As President Barack Obama scours the U.S. to drum up support for reforming healthcare, the Washington Post (among others) says the White House may be willing to dump its government-run insurance plan.
If so, this will have the duel effect of encouraging opponents of Obama’s goal to create a cheaper, non-profit, government-sponsored health plan for the 40 to 50 million Americans presently with no health insurance, while alienating liberal-left Democrats who seek to emulate a Canadian health system.
Looked at from the outside, it’s hard to see Obama succeeding.
Americans have been so conditioned for so long against anything resembling socialized medicine, that hackles rise at creating another government bureaucracy to manage health.
A couple of things stand out about universal healthcare.
A case can be made (from Canada’s experience) that you cannot maintain a healthcare system like Canada’s and at the same time maintain the world’s largest, best equipped, all-purpose military whose existence imposes caution on rogue elements of the world. A country that has the one, can’t easily have the other without a prohibitive tax increase.
America’s military is more important than universal healthcare.
Canada’s costly healthcare necessitates that its military be small, over-strained and under-financed. Competent but perpetually frustrated.
Another thing: Obama insists that if his health reform plan is passed, people can keep their current insurance plans. Wanna bet? (The bill is supposed to be ready by Sept. 15, but probably won’t be.)
If the government-run insurance plan were adopted whereby non-insured people would be insured, how long would private companies continue to contribute to the health insurance of their employees? Would they not start cutting health plans and force the government to pay? You know the answer as well as I do.
While Canada is cited by fans of universal health as an example to aspire to, opponents of socialized medicine see Canada as a disaster.
Apart from high costs necessitating a high tax rate, a huge downside is catastrophically long wait times for operations. This results in unknown numbers of deaths of patients waiting.
Emergency or critical cases are dealt with quickly and competently in Canada, but waiting to be diagnosed can be a death sentence. Access to healthcare in Canada is a continuing problem.
It is scandalous that getting an MRI in Canada can take weeks or months, and then done in the middle of the night. Often it’s who you know, what clout you have, your importance in the community that dictates if you go to the head of the queue. In the U.S., if you have money (a great equalizer) you get service. Period.
In the U.S., Obama must overcome prejudice against government-run health. While he stresses it’s reform he seeks, not control, critics fear “reforming” healthcare means “rationing” healthcare.
By instinct, Americans prefer less government to more government.
Judging from opinion polls and raucous town hall meetings, and from the unease of many elected Democrats, Americans are skeptical of Obamacare by a 2-1 margin.
And with a health reform bill that is 1,000 pages long, and wants the government rather than physicians deciding on end-of-life healthcare for the aged, few have a clue what reform would really mean.
Obama has staked his first year in office on healthcare reform – and so far he seems to have badly misjudged what Americans want or will accept.
46 responses so far
1 Observer // Aug 20, 2009 at 12:26 am
Omigod! Peter Worthington noticed there was a debate about health care!
Put that cane away, buddy – it’s slowing you down.
2 SFTor1 // Aug 20, 2009 at 12:43 am
This must be the most preposterous nonsense I have read in a long time.
Two key points:
The United States has the world’s largest military, AND is spending about twice that of any other industrialized nation on health care, the Canadian one included.
The Canadian health care system has better outcomes than the U.S. health care system.
Any questions?
P.S. The misconception of “more government” vs. “less government” covers over the insistent fact that health care is a national, macro-economic, and strategic issue. We are looking for an effective solution, not a philosophically pure half-measure.
3 greg_barton // Aug 20, 2009 at 12:54 am
“If so, this will have the duel effect…”
Try using ‘dual’ instead of ‘duel’ in this context…unless you’re fighting for your honor…
4 greg_barton // Aug 20, 2009 at 12:56 am
Oh, and Americans love big government, especially Republicans. Eight years of Bush showed us that much. Trillions for a prescription drug benefit? No problem! Trillions for a couple of useless wars? Cool!
5 Spartacus // Aug 20, 2009 at 1:34 am
Peter Worthington wrote: “A case can be made (from Canada’s experience) that you cannot maintain a healthcare system like Canada’s and at the same time maintain the world’s largest, best equipped, all-purpose military . . . ”
Are you serious? Did you just awake from a coma? If not, you must be incredibly stupid. Canada has a healthcare system that ranked higher than the U.S.’ and it spends only a fraction as much money on a per capita basis as is spent here in the U.S.
6 Spartacus // Aug 20, 2009 at 1:37 am
Worthington’s article is just another example of Frum not being serious about the healthcare reform debate. It’s impossible to post this article and, at the same time, expect to maintain any credibility.
7 sdspringy // Aug 20, 2009 at 1:43 am
Greg, you answered your own question. Conservatives and of independents did not support Rep in 06 & 08, mainly because of the spending.
Sftor1 or Spart, the cost of US healthcare is currently a burden of the individual. Which allows for some choice. You can carry insurance or not, you can determine your coverage and cost. That goes out the window in a public option. The statement from above:
If the government-run insurance plan were adopted whereby non-insured people would be insured, how long would private companies continue to contribute to the health insurance of their employees? Would they not start cutting health plans and force the government to pay? You know the answer as well as I do.
I find accurate. Which means the cost of my healthcare will be determined by the government which will lead to increased cost to me.
And when it comes to statistics concerning healthcare the one which I monitor is survival rates. We currently have the best survival rates for various cancer and illnesses than anywhere.
8 ProfNickD // Aug 20, 2009 at 3:59 am
The advocates of nationalized/socialized medical insurance system think they can repeal the law of supply and demand.
They want low cost, high quality services, and universal coverage — all entirely mutually exclusive.
It’s like saying you want everyone to have the same high quality autombiles for less than they cost now. It’s just a fantasy.
Here a very simple question for the socialists: if everyone gets the same high quality services, how can the price be kept low?
How will the surgeons, the specialists, the cancer centers, the cutting-edge pharmaceuticals, and the emergency room miracle-workers be paid at the same rate as they do now, when everybody would get the same high level of medical treatment anytime they need it?
If you want to make such high quality care avaiable for all, then the price would go *up*, not down.
