David Gratzer
Encyclopedia
David George Gratzer is a physician
, columnist
, author, Congressional expert witness, and a senior fellow at both the Manhattan Institute
and the Montreal Economic Institute. Though he has written essays on topics as diverse as obesity and political campaigns, he is best known for his first book, published by ECW Press, when he was just 24: Code Blue: Reviving Canada's Health Care System. That book won the Donner Book Prize and was a national bestseller in his native Canada. Gratzer is a critic of the Canadian health care system
, and of U.S. President Barack Obama
's health care reform proposals. Gratzer was a key health care policy advisor to Rudy Giuliani
's 2008 presidential campaign
.
at the University of Manitoba
who emigrated from Hungary
to the United States
in 1963 and to Canada
in 1966. Gratzer's mother, Catherine, is a dentist. She recently retired from her practice. Gratzer's older brother earned his medical degree and now practices in the United States.
Gratzer earned a B.Sc.
at the University of Manitoba in 1996, was president of the University of Manitoba Students' Union
(UMSU) during his final undergraduate year 1995–1996, and was appointed by the Lieutenant Governor of Manitoba to the University of Manitoba Board of Governors
for four successive years from 1994–1998.
In his early years, Gratzer was not particularly interested in health policy issues. As he noted later:
at the University of Manitoba from 1996–2000 and earned an M.D.
in 2000. On November 15, 1996, during his first year of medical school, the Canadian Medical Association Journal
(CMAJ) published a letter to the editor
from Gratzer criticizing a June 15, 1996 CMAJ report comparing reserve funds held by the Canadian Medical Protective Association
(CMPA) to those held by medical malpractice
insurers in the United States.
While in medical school, Gratzer was a regular contributor of opinion columns to National Post
, wrote a weekly opinion column for the London Free Press
and the Halifax Sunday Herald
, and wrote columns on health care that appeared in several major newspapers and magazines, including the Toronto Star
and Ottawa Citizen
and Calgary Herald
. A 1997 Gratzer column "Being a young conservative is nothing to apologize for" said "I am a conservative. This is somewhat unfortunate, as people don't seem to understand how anyone under 40 can be right-wing." A 1999 Gratzer column "Raising the minimum wage hurts the poor it hopes to help" lamented that even "two of Canada's three right-leaning governments have chosen to hike their minimum wages" and that "minimum wage earners are not underpaid but underproductive." Gratzer won $250 as fourth place runner-up in 1998–1999 and won $2,500 as first prize in the 1999–2000 Felix Morley
Journalism Competition of the Institute for Humane Studies
at George Mason University
for his newspaper columns.
During his second year of medical school, Gratzer began writing a book about problems with the Canadian health care system
but could not get anyone interested. Rejection letters piled up after he completed the book and he had doubts about his ability to get taken seriously until his third year of medical school, when Robert Lecker
, professor of English
at McGill University
and co-founder of ECW Press
agreed to publish his book. In August 1999, during his fourth year of medical school, ECW Press published the 24-year-old Gratzer's first book, Code Blue: Reviving Canada's Health Care System
Gratzer wrote about deficiencies in Canadian health care and argued that they were the direct result of the system's design, and thus not amendable to simple reforms.
Gratzer called for market-based reforms. He won praise from a former Member of Parliament who wrote: ““Gratzer proposes a workable solution for the biggest public policy problem of the coming generation – government-controlled health care monopoly… Canada needs Gratzer’s solution.” Stephen Harper
is now Prime Minister of Canada.
On May 4, 2000, Gratzer was awarded $25,000 by the Donner Canadian Foundation as winner of its second annual Donner Prize
for best public policy book of 1999 for Code Blue. The book beat out works by Prof. Stéphane Dion
, Member of Parliament and the previous Leader of Her Majesty’s Loyal Opposition, and Bob Rae
, former Premier of Ontario and the Opposition Critic for Foreign Affairs.
In his acknowledgment
s, Gratzer said his book "wouldn't have been possible without the encouragement and patience" of David Frum
, a National Post
columnist and senior fellow at the Manhattan Institute
(who introduced him to Manhattan Institute president Larry Mone—who hired Gratzer as a Manhattan Institute senior fellow in 2002) and Adrienne Snow, director of programs for the Donner Canadian Foundation.
program at the University of Toronto
. During his psychiatry residency, Gratzer continued to write newspaper opinion columns. A 2001 Gratzer column "Make room for prescription drug ads on television" advocated allowing direct-to-consumer advertising
of prescription drug
s on television in Canada
(the United States
and New Zealand
are the only countries that allow direct-to-consumer advertising of prescription drugs).
