Another comparison topic, a la the guns thread. Which system of health care do you think works best in practice? A socialized, government-run health care system like in Cuba (I also think this is the case in Canada)? Or the privatized system like in the United States?
Remember, be nice.
*wonders if a topic about health care systems can actually be flamed*
The United States government spends more than twice as much money per capita on health care as the Canadian government. Americans pay more than four times as much as Canadians do annually for health care, including dental, eye care, and drugs. Thread over.
Is there a difference in quality though?
I highly doubt it, most hospitals and government run health facilities have to follow the same codes of conduct, I'd think.
Is there a difference in quality though?
Some treatments in Canada, especially nonessential surgeries, have waiting lists, and generally people who have the money will go down to the States to get certain procedures done so they don't have to wait so long. But if, say, my appendix explodes tomorrow, then I can pretty much guarantee that I'll be getting whatever surgery I need to have it removed, and it won't cost me anything.
Canada comes out considerably ahead of the US in nearly every health-standards indicator, although it is not currently known whether this has anything to do with people having to sell their houses and liquidate their assets to get their appendices removed. Personally I'd put my money on it, but don't know of anything I can use to back up my claims.
WHO used to have a nice, user-friendly way to look at these but now you have to view a PDF of all the countries' basic health indicators: http://www.who.int/whr/2005/annex/annexe1_en.pdf
Quote:
Canada comes out considerably ahead of the US in nearly every health-standards indicator,
Canada's population 32,805,041 (July 2005 est.) British Isles origin 28%, French origin 23%, other European 15%, Amerindian 2%, other, mostly Asian, African, Arab 6%, mixed background 26%
US population 295,734,134 (July 2005 est.)white 81.7%, black 12.9%, Asian 4.2%, Amerindian and Alaska native 1%, native Hawaiian and other Pacific islander 0.2% (2003 est.)
note: a separate listing for Hispanic is not included because the US Census Bureau considers Hispanic to mean a person of Latin American descent (including persons of Cuban, Mexican, or Puerto Rican origin) living in the US who may be of any race or ethnic group (white, black, Asian, etc.)
The difference in average expected lifespan is 3.3 years adjusted. Yes Canadians are expected to live longer on average, but we are talking apples and oranges in population comparison, the 12% African American population is LARGER than Canada's TOTAL POPULATION.
So, sorry cycle, the conversation is not "over".
Cuba population 11,346,670 (July 2005 est.) Average lifespan is .1 years less than the US. mulatto 51%, white 37%, black 11%, Chinese 1%
UK population 60,441,457 (July 2005 est.) Average lifespan is 1.1 years above US. white (English 83.6%, Scottish 8.6%, Welsh 4.9%, Northern Irish 2.9%) 92.1%, black 2%, Indian 1.8%, Pakistani 1.3%, mixed 1.2%, other 1.6% (2001 census)
Germany population 82,431,390 (July 2005 est.) average lifespan .9 years above US German 91.5%, Turkish 2.4%, other 6.1% (made up largely of Greek, Italian, Polish, Russian, Serbo-Croatian, Spanish)
There are more forces at work than socialized medicine, genetics as well as median income make a huge difference.
Jimro
The best system is to have both and let the individual decide. Now there's topic over.
I suspect most people would choose public out of self-interest, but I wouldn't want private options to be unavailable. So, like those rich Canadians, we could get a private session if we choose, but wouldn't have to go to another country.
Kerry suggested something like this I believe.
And %$^# the FDA too. The FDA should be able to make an approval label or something, or require that unapproved claims are labeled as such, but its ablity to outlaw drugs and restrict the speech of manufacturers must be stopped.
The difference in costs probably has something to do with the private yet colluding health industry getting away with gouging, strict prescription patents, the ridiculously out of control FDA that makes drugs expensive to test and restricts cheaper alternatives that aren't profitable to test, and an expensive system that discourages people from getting preventative care, resulting in more expensive procedures later.
Alberta premier Ralph Klein just unveiled his new "Third Way" healthcare plan. I'll let Rick Mercer explain.
http://www.cbc.ca/mercerreport/video_player.html?ricks_rant_mar.07.2006
Makes sense, if you have money to pay, why wait?
After all, slapping down your Gold Card to pay an American hospital doesn't do much for the Canadian economy or health care system.
However, if a Canadian citizen who is willing to pay extra into the system for a service he/she needs, he/she has just blessed EVERY OTHER CANADIAN TAXPAYER with less of a burden.
By spending that money in America, it doesn't do any other Canadian any good, except to make the waiting list one person shorter.
Ralph Klein's plan has some economic merit. It doesn't sound fair, but life isn't fair, now is it?
Jimro
After all, slapping down your Gold Card to pay an American hospital doesn't do much for the Canadian economy or health care system. However, if a Canadian citizen who is willing to pay extra into the system for a service he/she needs, he/she has just blessed EVERY OTHER CANADIAN TAXPAYER with less of a burden.
You're missing the entire point of the system.
Is the point of the system to "be fair" or is the point of the system to provide health care to every citizen?
I don't see a problem where someone can buy their way to the front of the line, it puts money back into the system to provide for others to get medical care.
Look, people who CAN pay for it are paying for it, and the real question is will other people benefit from their money or not. Will they be putting their money into the American economy or back into the Canadian Healthcare system?
To be sure it isn't "fair", but life isn't fair. Hey I'm all for wealthy Canadians spending their money in US hospitals, so I have no problem keeping the "third option" the "American option" as the journalist so blithely put it.
But other Canadians get zilch out of the "American Option", they will get money back on the "Third Option".
Jimro
The point of the system is to administer the same diagnostic, treatment and preventive services to every Canadian regardless of income level or station in life.
Look, people who CAN pay for it are paying for it, and the real question is will other people benefit from their money or not. Will they be putting their money into the American economy or back into the Canadian Healthcare system?
There's not a lot of clear information on Ralph's plan, but from what I can figure out the system does not profit from the Third Way -- you pay the exact cost of whatever treatment you're getting. If someone pays to cut to the front of a waiting list, all they're doing is screwing over everyone else on that list. They're not reducing the tax burden anymore than they would if they just went somewhere else.
And honestly, even if that was how it works, if I were next in line to get a surgery only to have someone cut in front of me because they have a fatter credit line than I do, the fact that I'll end up paying a hundredth of a cent less in income taxes at the end of the year wouldn't make me happy about it.