On another note, sdspringy’s post above is correct about survival rates — it is well documented in refereed medical journals that the U.S. has far higher survival rates than do European countries for nearly every illness. To wit:
“Cancer survival in five continents: a worldwide population-based study”
Lancet Oncology, August 2008 (vol.9, Issue 8, pp. 730-756)
Here is a link to an news article that summarizes this academic study:
http://www.medscape.com/viewarticle/561737
If anyone can find a study showing Americans have a lower survival rate for illnesses than do Europeans, I’d be glad to read it. Otherwise, I think the socialists have to admit that universal medical care that lower costs does, in fact, substantially reduce the quality of care for everyone.
9 Rodak // Aug 20, 2009 at 5:14 am
Long waits to see a physician are the simple result of an insufficient number of physicians (in any given geographical region) to quickly meet the health care needs of the population of that region. If we want to make healing the sick a fiscal (and moral) priority, all we need do is allocate the funds to make it happen. This would entail enlarging our medical school capacities in order to graduate more physicians. It would also entail subsidizing physician salaries in sparsely-populated, rural areas, in order to make it feasible for them to live and work in those areas. And it would entail providing subsidized payment plans to allow those who cannot afford to pay for services access to the system.
None of this is impossible; all of it is expensive. We can funnel our resources into saving American lives, or we can funnel those resources into killing Muslims, half-way around the world. It’s “grandma” or Black Water, America. And you are free to make the choice.
10 LB // Aug 20, 2009 at 7:37 am
“Apart from high costs necessitating a high tax rate”
Sorry What ?
Last time I checked our marginal effective tax rate is just 1% higher than it is in the US. And we have the lowest corporate income tax rate in the G8. Basically we are maintaining a full service welfare state, with all of our social safety nets fiscally solvent at 1950’s levels of taxation.
And it is not like people are dying in the streets up here. Sure we have problems with the system but so does everybody. If anyone has come up with the perfect system by all means bring it forward.
11 ottovbvs // Aug 20, 2009 at 7:54 am
profnickd // Aug 20, 2009 at 3:59 am
“They want low cost, high quality services, and universal coverage — all entirely mutually exclusive.”
……….This guy is a bit like a toy mouse with a string in its back……you pull the string and it just keeps repeating the same message in a tinny voice……..despite having had this claim thoroughly de-bunked elsewhere with reference to the experiences in Scandinavia, Germany, the Netherlands and France he just chatters out the same falsehoods…….argument with a dining room table anyone?
12 chgok9dad // Aug 20, 2009 at 8:19 am
The problem is citing and hearing anecdotal information. I lived in Canada for four years, and feel that it was the best health care that I ever had. I lived in a big city, Edmonton, and had an incredible physician. I also knew other physicians who, unlike American physicians, agreed to cap their salaries to help bring the costs of health care down. In the US, I once had Kaiser HMO, and it was the worst. They wouldn’t listen to me, and considered patients moving along an assembly line; I felt Kaiser often wasted their money and mine. Are these two comments representative? I don’t know. All I know if that a government-run system can work, that we need to insure everyone, that we need to think more about preventative medicine, and that we need to do something now. Otherwise, it’ll just be campaign talk fodder in the upcoming 2010-2012-2014 elections, and nothing will have changed.
13 sinz54 // Aug 20, 2009 at 9:41 am
Mr. Worthington’s column is illogical on a couple of points.
The Canadian system is true single-payer, yet single-payer has been taken off the table here in the U.S. No matter what type of ObamaCare bill ends up coming out of Congress, it will NOT be a single-payer system. So to keep pointing to Canadian single-payer as an exemplar represents a strawman. On BOTH sides.
This means you too, sftor1: Touting the benefits of single-payer is meaningless when it’s not the way America is going to go.
I think it’s safe to say that the vast majority of Canadians prefer THEIR health care system to OUR health care system. The fact that many Canadians gripe about THEIR health care system is NOT an argument for maintaining OUR system just the way it is. It’s OUR system that’s on trial in the debate we’re having over health care, not the CANADIAN health care system.
To use an analogy: Lots of American soldiers gripe about various conditions in the U.S. military. (I remember when some of them gave Rumsfeld an earful about better protection from IEDs.) “It’s an American soldier’s right to complain.” But almost NONE of them would prefer the conditions in the Russian military!
Discussing the flaws of other countries’ health care systems is an attempt to deflect debate from what’s wrong with our own.
14 ryanb // Aug 20, 2009 at 9:51 am
sdspringy, in the same paragraph you say we currently have choice in health care, then follow it up with support of a statement implying we’re at the mercy of our employers. The fact is employers would continue to contribute to health care as part of total employee compensation to compete for workers.
profnickd, good points, the US does have bright spots where we outperform the rest of the world on care for specific illnesses, and we don’t want to lose that. The great things about studies is that you can find one to say whatever you want =). Here’s one that looks at the broader view of preventable mortality (“deaths that might have been prevented with timely and effective care”). In that category the US ranks last place among 19 industrialized nations (http://tinyurl.com/cox25y – supported by other studies of course).
What we need is elimination of the employer sponsored system, a means tested refundable tax credit for those that buy insurance int the private sector, and a public option for individuals who aren’t sophisticated enough to shop for a private plan or whom the private sector doesn’t want to cover.
15 Bulldoglover100 // Aug 20, 2009 at 10:19 am
Fact 1: A Bill will be passed without the Public Option.
Fact 2: This Bill then goes into committee
Fact 3: At this point the Public Option is added back into the Bill
Fact 4: This Bill then, according to law, only requires 50 votes to pass.
Fact 5: The Bill passes and Obama is still seen as the President who did all he could to be bipartisan but those pesky Republicans just put their political agenda ahead of what was best for the American people once again.
16 sinz54 // Aug 20, 2009 at 10:47 am
ryanb sez: “What we need is elimination of the employer sponsored system, a means tested refundable tax credit for those that buy insurance int the private sector, and a public option for individuals who aren’t sophisticated enough to shop for a private plan or whom the private sector doesn’t want to cover.”
Ridiculous.
If the refundable tax credit is “means tested,” that means all those millions of white-collar affluent workers won’t get it. So instead, they’ll be socked with something like a $10,000 per year tax hike, once the tax-free employer-sponsored system is eliminated. That’s why McCain’s health care proposal, which included your idea to eliminate the employer-sponsored system, fell like a lead balloon.
