Here’s the difference: In Canada, if you have money, you can get quality care, and if you don’t, you get better-than-average (globally speaking) care. In America, if you have money, you can get quality care, and if you don’t, you’re screwed. When Canadians complain about lack of access to quality care, they mean for rich people. Obviously poor people wouldn’t have access.

However the last point is a good one. Women, as primary caretakers of children, have to think about expenses because they never know what could happen to their children. They have to plan against risk for their babies (like the Canadian couple with their premature baby).

Men can put this worry aside because they are only worried about themselves (at least, in the example given in this post). If men felt the same responsibility towards their vulnerable children as women did, I’d venture they’d be much keener on a lower-risk system.

“Don’t mess with it, just throw more money at it, seems to be a common way of dealing with the problems.”

Well, that’s one thing our health care systems have in common!

There are no emergency rooms or private clinics in Canada? I know it’s illegal to set up a private practice in the UK (bad idea, in my opinion) but I wasn’t aware this was also the case in Canada.

Elizabeth: where are you from? Both Snow and Younghusband are from Canada, thus lending some native input. Certainly my experience with public and private care has left me solidly in favor of the later—although I’ll probably always have access to the best quality stuff.

I can’t disagree with anything Elizabeth said. I’ve read that the U.S. spends almost half again as much as Canada, per person per year, which is attributed mostly to paperwork. Breaking a child’s arm without anesthesia because of health insurance issues? That’s Dr. Mengele stuff. But a 3-month wait to treat an emergency is intolerable, too. YH’s dad has a ticking time bomb in his stomach. Unfortunately, any system that can be devised by humans will still have some people falling through the cracks

I recommend CA readers click on Dan’s link above for another look at the man-woman divide. It’s a very interesting and funny bit:

“The main difference between men and women is that men are lunatics and women are idiots.” Rebecca West (Black Lamb and Grey Falcon)

Over and over again she [Rebecca West] saw the same pattern: men were swept away by far-away schemes and ideas (like lunatics), while women were so absorbed by families and personal relationships they ignored those same forces (like idiots). To Dame Commander West, men were idiotically refusing to focus on the real details of daily living while women were foolishly refusing to focus on the fate of their nation and culture. In other words, men are idiots for not engaging in long-term coalition building on a family level (in “tight” or “dense” networks) while women are fools for not engaging in long-term coalition building on the national and ideological level (in “loose” or less “dense” nets).

It is worthwhile to read the entire article.

WHoa, whoa, WHOA. Listen, first of all, there are an enormous amount of pressures on the American healthcare system that the Canadian system would never in their wildest or darkest dreams have happen to it.

Consider the illegal immigrants who receive service and are unable to pay. Consider the pressures on the federal government to come to the rescue, causing taxpayer money. Consider that prescription drugs are cheaper in Canada because they FORCE pharmaceuticals to charge ALMOST AT COST thereby forcing them to raise costs here in America. Canada achieves through force what we never could here in America without completely bankrupting this prescription drug engine that is now spreading across the world extending lives and keeping people out of hospitals. (Canada is not the only countries that tries to put the American companies out of business—Japan and others do too.)

Consider the extraordinary cost of insurance caused by frivolous lawsuits. Doctors are being discouraged from practicing for similar reasons that doctors have for fleeing the UK—they just aren’t making the money in a lot of cases.

National health insurance in Taiwan is a disaster and in my opinion the system in Canada will collapse eventually too. It will in the long-run. These systems are now political footballs that will go where the political winds go, and it’s very, very sad.

The best way to go is, of course, private care mostly free of regulation. In the US, health savings accounts, as shown on the Beckner-Posner blog, would go a long way towards establishing some robustness in the price elasticity of demand now inelasticized by 8 years of “managed care” under Clinton.

I know I have rambled, so… in summary: Canada is able to spend less almost entirely because of their demographics and the United States. We subsidize their healthcare ENORMOUSLY with the drugs and the technology, not to mention the trade, which allows them to keep prices down so they may pay ludicrous taxes for their ridiculous healthcare system (waiting list fatalities/casualties anyone? Any waiting list in the US is but pale in comparison…) and have more discretionary dollars to keep their standards of living up. Yes, once again, Canada owes everything to us.

Their economic model is simply not the answer. They’re parasites, just like the rest of the world, when it comes to our healthcare. You try using the Canadian system for 300 million across such a beautifully stratified economic range. It’d be silly. We’re the best.

Wot Wot! as they say.

Gee, and they say women are hysterical.

Admiral, you got one thing right: Bush’s plan is ridiculous.

The rest of the hyperbole is hardly worth answering, because once again we have an extreme positive version of the idea of a free market (“markets solve everything, because self-interest is the main motivator in all human activity”) being pitted against systems which are imperfect and moreover- actually being implemented.

