Author Topic: Universal Health System is Doomed to Failure  (Read 8272 times)

0 Members and 1 Guest are viewing this topic.

Christians4LessGvt

  • Hero Member
  • *****
  • Posts: 11064
    • View Profile
    • "The Religion Of Peace"
  • Liked:
  • Likes Given: 0
Universal Health System is Doomed to Failure
« on: August 29, 2007, 07:06:36 PM »
Universal Health System is Doomed to Failure

In response to Merrill Matthews's Aug. 15 editorial-page commentary "Cost Control for Dummies1": Thank you for a rare breath of sanity and reality in the "universal health-care" debate.

I hear many individuals, including my own colleagues, wax eloquent about the supposed virtues of a government controlled health-care system. The issues outlined by the author are the first time I have seen a responsible opinion piece explaining why such a system is doomed to fail.

I believe that the American public is being steered into such an arrangement by well-intentioned individuals and cunning political grandstanders. My general impression is that the average person believes he will have all the benefits of the current medical system but none of the out-of-pocket expense. Of course, the devil will be in the details. But once a person becomes sick, he will surely find out the limits of "free" care as outlined in this sensible essay. But it will be too late for him.

Our current medical industry leaves plenty of room for improvement. But government control will only make the situation worse for everyone.

Daniel McDevitt, M.D.
Riverdale, Ga.

 http://online.wsj.com/article/SB118826705386510612.html?mod=todays_us_page_one

"Mr. Gorbachev, tear down this wall!" - Ronald Reagan - June 12, 1987

sirs

  • Hero Member
  • *****
  • Posts: 27078
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #1 on: August 29, 2007, 07:16:10 PM »
Stand by for the myriad of "what a massively stupid editorial" proclaimations      :P
"The worst form of inequality is to try to make unequal things equal." -- Aristotle

Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #2 on: August 29, 2007, 07:31:31 PM »
I had to laugh a little bit at this editorial, as today was largely taken up with my cardiac ultrasound, some kind of MRI-type chest imaging, and a stress test at a clinic about a ten-minute drive from my home, all in accordance with the instructions of my cardiologist, who I'll be meeting with as soon as the results come in.  I reported in at 8:30 AM sharp and was out by 11:15, returned at 12:30 and was out just after 1:00 PM.  All at a total cost of:  Zero dollars.  Which is exactly what all my cardiologist visits cost me. 

Yep, this system sure is doomed to failure.  It's the reason you Americans live so much longer than we Canadians - - oh, wait a second, I forgot:  You don't.   BWAHAHAHAHAHAHAHAHA.

sirs

  • Hero Member
  • *****
  • Posts: 27078
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #3 on: August 29, 2007, 07:34:08 PM »
Yep, this system sure is doomed to failure.  It's the reason you Americans live so much longer than we Canadians - - oh, wait a second, I forgot:  You don't.    

Good distortion of the facts, but you go with your strengths     ;)
"The worst form of inequality is to try to make unequal things equal." -- Aristotle

Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #4 on: August 29, 2007, 08:35:54 PM »
<<Good distortion of the facts, but you go with your strengths >>

Any particular facts you think were distorted, or is this your usual "deny it all" BS with no further elaboration, as a substitute for actual facts to the contrary?

sirs

  • Hero Member
  • *****
  • Posts: 27078
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #5 on: August 29, 2007, 08:44:39 PM »
<<Good distortion of the facts, but you go with your strengths >>

Any particular facts you think were distorted, or is this your usual "deny it all" BS with no further elaboration, as a substitute for actual facts to the contrary?

The fact of Canadians living longer fails to take into account many variables that have already been referenced here before, that occur here in the U.S.  When I get home, I'll endeavor to present some of them again, so you can spin those rationalization wheels
"The worst form of inequality is to try to make unequal things equal." -- Aristotle

Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #6 on: August 29, 2007, 09:02:10 PM »
I think when surveys in public use for decades establish differential rates of mortality, it should be obvious that the relative merits of each country's health-care delivery system would be only one of multiple variables producing the results.   Obviously, it was facile of me to attribute Canada's superiority over the U.S. in the mortality tables exclusively to differences in our health-care delivery systems.

