Socialized medicine in theory and in practice
I lived in Canada for several years, on and off, and one thing I learned as an American was that the Canadian health care system is the most wonderful health care system in the world, except for when it was actually you that’s sick. I’ve got a half dozen examples, but the one I’ve always thought was most telling was a distant cousin who had a gynecological problem that led to hemorrhaging. She was taken to the emergency room, received prompt palliative treatment that stopped the bleeding, and was given an emergency appointment with a gynecologist.
Which, being this was an emergency, was only six weeks in the future. The Gods alone know how long one has to wait for a regular prophylactic GYN checkup.
This struck me, because I’ve had a lot of contact with medicine in grad school and with physician friends, and knew that if my cousin had come into the Duke Hospital in the same condition, she’s have seen at least a GYN resident before they let her leave, probably before she could take her feet out of the stirrups.
Today, friend and PJM Contributor Paul Hsieh MD has a piece in Liberty Ink Journal (which I’d never seen before), discussing what Canadian and British healthcare is really like in practice:
According to the Vancouver-based Fraser Institute, “Canadian doctors say patients wait almost twice as long for treatment than is clinically reasonable, almost eighteen weeks between the time they see their family physician and the time they receive treatment from a specialist.”
These long waits for medical care naturally result in worse outcomes. A Canadian woman who discovers a lump in her breast might wait several months before she receives the surgery and chemotherapy she needs, while the cancer cells continue to multiply. If she lived in the United States, she could receive treatment within days.
David Gratzer, a doctor who practiced in Canada before moving to the United States, notes similar results for other cancers:
For men, the bladder cancer survival rate in the United States is 15 percent higher than the European average. With prostate cancer, the gap is even larger: 28 percent. For American women, the uterine cancer survival rate is 5 percent higher than the European average; for breast cancer, it is 14 percent higher. The United States has survival rates of 90 percent or higher for five cancers (skin melanoma, breast, prostate, thyroid, and testicular), but there is only one cancer for which the European survival rate reaches 90 percent (testicular). Lung cancer, once considered a death sentence, now has better survival rates over five years—and Americans do better than Europeans, 16 percent versus 11 percent.
Nor does socialized medicine guarantee equal access to care. Lee Kurisko, a physician who also practiced in both Canada and the U.S., notes that Canadians with political “pull” routinely use their clout to “jump the queue” and receive magnetic resonance imaging (MRI) scans and specialized surgeries ahead of ordinary Canadians with greater medical need. Access to healthcare in Canada remains unequal, but based on political favoritism rather than ability to pay—something Kurisko calls the “deep, dark secret” of Canadian medicine. [Emphasis mine -- CRM]
So what explains these failures of socialized medicine?
To find out, you’ll have to read the whole thing.
So many Canucks and Brits love their socialized medicine. Is this adulation a variation of the Stockholm syndrome? Is Socialism a secular religion with masochistic adherents?
As a Canadian I can say ours is truly a healthcare system, meaning you better not get sick.
Yes.
They don’t know anything better is why. I lived in the UK for 8 years and would not wish the NHS on my worst enemy – I can report no satisfactory encounters with it and chose to pay out of pocket for my own care to avoid it. Its only benefit is that it is “free” but you get what you pay for.
For all the “love” they have for it, an inordinate number of folks spend a lot of time trying to get out of it – in the UK that means getting private doctor. In Canada, it means crossing the border…
I think that there is a basic denial when discussing socialized medicine. Rather then take the approach that you may be discussing an evaluation of current state of medical care it becomes a debate on patriotism… I find that Americans are more willing to criticise what is presented to them and break it down and evaluate. I have had many discussions with persons living in Canada and UK who insist this is a great system because it’s free. My comment to them is when is the last time you recieved anything of any real value for free? I would rather sell everything I own to have the best money can buy then settle for an average doctor. There is no incentive for physicians in the socialized system to be the best at what they do, they are all compensated the same, so why try harder? Why be the best? Why would you go to seminars and conferences to learn about new procedures and spend your own money to attend when you are compensated equally whether you are great or just doing the least it takes to get by. Thousands come to the U.S. each year spending their own personal money to obtain surgeries and procedures that they may wait months or even years for in their countries. That being said it isn’t because what they have is working. However, when you have this debate with persons from these countries it always turns into U.S. against them, not the case at all.. this is not about patriotism it is about a serious problem which results in many needless deaths each year. As it has been stated here time and time again, Great system until you actually are really sick and need a high standard of care quickly.
