Leave Natasha Richardson out of the health care debate

Natasha Richardson in 1999 - ten years before her untimely death

Please don’t turn Natasha Richardson’s tragic death into a symbol for why Canadian-style universal  health care is bad and the United States is better.

In the last six hours, I’ve seen articles from at least a dozen media outlets asking whether Natasha Richardson would have lived, had her skiing accident occurred in the United States instead of Canada, where the quoted commentators say universal health care means insufficient access to high-tech scans and helicopters.

I’m not advocating for or defending Canada’s single-payer health system. Merely, I ask that journalists considering doing this story ask deeper questions that get beyond the anecdote. Consider asking about the trade-offs that go along with providing seemingly unlimited CT scans and helicopters. Ask what would happen if she were an uninsured U.S. resident.

Richardson’s tragedy may represent a larger problem, but those statistics need to accompany the punditry. While not diminishing the tragedy of Richardson’s untimely death, a sample of one is not a good measure of how well a state or nation’s health system performs.

Anecdotes make great stories and can put a face on a problem, but policy should be based on scientific research that reveals truths about the entire population.

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31 replies »

  1. This is truly sad to hear and I hope she did not suffer too much. I sincerely hope that she received proper health care to manage her pain at least, which must have been horrific. God bless her and her family!

  2. The for-profit medical industrial complex in the USA has a vested interest in keeping the status quo. They will find every person in Canada who is unhappy with their nation’s heath care plan and fly them down here first class to tell about the “horrors” of universal health care. This will go into 24/7 rotation in the corporate media. This will be how the debate will be framed in the USA…no polite, factual discussion allowed because they will loose if the facts are presented to the American public…Better to confuse and obfuscate the facts…as well as keep them distracted with the latest celebrity scandal or missing/murdered child scandal.

  3. What does this incident say about Health Care in Canada though?
    Does universal Health Care mean sacrificing the medical equipment that could save your life if you need it one day?
    How can a centralized Health Care system become more efficient, better managed, and further research in terms of medicine?

  4. Oh, and for those who think government run is a failure read this:
    “Yet, 15 years ago, the then-fragmented system was plagued with medical and aviation problems.” “During the early 1990s, the system was fragmented, run by private companies vying for ministry dollars, and plagued by medical and aviation problems.” “Finally, in 2005, the province heeded the advice of experts to streamline the service. It’s now a world leader in air medical transport.”

  5. Well if we’re going to do the battle of the links here’s one (Vancouver Sun):
    Be sure to read the comments at the bottom of the piece.
    “and only “died” here because this is where her vent was turned off ultimately.”
    Beth, I would have thought that Amercian medicine could have brought her back, or at least that’s what Stuart Browning would have us think, after all the U.S. spends all this money on healthcare over Canada. And where were all the Terry Schiavo demonstrators protesting that Natasha Richardson was actually viable?

  6. “Looks like she was alive in Canada and as soon as she was flown to U.S. for medical car she died. What does that say about American medicine?”
    Posted by: Peter | Mar 30, 2009 4:50:46 AM
    This is a rather inflammatory and incorrect statement. The reports were that she was already thought brain dead prior to leaving Canada and only “died” here because this is where her vent was turned off ultimately.
    In essence, it says nothing about American medicine.

  7. Actually – contrary to what Mr. Holt says – the care provided in Canada IS different. Patients wait inordinate times for diagnostic tests, for appointments with specialists, and for procedures. These long waits affect outcomes for everything from orthopedic surgery to cancer.
    Making everyone responsible for everyone else’s health care cost does nothing to reduce its cost. Canada and other OECD countries reduce heath care spending by denying care.
    This is the reality of collectivized medicine. Rationing, pure and simple. And this is what is advocated by Holt and others here. Individual rights, privacy rights, private property rights … all liberties are fair game until every person has the right to wait in line for a free gall bladder operation.

