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Socialized health care hasn't been a "DOOMSDAY SCENARIO" up here in the glorious nation of Soviet Canuckistan, comrade Kailen. :pQuote:
Originally posted by Kailen
You will see the root of the "DOOMSDAY SCENARIO" that Obama is pushing socialized healthcare, amongst other social policy.
Ah yes, you are one of the lucky ones who hasn't had the government dictate what type of care that you, or your loved ones get. Plugging your age into their magical formula to see if treatment is worth giving.Quote:
Originally posted by leira
Socialized health care hasn't been a "DOOMSDAY SCENARIO" up here in the glorious nation of Soviet Canuckistan, comrade Kailen. :p
The "DoomsDay Scenario" I was actually referring too. Is the horror flick that Obama is trying to peddle to the American people. The Porkulus Plan is garbage.
I'm sorry if I was unclear of this previously.
I don't want to derail the thread too much, but nationalized health care in Canada has been a terrible drain on its economic growth. There is no excuse for Canada to be so far behind the USA economically when the two countries have free trade and populaces of extremely similar education levels, cultural backgrounds, etc (not identical, but very close).
Stories are legendary of how terrible health care is in Canada, so I'd say it serves as an excellent example of why we do NOT want such a system, rather than the opposite.
And yes, when the article starts with a specific writer's byline you know its a columnist and not just a straight news article. So that colors it. But as Malacasta noted, I don't know many people who are thrilled with these old-school picks. It smacks of political payback for old timers being willing to back him in the campaign instead of forcing him to run as a complete outsider against Hillary.
I disagree with you. Canada's economy improved measurably (I'll try to find a source for this) when the single-payer healthcare system was implemented, especially in the manufacturing sector. Companies no longer having to supply healthcare benefits to employees resulted in a government pseudo-subsidy, which led to a manufacturing boom.Quote:
Originally posted by Aristotle
I don't want to derail the thread too much, but nationalized health care in Canada has been a terrible drain on its economic growth.
Firstly, for clarification, is GDP/capita the economic measure to which you're referring? If that is the case, according to the International Monetary Fund 2007 information, the GDP/capita (nominal) for the two countries are:Quote:
Originally posted by Aristotle
There is no excuse for Canada to be so far behind the USA economically
(all in USA dollars)
Canada: 43,674.038
United States: 45,725.348
Link
Also note that the USA's economic growth was bolstered in part by a long period of deficit spending on the part of the government, which will likely prove to be unsustainable.
Canadian's don't seem to think so, and we live with it every day. Universal healthcare is so popular in Canada that it's often described as practically being the national religion. There are certainly some horror stories, but there are horror stories with US healthcare as well. Shall we engage in a debate over which system's failings are more "legendary", or instead analyze statistical data regarding the average health of our respective citizens?Quote:
Originally posted by Aristotle
Stories are legendary of how terrible health care is in Canada, so I'd say it serves as an excellent example of why we do NOT want such a system, rather than the opposite.
Yeah, one of the 33,212,696 lucky ones.Quote:
Originally posted by Kailen
Ah yes, you are one of the lucky ones who hasn't had the government dictate what type of care that you, or your loved ones get. Plugging your age into their magical formula to see if treatment is worth giving.
You have some serious misconconceptions about how Canadian healthcare works, which I think is mostly inspired by Republican talking points along the lines of, "Healthcare decisions should be between the patient and their doctor, not the patient and the government" or some such nonsense.
The Canadian government doesn't dictate what kind of care people receive. There are no magical formulas, or formulas of any kind. Let me summarize how it works: I get sick, I see a doctor, the doctor decides what treatment is best for me and I get that treatment. The provice of Ontario health insurance plan pays the bill. End of story. Nothing has to be approved by any bureaucrat, or anyone for that matter aside from the patient and their medical professional.
There are some problems with the system, but the government interfering with the coverage of individual patients isn't one of them, because that doesn't happen.
[EDIT: Removed everything where I slaughtered the Canadian health care system]
I'm removing my whole post to just say this, Snrrub: You are totally right that Canadians treat their health care like religion. That includes the usual irrationality and replacement of facts with emotion.
Health care is the one thing I'd rather not rely on a bunch of workaday clock punching underachievers who aren't good enough to practice medicine in a country where they actually get paid what their work is worth.
Ok, I got sucked in by this comment because it is just so bogus.Quote:
Originally posted by Snrrub
Also note that the USA's economic growth was bolstered in part by a long period of deficit spending on the part of the government, which will likely prove to be unsustainable.
USA's debt is 60.8% of GDP.
Canada's debt is 62.3% of GDP.
While I'm throwing out stats:
<hr>
GDP per capita: USA's is 20% higher.
USA's GDP per capita: $48,000
Canada's GDP per capita: $40,200
<hr>
GDP Real Growth: USA's is double Canada's:
USA: 1.4%
Canada: 0.7%
<hr>
Education Expenditures (this one surprised me):
USA: 5.3% of GDP
Canada: 5.2% of GDP
<hr>
Military expenditures: (how small ours is as a % of GDP surprised me)
USA: 4.06% of GDP
Canada: 1.1% of GDP
<hr>
And this is after a 2+ year energy crisis that has rocked the US economy, on top of a brutal banking and housing collapse.
So yeah, lets not go there.
Canada is an awesome country. But their health care system is an epic fail and a total drag on their economy.
First off there are tons of horror stories. Your line of 1 out of 33 million couldn't be any further from the truth. The fact that Canadian Medicare ques their patients creates a slippery slope of unsatisfied customers within your country.Quote:
Yeah, one of the 33,212,696 lucky ones.
Queuing is the most common form of rationing scarce medical resources. Since the quality of patient satisfaction plays no role in determining incomes or other economic rewards for health care providers and administrators in the public system, patients' time is treated as if it has no value. (Basically go take a seat til we call you whenever we are ready.) This queuing affects many medical services, including access to some specialists, diagnostic testing, and surgery. If you are sick. I'd hate to wait around to get diagnosed.
The next problem that contributes to the horrible health care in Canada is access to Doctors and Medical Technology. In an OECD (Organization for Economic Co-operation and Development) report, Canada's access to Computed Tomography (CT) scanners, radiation equipment, lithotriptors, and MRI's were poor. Canada's access was significantly poorer in 3 of the 4, despite spending a full 1.6 GDP on healthcare.
Quote:
You have some serious misconconceptions about how Canadian healthcare works, which I think is mostly inspired by Republican talking points along the lines of, "Healthcare decisions should be between the patient and their doctor, not the patient and the government" or some such nonsense.
The only misconception is the misconception of Canadian Healthcare. Canadian Medicare is unsustainable at it's present course. Unless,Canadians receive less healthcare or more taxes for all the expensive health technologies. It's simple economics, and a good example of opportunity cost (Cost foregone).
The Royal Commission, and its commissioner Roy J. Romanow had no influence on medical care in Canada? Gotcha. Please refer to my previous statement about queuing, doctor access, and technology access. In closing if Canadian Medicare is so great, and so widely accepted. Why are there thousands of people coming to America weekly to get procedures done? Why not have them done in the all providing mother land?Quote:
The Canadian government doesn't dictate what kind of care people receive. There are no magical formulas, or formulas of any kind. Let me summarize how it works: I get sick, I see a doctor, the doctor decides what treatment is best for me and I get that treatment. The provice of Ontario health insurance plan pays the bill. End of story. Nothing has to be approved by any bureaucrat, or anyone for that matter aside from the patient and their medical professional.