“.. Canadians with political “pull” routinely use their clout to “jump the queue” and receive magnetic resonance imaging (MRI) scans and specialized surgeries ahead of ordinary Canadians with greater medical need. Access to healthcare in Canada remains unequal, but based on political favoritism…”
Jumping the queue, waivers, exemptions — aren’t these the sine qua non of the progressive elites ? They would make the rules for the rest of us dolts — but surely never have to personally endure the fruits of their creation.
By definition, when a system is run by a political organization (i.e., government), then the decisions will be made for political reasons.
One cannot be surprised that decisions on priority of care, rationing, or budgets are made for political reasons when the organization making the decision is, by its very nature, a political one.
The next wave, then, is when decisions on where hospitals or specialty care resources are built is not based on where the customers are, but where the political clout is.
New hospitals or other facilities will be built in the core cities of urban areas, because that’s where the largest electoral blocs and connected pols are, while the need is in the politically fragmented suburbs.
I’ve heard it said that government controlled health care in Canada polls extremely well, particularly among people have never been sick. For those who have been sick, not so well.
Why do you think there are huge medical centers in Spokane and Minneapolis ? For reasons similar to the presence of huge shopping malls near the Canadian border. I know many ex-Canadian physicians who left in the mass exodus about 1980 when doctors who resisted the new health system were threatened with prison.
I used to attend a good surgery meeting in Saskatoon. The surgeons who ran the meeting were pioneers in laparoscopic surgery. A few years later, I inquired about the meeting as I hadn’t gotten the usual notice. It was no longer being held, I was told. The surgeons conducting it had all emigrated.
Now, I understand, primary care physicians are being recruited from the US to go to Canada. I doubt they are going to work for the government but there are lots of new private clinics opening in spite of the fact that they are technically illegal.
Private clinics actually aren’t illegal in Canada. All provinces allow private radiology and other specialized services. And after Chaoulli v. Quebec where the Supreme Court found that Quebec’s ban on private insurance violated the Quebec Charter, most of the provinces have decided to allow full-service private insurance.
When my Canadian niece was born, she had a birth defect that was misdiagnosed by the local doctor. In the end, my brother went to New York to have her condition diagnosed and then corrected via surgery. He had to pay $40k in cash (through fundraising and the family coffers) to get the procedure done, but it was deemed the best option instead of waiting for the slow wheels of the Canadian medical system to “get around” to helping this little girl. They also got a surgeon who had done this procedure many times before and was more experienced than any Canadian doctor.
That’s because by and large Canadians are ignorant of what their alternatives are (I can say this because I am a transplanted Canadian living in the US permanently). They all believe the American liberal media horror stories of patients without insurance or the “means to pay” being left outside the ER doors to wither and die.
I have personal experience with the ineptitude of the Canadian system and wouldn’t wish it on my worst enemy. My mother, never having used the medical system but for my birth, was admitted with what was commonly thought of as a kidney stone and was immediately discharged. Few proper tests were run and (it is a rationing system) the attending urologists were dismissive and rude. The pain persisted and it was believed a small kidney operation would be needed. It was scheduled for 10 months into the future due to the lack of OR capacity for people with her surgery needs. The pain continued to be crippling and my mother spent the good part of the next 5-6 months in the ER until demanding to be operated on before she would leave the ER. The operation was done only to find a golf ball sized tumor that had already spread to her lungs/nods (could have already done so prior to the 6 months, but time is of the essence with cancer). She died 16 months later after a valiant fight against the disease. The thought of immediately going to Mayo had occurred to us 6 months prior to the surgery but the open ended cash liability downside was a little too much to risk.
Americans have NO idea how good they have it here. There are little in the way of doctor shortages (my mother’s GP had a sign up since 2004 that they were not accepting new patient’s due to lack of doctor’s), preventative tests are ordered and run immediately, access is always granted to specialists, and drugs are not rationed.