The only way to make it palatable is if the tax credit to the worker is EXACTLY equal to the tax credit that the employer now gets. IOW, the Federal Government is still paying for the health insurance, but through the worker, so that portability among employers is assured. Of course, this won’t do anything to control costs, which is what I’ve said about 50 times already.
The tax benefit that corporations now get for giving health care amounts to hundreds of billions of dollars every year. You can either move it to the workers, or you can abolish it, which would represent a huge, absolutely huge, tax increase on Americans.
17 sunroof // Aug 20, 2009 at 10:56 am
profnickd said: “Here a very simple question for the socialists: if everyone gets the same high quality services, how can the price be kept low?
How will the surgeons, the specialists, the cancer centers, the cutting-edge pharmaceuticals, and the emergency room miracle-workers be paid at the same rate as they do now, when everybody would get the same high level of medical treatment anytime they need it?Let’s distinguish between Utopian and practical goals.”
Well, I’m not a socialist, and object to such idiotic labelling. Someone can support a single payer system like we have in Canada as the foundation – though the entirety – of a cost-effective, universal health care system. In a single payer systems where the hospitals are owned by the province, where the province negotiates fee scales with medical associations, where the state makes the same decisions about coverage that US insurance companies and HMOs make every day, it is possible for the system to contain cost escalation. I’m not going to argue that the Canadian system – which is not what the Democrats are seeking – does not need improvement. It does. But it would be crazy to argue that a single payer entity like a provincial health insurance board or ministry of health can’t eliminate duplication in both the capital and operating budgets of health care in their jurisdiction.
My doctor files out one set of forms for the Ontario plan (OHIP), files them electronically, and is paid promptly, a far cry from what US doctors have to put up with dealing daily with multiple insurance companies. Not every hospital in Toronto offers the same services – for example, some do not have maternity wards. So there is not the duplication of resources that you have in the States. Is there still waste? I’m sure. Is it less wasteful than the US health care system? I suspect so, in spades.
18 barker13 // Aug 20, 2009 at 11:33 am
“…the 40 to 50 million Americans presently with no health insurance…”
There are NOT 40 to 50 million AMERICANS presently without health insurance. Let’s start with recognizing this reality.
“If the government-run insurance plan were adopted whereby non-insured people would be insured, how long would private companies continue to contribute to the health insurance of their employees? Would they not start cutting health plans and force the government to pay? You know the answer as well as I do.”
Yep. I do. You’re right.
“…getting an MRI in Canada can take weeks or months, and then done in the middle of the night. Often it’s who you know, what clout you have, your importance in the community that dictates if you go to the head of the queue. In the U.S., if you have money (a great equalizer) you get service. Period.”
Yep. (*NOD*)
“By instinct, Americans prefer less government to more government.”
(*SIGH*) It depends. Class and culture – not to mention race – make far a far more diverse “ideal” than the one you call forth. (BTW, I’m with you in terms of THIS American wanting less government!)
Re: Sftor1 // Aug 20, 2009 at 12:43 am (#2) –
“The Canadian health care system has better outcomes than the U.S. health care system.”
(*SNORT*)
No. It doesn’t. Certainly not compared to the results an insured middle class American such as I can expect as compared to a Canadian peer.
Re: Spartacus // Aug 20, 2009 at 1:34 am (#5) –
“Canada has a healthcare system that ranked higher than the U.S….”
(*SIGH*) Spart. Com’on. How many times do we have to go over this? I can play with the stats all day long – as no doubt you can or Sftor1 can – but if you’re insured and middle class in America then there’s probably nowhere else on earth you’d rather be if the $hit hits the fan and you’re diagnosed with a disease which might or might not prove fatal depending upon the variable of whether you’re an insured middle class American vs. a Canadian or Brit.
Is there a great deal of waste and “unnecessary” testing done within the confines of American medicine? Sure. Is it expensive? Yes. But you know what they say about unnecessary… everything is “unnecessary” until… it’s not.
If it’s me or a loved one who is the rare case where our technology and our willingness to utilize it and damn the cost (to an extent) finds a stage one cancer or something that might have been missed or found too late were the patient/victim a Canadian or Brit… well… then as far as I’m concerned it was worth every frigg’n red cent.
Again. Assuming you read it, recall my post on my sister-in-law’s situation. I’m absolutely certain than had she been a Canadian or a Brit she’d be dying right this moment… only she wouldn’t know it. Since she’s an American with health insurance it looks like – Thank God – she’s going to be fine.
Re: Spartacus // Aug 20, 2009 at 1:37 am (#6) –
Listen. To an extent I’m with you. (You know my broad views on foreign policy and military issues.) Still…
http://www.vancouversun.com/story_print.html?id=1878506&sponsor
Listen. We’ll continue to go back and forth. We can post dueling news reports and op-eds and research papers all day long. Bottom line, I would certain never trade America’s present system (as problematic as it is in some regards) for the Canadian system(s) or the British system, and even bright “reform” advocates like yourself admit that if you’re going to point to foreign systems which the U.S. might want to emulate in some regard, the Canadian and British systems are not the ones to focus on.
(*SHRUG*)
Re: Sdspringy // Aug 20, 2009 at 1:43 am (#7) –
“…the cost of US healthcare is currently a burden of the individual.”
It is…?!?! Hmm…. ok… (*SCRATCHING MY HEAD*)
If you have fully or even partially paid health insurance than the burden has been switched to the employer and the taxpayer in general (who must bear the cost of all government subsidies/tax loopholes.
I mean certainly *my* health insurance is a burden to *me* – but that’s because I pay roughly 85% out of pocket. Most folks I know – including those who make double, triple, quadruple our family income or more pay far LESS for insurance (and thus medical care) than I do. (*SHRUG*) Just throwing it out there, SD.
Re: Profnickd // Aug 20, 2009 at 3:59 am (#8) –
“It’s like saying you want everyone to have the same high quality automobiles for less than they cost now. It’s just a fantasy.”
(*NOD*) (*CHUCKLE*) I like that!
As for the rest of your post… (*SIGH*)… you’re preaching to the choir here, but I fear simply repeating the facts and going over the logic just isn’t going to move some on the Left.
