"Cancer scare in Britain that helped to shape Mitt Romney’s fear of public health" -- well this doesn't make sense

By Jon Swaine, Washington

Barack Obama, he says, wants to turn their country "into a European-style welfare state", by overhauling the US health care system and placing greater control in the hands of "government bureaucrats".

But what the Republican presidential challenger does not disclose is that he speaks from experience. His fear of "socialised medicine" was shaped by Britain's NHS and its response to a cancer scare involving one of his own children.

In 1995, his third son Josh was a young Mormon missionary posted to northern England. Navigating the A1 in a small Volkswagen, he knocked on doors from Mansfield to Ripon, spreading the word of Jesus Christ of Latter-Day Saints to working-class Britons unaware that he was the scion of Massachusetts millionaires.

One day in Sheffield, however, a stomach complaint led him to a local doctor, who had terrible news: symptoms indicated that he might have colon cancer.

Even worse, Mitt Romney later recalled, "the waiting time for a colonoscopy was six weeks – enough time to make an operable, curable cancer become an inoperable terminal condition".

The family was appalled. "It was scary," Josh, now a 36-year-old property developer in Utah, told The Daily Telegraph while campaigning with his father in Florida. "I am in favour of you reforming your health care system," he joked.

His parents, who were raised in the wealthy Michigan enclave of Bloomfield Hills, could not believe John Major's government would consign Britons to death by maintaining a creaking Soviet-style system – even if it was free for foreign visitors such as their son.

"It made us realise things were different over there," Josh's mother, Ann, said after a campaign rally in South Carolina. "He just couldn't get the answers he needed."

Mitt Romney, then 47, had just run unsuccessfully against Ted Kennedy for the US Senate in Massachusetts. A multi-millionaire from his private equity career, he reached for his wallet and paid cash to send Josh to a private clinic nearby.

"He received a timely examination and a very welcome clean bill of health," Mr Romney said later in a memoir. But tragically, "most of the British are not so fortunate," he warned his countrymen.

While Mr Romney has like Mr Obama faced criticism for introducing a "mandate" forcing people to have health coverage while he was governor of Massachusetts, his system remained devoted to private health insurance rather than government-run care funded by taxpayers, as in Britain.

"I dropped a log on my foot and cracked a bone," said Mr Governo. "I went to the emergency room, waited for hours and was told 'come back tomorrow'.

"Eventually they handed me some paracetamol and said. 'Don't walk on it for six weeks'." Paracetamol as the solution to any medical problem soon became an in-joke.

"But we were in northern England, where we'd heard there were more poor people," said Janelle Bartlome, 39, from Utah. "We were told in London things were different and better."

John Ashworth, now a manager at a cosmetics company in Utah, lived with Josh in a flat in Mansfield, Notts, for two months in 1995. "There was mould throughout the entire apartment," said Mr Ashworth, 36. "In the bathroom, on the ceilings. It was quite nasty."

Missionaries bought second-hand suits that could survive the grimy houses into which they were invited. Some, however, were not even fortunate enough to get that far. “Our German companions had a very difficult time,” said Mr Ashworth. “Often an elderly resident would tell me: 'You can come in, but the German stays outside'.”

Meanwhile their strict £150-a-month budget drove them to risk their health on Britain's most controversial product at the time. "Because of Mad Cow Disease, the price of beef came down dramatically," said Mr Ashworth. "I would buy beef for almost every meal. We had hamburgers, beef with pasta, all sorts. As a result I now can not give blood – and my wife claims I'm losing my memory."

Massachusetts Medical Society Releases 2011
Study of Patient Access to Health Care

Longer patient wait times, continued difficult access to primary care physicians,and gaps in physician acceptance of government coverage

ACCESS TO PRIMARY CARE PHYSICIANS

Access to primary care physicians is becoming more restricted, as more than half of primary care practices – 51% of internists and 53% of family physicians – are not accepting new patients. These figures remain close to those of last year’s survey which showed 49% of internists and 54% of family physicians not accepting new patients.

