Canada Trying to Innovate Itself Out of Long Lines
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  • Jim__L

    Any policy that bankrupts the country (through unsupported subsidies, open-ended promises, or the like) has downsides that are too serious to allow.

    • bpuharic

      And what about a financial system that bankrupts the country? Why is healthcare uniquely unqualified in this regard? We just went through the deepest recession in 80 years caused by banking deregulation. No one’s talking about THAT

      • Welcome to our planet! I hope you enjoy your visit. It sounds as though your planet went through some of the same problems as ours, except in our case they were caused more by corrupt political regulation. I hope you stay a while so we can compare and contrast the situations in each of our worlds over a beer or two.

        • bpuharic

          The right wing thinks insults substitute for logic

          No doubt why they lost the last 2 presidential elections.

          He doesn’t DISPUTE what I say. He just doesn’t like that I said it.

          • Of course, it would be impolite to dispute with a visitor from another planet.

          • Anthony

            Good line, insults substitute for logic; may I use it?

          • bpuharic

            Sure. It’s gospel for them…

          • Jeff Jones

            [laugh] I love how you’re specifying ‘presidential’ elections now – because your previous posts didn’t and you were quickly reminded of the painful truth that the presidency is nothing without Capitol Hill and the state governments.

            Obama has refused to reach out to either in any meaningful way and he’s paying for it now. Syria was only the beginning.

          • bpuharic

            Failed to reach out to Capitol Hill? The folks who set a historical record for filibusters? The crowd that’s the most right wing in 60 years?

            That the crowd you’re talking about?

          • cubanbob

            And everyone of those filibusters was done by senators who also won their elections.

          • bpuharic

            Which is why the GOP, which expected to win seats in the last election

            lost them. In them midst of the worst recession in 80 years, the GOP lost senate seats.

            They also lost the house by 1.4 million votes, but gerrymandering and redistricting protected the GOP from being wiped out

          • cubanbob

            So what will be the party line when the left lose in 2016?

          • Loader2000

            AIG was one of the lynchpins of the financial collapse, perhaps the largest. It wasn’t so much a matter of deregulation as it was that AIG came up with a totally new idea that exploited a hole in the
            regulations that no one knew really existed until it blew up in everyone’s
            faces. Rather than loan money and sell
            those loans to investors (which would have been regulated) they instead
            provided insurance against the failure of those loans to perform. Since insurance companies were not regulated the same way banks were, they could get around the tight regulations that banks and investment had to follow. Banks then
            used the fact that AIG had insured their securities to claim a AAA rating. Hardly anybody really knew what was happening, democrats or republicans.
            However, in 2005, John McCain and a coalition of republicans were
            concerned enough about what appeared to be a housing bubble that McCain tried to push through a bill that would start investigating the (at the time) exploding
            housing market. The bill was shot down
            by a coalition of democrats which included Chris Dodd. They believed it was an attach on home
            ownership. Scroll down to 2005 at the
            link:

            http://tjhancock.wordpress.com/housing-bubble-financial-crisis-detailed-comprehensive-assessment/

            Read the whole think for details on what the GSE’s were and
            what their role was and for a very comprehensive history of the crisis and it’s causes.

          • bpuharic

            Some hack job. Long on diatribe. Small on analysis.

            AIG alone was worth 85 billion. Significant but chump change in comparison with what really happened

            Your OWN REFERENCE shows that, between 1980-2006, home ownership rates changed by less than 5%.

            Five percent. Yet you claim THAT, via ACORN or some other paranoid connection, was responsible for the bankrupting of our economy.

            Instead, let’s look at what REALLY happened

            Your cavalier dismissal of AIG’s use of credit default swaps is the fatal flaw in your argument. Because AIG was FAR from the only one selling these

            In 1997, the total value of the CDS market was $320 BILLION.

            10 years later, after deregulation, and after the GOP had control of congress AND the presidency, the CDS market was worth

            $62 TRILLION dollars.

            TRILLION.

