I Love Canadians, I Really Do...

Another column; sorry, but it seemed relevant to Alex's post in another thread.

Free Health Care
by Walter E. Williams

Let's start out by not quibbling with America's socialists' false claim that health-care service is a human right that people should have regardless of whether they can pay for it or not - it should be free. Before we buy into this socialist agenda, we might check out just what happens when health-care services are "free." Let's look at our neighbor to the north - Canada.

The Fraser Institute, a Vancouver, British Columbia-based think tank, has done yeomen's work keeping track of Canada's socialized health-care system. It has just come out with its 13th annual waiting-list survey. It shows that the average time a patient waited between referral from a general practitioner to treatment rose from 16.5 weeks in 2001-02 to 17.7 weeks in 2003. Saskatchewan had the longest average waiting time of nearly 30 weeks while Ontario had the shortest, 14 weeks.

Waiting lists also exist for diagnostic procedures such as computer tomography (CT), magnetic resonance imaging (MRI), and ultrasound. Depending on what province and the particular diagnostic procedure, the waiting times can range from two to 24 weeks.

As reported in a December 2003 story by Kerri Houston for the Frontiers of Freedom Institute titled "Access Denied: Canada's Healthcare System Turns Patients into Victims" (http://ff.org/centers/ccfsp/pdf/ccsfp-1203-pp.pdf), in some instances, patients die on the waiting list because they become too sick to tolerate a procedure. Houston says that hip-replacement patients often end up non-ambulatory while waiting an average of 20 weeks for the procedure, and that's after having waited 13 weeks just to see the specialist. The wait to get diagnostic scans followed by the wait for the radiologist to read them just might explain why Cleveland, Ohio, has become Canada's hip-replacement center.

Adding to Canada's medical problems is the exodus of doctors. According to a March 2003 story in Canada News (www.canoe.ca), about 10,000 doctors left Canada during the 1990s. Compounding the exodus of doctors is the drop in medical school graduates. According to Houston, Ontario has chosen to turn to nurses to replace its bolting doctors. It's "creating" 369 new positions for nurse practitioners to take up the slack for the doctor shortage.

Some patients avoided long waits for medical services by paying for private treatment. In 2003, the government of British Columbia enacted Bill 82, an "Amendment to Strengthen Legislation and Protect Patients." On its face, Bill 82 is to "protect patients from inadvertent billing errors". That's on its face. But according to a January 2004 article written by Nadeem Esmail, for the Fraser Institute's Forum titled "Oh To Be A Prisoner," Bill 82 would disallow anyone from paying the clinical fees for private surgery, where previously only the patients themselves were forbidden from doing so. The bill also gives the government the power to levy fines of up to $20,000 on physicians who accept these fees or allow such a practice to occur. That means it is now against Canadian law to opt out of the Canadian health care system and pay for your own surgery.

Health care can have a zero price to the user, but that doesn't mean it's free or has a zero cost. The problem with a good or service having a zero price is that demand is going to exceed supply. Since price isn't allowed to make demand equal supply, other measures must be taken. One way to distribute the demand over a given supply is through queuing - making people wait. Another way is to have a medical czar who decides who is eligible, under what conditions, for a particular procedure -- for example, no hip replacement or renal dialysis for people over 70 or no heart transplants for smokers.

I'm wondering just how many Americans would like Canada's long waiting lists, medical czars deciding what treatments we get and an exodus of doctors.

Walter E. Williams

As I said in the other thread...

Having a Universal Free Health Service does not stop you going Private if you wish.

It actually makes the Insurance Premiums cheaper, than if you have to buy Medical Insurance.

It would cost me around $40 per month for full cover Private Medical Insurance, or i could pay for stuff as i needed it.

I believe the rate per person goes down for family cover..but i havent looked into that.