Re: Rodak // Aug 20, 2009 at 5:14 am (#9) –
Hmm… other than importing huge numbers of foreign doctors who will work directly for the United States government for the salary of a mid-level paper pusher in a downtown office building… I don’t see how government mandate is going to deal with the supply/demand problem you identify. (Hmm… bringing back indentured servitude – only to the State – it is at least “out of the box” thinking!) (*GRIN*)
“If we want to make healing the sick a fiscal (and moral) priority, all we need do is allocate the funds to make it happen.”
Ahh… so let me compare the two main liberal talking points: 1) We spend too much; 2) We need to spend more.
OK. Got it! (*GRIN*)
Re: Chgok9dad // Aug 20, 2009 at 8:19 am (#12) –
“I lived in Canada for four years, and feel that it was the best health care that I ever had.”
And exactly which often fatal diseases did they diagnose you with and then cure you of?
(*SHRUG*)
Nope. Not trying to be a wiseass. I’m just pointing out… every health care system in the world is “excellent” from a perspective of not requiring it to actually save your life.
“…we need to insure everyone…”
Yes. If by everyone you mean AMERICANS. I agree. (I’ve noted in the past how I’d handle the problem of illegal aliens; as for legal resident aliens… we’d have to work the numbers to see how they’d be covered – at higher costs no doubt.)
“…preventative medicine…”
(*SIGH*) (*HEADACHE*) Once again… preventive medicine ADDS to overall costs – it doesn’t subtract from them. I’m all for preventive medicine, but let’s have a clear picture of what it entails in terms of additional expenditures and thus costs.
BILL
19 Rodak // Aug 20, 2009 at 12:06 pm
1) We spend too much; 2) We need to spend more.
You’re skimming. You need to read more carefully. No. We need to reallocate our spending. I’m personally more afraid of cancer than I am of Osama bin Laden. No, we don’t only hire foreign-trained doctors (although we already are, and that could be expanded), but we also make funds available to medical schools so as to allow them to expand their capacities to graduate more physicians. Ditto nurse practitioners, who can provide very good service with regard to many primary care situations. In other words, we do need to think outside the box, imagine some new conformations of our health care “system,” and reallocate large amounts of $$$. (I’ll trust the NRA to protect me from the Muslim Hoardes, while I pay my share to send Dick and Jane to med school.)
20 ryanb // Aug 20, 2009 at 12:36 pm
sinz54: You’ve just demonstrated a serious problem – American’s don’t quite understand how taxes work. How do you come up with that $10,000 “tax increase” figure? What you’re saying is someone with an average effective tax rate of 30% is paying $33,000 per year in health insurance premiums. Do you know many people who are paying that much for health insurance?
The substance of your point is well taken. Even a $3,600/yr tax increase is unpalatable for “white-collar affluent worker” like me. But, I take solace in the fact that tax policy subsidizes my mortgage through tax deductions worth over $10,000 per year (actual tax savings on the 37k of mortgage interest I pay annually) – the “working” class gets nowhere near that, if anything at all. Not to mention that I take advantage of an HSA and take a $5,950 write off for that, something many people are unable to do (for various reasons).
21 sinz54 // Aug 20, 2009 at 12:37 pm
rodak: FYI, the U.S. spends some 14% of its GDP on health care (which will rise to 18% by 2050), and only 3% of its GDP on national defense.
You could zero out the entire military budget, and still not be able to pay for health care, if health care costs continue to rise at the present rate.
22 Rodak // Aug 20, 2009 at 12:55 pm
But we all know that much of our military spending is hidden, don’t we?
23 gcomeau // Aug 20, 2009 at 12:57 pm
Take it from another Canadian, Worthington doesn’t have any clue what he’s talking about.
First of all, considering Canada’s health care system costs 10% of it’s GDP while America’s is rapidly approaching 20% of IT’S GDP, it’s difficult to fathom how Worthington concludes it’s the cost of health care in Canada that stands in the way of spending more on the Canadian military. That’s pure idiocy.
The article does not improve from there.
Moving on, he claims that same health care program (the one that costs half as much as the one in the US, remember that one?) is also what’s causing the slightly higher tax rates in Canada! It’s not other social programs. It’s not maintaining the federal budget SURPLUSES and the paying down of the national debt that Canada was running for 12 straight years before the global recession. No… it’s the really inexpensive health care system that’s the culprit! If the US cut it’s health care costs in half like Canada it would obviously have to raise taxes right through the roof… for some reason… that’s obvious! Well, at least it’s obvious to Worthington, but I think he uses his own special type of math that isn’t well known to the rest of the sane world. Perhaps he’ll share it with us one day.
Although to be fair, the difference in costs between the Canadian and American health care systems is almost completely in massively higher private costs in the US. Maybe Worthington thinks the imbalance there is so incredibly astronomically lopsided that it is completely eclipsing what is, in reality, hugely higher tax spending on the Canadian system? Which mean Worthington has never read an economic report on international health care spending considering the latest available figures from the OECD statistical database that provide that breakdown (2005) show Canada was spending 6.95% of it’s GDP in public (as in tax) spending on health care. The US was spending 6.85% of GDP. Somehow I don’t see that 0.1% difference causing any massive tax hikes or bankrupting the Canadian military budget. And if THAT is the “increase” necessary to get universal health insurance coverage and cut out of pocket health care expenses by like 60% in the US… well, color me terrified. Flee Americans, flee!!
And I am about fed up with this wait time idiocy. I’m perfectly aware the system in Canada has some wait time issues for **some** procedures that it is working on addressing… but until someone shows me how long the average American REALLY waits for various medical procedures… (and that means the average for ALL Americans, not just the ones who actually get access to treatment at all while pretending all the ones priced out of the system and effectively wait-listed for years or decades until they turn 65 and qualify for medicare just don’t exist then exclaiming how short the lines are now that millions of people have been thrown out of them… ) shut the hell up about how the US does better on wait times and stop treating people like they’re brain dead and can’t see that sleight of hand trick you’re pulling making millions of patients disappear into thin air. Yeah, if I threw several million people out of any system I was trying to “fix” to have shorter wait times then pretended those people didn’t exist I could produce a nice short line too. Thing is, most people think a health care system is supposed to be actually treating the sick and injured, not just surgically removing cash from their bank accounts.