In April 2002, ECW Press published Better Medicine: Reforming Canadian Health Care a book of essays edited by Gratzer. The collection of essays had 17 contributors from 3 countries and 2 continents. Essayists included historian Michael Bliss
and columnist Margaret Wente
. Dr. Victor Dirnfeld, a physician and former president of the Canadian Medical Association, wrote the introduction. Gratzer co-wrote an essay on market reforms seen in various European countries, and also wrote the concluding essay on medical savings accounts.
The July 23, 2002 issue of CMAJ
highlighted Medical Savings Accounts (MSAs) with: a commentary by Gratzer in favor of MSAs as a counterpoint to a commentary opposing MSAs, a peer-reviewed
research article opposing MSAs, a peer-reviewed review article opposing MSAs,
and a book review
by a University of Toronto medical student of Gratzer's Better Medicine: Reforming Canadian Health Care.
In September 2002, Gratzer was one of 25 Canadians under age 30 featured in a Maclean's
"Leaders of Tomorrow" cover story. In 2002, while still a psychiatry resident, Gratzer joined the Manhattan Institute
as a senior fellow.
In 2004, Gratzer was first author of a peer-reviewed
brief report "Lifetime rates of alcoholism in adults with anxiety, depression, or co-morbid depression/anxiety: a community survey of Ontario" published in the Journal of Affective Disorders.
On June 28, 2005, Gratzer testified in support of H.R. 2355, the Health Care Choice Act of 2005, at a hearing of the U.S. House of Representatives
Subcommittee on Health of the Committee on Energy and Commerce
.
for independent practice of medicine in Ontario. In April 2006, Gratzer became licensed
to practice medicine in Pennsylvania
. In May 2006, Gratzer became board-certified
in psychiatry.
In October 2006, Encounter Books
published Gratzer's book, The Cure: How Capitalism Can Save American Health Care, about problems with the United States health care system
.
The book advocated moving health-care decisions closer to individuals and their families. Gratzer cited health savings accounts as a success story and bemoaned the state of health care in countries with government-run systems. He advocated various reforms: Gratzer proposed turning over all current federal
funding for Medicaid to state
government
s in the form of block grant
s to experiment with, using welfare reform as a model; tightening Medicaid eligibility for long-term care
; expanding health savings accounts; and encouraging the purchase of private long term care insurance
.
In the last chapter, he proposed more far-reaching reforms while acknowledging that neither political party would currently advocate them:
The Foreword was written by Nobel Laureate Milton Friedman
. He wrote: "David Gratzer is a practicing psychiatrist who combines firsthand knowledge of medical practice in both his native Canada and the U.S. with an independent point of view and a rare capacity for lucid exposition of complex technical material. . . If you want a well-written, interesting yet authoritative and thorough account of what is wrong with medicine today and how to cure American health care, this is the book for you."
The Cure was named a "Top Ten Reading Selection for 2007" by the National Chamber Foundation.
's 2008 presidential campaign
named Gratzer as one of his five key health care policy advisors, along with: Hoover Institution
senior fellow Dan Kessler, Hoover Institution
senior fellow Scott Atlas, Pacific Research Institute
president and CEO Sally Pipes, and The Moran Company founder and president Donald Moran. During the campaign, Giuliani championed interstate health-insurance markets and tax parity for non-employer purchases of health insurance, both positions favored by Gratzer.
Giuliani was criticized when he suggested that his chances of surviving prostate cancer
had been higher in the U.S. than in Britain, because of false positives, poor sensitivity of such tests, and the slow-growing nature of prostate cancer. Gratzer responded by defending his "snapshot" method of calculating "survival rates" as the method also used by economist John Goodman
, co-founder and president of the National Center for Policy Analysis
(NCPA), by economist June O'Neill
, and by U.S. Constitutional historian
and health policy expert Betsy McCaughey, a former John M. Olin
fellow at the Manhattan Institute. Gratzer also cited a September 2007 Lancet Oncology
article that found superior cancer outcomes in the United States for 16 cancers when compared to European countries.
After Giuliani withdrew, Gratzer endorsed the McCain health-care proposal.
Gratzer testified several times during the recent health-care reform debates, including before the House Budget and Ways and Means Committees. In a June 2009 U.S. Congressional hearing on the issue of single-payer health care
, Gratzer and U.S. Rep.
Dennis Kucinich
(D
-OH
) clashed over Canadian healthcare statistics.
According to a June 29, 2009 front-page article in Canada's National Post
, "armed with a stack of statistics about patient wait lists in Canada, and a fusillade of dire warnings about the life-threatening consequences of government-managed care," Gratzer "has emerged as the go-to expert witness for GOP lawmakers hoping to sow doubt in Congress about the wisdom of embracing Mr. Obama's call for a public health insurance option
to compete with private insurers."
In July 2009, he appeared on 20/20 to discuss health care.
In November 2009, Encounter Books
published a short book of his criticism of the White House plans, How Obama’s Government Takeover of Health Care Will Be a Disaster.