Quote:
The point of the system is to administer the same diagnostic, treatment and preventive services to every Canadian regardless of income level or station in life.
So you say the point is to be fair.
Repeat after me, "Life isn't fair".
Explain to me why everyone should be treated the same? Why should you treat the child rapist druggy the same as upper middle class mom?
I can't think of any logical reason why everyone should be treated the same. I can think of dozens of EMOTIONAL reasons why everyone should be treated the same...
I guess you don't have to think about things as long as you FEEL good about them.
Jimro
"Courage, my friends; 'tis not too late to build a better world."
Tommy Douglas
The learned fool writes nonsense in better language than the unlearned - but it's still nonsense.
Benjamin Franklin
Me: We have socialized medicine because we as a society have decided that health care is a fundamental right of every citizen.
Jim: I think life isn't fair so we should make no attempt as a society to improve our craptastic existence on this godforsaken rock.
Me: I disagree, we should do everything we can to make our world better. Here's a quote from the guy who invented Canadian healthcare to illustrate the philosophical rationale behind the system.
Jim: You're a learned fool and everything you say is nonsense.
I didn't know the army taught people to throw rocks when they run out of ammo.
Quote:
I can't think of any logical reason why everyone should be treated the same. I can think of dozens of EMOTIONAL reasons why everyone should be treated the same...
We all know that the army stripped you of human compassion long ago. But frankly, I don't wanna hear your "survival of the fittest" @#%$. Human's have compassion for a reason, it makes us better than animals.
You read any of my writings? One of the legends of Kyzarie is about the Warden wolf. A wolf, an animal, with compassion. Symbolizing that if even a wild animal can have compassion, all sentient beings should be capable of it.
But I'm VERY happy with the UK's healthcare system, where the government funds the NHS which treats all and everything (only partially for optical and dental though, although it DOES do FULL cover for children) but a lot of people prefer to go private to avoid waiting lists...
The system, when it works well, is brilliant.
When it doesn't though, we get a media hype pointing out that the government screwed up the taxes on our dental records and it's now nigh on impossible for dentists to make a profit when working for the NHS so most of them have gone private...
...
As I said, I'm happy with the system, but it does need constant tinkering to keep it in shape.
But, overall, I'd prefer the safety of public healthcare (waiting lists and all) than risking a heath insurance that might not cover me.
Cycle; treat everyone the same!
Jimro; but there are advantages to a more capitistic approach.
Cycle; But that's not fair!
Jimro; so what?
And conversely, whether it's a fair system or not really doesn't matter to me, because as it stands now it isn't "fair" system. Wealthy people simply have more options, and the only thing we are really talking about is where they spend that wealth.
Rico,
I have not read your stories, altho if you provide a link I will take the time to read them.
The Army did not strip me of compassion anymore than tribal life stripped you of common sense. After all, it is rational thought that seperates sapient from merely sentient.
Jimro
I believe Jimro's opinions stem from the observation the universal health-care can, in some cases, be of a lower standard in comparison to a private system, not a lack of compassion.
Cycle, seeing as you are the resident Canadian (well, the outspoken one, barring Wonderbat) of the MoFo, I'd like to hear your reaction to Michael Savage's opinons on health care (he mentions Canada, which is why I'm asking). It's from one his book 'The Enemy Within' (which came out in 2003, just to let you know).
xxxx
PICK YOUR POISON
The first step toward universal health-care is the relentless push for prescription drug benefits for seniors. For years, we've heard Hillary, Gephardt, Daschle, Lieberman, and Gore prescriping free drugs. We're hearing it again as candidates eye the presidential election of 2004. On the surface, it sounds very noble. Who wants grandma eating Alpo so she can pay for her medication?
But don't be fooled. Even after George Bush doled out a drug plan more generous than Gore promised during his failed presidential bid, the Dems screamed for more. These insatiable politicians won't stop with free drugs. They are intoxicated with the idea of prescribing universal health-care, their ultimate goal, for all Americans.
What's wrong with that?
Everything.
Universal health-care is a carrion call for the bottom-feeders out there who think I owe them a living. They think I owe them health-care, housing, a car, a chicken in every pot, and a pot for every chicken! What gives them the right to reach into my pocket for a handout? I owe you nothing. I don't owe you housing, I don't owe you a job, and I don't owe you health-care. That is what Marxists have promised from the beginning of the Bolshevik Revolution.
Sure, I might see a needy guy struggling to make it and choose to help him. But that's my decision.
These are the facts: While there was universal health-care in Russia, it was a poor system for the average Soviet citizen. While there was universal housing in Russia, it was sub-standard, often without heat. While there were universal jobs provided in Russia, you wouldn't want one. That is why we must stick to the free market system.
The entire Democrat machine is geared toward Marxism in one form or another, or communism if you want, Stalinism if you like. You think I'm making this up? Just listen to Dick Gephardt. He announced: "I want to get everybody covered with health insurance."1
What's this?
Is Dick offering to write a check to cover the tab from his personal account? Leave it to Dr. Savage to help decode Gephardt's grandiloquence. When he says "I," he really means "you." Sheeple, he is saying "You must pay to make sure everybody has health insurance (including people who refuse to work and illegal aliens)."
But we have heard this all before. Al Gore admitted his long-term strategy was to use the kids first to reach his utopian universal health-care nirvana. He said, "We will move toward universal health coverage, step by step, starting with all children. Let's get all children covered by the year 2004."2
Leading the carrion call for universal health-care is Madam Clinton. She's been at it ever since she chaired the subversive Task Force on National Health Care Reform behind closed doors in 1993. Since then, she admitted, "We need to take step-by-step progress toward providing [health] insurance for every American."3
Every American? Who's going to pay for that?
You and me, that's who.
Evidently, Gephardt, Gore, and Hillary are not happy with America as it is. They would like to see it look more like Cuba, Canada, or England. Of course, illegal aliens and welfare bums rejoice whenever Hillary (who they see as Martha Washington when she's really more like Eva Peron) pushes "free" health-care. These freeloaders really expect to get something for nothing.
Here's why that's shortsighted.
GONE TO THE DOGS
What is it I oppose about universal health-care?
In a word, it will bankrupt America. There is a limit to how much you can provide a society. Where do you think the cost to pay for universal health-care comes from? It comes from the hard-working taxpayer, not the government.