  8. Was there a CT scan at the first hospital where she was taken? I haven’t seen a comment on this.

  9. Picking Richardson’s death as an example is counter-weighted by the opening chapter of Jon Cohn’s “Sick” in which a woman dies because the hospital can’t take her. Oh, and that hospital is in Boston, the city that spends the most on health care.
    So to remind you all, especially Mr Browing–it’s not the care provided here or in Canada that’s so different. It’s how the cost of that care is visited on the poorest and sickest amongst us. And there’s no question, as countless studies here have shown, that the US system is by far worst for the financial health of the poor and now middle class.
    And whatever happens to a rich actress, no matter how tragic, won’t change that.

  10. “I don’t know of a major ski area in the US that is far from a CT scanner.”
    I don’t know a McDonalds that is far from a CT Scanner. That’s one of the problems with U.S. healthcare, too many toys to support.

  11. I don’t know of a major ski area in the US that is far from a CT scanner. Patients with head trauma are treated exactly the same, insurance or no insurance, in every hospital I have ever worked in.

  12. Duncan and Stuart — You make good points and I appreciate your criticism. I can tell you such editing is not common and in this case was a mistake. I think using a strike-through to mark changes is an excellent suggestion for future editing.

  13. Sarah:
    I appreciate you giving me the opportunity to explain my rationale. Hopefully there will be more dispassionate analysis of this tragedy.
    I think you have one of the best, if not best health care blogs going.

  14. Sarah – it’s not cool to stealth edit your post, especially after people have already commented on it. You should make clear your edit in the post, including the original language in strike-out, so that the comments that pick up on the original have proper context. Specifically, I think the contrast between Deamonte Driver and Natasha Richardson was appropriate and helpful, regardless of whether you feel your intent was misread.

  15. Cory thanks for responding and explaining your rationale. I actually found your commentary after I received a press release from the Galen Institute, quoting its president Grace-Marie Turner saying that Canada’s government-run system meant less lifesaving equipment. This fear-mongering release led me to write this story.
    Originally, I included the anecdote of the young Maryland boy who died after he couldn’t see a dentist and an infection spread to his brain. My original intent in including it was to show that said stories can be found on both sides of the border and probably to represent any claim. I removed it after people interpreted as my defending the Canadian system, which I’m not.
    Advocates on all sides use tragedies as rallying cries and they can be very effective. But for policy purposes, we should be asking how to improve the health of the entire population.

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  17. Looks like she was alive in Canada and as soon as she was flown to U.S. for medical car she died. What does that say about American medicine?

  18. I will also add that there are cases here in emergency rooms where people have died while waiting. So that problem existes in US also. Recall the story last year of a patient falling on the floor and perishing and no one came to do anything?
    Anyway, it is demagaugery….Natash is used as an example….
    We need to focus a solution for all and I tell you that I have been to emergency room in Canada and it was not bad…infact I had less wait there than I have had in US.

