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Congressional Democrats will soon put forward their legislative proposals for reforming health care. Should they succeed, tens of millions of Americans will potentially be joining a new public insurance program and the federal government will increasingly be involved in treatment decisions.
Not long ago, I would have applauded this type of government expansion. Born and raised in Canada, I once believed that government health care is compassionate and equitable. It is neither.
My views changed in medical school. Yes, everyone in Canada is covered by a "single payer" — the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.
There is a saying in law that justice delayed is justice denied. In medicine a diagnosis or treatment delayed can be worse. It can mean a fatality or great and irreperable damage and pain.
The problems were brought home when a relative had difficulty walking. He was in chronic pain. His doctor suggested a referral to a neurologist; an MRI would need to be done, then possibly a referral to another specialist. The wait would have stretched to roughly a year. If surgery was needed, the wait would be months more. Not wanting to stay confined to his house, he had the surgery done in the U.S., at the Mayo Clinic, and paid for it himself.
So health care is not so free and neither is it available. If America follows the Canadian example Canadians will have nowhere to flee and neither will Americans.
Bradford: So health care is not so free and neither is it available. If America follows the Canadian example Canadians will have nowhere to flee and neither will Americans.
I'm not sure "fleeing" is a problem, since non-government sponsored doctors are always a possibility when there's sufficient demand. Aren't they allowed in Canada?
My concern is that the U.S. government mandating prices for the vast majority of drugs and procedures will eliminate the financial incentive for the extraordinary amount of heath research currently going on. Pretty much everyone else has socialized their medical delivery, so we if do, too, there are no longer the big bucks for the next big breakthrough.
don provan: My concern is that the U.S. government mandating prices for the vast majority of drugs and procedures will eliminate the financial incentive for the extraordinary amount of heath research currently going on. Pretty much everyone else has socialized their medical delivery, so we if do, too, there are no longer the big bucks for the next big breakthrough.
I concur. Canada has placed price ceilings on drugs and treatments. I seem to recall that not long ago, it was big business for Canadian companies to stockpile drugs and sell them to Americans at a cheaper price. The problem with that was because of the price ceiling, the drug companies only allow a certain amount of their product to be sold in Canada (presumably to Canadians). Selling them to Americans would deplete the amount of drugs available to Canadians (at a cheaper price).
It is no coincidence that the U.S. is at the forefront of the majority of pharmaceutical innovations. Once the system gets socialised, less money will be available for research and innovation will be stifled.
don provan: I'm not sure "fleeing" is a problem, since non-government sponsored doctors are always a possibility when there's sufficient demand. Aren't they allowed in Canada?
Private (or "non-government sponsored") doctors do have practices in Canada, but do so in violation of the Canada Health Act (CHA). Under the terms and conditions of the CHA, it is the provinces that pay for some (not all) medical procedures and treatments. These procedures must be consistent with the "universal access" portion of the CHA. Private clinics violate the public administration, universality, and accessibility criteria of the CHA and are thus frowned upon by big daddy (i.e. the federal government). The CHA gives the federal government the right to withhold funds for healthcare administration. To give some perspective of how serious this is, in Alberta, healthcare takes up as much as (if not more than) 60% of the yearly expenditures, and that was when the Alberta gov't was raking in surpluses, not incurring deficits.
So how do private clinics/doctors operate in Canada? Usually with the government looking the other way since the current system actually violates the accessibility criteria of the CHA (i.e. long waiting times for access to doctors/specialists).
In 2005, the Supreme Court of Canada (SCOC) ruled that a government monopoly of health services is unconstitutional. This should set the stage for more and more private clinics to open. The challenge for Canadian governments is how to incorporate private healthcare with public healthcare. The CHA will be overhauled or replaced. It's only a matter of time.
Obama and the Democrats should be looking more closely at the Canadian system. Socialised healthcare is not the panacea they think it is. While no system is perfect, it would seem that privatised healthcare has greater benefits than public/socialised healthcare.
JJS: It is no coincidence that the U.S. is at the forefront of the majority of pharmaceutical innovations. Once the system gets socialised, less money will be available for research and innovation will be stifled.
An excellent point and one that is lost on those taking a simple minded approach to the healthcare issue.
Obama and the Democrats should be looking more closely at the Canadian system. Socialised healthcare is not the panacea they think it is. While no system is perfect, it would seem that privatised healthcare has greater benefits than public/socialised healthcare.
I agree. We have tested models out there in the real world. To ignore them and not make corrective adjustments is a sure sign that blind ideology is driving public policy.