This means you must pay more taxes to pay for someone else's misfortune. It means robbing Peter to pay Paul. It means small and large businesses will have to put their companies at risk in order to give everyone - including inmates and illegal aliens - a gold-plated medical care system.
There's another reason.
Universal health-care destroys the medical system.
In every country where it has been implemented, people suffer.
Witness Canada--where health care is "free," but access to it is largely unavailable. Canada's socialist, government-run system is one of the worst. With an extreme shortage of doctors, nurses, and hospital beds, the wait for basic treatment is horrendous.
Like geese, Canadians in need of health-care flock to America by the thousands. Which explains why hospitals in New York and Washington place billboards advertising their services to Canadians who, by law, are not permitted to pay for private health-care in Canada.
Need an MRI?
If you're in Canada, forget about it. The wait is at least eight months. Unless, of course, you're a dog. When it comes to MRI machines, veterinary services, which are privately funded, are better equipped than most Canadian hospitals. Several years ago, The Washington Post reported the true story of a man with a brain tumor who desperately needed an MRI. Rather than wait months and months, he scheduled an appointment with a local vet by registering under the name Fido. He paid cash.4
Tell me that isn't madness.
Britain's system of socialized medicine, where citizens are brought up to believe they will receive the best care in the world, is another example of why we should avoid universal health-care like the plague. According to the World Health Organization, 25,000 people will die unnecessarily of cancer every year in Britain. Why? Because experts have found Britain has "third world cancer care."5
I'm talking about Britain here, not Bangladesh.
This is what we're going to do to our system if we embrace national health-care. Open your eyes. Pay attention. Learn from those countries around you. Socialized medicine is an abject failure. As I've said, we will bankrupt not only the medical system but also the whole economy. Those proposing universal health-care ought to get their heads examined.
Yet, such evidence doesn't stop Hillary and the gang on the Left from announcing plans to provide what amounts to socialized medicine in the USA. They present a mulit-billion dollar national health-care program as though it were the latest and greatest thing in the world. They're putting one over on the American people because many of us don't understand what's at stake when we hear the phrase "universal health-care."
Their promises sound oh-so-shiny and new. And we sheeple reach for them like a child, as though they are toys dangling over our crib. In reality, their idea is really nothing more than dead man's pants.
It's beyond me how anybody can think a socialist-based approach to medicine is an improvement to what we have in America. Show me once country where it's a better system.
Show me where it's superior.
Show me where waits are shoter.
Show me where there's greater freedom of choice.
Show me where the doctors and surgeons are better.
Show me where the medicines are more sophisticated.
Show me where people have faster access to treatment.
You can't, because such a country doesn't exist.
If the care is so wonderful in nations with socialized medicine, then go to Cuba for your next cardiac bypass. Fly down there. I'm sure Dr. Castro will be happy to perform surger with his dirty smock. Dr. Castro went to medical school for maybe two years and did his internship operating on donkeys. Go ahead; take your hemorrhoids to Cuba. You'll find tenth-rated doctors with no medication on their shelves, long waiting lines, inferior surgical capabilities, and inferior diagnostic tools.
That's what universal health-care brings.
You see, leftists like Hillary are predictable. They appeal to the sick, injured, downtrodden, and the losers with their hands out, for one reason.
Getting the vote.
I say: Beware of an enemy bearing gifts. It's a shell game. Sometimes, instead of taking away your freedom, the Enemy Within appears to be giving you a gift. In reality, the gift comes with strings attached. They "give" you "free" health-care, then enslave you with a tax burden so heavy you go into cardiac arrest from the load.
STRONG MEDICINE
Here's a personal story of how a family can survive without universal health-care. I was junior in college. My father, as you know, owned his own little store. He worked as hard as any man I ever knew. One day while we were in the Catskill Mountains in upstate New York, he had a heart attack. It was traumatic. A real tragedy. It struck me like a bolt of lightning out of heaven.
Out of hell, frankly.
For the first time in my life, I see a strong man, who I always looked up to, lying in an oxygen tent. He was completely helpless. As we waited for the doctor's report, Mom and I wondered where would we get the money for Dad's treatment. We had no other income. He was the sole provider. In those days, moms didn't work outside of the home. And, we had no health-care because there was no health-care insurance in those days.
After what felt like an eternity, the doctor came into the waiting room. I'll never forget it as long as I live. He says to the family, "Well, his heart is like a tire with a flat. It's like a tire that's got a hole in it. We think we've plugged. But any minute the tire could blow up in your face and your father could be dead."
I was stunned.
But he wasn't through. The doctor explained, "In the interim, while I take care of him, it will cost you $100 a week." Now, $100 a week then was maybe equivalent to between $1000-$2000 a week now. It was more than the entire income of our family, I suspect.
The first thing we had to do was go directly into our savings. Which we did. Then, I had to go to the store, which I did. So what? It was tough on all of us. But we got through it. Why should anyone else pay for my father's illness? I don't think society owed us free medical care. Where does it say you have to pay for my dad's health-care? I don't understand the logic.
To this day I don't understand why my misfortune is your misfortune.
In that sense, I'm a libertarian. You can call me a mean SOB for saying, "I don't want to give you free health-care." I'm not a mean SOB. It's just that your misfortune is not my misfortune. Plain and simple.
Moreover, if you abuse your body, I don't want to pick up the tab for your negligence. Let's say you make the decision to go the clubs every night and screw ten people a week. Tell me, why should I pay for your STD? If you put a nose ring in or pierce your naval or put a genital ring on your body which becomes infected, you're telling me I have to pay for that--just because you are a self-mutilator?
No, I don't think so.
Am I liable to pay for your reconstructive plastic surgery because you fell asleep smoking in bed? If you stick a needle in your arm, do you think I'm supposed to pay for your addiction? No. No. No. I can't carry you on my back. Nor should you be forced to carry me.
Now, for the sake of argument, if I were to say, "Yes, I'll pay for your self-inflicted problems and your health-care," tell me, where does it stop? Answer: It will not stop until we have provided health-care to the ends of the earth.
First, the Left convinces us we need to provide health-care for everybody in America, starting with senior citizens and kids. Then, out of some twisted notion of fairness, they'll propose we provide health-care for the world.
We are already seeing the dawn of the day with George W, Bush's $15 billion handout to fight AIDS in Africa. Team Bush flies halfway around the world with a fat check in hand to announce, "The American people care deeply about the pandemic that sweeps across this continent."6
Don't get me wrong; I care about human suffering.
