End to Public Healthcare in Canada?

[storm1977 0]

There are many Canadians on DZ that always praise the public health care system of their country. I have always disagreed with the Idea here in the USA. Just curious what the Canadians think of this possible change (IN Quebec at least) in the future.

http://news.yahoo.com/s/csm/20050808/wl_csm/ocanadarx_1

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TORONTO - Canadians have long prized their public healthcare system as a reflection of national values, and have looked askance at the inequities of private medical care in the United States.

But now that the Canadian Supreme Court has ruled private health insurers should be allowed to compete with the public system, the future of Canadian healthcare is a question mark.

In the short term, the decision may light a fire under provincial governments to improve chronic problems, especially long wait times for surgeries, tests, and treatments. Some experts believe the ruling could eventually spawn a parallel, private healthcare system here.

"For our government, it's a very strong indictment of the way they've handled the system," says Dr. Albert Schumacher, president of the Canadian Medical Association. "I hope it will move us forward in the debate. 'Private' has always been used by politicians as a very evil word, associated with America and for-profit. But it's not necessarily so."

It all started with a disgruntled doctor, Dr. Jacques Chaoulli, and his patient, George Zeliotis, a retired salesman from Quebec who waited nearly a year for a hip replacement.

In a split decision, the Supreme Court in June found that waiting lists for medical treatments were unacceptably long, causing some patients to suffer or die. The judges struck down a Quebec law banning private health insurance for procedures covered by Medicare. Patients like Mr. Zeliotis should be allowed to go outside the public system and pay for timely medical treatments through private insurance, the court said.

"There are tens of thousands of Mr. Zeliotis out there languishing on waiting lists," Dr. Schumacher says. His patients, for example, go to nearby Detroit and pay out-of-pocket to get CAT scans in six days instead of waiting six months in Canada.

By the end of this year, the federal government has promised to establish benchmarks for "medically acceptable wait times" for treatment of cancer, heart disease, and other ailments. The government is already spending billions to try to reduce waiting lists.

Technically, the court ruling applies only to Quebec, and the court on Thursday granted the government's request to delay its decision for a year. But Chaoulli v. Quebec will eventually ripple through the entire country.

"No minister of health can say, 'We're going to deny you a right that exists in the province of Quebec,' " Monahan says. "As a matter of political reality, it's applicable in all provinces."

The man who sparked this revolution was often dismissed as a gadfly during the years he spent fighting the system. Dr.

Chaoulli once went on a hunger strike to protest fines levied on him for charging fees. Chaoulli represented himself in court, and his rough yet impassioned arguments struck home with the court.

"I am so happy," Chaoulli says. "Sooner or later, the medical monopoly will be stopped."

He predicts the emergence of a private healthcare system existing alongside the public one, as in Australia or New Zealand. Meanwhile, he is busy lecturing conservative US groups about the dangers of socialized medicine.

"Libertarians and conservatives do regard him as a hero," says Michael Cannon, director of health policy studies at the Cato Institute in Washington, a libertarian think tank. "He's going to be a very influential figure moving forward in Canada, in the US, and abroad."

Cannon hopes Chaoulli's victory dampens the ardor for Canadian-style healthcare in the US.

For many Canadians, private healthcare wears the scarlet A - for America.

"There is no political support for American-style healthcare," says Michael McBane, coordinator of the Canadian Health Coalition, a healthcare advocacy group. He says he hopes provinces will toughen laws to prevent private insurers from entering the market.

Allowing people to buy private health insurance violates fundamental rights, McBane says, because not everyone will be able to afford it.

"You can't discriminate based on the size of your wallet on something as important as healthcare," McBane says. "I would say this is an aberration and the democratic process will correct it."

The public appears ambivalent about the ruling. A new poll conducted for the Canadian Medical Association finds that 52 percent of Canadians view the decision "favorably," and even more said it will reduce wait times. But when asked if the ruling would weaken the public system, 54 percent agreed, saying it was "a bad thing."

Allyson Lange, a federal government employee, says she would support a parallel, private health system but doesn't expect dramatic changes.

"There would be too much opposition," Ms. Lange says. "We see a lot of what goes on in the US - people go broke because they have a health issue."

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Sometimes it is more important to protect LIFE than Liberty

[Gawain 0]

Just about any social system in the world is unable to compete on a level playing field. Communism, Socialism are examples of such failures in the face of free enterprise.

It's the very reason why the drugs, medical procedures and research that Canadians prize their "affordability" with, and use, are developed here in the US, at enormous cost to investors. If the Canadian economy were to attempt to shoulder that kind of cost, it would collapse in about 6 months time or less.

Having said that, the real question is this: If private enterprise is ultimately allowed to compete with the government social program, will the heavily burdened tax payers of Canada have the ability to choose which program they use?

Then the question becomes: Can the system withstand the shock of not having the government tit to suck on? Or, can the system withstand not having all 25M Canadians sucking on the tit?

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[IanHarrop 37]

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There are many Canadians on DZ that always praise the public health care system of their country

As a Canadian this statement surprises me - I personally don't know any Canadians that "praise" our health care system.

