Great post indeed

and where have you been lately biznology? =)

Funny...this was a headliner in the Toronto Star today...

quote:

Klein: We need more private health Seeks 'third way' - mixing medicare, for-profit projects Alberta premier vows to `push the envelope' on legislation CALGARY - More private health care would be a good thing for his province, Alberta Premier Ralph Klein says. Klein yesterday pledged to "push the envelope" of the Canada Health Act, with Alberta prepared to increase private care as it looks at a medicare overhaul. Speaking to reporters after a speech to the Canadian Club, the premier said people being able to spend their own money on health is "not evil." Klein has made it clear in recent months that he is willing to go his own way on the issue of medicare. Last September he walked out of a meeting provincial premiers had with Prime Minister Paul Martin before an agreement was reached on new funding. At the time, the federal government promised to fix medicare "for a generation." But Klein, who is in Toronto today and Montreal on Friday, continues to irritate the federal Liberals about the delivery of health care. Public Health Minister Carolyn Bennett said she's concerned over possible violations of the Canada Health Act, the Toronto Star's Tonda MacCharles reports. "I don't think it's an idle threat at all," she said on her way into a cabinet meeting. "I think that there is an ideology at play that has this idea that the private sector can do things that government can't." Bennett said the government "has a serious role in the accountability of making sure that all Canadians get what they need when they need it, and that people can't pay to get to the front of the line or to a different kind of care, so we will be watching this." Bennett said increased privatization raises troubling questions because "when you are accountable to shareholders who want you to get a profit, you will cut quality corners sometimes." Klein said Alberta is going to pursue "a third way" on health care, something that lies between a fully public system and a totally private one. "Privately delivered health care is neither the evil some people suggest nor is it the solution to all that ails Canada's health-care system," he told about 500 people at the Canadian Club. "It's simply one more option for delivering health-care services." But Klein stopped short of calling for the adoption of a predominantly private scheme like the United States. "We might be accused of a lot of things in Alberta but we're not stupid," he said. "We're not going to take the most expensive health-care system in the world — the American system — where countless people don't get coverage and adopt that model in Alberta. "Forget it. It's not going to happen." Klein has long threatened to violate the five principles of the Canada Health Act — public administration, portability, comprehensiveness, universality and accessibility — in the process of making his province's health-care system more financially sustainable. While insisting Alberta's plan doesn't start with "an assault" on the Act, Klein also made clear that he's prepared to test a federal dispute resolution mechanism on that issue.

Considering they're the only province with a budget surplus in the last 2 years ($8 Billion I believe), they have the luxury of even considering this...
It's just amazing the confusion that goes on when a province actually has a surplus budget lol!

I'd post the source but you'd need to register...

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Originally posted by wolverine16 This is simply the classic liberal vs. conservative ideological debate. In my opinion the government is supposed to be our collective good. We don't hire private militias to protect ourselves, we have a military that is to collectively protect us. We have the government build our roadways throughout the country, educate children and fight fires. We are all supposed to be represented by and own government, it is where we are all supposed to come together as a nation, so it is the most logical entity to pay for such services if needed, especially since it already does in life or death situations. If someone is shot right in front of a hospital and they stumble in looking for help, the hospitial cannot refuse them and the government already pays the health costs if the victim cannot afford it. While I know the conservatives wont agree with me on this any more than I agree with them in most instances, there is one very strange point about the current U.S. healthcare system that simply doesn't make any sense. If someone has a good paying job with an excellent healthcare plan, when they get sick, they pay little out of their own pocket for high quality treatment. How does it make sense that a poor person who cannot afford health insurance can only chose to pay the entire medical cost on their own for low quality care, which ends up being more expensive, or let their illness worsen by not receiving treatment? It's really the most regressive system possble and defies the logic of capitalism, where normally. for example,a rich person pays more money for a better car and a poor person pays less for a less quality automobile. As far as in poor communities, African-American, white or any other ones, the key to changing these numbers is to at least provide healthcare and quality education to children so that they can get out of the cycle of poverty and/or violence. Since many factors exist, these on their own would not solve the problems, but it would provide determined kids the opportunity to reach their fullest potential, gain quality employment and be able to afford quality healthcare on their own to ensure their longevity. I don't have the numbers in front of me,but I beleve the lifespan of all wealthy people,regardless of ethnicity, is far greater.

