, but in this case, a wasteful and inefficient distribution of helicopters and CT scanners is exactly what you say you want. Canada may or may not be too frugal (or poor), and private doctors and hospitals in the US may or may not have been economically savvy, but I don’t think the lesson you are drawing follows from the theory you hold. Certainly there are plenty of rural areas in the United States that are under-serviced.
Also, look at Carl’s story: he called the tax-funded fire department, not Joe’s private helicopter service. Some fire departments have helicopters, some don’t. I’m very glad Carl and his family were fortunate. But Carl’s story seems like 1) an advertisement for government services 2) a reason to subsidize fire departments that want to buy a helicopter but can’t currently afford it.
Ha! Jim, I didn’t your comment when I commented. We came to the opposite conclusion in the end regarding the need for small towns to have helicopters. You’re probably right, but I like technological preparedness, so I worked myself up and concluded “helicopters for everyone!”
Falls can happen anywhere, but most of us don’t plan ahead to make sure we’re always in cellphone range, near a suitable helicopter landing area, and within chopper range of a trauma center.
Bad argument. They weren’t skiing on some inaccessible slope (which oddly enough are usually only accessible by helicopters which weakens your argument even more). They were skiing at a resort. The resorts typically plan for emergenciess, at least in the US when they are held responsible for the health and safety of their patrons.
And Ms. Richardson’s sad demise does not mean that every town of 9,000 in Canada should get a CAT scan machine and access to a helicopter ambulance.
Yes, but we also don’t need to deny every town of 9,000+ in the US the ability to procure a CAT scan machine or a helicopter ambulance because the federal government doesn’ t consider it a priority or efficient. Rand’s argument wasn’t that Canada should have provided this to every town. It was that Canadian healthcare put limitations on the ability of this resort to provide adequate emergent care.
A free market of health care provides the most efficient means of distributing CT scanning machines and ambulance helicopters. Because the individual economic centers place their own priority on this equipment and procure or not procure based on this priority. At the federal level, such decisions are made once a year, and typically by individuals who will never be impacted by the decision.
By a strange coincidence, I was skiing last week (at Mt Hood, in Oregon). I read about Natasha Richardson’s injury right before we went to rent equipment. As it happens, my family usually wears helmets when skiing or snowboarding, but we have always rented. The ski shop was having a sale ($80 to buy vs $36 to rent for a week) so it was a no-brainer (oops, sorry, Natasha) and I now own a shiny red helmet. BTW ski helmet technology nowadays is fabulous — very adjustable and much more comfortable than messing with a hat.
After we got back to the condo we read that Richardson had died. I have to say it crossed my mind that letting a person with an epidural hematoma die in those circumstances seemed criminally negligent — and that someone would eventually have to take note that the Canadian health care system is not set up for timely care.
And all you folks who say, “tough cookies, she should have been wearing a helmet” have it backwards. If we all did exactly what we are supposed to, hardly anyone would need medical care. No traffic accidents, no HIV infections, no diabetes, no gunshot wounds, no lung cancer. Get a clue. The health care system exists to save us from ourselves. That’s why the richest country in the world spends so much on health care and has such poor health!
BBB
There are nine private MRI centers in Montreal. See here.
Facts are a very funny thing. It helps to use them in place of wild suposition and opinion.
Quoting some things I read elsewhere:
Richardson refused to wear a helmet and fell at 12:45 pm, refused treatment and turned away an ambulance , until calling again at 3pm. The paramedics took 30 minutes to stabilize her for transport. She was disoriented and vomiting. The Centre Hospitalier Laurentien has a CT scanner. She was operated on and suffered a stroke. She left for Montreal at 5 pm. Arriving at 6pm.
She was in the Centre Hospitalier Laurentien at Ste-Agathe, a 55 mile freeway drive to Hôpital du Sacré-Coeur de Montréal. Sacré-Coeur is one of the world’s best trauma centers, and it does have a helipad. When they decided she needed trauma care, they had ambulances parked ready to go take her to Sacré-Coeur immediately. If there was an chopper waiting, the flight would have taken 30 minutes, including rolling her to and from the helipads and starting the aircraft. But you don’t keep choppers at small hospitals, therefore add at least 15 minutes to bring one in. She was better off by ground and this is what they did.
Not having a helicopter rescue service is a provincial (equivalent to state) decision.
Fact is helicopter rescue service in the US is usually at the county level, at least in states the size of Canadian states.