As for those waits being “a death sentence”…
http://www.commonwealthfund.org/~/media/Images/Chart%20Maps/Chartcart/Testimony/Insurance%20Design%20Matters/SenHELP_2009_02_Schoen_Underinsured_15.gif
What was that you saying Peter? That the US has the worst record on the prevention of medically preventable deaths in the entire industrialized world? Yeah, I thought that’s what you meant.
Oh, and profnickd: No, Worthington is not correct about survival rates, and no it is not “well documented” that the US fares better on them. What people who make this claim do is cherry pick one study or another on, say, a few types of cancer (like the one you just linked) where the US performed well then wave it around as if it is fully representative of across the board system performance. It is not. But I’m happy to hear you’re willing to read more on the subject! For a slightly more comprehensive look at things try this:
http://www.openmedicine.ca/article/view/8/1
That is a systematic review of DOZENS of scientific studies of comparative health outcomes for the treatment of everything from cancer, to coronary artery disease, to chronic illnesses, to various surgical procedures.
Canada outperforms the US in the clear majority of them.
24 SFTor1 // Aug 20, 2009 at 1:08 pm
profnickd says: “They want low cost, high quality services, and universal coverage — all entirely mutually exclusive.”
profnickd, for God’s sakes, get a passport. Travel. See the world. LEARN SOMETHING!
25 Del // Aug 20, 2009 at 3:09 pm
As a Canadian, with some experience with both the U.S. and European
health care systems, I am amazed at some of the nonsense being propagated by the opponents of health care reform in the U.S. This seems especially so with regards to the Canadian system. I can only conclude that most of those behind this propaganda are ideologically and politically motivated and intellectually dishonest. The simple reality is that while far from being ideal, the overwhelming majority of Canadians want government run Medicare. There is not a single political party that is in favor of changing it … for to do so would
be political suicide.
I just returned from the U.S. where I injured my finger in an accident. I saw a doctor there, who charged me $250 for 3 minutes of his time. Since it wasn’t healing, when I returned home I called my MD, saw him the next day, walked across the street for an xray, then returned to my doctor. All I needed was my (credit card like) Medicare card. Perhaps the wait was a little longer, but the facilities and expertise were first rate.
The reality is that if Canada spent the same percentage of our GDP on
health care as Americans do, we would have a system that worked near
flawlessly. When Medicare was first introduced 40 years ago, there were far fewer problems. But governments have cut back on funding and naturally this has resulted in the system not working as well as it once did. However, by basic standards like life expectancy and infant mortality, Canada outranks the U.S., as do most, if not all, European countries and Japan.
The Canadian system needs some reforms. The problem is that for the
overwhelming majority of Canadians the system is so sacrosanct that
all political parties are concerned that even hinting at reform might
cause voters to turn away from their parties, afraid that they want to
change to a more American style system.
Peter Worthington is an intelligent and capable man. But to suggest
that the U.S. can’t afford a Canadian style system is absolute
nonsense. Americans are paying for health care. Employers pay for
their employees. The government pays for their employees, the military and seniors. Individuals are paying for it directly to for profit insurance companies. The public pays for it indirectly when they purchase goods and services. And, they pay more than Canadians do. In 2006 the U.S spent 15.3% of GDP on health care (and still 40,000,000 Americans had no health coverage). In Canada it was 10%. And, in the U.S. this percentage is increasing faster than in any other major industrialized nation. So on the contrary, considering the need for a large military, considering the large American debt and the enormous cost of American intervention in Iraq and Afghanistan, can the U.S. afford not to have government run health care?
26 fact checker // Aug 20, 2009 at 3:44 pm
If the government-run insurance plan were adopted whereby non-insured people would be insured, how long would private companies continue to contribute to the health insurance of their employees? Would they not start cutting health plans and force the government to pay? You know the answer as well as I do.
what i love about fools like you is how little you know about economics and in this case you dont even know the conservos argument
conservos want an end to employer provided healthcare and everyone sent to the individual market
if there were a public option that those that couldnt afford other insurance chose why would it mean the end of private insurance which as we all know is so wonderful
1. those people werent buying private insurance anyway
2. people who “learned” from you about how bad the public option would be would run to the private insurers giving them plenty of business
3. because poor people use the bare bones public option says nothing about the private alternative surviving
look at all the people in nyc taking cabs, private cars and limos while the hoi polloi take the subway amazingly enough the subway hasnt driven those private car services out of business (aktho the collapse of wall street might have done the trick for some)
btw look up the video of thousands and thousands waiting in the LA forum for free healthcare they couldnt afford and similar scenes elsewhere
27 barker13 // Aug 20, 2009 at 5:50 pm
Re: Rodak // Aug 20, 2009 at 12:06 pm (#19) –
“We need to reallocate our spending.”
Well I’m certainly with you there, Rodak…
(*HANDSHAKE*)
…though truth be told we both know that our spending priorities would be very different.
(I for one would dedicate 90% of our military resources towards creating an impenetrable shield around Scotland – thus ensuring the survival of the distilleries should war ever again envelop our world.)
(*WINK*)
“I’m personally more afraid of cancer than I am of Osama bin Laden.”
Me too!
“…we also make funds available to medical schools so as to allow them to expand their capacities to graduate more physicians.”
And then…???
“Ditto nurse practitioners…”
And then…???
Re: Ryanb // Aug 20, 2009 at 12:36 pm (#20) –
“I take solace in the fact that tax policy subsidizes my mortgage through tax deductions worth over $10,000 per year (actual tax savings on the 37k of mortgage interest I pay annually)…”
Not to switch topics, but just to throw this out… just as “real conservatives” (IMHO) should logically be opposed to taxpayer subsidized employee provided health insurance so should “true conservatives” (again… IMHO) be against the mortgage deduction.
$37,000 in interest alone – per year! Wow… you’re welcome! (*WINK*)
“…the “working” class gets nowhere near that, if anything at all.”
Yep. This is why I’m a flat tax kinda guy. (*SMILE*)
(Excellent post, Ryan! This is the kind of honest reflection we should all be echoing.)
I’m not against helping the poor… it’s subsidizing the middle and upper middle classes I can’t stand.
Oh, yes… agreed… it’s the upper middle, plain “upper,” and obviously “the rich” who pay the vast bulk of federal income taxes (as well as who create jobs and prosperity), but I still say that even if one accepts the idea of progressive taxation (which I do as a pragmatic bow to reality) wouldn’t it be simpler, easier, and more transparent to simply create a much flatter tax system.
