A Moderate Blight?

Cafe Alpha asks:

Isaac are you willing to admit that moderate market socialists like Canada's NDP are not the blight on humanity that the Chinese or Soviet Communists were? How about admitting that the Canadian socialized medical system (initiated by the NDP in Sask) is overall an improvement over an American style system?

Yes to the first question. The NDP is more annoying than a blight. Every time I see Jack Layton it's like seeing a rottweiler in a chihuahua body.

I'm not sure about the answer to the second question since I'm ignorant about the particular points of the socialized system in Ontario/Canada and the quagmire that is the American system.

Here's my thinking: I don't agree with a universal health care system from which people don't have a choice to opt out of. As long as I could not pay taxes towards the health care system and use that money as I see fit, then I don't care what Canadians decide to do with their portion of the taxes.

Why don't I like universal health care? Because of three main reasons:

1. It limits freedoms. The government is now in the business of telling people what's healthy and not healthy. What we should eat and not eat. To tax heavily those things that are not healthy...etc.
2. It destroys the price mechanism. Health care becomes "free". People use it more often and therefore the costs of it are higher than they normally would be.
3. It's not truly insurance. Insurance is, usually, a payment provided in the case of an emergency or disaster but people use their health care to pay for regular visits to the doctor or simple medicine. People ought to pay for that themselves! It would be like using car insurance to pay for gas. There won't be much money left over in case of a true emergency.

Comments

[Mike T]

A few things about socialized health care:

1) The United States has a very good health care system, and the health care itself is made expensive primarily because of insurance and administrative costs related to insurance.

2) The United States has one of the lowest real infant mortality rates in the world. Lower than most socialized states. The reason their numbers seem higher is that they don't count most of the premature infants that die, whereas we do. Nor, for that matter, do they usually even try to save them.

3) Canada's system has, by law, no free market component, and as such, every Canadian health care worker must be considered a government employee. Even if one ignores the inefficiency and danger inherent in this practice, one cannot escape the fact that it is immoral for a society to coerce an entire peaceful profession into public service and government-set prices.

4) Canadians often travel to the United States to buy the health care that they have to wait for in Canada. If Cafe Alpha had his way, it would no longer be possible for them to do that.

5) Only a fool would ignore the fact that we already have a socialized health care system in the form of the VA that most veterans only use when they're in such bad shape that they get sent there against their will. If you look at that example, and the example that exists in how poorly the public education system works (and how institutionally immune it is to reform), one would have to be certifiably insane to seriously suggest adopting Canadian health care policies.

[Mike T]

The real proof of whether Canadians like their health care system would be for the US government to pass a law saying that no American hospital shall render aid to any Canadian unless they are either here on a trip or a have a residence visa. Let the Canadian middle class and rich have to buy their premium health care in Cuba or Europe instead of being able to drive 10 miles over the border whenever the wait gets too long for their tastes.

[AC]

Why don't you ask my nephew if he likes the Canadian Health Care system. He waited 2 years on the list for his scoliosis surgery, not counting the years he suffered before being deemed bad enough for surgery. Then, he suffered another year & half before he could get the corrective surgery to replace the infected rod from the first surgery. So, he spent 3.5 years of his childhood suffering, (could not attend school, go out much, had a nurse visit everyday to deliver pain meds and check his iv) from an easily treatable condition because the federal gov. decided that they could run health care better than the free market.
BTW- Once surgery is deemed necessary in the US, the wait is usually 2 weeks, 3 or 4 if the hospital is backed up. If you can't pay, we have MANY programs to help you out. The only quagmire our system has is that a growing # of people think that the hard work of some should be given away for free.
Socialism means the common suffering of most, not all because the ruling class is never subject to the same rules as the pesants.

[Laura(southernxyl)]

Isaac and Mike T, all good points.

[Cafe Alpha]

Sigh I'm in too much of a hurry to go into detail right now, I will later.

A few points.

The American system fails in some basic ways, and the Canadian system.. well there IS NO Canadian system, there is one system per Province. My step mother is a doctor who has worked in Saskatchewan and California and Washington state - her point belief is that medical care is significantly better in Sask than under the insurance companies she encountered in California (I never asked her to compare with her new practice in Washington so I can't say about that).

Sask was pretty good, I guess (this was some years ago, I'm not up to date on this). Alberta, with twice the budget was probably even better. British Columbia was an abject failure. I haven't heard good things about Ontario, but what I heard was from patients not doctors...

One deep failure of the American system is that the FDA is unbelievable protectionist. I have shopped for medications that I needed and found that not only did some of them they cost eight times as much in the US as in countries with socialized medicine, they cost that much more than the same name brands in non-socialized (but poorer) countries.

There is no free market in medication, nor collective bargaining over price (such as in the countries with socialized medicine). The result is that we're getting cheated.

Another failure some years ago has to do with the lack of a social safety net... people who are sick often sue doctors for malpractice, and since juries in the US know that the government won't help sick people, they award millions of dollars in any case where a doctor might be at fault.. Some years ago the statistics I heard were that 50% of the cost of medicine in the US was going to malpractice insurance - in other words into this unbelievably inefficient form of welfare-by-lawsuit. There no doubt has been some improvement since then, but the underlying impetus for high awards - no social safety net - is still there.

In any case my mom says that in her experience far too much time, expense and pain is being imposed on patients for basically unnecessary tests so that hospitals and insurance companies don't face any risk of lawsuit.

Another problem with the system is the incredible cost of drug approval - and the fact that there is no money for drug research in cases where a drug isn't likely to be profitable... I could give you cases where far superior drugs are not being used, because there isn't funding for testing to the FDA's standards.

It may be that a cure for diabetes will be delayed 15 to 20 years if the FDA succeeds in getting a patient's own stems cells regulated as a drug.

