Canadian Healthcare from a Canadian...

[JWsleep]

Healthcare is a mess--not just in this country, whatever the truth of that email was.

Is it a right? I'm always worried about putting things this way (there's been a real proliferation of so-called rights), but it does seem to me that we as a society do not want people dying on the streets, old people (and young ones) choosing between food and vital medicines, etc. That just strikes me as something you don't want, if you can find a way to avoid it. The Herbert column linked above is an example of this sort of thing.

So, accepting that there's a responsibility of some sort for us as a nation, what do we do? Here, I think it's in part an economic question: how do you most efficiently bring care to those who need it, to avoid the stuff we want to avoid? And there, things get tricky. Healthcare, as I understand it, does not work in the same way other industries do. If you add a shoemaker to a town with a few shoemakers, the cost of shoes will drop. If you add a doctor, the cost of service goes up--one becomes a specialist. Plus, there is the very difficult conflict between what doctors want to do (and what patients need) and limitations on budgets and resources. Doctors may say of a patient "this guy needs a transplant" but it may cost too much if everyone who needs one gets one. What do you do then? Answer: Rationing. Canada does it. But so do we: we ration out services to those who can pay. (For what it's worth, we pay on the back-end, as people as a last resort go to public emergency rooms, after a preventable condition becomes serious.) Somethings gotta give.

It's a very tough situation--there's no obvious answer. Most economists would say you need a single-payer system, in some fashion, to pool the money, spread the costs, and subsidize those who need it. But why would the rich opt in? So it's got to be "socialized" in some sense. One factor that is moving things in this direction (MAYBE) is the need for American business to avoid the massive health-care costs of their pensions. but maybe they'll just dump everyone--go bankrupt and drop the retired workers. That, of course, might cause a rebellion of sorts, and push the single-payer approach through.

Two big interests are opposed to change: one, obviously, the insurance companies, who right now are raking it in--so much of those costs are "administrative" as well--nothing to do with care. The other is doctors: do they really want to be paid like the schlubs in England and Canada on National Health? No way--they need those big bucks to flow to pay for the life-style they've come to expect (and to cover liability insurance--another issue). The insurance and doctor's lobbies are very powerful in Congress--you don't get re-elected without their money, often. See how they smacked down Hilary last time! (They had some help from the republicans, no doubt!)

Hilary is out front on this issue--she has a plan of some sort, and that's better than most who just talk the talk. But that makes her a target--you'll hear lots of "socialized medicine" talk this election, aimed at her. Check who paid for the add--probably someone called "Americans for Health" or something,which is a PAC for the insurers and lawyers. (Maybe they wrote that Canada email? )

I hope that some decent debate does come of it, but Hillary is such a lightning rod that it may get lost in the mudslinging. One way or another, somethings gotta give.

[JWsleep]

Wow--that was long. Sorry! Procrastinating again from work.

[Schneed10]

Originally Posted by JWsleep

Wow--that was long. Sorry! Procrastinating again from work.

Don't apologize, JDub, nice post. Pretty solid analysis.

I do disagree with one point. Health insurers aren't really raking it in. Their margins are not big when compared to companies in other industries. Their administrative expenses are necessary to handle all the red tape that comes with the healthcare industry. Medical charts, billing, deciphering medical coding, managing reimbursement rates, case management; these jobs are all absolutely necessary just to work through the system.

Medicine's complicated. It does take a lot of brains to work through it all.

[firstdown]

Originally Posted by JWsleep

Healthcare is a mess--not just in this country, whatever the truth of that email was.

Is it a right? I'm always worried about putting things this way (there's been a real proliferation of so-called rights), but it does seem to me that we as a society do not want people dying on the streets, old people (and young ones) choosing between food and vital medicines, etc. That just strikes me as something you don't want, if you can find a way to avoid it. The Herbert column linked above is an example of this sort of thing.