            That’s more than the entire GDP of the planet earth.

            So in 10 years, home ownership rates changed about

            0%.

            CDS changed

            20,000%

            And yet it was ACORN’S fault?

            Ummm…have you ever taken a math course?

          • Loader2000

            For one thing, I wasn’t arguing anything about ACORN and the guy at the link was only arguing that ACORN played a roll, not that ACORN was the main direct cause. You are kind of setting up a staw man to attack in your comment because the article discusses all kinds of reason that government intervention precipitated the crises. I didn’t even read the whole thing. I merely was interested in the reference to the 2005 legislation that the democrats shot down, legislation that was aimed at investigating the housing market. At least I had a reference. I remember actually reading the 2005 NYTs article that mentioned Barney Frank as the one spear-heading the democrat resistance to the bill, but I couldn’t find a link to the original article anymore so I linked to the site I did because at least it mentions to 2005 legislation. What I was doing was linking to concrete evidence that the democrats were not interested in doing anything to fix what was wrong in 2005 and republicans were. Also, and I shouldn’t have to point this out, but the worth of a company like AIG tends to be much, MUCH smaller than the actual money that changes hands through such a company. Thus I have NO IDEA why you pointed out that AIG is only worth 85 billion.

        • Jim__L

          He’s actually a computer program designed to automatically dump Leftist talking points on websites that are critical of Obama and Leftist policies in general.

          I’m impressed that software has come so far, although it’s still a little like talking to the old “Eliza” program sometimes.

          • If they can’t pass the Turing test there is no sense trying to engage them in discussion. However, they can be put to other uses.

  • Jacksonian_Libertarian

    “But what it does to point is that there is no health care paradise that we could recreate in America by adopting the “right policies.” They’re will always be downsides to every system; what’s left to countries to decide is which combination of upsides and downsides they prefer.”

    This is wrong, there is a system that has proven to be the most efficient at providing the best quality, service, and price. I’ll give you a hint, it’s not a communist system like the now defunct Soviet Union had.

    • bpuharic

      Good thing no one has a communist system, isn’t it?

      • gwvanderleun

        Now, now, bpuharic, we’ve talked about this. You agreed yøu were to stay inside your room and in the closet when you felt compelled to guzzle yøur droolcup like this. If you can’t keep your word we will have to increase your medication. Again.

  • Richard Quigley

    I would pull this piece. It is not quite accurate to say that Canada’s provincially administered health plans (note the plural) could be called a “national” system. What happens in B. C. may not happen in Newfoundland & Labrador..

  • Kavanna

    Lots of countries are moving toward a mixed system of basic, universal care, paid for government like Medicare, and supplemental private insurance with favorable tax treatment. Unlike Obamacare, such approaches involve no coercive mandates and reply on the government’s unquestionable power to tax, borrow, and spend. They are also consistent with federalism.

    Germany, Holland, Scandalnavia, Canada, Israel, and others have such systems.

    • bpuharic

      If such systems are paid for by taxes…and they are, then, by definition, they include a ‘mandate’. Taxes aren’t voluntary.

      And, of course, the mandate was a CONSERVATIVE idea.

      • crabtown

        Hillary pushing HillaryCare kept trumpeting Canada’s single payer.

  • Why should countries decide this? Why can’t it be individuals, communities, and civic organizations that decide?

    • bpuharic

      Why? Let’s go with what works rather than gaming the system based on unproven assumptions

      • First we have to find out what works. So far, nothing we’ve tried works. All the more reason not to impose a single, totalitarian solution on everyone.

        • bpuharic

          How many examples do you need of what works? EVERY advanced nation has beat us in this area. We’re the losers.

          • Yes, that works if you want to conquer and rule the people, never mind the social pathologies and human rights losses that ensue.

          • bpuharic

            Having people get medical care is a human rights LOSS?

            Folks, you can’t make this stuff up. The US right wing is totally delusional

          • Oh, you’re the guy from the other planet! In that case, we’ll excuse your inability to read English.