Do I want the government involved in my health care? I certainly prefer government interference to the interference of insurance companies intent on maximizing the bottom line. Conservatives complain that if the public is given a choice, we will all choose the government option and the poor insurance companies will be driven out of business. That should tell you which option is better. Actually the tobacco companies didn't go out of business, and I suspect the insurance companies will think of another way to make a buck. If the insurance comapnies weren't spending millions on lobbying, universal health care would have been a reality long ago. One reason that the public option would be cheaper is burocrats are paid a fraction of the amounts raked in by CEO's and other corporate executives.
Bert: I suspect the insurance companies will think of another way to make a buck. If the insurance comapnies weren't spending millions on lobbying, universal health care would have been a reality long ago.
I suspect you're wrong about this Bert. America's Health Insurance Plans represents the interests of over 1,300 member companies providing health insurance coverage to more than 200 million Americans. That trade association launched a campaign, to push for government health care initiatives.
Bert: Do I want the government involved in my health care? I certainly prefer government interference to the interference of insurance companies intent on maximizing the bottom line.
Governments have a bottom line too. That's why rationing and waiting for medical treatment is common in nations with socialized healthcare.
Conservatives complain that if the public is given a choice, we will all choose the government option and the poor insurance companies will be driven out of business.
Actually what conservatives are concerned about is the proposal to tax as income health care coverage provided by employers. That would destroy a very good health care system and add those affected to the public dole.
Anyone who makes enough money that taxes are a problem is not going to switch if their present healthcare is all that great. If private healthcare can't complete against a government option, they don't deserve to survive. We have rationing of health care now. If you don't have the money, all you get is emergency room treatment. And we all pay for the health care of those "on the dole" one way or the other. It might be cheaper if it weren't confined to emergency treatment. How can anyone see the opponnents of healthcare reform as anything but mean, stingy, uncaring people?
Bert: Anyone who makes enough money that taxes are a problem is not going to switch if their present healthcare is all that great.
You're missing the point. Most employees are not wealthy but healthcare is an important job benefit. The taxes would apply to the employer as well through removal of a tax deduction. The end result would be a shot of revenue for the government in the short run (what most office holders are concerned with- the short run) and greatly increased costs in the long run. Government insurance is second rate. I live in a state which offers it. Options are greatly minimized.
If private healthcare can't complete against a government option, they don't deserve to survive.
Why is that? Private industry and individuals support the government. Forced to support the competition which is permitted cost overruns as well.
We have rationing of health care now. If you don't have the money, all you get is emergency room treatment. And we all pay for the health care of those "on the dole" one way or the other. It might be cheaper if it weren't confined to emergency treatment. How can anyone see the opponnents of healthcare reform as anything but mean, stingy, uncaring people?
They can become educated and realize that healthcare critics are focused on specific issues. They want improved healthcare which means avoiding the problems of Canada and other countries. We need to be honest about problems and not hide them for ideological reasons.
Bert: If private healthcare can't complete against a government option, they don't deserve to survive.
If that is indeed the case, I agree. The problem is that private healthcare/business is usually better than the government option (I would say 9 times out of 10).
I don't pretend to know the ins-and-outs of the American healthcare system. As a Canadian, I do know that I envy the American system. I wish I didn't have to wait six weeks to see my family doctor (I could go to an emergency mediclinic, but the doctors there tend not to be very good). I wish that I wouldn't have to wait four to six months to see a specialist. I wish that I wouldn't have to wait six months to two years to get an operation done. When I look at the States, it seems those waiting times are nearly as prevalent and widespread as they are in Canada.
I can tell you, if I can find a private family doctor, I'll be going there. It's worth the extra money.
JJS: Private (or "non-government sponsored") doctors do have practices in Canada, but do so in violation of the Canada Health Act (CHA).
Yeah. "Private". Thanks. And thanks for telling us how it works there. For clarification: are private practices literally illegal, or are they just not allowed to participate in the program? In the U.S., I can't imagine them ever being illegal.
You told us about the downside. How are the theoretical benefits? Are the taxes less than the cost we pay for insurance? (Embarrassingly, I don't know what I pay….) Does it help to have everyone covered, even those without jobs? Are there any advantages?
I'm sure that if you were willing and able to pay what a private doctor would charge, JJS P Eng, there would be a doctor willing to take you money. That's private enterprise. If everyone were as dissatisfied as you seem to be, private doctors would be springing up all over Canada. What you really wish is that someone would subsudize your medical care. The government is doing that in your country. In our country people in good health are being subisdized by those with serious health problems. Insurance companies don't insure sick people. Seriously ill people go through bankruptsy and then the government subsidizes them – sometimes not very adequately.
