Sen. Rand Paul’s call: reality v. rigidity

Two contemporary stories about Sen. Rand Paul (R- Ky.) illustrate the disconnect between one’s ideology and personal experiences. Imagine a fierce opponent of regulation being saved in a crash by government-mandated seat belts and air bags and the ensuing cognitive dissonance.

In the case of Rand Paul, MD (ophthalmology), the two experiences came almost at the same time. Last month, Sen. Paul went to the Shouldice Hernia Centre, the world-famous hernia repair institution located just outside of Toronto, Ont.

Before he departed for his surgery, some in the media recollected his virulent opposition to any government health insurance programs, including Medicare and Obamacare. 

Explaining why he chose Shouldice — a hospital in a country where single-payer covers everyone and gives them free choice of  physician and hospital, averaging half the price per person of the U.S. system (which still leaves over 27 million people without any insurance and millions more underinsured) — Paul replied that Shouldice is a private hospital that “accepts Americans who pay cash.”

But as any Canadian knows, there are many private hospitals in Canada. The single-payer system means that the governments (the Provinces assisted by Ottawa) are the payer while the delivery is mostly private. Shouldice operates under the Canadian single-payer system.

In any event, Rand Paul chose the best place for hernia repair — Shouldice uses tissue repair, not the risky mesh insertion used in U.S. hospitals that has bred so much tort law litigation (see Jane Akre’s recent column). Shouldice, as reported in peer-reviewed medical journals, has the lowest infection and recurrence rate in North America. It also conducts its operations, including a four-day stay at their hotel-like premises replete with gardens, at about 40 percent of the price charged for the in-and-out-in-one-day surgery prevalent at many U.S. hospitals.

By all accounts, Sen. Paul was pleased with how his operation turned out and enjoyed the food and company of his fellow patients over his four-day stay.

So has Sen. Paul changed his mind about single-payer, clearly the more efficient, humane system? Canada does not have socialized medicine like the U.K. Our Canadian neighbors have a public funding, private delivery system that hugely reduces the kind of anxiety, dread and fear afflicting Americans (see my recent column, “25 Ways the Canadian Health Care System is Better than Obamacare”). Moreover, Canadians are not subjected to arbitrary denials of care, maddening fine print complexity, co-pays, inscrutable bills often larded with fraud and sometimes a “pay or die” drug pricing or surgery confrontation. Then there are those choice-destroying narrow networks. Americans would benefit substantially in a single-payer system.

Apparently, Dr. Paul has not budged. He was unavailable for comment to this writer.

The other experience Sen. Paul had was with the tort law or personal-injury civil justice system. While piling brush near the property boundary with his neighbor, Sen. Paul was violently blind-sided and tackled by the neighbor, Rene Boucher. Later, Boucher pleaded guilty to a criminal charge and served a 30-day prison sentence.

The assault left Sen. Paul with several broken ribs and other injuries. “I went through horrendous pain,” he said, adding that his traumas resulted in two bouts of pneumonia and fluid buildup in his lungs.

As a physician and a U.S Senator, Rand Paul stands with the “tort deformers,” those lobbyists and lawmakers who push for legislation to restrict wrongfully injured people from adequate awards, their full day in court with trial by jury. Sen. Paul specifically favored a $250,000 lifetime cap on pain and suffering no matter how serious were the injuries to the victims of medical malpractice.

Yet when wrongfully injured, Rand Paul sued Rene Boucher under the law of torts and asked for far more money than the caps he has favored for others allow. After two hours of deliberation, a Bowling Green Kentucky jury awarded the senator $200,000 for pain and suffering, $375,000 in punitive damages and $7,834 for medical expenses.

Rand Paul sought justice in Kentucky’s state court and received justice for his painful wounds.

Now let’s see whether Sen.  Paul opposes Kentucky Senate Bill 11, filed by state Sen. Ralph Alvarado, which would amend the state Constitution and repeal the present ban on the state Legislature limiting jury awards.

It is a recurring question as to whether Sen. Paul, a libertarian conservative, is willing to modify his ideology due to his real-life experiences. Our civil justice system and the Canadian health care system have provided him with significant benefits. Don’t Americans deserve the same?

Ralph Nader is the founder of the American Museum of Tort Law in Winsted, Conn.