J2

Have you used this Walter Mitty guy before? His name seems familar. :)

I am off to Google "Frontiers for Freedom" (or was that a typo and it is a plastic surgery hospital "Front Ears for Freedom"). I am just curious :ph34r:

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Originally posted by Rat Faced@30 July 2004 - 15:37
As I said in the other thread...

Having a Universal Free Health Service does not stop you going Private if you wish.

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Did you read this part, Rat?

Some patients avoided long waits for medical services by paying for private treatment. In 2003, the government of British Columbia enacted Bill 82, an "Amendment to Strengthen Legislation and Protect Patients." On its face, Bill 82 is to "protect patients from inadvertent billing errors". That's on its face. But according to a January 2004 article written by Nadeem Esmail, for the Fraser Institute's Forum titled "Oh To Be A Prisoner," Bill 82 would disallow anyone from paying the clinical fees for private surgery, where previously only the patients themselves were forbidden from doing so. The bill also gives the government the power to levy fines of up to $20,000 on physicians who accept these fees or allow such a practice to occur. That means it is now against Canadian law to opt out of the Canadian health care system and pay for your own surgery.

In any case, were I to find my way back to my Civil Service past, I could have insurance.

I could neither find nor afford insurance in any other circumstance.

If I were dirt-poor, I'd be all set.

In any case, I am alive, and that's kind of important; if I had to wait like a Canadian, I wouldn't be here.

Example:

In Canada, you wait (according to the Fraser Institute) two to twenty-four weeks for a CT scan.

My Doctor decided I needed a CT scan, and I was undergoing the procedure about fifteen minutes later.

I should also point out that I live in a village of about 1800 people, and the largest city of any size whatsoever (Green Bay, Wisconsin) is 180 miles away.

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Originally posted by Biggles@30 July 2004 - 15:42
J2

Have you used this Walter Mitty guy before? His name seems familar. :)

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Yes I have; just the other day, I think. ;)

Walter is a free market economist, the Frontier chaps are right wing think tankers (both have Ronnie Reagan on their home pages :) ) and the Fraser Institute is a charmingly polite (Canadian) free market econometrics think tank, akin to the Adam Smith institute.

The only surprise is that the conclusion did not warn against rampant bubonic plague in all National Health hospitals. :unsure:

I may be wrong, but if the Canadian NHS is like the UK one, a heart attack victim generally gets seen right away rather than asked to wait 2 to 20 weeks.

I am not at all amazed by the report from this guy. He has an economic brain and not a humanistic brain.
the statisics quoted don't say what the waiting lists were for. In your case J2 you would have been seen by your doctor and if you needed immediate treatment you would get it. Social systems don't send out ambulances for bunions.
Even with our system a lot depends on location as to speed of treatment. In my town we have one hospital and it doesn't take medicare or medicaid. Obviously the law dictates emergency treatment but one is then transfered to Albuquerque.
I've heard people state that if one has no insurance and can't afford to see a doctor one can always walk into an emergency room and be treated, but this is for emergencies. If you have a non emegency condition you have to wait until it becomes so. (a lot would depend on the hospitals policies).
Our system penalises people without insurance. If you have no insurance and are a "cash customer" you may find that your bill is 5 times higher than a hospital would charge an insurance company for the same treatment.

i am not saying that social is better from the world examples that have it but i am not saying it's worse. Social systems can be their worst enemy because they don't run as efficiently as a private system needs to and this diverts money away from the treatment and into red tape.
Here in America we have the ability to run a system of healthcare that could be free at point of service and be run with private efficiency.... but we don't and probably never will because there is too much money being made to change the status quo.
One of the reasons for Clintons failed reforms was that profits would be reduced.
Another reason is the American fear of TAX. It doesn't matter that they could save thousands of dollars in insurance costs, they pay tax already and don't want to pay any more.
The mere suggestion that 5 cents on a gallon of gas could give every child under 18 and every adult over 65 FREE prescriptions even with the overpricing we have... oh the outrage

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Originally posted by Biggles@30 July 2004 - 22:18
...I may be wrong, but if the Canadian NHS is like the UK one, a heart attack victim generally gets seen right away rather than asked to wait 2 to 20 weeks.