We have rightly decided that doctors should be well-paid. Not as well paid as the CEO's and corporate executives of insurance companies, but well enough paid that the average person cannot afford them. I sure trust the government to handle healthcare, more than I trust some CEO looking our for his million dollar salary and the bottom line for share-holders.
bertvan http://30145.myauthorsite.com/
Bert: We have rightly decided that doctors should be well-paid. Not as well paid as the CEO's and corporate executives of insurance companies, but well enough paid that the average person cannot afford them.
There's more to it than that. Doctors in New Jersey routinely pay 50-70000 per year for malpractice insurance. Rates are exorbitant even for those who have no history of problems.
I sure trust the government to handle healthcare, more than I trust some CEO looking our for his million dollar salary and the bottom line for share-holders.
That seems to be the mood. Trust in the government. Like the Weimar Republic. Americans looking for a savior. You can just see how government management of the Post Office, Amtrak, the California budget, the car industry, the State of New Jersey, the Pentagon… inspires so much confidence. Bless us and save us politicians. After all most were former CEOs or people of much financial influence before they ran for office.
don provan: For clarification: are private practices literally illegal, or are they just not allowed to participate in the program?
According to the CHA, private practice (in principle) is illegal. Practically, the government tends to look the other way until a special-interest group (Friends of Medicare) squawks too much. With the 2005 SCOC ruling, I think we'll (Canada) see a lot more violations of the CHA until it is overhauled. To complete the answer to the above question, private practices receive no government money, but can be covered (in a very limited amount) by private health insurance (yes, we do have that here too, mostly through work benefits).
don provan: You told us about the downside. How are the theoretical benefits? Are the taxes less than the cost we pay for insurance? (Embarrassingly, I don't know what I pay….) Does it help to have everyone covered, even those without jobs? Are there any advantages?
The one big advantage is everyone is covered (theoretically, of course). This falls under the "universality" criterion of the CHA. In theory, under the CHA, one can go to a doctor when sick or a hospital if more serious and have the costs (mostly) covered by the government. For those with limited financial means, universality can mean the difference between life and death (theoretically).
Universality is quite the carrot to dangle. The obvious question is how do you make it function in the real world? IMO, the implementation of universality through the CHA is flawed. Is there a better way to obtain universality other than a pure public/private healthcare? I'm open to suggestions…
Bert: What you really wish is that someone would subsudize your medical care.
Thank you for telling me what I really wish, Bert. Are you sure you don't work for the government?
Let me tell you what I want:
1. Quality – sorely lacking under our system since specialists go where the money is (U.S. and Europe come to mind).
2. Choice – I want to have the ability to go for a second opinion, something that is currently very difficult under the public system we have (again, lack of specialists). Also, if I have to pay, I'll pay. I would like to have that choice available. Choice in doctors also drives down the cost of doctors. In order to compete, doctors would have to cut fees.
3. Accessability – I don't want to wait 5 hours in the emergency room to be treated. This is due to lack of doctors (again, going where the money is) and abuse of the system (people going to ER for a sniffle or scrap). In fact, the public systme violates the Accessability criterion of the CHA, something that didn't escape the notice of the SCOC in 2005.
4. Efficiency – when government pays the bills, apathy sets in. This happened in Alberta before King Ralph Klein cleaned house (it was not rare for nurses to be standing around like a bunch of teamsters high school students). The system is mismanaged.
I also want to put a sock in the mouths of the Friends of Medicare, but such is the price of Freedom of Speech.
Thank you for telling me what I really wish, Bert. Are you sure you don't work for the government?
I do apologize for that. I didn't mean it to sound as it did. I read today of a proposal for non profit cooperatives to handle health insurance. A coopertive wouldn't be saddled with million dollar executive pay, lobbying costs, dividends to shareholders or campaign contributions for politicians, and could obviously do it cheaper than private insurance companies. I'd also like to see the prohibition against advertising perscription drugs brought back. Anything to get the profit motive out of healthcare.
Speaking of intolerance. Self-appointed defender of leftist causes, David Letterman, amply demonstrated leftist meanness and intolerance by going after Sarah Palin's daughter and inferring sluttiness by mom. Of course it's a joke right. Ha ha. Where's their sense of humor when criticsm is directed at the policies and not the persona of their savior Barack OB?
Bert: Anything to get the profit motive out of healthcare.
Why would a scientist, researching ways to formulate effective drugs, do that if he did not make a profit in the form of a suitable salary? Why would a doctor or a nurse devote their time to patient care without compensation? Where does the money for their salaries come from if not an attempt to make profits i.e. money by their employers? We know what happens when profit motives are removed. Poverty ensues. Cuba, the USSR, eastern Europe, Cambodia…
Incidentally, how stupid ideologues can be is illustrated by the administration's decision to deliver Miranda warnings to combatants outside the USA. Obama's legal background was touted as his strong suit yet the Miranda warning is a legally vacuous notion in the circumstances it is anticipated it will be applied. Foreign nationals living outside the USA do not have constitutional rights.
