Canadian Healthcare from a Canadian...

Funny how our country was founded on limited government and strong states rights. The Federal government was formed in such a way as to govern interactions amongst states and to provide national defense. We don't look at the Federal government like that anymore I guess.

http://www.nytimes.com/2007/10/23/opinion/23herbert.html?ref=opinion

There are a million of these stories, but this is an article about two people who are struggling right now that I thought was affecting. If anyone here has the gall to criticize this family's work ethic then you can really go to hell as far as I am concerned.

http://www.nytimes.com/2007/10/23/opinion/23herbert.html?ref=opinion

There are a million of these stories, but this is an article about two people who are struggling right now that I thought was affecting. If anyone here has the gall to criticize this family's work ethic then you can really go to hell as far as I am concerned.

Sad story on many levels.

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.

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

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

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.

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.

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!

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.

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?