          • Jeff Jones

            To whom a you speaking when you say, “Folks?”

            Nobody believes anything you say. We’ll know when your rage has caused a coronary, because the following will no longer pepper these blogs:

            1. Bush and the right caused all the debt, not the $7 trillion dumped into great society sinkholes plus porkulus packages.
            2. Anyone who disagrees with your emotional belches is a racist or nazi.
            3. Anyone who wants to cut (not eliminate) social programs is an extremist
            4. The right caused union decline, not members second guessing the benefits of paying $100+ per month to politicians and union bosses.
            5. Single-payer will fix everything about our healthcare system and there will be no waiting and everyone will prance around in joyous celebration at the glory of the left’s genius.

            Your world is too simple to be a reality.

          • bpuharic

            The right is delusional because they believe any program that benefits the middle class is a moral failure. They sit back and pump trillions of dollars of welfare into their rich masters via tax expenditures, TARP programs, tax write offs, etc.

            And my ONLY comment about nazis is that the left uses that term like the right uses ‘socialist’. both are evidence of brain death.

            Racism is present, but not common on the right. It started with the ‘birther’ movement and continues to day in the right which calls Obama a ‘Muslim’…code word for ni**ger.

            The right caused union declines by FIRING organizers, right to work laws, etc etc. that made it impossible to organize. I saw the effects at one of the world’s largest companys, ATT in the early 80.

            ANd the right thinks our bloated, massively expensive healthcare system is a success because it denies healthcare to the poor, including the WORKING poor, who they consider a failure, and because people get rich on it. Whether or not it provides care is incidental.

          • cubanbob

            I don’t have a problem with you getting all the medical care you want as long as I am not coerced in to paying for it.

          • bpuharic

            And when your kid loses his job and becomes poor. Does he die because he can’t afford health insurance?

            We all pay for public education. Only a right wing idiot would say that’s socialist. Same for medical care. The poor and the middle class all have a right to medical care.

          • Jeff Jones

            Bologna. Evidently you didn’t even look at the very WRM blog entry under which we’re posting.

            The NHS relies on supplemental private plans, just like our own Medicare failure.

        • crabtown

          So far what a lot of others have tried doesn’t work, either.

          • bpuharic

            So let’s adopt their failed system

            1. it’s cheaper
            2. it’s universal
            3. it works

            Our failed system is the most expensive in the world, DOESN’T cover everyone and is no more effective than theirs

          • crabtown

            What works?

    • Boritz

      Yes, that freedom and pursuit of happiness thing. Some freedoms are precious and must be fought for. I refer to same-sex marriage and legal marijuana. Other freedoms such as personal choice in healthcare and use of tobacco.are bad and must be overturned.

    • Andrew Allison

      For the same reason that countries decide defense, social security and other issues which affect every resident, namely, everybody needs to participate.

      • Yup, or like abortion, or pre-paid contraceptive coverage, or national schools. Everybody needs to participate. All within the state, nothing outside the state, nothing against the state.

        • Andrew Allison

          Don’t be ridiculous. First, half the population doesn’t require either. Second, like gay marriage, marijuana and other lifestyle choices, they are obviously State’s Rights issues.

          • They were maybe state or local issues at one time. Now they are issues of state control.

  • bpuharic

    Trade offs in every system? That’s as fair and balanced a comment as I think I’ve ever seen here.

    Yes, that’s true. For conservative opponents of universal healthcare to say it’s ALWAYS a disaster is fanaticism, not evidence based decision making.

    MANY systems work better than ours. It’s time we had an objective look rather than just saying that, because it’s ‘Murrican, it’s the BEST

    • Doug

      Of course there are tradeoffs. No educated person would deny that. Health care is a scarce economic good. It’s like every other scarce economic good. You can allocate it by price or arbitrarily by the State. The advantage to the latter is that you can create the illusion of equal care (as we all know, the apparatchiks and other connected VIPs will always get better care when the State decides who gets what and when). The downsides to the latter are (i) long waits for the unconnected, (ii) far less innovation and (iii) higher costs and inefficiencies (these costs are often disguised or shifted around but they don’t disappear).