So, accepting that there's a responsibility of some sort for us as a nation, what do we do? Here, I think it's in part an economic question: how do you most efficiently bring care to those who need it, to avoid the stuff we want to avoid? And there, things get tricky. Healthcare, as I understand it, does not work in the same way other industries do. If you add a shoemaker to a town with a few shoemakers, the cost of shoes will drop. If you add a doctor, the cost of service goes up--one becomes a specialist. Plus, there is the very difficult conflict between what doctors want to do (and what patients need) and limitations on budgets and resources. Doctors may say of a patient "this guy needs a transplant" but it may cost too much if everyone who needs one gets one. What do you do then? Answer: Rationing. Canada does it. But so do we: we ration out services to those who can pay. (For what it's worth, we pay on the back-end, as people as a last resort go to public emergency rooms, after a preventable condition becomes serious.) Somethings gotta give.

It's a very tough situation--there's no obvious answer. Most economists would say you need a single-payer system, in some fashion, to pool the money, spread the costs, and subsidize those who need it. But why would the rich opt in? So it's got to be "socialized" in some sense. One factor that is moving things in this direction (MAYBE) is the need for American business to avoid the massive health-care costs of their pensions. but maybe they'll just dump everyone--go bankrupt and drop the retired workers. That, of course, might cause a rebellion of sorts, and push the single-payer approach through.

Two big interests are opposed to change: one, obviously, the insurance companies, who right now are raking it in--so much of those costs are "administrative" as well--nothing to do with care. The other is doctors: do they really want to be paid like the schlubs in England and Canada on National Health? No way--they need those big bucks to flow to pay for the life-style they've come to expect (and to cover liability insurance--another issue). The insurance and doctor's lobbies are very powerful in Congress--you don't get re-elected without their money, often. See how they smacked down Hilary last time! (They had some help from the republicans, no doubt!)

Hilary is out front on this issue--she has a plan of some sort, and that's better than most who just talk the talk. But that makes her a target--you'll hear lots of "socialized medicine" talk this election, aimed at her. Check who paid for the add--probably someone called "Americans for Health" or something,which is a PAC for the insurers and lawyers. (Maybe they wrote that Canada email? )

I hope that some decent debate does come of it, but Hillary is such a lightning rod that it may get lost in the mudslinging. One way or another, somethings gotta give.

Part of your respons is a reasons that allot of people have a concern with a single payer plan. You stated that doctors don't want to get payed like the schluds in England & Canada. So you want schlubs cutting you open because thats what we will have when the brightest go into other professions to make more money. I know several doctors and they make very good money but they work harder than anyone I know. You also stated that Hillary is at the front of the issue but you do not even know what kind of plan she has. I would think if you thought she was on the issue then you would know what her plan was.

[JWsleep]

I agree with you both, Schneed and Firstdown--these are serious problems that moving to single-payer system would create. On the administrative issues, however, there is some savings to be made by somehow streamlining billing and such into a single, standard format, as opposed to many competing formats. But you then often lose information--like in the English system, at least as it's sometimes represented.

As for Docs wanting lots of money--given the enormous amount of schooling, the incredible need for their services, and the importance of what they do, they should be well-compensated, no doubt. And in places where they are not, you get doctor shortages--a real worry. So it's gonna cost to keep our quality up. We need to find a balance, and (this is part of the problem), we are going to need to RAISE TAXES to pay for this sort of thing. No free lunch. I'm for taxing the top-teir and cutting things like corporate tax breaks and subsidies (especially on farming--that's just a payout to ADM and other HUGE argi-businesses, not mom and pop farmers, if there are any left!). But that is political trouble.

I agree: Medicine is complicated, and not just for doctors!

[firstdown]

Originally Posted by JWsleep

I agree with you both, Schneed and Firstdown--these are serious problems that moving to single-payer system would create. On the administrative issues, however, there is some savings to be made by somehow streamlining billing and such into a single, standard format, as opposed to many competing formats. But you then often lose information--like in the English system, at least as it's sometimes represented.

