Derwood

Who funded the orphanage?

Where did your college money come from?

Cynthetiq

Vig, see the guys here will come up with all the ways that you didn't forge ahead on your own. You know, someone else filtered the water and brought in electricity, built the roads and all that jazz. You didn't do it all by yourself.

Someone made the operating systems and built the computers... blah blah blah blah. Bunch of horseshit reasoning in my opinion.

We all get an OPPORTUNITY. At some point in time, we either get one or we make one. If you don't exploit that opportunity, and many people don't. Listen to how they talk about how they missed the boat on something... coulda, shoulda, woulda...

but yeah, i've been talking about having done it also from little to nothing... of an immigrant family but they go back... claim some crap about better education or something like that. Yet there are illegals, sorry undocumented workers who also make the same claims and achievements....

__________________
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rahl

The fewer non-medical people in the system to keep a check on the health care industry, the faster prices will skyrocket for treatments. Hospitals and doctors offices are for profit, they should be they are a business. The doctor is providing a service that people want, he deserves to charge what he wants within reason. the haggleing between insurance companies and doctors offices does keep prices from going completelty out of control

Derwood

Most people probably do get SOME opportunity, but not everyone gets the SAME opportunity

Cynthetiq

i didn't nor ever imply that it's ever the same... but hey isn't that what the idea of socialism is for? that everyone get the same?

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

Derwood

if you're into socialism, I suppose.

I'm all for increasing the opportunities for those who are dire situations though.

Rekna

I have to say Vigilante you are making some of the most ignorant and insulting comments I have ever read. You say you are not racist but your comments say otherwise. First you immediately assume any person who doesn't speak English is illegal, second you assume anyone on welfare or food stamps is lazy, third you assume anyone in the projects is a drain on society.....

Good grief you should really spend some time volunteering in the projects or with a church that is doing service projects to the needy. You need to open your eyes and stop generalizing. Are there illegals that go to the ER? Yes, but that doesn't mean every immigrant there is illegal. Are there lazy people on well fare and food stamps? Yes but that doesn't mean everyone on well fare and food stamps are lazy. Are there bad people in the projects? Yes but there are lots of really good people in the projects also.

The world exists beyond your own personal experiences and until you understand that your experiences will never explain everything you will be ignorant and in this case racist. And while were talking about generalizations why don't we throw another out there to see how you feel about it:

ratbastid

Well of course he didn't. That's the great myth of Libertarianism--that we're all self-determining little atoms, pulling ourselves up by our bootstraps independent of all the other little bootstrap-pulling-or-not atoms.

You don't have to reducto-ad-absurdam it about the electricity and the roads, by the way. If the guy really grew up in an orphanage, well yes, it's very impressive that he accomplished what he did, and a testament to his ability to cause results in his life. But there had to be SOMETHING paying for his college. SOMETHING kept him fed and housed, when he was a kid.

He's vehemently opposed to the public dole. Think he's trying to distance himself from anything? The psychology of his position isn't hard to fathom.

roachboy

i'm curious: is there any other way of interpreting the introducing of this libertarian nonsense into this debate than as a rationale for basically arguing that the poor (or uninsured) are as they are because they're less than those manly men who pull themselves up by their bootstraps blah blah blah so fuck em, let em die...who cares about the physical well-being of the less-than-us, the social parasites.

hell, why not speed that fine thinking up and set up camps where these inferiors can learn some manly virtues?

__________________
a gramophone its corrugated trumpet silver handle
spinning dog. such faithfulness it hear

it make you sick.

-kamau brathwaite

rahl

See this is the problem with political or religious debate. If someones views are different from your own you have to resort to name calling or the belittling of other political parties or ideals. I've got new for you, you're not always right. No one is, so instead of being a condescending dick to everyone you feel you are above inilectually, simply state your views, and your reasoning behind them

dippin

except that as we know, this is not true. The American healthcare system is, at the same time, the healthcare system with the highest overhead costs, and the healthcare system with one of the highest spending per capita, while having the worst outcomes of industrialized nations.

rahl

what is it in your mind that contributes to high overhead costs?

dippin

By definition, a high proportion of non medical personnel employed by hospitals and insurance companies.