Most countries that have a government run insurance program (which is most developed countries other than the USA) have some opportunity for people to buy additional coverage that allows for better access.

It always amazes me that Canada and the USA, residing on the same continent, have completely opposite medical insurance programs and that most other countries have been able to find the middle ground that makes both of our systems look bad.

"Where troubles melt like lemon drops, away above the chimney tops, that's where you'll find me" Dorothy

[SkyDekker 1,147]

personally I think it is great and am in favour of a two tiered system where basic healthcare is provided to all, but those wqho can afford it have the option of buying more insurance, or go to private clinics.

[AlexCrowley 0]

The UK, at least when I lived there, had a public and private healthcare system that seemed to work...sorta. Quite simply you got what you paid for. If you couldnt afford private healthcare you would be put on a waiting list for non-essential operations - which could be as long as several years. Successive governments butchered the original structure and started trying to treat it as a business (sure it is, I'll explain), and discovered that when you cut taxes and alter funding principles and forget why the national health service was created it starts to fall apart.

On the plus side there was never any BS about which drugs my doctor said were ok vs which drugs my insurance company says is ok. Given that generics have a 20% variability of the active ingredient and no regulation of 'inactive' that can be a big problem. I never had to worry about which doctors were in network, as the private system was modeled on the universal public system. Every doctor was in the system, so no inflated costs for specialists, or discovering that the one guy with expertise for whatevers ailing you is going to cost you $1000 every visit. And if you were going to die no one would tell you that the life saving operation wasnt covered or within your network. As opposed to little things like my kid's grandfather who at 55 had a series of massive strokes that left him mentally at age 5 with $500,000 of medical bills because he didnt have health insurance that covered that particular situation.

I'm not sure where Americans get the idea that public healthcare is a bad thing. The private system here is on the record as being hideously inefficient. Of the $x hundred I put in per month for family coverage only a couple of dollars actually get put into health care, the reset just maintains an insane system that like the oroburos feeds on itself.

Your medical companies here charge 2 to 3 times more for EXACTLY the same drug - ie, one with the same ingredients, manufacturing process and testing requirements - in fact, in some cases better testing than the FDA provides. That stuff about the Canadian FDA not being as good? yeah. Go ask your physician to make some calls if they dont already have the details.

Perhaps someone can untangle this conundrum for me.


1. It would be a government tit to suck on and that is a very bad thing. To suggest otherwise is unamerican.

2. Human life is absolutely sacred, it should be protected at all costs. Nothing, NOTHING is more sacred than human life, whether it be brain dead human life or Clumpy the 3 day old fetus.

Now, in my - admittedly limited - experience of Americans there's a very large overlap of people who believe both point 1 AND point 2.

Perhaps someone who identifies with that overlap can expain the following to me:

If life is sacred then why do you support a privatized system that means you have to pay to play. A system that allows a private profit driven company that is beholding only to its shareholders and profit margin to deny you treatment because 'its not covered by your medical coverage' wouldnt appear to be holding up their end of the 'life is sacred' reality.

Why is it so heretical to try and formulate a workable public system that would protect every human life and provide affordable treatment for everyone, regardless of the brain's functional state or it's development of skeletal structure and organs.

The argument of cost flies in the face of the facts as I understand them, which is Americans pay more per head for less health care than Europeans. The UK isnt the best example as a model for public healthcare as it's been stripped down and destroyed over recent decades, however most of Europe has universal healthcare systems that work, do not drain their economies and they're all driving BMWs so I'm thinking the 'tax burden will be crippling' might be a myth. The northern european countries consider life and health basic human right and have workable systems and healthy (although much smaller) working economies.

Any illumination, correction or opinions would be valued. thanks.

TV's got them images, TV's got them all, nothing's shocking.

[Gawain 0]

I have to respond to pieces of your post before I get into some broader points.

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I'm not sure where Americans get the idea that public healthcare is a bad thing. The private system here is on the record as being hideously inefficient.

I never said public healthcare is bad, or a bad thing. I do believe in choice. The US does have medicaid, medicare, and other "social" programs which suffer the inefficiencies of a government bureaucracy. In comparison to a "private, for profit" enterprise, the government program (even here in the US) comes up woefully short.

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Your medical companies here charge 2 to 3 times more for EXACTLY the same drug - ie, one with the same ingredients, manufacturing process and testing requirements - in fact, in some cases better testing than the FDA provides. That stuff about the Canadian FDA not being as good? yeah. Go ask your physician to make some calls if they dont already have the details.

My issue there isn't with the Canadian "FDA" or UK version, etc. My issue is the Canadian price controls which state (in simplistic terms): "If you want to sell your drugs in this country, you will sell them at $X.XX"

Meanwhile, it costs GSK, or Pfizer upwards of $300M to develop one drug. ONE DRUG. Now, add to that, that there are companies which copy the drugs, adjust ingredient without testing and sell them "on the cheap". It doesn't bode well for anyone if some half-wit/C+ researcher in Guatemala changes the "wrong" inactive ingredient.

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Perhaps someone can untangle this conundrum for me.

1. It would be a government tit to suck on and that is a very bad thing. To suggest otherwise is unamerican.

2. Human life is absolutely sacred, it should be protected at all costs. Nothing, NOTHING is more sacred than human life, whether it be brain dead human life or Clumpy the 3 day old fetus.