Our numbers are at odds with each other. What is your source?Quote:
Originally posted by Aristotle
Ok, I got sucked in by this comment because it is just so bogus.
USA's debt is 60.8% of GDP.
Canada's debt is 62.3% of GDP.
Again, what is your source? In my previous post I cited the IMF database where I got my numbers. Or have you decided to use PPP here to distort the true size of the country's economy?Quote:
Originally posted by Aristotle
While I'm throwing out stats:
GDP per capita: USA's is 20% higher.
The economic crisis has affected Canada's GDP, growth rate and debt numbers as well, albeit to a lesser extent - mostly as a result of regulations imposed by BIG GOVERNMENT :eekQuote:
Originally posted by Aristotle
And this is after a 2+ year energy crisis that has rocked the US economy, on top of a brutal banking and housing collapse.
Yeah, forgive me for not taking your word for it.Quote:
Originally posted by Aristotle
[EDIT: Removed everything where I slaughtered the Canadian health care system]
Riiight. I'm sure you nailed it right on the head, Canadian doctors aren't good enough to move to the United States. It clearly isn't related at all to the fact that there are plenty of other reasons to live in Canada except money. Or the fact that plenty of medical professionals wouldn't want to work in a private system. Seriously, this is the most bullshit thing I've read online this week.Quote:
Originally posted by Aristotle
Health care is the one thing I'd rather not rely on a bunch of workaday clock punching underachievers who aren't good enough to practice medicine in a country where they actually get paid what their work is worth.
The waiting time issue, which is probably the largest problem with Canadian healthcare, is not insurrmountable and is not inherent to public healthcare. Despite the wait times, Canadians still wouldn't even consider going back to a private US-style system.Quote:
Originally posted by Kailen
First off there are tons of horror stories. Your line of 1 out of 33 million couldn't be any further from the truth. The fact that Canadian Medicare ques their patients creates a slippery slope of unsatisfied customers within your country.
Wrong. Patient disatisfaction easily decides the outcome of public elections. This is why Canadian politicians are very sensitive to public demands regarding the healthcare system.Quote:
Originally posted by Kailen
Since the quality of patient satisfaction plays no role in determining incomes or other economic rewards for health care providers and administrators in the public system, patients' time is treated as if it has no value.
This is actually the same problem as above.Quote:
Originally posted by Kailen
The next problem that contributes to the horrible health care in Canada is access to Doctors and Medical Technology.
Canadians can easily afford to maintain the public system unless subject to some horrific and prolonged economic catostrophe orders of magnitude worse than we are currently experiencing.Quote:
Originally posted by Kailen
Canadian Medicare is unsustainable at it's present course.
I never said the Government has never influenced healthcare, I said that the Government isn't involved with the medical treatment of individual patients as it is often portrayed by the opponents of universal healthcare. Government influence on healthcare takes the form of strategic planning, which generally enjoys broad public support for fear of losing votes.Quote:
Originally posted by Kailen
The Royal Commission, and its commissioner Roy J. Romanow had no influence on medical care in Canada?
I think we need another thread for Canadian Health care versus privatized. I'd like to continue point out the glaring incompetence of Obama.
The source of those stats is the CIA World Factbook - a truly awesome resource if you check it out.
It most certainly is. When it is "free", people overuse. They make no effort to mitigate their own costs, so the heavy users, hypochondriacs, and people desperate for attention just pummel the system. We have the same problem in the US with people overusing health insurance, but it is nowhere near as bad as in a public health care setup because at least there are deterrents like co-pays and co-insurance that partially reduce abuse.Quote:
Originally posted by Snrrub
The waiting time issue, which is probably the largest problem with Canadian healthcare, is not insurrmountable and is not inherent to public healthcare.
And the Canadian health care system is legendary for its insane waiting lists for health care. In a particularly vivid story, I remember last year a woman was not even allowed to return to her home in Canada from visiting relatives in the USA because she was sick and they were completely out of beds in her entire region. Real nice. They basically hoped she'd have to get her health care in the USA since they were totally tapped out and overtaxed.
Because like you said, its religion now. And once people are trained to look at the government as their parent, they don't want to pull away from the teat. Self reliance is a tough pull to swallow, even if it is in your own best interests.Quote:
Originally posted by Snrrub
Despite the wait times, Canadians still wouldn't even consider going back to a private US-style system.
Quote:
Originally posted by Aristotle
[EDIT: Removed everything where I slaughtered the Canadian health care system]
Dude. Calm down and stop treating this like a flame war. I removed a section slamming the Canadian system that I felt was potentially inflammatory. I decided the dispositive value was far less than its potential to offend some of our Canadian players.Quote:
Originally posted by Snrrub
Yeah, forgive me for not taking your word for it.
It is clear you're taking this very emotionally. I guess its like you said: Canadians treat their health care system like religion.
Lets keep it real, the public loves SOME features of the system. In particular, there is huge support for the principle that no one should be denied access to needed medical care on the basis of ability to pay. More and more Canadians are becoming more willing to pay out of pocket for private healthcare to not have their taxes go up.Quote:
Originally posted by Snrrub
The waiting time issue, which is probably the largest problem with Canadian healthcare, is not insurrmountable and is not inherent to public healthcare. Despite the wait times, Canadians still wouldn't even consider going back to a private US-style system.
I also mentioned before in a previous post. If everyone is so happy with Canadian Meidcare. Why is it weekly thousands of procedures are done in the U.S? How come people are willing to take a lesser wage in the states to gain access to private health coverage on top of their Medicare?
Uh No, On the contrary, Medicare is not sustainable on its present course. A modest slowdown in the rate-spending increases has been bought through reductions in services, closure of facilities, fewer health professionals, dissatisfaction among those who remain, increased waiting times, and forgoing new technologies. Canadian Medicare as we know it can only be sustainable" if Canadians are willing to accept less service or more taxes.Quote:
Originally posted by Snrrub
Canadians can easily afford to maintain the public system unless subject to some horrific and prolonged economic catostrophe orders of magnitude worse than we are currently experiencing.
The commission which dictates policy and procedure, much like an HMO has influence over healthcare which is saying indirectly in controls healthcare, since its the standard in which procedures are conducted by. If I get something as little as a broken toe, or something as big as cancer. I do not want to wait in line, or have some bureaucrat phone jockey my doctor on how to treat me.Quote:
Originally posted by Snrrub
I never said the Government has never influenced healthcare, I said that the Government isn't involved with the medical treatment of individual patients as it is often portrayed by the opponents of universal healthcare. Government influence on healthcare takes the form of strategic planning, which generally enjoys broad public support for fear of losing votes.
When the government does something, it has to be funded out of what's possibly the single most voter-sensitive governmental policy: the budget. Everyone wants the gummint to spend more money on the things they care about, but not to tax them more. Ultimately, no government can ever hope to spend as much on everything as it would like to. So what happens? The same thing as in most businesses: instead of completely cutting out some projects and fully funding others, every project gets partial funding. This includes health care. I am sure that the Minister for Health (or whatever the title is) would be able to quote you an estimated figure for what s/he wishes the budget could provide, but the Treasurer just won't give that many dollars.Quote:
Originally posted by Snrrub
The waiting time issue, which is probably the largest problem with Canadian healthcare, is not insurrmountable and is not inherent to public healthcare.