Our system is SO over-regulated.

But the main point that you conservatives miss is that medicine is the difference between life-and-death, suffering-and-ease in a way that even food and shelter can't match. Because one can survive on ANY food or under ANY shelter, but if you need a specific drug or treatment to have a good life, often nothing else will do. Thus there is a moral component to medicine that applies to no other business. If you can't see that, then you have no morals at all.

[Mike T]

I'm going to be charitable and assume that that was not a serious critique of anything said here because it is so off the mark that I am left wondering if you were even aiming.

If you want to make the system better, then here's a thought: deregulate. The FDA is largely useless on medicine. If companies don't do due diligence in testing their goods, then the civil courts will handle that. That's how it actually ends up getting handled anyway, since the FDA frequently allows drugs to get through which turn out to be dangerous.

Every issue you complain about is a factor of bad government policy, and can be solved as follows:

1) Drug prices: IP law reform to limit a patent to a single 10-15 year term, and have that cover all variations of the product.

2) Drug availability: get rid of the FDA.

3) Access to doctors: double the number of slots in medical schools since medical schools frequently turn away qualified students in order to lower the number of graduates.

4) Malpractice insurance: provide strict statutory guidance on damages, and base them around the actual productive work that the injured party was capable of doing at the time of the incident (meaning no potential of a burger flipper getting a $20m settlement).

5) Safety net: make all donations to free clinics tax deductible with no limit.

The one issue you cannot solve is the one embodied by people like an old woman I know. She never worked more than few years in her life, and wasn't a traditional stay-at-home type of woman either. She now complains that Medicare won't cover this or that, and is too proud to go to a free clinic with "those people" (people honest enough to admit that they're poor and should be grateful for the free doctor's visit). She thinks it's her God-given right to have access to whatever health care she can't afford, despite never even trying to budget for it.

Socialism might work for basic health care if everyone were responsible and there were no entitlement mentality.

[Cafe Alpha]

I think your attitude is a little backward.

Doctors WANT people to go in for checkups more often than they do. Prevention is better than cure. Seeing doctors more often isn't abusing the system. The fact that our system discourages use is a mistake not a good feature.

On the topic of charity, the problem I alluded to about the safety net wasn't just about whether people can afford medicine itself, but the deeper problem of whether they can keep their houses etc if they get too sick to work for a while - or live at all if they become disabled.

THAT is the problem that juries address by raping the system for millions.

Our current system will give you all the free care you want, once you have no savings left, no investments, you sell all of your belongings, your house and your car. Then, once you're destitute, you can have all the medicine you need. People may prefer to die, especially if they have families.

[Cafe Alpha]

Hmm I didn't really read what you said about the woman who "abuses" the system.

I see your complaint was that she prefers Medicare to a free clinic? I think very few people want to wait in charity clinics because it's so clearly separate from the hospital system the rest of us use, and is likely to be inferior.

[Cafe Alpha]

As for being "entitled" ...

Look, insurance works by spreading the risk/cost around. We can all afford medicine for all of us for sure, but we can't have the same same certainty about being able to afford medicine for ourselves.

Such a system works fine if everyone participates... But the mathematics break down and fail once you have choices, tiers for different ages, young people opting out - and then you have to exclude already sick people (and poorer people) and much of the actual purpose has been lost.

Insurance is inherently better socialized because of the mathematics of it, not because of any ideology.

Because of this it makes sense to socialize medicine and then treat it as an entitlement - you WANT everyone to feel entitled to see a doctor both for prevention/checkups/advice and treatments.

Conservatives want everyone to work. So odd that they don't care so much if people can afford to be healthy enough to work.

[Laura(southernxyl)]

"Conservatives want everyone to work. So odd that they don't care so much if people can afford to be healthy enough to work."

I suggest that you stop the mind-reading.

What people can afford is a highly subjective thing. I remember reading an article in the paper about a woman who had breast cancer. She'd not been getting mammograms b/c her insurance didn't pay for them, and her cancer had metastasized when she got her diagnosis. I paused and thought about how awful it must be to be 50 years old and not able to shake loose $50 or $100 a year for such an important thing.

But the article went on to say that when she discovered a lump in her breast, she waited until she and her husband got back from their weeklong vacation in the Bahamas before she went to the doctor.

Would you say that she didn't get those mammograms because she couldn't afford them? Was it her health insurance's fault that she didn't get them?

To take a leaf out of your book - these are the kinds of things you liberals gloss over. You assume that everyone would act exactly as responsibly as you do, or as you know you should anyway, if only they had enough money to do it; and if they don't take care of business it's because some mean person or government is preventing them. We know that you could absolutely beggar yourself to try to solve some problems and people will be damned if they will take proper advantage and do the right thing. And we don't want to beggar ourselves for nothing.

[Cafe Alpha]

Laura, sigh, you got everything wrong.

When I said some people can't afford to be healthy enough to work I mean people who are sick and therefor can't work, Jesus I thought my English was clear!

As for the woman who should have paid for tests she could afford - uhm so what, the world is also full of people who can't afford tests and insurance etc. And I write this as someone in THAT circumstance.. Yes, of course, your every argument is with a rich liberal.

[Cafe Alpha]

Laura, you know saving your money isn't the ONLY virtue you could foist on society. Encouraging people to be healthy is also a mitzvahs (good deed).

A system like the one I grew up with in Saskatchewan, where taxes rather than individuals pay for doctors visits does promote that virtue. People DO all see doctors more often, they all DO have their tests, because in their case health isn't competing with every other thing in their lives. In this case not charging people money for the service promotes A GOOD THING. You are not thinking like a heath professional at all.

[Laura(southernxyl)]

"Laura, sigh, you got everything wrong."

OK. Please scan in your signed note from God and post it here for us to see.