Gratzer continues to comment and debate on health-care issues. He is founding contributor to FrumForum (formerly NewMajority). With former Senate Majority Leader Bill Frist, he debated at the Munk Debates
.
More recent work has focused on obesity. In a widely reprinted L.A. Times piece, he argued that society was suffering from a McVictim Syndrome with "[t]oo many pundits, public health experts and politicians are working overtime to find scapegoats for America's obesity epidemic." He rejects this: "governments can't micromanage your waistline for you. Even if governments could magically walk you to work, ban food advertising, regulate sugar out of food and suck those fat particles out of the air, in a free society you would still have the power to drive to the nearest restaurant, shake your salt shaker and order a second piece of pie. That's why understanding — and rejecting — the McVictim culture is crucial to obesity reduction policy."
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
, columnist
Columnist
A columnist is a journalist who writes for publication in a series, creating an article that usually offers commentary and opinions. Columns appear in newspapers, magazines and other publications, including blogs....
, author, Congressional expert witness, and a senior fellow at both the Manhattan Institute
Manhattan Institute
The Manhattan Institute for Policy Research is a conservative, market-oriented think tank established in New York City in 1978 by Antony Fisher and William J...
and the Montreal Economic Institute. Though he has written essays on topics as diverse as obesity and political campaigns, he is best known for his first book, published by ECW Press, when he was just 24: Code Blue: Reviving Canada's Health Care System. That book won the Donner Book Prize and was a national bestseller in his native Canada. Gratzer is a critic of the Canadian health care system
Health care in Canada
Health care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities. It is guided by the provisions of the Canada Health Act. The government assures the quality of care through federal standards...
, and of U.S. President Barack Obama
Barack Obama
Barack Hussein Obama II is the 44th and current President of the United States. He is the first African American to hold the office. Obama previously served as a United States Senator from Illinois, from January 2005 until he resigned following his victory in the 2008 presidential election.Born in...
's health care reform proposals. Gratzer was a key health care policy advisor to Rudy Giuliani
Rudy Giuliani
Rudolph William Louis "Rudy" Giuliani KBE is an American lawyer, businessman, and politician from New York. He served as Mayor of New York City from 1994 to 2001....
's 2008 presidential campaign
Rudy Giuliani presidential campaign, 2008
Rudy Giuliani’s 2008 presidential campaign began following the formation of the Draft Giuliani movement in October 2005. The next year, Giuliani opened an exploratory committee and formally announced in February 2007 that he was actively seeking the presidential nomination of the Republican...
.
Early life
Gratzer's father, George, is a professor of mathematicsMathematics
Mathematics is the study of quantity, space, structure, and change. Mathematicians seek out patterns and formulate new conjectures. Mathematicians resolve the truth or falsity of conjectures by mathematical proofs, which are arguments sufficient to convince other mathematicians of their validity...
at the University of Manitoba
University of Manitoba
The University of Manitoba , in Winnipeg, Manitoba, Canada, is the largest university in the province of Manitoba. It is Manitoba's most comprehensive and only research-intensive post-secondary educational institution. It was founded in 1877, making it Western Canada’s first university. It placed...
who emigrated from Hungary
Hungary
Hungary , officially the Republic of Hungary , is a landlocked country in Central Europe. It is situated in the Carpathian Basin and is bordered by Slovakia to the north, Ukraine and Romania to the east, Serbia and Croatia to the south, Slovenia to the southwest and Austria to the west. The...
to the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
in 1963 and to Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
in 1966. Gratzer's mother, Catherine, is a dentist. She recently retired from her practice. Gratzer's older brother earned his medical degree and now practices in the United States.
Gratzer earned a B.Sc.
Bachelor of Science
A Bachelor of Science is an undergraduate academic degree awarded for completed courses that generally last three to five years .-Australia:In Australia, the BSc is a 3 year degree, offered from 1st year on...
at the University of Manitoba in 1996, was president of the University of Manitoba Students' Union
University of Manitoba Students' Union
The University of Manitoba Students' Union is the university-wide representative body for undergraduate students at the University of Manitoba, located in Winnipeg, Manitoba, Canada. It was established in 1919, replacing the former University of Manitoba Students' Association established in 1914...
(UMSU) during his final undergraduate year 1995–1996, and was appointed by the Lieutenant Governor of Manitoba to the University of Manitoba Board of Governors
Board of governors
Board of governors is a term sometimes applied to the board of directors of a public entity or non-profit organization.Many public institutions, such as public universities, are government-owned corporations. The British Broadcasting Corporation was managed by a board of governors, though this role...
for four successive years from 1994–1998.
In his early years, Gratzer was not particularly interested in health policy issues. As he noted later:
Medical school and Code Blue (1999)
Gratzer attended medical schoolMedical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...
at the University of Manitoba from 1996–2000 and earned an M.D.