Incidentally, how stupid ideologues can be is illustrated by the administration's decision to deliver Miranda warnings to combatants outside the USA. Obama's legal background was touted as his strong suit yet the Miranda warning is a legally vacuous notion in the circumstances it is anticipated it will be applied. Foreign nationals living outside the USA do not have constitutional rights.
I haven't heard what you're talking about. It does seem absurd, mainly because if we take them into custody, we're kidnapping them, so we've already violated most of their rights. "Reminding" them that they can have a lawyer as we illegally spiriting them away from wherever we found them does seem silly.
But I suspect if we knew more about it, it would involve some little legal anomaly. For example, it may be because they may later come under the jurisdiction of the U.S. Constitution, and if they did, then anything they'd told us before that would have to be thrown out unless we anticipated that possibility from the beginning of our interactions with them. I'd hate to think we might tortured a confession out of someone, and then not be able to use it at their trial because of a Miranda technicality.
Self-appointed defender of leftist causes, David Letterman, amply demonstrated leftist meanness and intolerance by going after Sarah Palin's daughter and inferring sluttiness by mom.
I think "meanness" and "intolerance" go too lightly on him. It was horribly rude and cruel. Too bad he's getting so much press for it.
I heard he apologized, but I'm guessing it was more to fan the media flame than because he sincerely regretted it. Anyone hear that part of it?
As I said, I don't know the details. Yes, it would be kidnapping to take "armed members of the Taliban" into custory without justification.
From your reaction, you feel that, whatever the example is, there's justification — perhaps this is a combat situation? — but that really doesn't change what I said: there are various reasons to think something might come up that takes what, with "justification", was consider outside the Constitution's jurisdiction and moves it under that jurisdiction. Wasn't there at least one case where an armed member of the Taliban turned out to a U.S. citizen? That's probably the kind of problem they're trying to avoid.
The White House released a report titled, Global Climate Change Impacts in the United States., finding that “Climate changes are underway in the United States and are projected to grow.” Senator Barbara Boxer stated:
The findings released today add urgency to the growing momentum in Congress for legislation that cuts global warming pollution.
But do they? The relevant question remains: Is there evidence in the report that global warming legislation prevents climate change? Also is there an analysis of the costs of global warming legislation as contrasted to projected benefits? The answer- no. This is another example of ideology trumping reliable data.
While President Obama has chosen a deliberately measured response to the contested Iranian election, European leaders have been far less restrained in their comments. On June 16, four days after the presidential election, French President Nicolas Sarkozy called the contested poll a "tragedy" and added that "the extent of the fraud is proportional to the violent reaction." That same day, the Italian Foreign Minister, Franco Frattini, said the violence in the streets and the deaths of protesters were "unacceptable." Three days later, British Prime Minister Gordon Brown referred to "the repression and the brutality" in Iran. Over the weekend, German Chancellor Angela Merkel went further, calling on Iran's leaders to "allow peaceful demonstrations, allow free reporting of events, stop the use of violence against demonstrators and free imprisoned people."
America is becoming more like Old Europe and Europe more like Old America. Europeans taking moral stances. Americans adopting the Orwellian measured response approach. If this trend continues I'll have to look into European immigration laws.
As most of corporate America sits on the health-care sidelines — issuing vague statements, trying not to offend a new U.S. president — Mr. Burd has charged into the political debate. "I'm here because health-care simply isn't a partisan issue," he says. There is what works, and what doesn't. "I'm genuinely concerned someone might try to solve this by nationalizing health care, at the moment we at Safeway have proven that it is the market that reins in costs."
Trying not to offend? After 8 years of doing nothing but trying to offend. We need more people with balls in this country.
JJS: You are the Tanaka to the chilled-out Pedro Cerrano's of the world.
Although I'm a baseball fan I had to google this one.
In one of most heart-wrenching moments of "Major League II," the slugging Cuban defector Pedro Cerrano and the newly acquired Japanese outfielder Isuro Tanaka find a way to overcome the considerable language barrier that divides them and share their thoughts on manhood.