Medical Society officials say the percentage of practices closed to new patients reflects the persistent shortages of primary care physicians in the Commonwealth. For five consecutive years, the Medical Society has recorded critical and severe shortages of both internists and family physicians.

WAIT TIMES FOR NEW PATIENTS

Primary Care Long wait times continue for the primary care physicians of internal medicine and family medicine who are accepting new patients. The average wait time for an appointment for internal medicine is 48 days, five days shorter than last year, and the average wait time for family medicine is 36 days, up 7 days. Internal medicine was the only specialty reporting a shorter wait time, yet at 48 days it has the longest wait time of any of the seven specialties surveyed.

The average wait time for pediatricians – primary care for youngsters up to age 18 – was 24 days, the same as last year. Seventy-three percent of pediatricians are accepting new patients.

Specialty Care All four specialties reported longer wait times: gastroenterologists, 43 days, up from 36 days; obstetricians/gynecologists, 41 days, up from 34 days; orthopedic surgeons, 26 days, up from 17 days; and cardiology, 28 days, up from 26 days.

Access to specialists is easier than primary care, with 82% of cardiologists, 85% of obstetricians/ gynecologists, 95% of gastroenterologists, and 97% of orthopedic surgeons, accepting new patients.

ACCEPTANCE OF GOVERNMENT and GOVERNMENT-RELATED INSURANCE

Physician acceptance of government and government-related insurance products varies widely, within primary care and between primary care and specialties.

Primary Care The gap between primary care physicians accepting Medicare and MassHealth is striking. While most internists (85%) and family physicians (87%) accept Medicare, significantly fewer of both (53% of internists) and (62% of family physicians) accept MassHealth.

Even fewer accept Commonwealth Care (43% of internists; 56% of family physicians) and Commonwealth Choice (35% of internists; 44% of family physicians).

Similar differences were found for pediatrics: 89% accept MassHealth, but only 50% accept Commonwealth Care and only 45% accept Commonwealth Choice.

Specialty Care The overwhelming majority of specialists accept Medicare and MassHealth, but significant gaps exist between those plans and Commonwealth Care and Commonwealth Choice.

Accepting Medicare are 96% of cardiologists, 97% of gastroenterologists, 94% of obstetricians/gynecologists, and 98% of orthopedic surgeons.

Accepting MassHealth are 92% of cardiologists, 85% of gastroenterologists, 89% of obstetricians/gynecologists, and 82% of orthopedic surgeons.

Accepting Commonwealth Care/Commonwealth Choice: cardiologists, 78%/76%; gastroenterologists, 68%/60%; obstetricians/gynecologists, 82%/71%; and orthopedic surgery, 59%/42%.

The survey was conducted between February 16 and March 8 of this year, and included 838 telephone interviews. The complete study is available at www.massmed.org/patientaccess

Practice Environment Continues to Decline

The Society also released its latest MMS Practice Environment Index, a statistical compilation of nine factors that influence the practice climate for physicians in the Commonwealth. For 2010, the index declined 0.9 percent, representing a continued deterioration of the practice environment for physicians in Massachusetts. The index has declined in 17 of the 19 years the Society has been compiling such data.
The index is available at www.massmed.org/mmsindex

The Massachusetts Medical Society, with nearly 23,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information please visit www.massmed.org, www.nejm.org, or www.jwatch.org.

Definitions of Insurance Plans:

Medicare is the U. S. government sponsored health insurance program for people age 65 or older or under age 65 with certain disabilities. www.medicare.gov

MassHealth is a public health insurance program for eligible low and medium-income residents of Massachusetts. MassHealth is the name used in Massachusetts for Medicaid and the Children's Health Insurance Program (CHIP), combined in one program. www.massresources.org

Commonwealth Care is a health insurance program for low and moderate-income Massachusetts adults 19 and older who don't have health insurance and who are ineligible for Medicaid. Members get free or low-cost health services through managed care health plans. www.mahealthconnector.org

Commonwealth Choice is a health insurance program for uninsured adult Massachusetts residents. The program offers unsubsidized health insurance to people who are not eligible for Medicaid or Commonwealth Care. www.mahealthconnector.org