This is precisely what creates the queue phenomenon. The budget has spoken (long live the almighty budget), and there's only enough money for X cancer operations per year. Sorry, bud, we can't save everyone's lives, I'll put you on the queue for next year. This may not be an absolute certainty in a public health system, but it's pretty close to guaranteed, at least in Western society.
And that is a huge reason why government health care is rotten and broken at its core. Unless you find some magical way to pay for UNLIMITED, fast health care where the professionals are paid extremely well, these problems will arise.Quote:
Originally posted by Rosuav
This is precisely what creates the queue phenomenon. The budget has spoken (long live the almighty budget), and there's only enough money for X cancer operations per year. Sorry, bud, we can't save everyone's lives, I'll put you on the queue for next year. This may not be an absolute certainty in a public health system, but it's pretty close to guaranteed, at least in Western society.
The idea of needing a surgery, and being told that no matter how much I am willing to pay I simply CANNOT GET IT is just horrifying.
But this is another example of how Canada benefits hugely from its proximity to the USA. Canadians know that if they ever get to that point, where they are willing to pay for a surgery the Canadian government won't give them, they just make a short trip south and have it done. Things would be even worse in Canada if the Canadian people were not able to use the USA's health care system as a backup.
Canada better hope the USA never goes to a socialized health care system, or their "save my ass when I really need it" option will completely go away.
Here's a thought: Everyone pays for healthcare at some point. Here in the UK we pay for it via taxes, some countries you pay for it via insurance plans or actually pay at the hospital / Doc's surgery or whereever.
Personally I'd rather it be deducted at my income source so I never have to worry about it or dealing with corrupt as hell insurance companies whose sole reason for existing seems to be to take people's money and then try and find any way possible to weasel out of paying. I also don't have to worry about not being able to pay my insurance policy if my company shuts down and I lose my job, which is very reassuring to know that if I get made redundent through no fault of my own I can still get medical treatment if I need to. Just my 2 slags. *shrugs
As opposed to corrupt as hell governments whose sole reason for existing seems to be taking people's money through taxes? At least with an insurance company you have some choice. The government says pay us the taxes we want or you rot in jail.Quote:
Originally posted by Khortez
Personally I'd rather it be deducted at my income source so I never have to worry about it or dealing with corrupt as hell insurance companies whose sole reason for existing seems to be to take people's money and then try and find any way possible to weasel out of paying.
The reason both situations fail is because right now people have no incentive to mitigate their costs. Compare it to car insurance. Many, if not most, people actually give a crap about the idea of damaging their car (or someone else's). They try not to get speeding tickets - largely because of the insurance hit (which also means less damage/injuries). They try to be careful with their car because having their insurance rates get jacked up from claims is something they want to avoid.
But when you are going to get taxed the same no matter what, people have no incentive to keep their costs down. They just go to the doctor whenever the hell, and don't give a crap what it costs. They also have no incentive to engage in preventative behavior. Why take the extra time to wash your hands well or take any other precautions when you can just make the government pay for antibiotics? This also has the additional huge negative of causing bacteria to become more and more resistant or immune to the antibiotics we have.
And with insurance, doctors and patients have no incentive not to order up every test possible or take every drug under the sun because they pay the same no matter what.
Also here in Britain we have the NHS -AND- private healthcare firms (Bupa) etc. I think this is the best policy.
Bupa and PPP and all that mob aren't very expensive, to be honest, and it'd be great if everyone could afford them, but the brutal truth is they can't.
It's great to have top-tier medical care as well as the NHS (which does an absolutely sterling job) as a backup.
My dad, who has his Honours Degree in Economics, always says the NHS should be totally privatised, as nothing spells out accountability like paying customers leaving you. I agree with that, but some people -really- no matter what they do, will never ever have that option.
Conclusion? Have both.
QFT.Quote:
Originally posted by khaltek
Conclusion? Have both.
There needs to be a government funded saftey-net for people who just can't afford private healtchacare. Personally I could, but don't because I've never had any complaints with the NHS (I accept some people do have gripes with them, but personally I've nothing but good words for them), if I had problems with them I'd look elsewhere as many people in the UK do (ie going abroad to avoid waiting lists). But I only have myself to think about - no spouse, no kids and none of the expenses that come with them. A lot of people do have these financial drains, so couldn't afford to have to pay for private medical care.
I don't necessarily agree that there MUST be a government-provided safety net for people who choose not to pay for medical insurance. (Please note the word "choose" in there.) When the gummint says "Oh, it doesn't matter if you pay or not, we'll guarantee things for you", then you'll get the bludgers paying nothing and taking all the benefits, and that (as Ari said) is what throws the worst weight on the system. Insurance has its own problems, but the threat of jacked-up premiums does at least give some incentive to avoid claims.
A few questions by which I can evaluate what you are saying.Quote:
Originally posted by khaltek
I agree with that, but some people -really- no matter what they do, will never ever have that option.
Conclusion? Have both.
1) How does your conclusion follow from your premise?
2) Does this principle apply to all goods?
3a) If the answer to 2) is yes, how do you get around the fundamental problem of scarcity in, you know, our universe?
3b) If the answer to 2) is no...why the willing suspension of the acknowledgement of scarcity (as per 3a) for health care? Why is health care treated as an abnormal good?
In an ideal world, the government wouldn't have to provide health care; the genuinely needy who have no way to pay would be supported by donations (either doctors donating their own time, or other people donating money to cover the costs). There have been numerous cases where this has happened, but in this far-from-ideal world, it's not something that can be relied upon. Therefore the government steps in, because promising a baseline level of support/protection to people is seen as a good thing (in other words, a vote winner). The trouble is, as soon as the government has guaranteed something, people can and will take advantage.
Exam question: Come up with the perfect plan that solves all these problems. You have two hours. Show your work. There are no right answers.
Many people believe that access to neccessary medical treatment is a basic human right that everybody is entitled to, whether they can afford to pay for it or not.Quote:
Originally posted by Gaviani
Why is health care treated as an abnormal good?
Too pointless; didn't read.Quote:
Originally posted by Gaviani
A few questions by which I can evaluate what you are saying.
1) How does your conclusion follow from your premise?
2) Does this principle apply to all goods?
3a) If the answer to 2) is yes, how do you get around the fundamental problem of scarcity in, you know, our universe?
3b) If the answer to 2) is no...why the willing suspension of the acknowledgement of scarcity (as per 3a) for health care? Why is health care treated as an abnormal good?
Oh, good. Then you're an unserious asshole that's just declaring things without supporting them. You could have just said that up-front.Quote:
Originally posted by khaltek
Too pointless; didn't read.
Edit: Thanks for the response, Leira. See, Khaltek, my goal was to get you to mention your unstated premise.
Your premise was, and I quote: "some people -really- no matter what they do, will never ever have that option [private insurance/health coverage]."
Your conclusion was, and I quote: "Conclusion? Have both."
Your unstated premise was that all people are entitled to health care, regardless of ability to pay for it as a good. That's fine; if this is an axiom you make, then be prepared to state it. Also be prepared for the questions that result (such as my follow-ups), such as: why health care and not, say, housing? Education? Clothing? Transportation? One can envision a continuum of goods from the most absolutely necessary (say, air or water) to the most frivolous (plasma-screen television) to life. Clearly subsidizing one does not necessitate one subsidize others; however, if you cede the validity of basic economics (which I assume, despite your infantile response, you do), then you must explain why you are choosing to draw your line at one place or another on this continuum. So. Why here?
