perfidy

Do you really think socializing medicine is the answer? I suggest you look into the shortcomings of the military medical care (including the VA), which is already under that model. I've known two Canadian medical students, both itching to go south because Canadian doctors don't get paid squat under their system.

Yes I think socializing medicine is the answer. Did you read the post? You cannot compare the military medicine system to the civilian one. The military views veteran care as a cost that needs to be controlled, no matter what. Vets shouldn't be subject to a system that desperately wants to pay billions to get a new cannon that nobody wants or needs, but can't seem to find a few hundred billion to pay for health care for its retirees.

Hurray! You found two Canadians who would go south for money! Can't say I disagree. I am, after all, a Canadian who has gone south for money too.

Here's the bottom line. Look at the spending differential. Raise the Canadian spending up to US levels, and you have a whole bunch of extremely wealthy physicians up there; probably more so than here in the US. The Canadian system operates on a different principle: Society figures out what it wants to spend on health care and metes it out according to efficacy and need.

A system that spends almost DOUBLE and provides CRAPPY SERVICE is a broken system.

Let me repeat: Socializing medicine IS the answer. It works. And you, as a participating citizen, gain a wonderful new freedom -- you're not tied to your employer, and terrified of a new, catastrophic health issue in your life. You're covered.

Canadian doctors are no better or worse than the US. A huge part of the difference in cost is malpractice insurance. Screw up in Canada, and it's 'oh well', whereas in the US doctors have to cover their butts from ridiculously high lawsuit awards. Controlling jury judgements will do a lot to bring costs down. As for the military medical system, *every* form tries to control costs. Canada does it by limiting the amount of care you can get. In the US, if you want it and can pay for it, you can get it.
I guess I need you to define 'crappy service'. If you mean quality of care, you're wrong. If you mean coverage of everyone, well, that's the way the system works. I pay enough taxes already without the government thinking I need to kick in even more to further support the welfare state. Europe works that way, and thousands died during a summer heat wave.

Screw up in Canada, and it's "oh well, lose your license to practice medecine". Seems like the right approach to me.

Medical malpractice insurance pays out around $1 for every $4 they take in. There are _massive_ profits being generated in this area. Controlling jury awards can therefore only alter this portion of costs by around 25%, and malpractice insurance is probably a low double-digit expense overall (will have to ask doctor friends about that).

The bottom line is this: The US system is an incredibly expensive way to deliver good quality care to a very small number of people. Most people in this country put up with substandard plans, and a very large minority has no health plan at all. Oops, I forgot...WE PICK UP THE TAB FOR THEM. If there lives are in danger, or at the last minute, the US taxpayer picks up the tab.

So it gets payed for anyway.

You fail to refute my essential argument. If Canada (or any other nationalized health plan) were to DOUBLE the amount of money put into it, service would vastly exceed that provided in the US. Service in Canada is already pretty damn good, when it comes to real problems. You want elective surgery, go somewhere else.

I think the point of the original article is something that you're not agreeing with, or not understanding. It's that universal coverage is CHEAPER, for the same level of service. In other words, we could have a complete universal health care system for LESS than the current federal expenditures. How can this be? Simple -- the current system is penny saved, pound foolish. It forgoes cheap up-front care, in favor of catastrophic saves...if this kind of care were done, dramatic cost reductions are possible.

And as evidenced by the statistics from other countries, it seems to be a real solution.

You can't possibly talk about "limiting the amount of care" in Canada without mentioning that there are dramatically more people in the US who don't get care. Drawing an arbitrary line between those who have health insurance and those who don't doesn't make any sense. Those who don't have health insurance still PAY FOR IT, for other people, through their taxes.

Thousands died in an unusual heat wave in France this summer because they didn't have air conditioners, and the weather was incredibly, never-seen-before hot. No american health plan would have paid for an air conditioner. And in France, there weren't enough air conditioners to be had; they'd never needed them before.

Of course, thousands of people die from lack of medical care in this country all the time, but nobody cares about them -- they don't have insurance.

So here are a few questions:

1. Do you believe universal coverage is a good thing?
2. How can the current private system raise coverage rates?
3. How can significant cost reductions happen in the current system?

I think we just disagree on the most fundamental level.

As for question 1: No, I don't think universal coverage is good. Any time the government is in my life more than absolutely necessary is bad.

2: I think (hope) that the current rates are nearly topped out right now. There is already pressure on private HMO's to reduce costs and rates. I've worked in the field some, and I can tell you that there is a real push to provide 'prevention' medical services and not just catastrophic saves.

3. One of the biggest rackets I've seen among current doctors are the ones who invest in the latest and greatest technology, and then recoup their investments by using it even when cheaper and older technology would do. There are also pressures to end this kind of activity. How to stop that? I don't know, because someone investing money in technology shouldn't be penalized, but who draws the line? Once again, I don't want the government to be that involved.

Lasic eye surgery is the perfect example. Right now everyone and his brother is offering it, and new advances come along constantly. Prices are coming down slowly because of the competition, but not as much as they would if doctors were still using older equipment and techniques.

Although costs are high in the current system, those costs are being paid by those who can afford it. Your point is that we could cut costs and provide 'free' care to everyone, and that's where I disagree.

I find it a little amazing that you don't think that health care isn't a good thing, all around. Given that you feel universal health care is bad, would you care to describe the criteria you think should be used to determine who gets health care and who doesn't?

You are kidding yourself if you think rates are topping out. Today is the start of a giant sucking sound. The sound you hear is the intergenerational theft of wealth, as the seniors of this country vote themselves an unbelievably expensive new health benefit, to be paid for by young, struggling poor folks.

The high tech racket is exactly right -- why does it cost $10,000 a day to put someone in a hospital bed? Why do we administer drugs that cost $25,000 a dose? Because there is no control mechanism in our health situation that makes global decisions. In any individual case, it makes sense to spend anything, do everything that you possibly can. Spending controls can only be implemented when society as a whole is making the decisions, so that we are not favoring one group over another with public dollars.

Today's drug plan does exactly that. It dramatically favors seniors at the expense of younger people. A young person can be dying, needing a prescription drug that they cannot afford, and this government will tell that young person to go to hell. On the other hand, they'll hand-deliver thousands of dollars of medication to a senior who's on their death bed, sitting inside of a house worth a half a million dollars.

It boggles the mind.

Nice little twist there, saying I don't think health care is a good thing. The criteria you want is what I've stated all along, you get what you can pay for. Of course, in today's society, nobody gets turned away anyways for emergency care.

As for "public dollars", there is no such thing. Those are my dollars that are taken from me through taxation by the government, and you think the government should take more of my money that I earn, and I think they already take enough if not too much. Fundamental difference.

The only boggle is why you bother living in the US when Europe beckons.

I like the US. I think I pay too much in taxes, too. Therefore I want to see the money used _efficiently_, if I'm going to have to pay. The current medical system is inefficient, period. The original entry on this thread noted that studies have shown that it is _cheaper_ to provide comprehensive health care, than to provide emergency health care. That makes a ton of sense -- nip the problems in the bud, and you don't need to deliver ultra-expensive emergency care.

Comprehensive health care costs LESS than emergency-only care. That's the bottom line. This will _save_ tax dollars.

That being said, I've read enough of your site to know that you're a guy who's been through the wringer of the medical system. We all need to draw on our personal experiences, both in the government/military health care system and in private health care system, to form our opinions.