(Folks… tax loophole don’t save “society” money. All they do is shift money around, creating individual winners and losers.) (*SHRUG*)
* Oops! The wife is home! Off to play racquetball! More later…
BILL
28 liv&win // Aug 20, 2009 at 7:01 pm
http://money.cnn.com/magazines/fortune/fortune500/2009/performers/industries/profits/
wow, my estimates are more accurate than what you know, otto. Don’t get lost on #22, review #27, #30, #34 and my favorite, #35
29 Rodak // Aug 20, 2009 at 7:09 pm
And then…???
And then more patients could be seen in less time, if “long lines” is the big worry. You have to wait for care only to the extent that there is not the personnel and/or the facilities available to meet the needs of the local population. That is fixable. It’s just a matter of setting priorities.
30 barker13 // Aug 20, 2009 at 7:16 pm
Re: Gcomeau // Aug 20, 2009 at 12:57 pm (#23) –
“…until someone shows me how long the average American REALLY waits for various medical procedures…”
Gco. We don’t wait. Not for important shit. Hell, not for elective crap either.
Yes, for whatever reason women seem to have to get their gyno appointments months in advance – but we’re talking their routine exams. If my wife or daughter feels a lump… we’re talking days – if that.
Children? Today’s American mom’s take their kids same day to see the pediatrician on a couple hours notice the second their little tyke says, “mommy… I’ve got a sore throat… my ear aches…” and demonstrates a fever. (*SNORT*)
And if we’re talking something the doc doesn’t like… something that even remotely strikes your GP (or even yourself in most cases) as “worrisome,” it’s off the specialist pretty much immediately and just as the American military is very good at blowing things up… our doctors and hospitals are extremely competent in kicking the crap out of life threatening illnesses if such is at all possible.
You don’t have to believe me. (*SHRUG*) And no, I’m not going to go nuts posting this stat and that stat. I’m just telling you my personal experience as a 47 year old middle class college American.
BILL
31 barker13 // Aug 20, 2009 at 7:24 pm
Re: Del // Aug 20, 2009 at 3:09 pm (#25) –
“…I injured my finger…”
You’re kidding – right?
(*HEADACHE*)
(Oops – I’d better see a doctor!) (*GRIN*)
Seriously… again, Del, I’m happy that you’re happy with your Canadian health care system. I truly am. But the Canadian model is nothing I’d want us to emulate.
(If you’re new to the site just take my word that I’ve explained why time and again. I’ve also fleshed out what sort of reforms I see as the way to go.)
Bottom line, though… should the shit ever hit the fan with your health or a loved one’s health… well… again I wish you the best. Me? If and when I face that… I’ll be happy to face it as an American.
(*WINK*)
BILL
32 gcomeau // Aug 20, 2009 at 7:24 pm
barker: I’ve lived in California for 10 years, you can’t actually bullshit me with bald faced absurdities like “we don’t wait”. Especially when you then proceed to be completely incapable of providing any hard data to back that up.
Not only do I not have to believe you, I would need to have suffered some moderately serious neurological trauma to believe you.
33 barker13 // Aug 20, 2009 at 7:39 pm
Re: Rodak // Aug 20, 2009 at 7:09 pm (#29) –
“And then more patients could be seen in less time, if “long lines” is the big worry. You have to wait for care only to the extent that there is not the personnel…”
Yep. (*SMILE*) Figured my unstated point would go right over your head.
Rodak. We’re not talking about creating widgets. We’re talking about training physicians.
Anyway… I suppose what you’re thinking of is creating a kind of “medical” service academy. (I assume one for doctors, one for nurses, perhaps others for the various technicians…???)
So then of course you have to have a U.S. Medical Corp. where in return for free training the newly minted interns (they’re not “real” doctors till they’ve done their internships, right?) (*SHRUG*) would have to guarantee a certain number of years of government service at set pay scales. (And of course course government doctors would work in government facilities… government owned… government run… government equipped…)
Those docs and nurses who stayed with the government to make it a career… we pay them government scale? Do they retire after 20 years… 25… 30…??? (You know how these pension programs turn upside down within a few generations…)
So… you envision an endless supply of the same caliber folks as those who get accepted to med schools nowadays to present themselves for government schooling and a government career path? No risk of sacrificing quality for quantity? No lessening of standards…???
OK. I suppose it’s possible. (*SHRUG*) Probable no… possible… perhaps. (*SHRUG*)
Anyway, just throwing some details at ya. Points to ponder. Me? I just don’t want to create another huge government bureaucracy.
BILL
34 barker13 // Aug 20, 2009 at 7:52 pm
Re: Gcomeau // Aug 20, 2009 at 7:24 pm (#32) –
“I’ve lived in California for 10 years…”
Why? I mean… if Canada’s so superior… (*QUIZZICAL SHRUG*)
In any case, good for you. I’ve lived in New York most of my life and attended university in Boston. I also ran the British Empire for a few months in the fall of ‘86.
(*WINK*) (Study abroad internship with a MP; perhaps a SLIGHT exaggeration in saying I ran the country – though to this day I still don’t know how Maggie and Liz did it without me!)
“…bald faced absurdities…
Gco. You’re a poster on an internet site. I don’t know who you are or what you are; all I can do is depend upon your honesty.
(*SIGH*)
There’s nothing “absurd” about my claims. I’ve outlined my personal experience – mine, friends, family… if you wanna believe that insured middle class Americans typically face the sort of appointment/treatment delays you folks in Canada and the UK do… (*SHRUG*)… your prerogative. I’m telling you though… we don’t.
Can you find Americans who will give you horror stories – legitimate horror stories? Sure. No doubt. But I’m talking about my typical experience for the perspective of a 47 year old insured middle class American.
“Especially when you then proceed to be completely incapable of providing any hard data to back that up.”
