12-06-2005 15:50									#61
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quote: Originally posted by Oerdin It seems most people have a two tier system. A public system which gives everyone basic coverage then a second for profit system where people with money can pay extra to get more. It fills a demand and improves the system as a whole by lowering wait times and improving patient to staff ratios.

But should the poor be penalized with lower quality health care just because they are poor?

In Canada, everyone has access to high quality health care, regardless of whether their wealth.

There are waiting lines, but those could be significantly reduced if funding was increased. But instead, Conservatives and Liberals prefer to give tax cuts to corporations.

It is all about priorities.

	12-06-2005 19:38									#62
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Health care is already, by far, the single largest expenditure. Throwing more money at the system isn't going to solve the problems.

Secondly, sure everyone may get the same quality of health care, terming that quality of care as high, is not something you are going to find many agreeing with you. Quality health care is performed in a timely fashion, and right now our less than stellar system cannot deliver health care in a timely fashion.

You are very right that it is about priorities. In an effort to deal with costs here in British Columbia, we cut routine eye examinations, which now need to be paid for unless you have a pre existing medical condition. The problem with that is that routine eye examinations, are the best way to keep on top of these medical conditions when they first start to develop. Instead, we devote considerable funds to things that the majority of people do not want to pay for, such as abortion. We have priorities, but our priorities are backwards!

	12-06-2005 20:53									#63
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You call it throwing money, I call it adequate funding.

Look at the eye exams. All that did was shift the cost from the government to the taxpayer, in other words from an indirect cost to a direct cost.

Canada spends half of what the US spends on health care per capita. So there is room to increase spending.

If Canada continues to under-fund its health care, then it is not surprising that people will complain about the quality.

And yes, universal health care means your tax dollars are going to be spend on things that you don't like. The woman who has perfect eye sight has no need for routine eye exams, and for her, routine eye exams are a waste of money. But it all balances out in the end.

	12-06-2005 23:23									#64
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quote: Look at the eye exams. All that did was shift the cost from the government to the taxpayer, in other words from an indirect cost to a direct cost.

A cost to the government is a cost to the taxpayer. WTF are you smoking?

	12-06-2005 23:36									#65
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quote: Canada spends half of what the US spends on health care per capita. So there is room to increase spending.

Yes, but that's because Americans are permitted to spend their own money rather than having the government spend it for them.

The american government spends about as much per capita as the canadian government. If Canadians were permitted to spend their own money I am sure they would spend about as much as Americans do.

quote: And yes, universal health care means your tax dollars are going to be spend on things that you don't like. The woman who has perfect eye sight has no need for routine eye exams, and for her, routine eye exams are a waste of money. But it all balances out in the end.

Just because your eyes are perfect now, does not mean they will remain so. Routine eye exams may usually be unnecessary, but they are invaluable when they catch eye problems before they become more advanced. No different from mammograms in that regard.

As for abortion, what medical benefit does it provide the women? Why should abortion be considered part of 'universal medical coverage'? Most folks in Canada do not believe they should be paying for abortions here in Canada. Even if they agree with abortion, they do not believe they should be the ones paying for them.

	13-06-2005 00:03									#66
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quote: Originally posted by Tingkai But should the poor be penalized with lower quality health care just because they are poor? In Canada, everyone has access to high quality health care, regardless of whether their wealth. There are waiting lines, but those could be significantly reduced if funding was increased. But instead, Conservatives and Liberals prefer to give tax cuts to corporations.

Except the quality isn't necissarially better for the rich. They pay extra to not have to wait in line not because the doctors are superior. The extra money is for convience and maybe better costumer service.

In any event Canada does have to worry about its tax base and remaining competitive with the US and Mexico. Both of those countries have been lowering taxes so Canada's relative costs have been increasing. They either lower those costs or they risk losing businesses south.

	13-06-2005 07:05									#67
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quote: Originally posted by Kuciwalker quote: Look at the eye exams. All that did was shift the cost from the government to the taxpayer, in other words from an indirect cost to a direct cost. A cost to the government is a cost to the taxpayer. WTF are you smoking?

Think about it Kuci, I'm sure you'll eventually get it.