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
in 2000. On November 15, 1996, during his first year of medical school, the Canadian Medical Association Journal
Canadian Medical Association Journal
The Canadian Medical Association Journal is a general medical journal that is published biweekly by the Canadian Medical Association . It covers research and ideas aimed at improving health for people in Canada and globally. CMAJ publishes original clinical research, analyses and reviews, news,...
(CMAJ) published a letter to the editor
Letter to the editor
A letter to the editor is a letter sent to a publication about issues of concern from its readers. Usually, letters are intended for publication...
from Gratzer criticizing a June 15, 1996 CMAJ report comparing reserve funds held by the Canadian Medical Protective Association
Canadian Medical Protective Association
The Canadian Medical Protective Association , is an organization headquartered in Ottawa, Ontario, Canada that provides legal defence and liability protection to physicians across Canada, and provides compensation to patients and their families proven to have been harmed by negligent clinical care...
(CMPA) to those held by medical malpractice
Medical malpractice
Medical malpractice is professional negligence by act or omission by a health care provider in which the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient, with most cases involving medical error. Standards and...
insurers in the United States.
While in medical school, Gratzer was a regular contributor of opinion columns to National Post
National Post
The National Post is a Canadian English-language national newspaper based in Don Mills, a district of Toronto. The paper is owned by Postmedia Network Inc. and is published Mondays through Saturdays...
, wrote a weekly opinion column for the London Free Press
London Free Press
The London Free Press is a daily newspaper based in London, Ontario, Canada.The London Free Press began as the Canadian Free Press, founded by William Sutherland in 1847. It first began printing as a weekly newspaper in 1849. In 1852, it was purchased for $500 by Josiah Blackburn, who renamed it...
and the Halifax Sunday Herald
Halifax Chronicle-Herald
The Chronicle Herald is a broadsheet published in Halifax, Nova Scotia. The largest newspaper company in Nova Scotia, The Chronicle Herald is also the highest circulation newspaper in the Atlantic provinces and is currently the largest independently owned newspaper company in Canada...
, and wrote columns on health care that appeared in several major newspapers and magazines, including the Toronto Star
Toronto Star
The Toronto Star is Canada's highest-circulation newspaper, based in Toronto, Ontario, Canada. Its print edition is distributed almost entirely within the province of Ontario...
and Ottawa Citizen
Ottawa Citizen
The Ottawa Citizen is an English-language daily newspaper owned by Postmedia Network in Ottawa, Canada. According to the Canadian Newspaper Association, the paper had a 2008 weekly circulation of 900,197.- History :...
and Calgary Herald
Calgary Herald
The Calgary Herald is a daily newspaper published in the Canadian city of Calgary, Alberta.- History :The paper was first published on August 31, 1883 by Andrew Armour and Thomas Braden as The Calgary Herald, Mining and Ranche Advocate and General Advertiser. It started as a weekly paper with only...
. A 1997 Gratzer column "Being a young conservative is nothing to apologize for" said "I am a conservative. This is somewhat unfortunate, as people don't seem to understand how anyone under 40 can be right-wing." A 1999 Gratzer column "Raising the minimum wage hurts the poor it hopes to help" lamented that even "two of Canada's three right-leaning governments have chosen to hike their minimum wages" and that "minimum wage earners are not underpaid but underproductive." Gratzer won $250 as fourth place runner-up in 1998–1999 and won $2,500 as first prize in the 1999–2000 Felix Morley
Felix Morley
Felix Muskett Morley was a Pulitzer Prize-winning journalist from the United States.-Biography:Morley was born in Haverford, Pennsylvania, his father being the mathematician Frank Morley. Like his brothers, Christopher and Frank, Felix was educated at Haverford College and enjoyed a Rhodes...
Journalism Competition of the Institute for Humane Studies
Institute for Humane Studies
The Institute for Humane Studies is a classical liberal non-profit organization whose stated mission is “to support the achievement of a freer society by discovering and facilitating the development of talented students, scholars, and other intellectuals who share an interest in liberty and in...
at George Mason University
George Mason University
George Mason University is a public university based in unincorporated Fairfax County, Virginia, United States, south of and adjacent to the city of Fairfax. Additional campuses are located nearby in Arlington County, Prince William County, and Loudoun County...
for his newspaper columns.
During his second year of medical school, Gratzer began writing a book about problems with the Canadian health care system
Health care in Canada
Health care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities. It is guided by the provisions of the Canada Health Act. The government assures the quality of care through federal standards...
but could not get anyone interested. Rejection letters piled up after he completed the book and he had doubts about his ability to get taken seriously until his third year of medical school, when Robert Lecker
Robert Lecker
Robert Lecker is Greenshields Professor of English at McGill University, where he specializes in Canadian literature. Lecker was the co-editor of the critical journal Essays on Canadian Writing from 1975-2004, and the copublisher at ECW Press from 1977-2003...