Now, in my - admittedly limited - experience of Americans there's a very large overlap of people who believe both point 1 AND point 2.

I think that your point number 1 should be refined. In my particularly broad experience (being an American who has lived all over this country, MN, MA, CT, ME, VT, NY, KY, GA, SC, FL, OR, CA and visited nearly everywhere else), using the Government "tit" as a helping hand, isn't a bad thing at all, but continued sucking on it and using it as a crutch and not making an effort to dig one's self out of the "hole" is a bad thing.

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The argument of cost flies in the face of the facts as I understand them, which is Americans pay more per head for less health care than Europeans. The UK isnt the best example as a model for public healthcare as it's been stripped down and destroyed over recent decades, however most of Europe has universal healthcare systems that work, do not drain their economies and they're all driving BMWs so I'm thinking the 'tax burden will be crippling' might be a myth. The northern european countries consider life and health basic human right and have workable systems and healthy (although much smaller) working economies.

Your argument does not hold up to reality. Taxes in much of Europe are already crippling in nature. Let's pick the big players in the EU:

Germany: GDP growth rate under 1% from 2001-2003. Unemployment rate of about 11% and an aging population drawing on a social system that puts out well more than it takes in. National wage laws and stiff labor market regulations are not being addressed aggressively and its debt limit is above the EU limit of 3%.

France: GDP growth rate barely over 2% and an unemployment rate of 10% despite heavily subsidized work regs, 35 hr work week and the highest tax burden in Europe (43% roughly). Significant government run companies and inflexible market structure is strained by the social demands of its addicted people.

Italy: GDP growth rate under 2%, mega-state-run pension system and 9% unemployment (though in the Agricultural south, unemployment regionally is about 20%) is under the same labor pressures as Germany and France.

Spain: GDP growth rate under 3%, and 11% unemployment. Now under a socialist administration which does not favor a flexible market condition or ability to adjust to the changing economy.

Then, outside Europe:

Japan: Doing very well except for one thing: Debt. Totaling 160% of its GDP it has long term troubles and the Japanese live for a very long time. Their health system works. For them, the issue is going to be money and taxes.

Does the US have problems without the healthcare issues, absolutely. But history has proven that over-socialization of such matters is not a good thing. Socialism, in the end, does not work.

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[ViperPilot 0]

Great info Gawain.

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Socialism, in the end, does not work.

Everyone should realize, based on info such as provided by Gawain, that socialism, although good on paper, DOES NOT function properly in the real world. Socialized medicine basically functions the same as the worst of HMOs. Sounds so great, but proves to be horrible in actuality.

[Botellines 0]

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Everyone should realize, based on info such as provided by Gawain, that socialism, although good on paper, DOES NOT function properly in the real world.

Sure it does. I knwo the very sound of the word socialism sounds evil, like comunism, but i asure you that it works fairly well. There is many countries in Europe who work decently and have one form or another of socialism.

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Socialized medicine basically functions the same as the worst of HMOs. Sounds so great, but proves to be horrible in actuality.

Socialized medicine basicly means that the money that the shareholder would spend in a private jet if privatized, will be spent in giving you and your family better assitance.

Sure it has its problems, and the main problem is how easily abused the system is. But you don´t have to disregard the whole concept because it has some problems. Besides, can you see the drawbacks of capitalism?

Socialism is not an Uthopia.

[mikkey 0]

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Your argument does not hold up to reality. Taxes in much of Europe are already crippling in nature. Let's pick the big players in the EU:

Germany: GDP growth rate under 1% from 2001-2003. Unemployment rate of about 11% and an aging population drawing on a social system that puts out well more than it takes in. National wage laws and stiff labor market regulations are not being addressed aggressively and its debt limit is above the EU limit of 3%.

France: GDP growth rate barely over 2% and an unemployment rate of 10% despite heavily subsidized work regs, 35 hr work week and the highest tax burden in Europe (43% roughly). Significant government run companies and inflexible market structure is strained by the social demands of its addicted people.

Italy: GDP growth rate under 2%, mega-state-run pension system and 9% unemployment (though in the Agricultural south, unemployment regionally is about 20%) is under the same labor pressures as Germany and France.

Spain: GDP growth rate under 3%, and 11% unemployment. Now under a socialist administration which does not favor a flexible market

A very simplistic view. There are lots of reasons for the above, e.g. Germany got its economic spine broken by the cost of re-unification.

Have a look at the economic data for the Scandinavian countries in Europe. They have excellent growth, surplus in trade (export more then they import), very high living standards, low unemployment, and are the most "socialist" countries in Europe. They spend the most on public health care and education and have very high taxes.

So it is not that simple. You guys love the black and white view - just does not work..

I also don't get it, how you match above numbers with the health care system. The problems in above countries have other reasons (structual) then just the cost of health.
I live in Australia which has a strong economy, a conservative government for about the last 10 years, and much less "socialism" then Europe. And guess what, we have a public health care system (with a private top-up option like most countries with mainly public system). These issues are quite complex and from my personal experience of living in a number of countries, I prefer a system with a strong public health care system (not like the US one) with an option to "top up" it wit private health insurance if you can aford it.