That's what I'd have asked if, like Leira, you'd offered a principled response or justification for your opinion. I clearly do not agree with it, but it is at least intellectually honest to come out and state that you exempt traditional principles of scarcity, supply and demand, and personal responsibility to provide a given good for everyone. You weren't, though.
Here's a general rule: if you aren't willing to support a statement if politely questioned as to your reasoning or premises behind it, don't post in the first place. Argument and reason aren't democratic processes, where your thought counts just because you deigned to express it to we ignorant masses out of a few seconds of your very busy day. Nobody gives a shit that you just declare something to be so. If you want to be considered something other than an unserious asshole, be prepared to answer serious questions on your opinions.
I expect this is much too much to ask.
[Edited by me] Sorry.
As to the question I now understand you had; I believe that health care is a basic human right to which anyone in a civilised nation should be entitled to. We all pay taxes, this, along with a few other things, should be a primary resource for said taxes to be put towards.
That's a totally unacceptable, immature post, khaltek. It adds absolutely nothing to the discussion.Quote:
Originally posted by khaltek
Too pointless; didn't read.
If you do not want to discuss responses to your posts, fine. Then don't post. And certainly, don't take the time to post completely off topic junk like the above.
If you want to argue this point, PM it to me. Do not derail the discussion with it.
Healthcare is ridiculous. I can't afford to see a doctor, even at the reduced rates that the community health clinic is willing to give me. I can't pay for medication I need to perform optimally in a job or as a parent, and I can't FIND a job to help get me healthcare. If I get seriously injured or sick, I might as well kill myself. My life will basically be over if I discover I'm sick with something that requires major cash to treat.
Despite the fact that we live in (supposedly) the most advanced nation in the world, a huge number of people have this problem. If I lived in one of the horrible socialist dystopias you right-wingers are always making noise about, at least I'd be able to go to the doctor and have my meds.
I was going to write a very long post, and then realized I was digressing a little and would probably end up putting you all to sleep, so here are my two cents anyway:
I don't believe there is one true solution for any social benefit (healthcare, education). On the one hand, it is a known fact of micro-economics that in a free market (and let's assume for a moment we live in a free market, though it's not always true), taxes (in general) mean a reduction in the social surplus, and therefore every taxation that is used to create subsidy, actually hurts the country in a different way.
On the other hand, the percentage of marginal expenses (in simpler words, how much of your salary do you spend) of the needy are close to 100% and almost everything they get goes back to the market which is very healthy (income to the manufacturers and VAT and income taxes to the government). The less they get, the less the entire market gets. Healthy poor people = very good for the country.
I would think the following would be the best course of action:
As it is, healthcare is a "subsidy to a commodity", but in fact, "subsidy to the needy" costs less to the country and reduces the social surplus in a far lesser extent than a subsidy to a commodity.
We need to discard the public healthcares, recruit the money needed for the system (which would be far less than what is needed now because only the needy will receive the help) through progressive taxation (would let the needy spend more money and would take money from the rich that they are less likely to use anyway) and give that money for those truly in need (it could be easily decided through tax brackets) ONLY when they go to the doctor.
Will this solve all our problems? No, but this is the only way I see in which we can decrease taxes and still give those who are TRULY in need the basic care they need/deserve.
One of the worst things to do in any discussion of this type it to use yourself as an example in this manner. In order for anyone to counter your point, they would have to ask a whole host of personal questions, from which the conclusions may be things you take as personal insults.Quote:
Originally posted by Grantref
If I get seriously injured or sick, I might as well kill myself. My life will basically be over if I discover I'm sick with something that requires major cash to treat.
...
If I lived in one of the horrible socialist dystopias you right-wingers are always making noise about, at least I'd be able to go to the doctor and have my meds.
For example: do you smoke? do you drink? Both of those things are humongous wastes of money that also negatively impact your health to a severe degree. Do you eat junk food? Fast food? Same deal. People generally do not want to hurt other people's feelings by going down this road, but it is the only reasonable place to go when you make the issue about YOU personally.
So I'd say it is far better to avoid that in the first place, no?
Most people who want "meds" don't need them. People who need them would be far more able to afford them if they did not engage in self destructive behavior in the first place (smoking, drinking, etc.). But people don't like to take the blame for their own health (or lack thereof) so it is a lot easier to ask Mommy and Daddy Government to do it, and call people heartless for not wanting to foot the bill.
What it boils down to is this: why is it someone else's responsibility to pay for YOUR health care? Shouldn't that be YOUR responsibility? Shouldn't you be responsible to take care of your own health and bills?
I take steps to be healthy. This means I don't smoke, drink, go pub crawling in the rain, or do a lot of other unhealthy things. So why should I have to pay the health costs of people who do?
Quote:
Originally posted by Grantref
Healthcare is ridiculous. I can't afford to see a doctor, even at the reduced rates that the community health clinic is willing to give me. I can't pay for medication I need to perform optimally in a job or as a parent, and I can't FIND a job to help get me healthcare. If I get seriously injured or sick, I might as well kill myself. My life will basically be over if I discover I'm sick with something that requires major cash to treat.
Despite the fact that we live in (supposedly) the most advanced nation in the world, a huge number of people have this problem. If I lived in one of the horrible socialist dystopias you right-wingers are always making noise about, at least I'd be able to go to the doctor and have my meds.
Okay a couple of points:
1. Those who are medically ill, mentally ill, and those who are seniors get taken care of. Americans have common consensus on these individuals being covered since they are UNABLE to PROVIDE for themselves. Americans as a whole are quite charitable people, given our history.
2. There are many clinics (free & subsidized) that you can go and get basic treatments. Hell, I used them when I was traveling the country many years back. They are available. Most American's just don't take the time to get out and forage for themselves. Which is the underlying problem in the first place, and only roots itself further with anything socialized.
3. I believe healthcare for normal able body citizens is a privilege.
4. If you reside in a socialist country. You would have to wait in line for your meds or treatment. As some can testify. I hate waiting for anything; let alone for medical care.
Now don't get me wrong. Do I think private healthcare needs a bit of tweaking. I most certainly do. Do I think we need to move to socialized healthcare? No.
I would like to see Healthcare not tied directly to an employer. This creates a form of enslavement from the employee's standpoint, and a unneeded burden for the employer. You choose to quit, get fired, or laid off. You pretty much loose your healthcare, unless you pay higher premiums for a personal package. I believe employer should give the employee their health contribution to them. Then allow them to go around and shop for their own plan. This creates a few opportunities to haggle over plan types, coverages, deductibles. Which ultimately lowers prices and cost. People would think twice about ordering up some procedures if they had some skin in the game.
I hear stories everyday. How a girl was nauseous so she ranged for an ambulance to cart her to the hospital.
Anyhow, I'm on the toilet and need to prep myself for completion.. I hope you all get my drift.
Here I'm going to address the waiting time issue faced by the Canadian healthcare system, and particularly against the claims that this automatically makes the system worse than its American counterpart. For the purpose of this post, I'm going to neglect American patients who receive care via government assistance and also neglect Canadian patients who receive care privately - whether by visiting a private Canadian hospital or clinic, or by seeking private care in another nation.