, professor of English
Canadian literature
Canadian literature is literature originating from Canada. Collectively it is often called CanLit. Some criticism of Canadian literature has focused on nationalistic and regional themes, although this is only a small portion of Canadian Literary criticism...
at McGill University
McGill University
Mohammed Fathy is a public research university located in Montreal, Quebec, Canada. The university bears the name of James McGill, a prominent Montreal merchant from Glasgow, Scotland, whose bequest formed the beginning of the university...
and co-founder of ECW Press
ECW Press
ECW Press is a North American small press book publisher located in Toronto, Ontario. It was founded by Jack David and Robert Lecker in 1974 as a Canadian literary magazine named Essays on Canadian Writing. Five years later, ECW published its first books - trade and scholarly titles...
agreed to publish his book. In August 1999, during his fourth year of medical school, ECW Press published the 24-year-old Gratzer's first book, Code Blue: Reviving Canada's Health Care System
Gratzer wrote about deficiencies in Canadian health care and argued that they were the direct result of the system's design, and thus not amendable to simple reforms.
Gratzer called for market-based reforms. He won praise from a former Member of Parliament who wrote: ““Gratzer proposes a workable solution for the biggest public policy problem of the coming generation – government-controlled health care monopoly… Canada needs Gratzer’s solution.” Stephen Harper
Stephen Harper
Stephen Joseph Harper is the 22nd and current Prime Minister of Canada and leader of the Conservative Party. Harper became prime minister when his party formed a minority government after the 2006 federal election...
is now Prime Minister of Canada.
On May 4, 2000, Gratzer was awarded $25,000 by the Donner Canadian Foundation as winner of its second annual Donner Prize
Donner Prize
The Donner Prize is an award given annually by the Donner Canadian Foundation for books considered excellent in regard to the writing of Canadian public policy. The prize was established in 1998. The grand prize is $35,000; short-listed finalists receive $5,000 each...
for best public policy book of 1999 for Code Blue. The book beat out works by Prof. Stéphane Dion
Stéphane Dion
Stéphane Maurice Dion, PC, MP is a Canadian politician who has been the Member of Parliament for the riding of Saint-Laurent–Cartierville in Montreal since 1996. He was the leader of the Liberal Party of Canada and the Leader of the Opposition in the Canadian House of Commons from 2006 to 2008...
, Member of Parliament and the previous Leader of Her Majesty’s Loyal Opposition, and Bob Rae
Bob Rae
Robert Keith "Bob" Rae, PC, OC, OOnt, QC, MP is a Canadian politician. He is the Member of Parliament for Toronto Centre and interim leader of the Liberal Party of Canada....
, former Premier of Ontario and the Opposition Critic for Foreign Affairs.
In his acknowledgment
Acknowledgment (creative arts)
In the creative arts and scientific literature, an acknowledgment is an expression of gratitude for assistance in creating a literary or artistic work....
s, Gratzer said his book "wouldn't have been possible without the encouragement and patience" of David Frum
David Frum
David J. Frum is a Canadian American journalist active in both the United States and Canadian political arenas. A former economic speechwriter for President George W. Bush, he is also the author of the first "insider" book about the Bush presidency...
, a National Post
National Post
The National Post is a Canadian English-language national newspaper based in Don Mills, a district of Toronto. The paper is owned by Postmedia Network Inc. and is published Mondays through Saturdays...
columnist and senior fellow at the Manhattan Institute
Manhattan Institute
The Manhattan Institute for Policy Research is a conservative, market-oriented think tank established in New York City in 1978 by Antony Fisher and William J...
(who introduced him to Manhattan Institute president Larry Mone—who hired Gratzer as a Manhattan Institute senior fellow in 2002) and Adrienne Snow, director of programs for the Donner Canadian Foundation.
Residency and Better Medicine (2002)
In June 2000, Gratzer graduated from medical school and in July 2000 began a five-year psychiatry residencyResidency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
program at the University of Toronto
University of Toronto Faculty of Medicine
The Faculty of Medicine, University of Toronto is the medical school of the University of Toronto. The faculty is based in the Discovery District of Downtown Toronto along with most of its teaching hospitals and research institutes. Founded in 1843, it is one of Canada's oldest institutions of...
. During his psychiatry residency, Gratzer continued to write newspaper opinion columns. A 2001 Gratzer column "Make room for prescription drug ads on television" advocated allowing direct-to-consumer advertising
Direct-to-consumer advertising
Direct-to-consumer advertising usually refers to the marketing of pharmaceutical products but can apply in other areas as well. This form of advertising is directed toward patients, rather than healthcare professionals. The Food and Drug Administration holds responsibility of regulating DTC...
of prescription drug
Prescription drug
A prescription medication is a licensed medicine that is regulated by legislation to require a medical prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription...
s on television in Canada
(the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
are the only countries that allow direct-to-consumer advertising of prescription drugs).