PS: You might also think about the budget and trade deficits in the US. It is easy to achieve growth on the back of huge deficits in trade and budget, but it will come back to bite you...

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When people look like ants - pull. When ants look like people - pray.

[Gawain 0]

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Everyone should realize, based on info such as provided by Gawain, that socialism, although good on paper, DOES NOT function properly in the real world.

Sure it does. I knwo the very sound of the word socialism sounds evil, like comunism, but i asure you that it works fairly well. There is many countries in Europe who work decently and have one form or another of socialism.

1. Even in the days of the USSR, there has been no "truly communistic" country. It was extreme State-run Socialism.

2. No, fully centralized social programs don't function properly. Ask the millions that were protesting in Germany when Schroeder was re-elected and started suggesting reforms to the social systems in place there.

3. Please list the "many" countries in Europe that are flourishing under a socialistic umbrella in the currently expanding global economy.

Note too that Canada, whose economic survival is solely dependent on the economic health of the US (the US economy is doing pretty well right now), is seeing GDP growth under 3%, and has over 7% unemployment in the shadow of much lower unemployment in the US (under 5.5%) and greater growth of the GDP (averaging over 5% over the past 3 years).

Couple that with Canada's higher taxes, and it is unsustainable in the end.

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Socialized medicine basically functions the same as the worst of HMOs. Sounds so great, but proves to be horrible in actuality.

Socialized medicine basicly means that the money that the shareholder would spend in a private jet if privatized, will be spent in giving you and your family better assitance.

Did you even read the original article at the beginning of the thread? NO...they aren't getting "better" care or assistance.

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Besides, can you see the drawbacks of capitalism?

To an extent, I submit that many of the perceived "drawbacks" are not solely a result of the system itself, this is due to the fact that the system is a "reap what you sow" precept.

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Socialism is not an Uthopia.

That I can agree with.

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[Gawain 0]

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A very simplistic view. There are lots of reasons for the above, e.g. Germany got its economic spine broken by the cost of re-unification.

Point taken, I will point out too though that after 15 years with barely a trickle of a return on the mere $70B per year (in the face of the $2.4Tr GDP) is proof of the social systems taking too much of the investment needed for infrastructure and modernization of the former DDR. In other words, they broke their own back.

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Have a look at the economic data for the Scandinavian countries in Europe. They have excellent growth, surplus in trade (export more then they import), very high living standards, low unemployment, and are the most "socialist" countries in Europe.

Again, point taken, Norway is a good example. However their GDP is $180B, managing a population of only 4M. That's not socialism, that a welfare state. General Motors is bigger.

Sweden is another good example, but again, like Norway, very small in terms of the numbers. WalMart is bigger.

Finland should be on the list, but they've got 9% unemployment with a population of 5M.

I may be simplifying it, but that solely to conserve bandwidth (and save my fingers and wrists from carpal-tunnel) and put out the main points that interested folks can build a conclusion on.

It boils down to this: Canada and Western Europe are suffering from fundamental problems resulting from tax and welfare policies. Their economies cannot sustain them. Their socialistic nature will not allow the flexibility to adapt to the evolving environment. EU seems like a good idea, but ultimately you're trading lots of small systems that don't work for a big one that won't work.

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I live in Australia which has a strong economy, a conservative government for about the last 10 years, and much less "socialism" then Europe.
And guess what, we have a public health care system (with a private top-up option like most countries with mainly public system).

You kind of made my point for me.

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PS: You might also think about the budget and trade deficits in the US. It is easy to achieve growth on the back of huge deficits in trade and budget, but it will come back to bite you...

Indeed it may, however it has been proven time, and time again how resilient our economy can be, even when things come to bite us in the @ss. The difference is that our economy is free-market based and consumer driven. If you placed a proportional burden on any of my aforementioned countries economic systems, they would go dark overnight.

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[AlexCrowley 0]

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Meanwhile, it costs GSK, or Pfizer upwards of $300M to develop one drug. ONE DRUG. Now, add to that, that there are companies which copy the drugs, adjust ingredient without testing and sell them "on the cheap". It doesn't bode well for anyone if some half-wit/C+ researcher in Guatemala changes the "wrong" inactive ingredient.

As a former employee of Pfizer:
They have more sales staff on their executive board than scientists. All drug breakthroughs are reviewed by this board. The majority vote wins and it's generally based on marketability and profit.

From a report cited below: "In 2002 the thirteen largest U.S. pharmaceutical companies allocated their sales revenue to particular objects of expenditures and profits as follows: cost of goods sold, 25.3 percent; selling and administration, 32.8 percent; R&D, 14 percent; taxes, 7.3 percent; and net after-tax profits, 20.6 percent"

So, free market economics are fine, but my sense of morality within says 'Ethically is it correct for a company with a monopoly on a new, potentially life saving drug to have the freedom to charge 'what the market will bear' *if* we accept that all life is sacred. I know, it's unpopular to suggest that we, as society, should provide a safety net.

I wasnt suggesting radical reform to pay anyone but doctors and medical companies to give access to a basic human right to health care without crippling economic ruin in the future.