When a Canadian patient is subject to a prohibitive wait before treatment, this translates to a lack of access to medical care. Lack of access is also a phenomena in the United States, as access is related to an ability to pay. In order to logically show that waiting time makes the Canadian healthcare system worse than the American healthcare system, one would have to demonstrate that lack of access in Canada due to waiting times is worse than lack of access in the USA due to an inability to pay.
In Canada, the waiting time of a patient to access care is related to the urgency with which they require care. Rather than being on a first-come-first-serve basis, most health services are provided to the more urgent cases before the less urgent cases, regardless of when those patients entered 'the line'. Therefore, access to care in Canada is proportional to need of care. By comparison, in the United States, those who are unable to pay - namely, the poor, are also the people who typically eat a poor diet, work physically demanding jobs, and are exposed to higher levels of violent crime. Therefore, I make the assertion that at best, American access to care is unrelated to the need of care, and at worst, is weakly inversely proportionate to the need of care.
Of course, Canadian waiting times in most cases represent a terrible inconvenience, rather than an impenetrable barrier to care (clearly there are exceptions, namely if the person dies before care is provided).
I'd be interested in seeing statistics related to the percentage of citizens who are faced with an inability to pay in the United States compared to the average wait time in Canada for a number of different health services. This is information that I'll try to find after lunch.
Unfortunately the former is an impossible statistic. How many people are there each year who, because they know they have little/no money in the bank, choose to suffer through something rather than see the doctor?Quote:
Originally posted by Snrrub
I'd be interested in seeing statistics related to the percentage of citizens who are faced with an inability to pay in the United States compared to the average wait time in Canada for a number of different health services. This is information that I'll try to find after lunch.
Of course, to complete the statistical analysis, you'd have to then also evaluate how many of those people really needed medical attention, and how many were *just fine* without it. The advantage of a pay-for system is that it keeps the latter out; the disadvantage is that it keeps the former out.
A good baseline might be the number of people who don't have health insurance. According to this 2005 report by the US Census Bureau, 15.7% (45.8 million) were uninsured. I'm going to guess that only a tiny fraction of those lack health insurance by choice. The bigger uncertainty here is whether the typical uninsured person can afford routine medical services without insurance.Quote:
Originally posted by Rosuav
Unfortunately the former is an impossible statistic. How many people are there each year who, because they know they have little/no money in the bank, choose to suffer through something rather than see the doctor?
I like the public health service here in Britain. I've never had a problem with standing in line or queuing, never had to demean myself by waiting any longer than I would if I had the best private healthcare this country can provide.
I do have private health insurance, which would allow me to reside in luxurious hospitals if I ever needed serious medical attention, but I have never chosen to use it over the NHS yet.
I like that everyone has access to medical care. I don't mind paying my taxes every week because in my small way I am contributing to the society and country I like to call home, even if it's by paying for someones methadone.
I read a study the other day that reported 7% of Americans having unmet medical needs due to financial barriers, and 3.5% of Canadians having unmet needs due to wait times. Canada had less than 1% under financial barriers, while America had less than 1% under wait times. I'll link the study after I get home from work.Quote:
Originally posted by Snrrub
I'd be interested in seeing statistics related to the percentage of citizens who are faced with an inability to pay in the United States compared to the average wait time in Canada for a number of different health services. This is information that I'll try to find after lunch.
I go to the doctor when I am *just fine*, and there are two reasons I'm going quite regularly.Quote:
how many of those people really needed medical attention, and how many were *just fine* without it. The advantage of a pay-for system is that it keeps the latter out; the disadvantage is that it keeps the former out.
1. My daughter is often sent home from creche because of some little rash or mark or fever, but needs a doctor to sign her off before she can be allowed in with other children. I think this is perfectly acceptable (no matter how bloody infuriating I find it) since children's illnesses can get very serious very quickly.
2. I am a grown up. I am actually over 40. I have been in the same company for nearly 10 years and I have never had a warning or any counseling, on the contrary, I have received 'excellent work' awards and bonuses. My workplace actually has a POLICY of not infecting a workplace with flus and the like and you have to complete a course where it says it's more productive to take a day or two off work than infect the office and cause 20 people to take a day or two off work. We are given a set number of sick days a year. If you take more days than your allocated number, then you are unpaid. So. All this being the case, why is it that I have to get a freaking medical certificate from a doctor at a reputable clinic if I ever take off more than one day in a row? It's like I'm at elementary school again and needing a letter from my mum. Seriously, I'm a grown up, it's a bloody waste of my time to drive to an office, infect everyone in the waiting room (and maybe the doctor), wait for 20 minutes, when all he's going to tell me is that I should lie down in bed for a day or two. It's also a huge waste of system resources. That's not universal health care, that's bloody draconian work rules that treat workers like they're infants.
Other *just fine* visits to the doctor are things like pap smears and mammograms, unusual moles, various baseline tests when you reach a certain age and other preventative sort of checks like that . I don't actually know, are these things free in the US? What's the cost to society and the health care system of not treating things like suspicious moles that develop into melanomas, or missed pap smear tests that could have caught a terminal cervical cancer?
I couldn't agree more as to this point - the corporate (or even scholastic, when you're in graduate programs) norm of having to actually document or prove your own illnesses is fascinating, considering how many professionals actually are subject to this sort of treatment. I would think the instinctive baseline answer for a given employer would be to trust an employee's declarations of their sickness until they cannot, and then fire them. My completely wild speculation wants to wonder if, as a consequence, the policy has to exist to prevent threats of lawsuit over retaliatory discharge or other similar claims. It costs the company money to enforce this childlike policy too, Malacasta - so if they're doing so, it's either:Quote:
Originally posted by Malacasta
All this being the case, why is it that I have to get a freaking medical certificate from a doctor at a reputable clinic if I ever take off more than one day in a row? It's like I'm at elementary school again and needing a letter from my mum. Some text redacted here. That's not universal health care, that's bloody draconian work rules that treat workers like they're infants.
1) Irrational, redundant bureaucracy [unlikely, given that it affects their bottom line, but possible],
2) A function of the fact they subjectively expect it will reduce sick time amongst employees (and, by extension, increase aggregate productivity) [plausible],
3) An attempt to insulate themselves from threats of lawsuit if they wish to discharge employees that had good resumes or, for some reason, are now so frequently ill/unable to work that they are now a net liability the company would rather be rid of [again, also plausible], or
4) Some combination of the above.
I have no idea which the case is - as someone studying the law, my instinct is to say it's mostly 3 with a dash of 2; we'd have to prevail upon an entrepreneur or HR person to tell us any more, though - so take all of that as personal speculation rooted in reason but not very much else.
There's a bit of a fallacy of excluding false negatives here, and I think you're slightly missing Aristotle's point. Certainly there is some benefit to the system if a person with a precancerous mole detects that malady and has it excised before it turns into life-threatening cancer. There is also some additional cost when another person with a similar mole confirms that it is, in fact, a harmless mole. Experience tells us that, by necessity, most of these preventative/screening measures are going to turn up negative - essentially a needless cost. The justification, as you point out, is the one positive - and the logic goes that that individual's massive benefit offsets the costs. It may. That does not mean it is the most efficient arrangement.Quote:
Originally posted by Malacasta
What's the cost to society and the health care system of not treating things like suspicious moles that develop into melanomas, or missed pap smear tests that could have caught a terminal cervical cancer?