Derwood

$750 billion/year in administrative costs, if I remember correctly.

roachboy

rahl---you have got to be joking.

you have been running a tiresome little game of trying to control the way in which this discussion unfolds. you've been called on it repeatedly, and you've responded either by being an ass or ignoring the posts.

this in response to posts that have even tried to be polite.

given your m.o. in this thread, it's kinda hilarious to find you then turning around and taking a series of arbitrary potshots at me.


i wonder that if your technical knowledge is as dubious as is your ability to conduct yourself in a debate when you start to loose control of how it's framed.

i know.
let's start over.

how about you fill me in again on why an insurance man is a necessary reference point for discussing a social and political problem again?
how is it that social and political problems surface for you in your professional line? they're administrative problems, arent they? they kinda get dissolved, don't they?
isn't it the case that you have a personal. economic interest in the maintenance of the existing arrangement?
and that the company you work for also has such interests?

so where exactly is your competence in talking about the politics of health care?

__________________
a gramophone its corrugated trumpet silver handle
spinning dog. such faithfulness it hear

it make you sick.

-kamau brathwaite

rahl

So are you saying that hospitals will run themselves without an administration department?

---------- Post added at 01:18 PM ---------- Previous post was at 01:12 PM ----------


Thanks for proving my point. My intention was to provide a perspective from and insurance stand point which I have done. I have stated over and over that I don't know how to fix the problems, I'm able to admit that, others aren't. It's all a matter of opinion anyway. I also said that I have no experience in social or political arena's. I absolutely have an economic interest in keeping my job, anyone would when facing the extinction of their market. From my perspective I would rather we fix the current system rather than abolish it, but that's my OPINION

kutulu

The problem is that no matter how much you want to talk about opportunities, the number of people far exceed the number of opportunities. In the end we still need dishwashers, grocery baggers, and all the other low wage jobs in order for our economy to work. Whether or not those people are lazy is irrelevant, we need those jobs filled. Those people may not need the amenities that the higher paid people get but they still have the same health care needs.

dippin

Are you being willingly obtuse? At no point anyone even suggested that. But the fact is that there are systems with lower overhead costs and systems with higher overhead costs. The current American system has much higher overhead costs than those of any other developed nation.

It is not like people are pushing for a "never seen before" utopian system. Quite a few nations have achieved an efficient single payer universal health care system.

rahl

If I'm being obtuse I don't mean to. I don't know how other nations healthcare systems work, or what their administrative duties or costs are like, never said I did. I just don't know how we could adjust our system to have less overhead costs

Rekna

Here are a couple of questions.

Is health insurance primarily about helping people afford health care or primarily about making profit?

Are hospitals primarily about helping people or are they primarily about making profit?

biznatch

No, no, don't give me that victim stuff. You did not get bashed. You put your own self on a pedestal and told us you had more expertise/knowledge about the industry, and therefore knew better than us why it couldn't change.
I'm telling you, fine. For you, it pays your bills, because its your job, and I can understand you liking the status quo, or fearing major change, or whatever.
But I've lived my life without being able to afford a dentist or a visit to the doctor's, for more than three years now. Is that fair? Was I lazy? No, I needed food, and my boss gives me less and less shifts. Last time I went to the doctors, I had to pay 450 dollars just for blood tests.
The system is broken because tens of millions of people live in daily fear of becoming ill, or injured, and becoming a financial burden on their entire family.

So while I might not know how your employers work, administration-wise, I can tell you I've lived in France, where I had a family doctor. Who my parents had known for more than 15 years. Who knew all of my family's conditions, and knew how to treat them, and who would be able to prevent a lot of things from happening to us, just because we had one doctor we could trust with our health, and it was covered. And had we decided he wasn't good enough, we could have gone somewhere else.

Don't tell me it can't work. I've seen it work, and I'm sure there's more than just France who has gov't healthcare. The reason you think so is because you've only lived in a shitty for-profit system, where the MO is "make money."
The main objective should be to keep the people healthy, for the least amount of money possible. It's not something anyone should gamble and profit from.