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No, you aren't wrong. The only "wait time" there would be waiting for the ambulance to arrive. That'd be twenty minutes for me, but the first response team from the fire-hall would be there in perhaps a minute. The seriousness of the ailment determines your "place in line."

:ninja:

vidcc,

the irony is that the US Government already pays more % of GDP on health care than most of Europe (a lot more than the UK).... so they wouldnt have to pay more Tax for a Universal Health Service thats free at point of contact.

You said yourself the reason that they dont... they are getting ripped off by the Medical Professions and Pharmacutical Companies.. "Profit".

Most things in the US are a lot cheaper than elsewhere... the same cannot be said for Medicine's. Even basic prescription drugs are sold in the US for a lot more than anywhere else...

If someone is stupid enough to pay over the top, the Pharmacutical Companies will try and keep that status quo going, thats Capitalism ;)

I think they spend a fortune stopping people going to Canada to get the same drugs at a vastly reduced rate, as this is their closest neighbour.

I would be surprised if visitors to Europe didnt also take advantage of the cost of Low Price Prescription Drugs, however there are a lot fewer US citizens come over to Europe and none for just that reason... its more expensive to get here :P

@ J2K4,

I dont know the Canadian Health Laws, however I would be surprised if the Private Sector could not provide Health Care. Certainly I cant think of any European Countries that dont allow Private Health Care.

As I said before, the provision of Free Health Care actually makes the costs of Private come down quite a lot.. They can no longer charge what they want, and pitch the Insurance Policies and Treatment at a realistic level.

They still make huge Profits BTW, its not a strangled profession in any way shape or form. Anyone in the UK will tell you the Private Hospitals are much better.

I suspect that this may not be the case in Germany, France, Belgium or many of the other Mainland Europe Health Services, as they do spend more % of GPD on their respective services than we do.

RF

Likewise, I am sure I saw a piece on TV on the number of pharmacies just over the border in Mexico. The sole purpose of these shops is to cash in on the US market.

All this is true to a degree rat and well known.

We do get poor value for money. Yes the drug companies overcharge and every time a bill has attempted to "negotiate on price" it has failed due to our politicians bowing to the drug company lobby ( one of the most powerful we have). Medicare pays more for drugs than the private insurance companies do because of this.

I would like to make a case on some things though as even though it is overpriced there are some valid reasons.

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the irony is that the US Government already pays more % of GDP on health care than most of Europe (a lot more than the UK).... so they wouldnt have to pay more Tax for a Universal Health Service thats free at point of contact.

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The USA is vast and the populus is spread out, not huddled together as in europe so the "GDP" spending would have to be greater due to the cost of dispersion. Hospitals need equiptment for all treatments and we can't have the efficiency of specialist hospitals "down the road" That said we are overcharged.

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I think they spend a fortune stopping people going to Canada to get the same drugs at a vastly reduced rate, as this is their closest neighbour.

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Yes this is true. The FDA says it's to protect us because they haven't approved the drugs or the factories they are produced in, but it seems more like they are protecting the drug companies as the're the same drugs. some drug companies have threatened to stop supplying companies in Canada if they sell to Americans. So we can't legally buy drugs produced by our own companies cheaper. :angry:

I have a question for those of you who live outside the US.

What is the medico-legal climate.

In the US, we have hordes of attorneys who advertise on TV, encouraging people to sue for just about anything.

The trick is that even if the doctor is 100% in the right, he may lose the case because his malpractice insurance provider will lose less money than successfully fighting and winning the case.

So the doctor is stuck with a "malpractice suit" against his name, his medical license becomes in jeopardy, and his malpractice insurance goes through the roof. In South Texas, 50% of doctors in the "Valley"- (Southern tip that borders Mexico) have been sued or are currently being sued.