When I was living in Canada, it was as an employee of a US branch of several computer firms; I was on US insurance. I discovered that I could get quicker attention in Canada than Canadians because, through a quirk in the law, my US insurance paid them cash money and no government screwing about. A couple of my other horror stories were a guy I knew, a blind double-amputee because of inadequate treatment for his brittle diabetes, and an old boss who moved from IBM Canada to IBM US because in Canada, his sight-threatening eye condition wasn’t considered “serious” because he wasn’t actually blind yet.
I’m a physician in Missouri, and I have NEVER once heard of a patient who was refused care because he or she was not insured. Yesterday in the office, I saw a young woman who did not have insurance (it kicks in one week from now) but was quite ill. I admitted her to the hospital, and she will receive the treatment she needs regardless of cost. The hospital will work out a payment system with her, as will my practice. I’m sure I won’t get paid what I would if she had insurance, but I’m not going to let a 20 y/o woman suffer for that. When patients don’t get care because they aren’t insured, it’s usually because they choose not to get the care because they don’t want to pay anything for the services they receive. But that’s their choice.
So the socialized health care system, supposedly “equal” for everybody, merely substitutes political pull for ability to pay, while those without political pull wait on endless ques till they die. I sure as hell dont want that system for the US, no matter what kind of problems our present health care system has. Kind of like Obamacare, where the companies and unions with political pull get waivers, while the rest of us get mandates.
Exactly. Whatever you might think of Atlas Shrugged as a novel, Rand described very clearly the way in which more government substitutes “pull” for merit. I’d suggest this is inevitable.
So what explains these failures of socialized medicine?
They’re not failures, they’re features!
As a proud Canadian, I can honestly say I think most people who still laud the medical system we have are clinging to a dream of what they thought should have been. Socialism doesn’t work, socialized medicine doesn’t work, people who claim we don’t pay for it are delusional, our taxes are through the roof, and we still wait 6-8 hours in the ER on a regular basis. I would strongly urge my southern neighbours not to go down this route.
I’m an American living in Taiwan. They are very free market-low regulation and have high medical standards. Life expectancy is slightly higher than USA.
Last year, I had a toothache and went to a dentist planning to make an appointment. Dentist said, sit down, let me take a look. Filled a cavity and I was out of there in ten minutes! I was still in disbelief walking out the door.
We Canadians are courageously exploring the evil heart of the jungle of socialism, so you Yanks won’t have to.
What, You’re too stupid to learn from all our hard work, pain and early deaths?
As an American if you want to get a sense of how the health care system works in Canada, look at your own public education system.
Here in Canada, my children attended private school. There is no question that public school can give you a good education. However, it is very obvious that in the private setting, you are the customer and the provider is eager for you to be happy with the service. In the public setting, it is very hit and miss – some teachers and schools care, others not so much. You are a captive of the system and that is the poison that corrupts.
Anyone who really cares about health and wellness would want that delivered in the best way possible. A free market is the only way to accomplish that.
Advocates of socialized medicine or education are not at all interested in providing the best services, to the greatest number of people, no matter what they might say.
The average citizen of Canada lives longer than the average American. They must be doing something right.
Well, no, that doesn’t actually follow: longer life expectancy isn’t just a consequence of the health care system. In particular, in Canada, they’re collecting their statistics in a more favorable fashion — children who would be counted as stillborn in Canada are counted as live births in the US — and they have fewer accidental deaths.
You entitled to your own opinions but not your own facts. There is not one reliable study that suggests Americans live as long as Canadians or most other westerners. Enjoy the world you are living in. It is certainly not reality.
Are you controlling for demographics? Age, ethnicity, etc.?
Because only when you compare like groups to like, can you have any basis for concluding that the difference in outcome results from differences in the countries’ respective medical systems.
Actually, “America” is a very heterogeneous place, literally nearly as large as all of Western Europe, and its also more ethnically diverse than most countries.
Both of these things drag down the national average, considerably.
