couchcommander said:
The New England Journal of Medicine (american) reported that private hospitals have a significantly higher per patient cost for the same procedure than did public ones. Further, that on average, for private hospitals administrative costs were twice that of public hospitals.
In short, private health care is SIGNIFICANTLY more expensive than public health care.
You have to pay the bucks if you want the best care in the world. We don't get the system we should be getting. You are right, health care is more expensive in the States (I've read the same sorts of stats), but do you think it is better to spend less and have a system that is fraught with waiting lists, is falling behind in technological fields (we have an MIR per capita rate equivalent to Central American countries), and loses talent to better paying positions in the US?
Secondly, despite the fact the United States spends twice as much per capita on health care, their basic health indicators (infant mortality rate and life expectancy) which are general indicators for health care performance used in the WHO's World Health Report are both inferior to ours.
You'd think after spending twice as much they'd at least be a little better
Is "Health Care" the reason for this? I would think that the "inferior" stats stem from the problems facing US inner cities, and hence are related to specific issues such as race relations, etc, etc (when you take these areas out of the equation, statistics on violent crime are the same in both the US and Canada). I don't know if Health Care is going to prove to be a big thing when kids are wheeled in with gunshot wounds from gangwars and drug abuse is rampant in urban ghettos.
Third, though you are correct that if you have insurance you can get a hip replacement quicker, the problem is that 50 million americans don't have health insurance.
No health insurance means a REALLY long wait... ie not getting it unless you get a REALLY big raise.
The "50 Million un-insured Americans" is really quite a myth in that it implies that these 50,000,000 Americans are the same people who are constantly looking for proper health care insurance.
This "50 Million" is a rapidly shifting population. The poor are covered by Medicare and the Elderly by Medicaid (or is it the other way around?). Most Americans have insurance through their employer. The 50 million are people in between jobs, students not under their parents coverage, etc, etc. Canada has the same problem at times - I was not covered by Health Insurance for about 6 months because I had lapsed from my parents plan and never really put the effort into signing into the provincial system. As well, many important health care services are unavailable to many Canadians because the public adminstration has, in the effort to cut costs, eliminated them from basic coverage (ie: dental work - healthy teeth and gums is pretty important health wise, is it not?) Don't have
"Extended Coverage" through the private insurence of an employer? Sorry, you're shit out of luck, just like an American.
What both the US and Canada need is a privately managed system that is truly universal and comprehensive - Canada's system is so fraught with exceptions, regulations, and loopholes (ie: inter-provincial service is tricky) that people slick through the cracks here as well (this is the "perverse incentive" that public administration has)
Fourth. Even the socialists are saying that the system now has enough money, it's just up to the provinces to actually spend it correctly (Romanow about two weeks back).
There is enough money in the system now for it to be the best there is, and it's still half of what the US spends (ie taking up a LOT less of our income and economy than would otherwise be the case)
I'm sure they are right as well. :
Just in the last election, everyone was bleating for more money for the Health Care system. Since the 1970's, Canada's spending on health as a percentage of GDP has been steadily increasing. I think the figure pointed out that if we continued on the trend that we've been on, we would be spending 100% on health care in a few decades. Clearly, due to the fact that technology becomes more and more important in health care (driving up the average costs), demographics are shifting (meaning more elderly people are going to need the system), and that there never seems to be "enough" money for the system, the need for reform is staring us in the eyes.
History teaches us important lessons. By looking at the Soviets, we should have learned that command economies (regardless of sector) don't work. That's why we won and why China is moving with the times.
Regarding the health savings account that Bush has proposed...... taxing is a lot more efficient. I mean, look at it. We can either take money from everyone and put it into a big pool which is then used to pay for everyones health care, or we can take money from everyone and put it into a little account with their name on it, use that money to pay for health care until you "spend" it all, then take more money from everyone and put it into a big pool to pay for heath care after that point.
In one case, we just have one pool. In the second, we have 30 million small pools and one big pool. The only measurable effect is that it will cost a hell of a lot more to administer the 30 million pools, and that while the money we are taking from you is sitting in the small pool it is not actually being used in the health care system, instead it is just sitting there doing nothing (whereas with taxation all the money we give is doing something). This translates into the fact that they would end up taking MORE money from us than we currently are giving for a less efficient and worse off system.
Read through this thread, the role of "perverse incentives" is quite important. Abuse is widespread in our system, whether it be the politician, the health admin, the doctor, or the patient and is the main reason we aren't getting the health care system that we should be getting.
If, as you point out, there is one big pool, then nobody has any problem with treating it properly. If every Canadian has their own pool (which can be privately funded off of income, publically funded from the tax base, or made up of a mix), then they will treat it like their own and recognize that Health Care is a resource that costs money and should be used wisely (ie: Go to the emergency room for the sniffles and you can pay $300 instead of $30 at a drop in clinic from your pool).
Don't compare the Canadian Health Care System to the Americans - it is a straw man theory. We both suffer from the same debilitating problem in that we are stuck to large bureaucracies (public or private) to manage and direct how
we approach our personal health and, in the process, create a false patient/doctor relationship that is full of perverse incentives. I am all for a universal system of coverage - like vehicle insurance, the costs are too high to go around without it. However, it needs to be done properly, resting responsibility for individual health in, surprisingly, the individual.
I'll leave you with a favorite Mark Milke (of the CTF) quote of mine:
If governments ran grocery stores, bureaucrats in Ottawa and the provincial capitals would determine how many boxes of Corn Flakes were to be available in Halifax, Sarnia, and Kamloops. Government unions would argue that because food is so vital for human survival only they should be allowed to run farms, grocery stores, and the transportation system that surrounds the provision of foodstuffs. Lobby groups would spring up to decry the encroachment of "two-tier foodcare" where some rich folks could buy cavier while the rest of us make due with hamburger. If Canada's governments controlled retirement in the manner that health care is regulated, retirees would not be allowed to save for their retirement outside of the Canada Pension Plan and the government would determine how many Winnebagos and trips to Florida could be bought every year.
The great accomplishment of Canada's health care system is that it is universal; the great failure is that funding decisions are forced through bureaucrats and politicians.