Not “incapable.” I’m sure I could easily find and post all sorts of stats regarding waiting times and specific disease outcome stats. I’m not going to though. Two reasons: 1) I and various other posting provide links to such stats fairly frequently – no need to reiterate the same facts thread after thread after thread; 2) What “hard stats” would possible “verify” my own experiences in your mind? Again… I’m telling you what I’ve experienced. If you don’t believe it that’s your business. Frankly, Gco, I don’t give a damn. (*WINK*) (That’s from a famous American novel/movie… “Gone With The Wind”… perhaps you’ve heard of it?) (*CHUCKLE*)
“…I would need to have suffered some moderately serious neurological trauma…”
And if you ever do… pray God it occurs in California. (Or some other U.S. state.) (*WINK*)
BILL
35 tharock220 // Aug 20, 2009 at 8:11 pm
What seems lost on Canadians is that their health care industry isn’t better than America’s when the Americans can afford it. Knock off those 50 million uninsured and you see better preventative care, longer life expectancy, and more timely treatment to major conditions than in Canada.
Anyone who argues health care in America isn’t by far the best in the entire world is lying to themselves. It’s just that simple.
36 gcomeau // Aug 20, 2009 at 8:11 pm
barker: Don’t be a jackass. I live in California because I was made a very nice job offer there and like the company I’m at… so I stay. That doesn’t mean I like the health care system here.
And yes, I am a “poster on an internet site”. And this is a multi-city survey of patient wait times to access specialist care in the United States:
http://www.merritthawkins.com/pdf/mha2009waittimesurvey.pdf
Show me the tables with nothing but zeros in the wait times column if you don’t mind.
And then try to comprehend that that is only how long people WHO COULD SEE THOSE SPECIALISTS AT ALL had to wait. It doesn’t count people who are effectively **indefinitely** wait listed by being priced out of the system in the US. You do understand that right?
EVERYONE can afford to see a specialist in Canada when they need to. The average wait time there is the REAL average wait time for the REAL average Canadian. The numbers in the US just pretend large segments of the American population that don’t have proper access to the system don’t exist.
Is this becoming any clearer for you yet?
37 Del // Aug 20, 2009 at 9:38 pm
First off “Fact Checker,” I never said I was a conservative. I have been away in Europe for most of the debate over health care, and after witnessing the near hysteria in some circles about Osama’s health reforms during my brief stay in the U.S. recently, was simply surfing the net to inform myself … particularly about the distortions being promoted about the Canadian system.
There appears to be a very deliberate campaign of misinformation about socialized (dare I even use the word on this site) medicine that is being spread by conservatives, who for the sake of ideology seem quite willing to distort, manipulate and lie.
But the underling issue here is not about health care. It is the entire conservative agenda. The recent near economic collapse is at least partially a result of the “deregulation is best” mentality of this agenda. And now, due to government intervention, the economy seems to be recovering under Obama’s guidance. If he is successful in implementing an effective, universal system of health care in the U.S., conservatives are likely to be shut out of power for a very long time. Government health care plans, once implemented in a country, become as institutionalised as state run education. It is seen as much as a right as is the right to a free basic education. In no country has a government health care plan ever been reversed. Conservatives know this, and that is why they are fighting so hard to sabotage effective health care reform.
Though I have no doubt about your ideological sincerity, “Fact Checker,” I believe what the conservative power brokers most want is not to defeat an Obama health care plan. But to weaken it in such away as to make it ineffective and a possible election issue. Either way they win. Obama doesn’t deliver on his promise or the plan is so lame it proves problematic.
“You said: If the government-run insurance plan were adopted whereby non-insured people would be insured, how long would private companies continue to contribute to the health insurance of their employees? Would they not start cutting health plans and force the government to pay? You know the answer as well as I do.”
Yes, I do know the answer. You are absolutely right. That is why a modified version of the Canadian system would work best. Private insurance should only be for secondary coverage, for those aspects of medical care that are not covered by the government system. Employers should not pay for employee health insurance. In Quebec, where I reside, health care is primarily paid for by income tax. As far as choice: Doctors can opt out of the system and go private. Few do. And, patients can go to any doctor they choose, any hospital, go for as many opinions as they want.
What mystifies me is how the richest, most powerful country in the world doesn’t provide universal health coverage for its citizens. Given the amount of GDP spent on health care, the success of universal plans elsewhere, what exactly is your concern? The truth is, political expediency aside, that there is really only one basic issue in this debate. Is decent, health care a right or is it a commodity, with some being able to buy the very best care possible, and others receiving almost third world standards of health care.
And Barker, yes I injured my finger. It might sound trivial to you, though it sounds more like you’ve been watching too much FOX “news.” You jump to conclusions without knowing any of the facts. Regardless, I personally didn’t find paying $250 for 3 minutes of a doctor’s time in Philadelphia very trivial.
38 chgok9dad // Aug 21, 2009 at 9:25 am
To Barker13 who snorts a lot. Yes, I still contend that I got the best medical care while in Canada-ever. Two major events in my life there. (1) Hiking accident where I fell and landed on my back. The x-rays, physical therapy, medication, and care was quick, responsive, and all covered. (2) Diagnosed with leukemia, and went into chemotherapy, and have been in remission for 20 years. Thanks for asking.
39 barker13 // Aug 21, 2009 at 10:31 am
Re: Tharock220 // Aug 20, 2009 at 8:11 pm (#35) –
Yep. (*SMILE*)
Re: Gcomeau // Aug 20, 2009 at 8:11 pm (#36) –
“barker: Don’t be a jackass.”
Who the f–k do you think you’re talking to, you little worm?!
Jeezus… do you really think you’re MAKING your case?
(*SMIRK*)
You’re now in “time out.” Call it “Strike One.” I’ll give you another chance on Monday; till then… you’re “boxed” along with Otto.
Re: Del // Aug 20, 2009 at 9:38 pm (#37) –
“…the “deregulation is best” mentality…”
Perhaps you’ve heard of Fannie Mae. (*CHUCKLE*) How’bout Freddie Mac? Ginny Mae?
Ya know much about the short/mid/long term prospects of Medicaid/Medicare/Social Security…???
Would you consider taxation “regulation?” Do you consider the U.S. Tax code (and the 50 state tax codes) to be examples of… er… under-regulation?
The federal judiciary and 50 state judiciaries…??? You don’t see them as “regulatory bodies” in a sense? (*SHRUG*)
“…conservative power brokers…”
You might wanna re-check the ideological/Party affiliation of America’s top oligarchs. (*WINK*) (*CHUCKLE*)
Oh… and as far as GOVERNMENT itself is concerned (the defacto Power Broker of power brokers)… last time I checked there was this guy name Obama hanging out in the Oval Office and this chick Pelosi (with sidekick Harry Reid) presiding over Capital Hill.