Example:
My chronically disabled friend is forced to use Medicare and Medicade, lets just say that the system is designed for him to fail. Gets himself a job? Fine, loses all benefits immediately (his disability check). How many people do you know that can walk into a $60,000 first job? (which would barely cover his rent plus his annual medical bills) The kid's a genius, well educated, has won presidential awards and can't get himself off Medicaid/Disability because 'the system' says that gimps can live in a home and have their lives paid for or they can go screw, get minimum financial assistance and if ever they should try to be a normal person the system will ass rape them so hard that they'll never think about getting a job again. Three months ago he had an epileptic fit in public and passed out, he woke up in a state mental hospital and discovered he had ZERO rights as a person, he was 'incarcerated' for 4 weeks. He has refused to comment on it except for the day he got out and was finally able to call me (his emergency medical contact) when he gave a one sentence "they kept me hostage" and "I'll call you in a week once I've got over it".

Medicaid/Medicare did not cover the life support and hospital stay required for my kids grandfather that I mentioned earlier. I'm wondering how his relatives are going to handle the burden of a medical bill that runs into the $400,000s.

Your examples of European 'big boys' are not part of whats commonly called northern Europe: Denmark, Estonia, Faeroe Islands, Finland, Iceland, Ireland, Latvia, Lithuania, Norway, Sweden, United Kingdom.
In addition, the reasons for the crumbling finances of the countries listed has very little to do with overburdening their healthcare system, as I'm sure you realize.

So, given that I can't argue economics and you dont know European geography lets remove it from the conversation:)

I dont think one can over-socialize a basic human right like health, but like I said, I base that on my own moral compass. Like you I believe that total socialism is inherently flawed because people like stuff, but I do not believe that we, as individuals, should ever consider corporate responsibility to stock holders and profit margins to come before human lives - which, like it or not, is how the current system works. My perspective on safety nets comes from a year of being homeless and working my way across the US, not because I think government sanctioned handout abuse is an ideal.

From the research paper: US Health Care Spending in An International Context - which I urge you to read to ensure I am not manipulating in any way, plus its a very interesting read:

Using the US as the 100 percent total health cost spending per capita

United States 100%
Switzerland 68%
Norway 60%
Germanya 57%
Canada 57%

"administrative costs for insurers, employers, and the providers of health care in the U.S. health system (not even including the time costs patients bear in choosing health insurance and claiming reimbursement) were “at least” $294.3 billion in 1999, or about 24 percent of total U.S. health spending"

The paper also tackles some of the other points you bought up, since I can understand them but not defend them I'll leave it to you to check the sources :)

[ViperPilot 0]

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Sure it has its problems, and the main problem is how easily abused the system is.

Its problems outweigh its benefits IMO. Reasoning being is that sure everyone has an "equal" shot at healthcare unlike in capitalism where the more money you have, the better care you can get, but say you need some surgery...sure you won't have to spend your soul to get it, but too bad you have to wait 2 years to get it. While in America someone has the same condition and has to pay an arm and a leg for it, but they get the surgery within a month. Socialist and Capitalist healthcare programs have their share of problems, I just think socialist medical care is not the "answer to crappy capitalist healthcare" that many people seem to think it is (not saying you do).

Some people have more money, those people will be able to afford better healthcare (i.e. surgeries). If they have the ability to do it, then why not let them? That's why I like the capitalist way of doing things.

[lawrocket 3]

Part of the problem with health care is that it does not fit into any economic model. In medicine, there is a constant tension between three things: 1) quality of medical care; 2) quantity of medical care; and 3) affordability of medical care.

Cuba is a great example of this. Cuba has two different medical systems. The first is one for the general population that is socialized. The second is for government leaders and tourists or businessmen. The second is a high quality, highly available and high cost healthcare system. If you've got the money, they'll give you whatever you want, whenever, and do it as well as anyone in the world. On the other hand, the socialized system is cheap, but not high quality and is rationed.

In a socialized system, the medical care is meant to benefit society. Thus, importance is placed on funding procedures that can help members of the population go back to being productive citizens. It's why the 27 year old can get that surgery fairly quickly to repair his back that was injured when he was hit by a car. But, that 69 year old gentleman who is experiencing narrowing of his spinal canal due to age-related processes might become paralyzed before a surgery date is set. Here's where the high-quality care is rationed.

You simply cannot have affordable, high quality and readily available healthcare. That's where medicine is different from anything else. As doctors get better at doign what they are doing, prices usually go up, though there are some places where doctors can perform certain surgeries cheaply and effectively, i.e., surgicenters where the only thing the place does is inguinal hernia repairs.

Frankly, the only way I can see costs going down is to return the US healthcare system back to a cash operation. Eliminate the compliance costs and billing costs and healthcare prices will drop. We'll also find that people begin going for treatment when the 80 dollar visit is necessary. Keep insurance with high deductibles and use it for only catastrophic injuries, i.e., the bad car accident.

The problem is that a large portion of the population might not be able to get medical care for a while until the system balances out its pricing.

Politically, though, cash only system will not be viable.

My wife is hotter than your wife.