As for Docs wanting lots of money--given the enormous amount of schooling, the incredible need for their services, and the importance of what they do, they should be well-compensated, no doubt. And in places where they are not, you get doctor shortages--a real worry. So it's gonna cost to keep our quality up. We need to find a balance, and (this is part of the problem), we are going to need to RAISE TAXES to pay for this sort of thing. No free lunch. I'm for taxing the top-teir and cutting things like corporate tax breaks and subsidies (especially on farming--that's just a payout to ADM and other HUGE argi-businesses, not mom and pop farmers, if there are any left!). But that is political trouble.

I agree: Medicine is complicated, and not just for doctors!

Why not steam line the current system for a start. I currently pay over $700 a month for a family of four so its not like I'm not paying for my share for ins. If I thought the goverment could provide a better product for around the same cost I'd be all for it but if we look at the goverments past there's no chance of that. I am allready stuck paying for social security (which has major problems) and medicare which has the same problems so why would I want to compound the issue with more of the same. Maybe if the goverment could fix these two programs which are running way above projected cost then maybe I would entertain health ins.

[FRPLG]

Originally Posted by JWsleep

We need to find a balance, and (this is part of the problem), we are going to need to RAISE TAXES to pay for this sort of thing. No free lunch. I'm for taxing the top-teir and cutting things like corporate tax breaks and subsidies (especially on farming--that's just a payout to ADM and other HUGE argi-businesses, not mom and pop farmers, if there are any left!). But that is political trouble.

I agree with much of your analysis. Where I take issue is with raising taxes.

For sure I believe that something like this should be paid with taxes but our government already takes a ridiculous amount of our money for so many things that they run very poorly. I'd love to see the taxes I ALREADY pay be used for this.

The answer is not always raising taxes. When are we going to straighten up as a country and tell our politicians to spend our money more wisely rather than just taking more to pay for things that need to be paid for?

[Hog1]

Originally Posted by FRPLG

I agree with much of your analysis. Where I take issue is with raising taxes.

For sure I believe that something like this should be paid with taxes but our government already takes a ridiculous amount of our money for so many things that they run very poorly. I'd love to see the taxes I ALREADY pay be used for this.

The answer is not always raising taxes. When are we going to straighten up as a country and tell our politicians to spend our money more wisely rather than just taking more to pay for things that need to be paid for?

YOU ARE THE MAN!!!!!!!!!
USgovt=FAT, FAT......................the water RAT

FRPLG for President

[firstdown]

Originally Posted by FRPLG

I agree with much of your analysis. Where I take issue is with raising taxes.

For sure I believe that something like this should be paid with taxes but our government already takes a ridiculous amount of our money for so many things that they run very poorly. I'd love to see the taxes I ALREADY pay be used for this.

The answer is not always raising taxes. When are we going to straighten up as a country and tell our politicians to spend our money more wisely rather than just taking more to pay for things that need to be paid for?

First this would be the biggest program that the goverment ever took over and taxes would go up atleast as much is now being spent on health ins now. Then the next year taxes would go up some more because its not enough then more & more & more. 50% tax rates for anyone making over 45,000.

[Monkeydad]

Originally Posted by firstdown

First this would be the biggest program that the goverment ever took over and taxes would go up atleast as much is now being spent on health ins now. Then the next year taxes would go up some more because its not enough then more & more & more. 50% tax rates for anyone making over 45,000.

Welcome to the United Socialist States of Europe if this happens.

The government would take all of our money and we'd be WORSE off health-wise than before they began emptying our pockets for "healthcare".

Allowing the government to run this would be a disaster.

[firstdown]

Originally Posted by Buster

Welcome to the United Socialist States of Europe if this happens.

The government would take all of our money and we'd be WORSE off health-wise than before they began emptying our pockets for "healthcare".

Allowing the government to run this would be a disaster.

100% correct and it seems that the people who complain the most about how goverment runs push this the most. Don't make much sense and when you ask them to point out any federal gov. programe that is working and is efficent they never have an answer.

[JWsleep]

Originally Posted by FRPLG

I agree with much of your analysis. Where I take issue is with raising taxes.