(*SHRUG*)
“What mystifies me is how the richest…”
Depend how you define rich, doesn’t it? Unsustainable deficits… unsupportable long term debt and unfunded future liabilities as far as the eye can see…
(*SHRUG*)
“And Barker, yes I injured my finger. It might sound trivial to you…”
Yes. (*SMIRK*) It sounds trivial to me. Glad we’re on the same page.
Re: Chgok9dad // Aug 21, 2009 at 9:25 am (#38) –
“To Barker13 who snorts a lot.”
(*ROFLMAO*)
(*HIGH FIVE*)
Well at least you have a frigg’n sense of humor, Chgok! Good for you…!!!
“Hiking accident where I fell and landed on my back. The x-rays, physical therapy, medication, and care was quick, responsive, and all covered.”
Glad to hear Canada has enough X-Ray machines! (*WINK*)
“Diagnosed with leukemia, and went into chemotherapy, and have been in remission for 20 years.”
Now THAT’S what I’m talking about, Chgok! And I’m happy that you were diagnosed and treated in a timely manner and have been in remission for 20 years. I hope you’ve beat it for good.
Still… I’m talking stats as well as personal anecdotes; and the stats don’t lie. Middle class insured Americans are far more likely to overcome potentially fatal illnesses than our Canadian peers.
BILL
40 gcomeau // Aug 21, 2009 at 10:57 am
barker: Who I think I’m talking to is someone spewing totally unsupported nonsense with every single post he makes… and someone who just got called on it and is now acting all indignant and offended so he can proceed to **ignore the wait time survey** that just nailed him and his ridiculous “Americans don’t wait for care” fairy tale to the wall.
That’s who I think I’m talking to. But I’m devastated I’m now on “time-out”. I really am. So you just go about your business pretending like Americans don’t wait for care and you’ve contributed anything useful or meaningful to this discussion and I’ll keep posting real life facts and figures so you can ignore those too. Like you just did saying YOU are talking about stats and stats don’t lie. That’s rich. You haven’t provided a single statistic in any post you’ve made in this entire thread. The only two times I even saw you mention statistics were, in fsct, when you said this:
“I’m sure I could easily find and post all sorts of stats regarding waiting times and specific disease outcome stats. I’m not going to though.”
And when you said this:
“And no, I’m not going to go nuts posting this stat and that stat.”
Both REFUSALS to go look up statistics to support your argument. And then you have the nerve to say YOU are “talking stats” and the stats don’t lie? Do you think every single person you’re speaking to here suffers from total long term memory loss and can’t remember anything you did more than an hour earlier so they’ll actually believe that? AND that they CAN’T READ so they won’t just look up and see? What the hell are you even thinking? Is this some kind of poorly thought out joke or something?
The only time you’ve even come NEAR posting ans stats are when you were MAKING THEM UP about Americans having no wait times for medical care… and the one you just made up now about “middle class insured Americans” being “far more likely” to overcome potentially fatal illnesses. And IMAGINARY stats actually do lie barker.
Real ones on the other hand:
http://www.openmedicine.ca/article/view/8/1
Those show you’re lying (or just monumentally clueless, take your pick). THAT is a systematic review of DOZENS of scientific studies of the comparative outcome of treatment in Canada and the US for everything from cancer, to coronary artery disease, to chronic illnesses to surgical procedures. Canada comes out on top in the clear majority of them.
Quick! Make something else up to save your case!
41 Rodak // Aug 21, 2009 at 11:56 am
Still up to your old tricks, eh Bill?
42 barker13 // Aug 21, 2009 at 1:46 pm
Re: Rodak // Aug 21, 2009 at 11:56 am ($41) –
(*GRIN*)
BTW, can’t that halfwit READ?
I couldn’t help but notice the first word of his Post #40 was “Barker.” Doesn’t he know what “time out” means? (*CHUCKLE*)
Anyway, Rob, off to New Hampshire for the weekend. Out of here by 4:00 p.m. In the meantime if you have any points you’d like to make…
(*SMILE*) (*SHRUG*)
BILL
43 gcomeau // Aug 21, 2009 at 2:25 pm
Like I said…
“So you just go about your business pretending like Americans don’t wait for care and you’ve contributed anything useful or meaningful to this discussion and I’ll keep posting real life facts and figures so you can ignore those too. ”
Glad to see we’re on the same page. If it makes you feel better to pretend the reason you’re refusing to deal with any of the information this “half wit” is posting is because you’re just so emotionally devastated that “some poster on an internet site” told you to stop being a jackass that you couldn’t possibly interact with them any further until you’ve had several days to heal from the severe psychological trauma that inflicted, you go right ahead. You’re not exactly fooling anyone, but whatever you want to do.
What I want to do on the other hand is keep posting real life information. Like, oh, the US ranking (dead last) in the prevention of health care amenable mortality among industrialized nations… that’s a fun one:
http://www.commonwealthfund.org/Content/Charts/Testimony/Insurance-Design-Matters-Underinsured-Trends-Health-and-Financial-Risks-and-Principles-for-Reform/Mortality-Amenable-to-Health-Care.aspx
Or the rate of growth of health care costs in nations around the world:
http://graphics8.nytimes.com/images/2009/07/09/business/econgraphic2.jpg
http://graphics8.nytimes.com/images/2009/07/09/business/econgraphic3.jpg
Still want to keep telling us all about how the US health care system is the greatest? All ears. Really.
Oh wait… I forgot. You called “time out” so nothing I’m posting counts… darn. If only I had thought of that first.
44 liv&win // Aug 21, 2009 at 4:23 pm
Bill have you noticed the same thing about these posts that I have? Have a good weekend!
45 barker13 // Aug 24, 2009 at 5:12 pm
Re: Liv&Win // Aug 21, 2009 at 4:23 pm (#44)
Yep. (*SMILE*)
Plus, thread after thread on the same basic topic.
I’m starting to get bored here. (*SHRUG*)
BILL
46 TAKEbackMEDICINE.org » Blog Archive » Take It from a Canadian: You Don’t Want the Public Option // Aug 27, 2009 at 2:34 am
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