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rahl

Like any good business both are providing a service in which they are entitled to make a profit. I can't speak to what Insurance executives or hospital administrators are primarily about, but as an insurance agent I am about consulting with clients and making recommendations as to what would best benefit them and their families. Alot of my clients get into an "insurance poor" situation in which case I will try to disuade them from having their entire paycheck go towards insurance. I advise them to cover the basics: Health dental vision insurance first, Income protection in the form of short term Disability Ins, Life Insurance. If they feel they need additional protection I offer a variety of products from cancer to long term care(nursing home) ins. My number one concern is the clients well being, my second concern is commission. Admittedly not all insurance agents have this mindset but most do.

---------- Post added at 02:36 PM ---------- Previous post was at 02:27 PM ----------


I never once stated that it couldn't change, only that I don't know how to change it. Nor did I say if you don't have health insurance you are lazy. I agree things can't stay the way they are, I agree things need to change. I'm just hoping they change in a way that won't leave me unemployed that's all. And your right I've never lived anywhere else the here, and I have no idea what any other countries system of healthcare is like.

I'm just stating my opinion that I don't think that we could switch to a single-payer system, totally abolishing insurance companies and all their employees, and have the government tell doctors and hospitals what they are allowed to charge for the services they provide without having serious drawbacks and consequences

dippin

story time, so you can maybe envision a system with fewer overhead costs.

My brother lived in France for a while. One night, he was out with his girlfriend, and a drunk guy started hitting on her. He told the drunk guy to cut it out as she had company. The drunk guy sucker punched him and ran away. It was a friday night. He went to the ER. The triage nurse talked to him and sent him to the appropriate doctor in the hospital, where he had an xray done, was diagnosed with a fractured nose, and the doctor tended to him and gave him pain killers. The fact that he didn't have to pay a cent is beside the point, the point is that in his entire visit to the ER he talked only to 1- a nurse, 2- the doctor.

I live in the US. I have good health insurance provided by my university, which gets good rates since they operate what is generally considered a top 10 hospital in the US.
Playing basketball at a private gym once, I rolled my ankle and severely sprained it. I went to the ER, where after talking to the admissions person I was sent to the person in charge of insurance. After giving them my insurance information, I saw the doctor and was taken care of. At the time I didn't have to pay anything as they sent the info to my insurance. A few days later my insurance called to ask me where I got hurt, and i told them. They decided to go after the gym's insurance company to get the money for my treatment. Long story short, to deal with my ankle sprain, the billing depts. of the hospital and 2 different insurance companies had to get involved, and legal action was threatened by all parts, so we are also talking about lawyer costs. From the point of view of my insurance company, it made sense, as it cost less to them to go after the other insurance company (especially given follow up appointments and etc) than it did simply paying for everything. From a societal point of view, we are talking about severe overhead costs that drive prices up very fast.

Vigilante

Most people have several opportunities to make things right during the right time of their lives. The difference is whether they see it or not. Likewise, many people try to push them in the right direction, but many are too hard-headed or scatterbrained to listen. That was me growing up. I was too hung up on my abused past to deal with the present, until I found motivation through that sense of needing to provide for the one I love. Plus, I knew I had to grow up sometime anyways. I dreaded the responsibilities I would be taking on. I feared losing the battle. I was in the process of going to trial and feared I would be in prison for a while. I got lucky because others saw my struggle and used their pull to keep me out of the worst, and I ended up with probation and a lenient fine and community service period. It helped that the judge was retiring as well.

I saw the opportunity and brought myself from failing every class but the sciences (I always enjoyed biology and the like) to passing every class. Others saw my attempts at reviving my education and helped, too.

See, it's not that the world is against you. The world is against you as long as you are against the world. When you actually try, people around you see that and help. If some illiterate boy tried to read and wanted to learn, people would help him. If he sits back and ignores english class and gets passed anyways, then people are failing him and he is failing himself. If a kid has a disability like I did, then he should be put in classes that handle his issue. In Houston I was put in special ed classes. In beaumont, the entire ISD was special ed. I was years ahead of my peers when I moved. That is a failure of the system, and IMO that should be fixed above healthcare.