But I would like to know when the United States annexed Africa. What other African relief problems will our government volunteer to underwrite tomorrow? Hosung? Cars? Dental work? Psychologists?
It's one thing for the Red Cross, the Salvation Army, church and synagogue groups, or Bill Gates' philanthropic foundation to use private funds to address health-care needs overseas. It's a very different thing for this or any other president to grab money from my wallet by increasing my tax burden and then pass that money out to cover the latest world health crisis.
1. Dick Gephardt, Democratic Debate in Columbia, South Carolina, 3 May 2003.
2. Al Gore, Speech to the Democratic National Convention, 18 August 2000.
3. Hillary Clinton, Senate debate in Manhattan, 8 October 2000.
4. Kerri Houston, "Canada's health care is ailing," Dallas Morning News, 1 May 2000.
5. Sarah Lyall, "In Britain's Health Service, Sick Itself, Cancer Care is Dismal," New York Times, 10 February 2000.
6. Stephanie Strom, "Gates charity reshapes world health," International Herald Tribune, 15 July 2003.
xxxx
So Cycle, Rico, Jimro, or anyone else...
Would you care to point out the fallacies (I'm sure there are some) in Michael Savage's argument?
I wasn't raised out here, so that comment holds as much water as a kleenex.
It's not a fair system now. Cycle says it needs to be a fair system and you say it shouldn't. It's a very cold comment for someone who supposedly has compassion.
He reiterates saying that it needs to be a fair system and you respond by saying it's not a fair system now? We knnnooowwww tthhhaatt. 
I believe Jimro's opinions stem from the observation the universal health-care can, in some cases, be of a lower standard in comparison to a private system, not a lack of compassion.
No, they don't. He pretty much said just a minute ago that they stem from his philosophical belief that life isn't fair and there's no point trying to change that. He's very much entitled to this philosophy, but it's not the line of thinking that the system is based on.
Would you care to point out the fallacies (I'm sure there are some) in Michael Savage's argument?
I read it until I got to the part where he started moaning about "bottom-feeders", so basically no, I'm not going to read that sh-t. Michael Savage is a fat right-wing baboon and I am rarely able to read more than a paragraph of his over-the-top bile without vomiting all over my keyboard. I did notice he mentioned MRIs, which were indeed a problem in 2003, but it's pretty much been resolved since then.
He also blubbered about a lack of "choice". If by "choice" he meant the ability to choose your hospital or doctor, the Canadian system lets you go to whatever the hell hospital you like, and be examined by whatever doctor you like. This isn't like food stamps or something.
Quote:
tl;dr
Ten minutes. Fifteen at the most.
Okay, it's not that it's too long, but it's just that he, like Coulter Fhtagn and her degenerate ilk, is incapable of saying anything intelligent that isn't laced with venomous comments about various Democrats who I've never heard of, with words like "bottom-feeders" and "Stalinists" sprinkled about willy-nilly. Basically his entire argument is based around not wanting to indirectly subsidize medical care for people who aren't him.
The United States is the only industrialized nation that does not cover the cost of health care for all its citizens. The US spends more than twice as much per capita on health care than any other nation in the world -- over $4,000 per year for every man, woman, and child. Still, more than 50 million Americans have no health insurance. People without health insurance experience more illnesses and do not live as long as those who are covered.
In the United States two different government agencies, the Congressional Budget Office and the General Accounting Office, conducted comprehensive studies on the cost of providing health care to all. Both concluded that the conversion of the current patchwork of private and public health insurance programs to a universal health care system would save $100 billion on paperwork alone. There would be additional savings depending on how the plan is structured. The GAO concluded that the savings created by switching to a national health system would make it possible to provide comprehensive care for all Americans.
About a quarter of health care expense in the United States essentially comes from paperwork - having to comply with the requirements of a multitude of different insurance companies for documentation, eligibility determinations, billing of patients, and collections. Because of this complicated payment system, trying to sort out who will pay for the care of a patient means hospitals need large administrative staffs to deal with the procedures of a variety of insurers. Further complicating matters, the present system offers a limited, expensive, and ineffective form of universal coverage by requiring hospitals to provide emergency care to the uninsured. Emergency care is the most expensive form of health care.
Physicians in the United States presently average about an hour a day completing paperwork for different insurance companies in order to get paid for services they have provided. Patients often experience long delays in receiving care because paperwork is being processed. Under many plans, insured patients must make the initial payment for medical care, then submit a request to their insurance provider to get reimbursed.
When everyone is covered under the same plan, the need to keep track of who has insurance no longer exists. A patient in a doctors office or hospital doesn't need to provide insurance information before receiving care. Everyone simply carries a card that guarantees access to the care needed.
A single-payer system of health-care financing frees physicians and their patients to keep their focus on health care and the best way to deliver it. The term single-payer describes a government-sponsored form of health-care financing in which a single insurer, the government, pays all of the bills. Hospitals in a single-payer system are paid on the basis of the costs they incur in serving a population, not by each individual patient admitted. The hospital does not need to submit a bill for each aspirin or bandage that is given to each patient. The amount each hospital receives from the government is based on its costs from the previous year plus the cost of inflation. This aspect of the single-payer system is called global budgeting.
The concept of global budgeting for hospitals allows communities and government agencies to make plans to improve the health of the population and prevent illness. By focusing on preventive medicine, universal health care invests in measures such as immunizations to prevent diseases, campaigns against smoking, and mammograms to detect breast cancer in its early stages. A forward-looking health policy carries benefits for public health and government budgeting.
An increased focus on preventive medicine will improve general health conditions and help avoid many costly medical procedures in the future. The use of expensive resources for individual patients can also be reduced as care is shifted to other venues such as outpatient clinics and community care. The outpatient setting allows healthcare professionals to focus on preventive care. Outpatient clinics and community health centers have been shown to reduce the incidence of pregnancy complications and to improve the treatment of chronic illnesses such as diabetes and asthma, resulting in tremendous savings on health costs.
The Canada Health Act of 1984 includes five basic principles that determine how care is to be provided. The act requires that care be publicly administered to avoid the profiteering and increased costs of for-profit health care; comprehensive, so all medically necessary care is covered; universal, so everyone will be covered; portable, so people can move from job to job or city to city without losing coverage; and accessible, so people do not have to go too far to receive health care. This simple act provides one successful example of how the principles of the single-payer system can be put into use.