If we look at the most free markets in the world- where systems have totally broken down- like Russia, we see that their citizens and doctors for some reason prefer to emigrate to Western Europe and America. That’s because the richer you are, the better the systems work. Funny thing, that.

It’s really cute that you appear to think only America has an immigration issue, though. Sweet.

“Functioning capitalism requires the reinvestment of profits; Russia was a loot-and-run system and fluctuates between orderless and oligarchy.”

I couldn’t agree more. I didn’t say Russia was a functioning capitalistic system. I said it was a free market. I believe these are different things. I don’t care for ready-made “isms” but I do believe that a market requires some level of regulation to prevent oligarchy (as you refer to).

My point was to emphasize to Admiral that the free market does not, in and of itself, solve social problems.

I presume that you would agree with me that capitalism is more than free markets.

I sincerely regret that I cannot go any further than Merriam-Webster, but for various reasons I cannot.

Free market proponents are not allowed to just define in all they want to their own advantage.

“Main Entry: free market
Function: noun
: an economic market operating by free competition”

I realize this is not what many people have in mind when they talk about their free-market utopias, but because each utopia differs in its degrees of freedom, I think that the burden is on free marketeers to define to what extent the market should be free. You can’t just say, “free market means only this free, because that’s what it would take to work”. Free means free. The definition of “free market” is taken. Y’all will have to come up with your own definition.

Essentially, Russia was just this for a time: an economic market operating by free competition. No ifs, ands, or buts. Unfortunately.

Man, this discussion reminds me of the guy at my college who held up a sign saying “I HATE…” and then listed basically every ethnic and religious group in the world.

It comes down to a tradeoff. If you want universality, you have to sacrifice quality; there’s no way to have both unless you have an abnormally high per-capita GDP to fund it.

People who advocate universal health care never address how to tackle this issue. They never really address how to bring down the R&D costs for medicines, or how to keep people coming into the medical profession. There are a host of interconnected issues here that have yet to be resolved in a way that’s satisfactory to everyone, and I don’t think these issues ever /can/ be resolved to everyone’s satisfaction because it all comes down to an issue of haves vs. have-nots, the debate we all know will never end.

That said I don’t think it pays to be fatalist about the system and say “it will never work that well, so why care?” The key is to find the proper balance between the haves and have-nots. It’s the story of America, right? So I think Curzon’s view from both sides is really the right way to look at this.

I reckon that if health care is fixed in America, it has to happen on a local level where the system can actually be tinkered with on a day-to-day basis. A top-down national universal health care system is not happening in the US. It sounds nice but it’s too impractical; look at the bloat we have /just to pay our taxes/. If we can get good, balanced local systems, turn those into good, balanced state systems, then turn those into a functioning national system (if we deem it necessary), we might have something. It’s just going to take lots of experimentation that doesn’t work on paper.

This is just a general thought, though, because I really know jack-all about health care administration.

What’s being forgotten here that, in developed countries, there was no correlation between health care spending and life expectency until 1980. All life-expectency gains until that point appear to be reducible to childhood shots, basic hygene, and a basic diet.

The clear implication is that, until 1980, hospitals, doctors, &c across the world were killing as many people as they were saving. So before 1980, it really didn’t matter how you ran your system, it wouldn’t be that bad. Life expectency didn’t vary dramatically between the Germanies, or between Russia and America, for example.

What changed after this were the introduction of two medical technologies: prescription drugs and assembly-line surgeries. Prescription drugs are currently subsidized by America for the world. Assembly-line surgeries, which are fought everywhere because they threaten the profits of otherwise useless (literally on a net basis) hospitals, are available in the United States, India, Thailand, etc.

Elizabeth, for sake of argument I’ll grant you that the “free market” requires that the market be absolutely free. And what would be wrong with that? Nevertheless, Russia manifestly fails the granted definition, since much of the rapacity was conducted by and for groups favored of the government. There was competition, perhaps, but one for assets instead of custom, and transacted by influence rather than coin.

And, though I dislike Medicare/Medicaid (for, inter alia, their costs and the dilution of the federal system), it isn’t a monolith: There’s at least modest variation and tinkering with the programs at the state levels, under “waivers” from CMS: Tennessee, for example, provides services through managed care, whereas Florida simply reimburses or funds recipients for covered services at approved physicians. States have seen no small process innovation to contain costs whenever possible.

Apologize for quotes around the term “dismantling” in last post. Those should not be there.

“the Index”? Which index?

Have you ever tried to do business there? I can tell you, it was either a million pieces of paper- and even then you’ll never get anywhere- or a bribe, which will get you past anything. I’m not trying to describe Russia as a great place to do business. I’m just saying the laws applied not as laws, but as roadblocks for people who could not pay. That is very close to lawlessness, which is why so much of the worst kind of business flourished there for a time.

I mean, do you really think Abramovich succeeded because he filled in all the papers?