However, I don't see a whole lot of differences between the two countries apart from the health-care systems that could be expected to have any great influence on mortality rates.

Christians4LessGvt

  • Hero Member
  • *****
  • Posts: 11064
    • View Profile
    • "The Religion Of Peace"
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #7 on: August 29, 2007, 10:19:32 PM »
Yep, this system sure is doomed to failure. 



Canada's Private Clinics Surge as Public System Falters

VANCOUVER, British Columbia, Feb. 23:

The Cambie Surgery Center, Canada's most prominent private hospital, may be considered a rogue enterprise.

Accepting money from patients for operations they would otherwise receive free of charge in a public hospital is technically prohibited in this country, even in cases where patients would wait months or even years before receiving treatment.

But no one is about to arrest Dr. Brian Day, who is president and medical director of the center, or any of the 120 doctors who work there. Public hospitals are sending him growing numbers of patients they are too busy to treat, and his center is advertising that patients do not have to wait to replace their aching knees.

The country's publicly financed health insurance system frequently described as the third rail of its political system and a core value of its national identity is gradually breaking down.

Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine.

Dr. Day, for instance, is planning to open more private hospitals, first in Toronto and Ottawa, then in Montreal, Calgary and Edmonton. Ontario provincial officials are already threatening stiff fines. Dr. Day says he is eager to see them in court.

"We've taken the position that the law is illegal," Dr. Day, 59, says. "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."

Dr. Day may be a rebel (he keeps a photograph of himself with Fidel Castro behind his desk), but he appears to be on top of a new wave in Canada's health care future. He is poised to become the president of the Canadian Medical Association next year, and his profitable Vancouver hospital is serving as a model for medical entrepreneurs in several provinces.

Canada remains the only industrialized country that outlaws privately financed purchases of core medical services. Prime Minister Stephen Harper and other politicians remain reluctant to openly propose sweeping changes even though costs for the national and provincial governments are exploding and some cancer patients are waiting months for diagnostic tests and treatment.

But a Supreme Court ruling last June it found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists ? appears to have become a turning point for the entire country.

"The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services," the court ruled.

In response, the Quebec premier, Jean Charest, proposed this month to allow private hospitals to subcontract hip, knee and cataract surgery to private clinics when patients are unable to be treated quickly enough under the public system. The premiers of British Columbia and Alberta have suggested they will go much further to encourage private health services and insurance in legislation they plan to propose in the next few months.

Private doctors across the country are not waiting for changes in the law, figuring provincial governments will not try to stop them only to face more test cases in the Supreme Court.

One Vancouver-based company started a large for-profit family medical clinic specializing in screening and preventive medicine here last November. It is planning to set up three similar clinics ? in Toronto, Ottawa and London, Ontario ? next summer and nine more in several other cities by the end of 2007. Private diagnostic clinics offering MRI procedures are opening around the country.

Canadian leaders continue to reject the largely market-driven American system, with its powerful private insurance companies and 40 million people left uninsured, as they look to European mixed public-private health insurance and delivery systems.

"Why are we so afraid to look at mixed health care delivery models when other states in Europe and around the world have used them to produce better results for patients at a lower cost to taxpayers" the premier of British Columbia, Gordon Campbell, asked in a speech two weeks ago

While proponents of private clinics say they will shorten waiting lists and quicken service at public institutions, critics warn that they will drain the public system of doctors and nurses. Canada has a national doctor shortage already, with 1.4 million people in the province of Ontario alone without the services of a family doctor.

"If anesthetists go to work in a private clinic," Manitoba's health minister, Tim Sale, argued recently, "the work that they were doing in the public sector is spread among fewer and fewer people."

But most Canadians agree that current wait times are not acceptable.

The median wait time between a referral by a family doctor and an appointment with a specialist has increased to 8.3 weeks last year from 3.7 weeks in 1993, according to a recent study by The Fraser Institute, a conservative research group. Meanwhile the median wait between an appointment with a specialist and treatment has increased to 9.4 weeks from 5.6 weeks over the same period.

Average wait times between referral by a family doctor and treatment range from 5.5 weeks for oncology to 40 weeks for orthopedic surgery, according to the study.