      The advantages to a market system are no waits and lots of innovation. The downside to a market system is that some people can’t afford, or would choose not to spend their money on, some medical care.

      It would be nice if we could have a rational discussion of these problems. Of course, the current system we have (including, but not limited to, Obamacare) combines some of the worst elements of a market system with a command-and-control, state-owned system.

      • Andrew Allison

        Rational discussion of healthcare? Good luck with that. The comments to this post and the previous one on this make clear that it’s impossible.

    • cubanbob

      You are long on rants but short on proof. Where is the apple-to-apple proof those countries actually have better outcomes?

      • bpuharic

        Life expectancies. The US ranks about 36

        The right wing generally hedges on this, saying that if you confine analysis to rich white men, our life expectancies are among the best in the world

        Which says alot about the right wing.

  • crabtown

    Captain Renault was shocked to find gambling going on at Rick’s. Just do a search on Canada’s wait times going back at least 10 years. Doesn’t Canada issue a report every year or so? Doesn’t The Fraser Institute also cover wait times for various things? Canada only has approximately 35 million people, California’s population is higher. Canada’s been trying to make it work for decades, what makes people think it’ll work better with 315 million people?

  • ljgude

    I’m a bit cross reading this discussion. Nowhere does there seem to any awareness that US healthcare costs are about double any other first world healthcare system. Any discussion that takes place without that fact in mind can’t make any progress. US healthcare spending is variously quoted at 16-17.5% of GDP. Australia was 8.5% in 2005 according to Wikipedia. More recently I saw that Switzerland, which has an insurance based system like the US, is 11% of GDP. This double cost of US healthcare was all spelled out in painful detail in an article in Time Magazine entitled Bitter Pill earlier this year. Americans seem to be able to see no further than Canada, something Australians are generally quite grateful for, but here in the Antipodes we have actually gotten ahead of WRM by several decades on that waiting list thingie. We have both a public and a private system. We pay a clearly designated Medicare levy as part of our income tax and can opt to buy private insurance. If waiting times get too long people buy insurance. If the insurance gets too expensive they drop it and rely on the public system. No, it ain’t perfect but it sure seems better to me than the various Neanderthal class systems in use in North America. And no, Australian health outcomes are slightly better than the US. There is a simple reason for the high cost of health care in the US. Corruption. Unlike Wall St, government at all levels, and Higher Education, US medicine still delivers the goods even if they steal a dollar for every dollar they charge.

    • We need to civilize those Americans–eliminate the bad ones and rehabilitate the rest. Just like the great progressive movement to civilize the Native Americans in the 19th century. They’re still grateful for what we did to them.

      • ljgude

        Well, I’m a Jacksonian American myself and I don’t mind a bit of gunplay but what I am saying in my comment is that I’ve lived outside the US for a long time and we are never going to resolve our problems if don’t recognize the corruption that is ruining the nation. And no I am not an expatriate because I don’t love America. I was being sarcastic to try to wake people up the very sad fact that on healthcare American are being taken to the cleaners.

        • You can’t have a government as big as ours without corruption.

          • ljgude

            That’s true, but I think the problem is the scale of the corruption not its simple existence. It isn’t just government obviously. My personal opinion is that the US has been too rich too long and like a family suddenly come on hard times at first it has no idea where it needs to make cuts. I’m actually optimistic that we can work it out and that both sides of politics can make a contribution. At the state and municipal level it is already happening. They have all seen Detroit and Dems like Rahm Emanuel, and Jerry Brown have responded. So have Repubs – for example Christie and Walker. I’m not fussed about who fixes it as long as it gets fixed.