	13-06-2005 07:38									#68
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quote: Originally posted by Ben Kenobi Yes, but that's because Americans are permitted to spend their own money rather than having the government spend it for them. The american government spends about as much per capita as the canadian government. If Canadians were permitted to spend their own money I am sure they would spend about as much as Americans do.

Americans spends more than Canadians, and yet they receive about the same quality of healthcare, if not less, because a large chunk of the extra spending is swallowed up by medical insurance bureaucracy.

A two-tiered system means that Canadians would pay more without receiving any additional benefits.

quote: Originally posted by Ben Kenobi Routine eye exams may usually be unnecessary, but they are invaluable when they catch eye problems before they become more advanced. No different from mammograms in that regard.

You're overstating the case. No one dies from not having an eye exam, while mammograms deal with cancer.

IIRC, you wear glasses. So you think the government should pay for eye exams, but you're opposed to medicare.

Sounds like you want medicare to cover your problems while denying benefits to solve other people's problems.

quote: Originally posted by Ben Kenobi As for abortion, what medical benefit does it provide the women? Why should abortion be considered part of 'universal medical coverage'? Most folks in Canada do not believe they should be paying for abortions here in Canada. Even if they agree with abortion, they do not believe they should be the ones paying for them.

I can't recall any surveys done about whether abortions should be covered by medicare. Can you provide any links?

There are numerous situations where abortion provide a medical benefit, where pregnancy puts a woman's life at risk, or effects her mental health.


Why should abortion be considered part of 'universal medical coverage'? Oh, I don't know, maybe because it is a medical procedure.

	13-06-2005 07:40									#69
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quote: Originally posted by Tingkai You call it throwing money, I call it adequate funding. Look at the eye exams. All that did was shift the cost from the government to the taxpayer, in other words from an indirect cost to a direct cost. Canada spends half of what the US spends on health care per capita. So there is room to increase spending. If Canada continues to under-fund its health care, then it is not surprising that people will complain about the quality. And yes, universal health care means your tax dollars are going to be spend on things that you don't like. The woman who has perfect eye sight has no need for routine eye exams, and for her, routine eye exams are a waste of money. But it all balances out in the end.

It's a nice trick to use the US as the measuring rod.

Last time I looked, we were third in per capita spending among G7 nations. Germany was slightly ahead of us. The US was way ahead of everyone.

The problem is not funds. The problem is the results we are getting, or not, from the funds we are already spending.

The public only system has had a very good chance to prove it's worth. People waiting a year for a hip replacement is proof that it is failed.

	13-06-2005 08:09									#70
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quote: Originally posted by notyoueither It's a nice trick to use the US as the measuring rod. Last time I looked, we were third in per capita spending among G7 nations. Germany was slightly ahead of us. The US was way ahead of everyone.

As a percentage of GDP, Canada spends 1 percentage point more than the OECD average (9.9% compared to OECD average of 8.6%), but less than U.S. (15%), Germany and Switzerland (11%), Iceland, Norway and France (10.1% - 10.5%)

In terms of per capita spending:
U.S. $5,635
Norway and Swizerland $3,800
Canada $3,003
OECD average 2,307

http://64.233.179.104/search?q=cach...es+france&hl=en[/url]


Slightly older data:
http://www.oecd.org/dataoecd/5/25/2465559.pdf

	13-06-2005 08:12									#71
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quote: Originally posted by Oerdin In any event Canada does have to worry about its tax base and remaining competitive with the US and Mexico. Both of those countries have been lowering taxes so Canada's relative costs have been increasing. They either lower those costs or they risk losing businesses south.

Our lower health care costs gives Canada a competitive edge over the U.S. Private health insurance is like a tax in the U.S. Canada has no need to lower its health care spending just to remain competitive. Instead, Canada has room to expand spending.

	13-06-2005 08:30									#72
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quote: Originally posted by Tingkai As a percentage of GDP, Canada spends 1 percentage point more than the OECD average (9.9% compared to OECD average of 8.6%), but less than U.S. (15%), Germany and Switzerland (11%), Iceland, Norway and France (10.1% - 10.5%) In terms of per capita spending: U.S. $5,635 Norway and Swizerland $3,800 Canada $3,003 OECD average 2,307 http://64.233.179.104/search?q=cach...es+france&hl=en[/url] Slightly older data: http://www.oecd.org/dataoecd/5/25/2465559.pdf

As a percent of GDP... so what?