In the United States, by contrast, the government provides health insurance only for the poor, citizens over the age of 65, and people with disabilities under the Medicaid and Medicare programs. These programs account for less than half of all Americans. The majority of the uninsured are working people and their families. Many employers do not provide health care as a benefit to their employees, or they make the employees pay for such a large portion of the premium that employees cannot afford it.
The single-payer system of health care is not the only possible way to provide universal health care, but it would probably cause the least disruption. In another alternative, known as a national health service, all physicians and nurses are employees of the government and are paid flat salaries. A national health service provides inexpensive and comprehensive care, but reduces the independence of health-care professionals. The single-payer system is more compatible with the way health care is now provided in the United States.
If the United States adopts a single-payer system, the cost of care will be included in taxes instead of the payroll deduction most people pay to cover their health insurance premium at work. Working people who are presently covered through their employment would not experience an increase in taxes. Instead, the money now deducted from their paycheck to pay their health insurance provider would go to the government to help cover the cost of universal health insurance.
Some critics contend that greater government involvement in health care will result in inefficiency and declining quality. In a single-payer system it is not necessary for hospitals to be owned by the government, or for physicians and nurses to be government employees. Government involvement in actual medical care can be minimal. Single-payer is only a method to finance universal health insurance. The governments primary role is simply to collect money and pay bills, a role that the government can carry out effectively and efficiently.
The single-payer system allows people to decide where they would receive their health care. For many people in the present system, especially those covered by HMOs that restrict choice, the single-payer system would provide far more choices about who they could see for their care and what kind of care they could receive. The current system often does not allow people to have long-standing relationships with a physician because coverage plans change so often that patients never really get to know their doctor.
Some people worry that if the United States adopts a single-payer form of health-care financing, problems with waiting lists might begin here. Indeed patients in some countries where everyone is guaranteed health care, such as Britain and Canada, must wait for certain types of elective care. In these countries, patients with urgent problems receive care immediately. Where waiting lists do exist, such as in Canada, governments are working on managing the systems better. More importantly, in these systems care is given based on medical need instead of the ability to pay. Those who need care the most get the best care first. It is important to note that in any system insufficient financing creates bottlenecks when people try to get access to limited resources. The problem of waiting lists arises from insufficient funding, not from any fundamental problem with guaranteed care.
An important difference between the United States and other industrialized nations is the amount of money the United States spends on health care - over twice as much per capita on health care as the next closest nation. The United States spends nearly 14 percent of its GDP on health care, whereas most nations spend only 6 to 9 percent of their GDP on health care.
The United States is certainly spending enough money. However, in addition to the amount spent on paperwork, much of this money is diverted into profits for insurance companies and large for-profit managed care organizations. In the US system, care is also rationed, but it is distributed according to the ability to pay rather than according to need.
In most industries free-market competition tends to increase the quality and decrease the cost of goods and services, but this tendency does not apply to health care. Numerous studies show that for-profit HMOs and hospitals tend to have lower quality as measured by complication rates. Increased costs and reduced quality of the US system are evidenced by rising health-care premiums and decreasing patient satisfaction. At the same time more than 125 studies have demonstrated that people who lack health insurance suffer more illnesses and die earlier because they fail to obtain preventive care and receive health care only when their conditions are more advanced.
People in the United States have always had a great deal of pride in the technology and innovation available through the health-care system in their country. Some people worry that changes in the way health care is financed might diminish the incentive to create new innovations. Although many innovations in health care have originated in the United States, countries with universal health care and single-payer financing have also been on the cutting edge of medicine. The first heart-lung transplant was performed in Toronto. The first laparoscopic cholecystectomy was performed in Newfoundland. Surgeons at Saint Paul's Hospital in Vancouver recently pioneered an efficient new way of replacing heart valves. The incentive to create and innovate in medicine comes from physicians ambition to help patients and from the prestige and compensation that follow. Single-payer financing does not negate these rewards.
The single-payer form of health-care financing does not necessarily change the way in which physicians are compensated for the care they provide. Physicians still have incentives to provide care under a single-payer system because patients can choose their providers based on their satisfaction with the health-care provider. For example, a physician who sees patients in a private office gives the government a slip imprinted from each patients health security card. The government then pays the physician according to a predetermined fee schedule. Income is determined by how many patients a physician sees. As in any system, of course, there can and should be limits on how many patients a physician may see in a given time, to ensure that each patient receives optimal care.
Universal health care with a single-payer form of financing would make the United States a more productive society and allow citizens to feel good about taking care of each other. The current system is broken and harmful. Studies have shown people stay in unwanted jobs to keep their health insurance. There is a growing dissatisfaction with the way in which health care is provided in the United States. This is especially true with the for-profit HMOs. Dissatisfaction with the health-care industry in general is increasingly driving bright, innovative people away from careers in health care.
The biggest question about universal health care is not whether it works, but whether sufficient political will exists in the United States to make such a dramatic change in the way health care is provided. This is the challenge that lies before the United States in the new century. The public acknowledges the need to guarantee the education of all children and the obligation to provide police and fire protection for everyone. Do US citizens feel it is the responsibility of society to provide health care for everyone? If not, who does not deserve to have health care?
Quote:
No, they don't. He pretty much said just a minute ago that they stem from his philosophical belief that life isn't fair and there's no point trying to change that. He's very much entitled to this philosophy, but it's not the line of thinking that the system is based on.
Jimro replied while I was still typing my post, so I didn't see.
As for your post, thank you for taking the time to write a well-thought out endorsement of universal health-care. It's almost a shame that I have to post a few counterpoints.
The reason you pay more for health care in the USA is because there is no government price fixing which inevitably results in poorer service by less qualified individuals using older equipment and technology. As far as consolidating the industry...of course it would result in some efficiencies. That would hold true for any industry. That doesn't mean that you don't give up anything. What about the loss of jobs? What about the loss of tax revenue to the government resulting from those jobs? What about future innovations and breakthroughs that come as a direct result of competition?
Do you have an example or two of what the Canadian government does more efficiently than the private sector (doesn't matter what type of industry it is, be it medical, school, etcetera)?