For sure I believe that something like this should be paid with taxes but our government already takes a ridiculous amount of our money for so many things that they run very poorly. I'd love to see the taxes I ALREADY pay be used for this.

The answer is not always raising taxes. When are we going to straighten up as a country and tell our politicians to spend our money more wisely rather than just taking more to pay for things that need to be paid for?

Yeah--no doubt there's tons of pork in the budget already--it's frightening to think about. I'm all for using that, but it would require congress to do something they do not usually do--take money from their pet re-election projects and use it for something for everyone.

[GhettoDogAllStars]

A couple of relevant points:

1.)

One of my teachers once told me, "everything any person does is their first choice." This means that people do what they want to do, and they never settle for less.

Take for example the homeless: they are homeless because they are jobless, and they are jobless because they want to be (assuming there are jobs to be had). So, if there are jobs to be had, and somebody is jobless, it's because they'd rather deal with the consequences of being jobless, than deal with the consequences of having a job. They prefer the stress of not having a job over the stress of having one. Therefore, being jobless is their first choice. I think this applies to almost every decision anybody makes.

2.)

I took an Ethics class in college, and I had to give a presentation about Human Rights. I had prepared well, and I was ready to talk about rights which all humans are entitled to. During my presentation I became aware that many people disagreed about what rights are universal and inalienable. So, I threw my presentation out the window and decided to just make a list with the class of universal inalienable rights. Sadly, nobody could agree on a SINGLE one! The class decided there are no Human Rights. They couldn't even agree that the right to live should be universal and inalienable! They kept saying that a murderer doesn't deserve to live, so therefore life itself is not inalienable. It was a sad day for me, because I realized how little people respect other humans. I seriously wanted to cry. I was so disappointed.

[JWsleep]

Originally Posted by GhettoDogAllStars

A couple of relevant points:

2.)

I took an Ethics class in college, and I had to give a presentation about Human Rights. I had prepared well, and I was ready to talk about rights which all humans are entitled to. During my presentation I became aware that many people disagreed about what rights are universal and inalienable. So, I threw my presentation out the window and decided to just make a list with the class of universal inalienable rights. Sadly, nobody could agree on a SINGLE one! The class decided there are no Human Rights. They couldn't even agree that the right to live should be universal and inalienable! They kept saying that a murderer doesn't deserve to live, so therefore life itself is not inalienable. It was a sad day for me, because I realized how little people respect other humans. I seriously wanted to cry. I was so disappointed.

I agree that it's hard to agree on the rights people have, and how to justify those rights. But even if there are rights, you can forfeit your rights in some situations. A murderer, by their choice, forfeits their rights. That may not entail the death penalty--that's a question of appropriate punishment--but it might. With rights come responsibilities. If you don't fulfill those responsibilities, you can lose your rights.

About which rights are basic--as the Declaration of Independence says, "Life, Liberty, and the Pursuit of Happiness." That works for me. From there it's a matter of debate, though I'm partial to much of the Bill of Rights. But there's no easy answers in these things--don't get discouraged!

[GhettoDogAllStars]

Originally Posted by JWsleep

I agree that it's hard to agree on the rights people have, and how to justify those rights. But even if there are rights, you can forfeit your rights in some situations. A murderer, by their choice, forfeits their rights. That may not entail the death penalty--that's a question of appropriate punishment--but it might. With rights come responsibilities. If you don't fulfill those responsibilities, you can lose your rights.

About which rights are basic--as the Declaration of Independence says, "Life, Liberty, and the Pursuit of Happiness." That works for me. From there it's a matter of debate, though I'm partial to much of the Bill of Rights. But there's no easy answers in these things--don't get discouraged!

Yes, I know exactly what you're saying. That's all well and good for Constitutional Rights. However, Human Rights cannot be forfeited. By definition, they are inalienable, meaning they are not granted to you by another and cannot be taken (or given) away.

I'm sure we could get people to agree on Human Rights, if they think they can take them away for good reasons. What's difficult is getting people to agree on rights which can NEVER be taken away -- for any reason whatsoever.