With Cerrano mired in an ugly slump, Tanaka takes it upon himself to confront his teammate one day in the locker room. Lifting his cupped arms up and down below his waist while flipping furiously through his Japanese-English dictionary, Tanaka shouts at Cerrano, "You have no … you have no …" Cerrano struggles to infer his teammate's meaning as Tanaka's hanging arms continue to exaggerate the presence of something between his legs. "Marbles!" Tanaka yells in broken English. "You have no marbles!" Tanaka's gesture fills in the rest for Cerrano, who incredulously translates the anatomical term into his native Spanish: "Marbles? … huevos?"
June 9th, 2009 at 3:01 pm
Woohoo! Open thread!
Canadian Health Care, take two!
Comment by JJS P.Eng. — June 9, 2009 @ 3:01 pm
June 9th, 2009 at 3:14 pm
Thanks for the link JJS. Quoting:
There is a saying in law that justice delayed is justice denied. In medicine a diagnosis or treatment delayed can be worse. It can mean a fatality or great and irreperable damage and pain.
So health care is not so free and neither is it available. If America follows the Canadian example Canadians will have nowhere to flee and neither will Americans.
Comment by Bradford — June 9, 2009 @ 3:14 pm
June 9th, 2009 at 3:33 pm
Astronomers Find New Way to Measure Cosmic Distances
Comment by Bradford — June 9, 2009 @ 3:33 pm
June 9th, 2009 at 7:57 pm
I'm not sure "fleeing" is a problem, since non-government sponsored doctors are always a possibility when there's sufficient demand. Aren't they allowed in Canada?
My concern is that the U.S. government mandating prices for the vast majority of drugs and procedures will eliminate the financial incentive for the extraordinary amount of heath research currently going on. Pretty much everyone else has socialized their medical delivery, so we if do, too, there are no longer the big bucks for the next big breakthrough.
Comment by don provan — June 9, 2009 @ 7:57 pm
June 10th, 2009 at 11:05 am
I concur. Canada has placed price ceilings on drugs and treatments. I seem to recall that not long ago, it was big business for Canadian companies to stockpile drugs and sell them to Americans at a cheaper price. The problem with that was because of the price ceiling, the drug companies only allow a certain amount of their product to be sold in Canada (presumably to Canadians). Selling them to Americans would deplete the amount of drugs available to Canadians (at a cheaper price).
It is no coincidence that the U.S. is at the forefront of the majority of pharmaceutical innovations. Once the system gets socialised, less money will be available for research and innovation will be stifled.
Private (or "non-government sponsored") doctors do have practices in Canada, but do so in violation of the Canada Health Act (CHA). Under the terms and conditions of the CHA, it is the provinces that pay for some (not all) medical procedures and treatments. These procedures must be consistent with the "universal access" portion of the CHA. Private clinics violate the public administration, universality, and accessibility criteria of the CHA and are thus frowned upon by big daddy (i.e. the federal government). The CHA gives the federal government the right to withhold funds for healthcare administration. To give some perspective of how serious this is, in Alberta, healthcare takes up as much as (if not more than) 60% of the yearly expenditures, and that was when the Alberta gov't was raking in surpluses, not incurring deficits.
So how do private clinics/doctors operate in Canada? Usually with the government looking the other way since the current system actually violates the accessibility criteria of the CHA (i.e. long waiting times for access to doctors/specialists).
In 2005, the Supreme Court of Canada (SCOC) ruled that a government monopoly of health services is unconstitutional. This should set the stage for more and more private clinics to open. The challenge for Canadian governments is how to incorporate private healthcare with public healthcare. The CHA will be overhauled or replaced. It's only a matter of time.
Obama and the Democrats should be looking more closely at the Canadian system. Socialised healthcare is not the panacea they think it is. While no system is perfect, it would seem that privatised healthcare has greater benefits than public/socialised healthcare.
Comment by JJS P.Eng. — June 10, 2009 @ 11:05 am
June 10th, 2009 at 11:48 am
An excellent point and one that is lost on those taking a simple minded approach to the healthcare issue.
I agree. We have tested models out there in the real world. To ignore them and not make corrective adjustments is a sure sign that blind ideology is driving public policy.
Comment by Bradford — June 10, 2009 @ 11:48 am
June 10th, 2009 at 12:18 pm
Do I want the government involved in my health care? I certainly prefer government interference to the interference of insurance companies intent on maximizing the bottom line. Conservatives complain that if the public is given a choice, we will all choose the government option and the poor insurance companies will be driven out of business. That should tell you which option is better. Actually the tobacco companies didn't go out of business, and I suspect the insurance companies will think of another way to make a buck. If the insurance comapnies weren't spending millions on lobbying, universal health care would have been a reality long ago. One reason that the public option would be cheaper is burocrats are paid a fraction of the amounts raked in by CEO's and other corporate executives.
bertvan
http://30145.myauthorsite.com/
Comment by Bert — June 10, 2009 @ 12:18 pm
June 10th, 2009 at 1:20 pm
I suspect you're wrong about this Bert. America's Health Insurance Plans represents the interests of over 1,300 member companies providing health insurance coverage to more than 200 million Americans. That trade association launched a campaign, to push for government health care initiatives.