Examples are a bit flawed in that sure the government pays for roads but only for government highways, normal roads are payed for at the city and state level. More affluent cities do get better treatment due to higher taxes. My boss lives in a neighborhood with 1/10 the population of my city, but their income probably averages around $800,000+ where here it is $250,000. The common folk who are in a more highly populated area who you think would need the roads more are not getting the same treatment.

Also schools can be non government funded. For those with money they can go to private schools therefore getting a higher education than those who can't afford to get into the system.

Guess what I am trying to say is that those with money typically get better service and better treatment.

In a system of poor how do you differentiate between the poor who are poor not by choice or the poor who are poor because of pure laziness or should that matter? The thought that comes into my head is ODB (the rapper) when he picked up food stamps in a limo and when asked why he said "hey it's free money", even though the guy probably made millions on all the Wu Tang albums, clothing lines, etc. He is taking advantage of the system.

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quote:

Originally posted by BadBadNeil Examples are a bit flawed in that sure the government pays for roads but only for government highways, normal roads are payed for at the city and state level. More affluent cities do get better treatment due to higher taxes. My boss lives in a neighborhood with 1/10 the population of my city, but their income probably averages around $800,000+ where here it is $250,000. The common folk who are in a more highly populated area who you think would need the roads more are not getting the same treatment. Also schools can be non government funded. For those with money they can go to private schools therefore getting a higher education than those who can't afford to get into the system. Guess what I am trying to say is that those with money typically get better service and better treatment. In a system of poor how do you differentiate between the poor who are poor not by choice or the poor who are poor because of pure laziness or should that matter? The thought that comes into my head is ODB (the rapper) when he picked up food stamps in a limo and when asked why he said "hey it's free money", even though the guy probably made millions on all the Wu Tang albums, clothing lines, etc. He is taking advantage of the system.

Well yes, local government pays for local roads, but it is nonetheless paid by a type of government, rather than private entity, which was my point, though I see where you're coming from. That is true that people can pay for private schools, but the point is that availability of public school is there for everyone, just as healthcare should be.

There are multiple ways that this could be accomplished: There is the Bill Bradley/John Kerry version where we simply keep the HMO system and add a program like government employees use for those who cannot afford HMOs (though this would not cover 100% of the poor) or there is what the Clintons wanted to do, with creating a national healthcare system that would cover all Americans, among other possible plans. The latter would not see much possibility for fraud, since all Americans would be covered. One thing as far as the ODB example: that kind of relates to Reagan's "welfare queen" myth, that many unqualified people are getting benefits and therefore the system should be done away with to prevent abuse. I went to the emergency room in October and still get forms from my insurance company to protect against insurance fraud, because it goes on right now even with private insurance companies.

I'd be interested to see the details of the plan outlined in Fir3start3r's article, as I think some middle ground would be appropriate and the ability of people to have different choices would be far greater than having simply one program for everyone.

My point is simply this: there are many areas where profit is a good motivator for our society, like developing new technologies, but profit is not a good motivator for dealing with the necessities of living, because then profits compete against people's needs.

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quote:

Originally posted by wolverine16 ...because then profits compete against people's needs.

Vs. Peoples' needs(though it's probably more peoples' wants) competing against other peoples' rights.

