John;
What can you tell us about the history of socialized medicine in Canada? Was there ever a time when insurance companies dominated medical care? If so, how did the transition to non-profit medicine occur?
The reason I ask is that the transition to non-profit medicine in the US has to overcome the huge obstacle of the insurance companies that currently dominate the industry. It woud be as if all the roads in the US were private owned and we tried to return the roads to the public sphere. The road owners with all their tolls would have immense power to control the debate and politician's votes. It seems that industries only move from the private to the public sphere when there is no more profit to be made. Railroads and Amtrack are a fine example.

Tommy Douglas was a preacher from Saskatchewan that basically is considered the "father" of universal health care. It was a bitter fight at times, and I find it not a bit ironic today that socialized health care in it's current form is a part of our Canadian "identity."

Insurance was not nearly as powerful an industry as it is today. I wonder if we could make the same transition given how powerful our insrance companies have become. However, some provinces have gov't run car insurance programs, and they're working quite well, with premiums lower than provinces with private insurance plans.

But, there are ways for the insurance biz to make money in Canada. We buy dental coverage, vision coverage, disability insurance, home insurance, car insurance (in Alberta) and life insurance. In fact, counting the insurance premiums deducted from my wife's paycheque, insurance is our largest single monthly expense, exceeding even income taxes or mortgage interest.

There has been talk of two (or several) tier health care, with income level as the defining factor. Not greeted well here. With a low percentage of the truly rich, most people see the benefit of being automatically insured. Even a family with a substantial income (say $200K) would be wiped out by one major medical requirement and no insurance. So, since we have to buy it anyway, why not go with the lowest total cost option, which works out to the set-up we've got in place.

Economists that study the labour market have also seen employer-tied benefits introducing friction into the labour market, and the friction is in favour of employers as some might not be willing to take the chance on being unemployed as they lose their health benefits. It also might be a hindrance to the creation of small business, as they would not be able to afford insurance for either the owners or the employees.

Many business leaders are in favour of privatizing all kinds of things, but few in Canada talk of health insurance. They have watched the US example and the rising cost of providing the benefits to their employees, and it scares them. Now, the citizens pick up nearly the entire tab as we have almost no corporate taxes.

If you Yanks really wish to have socialized halth care, elect a gov't that will implement it. That's what we did.

Unfortunately there are too many Republican Wannabees. Association with wealth and power means too much to too many. Of course the Left has just as many problems. Too much government. Too little government. Middle ground would provide too many real solutions and result in too much real equality. Can you imagine the silence within the media should that ever happen?

I'm not sure we should be envious of our friends in Canada. I've heard stories about the availability/unavailability of care, and I'm told some people have to wait months to see a doctor. Also, it should be noted that the quality of health care in the U.S. is the best in the world. Our wealthy friends in the Middle East ... the guys with all of the oil ... recognize that, which explains why they come to the U.S. for checkups and treatment. The Mayo Clinic in Rochester is recognized as the leader in health care worldwide.

Now then, I came across the following about a year ago. It was written from a California perspective, but I think much of it applies nationwide. Here it is:


California faces a health care crisis. No doubt about it. And we are not alone. The crisis is nationwide, and earlier this week, the Institute of Medicine (IOM) of the National Academy of Sciences issued a 93-page report that underscores the seriousness of the crisis and proposes some solutions.


The report was requested by Tommy Thompson, the Bush administration's secretary of Health and Human Services. A panel of 16 people from various segments of the health care field prepared the report, and their findings and conclusions are in stark contrast to attempts by the Clintons to solve the nation's health care crisis in the mid-1990s.


The report begins by summarizing the findings of various studies.


"The American health care system is confronting a crisis. The cost of private health insurance is now increasing at an annual rate in excess of 12 percent, while at the same time individuals are paying more out of pocket and receiving fewer benefits.


"One in seven Americans is uninsured, and the number ... is on the rise. Many states are confronting serious financial constraints that are likely to result in a narrowing of the eligibility criteria and benefits of public insurance programs. Tens of thousands die from medical errors each year, and many more are injured.


"Quality problems, including underuse of beneficial services and overuse of medically unnecessary procedures, are widespread. And disturbing racial and ethnic disparities in access to and use of services call into question our fundamental values of equality and justice for all.


"The health care delivery system is incapable of meeting present, let alone the future, needs of the American public."