Comment by Bradford — June 10, 2009 @ 1:20 pm
June 10th, 2009 at 1:25 pm
Governments have a bottom line too. That's why rationing and waiting for medical treatment is common in nations with socialized healthcare.
Actually what conservatives are concerned about is the proposal to tax as income health care coverage provided by employers. That would destroy a very good health care system and add those affected to the public dole.
Comment by Bradford — June 10, 2009 @ 1:25 pm
June 10th, 2009 at 2:18 pm
Anyone who makes enough money that taxes are a problem is not going to switch if their present healthcare is all that great. If private healthcare can't complete against a government option, they don't deserve to survive. We have rationing of health care now. If you don't have the money, all you get is emergency room treatment. And we all pay for the health care of those "on the dole" one way or the other. It might be cheaper if it weren't confined to emergency treatment. How can anyone see the opponnents of healthcare reform as anything but mean, stingy, uncaring people?
bertvan
http://30145.myauthorsite.com/
Comment by Bert — June 10, 2009 @ 2:18 pm
June 10th, 2009 at 2:27 pm
By the way I, as a military dependent, have the best of healthcare, the equivilent of what members of congress have.
Comment by Bert — June 10, 2009 @ 2:27 pm
June 10th, 2009 at 2:33 pm
You're missing the point. Most employees are not wealthy but healthcare is an important job benefit. The taxes would apply to the employer as well through removal of a tax deduction. The end result would be a shot of revenue for the government in the short run (what most office holders are concerned with- the short run) and greatly increased costs in the long run. Government insurance is second rate. I live in a state which offers it. Options are greatly minimized.
Why is that? Private industry and individuals support the government. Forced to support the competition which is permitted cost overruns as well.
They can become educated and realize that healthcare critics are focused on specific issues. They want improved healthcare which means avoiding the problems of Canada and other countries. We need to be honest about problems and not hide them for ideological reasons.
Comment by Bradford — June 10, 2009 @ 2:33 pm
June 10th, 2009 at 2:43 pm
If that is indeed the case, I agree. The problem is that private healthcare/business is usually better than the government option (I would say 9 times out of 10).
I don't pretend to know the ins-and-outs of the American healthcare system. As a Canadian, I do know that I envy the American system. I wish I didn't have to wait six weeks to see my family doctor (I could go to an emergency mediclinic, but the doctors there tend not to be very good). I wish that I wouldn't have to wait four to six months to see a specialist. I wish that I wouldn't have to wait six months to two years to get an operation done. When I look at the States, it seems those waiting times are nearly as prevalent and widespread as they are in Canada.
I can tell you, if I can find a private family doctor, I'll be going there. It's worth the extra money.
Comment by JJS P.Eng. — June 10, 2009 @ 2:43 pm
June 10th, 2009 at 4:32 pm
Yeah. "Private". Thanks. And thanks for telling us how it works there. For clarification: are private practices literally illegal, or are they just not allowed to participate in the program? In the U.S., I can't imagine them ever being illegal.
You told us about the downside. How are the theoretical benefits? Are the taxes less than the cost we pay for insurance? (Embarrassingly, I don't know what I pay….) Does it help to have everyone covered, even those without jobs? Are there any advantages?
Comment by don provan — June 10, 2009 @ 4:32 pm
June 10th, 2009 at 4:52 pm
I'm sure that if you were willing and able to pay what a private doctor would charge, JJS P Eng, there would be a doctor willing to take you money. That's private enterprise. If everyone were as dissatisfied as you seem to be, private doctors would be springing up all over Canada. What you really wish is that someone would subsudize your medical care. The government is doing that in your country. In our country people in good health are being subisdized by those with serious health problems. Insurance companies don't insure sick people. Seriously ill people go through bankruptsy and then the government subsidizes them – sometimes not very adequately.
We have rightly decided that doctors should be well-paid. Not as well paid as the CEO's and corporate executives of insurance companies, but well enough paid that the average person cannot afford them. I sure trust the government to handle healthcare, more than I trust some CEO looking our for his million dollar salary and the bottom line for share-holders.
bertvan
http://30145.myauthorsite.com/
Comment by Bert — June 10, 2009 @ 4:52 pm
June 10th, 2009 at 5:17 pm
There's more to it than that. Doctors in New Jersey routinely pay 50-70000 per year for malpractice insurance. Rates are exorbitant even for those who have no history of problems.