A person who wants medicine has no right, IMO, to demand it from a doctor at zero cost. The doctor is under no obligation(other than his own hippocratic oath) to give any of his ability away for free, as that would be a infringement on his own rights. Are we at the point where we're willing to throw away certain peoples' rights because there is a supposed "greater good" that we're working for so we don't have to accept some of the harsh realities of life? What a shitty compromise. Who owns me? I own me. Therefore, I am responsible for me. Not the government, and certainly not the government at the cost of my own precious rights.

Be careful how much government involvement you wish for, as you might get what you ask for, and you might not like the result.

If a person is too poor to pay for cutting edge, overpriced healthcare, then they should check into a clinic. There are alternatives out there.

This discussion should probably broaden out a bit...we seem to be concentrating on North America (again) rather than a wider context imo...

quote:

Originally posted by Shakka Vs. Peoples' needs(though it's probably more peoples' wants) competing against other peoples' rights. A person who wants medicine has no right, IMO, to demand it from a doctor at zero cost. The doctor is under no obligation(other than his own hippocratic oath) to give any of his ability away for free, as that would be a infringement on his own rights. Are we at the point where we're willing to throw away certain peoples' rights because there is a supposed "greater good" that we're working for so we don't have to accept some of the harsh realities of life? What a shitty compromise. Who owns me? I own me. Therefore, I am responsible for me. Not the government, and certainly not the government at the cost of my own precious rights. Be careful how much government involvement you wish for, as you might get what you ask for, and you might not like the result. If a person is too poor to pay for cutting edge, overpriced healthcare, then they should check into a clinic. There are alternatives out there.

So by your standards if someone has a massive heart attack and they can't show proof that they can pay for their ER visit, just let them die? I don't think anyone believes in anything as extreme as you mentioned in your kidney example before in terms of what government should do. It's true clinics do exist, but if you have ever seen one in a very poor neighborhood, I think we could do a little more than that.
I think it's rather hypocritical for neo-cons to argue that we waste too much of THEIR money on the poor, because they should take care of themselves, when neo-cons support massive corporate welfare and record deficits caused largely by military spending and a war that didn't need to happen. Why do we have enough to provide Iraqi people these things and not citizens in our own country? The tax burden of country has shifted more onto the people since WWII, because of corporations that find offshore loopholes and pay nothing. I paid my tax dollars to help build roads and be protected by the police, the same ones Tyco uses, except they don't pay taxes. If someone is a true conservative they cannot support corporate welfare as a general practice, because that goes against the free market system.

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quote:

Originally posted by zig This discussion should probably broaden out a bit...we seem to be concentrating on North America (again) rather than a wider context imo...

I've discussed the U.S. because the original story that started the thread was related to issues here, but yeah, I'd like to hear any perspecitves anyone has. I doubt my long rants will convince any of the conservatives as their will likewise to the liberals, but there's got to be other perspectives that might find some common ground.

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Well from what I have seen many of the poor seem to be those who either have kids too young and can't support them or too many kids and they can't support them, at the same time risking their own education and in turn having no money to save and no education to get a better job and this trend continues down with their kids.

I would like everyone to get equal healthcare, I know I'd want it if I was in down lull where I'd lost healthcare and needed some work. In fact I've been in a time where I had no healthcare, when I had a car accident and it wasn't fun.

At the same time though I think people that make being poor their own problem with a series of naive choices and then look to the government for free handouts is wrong too. If you can't support kids, don't have them. I see way too many kids get forced into early adulthood at their own and their kids expenses, and ultimately our own expenses.

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There are a lot of point to tackle here.

First, I disagree that medicine should not be "for-profit." If you want the best people to become doctors, in light of the cost of medical school and the personal sacrifices they make (hours worked, time away from family), they need to be compensated. If it comes to the point that a doctor makes as much as a factory worker, or someone else that doesn't require 7+ years of schooling (not including undergrad) and racks up such overwhelming debt, you will have a doctor shortage worse than it is now.

Nursing and all other health care staff are in the same boat. From personal experience, I can tell you that health care is not glamorous. Everyday I am surrounded by death, mean patients and family members, horrible smells and sites and chronic fatigue. If you make medicine pay even less than it does now, the shortages of health care workers will only increase.

