Back from Canada

I recently returned from our annual trip to rural Quebec, a refreshing break from everything (including the internets!). Eli’s post below, about resource-intensive approaches to infection prevention that seem so attractive compared with the hard work of basic hand hygiene, reminded me of a conversation I had over dinner with a Canadian family friend. He asked for details about the current political debate over Medicare, and I explained how one side is interested in restructuring the program from a defined benefit plan to a defined contribution plan, thereby shifting the risk of future increased health costs from the government to the individual.

“What happens when you need care that you can’t afford?” he asked. I pointed out that medical illness and the associated costs were a common cause of personal bankruptcy in the United States. He sat in stunned silence for a few moments before ending our discussion with, “Well, that’s barbaric.”