“The idea is that if you want to pay to access health care faster than the public system permits, go for it – it would even take some pressure off the public system.”
And this is were Canadian hospitals are begin subsized to some limit by the U.S. health care system. When those people stack up 8 at a time then after a while the guy in 6 spot looks around and says, ‘Hey I could be in the U.S. in under x hours, I’ll just go there’. Because of this I’m willing to expect that relief in pressure on the Canadian hospital makes the experience better for those that do get through.
Look down in South America and you will find that despite their universal practitioner service the people with private coverage are the only ones that receive adequate hospital service.
“Fact is helicopter rescue service in the US is usually at the county level, at least in states the size of Canadian states.”
I was gonna say, around here if one fire department doesn’t have a helo then they sure as hell have the ability to get on the horn and get someone who does fairly quickly.
I’ve been to drag race tracks all around North Texas and I can’t tell you how many times I’ve seen a drive flown off in a helicopter — these are some back woods tracks even.
Alternatively, skiers should wear helmets. Helmets for everyone is quite a bit cheaper than CAT scans, helicopter ambulances, and neurosurgery for everyone.
Which may or may not have prevented this. Of course, it could have happened while not skiing as well. Should everyone wear helmets all the time?
Making a statistical argument on a sample size of one is not very useful. The valid question is this: How many Canadians per 100,000 die of subdural hematomas vs. how many Americans per 100,000?
I have no idea what the answer is and a day job which doesn’t involve researching this issue.
This is a perfect illustration of what happens in a universal care system. You get a well run, highly efficient general practitioner service but a poor and stodgy hospital service.
I’m all for the ounce of prevention/pound of cure philosophy but I also subscribe to the dictum of Shit Happens. For all those possibilities that accidents sometimes happen the former Boy Scout in me salutes 3 fingers and says, “Be Prepared”.
Sure, Jim, and if the major criterion here is economy, they could just have made her comfortable at the resort and let her die. That would be cheaper still, and certainly not inhumane by the standards of, say, 1950s medicine.
What’s overlooked in your little Stalinist calculus of death is that Natasha Richardson and Liam Neeson are wealthy. They could easily have afforded to pay for the air transport to a top-notch trauma center that would have saved her life. And I don’t doubt that they would have, gladly.
But she didn’t have that choice, because nasty people such as yourself in Canada decided it wasn’t her business to decide how much of her own wealth to spend on saving her life. It was the government’s job to decide what her life was worth — and they did, and it wasn’t worth the price of a helicopter ride. Too bad, Tasha. After all, statistically speaking, it was probably a reasonable choice. Why spend the money on saving one woman, when there are so many more socially useful places it could be spent? Bailing out you friends at Goldman Sachs, for example? Or some cool neato techno “green energy” boondoggles that, oddly enough, private investors haven’t been panting to buy into, the sods.
Now, interestingly, back here in the evil expensive US, my daughter suffered a very similar injury — a fall while in the mountains. No, she wasn’t wearing a helmet. One rarely does while merely walking about. But she hit her head and became altered. Just like Richardson. It was a two hours’ drive to the hospital down windy roads. Just like Richardson.
But fortunately, here in the US, you have choices. My choice was to call the FD, and they offered me the choice of a helicopter ride to the hospital. It landed on the mountain road, and she was in the ER getting a CAT scan of her head 40 minutes after the accident, instead of 3 hours, like Richardson. Problem solved.
The 20 minute helicopter ride cost me $2,000, and I paid it gladly. What’s a daughter’s life worth? I’m glad I had the choice. I’m sorry Liam Neeson didn’t have a similar choice, because dickheads decided he shouldn’t — for the greater good, of course.
I disagree with the characterization of “poor and stodgy hospital service.” Generally, I’ve found Canadian health care to provide excellent service – once you get into the treatment system! The shortcoming of the Canadian system is that we’ve pared down capacity to reduce costs. That works well much of the time, but as anybody who’s been to a grocery store knows, the average size of a line-up doesn’t reflect the way that lines tend to vary between 1-2 people most of the time, then suddenly jump to a line-up of 8 people in a matter of a minute.
I’m not sure how many Americans are aware of this, but there’s been a push among a lot of Canadians to create a parallel private health care system in Canada for a number of years. The idea is that if you want to pay to access health care faster than the public system permits, go for it – it would even take some pressure off the public system. Needless to say, this doesn’t go over well with the left wingers who regard universal public health care as the sine qua non of Canadian identity.