In April 2002, ECW Press published Better Medicine: Reforming Canadian Health Care a book of essays edited by Gratzer. The collection of essays had 17 contributors from 3 countries and 2 continents. Essayists included historian Michael Bliss
Michael Bliss
John William Michael Bliss, CM, FRSC is a Canadian historian and award-winning author. Though his early works focused on business and political history, he has written several important medical biographies, including of Sir William Osler...
and columnist Margaret Wente
Margaret Wente
Margaret Wente is a columnist for Canada's largest national daily newspaper, The Globe and Mail and a director of the Energy Probe Research Foundation. She has received the National Newspaper Award for column-writing twice....
. Dr. Victor Dirnfeld, a physician and former president of the Canadian Medical Association, wrote the introduction. Gratzer co-wrote an essay on market reforms seen in various European countries, and also wrote the concluding essay on medical savings accounts.
The July 23, 2002 issue of CMAJ
Canadian Medical Association Journal
The Canadian Medical Association Journal is a general medical journal that is published biweekly by the Canadian Medical Association . It covers research and ideas aimed at improving health for people in Canada and globally. CMAJ publishes original clinical research, analyses and reviews, news,...
highlighted Medical Savings Accounts (MSAs) with: a commentary by Gratzer in favor of MSAs as a counterpoint to a commentary opposing MSAs, a peer-reviewed
Peer review
Peer review is a process of self-regulation by a profession or a process of evaluation involving qualified individuals within the relevant field. Peer review methods are employed to maintain standards, improve performance and provide credibility...
research article opposing MSAs, a peer-reviewed review article opposing MSAs,
and a book review
Book review
A book review is a form of literary criticism in which a book is analyzed based on content, style, and merit. A book review could be a primary source opinion piece, summary review or scholarly review. It is often carried out in periodicals, as school work, or on the internet. Reviews are also often...
by a University of Toronto medical student of Gratzer's Better Medicine: Reforming Canadian Health Care.
In September 2002, Gratzer was one of 25 Canadians under age 30 featured in a Maclean's
Maclean's
Maclean's is a Canadian weekly news magazine, reporting on Canadian issues such as politics, pop culture, and current events.-History:Founded in 1905 by Toronto journalist/entrepreneur Lt.-Col. John Bayne Maclean, a 43-year-old trade magazine publisher who purchased an advertising agency's in-house...
"Leaders of Tomorrow" cover story. In 2002, while still a psychiatry resident, Gratzer joined the Manhattan Institute
Manhattan Institute
The Manhattan Institute for Policy Research is a conservative, market-oriented think tank established in New York City in 1978 by Antony Fisher and William J...
as a senior fellow.
In 2004, Gratzer was first author of a peer-reviewed
Peer review
Peer review is a process of self-regulation by a profession or a process of evaluation involving qualified individuals within the relevant field. Peer review methods are employed to maintain standards, improve performance and provide credibility...
brief report "Lifetime rates of alcoholism in adults with anxiety, depression, or co-morbid depression/anxiety: a community survey of Ontario" published in the Journal of Affective Disorders.
On June 28, 2005, Gratzer testified in support of H.R. 2355, the Health Care Choice Act of 2005, at a hearing of the U.S. House of Representatives
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
Subcommittee on Health of the Committee on Energy and Commerce
United States House Committee on Energy and Commerce
The Committee on Energy and Commerce is one of the oldest standing committees of the United States House of Representatives. Established in 1795, it has operated continuously—with various name changes and jurisdictional changes—for more than 200 years...
.
Independent practice and The Cure (2006)
On June 30, 2005, Gratzer completed his University of Toronto psychiatry residency and became registeredCollege of Physicians and Surgeons of Ontario
The College of Physicians and Surgeons of Ontario is the governing body for medical doctors in Ontario, Canada.The college issues certificates of registration for all doctors to allow them to practise medicine as well as:...
for independent practice of medicine in Ontario. In April 2006, Gratzer became licensed
Medical license
In most countries, only persons with a medical license bestowed either by a specified government-approved professional association or a government agency are authorized to practice medicine. Licenses are not granted automatically to all people with medical degrees...
to practice medicine in Pennsylvania
Pennsylvania
The Commonwealth of Pennsylvania is a U.S. state that is located in the Northeastern and Mid-Atlantic regions of the United States. The state borders Delaware and Maryland to the south, West Virginia to the southwest, Ohio to the west, New York and Ontario, Canada, to the north, and New Jersey to...
. In May 2006, Gratzer became board-certified
American Board of Psychiatry and Neurology
The American Board of Psychiatry and Neurology, Inc. is a nonprofit corporation that was founded in 1934 following conferences of committees appointed by the American Psychiatric Association, the American Neurological Association, and the then Section on Nervous and Mental Diseases of the American...
in psychiatry.