Ideally, we want individuals to essentially self-select appropriately into having these things pre-screened. People with a serious history of cancer or higher risk behaviors should do so; people who do not should not. Obviously this all works in the aggregate; in any one individual case, the odds of having cancer are either 0 or 1. If you give an entire body of people these preventative measures for no cost, they will all make the same calculation: "Hmm. This procedure costs me nothing (but time), and it could detect cancer - so I'll go." The problem with this logic is that many people who are not in any reasonable risk for cancer will go get screened, ballooning costs as a consequence. The only meaningful way you can ask people to express their preferences consequentially is to ask them to employ their own resources in doing so. If a test costs $100 and I am responsible for it, I will, implicitly or explicitly, only get that test if I think I have $100 worth of risk for cancer. People will self-select into what they perceive as higher and lower risk groups, appropriately weighting their behavior due to the amount of time it costs, their own subjective concern over the potential health malady, and their opportunity cost for inaction (it costs a businessman a lot more to take an hour out of his day than someone who is unemployed).
Preventative care is a good and worthwhile thing. Many, in fact, health procedures are good and worthwhile things. That does not mean they should be indiscriminately showered upon any and all who request, or even claim to need, them. For every treatment or procedure you offer, you, by necessity, cannot offer some other good (health or otherwise) to another person. The only way to maximize scarce resources in a limited world is to employ those resources at maximum efficiency. People are most likely to behave efficiently when they act on their own dollar. That is what Aristotle's point gets at, and why the mere fact that preventative screening can ease the costs of medicine does not justify shifting those costs to the body public - because you nonetheless have the same perverse incentives as before, merely at a different phase of the medical process.
Saying that someone was fine without going to the doctor does not simply mean that they were in good health. What I meant was the proportion of people who forewent medical attention for financial reasons, and actually did not need it at all. Preventative checks/treatment is just as important as curative, and if you need a certificate... well, that's a need of a different sort, and the place to argue that is not the doctor's lobby but the political lobby.Quote:
Originally posted by Malacasta
I go to the doctor when I am *just fine*, and there are two reasons I'm going quite regularly.
Yup. I'd say your evaluation of reasons is probably about right, although I'm going only on broad notions of what seems to happen.Quote:
Originally posted by Gaviani
... a whole lot of stuff about demanding certificates
I think those aren't what people are talking about when they cite abuses of the system. Yearly checkups are part of excellent preventative care and being healthy. Abuses of the health system would be going to 3 different pediatrician for your child until you finally find one that will prescribe ritilin. Abuses would be calling for an ambulance rather than a cab, a neighbor, a family member, or a friend to get to the hospital to get to the ER. Abuses would be something like bringing your newborn into the pediatrician every day for the first 2 weeks of his/her life because you don't have to pay for your healthcare costs.Quote:
Originally posted by Malacasta
Other *just fine* visits to the doctor are things like pap smears and mammograms, unusual moles, various baseline tests when you reach a certain age and other preventative sort of checks like that . I don't actually know, are these things free in the US? What's the cost to society and the health care system of not treating things like suspicious moles that develop into melanomas, or missed pap smear tests that could have caught a terminal cervical cancer?
This happens in the US, too, because we DO have government subsidized health care already, and the abuses are phenomenal. So, to whoever said we need to have both, we already do have it. The problem is that it's not available to everyone, just the poor and the people who know how to abuse the system. So, in the US, if you're poor, you don't really have a barrier to healthcare cost. You have MedicAid and MediCare, and you also have the ER at any public hospital which is required to take in anyone who shows up at the doors regardless of their financial situation.
The argument here is probably really one of equality rather than availability. Joe Billionaire receives better care than Average Joe, who also receives worse care and has less options than Poor Old Joe. I'm not sure what the solution is for the US insurance system, but it's a bad sign when it's the middle of the road people (like me) who are making all the difficult choices and sacrifices.
And that would be a terrible guess, since a significant portion of those who do not have health insurance choose not to. Either because they are young, healthy, and choose to spend their money differently, or because they are between jobs and decide to roll the dice until they get new insurance. I did not have health insurance for at least 3-5 years when I got out of school because I decided to invest that money into Threshold. That worked out pretty well for me.Quote:
Originally posted by Snrrub
I'm going to guess that only a tiny fraction of those lack health insurance by choice.
Also, it is important to note that people are not denied treatment due to a lack of ability to pay. Medicare and Medicaid pay for the elderly and the poor, and emergency rooms do not turn people away regardless of ability to pay.
Why would you neglect this? Without the ability for Canadians to come to the US for private treatment, and for superior treatment for which Canada simply lacks sufficiently skilled doctors, the Canadian system would be in even worse shape. You can't simply ignore these elements.Quote:
Originally posted by Snrrub
For the purpose of this post, I'm going to neglect American patients who receive care via government assistance and also neglect Canadian patients who receive care privately - whether by visiting a private Canadian hospital or clinic, or by seeking private care in another nation.
Furthermore, the biggest provider of health care in the USA is the government - by far. Through Medicare, Medicare, VA, and government employment heath care, they are the dominant provider of health care even in the USA. That's part of the problem, actually.
I believe it is inherently worse in a socialized system, because denial of health care happens due to something completely out of my control. In a socialized system you are at the whim of politicians and bureaucrats deciding how many people they have budgeted treatment for your type of ailment. At least in a private system I can decide how much it is worth to me to pay for the care.Quote:
Originally posted by Snrrub
In order to logically show that waiting time makes the Canadian healthcare system worse than the American healthcare system, one would have to demonstrate that lack of access in Canada due to waiting times is worse than lack of access in the USA due to an inability to pay.
It all boils down to how you want a scarce resource (health care) to be distributed. Do you want it distributed by politicians making the choice, or by the actual people making the choice. It is a classic command economy vs. market economy question.
That's not true at all. If someone already has the hospital bed, they are rarely going to be thrown out. Or if the money is already spent, there's no more money for someone with a more urgent condition. If there is no more money for transplants, or cancer drugs, or an expensive procedure, or hospital beds, and someone with more severe need shows up, too bad.Quote:
Originally posted by Snrrub
In Canada, the waiting time of a patient to access care is related to the urgency with which they require care. Rather than being on a first-come-first-serve basis, most health services are provided to the more urgent cases before the less urgent cases, regardless of when those patients entered 'the line'.
Socialized medicine operates on a budget, and that budget is decided upon in advance of the actual need. If needs exceed the budget allotment (which it almost always does), then people are simply turned away.
So in truth, people in a socialized system are denied health care for two major reasons:
1) Wait times
2) The government's inability to pay (not enough money allocated via the budget).
By that logic, inability to pay is simply a terrible inconvenience, rather than an impenetrable barrier to care - unless someone dies before they earn enough money to pay for it. But again, this is not even accurate, because people are very rarely *denied* health care because of an inability to pay.Quote:
Originally posted by Snrrub
Of course, Canadian waiting times in most cases represent a terrible inconvenience, rather than an impenetrable barrier to care (clearly there are exceptions, namely if the person dies before care is provided).
In a socialized system, you can die while waiting in line for care, or you can die while waiting for the politicians to allocate enough funds to pay for the care you need. Or you can die because politicians decide the type of care you need is not called for at this time, or any other decisions they make for how to allocate health care. In all of these situations, you have no options under the system. You can't save up money, you can't borrow money, you can't raise money, nothing. Either the politicians decide you get the health care or not.