I have no idea what the answer is and a day job which doesn’t involve researching this issue.
If you don’t have the time to figure it out, why did you waste time posting the comment? I mean, your statisical argument discussion is not valid either, because it doesn’t consider the numerous means in which the damage occurs. The question posed in the NY Post is more along the line of, how many hospital’s have CT scanning equipment? If a Canadian hospital doesn’t have a CT scanning equipment, as the article suggest, then the only way to know if the cause of death was a subdural hematoma (had she died in Canda) is via autopsy or guess.
Making a statistical argument on a sample size of one is not very useful.
Neither is manufacturing straw men. I made no statistical argument.
Leland – my point is we’re arguing about the wrong thing here. One individual case proves nothing. I am sure that, here in the US, some number of hematomas are missed.
The valid question from a policy point of view is whether or not Canadian hospitals miss more hematomas (in particular) or emergency health problems (in general) then US hospitals?
I don’t have those numbers. Nor is Canadian care the only “socialized” medical system. In France, for example, one can buy private medical insurance and go to private hospitals or rely on the public insurance system.
Rand: The helicopter, CAT scan and neurosurgeon might not have saved her either. Falls can happen anywhere, but most of us don’t plan ahead to make sure we’re always in cellphone range, near a suitable helicopter landing area, and within chopper range of a trauma center. Some risks have to remain risks, but given the accident rate in skiing, putting on a helmet is cheap insurance.
It will be interesting to see if the ski area makes helmets mandatory. A Dartmouth student died after an accident in a beginner skiing class. Her parents sued the college, and one of the results is that all Dartmouth students now must wear helmets in skiing classes. Note: our Dartmouth Hitchcock Medical Center is a regional trauma center, with helicopter ambulances and CAT scan machines galore, but they couldn’t save this particular girl; a $60 helmet would have.
Carl: Ms. Richardson was free to travel with her own helicopter, CAT scan machine, and neurosurgeon; if she ever considered the idea, she wisely dismissed it as a poor use of resources, because the odds of her (or any one person) needing them were vanishingly small.
You aren’t asking for Canada to let her pay for those things, you’re asking for Canada to pay for them, and let her defray the expense a bit if they end up helping her. That’s a very different matter.
My brain bleed anecdote: A radiologist friend was doing some research for a paper, involving CAT scans of brain abnormalities. To have a “control” illustration for the paper he scanned his own head. When he examined the scan he was astonished to see a potentially fatal brain aneurism that might blow at any moment. He immediately scheduled surgery, and is fine today.
This happy accident may have saved his life. But that doesn’t mean that all of us should have our heads scanned every month, just in case. And Ms. Richardson’s sad demise does not mean that every town of 9,000 in Canada should get a CAT scan machine and access to a helicopter ambulance.
The availability of helicopters and CT scanners is the issue here – whether health care is socialized, private, or some mix is not the issue. If you are in a rural area in the USA when you suffer a head injury that requires immediate attention, if there isn’t a helicopter or CT Scanner immediately available, your ability to pay for one, and the health care system’s willingness to let you go private doesn’t really matter.
You’re really arguing that private companies will have a better distribution of expensive and occasionally life-saving equipment than public services will. You cite Canada’s desire for economy as a reason to think that. But private companies have a much greater incentive to think about the overall economic impact of their choices. The rap on government is that it is wasteful and inefficient, but in this case, a wasteful and inefficient distribution of helicopters and CT scanners is exactly what you say you want. Canada may or may not be too frugal (or poor), and private doctors and hospitals in the US may or may not have been economically savvy, but I don’t think the lesson you are drawing follows from the theory you hold. Certainly there are plenty of rural areas in the United States that are under-serviced.
Also, look at Carl’s story: he called the tax-funded fire department, not Joe’s private helicopter service. Some fire departments have helicopters, some don’t. I’m very glad Carl and his family were fortunate. But Carl’s story seems like 1) an advertisement for government services 2) a reason to subsidize fire departments that want to buy a helicopter but can’t currently afford it.
Ha! Jim, I didn’t your comment when I commented. We came to the opposite conclusion in the end regarding the need for small towns to have helicopters. You’re probably right, but I like technological preparedness, so I worked myself up and concluded “helicopters for everyone!”
Falls can happen anywhere, but most of us don’t plan ahead to make sure we’re always in cellphone range, near a suitable helicopter landing area, and within chopper range of a trauma center.