Last December, provincial health ministers unveiled new targets for cutting wait times, including four weeks for radiation therapy for cancer patients beginning when doctors consider them ready for treatment and 26 weeks for hip replacements.

But few experts think that will stop the trend toward privatization.

Dr. Day's hospital here opened in 1996 with 30 doctors and three operating rooms, treating mostly police officers, members of the military and worker's compensation clients, who are still allowed to seek treatment outside the public insurance system. It took several years to turn a profit.

Today the center is twice its original size and has yearly revenue of more than $8 million, mostly from perfectly legal procedures.

Over the last 18 months, the hospital has been under contract by overburdened local hospitals to perform knee, spine and gynecological operations on more than 1,000 patients.

http://www.nytimes.com/2006/02/28/international/americas/28canada.html?pagewanted=1&ei=5088&en=25bafd924c66a0ed&ex=1298782800&partner=rssnyt&emc=rss

« Last Edit: August 29, 2007, 11:06:28 PM by ChristiansUnited4LessGvt »
"Mr. Gorbachev, tear down this wall!" - Ronald Reagan - June 12, 1987

BT

  • Administrator
  • Hero Member
  • *****
  • Posts: 16138
    • View Profile
    • DebateGate
  • Liked:
  • Likes Given: 3
Re: Universal Health System is Doomed to Failure
« Reply #8 on: August 30, 2007, 12:27:02 AM »
Quote
Any particular facts you think were distorted, or is this your usual "deny it all" BS with no further elaboration, as a substitute for actual facts to the contrary?

You never did answer my question as to what payroll tax percentage pays for this free health care.


Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #9 on: August 30, 2007, 08:48:56 AM »
<<You never did answer my question as to what payroll tax percentage pays for this free health care. >>

Sorry.  I don't recall the question.  But I don't know the answer.  There isn't any specific payroll tax, only payroll deductions (a.k.a. "withholdings") on account of the individual's income tax obligations.  The employee pays, the employer, in effect, collects and remits.  Canadians pay a Federal income tax which is calculated differently for the residents of each Province so that although all of the income tax payment goes to the Federal government, my own income tax, for example, is calculated as the sum of Federal and Provincial (Ontario) income taxes.  Then through tax-sharing agreements between the Federal government and the Provinces, some of the tax revenues are distributed to the Provinces and some are kept by the Feds.  Each Province has its own Provincial health-care scheme (ours is OHIP) which must meet Federal standards as to universality, single-payer concept, etc. and is financed partly by Provincial funds and partly by Federal grants.  The amount of the Federal financing is too complex for me to understand, but it's by formula and agreement, the overall scheme consisting of how much Federal revenue came from a particular Province, what that Province's entitlement is under Federal-Provincial tax-sharing agreements and so on.  The general idea behind the agreement is that the richer Provinces contribute more taxes to the Federal government which shares it out to the poorer Provinces. 

Since the taxes aren't (as far as I know) earmarked at the time of collection, so much for health-care, so much for National Defence, etc., I don't know that there is an easy answer.  The subject has been studied extensively, but the most exhaustive study that I am aware of is the Romanow Commission Report.  Roy Romanow, a former Governor-General of Canada, was given a Royal commission to study the health-care system and the Commission Report is the end result of numerous Royal Commission hearings, conducted (I believe) across Canada.  I could never get through the Report because it's pretty dense reading, but from the newspaper summaries that I saw at the time, it seemed to indicate that the Canadian system was much more effective and equitable both in delivering health care and in equalizing the risk, than any private-enterprise model, because of its universality.  My impression at the time was that meant it was more cost-effective, i.e. that the cost per capita was significantly less than the per capita costs of private health insurance.  This made sense because while both systems would require an administrative bureaucracy, the private-sector in addition to paying for administration, would also have to show profits for the shareholders and the usual lavish over-compensation for its senior executives, who often were also owners.  Furthermore, our system allows complete control over the provider payments, whereas private insurance schemes either leave the provider 100% uncontrolled as to his or her fees for services or more commonly now, exercise a looser control over them which in any event is not legally binding and does not affect providers outside of the scheme except indirectly.
« Last Edit: August 30, 2007, 08:52:20 AM by Michael Tee »

Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #10 on: August 30, 2007, 09:11:03 AM »
THE NEW YORK TIMES

Canada's Private Clinics Surge as Public System Falters

VANCOUVER, British Columbia, Feb. 23:

The Cambie Surgery Center, Canada's most prominent private hospital, may be considered a rogue enterprise.
----------------------------------------------------------------------------------------------------------------------------------------------

The article might be more applicable in some Provinces than in others. 

