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 v pxgt ubvmsb cc buffalo edu daniel b case writes gld cunixb cc columbia edu gary l dare writes okay but do doctors willingly testify against each other in malpractice cases when they do go to court obviously absolutely essential to prove malpractice it used to be impossible to get doctors here to do that a possible advantage of the us system you won t hear about from the ama our doctors monopoly is exactly the same as in the u s if not more powerful now that they can dictate insurance payment rates but i don t know an answer to this one anecdotally my friends who are md s including my main buds from high school talk about how hard it is to turn state s witness against someone else no direct experience there though also in some circumstances you may have to sue the insurance plan people here after all sue health insurance companies all the time i heard about a guy in alberta who came down with some rare eye disease that he had to take repeated trips to seattle to get treated it cost him and his family something like and the province years later still has only reimbursed them for or so well what american private insurance plans cover travel expenses since our public insurance plans are publicly accountable one can raise a stink in the media to try and extort benefits beyond which one is entitled hey not alberta s fault that he lives there if he lived in cheyenne wy his private insurance would ve told him to go to hell for the travel expenses and that s that an hmo would have just kept quiet and let him go blind well yeah tell us about the national defense medical centre outside ottawa 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 my point was that something that should necessarily remain unpoliticized has become very politicized to the detriment of its mission i don t think that this has been shown with the dmc 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 but to what extent does it affect the system and why is an urgent care list necessary in the first place it s worth thinking about it s regular practice in a hospital to figure out who needs to get at what facilities don t americans have to arrange in advance for operations too i think that there are two standards being applied here and that canada can t give beverly hills style treatment to everybody it s not a big brother list it s more like calling around town for a table for dinner yeah but private nonprofit foundations have to make money somehow especially in the hospital business yes and the tories in ottawa are trying to make them do that rather than hope for a bigger grant from the feds and their province the next time around whether it s using mop a couple of weeks longer or even selling services to americans remember our system is cash based and since our health care infrastructure is overbuilt except in specialties that require larger populations to generate business why not the alternative is closing unused wards business whether canadians would be thrilled at the prospect of their own health services catering toward americans who would be willing to pay more than they do is another issue entirely it must be noted that they said they were doing it partly because their grants from the province were getting smaller if those grants are so insubstantial why the need to attract foreigners to make up the difference you answered the question yourself private nonprofit foundations have to make money somehow and i think that it s about time that they acted like the private hospitals that they are personally i m fed up with canadian socialists trying to tell everyone that their health care is free when we are actually buying insurance that s one at you bob rae 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 but don t the us figures include dentistry and optometry where the canadian one until recently anyway didn t since we have always been evaluated in an oecd style i don t see how remember oecd counts both private and public funds and in canada like france and germany of health care spending is private funds i e not the basic health insurance money 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 well if you spend more than you take in you go bankrupt it s that simple if the provincial insurance systems find themselves paying out more than they get in revenue they won t be able to pay for everybody s primary care yes the infrastructure will be there but will everybody be able to continue using it at the same rate minor copayments can flush out abusers remember that our system is only an insurance policy but our costs aren t rising fast enough to ensure adequate copayments deductibles last year quebec s user fee proposal came out with the number of as the necessary hike that could be done through a copayment rather than give the qma a raise and it s not contract time yet as far as i can tell from upi clarinet even the new reform party a breakoff of traditionalists from the conservatives with a mildly libertarian faction holds our public health insurance as an untouchable but that just a few people have to be reminded that it s not free the average canadian european is more fiscally naive than their american counterparts on issues like these but no mention of copayments anywhere to be seen but cutting public spending all over the place and bringing back the death penalty with little haste if elected i know that for pete s sake i live right on the border i know the canadian system isn t socialized medicine unlike britain s nhs sorry it s just that i even run into people from buffalo and from michigan who don t know the point is that means that if the money runs low in the plan you re out of luck unless you can afford it yourself yeah but there d be a lot of lead time and a health care crisis that would preclude it if provincial governments as bad as some of them are heck we have the ndp cleaning up a spending mess made by the conservatives in saskatchewan embarassing can be so irresponsible there is still reallocation health insurance is so important that it s about the only thing that can inspire open rebellion and violent insurrection outside of the hockey rink right now attempts to get the system and its users to learn good habits are being treated like cod liver oil 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 yeah but eventually it s going to create a kind of two tiered effect that will be noticeable after a while like in britain most americans are fearful of a single tier system seriously there are few areas that have sufficient population for a two more tiered system like what the french have a health policy prof d g shea has cited studies in the nejm that indicate having a population of is necessary for adequate competition and in canada there are only four cities west of the great lakes with that population or larger anyways the numbers show that costs have held steadier than those in the u s and barring any future chernobyl like crisis sudden transients in spending are unlikely in fact the health allocation is one of the most well behaved sectors of spending up north so any talk of bankruptcy is talk radio fodder far away from the border if the provinces hit fiscal rough spots and have to cut back the things private insurers have to offer will seem less and less like luxuries and the gap will be more and more noticeable this won t be overnight and something like this would force canada to have a system more like the french one but that s not a bad thing and the change will be minimal i e add copayments and frustrate the socialists chanting hey it s free gld je me souviens gary l dare gld columbia edu go winnipeg jets go gld cunixc bitnet selanne domi stanley