Speaking of, back to healthcare. You do make an interesting point on the fact that they need it as much as anyone else. Ironic, because I had NO insurance at all until I started working in IT. I barely knew health insurance existed until I was out of college.

Maybe we could set tax bracket standards. If you're a professional bagger, you get gov't healthcare. If you're a banker, you get your own. I don't know what's best, this is not my area of expertise. I do know that I don't want my current system to change though. I don't want to be forced to go to the doctor that everybody else goes to. I want to choose my doctor. I don't want the gov't to give me a list to choose from, either. I don't want to pay for some else's healthcare, or their food, or their housing, or their medication for their addiction. I would gladly pay for AIDS education though, or sex education in general, or research into controlling tuberculosis. That is definitely a worthy cause for me. Feeding and treating a family of 5 because the mom's ultimate fantasy was to do every boy on her block is not what I wish to pay for.

---------- Post added at 01:49 PM ---------- Previous post was at 01:44 PM ----------

Now I'm not going to lie, that is disturbing to me.

Bear in mind I have very little information to go on concerning what is planned in the upcoming proposals.

What I wonder is why we should somehow restructure our health care when the insurance is to blame. What if insurance companies were forced to work with people, or be sanctioned or dissolved? Just a thought.

__________________
We contend that for a nation to try to tax itself into prosperity is like a man standing in a bucket and trying to lift himself up by the handle.
-Winston Churchill

biznatch

Well, we're telling you that some of these systems in other countries work better, have less costs, and have more people covered. How about instead of only using what your personal experience tells you, you hear about how people in other countries do it, and why it might benefit many more people here.

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rahl

I am listening, and I do know that other countries have different systems than we do. And their system may work for them, I don't know that it can in ours any time soon.

biznatch

So, if it were up to you, what would you do?
Would you try and reform the system, or would you keep it as it is? From your perspective, what do you think is feasible? What do you think is impossible in the short term?

__________________
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POHP

10 Myths About Canadian Health Care, Busted

--------------------------------------------------------------------------------

Posted on February 13, 2008
10 Myths About Canadian Health Care, Busted
By Sara Robinson
TomPaine.com
February 5, 2008

2008 is shaping up to be the election year that we finally get to have the Great American Healthcare Debate again. Harry and Louise are back with a vengeance. Conservatives are rumbling around the talk show circuit bellowing about the socialist threat to the (literal) American body politic. And, as usual, Canada is once again getting dragged into the fracas, shoved around by both sides as either an exemplar or a warning — and, along the way, getting coated with the obfuscating dust of so many willful misconceptions that the actual facts about How Canada Does It are completely lost in the melee.

I’m both a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border. As such, I’m in a unique position to address the pros and cons of both systems first-hand. If we’re going to have this conversation, it would be great if we could start out (for once) with actual facts, instead of ideological posturing, wishful thinking, hearsay, and random guessing about how things get done up here.

To that end, here’s the first of a two-part series aimed at busting the common myths Americans routinely tell each other about Canadian health care. When the right-wing hysterics drag out these hoary old bogeymen, this time, we need to be armed and ready to blast them into straw. Because, mostly, straw is all they’re made of.

1. Canada’s health care system is “socialized medicine.”
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is “single-payer insurance.” In talking to Americans about it, the better phrase is “Medicare for all.”

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don’t have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don’t have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid — quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren’t interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don’t realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don’t operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor’s debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family’s major expenses, expectations tend to run very high. A doctor’s mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it’s no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they’re not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don’t have to include coverage for future medical costs, which reduces the insurance company’s liability.

3. Wait times in Canada are horrendous.
True and False again — it depends on which province you live in, and what’s wrong with you. Canada’s health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don’t plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that’s just as true in any rural county in the U.S.

You can hear the bitching about it no matter where you live, though. The percentage of Canadians who’d consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country’s health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland’s grandfather.). In spite of that, though, grousing about health care is still unofficially Canada’s third national sport after curling and hockey.

And for the country’s newspapers, it’s a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it’s on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it’s certainly one of the things that keeps the quality high. But it also makes people think it’s far worse than it is.

Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I’m finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It’s the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don’t have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that’s just as true in the U.S. — and in America, the government won’t cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.

5. You don’t get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don’t get a choice. Be afraid! Be very afraid!

For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country’s top specialists that rich ones do.

6. Canada’s care plan only covers the basics. You’re still on your own for any extras, including prescription drugs. And you still have to pay for it.
True — but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees’ premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

“The basics” covered by this plan include 100% of all doctor’s fees, ambulance fares, tests, and everything that happens in a hospital — in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn’t include “extras” like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you’d pay for a room in a middling hotel). That other stuff does add up; but it’s far easier to afford if you’re not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren’t nearly as expensive here, either.

Filling the gap between the basics and the extras is the job of the country’s remaining private health insurers. Since they’re off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month — about $300 for a family of four — if you’re stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America’s largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they’re actually likely to be safer.

Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It’s amazing.

8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.

One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they’re getting a constant level of care that ensures small things get treated before they become big problems.

The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren’t working 60-hour weeks trying to hold onto a job that gives them insurance.

9. People won’t be responsible for their own health if they’re not being forced to pay for the consequences.
False. The philosophical basis of America’s privatized health care system might best be characterized as medical Calvinism. It’s fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one’s own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One’s Own Health.

They’ll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you’ll never get sick. (Like all good theologies, there’s even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it’s a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can’t complain. It was their own damned fault; and it’s not our responsibility to pay for their sins. In fact, it’s recently been suggested that they be shunned, lest they lead the virtuous into sin.

Of course, this is bad theology whether you’re applying it to the state of one’s soul or one’s arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us — even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it’s built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.

This difference is expressed in a few different ways. First: Canadians tend to think of tending to one’s health as one of your duties as a citizen. You do what’s right because you don’t want to take up space in the system, or put that burden on your fellow taxpayers. Second, “taking care of yourself” has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you’re contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they’re still small and cheap to fix.

Third, there’s a somewhat larger awareness that stress leads to big-ticket illnesses — and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there’s a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.

The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.

10. This all sounds great — but the taxes to cover it are just unaffordable. And besides, isn’t the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we’re not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we’re actually money ahead. When you factor in the greatly increased social stability that follows when everybody’s getting their necessary health care, the impact on our quality of life becomes even more signficant.

And True — but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There’s always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.

But, as many of us know all too well, there’s also constant tension between what patients want and what private insurers are willing to pay. At least when it’s in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.

It is true that Canada’s system is not the same as the U.S. system. It’s designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It’ll be a good day when when Americans can hold their heads high and proudly make that same declaration.

__________________
Diagonally parked in a parellel universe

rahl

Depending on what state you live in, because it varies from state to state, insurance companies have the "right of subrogation" meaning that if you file a claim that your insurance pays, if another persons insurance was actually liable then your insurance company has the right to recoop moneys paid out on your behalf. Some states have whats called "no fault" insurance, meaning everyones insurance pays for their own insureds. Think of car accidents, in most states when you have an accident you need a police report to document who was at fault, and an exchange of insurance info so damages are paid accordingly. In no fault states, your insurance pays for damages to your car only so there's no need to find out who was actually liable

flstf

You are probably right. I talked with a dental office manager recently about price competition and she pulled out a price booklet and said the last 4 offices she worked at used the same prices for procedures. Of course she was trying to sell their services and was answering my complaint that the three bids I had for dental work were all within a few percent of each other. I think she said something about insurance agreements and industry standard pricing and they all use the same dental labs, etc...

aceventura3

After careful consideration I have come up with the perfect reform for heath care. You guys pay for my health care, and I spend my money on things that make me feel good.

__________________
"Democracy is two wolves and a sheep voting on lunch."
"It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion."
"If you live among wolves you have to act like one."
"A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

Willravel

Medicine doesn't make you feel good?

ratbastid

Snark aside, ace, would you reform our current health system? Or do you think it works well the way it is?

aceventura3

No. I have never taken any medication that made me feel good. I have taken medicine that has alleviated pain after an injury, but generally I prefer gas guzzling fast cars, good food, travel, romantic walks on the beach, and puppies.