In October 2006, Encounter Books
Encounter Books
Encounter Books is an American conservative book publisher. It is an activity of Encounter for Culture and Education, Inc. Encounter Books draws its name from Encounter , the now defunct literary magazine founded by Irving Kristol and Stephen Spender....
published Gratzer's book, The Cure: How Capitalism Can Save American Health Care, about problems with the United States health care system
Health care in the United States
Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector...
.
The book advocated moving health-care decisions closer to individuals and their families. Gratzer cited health savings accounts as a success story and bemoaned the state of health care in countries with government-run systems. He advocated various reforms: Gratzer proposed turning over all current federal
Federal government of the United States
The federal government of the United States is the national government of the constitutional republic of fifty states that is the United States of America. The federal government comprises three distinct branches of government: a legislative, an executive and a judiciary. These branches and...
funding for Medicaid to state
U.S. state
A U.S. state is any one of the 50 federated states of the United States of America that share sovereignty with the federal government. Because of this shared sovereignty, an American is a citizen both of the federal entity and of his or her state of domicile. Four states use the official title of...
government
State government
A state government is the government of a subnational entity in a federal form of government, which shares political power with the federal or national government. A state government may have some level of political autonomy, or be subject to the direct control of the federal government...
s in the form of block grant
Block grant
In a fiscal federal form of government, a block grant is a large sum of money granted by the national government to a regional government with only general provisions as to the way it is to be spent...
s to experiment with, using welfare reform as a model; tightening Medicaid eligibility for long-term care
Long-term care
Long-term care is a variety of services which help meet both the medical and non-medical need of people with a chronic illness or disability who cannot care for themselves for long periods of time....
; expanding health savings accounts; and encouraging the purchase of private long term care insurance
Long term care insurance
Long-term care insurance , an insurance product sold in the United States, United Kingdom and Canada, helps provide for the cost of long-term care beyond a predetermined period...
.
In the last chapter, he proposed more far-reaching reforms while acknowledging that neither political party would currently advocate them:
- "Making Health Insurance Portable": ending the tax exemptionTax exemptionVarious tax systems grant a tax exemption to certain organizations, persons, income, property or other items taxable under the system. Tax exemption may also refer to a personal allowance or specific monetary exemption which may be claimed by an individual to reduce taxable income under some...
of employer-provided health insurance and scrapping government regulations mandating what conditions and whom and at what rates private health insurance companies must provide coverage, thereby making it easier for families to purchase health insurance through their employer, their union, or their church; - "Shoring up Medicare": pre-funding the program (either through individual accounts or a trust fund), and raising the Medicare eligibility age to 70;
- "Creating a Market for Medical Progress": ending the FDA's requirement that drugs demonstrate "efficacy", and return to only requiring pre-marketing demonstration of safety.
The Foreword was written by Nobel Laureate Milton Friedman
Milton Friedman
Milton Friedman was an American economist, statistician, academic, and author who taught at the University of Chicago for more than three decades...
. He wrote: "David Gratzer is a practicing psychiatrist who combines firsthand knowledge of medical practice in both his native Canada and the U.S. with an independent point of view and a rare capacity for lucid exposition of complex technical material. . . If you want a well-written, interesting yet authoritative and thorough account of what is wrong with medicine today and how to cure American health care, this is the book for you."
The Cure was named a "Top Ten Reading Selection for 2007" by the National Chamber Foundation.
2008 Campaign and Beyond
On July 30, 2007, Rudy GiulianiRudy Giuliani
Rudolph William Louis "Rudy" Giuliani KBE is an American lawyer, businessman, and politician from New York. He served as Mayor of New York City from 1994 to 2001....
's 2008 presidential campaign
Rudy Giuliani presidential campaign, 2008
Rudy Giuliani’s 2008 presidential campaign began following the formation of the Draft Giuliani movement in October 2005. The next year, Giuliani opened an exploratory committee and formally announced in February 2007 that he was actively seeking the presidential nomination of the Republican...
named Gratzer as one of his five key health care policy advisors, along with: Hoover Institution
Hoover Institution
The Hoover Institution on War, Revolution and Peace is a public policy think tank and library founded in 1919 by then future U.S. president, Herbert Hoover, an early alumnus of Stanford....
senior fellow Dan Kessler, Hoover Institution
Hoover Institution
The Hoover Institution on War, Revolution and Peace is a public policy think tank and library founded in 1919 by then future U.S. president, Herbert Hoover, an early alumnus of Stanford....
senior fellow Scott Atlas, Pacific Research Institute
Pacific Research Institute
The Pacific Research Institute , or officially the Pacific Research Institute for Public Policy, is a California-based free-market think tank founded in 1979 whose stated vision is the promotion of "the principles of individual freedom and personal responsibility"...
president and CEO Sally Pipes, and The Moran Company founder and president Donald Moran. During the campaign, Giuliani championed interstate health-insurance markets and tax parity for non-employer purchases of health insurance, both positions favored by Gratzer.