[Gawain 0]

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As a former employee of Pfizer:
They have more sales staff on their executive board than scientists. All drug breakthroughs are reviewed by this board. The majority vote wins and it's generally based on marketability and profit.

Understandable in my opinion.

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From a report cited below: "In 2002 the thirteen largest U.S. pharmaceutical companies allocated their sales revenue to particular objects of expenditures and profits as follows: cost of goods sold, 25.3 percent; selling and administration, 32.8 percent; R&D, 14 percent; taxes, 7.3 percent; and net after-tax profits, 20.6 percent"

What this "report" is saying is where the revenue is going. Not where the costs are. Pfizer's net income amounts to less than 1/5th of their total revenue. Novartis out of Switzerland is in a similar situation.

The healthcare providers (Apria, Kaiser, Cigna, etc) are on even thinner margins. Then there's the monumental insurance costs to cover liability.

What does not get enough discussion on these and related subjects, in my opinion, is this: If people want to see a true, real reform and reduction in the costs of medicine, the answer is simple -- reform insurance requirements and tort reform (except in areas of deliberate negligence).

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Your examples of European 'big boys' are not part of whats commonly called northern Europe: Denmark, Estonia, Faeroe Islands, Finland, Iceland, Ireland, Latvia, Lithuania, Norway, Sweden, United Kingdom.
In addition, the reasons for the crumbling finances of the countries listed has very little to do with overburdening their healthcare system, as I'm sure you realize.

I was never using Northern Europe as an initial example. I was mentioning the big boys because that is where the money, people and economies of Europe as a whole are centered.

Using your examples cited above, Faroe Is., are a part of Denmark in terms of Government, and thus Government programs. Not including the UK (who is doing rather well I think), you are citing countries with a combined population somewhere shy of 20M and a combined GDP of something less than $500B and a population growth rate of less than 1%, and in several cases, negative population growth. Numbers like that are easy to manage. Corruption is harder to hide and since they don't have defense budgets, they got wads of cash to spend on that stuff.

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So, given that I can't argue economics and you dont know European geography lets remove it from the conversation:)

I don't know European geography as well as a native, but I know some sh*t (I mean, come on...Faroe Islands??!!, red-neck-town-USA has more people than the Faroe Islands...jeez...all 47,000 people there could sneeze at once and Denmark wouldn't even notice ).

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I dont think one can over-socialize a basic human right like health,

There's a fundamental difference. US rights are based around a right to life, liberty and the pursuit of happiness. Not health, nor health-care. Should they be available, basics can make it I think. But beyond that, forget it. I work for everything I have and I wouldn't want it any other way.

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[AlexCrowley 0]

I'm not sure tort reform numbers really create that big an impact, although I've not seen the numbers myself. I do agree that insurance requires major reform, I can live with greedy pharmcorps if the health insurance companies aren't such money grubbing enablers. The numbers on HMOs are staggering, as the report goes into great detail regarding.

Yeah, I know their small, I didnt think scale was the issue, I thought the socialist evils of universal healthcare were under discussion. Your comment about corruption and abuse are right on - health care is seen as a universal human right in these countries (not premium awesome super care, but quality health care) and as such theres less tolerance of bullshit. Of course, the issue is less complex to manage. But it does show that a logical mix of premium paid health insurance + quality state managed care can be of value in terms of human lives and managing health care costs.

Those with more cash purchase additional insurance and have greater access to better care - something which is totally logical. I certainly am not one to scream for equal health care for all - just health care that is denied to no one person for any reason, and isnt going to destroy their lives when they recieve the bill.

I used northern europe in my example, you wanted to show financial problems by using comparable economies - fine by me. I merely listed the countries/regions that are officially part of northern europe, and in all honest I can never remember is it's Iceland, Sweden or Denmark that have the super-awesome two tier medical system - but their all quite similar, with one of those three leading....saw a show on TV about it not so far inthe past (within the last 3 years), also talked about parents rights in the workplace and the other human quality of life issues that were being provided with only a marginal and for the most part, happily accepted additional tax burden.

..............we've only just begun.....

TV's got them images, TV's got them all, nothing's shocking.

[AlexCrowley 0]

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I dont think one can over-socialize a basic human right like health,

There's a fundamental difference. US rights are based around a right to life, liberty and the pursuit of happiness. Not health, nor health-care. Should they be available, basics can make it I think. But beyond that, forget it. I work for everything I have and I wouldn't want it any other way.

You know, this was really asking for trouble. Bring up something an information junkie is interested in but doesnt know much about. In the last couple of hours I've read the history of the DoI, related parts of Jeffersons Biography and a lot of highly influential 18th Century philosophy. So here goes, if you get bored easy you can skip this........

First, you start the quote in the middle:

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness"


Now, I'm not a great with history, but I can read: "We hold these truths to be self evident" seems to say "We realize this is pretty obvious but...." so, "among these" self evident truths is the inalienable right to Life, perhaps its just me but the word life has always led me to think of a functioning entity, and I might argue that to keep an entity functioning requires both food and adequate access to technologies to maintain that life.