__________________
"Democracy is two wolves and a sheep voting on lunch."
"It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion."
"If you live among wolves you have to act like one."
"A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

Willravel

I remember this time my little brother was playing in the front yard. He was jumping over a fence when his pants go caught and he snapped his wrist. It hurt. In order to feel better, we took him to the ER and the bone was set and a cast put on. A few short months later, and he felt good.

That's what I meant.

aceventura3

I would make some modifications.

1) Make insurance manditory.
2) Change from state regulation to national regulation, so if I buy a policy in California I can keep the same policy in North Carolina.
3) No preexisting condition. Since everyone has insurance, I would randomly assign difficult risks to existing insurers based on market share.
4) With national regulation, I would standardize risk classifications for premium purposes, leveling the playing field.
5) Tort reform
6) Streamline FDA drug approval process to lower drug development costs.
7) Lower the length of time a drug maker has exclusive rights to a drug, making generics more availabe
8) Pay for the insurance of every child under 18 and disabled person who can not work.
9) Do away with employer plans.
10) Develop a waiver of premium plan for those temporarily disabled or unemployed.
11) Make me the health insurance Czar with a 7 figure salary.

---------- Post added at 07:19 PM ---------- Previous post was at 07:16 PM ----------

Oh.

I prefer to avoid pain to begin with, or at least the type of pain the requires medicine. Occasionally, I test the limits with some habanero pepper in my chili.

__________________
"Democracy is two wolves and a sheep voting on lunch."
"It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion."
"If you live among wolves you have to act like one."
"A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

Willravel

Isn't that heavily regulating the health care industry, though? In other words, isn't this a violation of your basic political principles? I do agree with some of those things, but it seems that if you're willing to set ideology aside for the sake of pragmatism, you should get the most pragmatic system available.

loquitur

How I would reform health care:

1. Make third-party payments for routine, non-catastrophic medical treatment illegal. Watch prices come down when (a) people pay for their treatment with their own money and (b) the reimbuarsement paperwork for every routine medical visit is eliminated. This also gets the middleman (whether it's an insurance company or a govt agency) out from between patients and doctors.

2. Enable pretax financing of medical expenses in segregated accounts. (For poor people this stuff would get financed through Medicaid or food-stamp-like vouchers). These accounts would pay for doctor visits and medicines, and also will be used to pay for.........

3. Catastrophic coverage, i.e. real insurance -- if you have an unforeseen medical disaster like a car accident, heart attack, stroke, broken bones, you have insurance to cover it. Just like if your house burns down or your car gets totalled.

This setup will, at minimal cost, give us universal coverage and maximum freedom. No big govt bureaucracy and no grasping insurance companies other than for catastrophic. People can choose how much medical care they want, and the minimum annual checkup and other stuff would be financed out of the special account.

I'm sure there are details that this doesn't pick up but it's a pretty good template as a starting point. Yes, there will be transitional issues to be managed; that can be done.

aceventura3

Yes. Health care is currently heavily regulated and will be.

Yes and no. I am a free market capitalist, but I do believe there are certain legitimate roles for government and regulation. I think national defense is one and regulating health care is another.

Personally I think it is immoral that children are born in this country without health care available to them. Health care for children should not be a function of who the parents are. Children have no control over the circumstances of their birth. Every child born in this country should have equal access to the best medical care this nation has to offer, no questions asked. And I would love to see that apply internationally.

The basic ideology driving my "pragmatic" approach is that people able to pay for health insurance should pay their fair share. Secondly, people should be actively involved in their health care, not delegating this personal decision to a third party like an employer. I think with national competition and a regulated classification system, standard premiums would be fair, companies could compete on tings like deductables/copays/service/wellness programs/etc.

__________________
"Democracy is two wolves and a sheep voting on lunch."
"It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion."
"If you live among wolves you have to act like one."
"A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

Willravel

Interesting. Just out of curiosity, do you think the military would be better if it were privately run but publicly regulated? If no, what separates the health care industry from the defense industry?