The basic problem is that once health care becomes a political matter, your voice in it is effectively subordinated to what bureaucrats determine is in your best interests. That shift in power is enhanced by the fact the government pays all the bills instead of you. The government determines how much it will pay doctors and health care providers. Decision-making will be driven by pressures to control costs and cut corners through rationing. If you need a hip replacement procedure done, you can wait years for that or any other medical care deemed elected by bureaucrats. Taxes will rise to fund the health care system. You will get coverage but it may not be what you need or want. There is no free lunch under any system of health care financing. Someone ultimately has to pay the bills and keep the costs in check.
The sad fact is that whether you're in Canada or the US, the health care industry is not market driven. It's the most regulated industry in the country. Of course, it's more true in Canada than the US, but the regulators have made a royal mess of things on both sides of the border.
When government regulates an industry as heavily as our government does, it effectively blocks or discourages some people who would go into the industry from doing so. And that means that there is inadequate capacity to supply demand at free market prices, so prices go up, and those who are least willing or able to pay the higher prices get pushed out of the market. That's what's been happening for decades, and our politicians just keep adding new bandaids to the wounds they've inflicted over the years. They've got no clue how to fix the problem. More regulation is their answer to every problem. The answer is less regulation.
What you're arguing (consolidating entire industries and making everyone goverment workers) is called Communism and it has failed in every instance that it has been tried.
Canada's health plan isn't perfect, which is why citizens (who can AFFORD it) are (now) buying supplemental insurance.
Or as one Canadian justice put it; "access to a waiting list is not access to healtcare".
www.cbc.ca/news/background/healthcare/
A speech that sums up international comparisons nicely
www.hc-sc.gc.ca/ahc-asc/m..._15_e.html
This is slightly more dated, but still a good read.
www.independent.org/newsr...sp?id=1292
Jimro
And just one more thing out of curiosity; how come you hear about Canadians coming to the US for health-care, but you don't hear about Americans going to Canada for health-care?
I'll reply to your earlier post when I have time, but I'll answer this quickly:
And just one more thing out of curiosity; how come you hear about Canadians coming to the US for health-care, but you don't hear about Americans going to Canada for health-care?
Because they're not covered. It's not like the actual services are free. Each province's medical plan is basically an insurance policy, and to qualify for this policy you need to be a Canadian taxpayer. When you receive treatment that is covered under the plan, the hospital or doctor bills the ministry of health for the services. If you're not covered, and you receive treatment at a Canadian hospital, they'll send you the bill.
This image should give you an idea of why universal health-care in the US would be a bad idea and break the system even more (for more information about how Medicare's negative impact, read here.).
Also, after reading your post again, I have a few other points to make.
Quote:
The governments primary role is simply to collect money and pay bills, a role that the government can carry out effectively and efficiently.
This line is laughable. At least, when it comes to the government's involvement with health-care in the US. They now administer the Medicare program, and they do a lot more than 'pay the bills'. Congress currently micromanages the Medicare system. They decide what will be paid for and why, and they do this through Congressional bills. The doctors DO NOT decide medical necessity, Congress does. For example, up until a few years ago, a Medicare patient would go into a doctor's office because he had been suffering nosebleeds. Medical necessity would indicate a CBC (blood test used to determine anemia among other things), but at that time, Medicare did not consider it a medical necessity so they wouldn't pay for it (this example has been changed in recent years, however). Because of Medicare's other rules, if the physician did not tell the patient before hand that it wouldn't be covered, and if they didn't have them sign a waiver, the physician COULD NOT bill the patient for this test. The physician would have to write it off.
As for the efficiency of the consolidated system (say, Medicare), it doesn't look at the whole picture. Compared to private medical companies, Medicare's paperwork efficiency rockets past them with an 85% efficiency rating. The #1 reason for their high efficiency rate is due to their unbendable rules. If a claim comes in that is not 100% correct, it is automatically rejected. So it then becomes the physician's responsibility to do the paperwork, refiling, etc. They are so efficient because they don't do anything but either accept or reject a claim. In the cases of other insurance companies, they will actually look at the claim, and based on certain criteria they will pay it without resubmitting it. An example of this would be the CBC mentioned above. If the nosebleed diagnosis was not in Medicare's database as a payable diagnosis, they would reject it automatically. If the nosebleed diagnosis was not in Blue Cross/Blue Shield's database, they would have someone manually look at the claim, hopefully decide that yes, it should be paid for it in this situation, and then pay it. All this generally without rejecting it first. They may ask for medical records and whatnot, but they would try and get it paid, before rejecting it out of hand.
All in all, I think this quote from Sir Winston Churchill describes it best.
"The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries."
This line is laughable. At least, when it comes to the government's involvement with health-care in the US.
Which is something I explained in that long-ass post up there -- most of the inefficiency is caused by having to satisfy the multitude of clerical demands of a litany of different insurance policies and the companies who provide them. I will address your earlier comment about government efficiency tomorrow evening.
Quote:
Because they're not covered. It's not like the actual services are free.
But if the care is free, then why are Canadian citizens coming down to the US to pay for medical services with cash?
Quote:
most of the inefficiency is caused by having to satisfy the multitude of clerical demands of a litany of different insurance policies and the companies who provide them.
Define inefficiency. I mean, are you saying it's inefficient because there are private insurance companies? If so, what mechanism do you suggest to hold government employees accountable for bad performance? In America, you can always fire your insurance company. It's a bit harder to fire a civil service-protected bureaucrat who is going to get paid whether you see a doctor or not.
Or are you saying it's inefficient because unnecessary work is being performed and time is wasted before health care is provided? Then why would you want to add ANOTHER governmental layer and spend unnecessary money and waste needed time?
Or are you saying that the insurance companies are doing unnecessary work? I reject that. The insurance companies are tracking compensation for health services; getting rid of them would require adding government workers (who could never be fired, see above.) In any case, the greatest efficiencies occur with 'fee for service' with no middleman, but you are not suggesting that.
Long story short, the 'needs' of others are not a claim on my productivity or property, nor are my 'needs' a claim on theirs.
The reason you pay more for health care in the USA is because there is no government price fixing which inevitably results in poorer service by less qualified individuals using older equipment and technology.
Price fixing? I'm not sure what you mean.
Do you have an example or two of what the Canadian government does more efficiently than the private sector (doesn't matter what type of industry it is, be it medical, school, etcetera)?
I received my refund cheque within 14 days of filing my tax return. I still haven't gotten my cheque from Canon, and it's been like two months since I sent in the mail-in rebate for my scanner.