Of course, you could argue that Virginias declaration of rights - on which the DoI was influenced has an almost identical opening passage "Section 1. That all men are by nature equally free and independent and have certain inherent rights, of which, when they enter into a state of society, they cannot, by any compact, deprive or divest their posterity; namely, the enjoyment of life and liberty, with the means of acquiring and possessing property, and pursuing and obtaining happiness and safety." Does it mean thats what the DoI means?

Or, looking at history and Jefferson, we see that he - like many educated men of his time was greatly influenced by the writing of John Locke, a philosopher who pretty much created the 'unalienable natural rights' of a man within society.

The blueprint of these self-evident truths, and the a method of governing that would support the rights of the individual is 'Two Treatises of Government' available all over the web for free in pdf form.

His argument w/regards to rights is: as an individual you have a god given natural right to life, liberty and property. By entering into a compact with your government you agree to let those rights be controlled to a certain extent by a democratic government that follows a design similar to the one in the DoI. This government is formed by the people for the people to maintain equality for all. (chapter 2, page 106 of the pdf version.)

Part 6 of these self evident truths is probably most interesting to this discussion: [while man has these certain basic rights he does not have the right to harm another person within his society and infringe on THAT persons rights, to murder another person or himsefl, he should harm no one...]...."And, being furnished with like faculties, sharing all in one community of Nature, there cannot be supposed any such subordination
among us that may authorise us to destroy one another, as if we were made for one another’s uses, as the inferior ranks of creatures are for ours. Every one as he is bound to preserve himself, and not to quit his station wilfully, so by the like reason, when his own preservation comes not in competition, ought he as much as he can to preserve the rest of mankind, and not unless it be to do justice on an offender, take away or impair the life, or what tends to the preservation of the life, the liberty, health, limb, or goods of another."


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"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness"

- Thank you Gawain, getting this far has been a fun ride

TV's got them images, TV's got them all, nothing's shocking.

[mikkey 0]

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Point taken, I will point out too though that after 15 years with barely a trickle of a return on the mere $70B per year (in the face of the $2.4Tr GDP) is proof of the social systems taking too much of the investment needed for infrastructure and modernization of the former DDR. In other words, they broke their own back.

Well, hard to say. Imagine the US unifying with Mexico and having to pay to bring their infrastructure and economy up to US standards... the effort required in Germany would be similar in relative terms.

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Again, point taken, Norway is a good example. However their GDP is $180B, managing a population of only 4M. That's not socialism, that a welfare state. General Motors is bigger.

Sweden is another good example, but again, like Norway, very small in terms of the numbers. WalMart is bigger.

Finland should be on the list, but they've got 9% unemployment with a population of 5M.

You forgot about Denmark - very strong economy, low unemployment, high taxes, welfare state.

Don't understand why its matter that these countries have small populations. They just show that you can gave "social democratic" / welfare societies that actually have good economies and are successful. Does not mean you have to like their system (I did not when I lived there) - but it illustrates that having a much more "social" system does not alway imply a bad economy and low living standards. The UK has also a good economy and has been run by a Labor goverment for many years.

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I live in Australia which has a strong economy, a conservative government for about the last 10 years, and much less "socialism" then Europe.
And guess what, we have a public health care system (with a private top-up option like most countries with mainly public system).

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You kind of made my point for me.

Well Australia can not be accused of being "socialist" but has many more social programs and greater public access to health care and eductaion then the US. We have a public health system not so different from Canada and we have cheap regulated prescription drugs. So.... you don't have to be a socialist country to have public health care system.

Actually I would warn against calling the European systems for "socialist" in the "old" sense. Most of them are more "social democratic" third way type of societies. They have structural problems - but so has the US. I don't believe there are "ideal" systems. Every type of society has its advantages and its problems. What you prefer is up to you. But I would suggest to study the differences with an open mind - everybody can learn from each others experience...

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When people look like ants - pull. When ants look like people - pray.

[AlexCrowley 0]

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Well Australia can not be accused of being "socialist" but has many more social programs and greater public access to health care and eductaion then the US. We have a public health system not so different from Canada and we have cheap regulated prescription drugs. So.... you don't have to be a socialist country to have public health care system.

Thank you for articulating so succinctly my garbled question/statement regarding the 'socialism' of universal health care. The US psyche has some weird issues with liberalism being a dirty word.

Having spent the evening studying stuff that 9th graders read in US history I find the gung-ho, free-market, right to do as I please because its in the goddamn DoI that I have unalienable rights attitude even more funny now I have discovered how very liberal the main inspiration for the DoI was.

TV's got them images, TV's got them all, nothing's shocking.

[Remster 24]

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1. Even in the days of the USSR, there has been no "truly communistic" country. It was extreme State-run Socialism.

Is there a truly capitalistic contry out there that I am not aware of?

Remster

[lawrocket 3]

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1. Even in the days of the USSR, there has been no "truly communistic" country. It was extreme State-run Socialism.

Is there a truly capitalistic contry out there that I am not aware of?

Nope. Probably the closest you'll find is Taiwan, although there are some banana republics that are pretty damned close becuase of ineffective governments dominated by drug cartels.

My wife is hotter than your wife.

[AndyMan 7]

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It's the very reason why the drugs, medical procedures and research that Canadians prize their "affordability" with, and use, are developed here in the US, at enormous cost to investors.