If you, for example, look at life expectancy in more affluent and ethnically homogeneous States of Hawaii, Minnesota, or Connecticut, they all exceed 80 year. That’s effectively identical to Canada’s average of 80.4 years, and in fact better than median life expectancies in the provinces of Manitoba and Newfoundland.
Its also a mistake to think that there is a perfect correlation between healthcare quality and median lifespan. Ethnicity plays a big factor in lifespan, and so does lifestyle, and neither one is really dependent on the availability of good healthcare.
Its funny, I have lots of Canadian friends and family and they all defend the “equal access” of the Canadian system to death. But when I ask them which country they’d rather be in when they have a heart attack, or need surgery for cancer, to a one, they all say they’d rather be in the USA!
Not just Canada; most other countries will not count stillborn infants against their average life expectancy. In the U.S. we will spend tens of thousands to save a catastrophically premature infant, also, and count it against average life expectancy if it dies anyway.
I remember 2 things, I read a book in the early 00′s by Larry Elder. He stated that in 1997, Canada had 13 MRI machines for the entire country.
About that time in 1 of the Canadian papers, there was an article wondering why dogs & cats were getting MRIs faster than humans.
There was another article in the mid 00′s in a Canadian paper that explained that the middle & upper classes were taking out HELOCs to get the surgery they needed when they wanted it.
Another Canadian papar had an article that Windsor was getting 2 heart surgeons to perform about 500 surgeries a year.
1 of the surgeries was angioplasty.
The year was 2008!
“We are all going to get the same quality of health care”
Might end up being as true, have the same inside joke quality as the statement:
“Work shall set you free”
Just looked it up. The average American lives two years less on average than the average Canadian. We also have shorter life spans than Brits, the French, and the Germans. Our system is NOT the best in the world. Results matter people!!!
Keep looking, Mike. See my previous answer: when statistics are collected in a consistent fashion, the US does much better. In particular, we try, and sometimes succeed, in saving babies that would have been called stillborn in other places; the ones that don’t survive become part of the left expectancy calculation. This is also why US infant mortality is higher.
As our host points out, gross length of life statistics at a national level do not count things like a higher murder rate, death due to auto accidents, higher levels of obesity, ethnic composition of the population, etc.
Simple statistics tend to work well for simple people. If you ask better questions, you might get a better answer.
So our murder rate is so high that out life spans are two to three years shorter. OK. Maybe we should do something about that. But try this, if there systems are SO bad why don’t they have SHORTER life spans than we do?
Mike, that’s another “fact” that you need to correct; you seem to have a real problem comparing apples with papayas.
If you look at similar ethnic/cultural groups, the homicide rates between the U.S. and Canada effectively disappear, and in some cases U.S. rates are lower than those of equivalent Canadian groups. It has long been the case, for example, that with only two or three exceptions, homicide rates in states bordering Canada are the same or slightly lower than their neighbor provinces.
The demographic groups that make up almost all the difference, which are young urban hispanic and black males, are comparatively almost nonexistent in Canada. It makes a difference, although you probably don’t want to look at the implications.
Two whole years! When I took statistics, that was called “noise.”
Guys, Its not just life span. Europeans are now TALLER on average than Americans. That was not the case a century ago. They are HEALTHIER than us. Sad, but true.
Another failure of the European social model.
http://www.washingtonpost.com/wp-dyn/content/article/2007/08/12/AR2007081200809.html
Well, maybe not.
What did you *think* would happen to average height, when we imported several million (shorter than average) Mexicans?
What is the average height of a Swedish-American living in Minneapolis, versus that of a Swedish-Canadian living in Winnipeg?
Really?
Your arguments aren’t even internally consistent.
If height and health are related, then why do the Japanese, whom you cite as the longest-living in the world, live the longest when they are not amongst the tallest?
Why are the Dutch, who are on average the tallest in the world, NOT the longest-living?
Cite me some data showing a correlation between height and longevity, and then we’ll talk.
In the meantime, I’ll show you some. In fact, in every study I’ve ever seen on the topic, height and longevity are actually INVERSELY correlated. Blunty, short people tend to live longer!
http://www.ncbi.nlm.nih.gov/pubmed/1600586
I lived in Canada as a teenager. We lived in southern Ontario, in a town of 80,000 that was just south of the QEW from twin cities of 150,000 and 75,000. The twin cities were the home of two respected Canadian universities, though neither had a medical school.