The basic problem is that once health care becomes a political matter, your voice in it is effectively subordinated to what bureaucrats determine is in your best interests.
I'll forgive you for saying this only because you don't live in Canada and are unfamilliar with the political climate here. But basically, with the sole exception of oil-rich Alberta, every government in the history of this country that has tried to screw with healthcare, or toyed with privatization, has been kicked out by the electorate on this sole issue.
The government determines how much it will pay doctors and health care providers.
Wrong. In the case of doctors, each provincial government works out an annual agreement with the Canadian Medical Association, which is the professional association representing all the MDs in the country (it's basically a union, only it calls itself something else), and creates payment schedules for everything from a routine checkup to a triple-bypass. If for any reason the CMA is not satisfied with the agreement, they withdraw services. In other words, the doctors go on strike.
Everyone else -- nurses, assistants, technicians, receptionists, even housekeepers -- is unionized and pretty much does the same thing. Recently the BC government tried to cut the nurses' pay and they nearly provoked a general strike. In fact, basically everyone who works in the public sector is unionized and fully protected from the kind of unilateral decision-making you just described.
Decision-making will be driven by pressures to control costs and cut corners through rationing.
Only if the system is underfunded. Besides, it's not like a for-profit organization doesn't do that every time the shareholders decide they're not making enough money.
If you need a hip replacement procedure done, you can wait years for that or any other medical care deemed elected by bureaucrats.
Not true. A patient's need is always assessed on a case-by-case basis by an experienced healthcare professional.
Taxes will rise to fund the health care system.
My taxes have been holding steady ever since I started paying them.
And apparently, even the former Canadian Prime Minister's doctor thinks your country's universal health-care system needs work.
There's not a single individual in this country who doesn't disagree that it needs work. That doesn't stop people from being glad to have it. I mean, my spoken French needs work -- my pronunciation is slow and my vocabulary is limited -- but I'm still proud to be bilingual.
What you're arguing (consolidating entire industries and making everyone goverment workers) is called Communism and it has failed in every instance that it has been tried.
First, you didn't read my post -- I actually recommended against making physicians and nurses government employees. You also demonstrate a lack of understanding of both communism and Canadian healthcare. Canada does not have a government funded and operated monopoly, it's a series of taxpayer-funded insurance schemes for hospital care and certain doctors services, supplemented by private insurance and out-of-pocket payments for other health services. It is not, by any reasonable stretch, communism.
But if the care is free, then why are Canadian citizens coming down to the US to pay for medical services with cash?
Because some procedures (hip replacements, for example) have long waiting lists, and people are treated in order based on need. (And before you start typing, remember that how badly someone needs a procedure done is determined by experienced healthcare professionals, not by the big, bad, bureaucratic government.) People who have the money will often go down to the States to have it done so they don't have to wait. Rich people have this idea that they should be able to get what they want, when they want it, rather than getting in line like everyone else.
What is clear to me is that a purely socialist approach to healthcare lacks flexibility and choice, hence Canada's supreme court ruling that private insurance is legal.
A purely capitalistic approach doesn't provide universal coverage for routine and long term care.
The "Two tier" boogeyman that scares socialists is really just a boogeyman. Right now Canada has at least a two tier system, the wealthy can afford healthcare even if they have to travel to get it, and now they can purchase private insurance to cover procedures offered by Canada.
This means that even in Canada, home of "world class socialist healthcare" that consumers are demanding options. It seems here in the States that the poor are demanding other people pay for their medical care.
Completely socializing healthcare is not the answer, it never has been.
Jimro
What is clear to me is that a purely socialist approach to healthcare lacks flexibility and choice, hence Canada's supreme court ruling that private insurance is legal.
In Qubec. Qubec has a different constitution from the rest of Canada.
Read this short PDF for more information on the differences between Canada's system and the systems in Cuba and North Korea.
The material you linked said that 6 out of 10 provinces did not allow private insurance for services offered through the state. Of course now that is out the window with the supreme court ruling, unless the ruling only affected Quebec.
Quote:
While private insurance for publicly covered
services is largely illegal, there is nothing to stop
patients from paying out of their own pockets if they
can find a doctor who is not part of the public plan.
Tell me how that isn't a two tiered system? First they have to have money then they have to find a doctor who won't take public money to take their private money.
A socialist system cannot meet the needs of everyone, which is why the "American Option" exists.
Jimro
Of course now that is out the window with the supreme court ruling, unless the ruling only affected Quebec.
It only affects Qubec. Their judicial system is entirely separate from the rest of the country.
So in 50 percent of Canadian provinces it is illegal to buy private health insurance...
Why is that?
Jimro
Quote:
Price fixing? I'm not sure what you mean.
You answer your own question further down.
Quote:
Wrong. In the case of doctors, each provincial government works out an annual agreement with the Canadian Medical Association, which is the professional association representing all the MDs in the country (it's basically a union, only it calls itself something else), and creates payment schedules for everything from a routine checkup to a triple-bypass
Everyone else -- nurses, assistants, technicians, receptionists, even housekeepers -- is unionized and pretty much does the same thing.
Seeing as how a Canadian doctor or a health-care specialist can't charge more in discretionary situations they're inclined or even forced 'to provide poorer service by less qualified individuals using older equipment and technology.'
And are you seriously saying that doctors and nurses can go on strike? This is something far different than workers at an automobile factory or other industrial plants; these people provide important live-saving services. What happens to patients when doctors go on strike?
Quote:
Only if the system is underfunded. Besides, it's not like a for-profit organization doesn't do that every time the shareholders decide they're not making enough money.
That's not really true. If a service is desired, the market will provide unless regulation makes it impractical. Anyway, not every medical practice has shareholders.
Quote:
Rich people have this idea that they should be able to get what they want, when they want it, rather than getting in line like everyone else.
Just to let you know, middle class Americans don't have to wait in line.
Quote:
There's not a single individual in this country who doesn't disagree that it needs work.
It needs work in both countries, true.
Also, although US health standards are down compared to other industrialized nations (when comparing health-care systems, there aren't that many in which accurate comparisons could be made; the only candidates would be Britain, Canada, France, Germany, and maybe a few others), there are two things to keep in mind.
1) The US has a much higher portion of its population living in exurban and rural areas where high-quality health-care services may not be readily available. Countries with large portions of their citizens living in urban areas tend to rank very high on any list of health statistics based on life expectancy - mainly because someone who suffers a serious illness or injury is far more likely to receive immediate care in an urban area than in a rural area.