That seems to be the mood. Trust in the government. Like the Weimar Republic. Americans looking for a savior. You can just see how government management of the Post Office, Amtrak, the California budget, the car industry, the State of New Jersey, the Pentagon… inspires so much confidence. Bless us and save us politicians. After all most were former CEOs or people of much financial influence before they ran for office.
Comment by Bradford — June 10, 2009 @ 5:17 pm
June 10th, 2009 at 5:25 pm
According to the CHA, private practice (in principle) is illegal. Practically, the government tends to look the other way until a special-interest group (Friends of Medicare) squawks too much. With the 2005 SCOC ruling, I think we'll (Canada) see a lot more violations of the CHA until it is overhauled. To complete the answer to the above question, private practices receive no government money, but can be covered (in a very limited amount) by private health insurance (yes, we do have that here too, mostly through work benefits).
The one big advantage is everyone is covered (theoretically, of course). This falls under the "universality" criterion of the CHA. In theory, under the CHA, one can go to a doctor when sick or a hospital if more serious and have the costs (mostly) covered by the government. For those with limited financial means, universality can mean the difference between life and death (theoretically).
Universality is quite the carrot to dangle. The obvious question is how do you make it function in the real world? IMO, the implementation of universality through the CHA is flawed. Is there a better way to obtain universality other than a pure public/private healthcare? I'm open to suggestions…
Comment by JJS P.Eng. — June 10, 2009 @ 5:25 pm
June 10th, 2009 at 5:48 pm
Thank you for telling me what I really wish, Bert. Are you sure you don't work for the government?
Let me tell you what I want:
1. Quality – sorely lacking under our system since specialists go where the money is (U.S. and Europe come to mind).
2. Choice – I want to have the ability to go for a second opinion, something that is currently very difficult under the public system we have (again, lack of specialists). Also, if I have to pay, I'll pay. I would like to have that choice available. Choice in doctors also drives down the cost of doctors. In order to compete, doctors would have to cut fees.
3. Accessability – I don't want to wait 5 hours in the emergency room to be treated. This is due to lack of doctors (again, going where the money is) and abuse of the system (people going to ER for a sniffle or scrap). In fact, the public systme violates the Accessability criterion of the CHA, something that didn't escape the notice of the SCOC in 2005.
4. Efficiency – when government pays the bills, apathy sets in. This happened in Alberta before
KingRalph Klein cleaned house (it was not rare for nurses to be standing around like a bunch ofteamstershigh school students). The system is mismanaged.I also want to put a sock in the mouths of the Friends of Medicare, but such is the price of Freedom of Speech.
Comment by JJS P.Eng. — June 10, 2009 @ 5:48 pm
June 10th, 2009 at 7:46 pm
This kind of ass kissing is nauseating and unprofessional for those entrusted with bringing us the news rather than a personal adoration rite.
Comment by Bradford — June 10, 2009 @ 7:46 pm
June 11th, 2009 at 8:45 am
I do apologize for that. I didn't mean it to sound as it did. I read today of a proposal for non profit cooperatives to handle health insurance. A coopertive wouldn't be saddled with million dollar executive pay, lobbying costs, dividends to shareholders or campaign contributions for politicians, and could obviously do it cheaper than private insurance companies. I'd also like to see the prohibition against advertising perscription drugs brought back. Anything to get the profit motive out of healthcare.
bertvan
http://30145.myauthorsite/com/
Comment by Bert — June 11, 2009 @ 8:45 am
June 11th, 2009 at 3:49 pm
Speaking of intolerance. Self-appointed defender of leftist causes, David Letterman, amply demonstrated leftist meanness and intolerance by going after Sarah Palin's daughter and inferring sluttiness by mom. Of course it's a joke right. Ha ha. Where's their sense of humor when criticsm is directed at the policies and not the persona of their savior Barack OB?
Comment by Bradford — June 11, 2009 @ 3:49 pm
June 11th, 2009 at 4:05 pm
Why would a scientist, researching ways to formulate effective drugs, do that if he did not make a profit in the form of a suitable salary? Why would a doctor or a nurse devote their time to patient care without compensation? Where does the money for their salaries come from if not an attempt to make profits i.e. money by their employers? We know what happens when profit motives are removed. Poverty ensues. Cuba, the USSR, eastern Europe, Cambodia…
Comment by Bradford — June 11, 2009 @ 4:05 pm
June 11th, 2009 at 4:10 pm
Incidentally, how stupid ideologues can be is illustrated by the administration's decision to deliver Miranda warnings to combatants outside the USA. Obama's legal background was touted as his strong suit yet the Miranda warning is a legally vacuous notion in the circumstances it is anticipated it will be applied. Foreign nationals living outside the USA do not have constitutional rights.