On top of that, "for-profit" medicine leads to medical advances far faster than a non-profit system could. With companies striving to make the next medical advance or breakthrough in order to make money, we as patients recieve the rewards. Yes, hospitals try to cut costs to make money, but so does every financially sound institution.


I think the heart of the issue is "why is American health care so expensive," and that has several answers.

First is that medicine is a technology field. As technology becomes more advanced, and everyone wants only the "latest and greatest," costs go up, not down. If you want a top of the line computer today, you're going to pay premium prices, if you want a top of the line computer from 5 years ago, you won't. However, when it comes to medicine everyone wants the best, there is no "5 year old" option. We could give everyone cutting-edge 1970's medicine at wonderfully low costs, but people want 2005 medicine.

Second is the amount of people that don't pay for health care and those differed costs. Almost a quarter of my hospitals annual budget is to cover these costs. However, these costs are taken from other patients not some magical slush fund or government aid. Think of it this way, every 2 patients pay for 1 patient that doesn't. So your bill is 50% higher because of people that don't pay. And not all of these people are "poor." Roughly 50% of those uninsured choose not to be. They can afford health insurance, but they choose not to have it. 50% of these uninsured people have incomes in the 6-figures.

Mal-practice is another reason, but it really varies by profession. OB/GYN's are the hardest hit, while other fields aren't quite as bad. However, it is a concern for everyone. If one patient wins millions, it is the other patients that will pay for it. There is no "free money" to the winner, it just comes from all of our pocket books.


Really though, all this debate is pointless. The government has already set the stage for the next big change in medicine. Beginning in two years, medicare/medicaid will begin cutting payments for services by roughly 8% a year. Lawmakers think tort reform will cover the cost, but even if severe tort reform is passed, it will be like putting a band aid on an femoral gusher.

Health care costs will continue to increase to a point at which roughly 50% of Americans are uninsured and the government will be forced into socialization. At this point you will see a major stratification in health care. The majority of hospitals will be public, and whatever health care system is in place will pay for these "free" hospitals. At these hospitals, waiting times will be extreme, the staff will be underpaid, over-worked and the least proficient. The level of care will be much lower than what we find today.

On the other side of the coin, you will see "for profit" hospitals that cater to subscribers. Here you will find the best paid, most proficient staff and the shortest waiting times. The level of care will be what it is today for everyone, if not higher.

So, eventually we will have a socialized medical system, it is almost unavoidable, but the costs it will have medically on most will be severe. The most affluent may get the best care today, although I would debate that is at the same level as everyone else, but that will not change in the future. What will change is that while everyone has the best medical care available today, that will not be the case under socialized medicine in the US.


I've said it before, but it's simply the business model. You can have low cost, accessibility and quality, but only two at the same time. Right now we have accessibility and quality, under the socialized system that seems to be coming, we will have low cost, but instead of sacrificing accessiblity or quality, we will have a lowering of both. So medicine will be "cheap" but waiting times will be long and quality will be lower than it is today.

I would also throw out there that with a government that already has hundereds of thousands of pages of medical guidelines, could turning it completely over to the government make it better? Where has increased beaurocracy and control ever made a situation better?

I wish I could offer a better outlook, but everyone I've talked to comes to the same conclusion.

Since you are into medicine can you answer a question that I don't understand (my girlfriend is a nurse but doesn't work in certain areas).

I went for an MRI. Now the machine cost probably a few million dollars and the technician probably makes about $60K-100K a year but when you factor in that the test takes 15 minutes, is printed on the spot, and there are so many people that have used the device that is has probably been paid for 10 times over, why do they still charge hundreds and hundreds of dollars for something that lasts 15 minutes and requires no professional? I think there are things in healthcare that seem overinflated costs wise and is contributing to the rediculous costs.

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