The report focuses on five facets of health care and recommends solutions and testing in several states. The five facets are:


* Information technology development. Health care providers in many instances still rely on paper documents, and that limits accessibility by other providers, requires costly duplication of effort and sometimes causes errors. The report recommends that eight to 10 states implement "state-of-the-art information technology" in all care settings.


* Expanded health insurance coverage. More than 41 million Americans don't have health insurance coverage, and it is recommended that three to five states take steps to insure all residents, either by providing tax credits to offset the cost of premiums or by expanding Medicaid and other government insurance programs.


* Malpractice reform. The cost and availability of malpractice insurance has, among other things, limited the delivery of health care in some communities. The report recommends that four or five states set up injury compensation systems outside of the courtroom that are patient-centered and focus on safety. Patients who waived the right to jury trial could receive "faster, fairer, surer compensation," the report says.


* Chronic disease management. An estimated 120 million Americans have chronic illnesses of some sort, and many of the illnesses could have been prevented or delayed through education or other intervention. The study recommends 10 to 12 projects to develop care programs for chronic conditions and implement community-wide prevention and health promotion strategies.


* Primary care enhancement. Most people enter the health care system through primary care facilities. The study recommends establishing 40 community health centers to "reinvent and substantially enhance primary care through new models of care delivery, support for patient self-management and other strategies."


Trying the various proposed solutions on a smaller scale, in state demonstrations, would test the feasibility of the solutions and allow the separate projects to be used as "building blocks" for nationwide reform of the health care system, the panel noted.


Most of the recommendations involve the outlay of additional federal dollars, it should be noted. Thompson could start some next year. For others, he would have to receive approval and funding from Congress


The "quality aims" for a 21st century health care system are to make it safe, effective, patient-centered, timely, efficient and equitable, the report says, and we like the IOM approach.


The only problem we see is that it isn't a "quick fix." The president and Congress could nationalize the health care system much quicker, certainly ... but in doing so, they would risk destroying the quality of care we have grown accustomed to in this country. We therefore prefer the IOM approach, even though change will come more slowly.


We hope Gov. Gray Davis, members of the state Legislature and state officials are made aware of the report and read it, because some of the information it contains and some of the approaches it suggests could be incorporated into a state plan the governor says he is putting together for California.


The findings by the IOM are important, we believe. They identify the problems, which are growing worse day by day, and they point the way to much-needed solutions. We're sure you'll be hearing more about the report in the weeks, months and years to come, and if you would like to read it for yourself, it can be found at

You're missing the most important aspect of the whole thing.

CHOICE

Under the system you have, unless you plan to leave Canada, then you have NO CHOICE as to whether you invest in healthcare or not. You are forced by your government to participate. In the US we have the choice to invest in such an insurance/healthcare plan, or not to.

What if you are/were wealthy enough that you don't need insurance, universal healthcare, or any of that crap? You are at a financial level where you can "self-insure". Why should someone in such a position be forced to pay for "government-coerced health insurance" if they do not need to?

You obviously prefer the security blanket of universal care at the expense of personal freedom of choice, while we prefer being free to choose, even if it means doing without certain things, or paying more for certain things.



Mike

You speak of people that you obviously know NOTHING about.

Mike

True. It happens. It depends on the urgency of the care you require. Some folks expect that no matter the state of their ailment, they should see that specialist right away. It's not the care approach we take.

There are gaps, no doubt. Hip replacements are behind, and should be done faster, as an example. However, with 44 million US citizens without health care coverage, is it possible to say the US system is not without it's own set of problems?

We have compromised our system to a degree to ensure that a certain level of care is given to everyone at the expense of perhaps some procedures. There has been some emphasis on preventative care as well. Every preganant woman is entitled to extensive pre-natal care. While this sounds expensive, it's actually a huge money saver in the long term. Less complications and a low infant mortality rate are the result. However, we are less likely to spend hundreds of thousands of dollars on medical procedures to save an extremely pre-term baby.

Health care costs are rising in all developed nations regardless of insurance system. This is thanks to the increased use of technology and the horrendous cost of new procedures. The key to the future of health care, regardless of nation or system, is to be able to have a healthy population that can afford decent health care.

We should also be putting more time and energy into preventative measures. Type II diabetes is becoming a plague on our middle aged population thanks to an increasingly overweight under-active population. The same is true for heart disease and stroke.

Some people have floated the idea of a "fat tax" for greasy friend fast foods. Maybe there's something in it...

