What Happens When You Don't Plan Things?

What Happens When You Don't Plan Things?

You get disasters like this, where a First World country can't even arrange its health care system adequately to handle its own births. Fortunately, they live next to a country where the government doesn't run things. From the May 5, 2008 Toronto Globe & Mail:

More than 100 Canadian women with high-risk pregnancies have been sent to United States hospitals over the past year – in what a doctors' group attributes to the lack of a national birthing plan.
The problem has peaked, with British Columbia and Ontario each sending a record number of women to U.S. neonatal intensive care units (NICUs). Specifically, 80 B.C. women have been sent to U.S. hospitals since April 1, 2007; in Ontario, 28 have been sent since January of 2007, according to figures from the respective health ministries.
André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada, said the problem is due to bed closings that took place almost a decade ago, the absence of a national birthing initiative and too few staff.
“Neonatologists are very stretched right now,” Dr. Lalonde said in a telephone interview from Ottawa. “We're so stretched, it's kind of dangerous.”

A national birthing initiative, he said, is urgently required to ensure services are planned, guidelines on the best way to care for these patients are implemented, and a stronger focus is placed on maternity patient safety.
Canada, once able to boast about its high rank in the world for low infant-mortality rate – sixth place in 1990 – saw its rank plummet to 25th place in 2005, according to figures published this year by the Organization for Economic Co-operation and Development.
Specifically, Canada's infant mortality rate of 5.4 deaths per 1,000 live births is tied with Estonia's and more than double Sweden's rate of 2.4.
The inability for Canada to care for all of its sick and premature babies has caught the attention of renowned pediatrics professor Shoo Lee, who is studying the health outcomes of infants sent abroad, in addition to those who remain here, often under stretched staffing conditions.
“If you have insufficient resources in the province, what does that mean for those kept in the system?” Dr. Lee, director of the Canadian Neonatal Network, said from Edmonton. “Are they being admitted to the NICU only when they are very sick? Are they being pushed out too early to make room for others?”
Philippe Chessex, division head of neonatology for B.C. Women's Hospital & Health Centre, said every effort is made to avoid out-of-province transfers. Even sick babies who aren't sent to the U.S. can still face several moves while at home.
“We're transferring babies across the province, in all directions, to try to find an extra bed for the next potential birth or for any baby already born,” Dr. Chessex said in a telephone interview from Vancouver. “We now have babies who have been transferred up to six times after leaving here before reaching home.”

Will someone please page Michael Moore?

Part of what makes this happen isn't just that Canada has socialized health care. It is that, unlike a number of other countries with socialized health care, it prohibits doctors treating anyone outside of that system. Some of the problem is also that when you adopt socialized health care as a way of controlling costs--one way to control costs to reduce the amount of health care provided.

That might be a legitimate collective, social decision--but prohibiting health care outside of the socialized system is what takes you from a bad collective decision to something that smacks of totalitarianism--the grave fear that someone, somewhere, might be able to buy better health care because they have more money.