  19. I wrote the article and have been reluctant to respond to criticisms but since I read your blog I will here. So many people, both sides, are tied into their political beliefs about health care that virtually no one is actually looking at the record as we know it and asking a quite logical question.
    1. Here’s what’s important- the facts of this case- check the 911 transcripts in the Globe and Mail. The paramedics document the patient has a Glascow Coma Score of 12 upon arrival to the first hospital at St. Agathe. That is the key. The medical literature is quite clear – patients who present with scores in that range on presentation almost always survive. Where are the Canadian neurosurgeons and trauma people commenting on that? The questions that should be asked in light of that are who made the diagnosis and when, who treated and when, and what was the condition upon treatment. But it is clear that at 4 PM she was neurologically intact enough to survive with the appropriate treatment. By the way, this major ski resort is no further from Montreal than Vail or Breck is from Denver. And the Canadian defenders talk about how close it is by ambulance to minimize the medevac issue. You can’t have it both ways.
    2. I am not criticizing all Canadian health care. This is merely one case and it looks like there is a hole somewhere in the regional trauma system. It is disturbing more people aren’t focusing on that. We have our problems in the US, I mentioned that in the article and have written about them and my point is that policymakers on both sides of the border should be examining this case. I hope that happens.
    3. It’s not the hole in the regional trauma system that speaks poorly of the system, we have just as many problems. But one thing is for sure – if a high-profile case like this went bad in the US, as it might, there would be commentary everywhere questioning what went wrong and our system. Here, almost nothing. That is what is disturbing.
    4.I have no personal political agenda here- I am concerned with the best possible care for every patient on both sides of the border regardless of the delivery system. Both systems have their strengths and weaknesses.
    5. My heart goes out to the Richardson family and all connected with them. Let me make it very clear – she was not to blame. Perhaps she should have worn a helmet but that is something we deal with. The delay in care is normal for this condition, she did not feel it necessary to be examined. That happens too, we deal with that. The facts show there was ample time for her to receive care. The pervasive “blame the victim” mentality in this case does no credit to anyone who uses it, and unfortunately many people on both sides of the border are using it. I will state again unequivocally, it was not her fault.

  20. Thanks for a very good post.
    I agree with Ron and AfterCancer–this has nothing to do with the healthcare system.
    Also, from what I have read, her odds of survival woudl have been better only if she gotten to a hopsital very, very quickly after the accident. But she didn’t feel she needed to go to a hospital and, even if she had, ski slopes are usually quite distant form major hospitals, wherever you are.
    It was a tragedy. Period.

  21. Putting aside this tragic accident anyone who thinks US Medicine, as a whole, is better than Canadian Medicine as a whole is just not dealing in reality.
    No nation on the planet has completely figured out the balance of quality,cost and access. It seems like a cultural values issue that citizens of a nation should decide?
    But US Medicine especially in the last 10 years or so has really hit bottom on many fronts and is in severe crisis.
    Dr. Rick Lippin

  22. I can’t believe this argument is even occurring. The patient chose not to go for immediate treatment. It was an accident and a tragedy not malpractice. Had the injury occurred in the U.S. she would have had the same odds, particularly if she had chosen not to receive immediate treatment. It has nothing to do with health insurance.
    Kate@ http://aftercancernowhat.blogspot.com

  23. This is as good a place as any to link CNN — Sanjay Gupta looks at medical tourism in India.
    Be sure to watch the video.

  24. Ms. Arnquist,
    It’s good to see that you have reconsidered the use of the Deamonte Driver propaganda in your original post. However, it’s dishonest that you airbrushed it away as if it was never posted – rather than issuing a mea culpa.
    Nothing but the highest journalistic standards here on THCB!

  25. People should avoid concluding anything other than that skiing is an inherently dangerous activity. Sonny Bono and one of the Kennedy boys died in skiing accidents right here in the USA.

  26. I agree with the post but not the headline: it’s not that Natasha Richardson should be off-limits. Many of these articles are tactless and awkward, but the real problem is that many people want to impute to this tragedy conclusions that just aren’t backed up by any real evidence – or even the circumstances of the specific case. It’s all well and good to say that sort of thing couldn’t happen here – but not when the data show otherwise.
    I might also point out Deamonte Driver’s (easily preventable) death was used as a rallying cry by folks lobbying for SCHIP expansion in 2007 – http://www.npr.org/templates/story/story.php?storyId=14962685 . It also inspired a bill to expand Medicaid-SCHIP dental coverage – http://www.opencongress.org/bill/111-h462/show. In that case, the data clearly showed that this kind of thing was too frequent; Deamonte gave a name to the numbers, but the numbers were there in the first place.

  27. I see … anecdotes casting a negative light on the socialized system in Canada are out of bounds, while anecdotes portraying the US system negatively are OK.
    The case of Deamonte Driver is more an example of parental neglect (see http://tinyurl.com/2gytyg) – than an indictment of American medicine.
    What rubbish.