Bad argument. They weren’t skiing on some inaccessible slope (which oddly enough are usually only accessible by helicopters which weakens your argument even more). They were skiing at a resort. The resorts typically plan for emergenciess, at least in the US when they are held responsible for the health and safety of their patrons.
And Ms. Richardson’s sad demise does not mean that every town of 9,000 in Canada should get a CAT scan machine and access to a helicopter ambulance.
Yes, but we also don’t need to deny every town of 9,000+ in the US the ability to procure a CAT scan machine or a helicopter ambulance because the federal government doesn’ t consider it a priority or efficient. Rand’s argument wasn’t that Canada should have provided this to every town. It was that Canadian healthcare put limitations on the ability of this resort to provide adequate emergent care.
A free market of health care provides the most efficient means of distributing CT scanning machines and ambulance helicopters. Because the individual economic centers place their own priority on this equipment and procure or not procure based on this priority. At the federal level, such decisions are made once a year, and typically by individuals who will never be impacted by the decision.
By a strange coincidence, I was skiing last week (at Mt Hood, in Oregon). I read about Natasha Richardson’s injury right before we went to rent equipment. As it happens, my family usually wears helmets when skiing or snowboarding, but we have always rented. The ski shop was having a sale ($80 to buy vs $36 to rent for a week) so it was a no-brainer (oops, sorry, Natasha) and I now own a shiny red helmet. BTW ski helmet technology nowadays is fabulous — very adjustable and much more comfortable than messing with a hat.
After we got back to the condo we read that Richardson had died. I have to say it crossed my mind that letting a person with an epidural hematoma die in those circumstances seemed criminally negligent — and that someone would eventually have to take note that the Canadian health care system is not set up for timely care.
And all you folks who say, “tough cookies, she should have been wearing a helmet” have it backwards. If we all did exactly what we are supposed to, hardly anyone would need medical care. No traffic accidents, no HIV infections, no diabetes, no gunshot wounds, no lung cancer. Get a clue. The health care system exists to save us from ourselves. That’s why the richest country in the world spends so much on health care and has such poor health!
BBB
There are nine private MRI centers in Montreal. See here.
Not having a helicopter rescue service is a provincial (equivalent to state) decision. Ontario has a very large and well-established service.
Facts are a very funny thing. It helps to use them in place of wild suposition and opinion.
Quoting some things I read elsewhere:
Richardson refused to wear a helmet and fell at 12:45 pm, refused treatment and turned away an ambulance , until calling again at 3pm. The paramedics took 30 minutes to stabilize her for transport. She was disoriented and vomiting. The Centre Hospitalier Laurentien has a CT scanner. She was operated on and suffered a stroke. She left for Montreal at 5 pm. Arriving at 6pm.
She was in the Centre Hospitalier Laurentien at Ste-Agathe, a 55 mile freeway drive to Hôpital du Sacré-Coeur de Montréal. Sacré-Coeur is one of the world’s best trauma centers, and it does have a helipad. When they decided she needed trauma care, they had ambulances parked ready to go take her to Sacré-Coeur immediately. If there was an chopper waiting, the flight would have taken 30 minutes, including rolling her to and from the helipads and starting the aircraft. But you don’t keep choppers at small hospitals, therefore add at least 15 minutes to bring one in. She was better off by ground and this is what they did.
Not having a helicopter rescue service is a provincial (equivalent to state) decision.
Fact is helicopter rescue service in the US is usually at the county level, at least in states the size of Canadian states.
“The idea is that if you want to pay to access health care faster than the public system permits, go for it – it would even take some pressure off the public system.”
And this is were Canadian hospitals are begin subsized to some limit by the U.S. health care system. When those people stack up 8 at a time then after a while the guy in 6 spot looks around and says, ‘Hey I could be in the U.S. in under x hours, I’ll just go there’. Because of this I’m willing to expect that relief in pressure on the Canadian hospital makes the experience better for those that do get through.
Look down in South America and you will find that despite their universal practitioner service the people with private coverage are the only ones that receive adequate hospital service.
“Fact is helicopter rescue service in the US is usually at the county level, at least in states the size of Canadian states.”
I was gonna say, around here if one fire department doesn’t have a helo then they sure as hell have the ability to get on the horn and get someone who does fairly quickly.
I’ve been to drag race tracks all around North Texas and I can’t tell you how many times I’ve seen a drive flown off in a helicopter — these are some back woods tracks even.