In 1983-4 my mother developed a lump on her back, and was admitted to the hospital in the town of 150,000 to wait for a CT slot as an inpatient. It was wait for 3 days in the hospital, otherwise healthy, or wait three weeks for a CT slot as an outpatient. The results showed a subcutaneous mass of indeterminate origin. The surgeon told my parents that there was about an 80% chance it was a benign process like a sebaceous cyst, and a 20% chance it represented a malignancy. He said that if he did the surgery and it was a sebaceous cyst, the Ontario Health Insurance Program (OHIP) would consider the procedure to be cosmetic and refuse payment, leaving the patient with the hospital bill. If it was malignant, they would pay for the surgery.
Dad worked for a US company and retained private insurance coverage. He indicated to the surgeon that they would want the surgery in any event. He asked the surgeon, “What would someone with only OHIP do in this situation?” The surgeon said, “About 20% of them will die from malignancy.” There was simply not enough money left over after paying for OHIP in the form of taxes for the average person to consider risking the cost of surgery.
What might be surprising to people is that a metro area of 300,000 had one CT scanner in 1983, while dinky little Paris, Texas, population 20,000, had a CT scanner. I am sensitive to that, given that I am a radiologist, but the disparity in the ability of socialized systems to provide for their citizens is pretty astounding. We do treat and image the worried well quite a bit in the US, but the sick people get seen and treated just fine.
I second my Missouri colleague in saying that I have never seen anyone not treated for inability to pay. There are plenty of Canadians who suffer and die due to the inability to wait, though.
Maybe we should try the model of healthcare that has produced the longest life spans in the world.–
“The health care system in Japan provides healthcare services, including screening examinations, prenatal care and infectious disease control, with the patient accepting responsibility for 30% of these costs while the government pays the remaining 70%.”
The Japanese live to be 82.6 on average versus 78.3 in the US. \
Socialized medicine seems to be working for them.
Yes, because Americans share the exact same life styles as the homogeneous population of the Japanese mainlands.
Otherwise, such a statement would just look stupid.
Its not just the Japanese who live longer than us. Almost every decent country in the world has longer life spans than the US. Canada, Britain, Germany, etc…. Why can’t you right-wingers accept the fact that our system produces worse RESULTS than other systems.
Why can’t you left-wingers compare apples to apples? Oh, because it makes a mockery of your beliefs.
The US has lower results in absolute terms because of the inputs that we include that other countries don’t (among other things). Infant mortality (already mentioned) is one of the easiest examples, but that we manage to save more such infants actually REDUCES our average life expectancy, since people who survive such early births and other birth traumas have noticeably lower life expectancy (due to many factors).
Many other areas are similar. The US system is not only the best in the world is several areas and among the best in the world in almost all others, it also funds most of the medical R&D in the world (especially in the area of drugs, where the rest of the world almost completely freeloads on us).
Mostly because it doesn’t. You have governments self reporting on statics (see official unemployment rate or budget proposals for examples). But more importantly, why do you assume that it is purely medical care that is leading to the higher life expectancies among homogeneous populations in developed counties. I could just as soon make the argument that the socialized medicine is leading to declining birth rates in those countries as well (and have more statistical data to back it up). Why do you hate children, Mike?
Because we’re sophisticated consumers of statistics, and you’re a parrot.
To which system are you referring?
The criminal justice and law enforcement system that has to do with higher murder rates in the US (and premature deaths) and high rates of drug use and addiction (and premature deaths)?
The transportation system that results in tens of thousands of premature deaths?
The immigration system that results in people of varying genetic predispositions to disease that make it to the United States, resulting in a different set of diseases in this country than any other?
The agricultural system in the United States that is so ridiculously productive that we have the only obese poor population in the world?
It has become clear that you do not understand the numbers you are throwing around, because you don’t understand that population survival statistics are derived from more than just the health care delivery and payment systems of a given country.
What part of this are you still not understanding?
Iceland’s life expectancy is second in the world — almost two years ahead of Norway.
Both countries have public provision of health care.