This tends to drive doctors to practice "defensive" medicine, instead of acting on their training and instincts. A simple car wreck can cost 10's of thousands in diagnostic tests, even if you are completely without injury, because doctors are afraid to let you walk out the door without crossing every "t" and dotting every "i".

In many countries, doctors cannot be sued. Some balance between that system and what is going on now would squeeze out so many wasted health care dollars.

I watched my father suffer through 2 years of litigation before the insurance company decided to settle. He did nothing wrong, but he had to deal with the stress of being unfairly accused for 2 years, he was punished for doing nothing.

Kind of hard to go to work everyday with a good attitude when the system we have in place makes the patient someone you fear, rather than someone you want to help.

Hobbes

There have been some attempts recently with the "Where there is blame there claim" style adverts. However, these companies received some criticism (their fees took a fair percentage of the "claim") consequently they don't appear as often as they did.

I think, as a rule of thumb in the UK, they pretty much have to cut the wrong leg off before a judge will even countenance a claim. Some of the crustier judges get quite irritated by frivilous suits and often end up awarding fairly small (tiny) damages.

We have yet to truly embark on the litigacious road the US has gone down. However, where there has been clear negligence such an option has always been there. Hopefully it will be a while yet before we see lawyers trying to sue restaurants for making people fat.

Actually my favourite (and this may not be true) is the story that a US vacuum company has a warning not to use the device as a sex aid after a suit filed by some maniac who had all but had his dick sucked off by one of their vacuums. As I said, this may not be true. :)

It's a very good point hobbes, and yet another reason for the consumer getting a raw deal, but in this case it's caused by the consumer.
In other countries the lawsuit culture isn't so common but in recent years tv ads such as ours are pushing things.
We do need common sense in our society but the $ signs bring out the worst in some people.
The malpractice suits have made it hard for some areas to get medical facilities, but i wouldn't outlaw them as some suits are just. What we need is some sort of control to weed out frivilous suits

u wouldn't be dead j2k4, u see the secret is not to get injured ;)

There are fixed damage awards I believe for the most common things, so that they very rarely have to go to court.

If a Judge see's something as Frivilous, then he will give only Token damages... If they decide to go to court because the compensation scheme "Isnt enough", then the Judges will look at that...

If they dont agree with you, then you'll get that amount anyway and have to pay your legal costs and that of the defendant.

As the amount awarded in these schemes are looked at regularly, then its very rare that a Judge would revise them on the back of one court case (Im not sure that they could anyway, however there decision would probably be taken into account at the next review)

If its serious then Damages to fit are awarded:

eg:

If it was something that stopped you working again, then you would receive damages that would make it unlikely you'd need to work again.

If a Dr made a minor error and you got the runs for a few weeks, then you certainly wouldnt receive 1000's in punitive damages.

No-one wants to follow the American Route of suing everyone for everything, however legitimate cases are allowed and acted upon.

I do recall that I have to sign a waver before any operation, which also helps.

Basically, do i want them to help me, and not hold them liable for something that goes wrong that is beyond their control. Its not negligence if i have a reaction to the anesthetic...thats a risk I chose to take, it is negligence if they remove the wrong Kidney.. that type of thing.

I just felt compelled here to search out an old post of mine that is relevant to the health care issue:

Quote:

....This very point is what is responsible for all the political squabbling here in the U.S.; if the politicians (all of them; in both parties) didn't owe their livelihoods as politicians to the distribution of tax revenue (how much they drag back to their districts), things could be more easily accorded proper funding.

An example: Medical Care is the eternal political football; the libs (if they had their way) would nationalize it, effectively dulling the "cutting edge" of medical research (no competition=no profit opportunity=no money for research=no breakthroughs) and we'd have to also pay the exhorbitant costs of the attendent bureaucracy The conservative side opposes this for the same reasons.

The irony is, if this issue were ever resolved, ALL of the politicians lose their raison d`etre, a fact which is not lost on them.