Your first link is broken, and the first chart of the second link confirms what I already said. The US dwarfs everyone, and only Germany of other G7 nations is ahead of us in per capita spending (by $1).

The US $4165
Switzerland $2853
Germany $2361
Canada $2360
Luxembourg $2246
etc...

Do you think it is reasonable to spend more per person than every other nation on Earth (save three) and have to wait a year in agony for a basic procedure that can easily be done in a private setting?

	13-06-2005 08:34									#73
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quote: Originally posted by Tingkai Our lower health care costs gives Canada a competitive edge over the U.S. Private health insurance is like a tax in the U.S. Canada has no need to lower its health care spending just to remain competitive. Instead, Canada has room to expand spending.

We gain a competitive edge by our rich people going to US institutions for prompt care, and thereby exporting cash from our economy?

	13-06-2005 08:54									#74
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quote: Originally posted by notyoueither As a percent of GDP... so what? Your first link is broken,

Try this link:
www.oecd.org/dataoecd/16/9/34969633.pdf

GDP percentage is the best measure because it reflects what a country can afford to spend and it reflects the difference in costs. Doctors in a rich country will tend to be paid more than those in a poor country.

quote: Originally posted by notyoueither Do you think it is reasonable to spend more per person than every other nation on Earth (save three) and have to wait a year in agony for a basic procedure that can easily be done in a private setting?

Either people will pay through taxes for better medicare, or those who can afford it will pay more for private health care.

Either way, it will cost money to eliminate waiting lists.

But applying the private healthcare solution will only benefit those who can afford it. The average family raising kids doesn't have the spare income to pay for private medical care.

There's also the cost that allowing private medical services creates, the unnecessary overhead.

Increasing public health care benefits all, at a lower cost than private health care.

	13-06-2005 09:05									#75
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Tingkai, you are ignoring France, Sweden, The Netherlands, etc., etc... where private and public coexist, people have longer life expectancies, and the total costs are lower than we are currently paying.

Part of the problem, I feel, is the public is better mantra.

Public is not better when it comes to controlling costs. Accountability gets shot all to hell when results are filtered through the lens of our public service unions and then the governments of the day.

Competition, while a dirty word for some, is also a way of keeping costs down as measured by inputs vs outputs. What we have now is the worst of all possible worlds. A government run monopoly where the monopoly is enforced not by economics, but by divine writ.

	13-06-2005 09:22									#76
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quote: Originally posted by notyoueither Public is not better when it comes to controlling costs.

And yet, all the studies show that the U.S. spends far more on health care administration than Canada.

So the public system is more efficient.

As for comparing costs with European countries, Canada and the U.S. will always have higher costs because of the need to provide health care to people in rural areas. How much of a factor this is, I don't know, but it is a cost factor.

And if we use life expectancy as a measure, Canadians are better off than in most countries.

	13-06-2005 09:32									#77
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Sweden has relatively large rural areas, and if we use life expectancy as a measure we are not better off, and we spend more while getting less.

You seem to want to play fast and loose with comparisons. For comparisons of costs you admit only the US. For comparison of overall health, you want to introduce Thailand.

Not very honest of you, is it?

	13-06-2005 09:44									#78
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quote: Originally posted by notyoueither Sweden has relatively large rural areas, and if we use life expectancy as a measure we are not better off, and we spend more while getting less. You seem to want to play fast and loose with comparisons. For comparisons of costs you admit only the US. For comparison of overall health, you want to introduce Thailand. Not very honest of you, is it?

You're the one comparing apples to oranges. So not very honest of you, eh.

Population density, people per square kilometre

Canada 3.1
Sweden 19.7
Netherlands 390
UK 244

	13-06-2005 09:47									#79
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Yes but, what percentage of our population lives within 200 miles of the US border?

Using a density number that includes 3 people living in a thousand square miles of the arctic isn't very honest, eh? Do you think we spend 300 times as much per person on them?

The vast majority of our dollars are spent on the vast majority of our people, those who live in the major cities.