So now are you ready to admit that other factors than the health care system have a significant effect on longevity?
Worth noting as well that Russia has mandatory health insurance with a large public system operating alongside private healthcare providers. Their life expectancy for men is 62 years for men, and 74 years for women — lower than pretty much every other Western country.
If it’s the health care financing system that is making such a difference, Mike, why are Russian men living a full decade less than US men?
Why do you hate Russians?
“The Japanese live to be 82.6 on average versus 78.3 in the US.”
Compare that 82.6 with the average lifespan of people of direct Japanese descent who live in the US, and get back to me – genetics are a significant factor in longevity, and the US pool is VERY mixed (not to mention the influx of migrants of HIGHLY varied health from HIGHLY varied circumstances that gets added to our mix, dragging down the average).
Also, the numbers in Japan are likely to undergo a noticeable revision downward due to the recent discovery of significant numbers of very old people who have actually been dead for years, with their families collecting their pensions. That investigation is ongoing, but the initial results are a bit scary.
In theory, theory and practice are the same, but in practice, they aren’t.
So it is with socialized medicine. In practice, it is never all that good. The very best systems are about as good as the US system for normal and somewhat unusual stuff, but still worse for the really rare stuff, and they still don’t produce near the R&D we do. And the “very best” are pretty rare – most socialized medicine systems SUCK.
And don’t get me started on drug costs – suffice it to say that the rest of the world is freeloading on the US, and that there would be very few new drugs if we weren’t paying for them.
A major difference in US life expectance is African American children: African heritage women have lower birth weight babies. With my first wife (German Irish) we had 3 children: 8 lb 6 oz lbs, 10 lb 2oz and 9 lb 4 oz. With my second wife, (African/Amerind/White) we had two children, 6 lb and 6 lb 7 oz.
Smaller birth weight babies have, sadly, higher infant mortality.
All covered by blue cross. Genes have a lot to do with life expectancy. So does diet. Proper studies would control for those.
My tale of woe in the Canadian healthcare system: my brother had his hernia operation postponed several times, eventually had it, developed blood clots, took blood thinners, commenced bleeding like the proverbial stuck pig.
“Its hemorrhoids”, overworked and incompetent clinic doctor said (he couldn’t find a family doctor, which is quite common in Canada).
“Doesn’t feel like hemorrhoids”, he said, continuing to bleed.
“Trust me”, said Dr. Dumb.
“Ow!”, said bro.
Finally, three months later, he is diagnosed with colon cancer. By the time he began treatment for that, it had digressed down a Stage.
That’s bad enough (he’s doing OK on chemo, all things considered, thanks).
He finally found a new doctor, but in order to ensure that he isn’t “queue jumping”, he has to jump through hoops to disentangle himself from the incompetent doctor. You know the one who may have killed him? He just can’t start being a patient without the government dotting every i and crossing every t. Can’t have a cancer patient jumping in front of a hypochondriac!
Nice, huh?
You are a racist bigot.
And you’re a stinky doo doo head.
Next?
I’m Canadian and live in a city with a major university and pediatric research hospital. Several months ago my 2 year developed breathing difficulties, sending us to the ER. We were seen quickly, my daughter was accurately assessed and admitted and recovered in a couple of days. The hospital also set up a prompt follow-up check with an asthma clinic. I can find no complaint in that experience and was grateful that I didn’t have to worry about dealing with an insurance company.
That said, my mother does wait months on end for appointments with specialists and it is really difficult to find a family doctor accepting new patients. My usual take on this debate is that the American medical system has a higher ceiling, but also potentially a lower floor if you don’t have insurance or the financial wherewithal to pay the bills. Perhaps I’ve been swayed by the occasional horror stories about the treatment of the uninsured that occasionally make the airwaves up here.
Guys, you are wasting your time with Mike – his mental capacity can only handle what fits on a bumper sticker.
I’m Canadian, and have some experience with the healthcare system. It’s great for one thing — if you have a major accident or sudden illness, you won’t end up hundreds of thousands dollars in debt. Otherwise, though, it’s very poor.
