re eight myths about national health insurance pt ii v pxgt ubvmsb cc buffalo edu daniel b case writes gld cunixb cc columbia edu gary l dare writes the difference in the litigation environment is reflected in the fees lack of defensive medicine and near absence of malpractice is really why we spend less using the most expensive approach of pure insurance and maybe that s not such a good thing i also read somewhere that it is next to impossible in canada to litigate against the health system class action suits are nearly impossible and you can t sue the provincial health officials at all since our doctors are private and the system is just an insurance plan litigation would not involve the insurance fund our lawyers do not work on contingency so that if you were to sue for malpractice then you d better be sure of winning to cover your fees likewise if you were a doctor and subject of a suit it s time to sweat since the provincial wings of the cma are the ones that go to bat when the fee schedule hikes are presented the politically bent doctors were just cackling when they realized the cma would grow in strength rather than diminish especially when unopposed unlike in socialized medicine approaches like britain s national health service oh no don t let the ama know about this they have enough power as it is ask most americans whether they d like the doctors lobby to get more powerful a few weeks ago the president of the canadian ma wrote a letter to the nyt to decry a lobbyist s advert repeating the same old trash this is significant because the ama and the cma are interlinked organizations and he would not have done it without the approval of his ama cronies well yeah tell us about the national defense medical centre outside ottawa theoretically it s limited to service personnel but some studies i ve heard about have suggested that about half the patients there are civilians who not only have connections but aren t urgent at all it serves the same purpose as the bethesda naval hospital since not all hospitals can provide everything maybe they have some stuff that others don t ottawa s population is only a quarter million if you include the surrounding counties the problem is in a system where hospitals annual budgets are approved by the government how do you keep political considerations out of medical decisions i bet that if you re an mp or mpp or good friends with one you re put on any hospital s urgent care list no matter how minor your problem which is ok unless you re someone who gets bumped off the list for some bigshot people of influence will get their way in any system american or european it s the golden rule he who has the gold makes the rules as for annual budgets those are actually annual grants for facilities e g mops pans etc given to hospitals of which most are private nonprofit foundations btw i have no problem with having aggressive for profit hospitals like the french who use our approach but in the paris region they have almost as many people as canada does so their market is much more diverse the rest has to be made up for by billings from patients who use their services wouldn t national health insurance mean that americans who are now fully insured might have to settle for less in canada provincial insurance covers all health costs except dental care eyeglasses prescription drugs ambulance service and private hospital rooms so many canadians do end up buying some private insurance a policy to cover all of these things runs about to a month hmm how much difference would it make in the figure of percentage of gnp spent on health care if dentistry and optometry were included in the accounting maybe canada spends proportionately just as much on health care as we do the gdp figures are combined public and private expenditures for total outlay and are compiled use the same methods by the oecd that yield the figure for the u s so what happens if the health care systems financially collapse how they are collecting premiums and i m an advocate of having copayments like the french do in their system in order to make it look more like the real insurance that it is the private doctors and hospitals will still be there after the insurance hypothically disappears as they were there before it appeared bob rae the second least popular man in ontario warned ontarians a few years ago that if they didn t stop cross border shopping in such huge numbers the services they expect from the province just won t be there in a few years for one thing i think that bob rae is an idiot he didn t say so but i knew he meant the ohip most of ohip comes from separate premiums on your paycheck if you are a player he wants to spend our money on other things than the health insurance our high taxes are high for other spending but health insurance which is separate and optional and it is being spent in a nonpartisan manner by every party ohip is just a health insurance plan it does not provide any kind of health care that is up to you and your private doctors would the private insurers take up the slack they d be under no obligation to of course they could eventually make money again but if what you say is true they d be loathe to do so and out of practice in handling such basic services too some of the companies providing extra insurance are subsidiaries of american companies and their parents provide full insurance down here regardless all firms up north can easily turn on cable tv to see how well the american firms are doing by being involved in basic coverage the private firms are making too much money after having gotten rid of basic coverage they run around patting them selves on the back for their own cooperation in providing extras for those people who deserve it when private insurance realized how much money they d make without the risks involved in basic insurance e g neurosurgery versus deluxe amenities e g having to call granada tv to replace a rental set on the fritz in someone s private hospital room they started to pat themselves on the back for their social responsibility in quebec last spring a consortium of private insurers publicly warned against any thoughts of privatizing routine low cost parts of that province s public health insurance plan again i doubt americans would like giving the insurance companies that much power i half wonder if the canadian health insurers didn t go along with the provinces and the federal government years ago because they knew that there was a good chance of the public system going bust in the long run and then afterwards they could clean up okay this sort of contradicts what i said higher up but it s another possibility they d have an added bonus when arguing against government involvement in their industry as they could then point to its failure instead of just citing theoretical principles i agree they were in a win win situation but right now it seems that they have won bigger when you look at how full their coffers are friends from my sisters mba class were still being flown out for job interviews individually with insurance firms in london on canada s insurance capitol a la hartford along with generous expense privileges this year despite the ongoing post recession blues gld je me souviens gary l dare gld columbia edu go winnipeg jets go gld cunixc bitnet selanne domi stanley