	13-06-2005 09:48									#80
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quote: Originally posted by Tingkai But should the poor be penalized with lower quality health care just because they are poor? In Canada, everyone has access to high quality health care, regardless of whether their wealth. There are waiting lines, but those could be significantly reduced if funding was increased. But instead, Conservatives and Liberals prefer to give tax cuts to corporations. It is all about priorities.

Nobody is saying ( as yet , at least ) that the public system should be dismantled .

Thus , the poor are not penalised , only that the rich are rewarded - and they pay for it . It's like the computers market - in the beginning , all computing equipemnt which is on the cutting edge is very powerful and very expensive . But as initial costs are recovered ( from the rich , I may add ) , the same technology grows cheaper and is finally affordable and soon becomes the standard .

Finally , it ends up like this - A new medical tech is developed , but in a private hospital . For the first few years , only the very rich can afford it , because it's new and cost a lot , and is still a prototype without much refinement . The rich pay the initial costs anyway . Soon , it becomes more popular , and slowly percolates down into the public system , where it is accessible to everyone .

The point is , the rich still subsidise the initial costs of developement , because they are the first benificiaries , and the others , who want to freeload off the rich , still get the treatment , at a lower cost , later .

Of course , such a system is unviable in the long run ( as are almost all types of coercive statist wealth and services redistribution schemes ) , but it's good to go for a long time - Canada is a wealthy country after all .

I say again - it does not penalise the poor , it rewards the rich , but they pay for it , and the ultimate cost to the poor comes out to be less , because the rich have borne the initial costs .

	13-06-2005 10:59									#81
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quote: Originally posted by notyoueither Yes but, what percentage of our population lives within 200 miles of the US border? Using a density number that includes 3 people living in a thousand square miles of the arctic isn't very honest, eh? Do you think we spend 300 times as much per person on them?

Sweden's population is also focused on urban centres.

15% of Swedes live in rural areas.
http://www.map21ltd.com/COSTC11/sw-planning.htm
22% of Canadians live in rural areas.

(This is like shooting fish in a barrel)

You seem intent on denying the obvious.

Canada needs to spend more money to provide health care to isolated areas, whether it is a hospital for the 5,000 people in The Pas, Manitoba, or transporting sick people by plane to hospitals where they can get proper care, providing accomodation for parents who accompany their sick children.

You can stick your head in the ground, but you can't deny that these cost exists.

	13-06-2005 11:04									#82
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People who live in rural areas don't deserve medical care.

	13-06-2005 11:14									#83
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quote: Originally posted by Tingkai Sweden's population is also focused on urban centres. 15% of Swedes live in rural areas. http://www.map21ltd.com/COSTC11/sw-planning.htm 22% of Canadians live in rural areas. (This is like shooting fish in a barrel) You seem intent on denying the obvious. Canada needs to spend more money to provide health care to isolated areas, whether it is a hospital for the 5,000 people in The Pas, Manitoba, or transporting sick people by plane to hospitals where they can get proper care, providing accomodation for parents who accompany their sick children. You can stick your head in the ground, but you can't deny that these cost exists.

And they are a small fraction of the total costs.

The big costs are in the hospitals in the major cities, whether people live there or have to travel there.

You can stick your head in the sand and insist that a public only system is the best. You will be in good company among the Cubans and North Koreans.

	13-06-2005 11:42									#84
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Incidently, it sounds very comparable. Except these guys say 80% urban.
http://www.sweden.se/templates/cs/B...et____6048.aspx

quote: Sweden is a large country with a small population (8.9 million). This population is far from evenly distributed, half being concentrated in just 3% of the country's area. Around 1880, when industrialisation was just beginning in Sweden, only some two out of every ten persons lived in urban areas. It then became increasingly difficult for the rural population to support itself in the traditional way in agriculture or forestry. Industrialisation created a demand for labour, and since factories were usually located in urban areas people started to move from the countryside. By 1930, half of Sweden's population was urbanised. Today, eight out of ten live in conurbations* in the south of the country, the largest of which are the capital Stockholm, Göteborg (Gothenburg) and Malmö. The population of the countryside, especially the northern two thirds, is extremely sparse-three inhabitants per square kilometre in Norrbotten, the northernmost county, compared to 253 in Stockholm.

Talk about herring in the pickle barrel, or something.