My wife had tendon problems in her left hand. They scheduled surgery “six to eight months from now,” never mind that she could barely move her fingers. They did the surgery just three months later because she went back with a completely frozen hand and tears in her eyes.
Our family doctor? Got him via connections and favor swapping. Otherwise couldn’t get one despite trying for years.
My 35-year anniversary health check? Had to go to a private clinic and spend the money. Public system doctors don’t have time for you if you’re not actually sick.
A friend of mine spent several hours with abdominal pains lying on a gurney in a corridor of the ER, and his mother was a nurse on staff! He finally got some medical attention when he decided to start screaming himself hoarse. Morphine arrived quickly after that.
On the positive side, though, the births of my sister-in-law’s two sons went well, was pleasant, and didn’t cost an extra dime (beyond what we all pay in taxes).
Well, that “hundreds of thousands dollars” has to come from somewhere, whether its socialized, or not, i.e. one individual paying for himself, or all taxpayers paying for the individual. So the real question is: Does the government do it cheaper than it can be done privately? (assuming quality as a constant). I have yet to see a documented case where that occurs.
But this leads to another question: Why am I responsible for the debt obligation of another individual? What is wrong with them structuring their remaining life to pay for the debt that they accumulated, or go into bankruptcy and rebuild from there? If this debt had been made via a bad business investment or other bad choice, would the government then be inclined to nationalize that industry as well?
But I definite understand government health systems. I once traded a Zippo lighter for my yearly health exam, while I was in China, and I will say that it was far more efficient than anything I could do in America.
My family has had experiences with both systems. My grandfather, a Canadian, was diagnosed with cancer. Under cost/benefit and age analysis, the Canadian system refused to treat. He went to Minnesota for treatment.
My sister is a professor in England in the medical school. Routinely, she has been able to jump the queue and have treatment right away as a matter of professional courtesy. Others wait weeks to get their appointments. This is a big deal when you need to see a specialist.
Status is the new currency of any socialized system. There will always be winners and losers in any human system. The only thing that changes is the payment metric.
You’ll only end up in debt if you are one of the 8% of us citizens without insurance; many of whom are young people that choose not to purchase it. And anyone should be allowed not to purchase health insurance. Those horror stories are often people that choose to live unhealthly lives and then are shocked an insurance company won’t pick up the lung cancer tab for a life long smoker. Or a company not insuring a fat idiot with ‘diabeeetus’.
I am a Canadian who grew up and raised three sons in Canada, moving to the U.S. a bit over five years ago. I have a great example of the difference between the U.S. and Canadian systems. One of my sons needed to have a consult with a neurologist. We had to wait one whole year for the appointment. You didn’t miss-read that, from the time that the referral was made by our GP until the appointment occurred was one entire year, and we lived in a major urban center.
I’m a dual Canadian-American living in the states, but most of my family still lives in Toronto, so I have a fair bit of experience with both systems. The two biggest differences I’ve noticed are 1) that the Canadian system has more shortages, and 2) that the American system has more paperwork and administrative hassles for the consumer.
In general, my family and I have had great care in Canada. Every major emergency (heart attack, collapsed lung, broken hip, etc.) was dealt with quickly and competently. Serious but non-life-threatening conditions were also treated well (for example, when mother needed a knee replacement, she got it in a couple months and had great physiotherapy as well). But these were always in Toronto or Hamilton, where there are good hospitals. I don’t know what would have happened in Quebec or in a small town.
Where Canadian care breaks down in my experience is when you have something that doesn’t appear serious at first glance. That’s when you end up waiting forever to see a specialist or just can’t get a certain type of service. For example, I partially tore my patellar tendon in 1995. I got to see a specialist fairly quickly, and had excellent physiotherapy for a couple years, but my follow-up examinations weren’t goof, I was never able to get an MRI done, and now I’m finally going to have surgery on the knee next month.
That was a pretty minor problem, and overall my family’s been lucky, never having anything serious get over-looked. In fact, personally, I can’t say I’ve noticed much of a difference between the quality of care in Toronto and that in the US.