I would much prefer being the one who makes my decisions about my health care. Having politicians (who are almost always corrupt) decide a year or more in advance how much money will be budgeted towards my type of ailment does not sit well with me at all. Even worse, having politicians decide when people get certain types of care, under what conditions, etc. is even worse. It is like the worst HMO ever because you don't even have alternatives (short of fleeing south to the USA).
Well, in socialized systems people tend to be LESS likely to seek out preventative health care. Why? Likely because they know if they get sick the government is going to pay for it anyway. So why bother?Quote:
Originally posted by Malacasta
What's the cost to society and the health care system of not treating things like suspicious moles that develop into melanomas, or missed pap smear tests that could have caught a terminal cervical cancer?
Americans are significantly more likely to seek out preventative health care.
Quote:
* Mammograms: 88.6% of American females 40-69 had ever had a mammogram compared to 72.3% of Canadians.
* PAP smear: 86.3% of American females 20-69 had a PAP smear in the last 3 years compared to 75.1% of Canadians.
* Prostate screening: 54.2% of American men 40-69 had ever had a PSA test compared to 16.4% of Canadians.
As an economist, I attributed this finding to moral hazard: Canadians know that if they would get a disease that their government will pay for their care. Thus, they may be less motivated to ask for preventive services.
My quick google searching bore out similar results for Australia too however, your explanation for this is strange and it seems unlikely. The prognoses for treatment of these cancers is way worse the later it's caught, and most people know that. I haven't been able to find any studies that examine why this disparity is occurring - though I think studies are underway.Quote:
Originally posted by Aristotle
Well, in socialized systems people tend to be LESS likely to seek out preventative health care. Why? Likely because they know if they get sick the government is going to pay for it anyway. So why bother?
What I did find though, was this study:
The role of health insurance on Pap smear and mammography utilization by immigrants living in the United States
This is what it concludes:
That is, people who are uninsured are less likely to participate in preventative health screening.Quote:
Among recent immigrants, 73% and 78% (SE 4%) reported a Pap smear or mammogram, respectively, in the previous 2 years versus 89% and 89% of U.S.-born women (P < 0.05 for both comparisons). Among those with insurance or a USC, differences in screening between recent immigrants and U.S.-born women were four percentage points or less and not statistically significant. However, uninsured recent immigrants were less likely than uninsured U.S.-born women to have Pap smears [60% (SE 7%) versus 71%, P < 0.05]. Adjusting for differences in sociodemographics, health attitudes or beliefs, patient or provider communication, and the medical care environment, insurance remained the strongest predictor of screening.
Dal, I tried to find stats or evidence for this. The only numbers I could come up with was something like this:http://www.medicareaustralia.gov.au/...are-system.jspQuote:
Originally posted by Dalaena
Abuses of the health system would be going to 3 different pediatrician for your child until you finally find one that will prescribe ritilin. Abuses would be calling for an ambulance rather than a cab, a neighbor, a family member, or a friend to get to the hospital to get to the ER. Abuses would be something like bringing your newborn into the pediatrician every day for the first 2 weeks of his/her life because you don't have to pay for your healthcare costs.
And elsewhere there was a passing reference to a 1% or 130 million dollars lost to fraud or abuse in the Australian system. These numbers seem too low to me. Maybe I'm doing the wrong searches. In any case, I can't find anything that discusses the concrete details of the concerns you have about a universal health care system.Quote:
Mr Bridge said that last financial year Medicare Australia’s overall compliance activity resulted in repayments of $4.65 million in incorrect benefits from 5,288 people, of whom 2,802 were doctors.
WRT ambulances. They're private in Australia, they cost me something like $120 a year for my whole family. If I abuse the system it's not going to cost me anymore than it already does, my charges wont go up so I don't see how there's any argument to be made here about systemic abuse on the public purse when there is just as likely to be systemic abuse of the private.
I'll concede this. Therefore, the useful statistic would be to find how many people lack health insurance specifically due to a financial barrier.Quote:
Originally posted by Aristotle
And that would be a terrible guess, since a significant portion of those who do not have health insurance choose not to. Either because they are young, healthy, and choose to spend their money differently, or because they are between jobs and decide to roll the dice until they get new insurance.
This is a good point. It leads me to believe, however, that a prive healthcare system discourages people from starting their own business compared to a public system for precisely the reason you stated. Or, put another way, buying one's own health insurance represents an additional capital cost to running a business rather than being an employee and having insurance provided to you by the employer.Quote:
Originally posted by Aristotle
I did not have health insurance for at least 3-5 years when I got out of school because I decided to invest that money into Threshold. That worked out pretty well for me.
Not everyone is denied all forms of treatment due to an inability to pay. Countless health services are denied for that reason, though.Quote:
Originally posted by Aristotle
Also, it is important to note that people are not denied treatment due to a lack of ability to pay. Medicare and Medicaid pay for the elderly and the poor, and emergency rooms do not turn people away regardless of ability to pay.
Italics mine.Quote:
Originally posted by Aristotle
Why would you neglect this? Without the ability for Canadians to come to the US for private treatment, and for superior treatment for which Canada simply lacks sufficiently skilled doctors, the Canadian system would be in even worse shape. You can't simply ignore these elements.
I was neglecting it for the purposes of comparing an entirely public system to an entirely private system. If I were considering measurable indicators of population health, then I would had to take them into account. Instead, I was simply stating the logical consequences of public vs. private system.
As for the italics, I do not believe this is the case. In order to make any kind of judgement regarding the relative competences of the doctors in each nation, we'll need to see some factual evidence, such as the mortality rates for a number of routine procedures performed in each country, and each country's professional licensing standards, for example.
I need some clarification. As I understand it, your initial argument went something like,Quote:
Originally posted by Aristotle
Furthermore, the biggest provider of health care in the USA is the government - by far. Through Medicare, Medicare, VA, and government employment heath care, they are the dominant provider of health care even in the USA. That's part of the problem, actually.
1) USA healthcare is better than in Canada.
2) Canadian healthcare is a public system
3) Therefore Canada is an example of why public systems are inferior to private systems.
If now you're saying that the US system is in fact primarily a public system in disguise, it would seem to contradict your initial argument that the socialized element is the reason that Canada's heathcare is worse.
Note that I'm not agreeing that the Canadian healthcare system is worse, I was just trying to restate your own argument.
You're using the term 'worse' here in the context of being in conflict with your principles. I was using the term 'worse' in the context of the efficacy of the healthacre system.Quote:
Originally posted by Aristotle
I believe it is inherently worse in a socialized system, because denial of health care happens due to something completely out of my control.
Millions of Americans are at the whim of their insurance companies, and have no control over which insurance company is their provider. They are subject to the policy that is provided by their employer, and for low wage earners, supplemental insurance is unaffordable.Quote:
Originally posted by Aristotle
In a socialized system you are at the whim of politicians and bureaucrats deciding how many people they have budgeted treatment for your type of ailment.
Canadians can make this decision as well, by seeking treatment in other nations. Clearly this would not be the case if every nation had a public system, however. This is why private and public systems operating in parallel is what I believe is the best solution.Quote:
Originally posted by Aristotle
At least in a private system I can decide how much it is worth to me to pay for the care.
Italics mine.Quote:
Originally posted by Aristotle
Socialized medicine operates on a budget, and that budget is decided upon in advance of the actual need. If needs exceed the budget allotment (which it almost always does), then people are simply turned away.