Giuliani was criticized when he suggested that his chances of surviving prostate cancer
Prostate cancer
Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize from the prostate to other parts of the body, particularly...
had been higher in the U.S. than in Britain, because of false positives, poor sensitivity of such tests, and the slow-growing nature of prostate cancer. Gratzer responded by defending his "snapshot" method of calculating "survival rates" as the method also used by economist John Goodman
John C. Goodman
John C. Goodman is a libertarian economist and the founding president of the Dallas based, conservative think-tank the National Center for Policy Analysis...
, co-founder and president of the National Center for Policy Analysis
National Center for Policy Analysis
The National Center for Policy Analysis is a non-profit American conservative think tank whose goals are to develop and promote private alternatives to government regulation and control...
(NCPA), by economist June O'Neill
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
, and by U.S. Constitutional historian
History of the United States Constitution
The United States Constitution was written in 1787, but it did not take effect until after it was ratified in 1789, when it replaced the Articles of Confederation. It remains the basic law of the United States...
and health policy expert Betsy McCaughey, a former John M. Olin
John M. Olin Foundation
John M. Olin Foundation was a grant-making foundation established in 1953 by John M. Olin, president of the Olin Industries chemical and munitions manufacturing businesses. Unlike most non-profit foundations, the John M. Olin Foundation was charged to spend all of its assets within a generation of...
fellow at the Manhattan Institute. Gratzer also cited a September 2007 Lancet Oncology
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
article that found superior cancer outcomes in the United States for 16 cancers when compared to European countries.
After Giuliani withdrew, Gratzer endorsed the McCain health-care proposal.
Gratzer testified several times during the recent health-care reform debates, including before the House Budget and Ways and Means Committees. In a June 2009 U.S. Congressional hearing on the issue of single-payer health care
Single-payer health care
Single-payer health care is medical care funded from a single insurance pool, run by the state. Under a single-payer system, universal health care for an entire population can be financed from a pool to which many parties employees, employers, and the state have contributed...
, Gratzer and U.S. Rep.
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
Dennis Kucinich
Dennis Kucinich
Dennis John Kucinich is the U.S. Representative for , serving since 1997. He was furthermore a candidate for the Democratic nomination for President of the United States in the 2004 and 2008 presidential elections....
(D
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...
-OH
Ohio's 10th congressional district
Ohio's 10th congressional district is currently represented by Representative Dennis J. Kucinich . The district is based in the western part of Cleveland and surrounding suburbs in Cuyahoga County. Cook PVI rates this district as D+8....
) clashed over Canadian healthcare statistics.
According to a June 29, 2009 front-page article in Canada's National Post
National Post
The National Post is a Canadian English-language national newspaper based in Don Mills, a district of Toronto. The paper is owned by Postmedia Network Inc. and is published Mondays through Saturdays...
, "armed with a stack of statistics about patient wait lists in Canada, and a fusillade of dire warnings about the life-threatening consequences of government-managed care," Gratzer "has emerged as the go-to expert witness for GOP lawmakers hoping to sow doubt in Congress about the wisdom of embracing Mr. Obama's call for a public health insurance option
Public health insurance option
The public health insurance option is a proposed government-run health insurance agency which competes with other health insurance companies. It is not the same as Publicly-funded health care. Called the public insurance option or public option, for short, it was a proposed health insurance plan...
to compete with private insurers."
In July 2009, he appeared on 20/20 to discuss health care.
In November 2009, Encounter Books
Encounter Books
Encounter Books is an American conservative book publisher. It is an activity of Encounter for Culture and Education, Inc. Encounter Books draws its name from Encounter , the now defunct literary magazine founded by Irving Kristol and Stephen Spender....
published a short book of his criticism of the White House plans, How Obama’s Government Takeover of Health Care Will Be a Disaster.
Gratzer continues to comment and debate on health-care issues. He is founding contributor to FrumForum (formerly NewMajority). With former Senate Majority Leader Bill Frist, he debated at the Munk Debates
Munk Debates
The Munk Debates are a biannual series of debates on major policy issues held in Toronto, Canada. They are run by the Aurea Foundation. A charitable foundation set up by Peter Munk, founder of Barrick Gold and his wife...
.
More recent work has focused on obesity. In a widely reprinted L.A. Times piece, he argued that society was suffering from a McVictim Syndrome with "[t]oo many pundits, public health experts and politicians are working overtime to find scapegoats for America's obesity epidemic." He rejects this: "governments can't micromanage your waistline for you. Even if governments could magically walk you to work, ban food advertising, regulate sugar out of food and suck those fat particles out of the air, in a free society you would still have the power to drive to the nearest restaurant, shake your salt shaker and order a second piece of pie. That's why understanding — and rejecting — the McVictim culture is crucial to obesity reduction policy."