The fact is, there is enough money wasted in government bureaucracy to pay off our debt, provide free medical care and prescription drugs. etc., etc.,.... but the pols won't spend responsibly.

We are beset by incredible greed, and a system which accomodates and winks at this behavior.

THAT is the bottom line.

-UNQUOTE

I don't feel any differently about it these days; the grandiose endeavor to push the envelope of medical technology would be blunted to some extent; the question of malpractice, and it's effect of pushing doctors out of certain disciplines, or, indeed, pushing students into the legal profession instead, would have to be addressed.

Prescription drugs would take a hit or develop their own discipline, one or the other; research would be reined in.

Perhaps some developing African country would emerge as a the world-leader in pharmaceutical development.

As I said, though-I'm sure it could be done; the money is there, but only if our legislature is responsible with our cash, and if P. Diddy's rush to bring uninformed newbie voters to the polls succeeds and becomes the new norm, I doubt we will see any sort of spending discipline in our grandchildrens lifetimes, because boring facts such as those I've recounted would not engage a new voter who is most intent on exercising his new "right".

J2

i am getting a deja vue feeling on that post :lol:

I agree totally that our enemy with this is the people we vote for.
however one thinks, we do have a problem that needs to be addressed and that is the fact that healthcare is pricing itself out of the reach of millions of Americans and that number is rising. If we don't address the financial aspect soon we may find that we have social healthcare by default of the amount of people needing the safety net making it the norm....and that would really cost.

The problems with total social systems is the size....they own everything and don't run efficiently because of the typical state run "gravey train" aspect. America has the ability to show the world how to do things properly, still keeping healthcare in the private sector but coupled with social funding.

In answer to the costly red tape issues and to give you some indication of how i believe we could make a system that works and is still free at point of service.

we already have a system that works but for the cost so i wouldn't touch the actual frontline providers. They give excellent service.
we don't need to set up a costly bureaucratic dept. to run the financing, we already have insurance companies that can do that on government contract.
We would however need co-operation and the will to police it so we get value for money. Government contracts are like the goose that lays golden eggs because they charge top dollar and we pay it. We need to start negotiating on prices for drugs as well and the insurance companies could do that for us as they do now for themselves...take the politicians out of it as they are the ones that have been the "berlin wall" to affordable healthcare.

This is just a rough idea and i do appreciate that it is simplified, but it would give us the efficiency and service of private medicine thereby avoiding the problems with a social system that owns and runs everything, coupled with social financing which give EVERYONE full access . Obviously it would be nearly impossible to bring about in the USA as no doubt the medical lobbyist would resist and our politicians would support them over the people that voted for them.


Just an idea :P

I'd vote for vidcc....













.......except neither of us is American :ph34r:

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Originally posted by Rat Faced@1 August 2004 - 14:33
I'd vote for vidcc...

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i'm not sure if that's good or bad. :unsure: :lol:

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Medical Care is the eternal political football; the libs (if they had their way) would nationalize it, effectively dulling the "cutting edge" of medical research (no competition=no profit opportunity=no money for research=no breakthroughs) and we'd have to also pay the exhorbitant costs of the attendent bureaucracy The conservative side opposes this for the same reasons

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Oh...this is just so wrong.
Over the past few decades pharmaceutical companies have managed to sustain profit level that would make Bill Gates green with envy.
Yet, they spend a mere pittance of this money on research.
The main priority of Big Pharm is to MAKE MORE MONEY.
The method of choice has been to raise prices on drugs that were developed decades ago ( and in some cases by other companies in other lands) and fiercely fend off generic replacement drugs.
Sweetheart deals with the government, which preclude price negotiation and importing drugs from abroad, haven't hurt the ole bottom line either.

My guess is that the (assumed) "exhorbitant costs of the attendent bureaucracy " would be far less than the cost of the trough we currently provide for the pharmaceuticals to feed in today.