	13-06-2005 12:18									#85
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quote: You're overstating the case. No one dies from not having an eye exam, while mammograms deal with cancer. IIRC, you wear glasses. So you think the government should pay for eye exams, but you're opposed to medicare. Sounds like you want medicare to cover your problems while denying benefits to solve other people's problems.

Actually I do not believe the government should pay for my hearing aids, and my routine hearing checkups simply because of the costs involved. I don't think it is reasonable to ask the government to pay several thousand dollars for the very small portion of people who cannot hear.

However, eye examinations, are another matter entirely. Up until the last while, they changed the policy to cut eye examinations from medicare in British Columbia, which had up until then, been covered. Yes, people will not die from not having a routine checkup, but to become blind is very catastrophic to the well being of anyone.

quote: I can't recall any surveys done about whether abortions should be covered by medicare. Can you provide any links?

http://www.cbcwatch.ca/?q=node/view/1048

quote: There are numerous situations where abortion provide a medical benefit, where pregnancy puts a woman's life at risk, or effects her mental health.

I wholeheartedly agree with you in the situations where the life of the mother is in danger, however, you must understand that all pregnancies pose some effect on the mental health of the mother. Is abortion then the proper treatment for all pregnancies, just because all pregnancies have an effect on the mental health of the mother?

quote: Why should abortion be considered part of 'universal medical coverage'? Oh, I don't know, maybe because it is a medical procedure.

It is a surgical procedure, an elective surgical procedure. Like other elective procedures it is medically unnecessary, except in cases where the life of the mother is in danger.

	13-06-2005 18:48									#86
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For supporters of "public health":

1) Are other countries coming to Canada to see how we deliver healthcare so they may emulate our system? If so, who?

2) Do we do away with the 2nd tier that exists now (an estimated 30% of total dollars)?

3) How would you improve the current system w/o increasing the private portion that already exists? Is it simply a question of more money?

	15-06-2005 10:06									#87
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http://www.cbc.ca/national/rex/rex_050609.html

quote: The sacred Charter cat is among the holy health care pigeons June 9 2005 The sacred Charter cat is among the holy health care pigeons. The Supreme Court has just done something as radical in this country as any court here has done any time. It has more than nudged the Charter of Rights and Freedoms, a document most dear to this country, towards a collision with the one social policy that many think defines this country, universal medicare. No private health care. On a political front, the Quebec decision may have more impact than the various provincial court decisions on same-sex marriage. Expect the Liberals to leap to the defence of medicare as we know it with the eagerness of the nearly doomed reaching for the life raft. At last, something other than Gomery and Grewal. It's also an interesting decision because this decision, if it's an example of the dreaded judicial activism, always a problematic term, is activism towards the right side of the spectrum. All of those who saw the enlightenment of court leadership on same-sex may have to limber up to find the flexibility to dam the reactionary impulse of this one. But it's what the court has said and what this decision implicitly acknowledges that is the real bundle of explosive here. That the system that Canadians treasure, that has become our litmus and brand as a society, which cares for its members, the health care system has become, in practice, a turmoil, a frustration, and a disappointment on a daily basis for a very long time for just too many Canadians. It has also said that leaving it alone to preserve the purity of it as an idea is not worth the cost of all the inconvenience, anxiety, and sometimes even danger that waiting lists and stretched out appointments and insensitivity to the particular suffering patient or family is not an option. The decision has also called the bluff of the governments that have stalled real reform, done their endless commissions and reports, kept promising from at least Mulroney to Martin to fix what isn't in experience really working and exposed a fair bit of hypocrisy too. That in Quebec already there is so-called private care. That those who can't afford for their health to wait are already being driven to go out of the country, and that the really well off and sometimes the well connected find a way around the lines and the waiting lists. That's not in the decision itself, but it is the open secret of our so much self-lauded system, that it is already broken, worked around or in emergency bypassed. Finally, the initial response from the government that this is just Quebec and that the health care system across Canada is safe is platitude and poppycock. One decision, remember, in Ontario begat same-sex decisions in seven other provinces. The Charter is a bigger idea than the ideology of health care, and the Charter will trump whenever it is raised. This court decision may do what a million royal commissions haven't: force a real fix on the system as it is or open the system up to some mix that will deliver true health care to those people who need it when they need it. I can hear that sacred cat purring. For "The National," I'm Rex Murphy