But that gets to what I think is the heart of the difference between the Canadian and the American system. When the Canadian system is working, it’s as good or almost as good as the US system. But when it breaks down, you just can’t get treatment in a timely manner. In the American system, on the other hand, the flaws are always in your face. Even when the system is working perfectly, everyone has to deal with massive amounts of paperwork and inefficient insurance/benefits providers, and the need to keep looking into what exactly one’s insurance covers serves as a constant reminder that those with bad or no insurance may not receive adequate levels of care. In Canada, the health-care system seems great until something very bad happens, in the US, every visit to the doctor reminds you that things could be better.
Well, I guys are entitled to your opinions. Keep living in your Sara Palin dreamland. Enjoy looking up to the healthier and taller Europeans as you age.
http://www.washingtonpost.com/wp-dyn/content/article/2007/08/12/AR2007081200809.html
Most of the people who will be looking up at your European ubermenschen, will be Democratic constituents.
From your article:
“The difference cannot be explained simply by the fact that Europeans became more prosperous, Komlos said. The United States continues to lead the world in per capita income, but the richest Americans are still shorter than the richest Europeans, he noted.”
Unless you are prepared to argue that the richest Americans are without healthcare, your argument is useless.
OK, how exactly is height correlated to health care? Cause earlier you were touting the Japanese system. Might also notice that given proper nutrition, a homogeneous European population might be genetically inclined to be taller, and that in a post-world war world that Europeans did not have access to the proper nutritional diet. Of course, then you would have to thank globalization for the trend. And who wants to do that?
I am a physician, have close friends who are practicing physicians in Canada, and have seen up close and first hand the “wonderful” healthcare available there in a few different settings.
Rather than relate an endless stream of personal anecdotes involving people waiting for hours/days in emergency rooms, waiting months for cancer treatment or diagnosis, or waiting 6-12 months to see various specialty physicians, I can summarize my experiences in two sentences:
The quality of the Canadian care itself is generally fine, IF YOU CAN GET IT!
Like socialized medicine everywhere, the demand for healthcare in Canada exceeds the supply. So the system works wonderfully if you’re politically or personally connected and can jump in front of the line.
Otherwise, its “get in the back of the line and wait”.
Charlie,
An Aleister Crowley fan?
Political favoritism isn’t a bug, it’s a feature.
I realize this won’t penetrate mikey, but this study does a decent job at outlining the main factors that contribute to the decrease in life expectancy in the U.S.:
http://www.physorg.com/news188542126.html
“A new study led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington estimates that smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the U.S. by 4.9 years in men and 4.1 years in women. It is the first study to look at the effects of those four preventable risk factors on life expectancy in the whole nation.”
That anon post was mine, sorry.
I’m a dual US-Canadian citizen living in Quebec for over 20 years. I’m afraid to tell you that the present situation has the disadvantages of both systems. Quebec already has a two-tier (I.e. optional pay for your care system) that’s rapidly taking over. It’s virtually the only way to get a pediatrician, for example.
This is the result of the decision by the Supreme Court (Chaoulli decision) that the unreasonable waits made the prohibition against private-pay illegal.
So we have both the astronomical taxes to cover socialized medicine; and you actually need a doctor, have to pay privately.
I submit that increased life expectancy rates in relation to quality or access to healthcare is only part of the story. I am medical biller for a hospital and over and over again I see bills for diabetic patients taken to the ER …who were drunk. If you have diabetes, drinking is one of the worst things you can do. My office has 4 people in it who are diabetic but they are not doing a good job of taking care of it by the constant snacking on junk food and candy. The overweight folks in our office also constantly snack on junk and they go for a walk most days at a snails pace. When we have a pot luck the emphasis is on desserts and light on fruits or even a decent main dish that isn’t full of fat. All of the people in our office have good health insurance and go to the doctor often, but it does little good if they don’t follow doctor’s advice. This is what is wrong with comparing apples and oranges. Limited access to timely healthcare (apples) kills but so does not following basic health practices (oranges) such as limiting alcohol consumption, controlling your diet, exercising and taking medicines as prescribed regardless of whether your are diabetic or not. Lots of people talk about taking steps on their own to better their health but from what I can see, its more talk than action. So when talking about longevity, you have to ask also, how many people would have lived longer if they had just followed some of these basic healthy habits?