Comment by Bradford — June 11, 2009 @ 4:10 pm
June 12th, 2009 at 7:11 pm
I haven't heard what you're talking about. It does seem absurd, mainly because if we take them into custody, we're kidnapping them, so we've already violated most of their rights. "Reminding" them that they can have a lawyer as we illegally spiriting them away from wherever we found them does seem silly.
But I suspect if we knew more about it, it would involve some little legal anomaly. For example, it may be because they may later come under the jurisdiction of the U.S. Constitution, and if they did, then anything they'd told us before that would have to be thrown out unless we anticipated that possibility from the beginning of our interactions with them. I'd hate to think we might tortured a confession out of someone, and then not be able to use it at their trial because of a Miranda technicality.
Comment by don provan — June 12, 2009 @ 7:11 pm
June 12th, 2009 at 7:20 pm
I think "meanness" and "intolerance" go too lightly on him. It was horribly rude and cruel. Too bad he's getting so much press for it.
I heard he apologized, but I'm guessing it was more to fan the media flame than because he sincerely regretted it. Anyone hear that part of it?
Comment by don provan — June 12, 2009 @ 7:20 pm
June 12th, 2009 at 7:27 pm
Kidnapping armed members of the Taliban?
Comment by Bradford — June 12, 2009 @ 7:27 pm
June 15th, 2009 at 2:58 pm
As I said, I don't know the details. Yes, it would be kidnapping to take "armed members of the Taliban" into custory without justification.
From your reaction, you feel that, whatever the example is, there's justification — perhaps this is a combat situation? — but that really doesn't change what I said: there are various reasons to think something might come up that takes what, with "justification", was consider outside the Constitution's jurisdiction and moves it under that jurisdiction. Wasn't there at least one case where an armed member of the Taliban turned out to a U.S. citizen? That's probably the kind of problem they're trying to avoid.
Comment by don provan — June 15, 2009 @ 2:58 pm
June 16th, 2009 at 7:03 pm
Now this is interesting/entertaining: DIPing into Delphi – Has Team Obama given a sweetheart deal to one favored group of investors?
Comment by JJS P.Eng. — June 16, 2009 @ 7:03 pm
June 17th, 2009 at 6:18 pm
The White House released a report titled, Global Climate Change Impacts in the United States., finding that “Climate changes are underway in the United States and are projected to grow.” Senator Barbara Boxer stated:
But do they? The relevant question remains: Is there evidence in the report that global warming legislation prevents climate change? Also is there an analysis of the costs of global warming legislation as contrasted to projected benefits? The answer- no. This is another example of ideology trumping reliable data.
Comment by Bradford — June 17, 2009 @ 6:18 pm
June 23rd, 2009 at 11:51 am
From Yahoo news:
America is becoming more like Old Europe and Europe more like Old America. Europeans taking moral stances. Americans adopting the Orwellian measured response approach. If this trend continues I'll have to look into European immigration laws.
Comment by Bradford — June 23, 2009 @ 11:51 am
June 29th, 2009 at 4:09 pm
Finally, someone who understands how humans tend to think and act, how the free market works, and how to apply that knowledge to healthcare.
Comment by JJS P.Eng. — June 29, 2009 @ 4:09 pm
June 29th, 2009 at 4:15 pm
From JJS's link:
Trying not to offend? After 8 years of doing nothing but trying to offend. We need more people with balls in this country.
Comment by Bradford — June 29, 2009 @ 4:15 pm
June 29th, 2009 at 4:41 pm
You are the Tanaka to the chilled-out Pedro Cerrano's of the world. I would personally pay to see you do the "grapefruit dance" at an Obama speech.
Hell! For the price of a return ticket, I'll do it!
Comment by JJS P.Eng. — June 29, 2009 @ 4:41 pm
June 29th, 2009 at 4:52 pm
here
Comment by Bradford — June 29, 2009 @ 4:52 pm
June 29th, 2009 at 4:58 pm
The grapefruit dance.
Comment by Bradford — June 29, 2009 @ 4:58 pm
June 29th, 2009 at 5:00 pm
Thanks for the correction, Bradford! Colour me embarassed
The
grapefruitmarble dance by Cerrano/Cassell is classic!Comment by JJS P.Eng. — June 29, 2009 @ 5:00 pm
June 29th, 2009 at 5:06 pm
You're a classic JJS. Would any corporate exec have the huevos to tell Obama he has no marbles if the occassion called for it?
Comment by Bradford — June 29, 2009 @ 5:06 pm