The one good thing about universal healthcare is that physicians will no longer have anyone to blame but themselves for their predicament.

The argument I often see here is that exhorbitant health care costs are driven by defensive testing which is driven by malpractice fears. But in at least two recent situations, I have seen our clinic actively marketing its tests to the general public. There's nothing "defensive" about it — the clinic is on the offense, pursuing profit.

I'm not even remotely knowledgeable enough about medicine to know how valuable these tests are to good ol' Joe Sixpack. I'm just tired of seeing the blame finger always pointing at the stereoptyped litigious patient. There's a whole lot more going on here than that.

Is Canada’s lower economic vitality completely unrelated to the socialist attitudes and economic system that created their socialized health care system?

Is their more extensive system of entitlements, defined primarily by their “right to healthcare”, promoting lower economic activity and passivity in it’s population?

Is the American’s greater emphasis on personal responsibility for taking care of oneself and greater personal risks if one fails to do so the reason that we are more productive?

Doesn’t that greater productivity more than exceed the greater health care costs? His chart shows that it does!

Health care is a commodity, a service, not a right and is as appropriate a door prize as a new TV. People are perfectly free to live out their natural lives without health care if they don’t want to work and pay for it. A lot of them would live longer if they did. That attitude towards personal responsibility is what makes us so productive dispite all of our social liabilities (which are much greater than Canada–and still we out produce them).

BTW, malpractice may be unfair sometimes in it’s application, but the basic notion of holding doctors personally responsible to the patient for their care is also part of that foundation of ownership of responsibility.

The POINT IS that there is no evidence that defensive medicine exists, i.e., fear of lawsuits cannot be shown to increase the number of procedures and may be indistinguishable from cautious medicine.

For a few recent rigorous analyses of the issue, see http://www3.interscience.wiley.com/journal/117994350/abstract?CRETRY=1&SRETRY=0 (showing POSITIVE effect of fear on lawsuits on mortality) and http://www.journals.uchicago.edu/doi/abs/10.1086/587430?journalCode=jls (finding no effect of increase likelihood of being sued on likelihood to perform caesarians)

It's times the aspiring-goebbels of medicine stop their big lies about defensive medicine and let evidence, not self-interest guide their rhetoric,

No offense, but doesn’t anyone else get the preposterous-ness of this proposition?

So yes, he gets the heart scan, but in order to understand the results he has to schedule an appt. with a doctor, who recommends a stress test, a physical, and a colonoscopy.

Bear in mind that this man, although in his mid-50s, had no health complaints. He was just taking advantage of his “prize”.

That’s not malpractice-related; it’s pure capitalism at work, opportunistic bait-and-switch. How much of this conduct is improperly categorized as “defensive medicine,” I wonder.