  • Andrew Allison

    VM’s bias against single-payer health insurance is not only tedious, but not supported by the facts. As others have noted, the US system provides worse outcomes for the people who can actually get health care, at much higher cost. Given an aging population (and resulting increase in Medicare costs and reduction in per capita tax revenue) and the social responsibility to provide some minimal level of healthcare for all, single-payer (with all it’s faults) with optional private insurance for those who can afford it appears to be the only viable alternative.

    • The only outcome the leftDemMediaCelebrity class cares about is control. The rest is false advertising, bait-and-switch, etc.

      • Andrew Allison

        You appear to have joined burpaholic on his planet. The issue is social, not political; namely what minimal level of heathcare should be available to everybody, and how can it be paid for.

        • If government is involved, it’s political.

          • Andrew Allison

            Duh! My point was and is that we need to decide what we want to do before we can figure out how to do it.

          • For conservatives, limited government constitutionalists, and Obama’s rhetoric before he became President, the end does not justify the means. So no, we don’t do things in that order.

        • crabtown

          Ahhh, the “Bronze” plan. Which may be more than what some people want to pay for. How about having an actual minimum plan?

          • Andrew Allison

            No, I’m discussing what people get just by being here.

    • crabtown

      Worse outcomes for the people who can actually get healthcare? Everyone can “get” healthcare. Bodies aren’t piling up in the streets because only the few “can” get healthcare.

      • Andrew Allison

        You obviously don’t “get” healthcare. The fact that bodies are not piling up in the street is irrelevant. What is relevant is the health of those who lack insurance.

        • cubanbob

          Some people actually pay cash for service.

          • bpuharic

            Yeah.

            They’re called ‘billionaires’. To the right wing they’re the only ones who should get healthcare. they’re better than we are, you see.

          • crabtown

            Someone never heard of HSAs or catastrophic plans? Or read the pay cash and get a discount at their doctor’s office?

          • The reason they’re called billionaires is the distortions in the market created by the dominance of 3rd party payer systems.

          • Douglas6

            I went to a clinic in Hong Kong recently at a private hospital. They wanted a 75 USD deposit upfront. I paid. I then saw a (Western-trained) doctor, who diagnosed an infection and prescribed two antibiotics. I got the antibiotics at the front counter. The hospital refunded 25 USD for a net cost of 50 USD.

            This is what you get with free-market medicine, without insurance intermediaries, in one of the most expensive cities in the world.

          • bpuharic

            Well let’s see…the US right wing congress prohibited the govt from negotiating lower prices for drugs purchased by the govt

            Guess which country has the most expensive drug prices in the world?

            And if you’d had a heart attack or stroke in Hong Kong…you gonna put that on your credit card, too?

            If free market medical care worked, someone would have adopted it and it would blow everyone else away. We have the most unregulated medical care in the advanced world.

            And the most expensive.

            Any more cliches you want to propose?

          • Douglas6

            I don’t know if they would have taken a credit card. They wanted cash.
            But you haven’t explained why medical services in Hong Kong, which has a free market in medical care (and just about everything else) cost a small fraction of the same services in, say, New York City, a place with a comparable cost of living. What’s your explanation?

          • bpuharic

            What’s YOUR explanation for the fact our free market system is the most expensive in the world?

          • Douglas6

            The basic problem is that the tax favoritism for employer provided insurance has created a monster. Without that, people would have their own, portable insurance (like car or homeowners or life insurance), and they would have real insurance – i.e., coverage for rare but catastrophic events – instead of prepaid medical coverage, which is what we have now. The prepaid medical system, where consumers are insulated from cost and the “insurers” try to regulate cost in their place, is an awful system, with all the terrible results that you correctly point out.

        • crabtown

          The young? The 20-somethings who are relatively heathy or healthy and forced to buy insurance they don’t need?
          In our grade school system, we used to get pamphlets about cheap health insurance for the kids, don’t know if that’s still sent because of Obamacare. Universities also offered insurance policies for those who were off their parents’ policies until Obamacare changed that.
          You really don’t know, you assume. Health of Americans or those who come from other countries and don’t have the same standard of health care?

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