That is factually incorrect. Most of the big drug companies are based in Europe. Canada has a few, too.

Your economic argument is weak, too. There are countless studies done by economists around the world that suggest that the US health care system is the most innefecient one, anywhere. Here's just one: http://www.bloomberg.com/apps/news?pid=10000082&sid=a4J.ER8r4CrM&refer=canada. Moreover, Canadians tend to live longer than Americans - that being one very strong indicator that not only is it cheaper in Canada, but it's better too.

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Then the question becomes: Can the system withstand the shock of not having the government tit to suck on? Or, can the system withstand not having all 25M Canadians sucking on the tit?

I'm not sure why you think this is the question. The model changes from one of pure government support to one where people have the option of paying for a higher level of service. This sounds an awfull lot like the public school system, where everyone pays for a good level and those who choose to pay for more can, by sending their kids to private school. The existance of private schools does not threaten the future of public ones.

_Am

__

You put the fun in "funnel" - craichead.

[storm1977 0]

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Well Australia can not be accused of being "socialist" but has many more social programs and greater public access to health care and eductaion then the US. We have a public health system not so different from Canada and we have cheap regulated prescription drugs. So.... you don't have to be a socialist country to have public health care system.

Thank you for articulating so succinctly my garbled question/statement regarding the 'socialism' of universal health care. The US psyche has some weird issues with liberalism being a dirty word.

Having spent the evening studying stuff that 9th graders read in US history I find the gung-ho, free-market, right to do as I please because its in the goddamn DoI that I have unalienable rights attitude even more funny now I have discovered how very liberal the main inspiration for the DoI was.

Don't confuse Liberalism with Socialism....
However, I don't like either word. They are both Dirty to me


IMO you are misinterpreting the DoI. You are looking at it with a social slant. Hey, you are aloud to, it is free for interpretation I guess.
The DoI IMO speaks of the inalienable rights simply as saying every man has an Opportunity (an equal one) to be someone or do something without Gov intrusion. What is implied, however, is that though we all start off equal, and have equal opportunity, not all of us will take advantage of those opportunities. It is up to the person, not the government to succeed in life. The Governments only real obligation is to protect Life, Liberty, and the pursuit of Happiness

IMO meaning the government says... You are free to do what you want, and we will protect this nation, to keep that freedom alive.

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Sometimes it is more important to protect LIFE than Liberty

[SkyDekker 1,147]

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My issue there isn't with the Canadian "FDA" or UK version, etc. My issue is the Canadian price controls which state (in simplistic terms): "If you want to sell your drugs in this country, you will sell them at $X.XX"

Meanwhile, it costs GSK, or Pfizer upwards of $300M to develop one drug. ONE DRUG. Now, add to that, that there are companies which copy the drugs, adjust ingredient without testing and sell them "on the cheap". It doesn't bode well for anyone if some half-wit/C+ researcher in Guatemala changes the "wrong" inactive ingredient.

First of all, the pharmaceutical companies are free not to do business in Canada. The world is a big place.....if they were losing money in Canada I am sure they wouldn't do business here.

It is no differenmt then WalMart who dictates to their suppliers what the purchase price is. Before you can do business with them, you have to open your books. WalMart then decides what your profit margin should be and then sets the price they are willing to pay for your merchandise. As a supplier you are free not to go through this process and hence not do business with them.

[AlexCrowley 0]

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IMO you are misinterpreting the DoI. You are looking at it with a social slant. Hey, you are aloud to, it is free for interpretation I guess.
The DoI IMO speaks of the inalienable rights simply as saying every man has an Opportunity (an equal one) to be someone or do something without Gov intrusion. What is implied, however, is that though we all start off equal, and have equal opportunity, not all of us will take advantage of those opportunities. It is up to the person, not the government to succeed in life. The Governments only real obligation is to protect Life, Liberty, and the pursuit of Happiness

IMO meaning the government says... You are free to do what you want, and we will protect this nation, to keep that freedom alive.

With much respect I think that your interpretation might be flawed. When I started going thru the civics stuff last night (remember, i'm not a native) I read Jeffersons Biography, John Lockes work because I wanted to find out exactly what a 18th century gentlemans idea of 'self-evident' rights were. Even the most open reading of Lockes work shadows the DoI incredibly, with much of the language mirroring what Jefferson wrote. In fact, the opening paragraph of the DoI is taken almost wholesale from the paragraph I mentioned - except the paragraph mentioned is far wordier. In the Treatise a form of government is suggested that closely resembles the original form.


We also know from the DoI draft that Jefferson included wording about the nature of slavery, again something that is covered explicitly in Lockes work. I think it a stretch to think that Jefferson merely plagarised the syntax while ignoring the intended context.

I dont know if this is what you study in high school or not: Of the State of Nature, John Locke

I look at it with a social slant because Locke was considered one of the 'Age of Enlightenments' liberal philosphers, that being his intention I consider that those influenced by him enough to adopt his theories, and using his words, and try to apply them in reality may also have had some liberal leanings. It's the whole 'self-evident' 'unalienable' key words.

TV's got them images, TV's got them all, nothing's shocking.