When the healthcare system is faced with a lack of operating money, it is supplemented immediately by the Provincial government in question. People are not turned away because the healthcare system is short on operating cash.
#1: YesQuote:
Originally posted by Aristotle
So in truth, people in a socialized system are denied health care for two major reasons:
1) Wait times
2) The government's inability to pay (not enough money allocated via the budget).
#2: This does not take place, see above.
But the average wait for Canadians is on the order of weeks, and the wait for poor Americans (to, say, increase their income so that healthcare is affordable) is on the order of years, or decades, I'd wager. In any case, the likelyhood of the wait time being longer than the time before death is much higher in a private system due to an inability to pay than in a public system where the wait time is a function of medical urgency.Quote:
Originally posted by Aristotle
By that logic, inability to pay is simply a terrible inconvenience, rather than an impenetrable barrier to care - unless someone dies before they earn enough money to pay for it.
I disagree with the level of implied intimacy that politicians have with the individual treatments of individual patients. It's analagous to saying that politicians decided to lose a particular skirmish in a war because they didn't allocate more resources to the entire war effort. Did Bush decide to kill individual soldiers in the Iraq war, for example? Clearly not. While strategic decisions at the top obviously have a great affect, individual cases are not decided by politicians, or beurocrats of any kind.Quote:
Originally posted by Aristotle
you have no options under the system. You can't save up money, you can't borrow money, you can't raise money, nothing. Either the politicians decide you get the health care or not.
However, in the American systems, cases that require approval by insurance companies can be denied. I recall one story in which an insuree with a medical emergency had to pay out-of-pocket for an ambulance ride because it wasn't pre-approved by the insurance company. I guess it was lucky for her that in her particular case coverage was denied after the service was rendered.
Again, this relates to principles rather than efficacy, which is what I was addressing.Quote:
Originally posted by Aristotle
I would much prefer being the one who makes my decisions about my health care. Having politicians (who are almost always corrupt) decide a year or more in advance how much money will be budgeted towards my type of ailment does not sit well with me at all.
That is not whast unsustainable means. Unsustainable means cannot be sustained. My food bill might be a few dollars more expensive next week than it was this week. That does not mean that my diet is unsustainable, all it means is that resources need some level of reallocation. It only becomes unsustainable once that reallocation becomes impossible. If healthcare in Canada becomes more expensive, tax money will be reallocated to cover those expenses. This will likely not even result in a tax increase, but simply the defunding of a lower priority budgetary item.Quote:
Originally posted by Kailen
Uh No, On the contrary, Medicare is not sustainable on its present course.
(snip)
Canadians are willing to accept less service or more taxes.
[edit] Healthcare costs are rising in the United States as well. Are you willing to claim that private healthcare in the United States is also unsustainable at its present course?
Incorrect. In a socialized system, I am forced to pay for health care no matter what. I have to pay it through my taxes. I have no option to redirect those funds in a direction I prefer - like funding a business.Quote:
Originally posted by Snrrub
This is a good point. It leads me to believe, however, that a prive healthcare system discourages people from starting their own business compared to a public system for precisely the reason you stated.
No. As the US system gets more socialized, it progressively becomes worse - for the same reasons the Canadian system is worse. Both systems suck hugely, but that is an issue for a whole other thread.Quote:
Originally posted by Snrrub
If now you're saying that the US system is in fact primarily a public system in disguise, it would seem to contradict your initial argument that the socialized element is the reason that Canada's heathcare is worse.
We are talking about two steaming piles of shit and trying to argue about which one has grosser looking chunks in it.
My point is that in the end, a health care system where the government has all the power and all the choice is worse than a system where the citizen has the actual decision making power.
Actually, bureaucrats are making the decisions along every stage of the process in a socialized system. That's the whole point of it. From the very beginning when the budget is decided on, to the actual rationing of care that is necessitated at the end. If you aren't ok with this fact, then you aren't ok with socialized medicine.Quote:
Originally posted by Snrrub
Clearly not. While strategic decisions at the top obviously have a great affect, individual cases are not decided by politicians, or beurocrats of any kind.
As for insurance companies that deny coverage: that sucks too, but at least people then have the option to fire their insurance provider and find another. You can't fire your government, and you cannot refuse to pay them. If you refuse to pay your insurance company, they have to sue you and win in court. If you refuse to pay your "insurance" in a socialized system (taxes) you go to prison.
I was searching a little more on the subject and found an economic reason for public health care.
The problem here lies with a term called "market failure" where the market fails to function as it should as a free market.
In this situation, the problem of information assymetry from the customers side. When you receive treatment, the doctor knows the ailment, which drug will suit you best and how many more appointments you need. When the doctor earns money per appointment, he certainly has a reason to make more appointments than is needed, and if he is a "bad" doctor, give a drug that is not fully efficient so that it takes you a little longer to heal. That paradox is most famous from the psychology world - you go to a psychologist, usually, to solve a certain problem, and the psychologist faces a problem - the quicker he helps, the less appointments you have with him and the less money he receives (and the same rule applies to mechanics, which most of us been down that alley before). In a world where everyone is honest, it is not a problem, but we all know it's not the case here.
When the doctor knows he won't receive additional income from many appointments, it is likely he will give you the best treatment so that he has "less work".
In addition, Adam Smith reckoned that healthcare and education are two things that benefit the society more than it benefits the private person. For example, one might feel healthcare is worth x$ a month for him, but for the entire society it's worth far more: income tax, labour, not infecting other people (that in itself is worth more than what it is worth for him). So each and every person feels wants to pay a certain amount of money for healthcare, but since for the country it's worth much more, it creates more resources to the country to actually subsidize the difference between what it is worth to the society and what it is worth to the private person, thereby increasing the societal surplus.
The following link is to the article Social Choice and Individual Values by Nobel Prize winner Kenneth Joseph Arrow, where he explains in much detail the situation with its pros and cons. It is a rather long read, but a nice thing to look at if you ever have time.
That's a good argument for a partial subsidy - that is, not socialised health care, nor complete "you get what you pay for" pure capitalism, but somewhere in between. For instance, a scheme like that could be implemented thus: doctors could be paid a retainer (from tax money) for their availability, and then they will be able to charge individual patients less. In return for the retainer, they could be required to accept certain patients (eg those with state pension cards - that means the elderly, but also certain other categories) at an even lower fee, which would then be well below market rates. This would mean that people still have to pay for a doctor's visit - and the fee could be high enough to discourage frivolous abuse - but it could be kept "affordable", whatever that means.Quote:
Originally posted by Jidoe
In addition, Adam Smith reckoned that healthcare and education are two things that benefit the society more than it benefits the private person. For example, one might feel healthcare is worth x$ a month for him, but for the entire society it's worth far more: income tax, labour, not infecting other people (that in itself is worth more than what it is worth for him). So each and every person feels wants to pay a certain amount of money for healthcare, but since for the country it's worth much more, it creates more resources to the country to actually subsidize the difference between what it is worth to the society and what it is worth to the private person, thereby increasing the societal surplus.
I still am not convinced this is the best way to do things, but it's something that would probably work.
Oh, certainly. Partial subsidy was also the point of my first post - private healthcare system with progressive subsidy to the needy instead of full subsidy to the commodity.Quote:
Originally posted by Rosuav
That's a good argument for a partial subsidy