The health-care scheme is based on universality of access and single-payer payments to providers.

Like any scheme, it depends on enforcement by the government of the day.  The private clinics are a death-threat to the system.  If left un-checked they will lead to a return of the old system of excellent and state-of-the-art medicine for the rich, nothing for the rest of us and bankruptcy for the middle class if they are unfortunate in health.  The only escape for the middle class being costly insurance policies, some of which require years of expensive litigation to make the insurers honour their obligations under the policy.

The federal government of the day is minority Conservative.   The same political party which in 8 years of misrule in Ontario, managed to bring the Province to its knees, gutting the public health and public education systems and bringing us, among other goodies due to tax cuts for the rich, the SARS epidemic and the Walkerton water crisis, where due to drastic cut-backs in government water-inspection stations, about half a dozen people died of poisoned well-water.  Thankfully, the Conservatives were finally thrown out in a landslide before they could do further damage.

Now we are blessed with a Conservative government federally.  The federal government can easily require any Province to close down private clinics by threatening to cut off Federal contributions to the Provincial health-care scheme.  For ideological reasons the present Conservative government is unwilling to intervene.  Their object is the destruction of the existing system, which the clinics will weaken by draining manpower from it, thus creating longer waiting times (which the Supreme Court has indicated can be construed as a denial of Constitutional rights) and thus further weakening the legal underpinnings of the system.

The system works fine when it's enforced.  What the Times is reporting, as superficially as ever, is the effects of governmental sabotage of a fine system for ideological reasons.

_JS

  • Hero Member
  • *****
  • Posts: 3500
  • Salaires legers. Chars lourds.
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #11 on: August 30, 2007, 09:29:33 AM »
What amazes me is that people scrape the Internet to find articles critical of healthcare systems in Canada and Britain.

Of course you'll find them. Hell, the British are always complaining about the NHS - but try and tell them that the American system of private insurance providers is better.

I'm consistently amazed at people, many of whom have never been to these countries, who clearly hate and loathe universal healthcare first - then seek reasons to justify that ideological hatred.
I smell something burning, hope it's just my brains.
They're only dropping peppermints and daisy-chains
   So stuff my nose with garlic
   Coat my eyes with butter
   Fill my ears with silver
   Stick my legs in plaster
   Tell me lies about Vietnam.

Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #12 on: August 30, 2007, 09:42:38 AM »
I only wish the Times were as zealous in exposing the malfunctionings of the U.S. health-care system as it is in scouring the net for facts which it can misrepresent as failures of the Canadian system.

Christians4LessGvt

  • Hero Member
  • *****
  • Posts: 11064
    • View Profile
    • "The Religion Of Peace"
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #13 on: August 30, 2007, 10:30:21 AM »
"Sorry.  I don't recall the question.  But I don't know the answer"

I believe it is about half of the taxes in Canada go to fund their failing health care system.
« Last Edit: August 30, 2007, 10:31:57 AM by ChristiansUnited4LessGvt »
"Mr. Gorbachev, tear down this wall!" - Ronald Reagan - June 12, 1987

Michael Tee

  • Hero Member
  • *****
  • Posts: 12605
    • View Profile
  • Liked:
  • Likes Given: 0
Re: Universal Health System is Doomed to Failure
« Reply #14 on: August 30, 2007, 10:41:35 AM »
<<I believe it is about half of the taxes in Canada go to fund their failing health care system.>>

Do you recall the source of that?

Besides, our health is our most important asset.  Why SHOULDN'T half my taxes go into it?  What better use could the money be used for?  Anything better than my health?  Killing Arabs in Iraq maybe?  Fuck that.  You stay with your system, I'll stay with mine.