2) The US ranks relatively poorly in life expectancy and infant mortality compared to other industrial nations simply because we have much more of a libertarian outlook than other countries (and are far less homogenized; Americans as a whole value individualism to a high degree, which is a BIG reason why universal health-care won't exactly fly well with the public), which means we have a much higher incidence of almost any physical/psychological illness that could potentially reduce a person's life expectancy. For example, as recently as a few years ago a term like 'crack baby' couldn't even be translated into Japanese - because there was never any need to come up with a term to describe something that doesn't exist in that culture.
So in 50 percent of Canadian provinces it is illegal to buy private health insurance... Why is that?
It's merely illegal in those provinces to buy insurance that provides the same services as the Medical Services Plan. You can buy private supplemental health insurance from Blue Cross or whatever -- usually this'll cover anything that's not covered by the MSP, like dental, psychotherapy, massage, the chiropractor, whatever. Even in the provinces in which it is legal to buy basic insurance, you'd be hard-pressed to find someone selling it, and there'd be no point in doing so since you'd essentially be paying for something you already get for free. It'd be like paying $1.75 for a bottle of Dasani (essentially filtered tap water from Calgary) when you own a Brita filter.
And are you seriously saying that doctors and nurses can go on strike? This is something far different than workers at an automobile factory or other industrial plants; these people provide important live-saving services.
Indeed, which is why it's important that the government not try to screw them over, and do everything it can to work out a satisfactory arrangement. Unilaterally and arbitrarily deciding how much to pay everyone, like you described, is generally not a good way to go about this.
What happens to patients when doctors go on strike?
Usually what happens is doctors will withdraw certain services, such as elective surgeries, or they'll refuse to work overtime. They're not about to break their Hippocratic Oaths. As for nurses, housekeepers and technicians, they generally take shifts on the picket lines. They don't fully close it all down, but they make visits to the hospital a royal pain in the ass because it'll be understaffed and probably dirty.
Just to let you know, middle class Americans don't have to wait in line.
Yeah, instead they pay exorbitant prices for private insurance and put up with all the shortcomings of a privatized system that I described earlier. I know three people from the States who lost their health insurance because their well-paying jobs were outsourced to India. One of them was seriously injured while riding his bike shortly afterwards, and now has to pay a $7500 bill for the emergency care he received. As you can imagine, it's doing wonders for his credit rating.
Cycle,
Why is private health insurance illegal in 50 percent of Canada?
Inquiring minds want to know.
Jimro
Why is private health insurance illegal in 50 percent of Canada?
I edited my post (see above)
Also, and I can't believe I missed this:
What you're arguing (consolidating entire industries and making everyone goverment workers) is called Communism and it has failed in every instance that it has been tried.
Not that I agree that public healthcare is communism, and not that I'm endorsing communism, but I want you to do something. Get a stopwatch, start it, click here, and see how long it takes you to spot the obscenely large hole in your statement. We're talking like nine and a half million square kilometres here.
...and you're actually saying that Communist China is a better place to live than Canada or the US? Am I hearing you right?
I'm sorry, but if given the choice (and the chance), which system of government would the Chinese rather live under? Humor me.
Communism may be a form of government, but in terms of serving the people that live under it, it falls far short of democracies and republics.
Communism in China can hardly be described as having "failed" when, economically, China is basically poised to overtake the US within 20 years. Their standard of living is up every time someone checks on it, the economy is highly market-oriented even though it's still kept within the political framework provided by the Communist Party, and the government is being more lenient with artists and journalists than ever. If you go to the middle of Beijing, you can hardly tell it apart from any urban center in the West -- office towers, people in suits, crowded streets, shopping centres, big reader boards. All my Chinese contacts' Internet connetions are like 20 times faster than mine. And for God's sake, they own half of IBM.
See, now you're backpedalling. You said that communism has "failed in every instance that it has been tried", and I called you on it. Asking me to answer a retarded question like that is just a petty way of salvaging your argument.
How does any of that make your original statement any less retarded?
How is asking whether or not a Chinese citizen would want to live under the repressive Communist government in China instead of America, Canada, Britain, etcetera 'retarded'?
And to be honest Cycle, the speed of one's Internet connection isn't exactly what I would call an 'indicator of quality of life'.
Where was that mentioned?
How is asking whether or not a Chinese citizen would want to live under the repressive Communist government in China instead of America, Canada, Britain, etcetera 'retarded'?
Your original statement, which was that communism has "failed in every instance that it has been tried", was plenty retarded. Asking whether I would rather live in China was just a petty trap.
Cycle,
You still haven't answered my question why private health insurance is illegal in half of the Canadian provinces.
You haven't explained why private citizens should be prohibited from paying for an alternative to state care.
Jimro
From a few posts above...
Quote:
All my Chinese contacts' Internet connetions are like 20 times faster than mine.
And there you are Rico.
Quote:
Your original statement, which was that communism has "failed in every instance that it has been tried", was plenty retarded.
How so? (Just for the record, governments serve the people, and when a form of government brings about the deaths of millions of its own citizens, I'd consider that a big mark of failure. And to say otherwise WOULD be 'plenty retarded' as you put it.)
How so? (Just for the record, governments serve the people, and when a form of government brings about the deaths of millions of its own citizens, I'd consider that a big mark of failure. And to say otherwise WOULD be 'plenty retarded' as you put it.)
Your entire post was written in an economic context. At the moment you typed "failed", you meant "failed economically, like the Soviets". You weren't even thinking about China.
You still haven't answered my question why private health insurance is illegal in half of the Canadian provinces.
Saying "private health insurance is illegal" is a misrepresentation of the truth, as I explained in my previous post. You can still buy private insurance for services that are not covered by the basic package that is provided by the province you live in.
The reason why private basic insurance is illegal is essentially explained in another post:
About a quarter of health care expense in the United States essentially comes from paperwork - having to comply with the requirements of a multitude of different insurance companies for documentation, eligibility determinations, billing of patients, and collections. Because of this complicated payment system, trying to sort out who will pay for the care of a patient means hospitals need large administrative staffs to deal with the procedures of a variety of insurers.
It's illegal mainly to prevent this from happening. But as I said earlier, even in the provinces where it is legal, nobody sells basic insurance because it'd be like selling air. Nobody's going to pay for what is essentially the same thing they're already paying for and receiving.