The compensation is not what determines slavery, its the compulsion. I may or may not choose to buy insurance. I may or may not choose to have this or that medical service performed. These are my choices.

When the government seizes my wealth and spends it on whatever program--defense, health, whatever, that is coercive and thus, slavery to a degree. That is, they take my labor to a degree of their choosing and use it with only modest input from me (I vote for the ********* that decides where it goes). Now I choose to live under those circumstances so I assume a level of bondage as the price of citizenship.

But part of the sale price of my bondage is that I choose to sell myself dearly--I do not consent to every whimsical, fanciful idea of "fairness" that my government chooses to pursue. I look forward every election cycle to vote whatever opposition candidate is running for whatever post. In my estimation, the incumbent distributes goodies and the challenger distributes promises of goodies. The differences between parties is trivial compared to their common venality.

Concerning healthcare, like I said, its your country and your taxes. have at it in whichever way you choose.

I wish each state in the USA would establish their own unique approach to health issues. If New Hampshironians want cradle to grave healthcare let New Hampshirites pay for it themselves.

As for me, I would choose to pay my own way and not pay for somebody else. Let others get a job and save their money and pay their own dang way.

Botnst

44 million U.S. citizens without health care coverage?

No, no, no.

There are many people who do not have private health insurance coverage, but they are covered by the government ... i.e., the rest of the citizenry.

In my town, we have a large number of indigent people who also happen to be illegal aliens. When they're sick, do they die in the streets? Heck no. They go to the local hospital emergency room and are treated. Medi-Cal reimburses the hospital at a less than satisfactory rate (thank Gray Davis for that), and the hospital makes ends meet by socking it to the rest of us.

U.S. streets are not littered with the sick and dying. Even though many cannot afford private insurance, they are receiving treatment in the best health care system in the world.

My guess is that if we asked those folks, they'd rather be treated in the U.S. than in Canada. They came to the U.S., and not Canada, after all.

Huh? Have these folks had the opportunity to be treated in a different nation? Did they make their decision of where to live based on the health care system? Perhaps some did, but I doubt it's many. Maybe it's just where they can hide in plain sight.

Having everyone that cannot afford private insurance use ER's as their family doctor system is inefficient at best. It's also a reactive system with no proactive measures.

As to why your "illegal aliens" don't chose Canada might have more to do with snow than health care.

It could be darned-near anything that brings people to the USA.

Our population due to immigration has been expanding at a terrific rate, about 1M/year since 2000 and a bit less than a third are illegals. The Canadian immigration rate is higher for legals and much, much lower for illegals.

I doubt in either case that folks come to our countries for any gov services. Rather, they see in our countries opportunities not available in their own--China, Mexico, Palestine, India, Pakistan, whatever.

If you want and efficient, pro-active government, the totalitarian/despotic models reign supreme. They don't muck-around with all that individuality stuff. People com here for that reason, too-we generally believe that a truly free society is unencumbered by coercive government.

Botnst

I repeat:

"My guess is that if we asked those folks, they'd rather be treated in the U.S. than in Canada. They came to the U.S., and not Canada, after all."

That is not to say they came to the U.S. because of our health care system, but if they were informed and were given a choice, I'd guess they'd opt for the U.S. health care system.

I agree that treating them in the emergency rooms is inefficient, etc., but that is reality for now. The ideas included in my earlier posting seem to hold the best hope for improvement in U.S. health care. Adopting the Canadian system, which would amount to gutting the U.S. system, certainly is not the solution.

I think we in the U.S. should try to fix the system, not destroy it. And adopting the Canadian system would definitely be destroying it.

I started this thread about the recent coverage of drugs for the seniors. Rather than incororate the drugs into the medicare system, the politicians re-invented the wheels. The new bill has 1100 pages!!!At the end, it benefited healthcare providers, drug industry, and the insurance industry!!! The bill completely lost its focus. If the bill is so great why are so many people against it, including me.

Our neighbor in the north does a tremendous job in keeping the prices of drugs in line. We should emulate.

Our drug prices are so high partially BECAUSE of Canada's government-enforced lower drug prices. If we force prices down too, then who will make up for it? Europe? Asia? South America? I doubt it. Less research and development and innovation, fewer options, and lower quality would be the inevitable result.

Mike

So you are associating high profit margins with innovation, R&D, and the quality of products? Please think again. You don't really mean it;) Doe your arguments hold true for any other business? You know how much the drug industry spends on lobbying so you and I have to pay a high premium? :(