The great debate of healthcare, private or public?

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Originally Posted by Dylan H

Frankly I do find it incredibly odd that in Canada there is no private healthcare option, I even suspect that in the EU that would be illegal under free competition regulations (assuming there is legislation banning private healthcare) and I agree that freeing that sector up would be beneficial to most parties. That is where the debate should be in Canada, and I'm surprised that the political debate hasn't gone that way.

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As I said before Dylan, it is the third rail of Canadian politics. The dimwits who pass for politicians have yet to figure out a way to even bring up the topic of privatizing some aspects of it without the public service unions, left of center parties going on a major PR campaign stating how we would be more "American" and people would be left without care. Utter rot....

Even the most Conservative Conservatives in this country will NOT put that plank on the platform because the hysteria and lies will derail their electoral hopes. If they are in power and they voice such ideas, it consumes them. WE have this wacky idea in this country that it is all or nothing.....and as you have very adroitly explained, it doesn't have to be that way. It probably explains my frustration with the debate because much of what is out there in this country is clouded by this myth.

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Originally Posted by Mark in Oshawa

As I said before Dylan, it is the third rail of Canadian politics. The dimwits who pass for politicians have yet to figure out a way to even bring up the topic of privatizing some aspects of it without the public service unions, left of center parties going on a major PR campaign stating how we would be more "American" and people would be left without care. Utter rot....

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There is no need to privatise portions of public healthcare, merely legalise third party suppliers to build hospitals and provide insurance cover. Is this currently illegal?

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Originally Posted by Dylan H

There is no need to privatise portions of public healthcare, merely legalise third party suppliers to build hospitals and provide insurance cover. Is this currently illegal?

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Hospitals can be private/public partnerships but they are run not-for-profit and basically might as well have the provincial badge on them. No private insurance can be used in place of the provincial system, but the benefits can be used to upgrade things such as private room vs a shared one, and pay for thearpy or aids such as crutches or wheel chairs. The thing is, a private corporation cannot open a hospital, and accept patients and bill the province. A private insurance company cannot take their client ( the patient ) and put them ahead of the line for treatment. So if there is a 3 month delay for surgery for a new knee, too bad....you wait.

The doctors cannot take money from patients. The doctors are limited in how many patients they can see a week, and they have to bill the government for payment. There is no essential competition for medical care in the core services. If you have cancer, it is a provinically funded hospital you go to, and you wait in the line if there is one for the treatment. If you want a new treatment, if the bureaucrats haven't ok'd that service for whatever reason, you are denied it. IN the US, if you have the money, you can get whatever treatment you want if it is offered legally. Not in Canada. We have to wait on bureaucrats to keep up to the medical community.

Some of this may have it's roots in the "is it a right or is it a privilege?" argument. As a general rule, one shouldn't be allowed to purchase additional rights or a better set of them.

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Originally Posted by Fiero 5.7

Some of this may have it's roots in the "is it a right or is it a privilege?" argument. As a general rule, one shouldn't be allowed to purchase additional rights or a better set of them.

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This is being abused here in our debate. Those for public healthcare treat those who would want to opt out of the public system are somehow wrong for wanting to pay more for the best.

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Originally Posted by Fiero 5.7

Some of this may have it's roots in the "is it a right or is it a privilege?" argument. As a general rule, one shouldn't be allowed to purchase additional rights or a better set of them.

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Originally Posted by Mark in Oshawa

This is being abused here in our debate. Those for public healthcare treat those who would want to opt out of the public system are somehow wrong for wanting to pay more for the best.

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I fail to see you point here.

An analogy:
We should all have the right to clean drinking water. If everyone has access to clean drinking water then it is fair. This doesn't mean that you have to drink water if you have the money and desire to buy Coke.

Most of the people on here seem to like a public system for all with a private option.

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Originally Posted by Brown, Jon Brow

I fail to see you point here.

An analogy:
We should all have the right to clean drinking water. If everyone has access to clean drinking water then it is fair. This doesn't mean that you have to drink water if you have the money and desire to buy Coke.

Most of the people on here seem to like a public system for all with a private option.

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Jon, you missing what is happening here. In Canada, you cant HAVE Coke. They give you water no matter what you want. One size fits all. The only 3 nations to have nationalized health care are North Korea, Cuba and CANADA. Now I don't know about you, but I don't want to be in any club with those two.

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Originally Posted by Mark in Oshawa

This is being abused here in our debate. Those for public healthcare treat those who would want to opt out of the public system are somehow wrong for wanting to pay more for the best.

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That is what they are telling you, the public. Given how you have described the layout of Canadian healthcare I suspect the real issue is a concern about how liberalising the system would affect private investment in public healthcare and how current services could be maintained if they pulled out, or how current vested interests would be threatened. Politics isn't so different from F1, always follow the money.

e

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Originally Posted by Dylan H

That is what they are telling you, the public. Given how you have described the layout of Canadian healthcare I suspect the real issue is a concern about how liberalising the system would affect private investment in public healthcare and how current services could be maintained if they pulled out, or how current vested interests would be threatened. Politics isn't so different from F1, always follow the money.

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Glad to see you back Dylan and I'm hoping you'll take the time to address this as you appear to work in the field.
This is not about health insurance, that has been flogged to death.

My biggest gripe is with the cost and attitudes of the healthcare business in general. To some degree, it's kind of like diamonds. With some exceptions, diamonds are not rare at all, and the price of the finished product is that of propaganda and a very controlled market.

In my opinion, the cost of many medical services is way out of line. In addition take someone with say, prostrate cancer. Maybe after 5 years of treatment and removals with the cancer returning each time, it's time the medical profession quit charging this man for the privilege of being able to experiment on him and started paying him for using him as a test bed. Nobody gives the profession lab rats for free, they have to buy them.

I worked with a guy that had an irregular heartbeat. He had always had it. His doctor, mainly by working through horror stories to his wife, finally got him into a hospital for a week of tests. End result, after insurance he still had to pay $1500, the doctor still didn't know what was causing it, and hot dogs, cheetos, and cigarettes did not make for a healthy lifestyle. No sh!t Rick, I would have warned you about the cheetos for $100. You can bet your life that the data from all those tests Rick paid for is being used for free by all those that track that condition in search of a profit.
You are correct about following the money and the same applies to medicine. If people didn't go running to the doctor for every littlt thing nowadays, the prices would fall as doctors tried to attract patients. I think the health industry has done a great job of selling itself as something far more knowledgeable and necessary than they truly are.

What frustrates me is that my dental plan will not cover braces. I don't need braces. And I don't have a child that needs braces. But what if I marry a woman with crooked teeth, and we have a child with crooked teeth. What then?!

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Originally Posted by Fiero 5.7

In my opinion, the cost of many medical services is way out of line. In addition take someone with say, prostrate cancer. Maybe after 5 years of treatment and removals with the cancer returning each time, it's time the medical profession quit charging this man for the privilege of being able to experiment on him and started paying him for using him as a test bed. Nobody gives the profession lab rats for free, they have to buy them.

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I'll assume that paragraph isn't a joke.

The problem there is that your expectation is too high. You are not a car, replacing a faulty part does not mean the problem goes away. You're lucky the prostate cancer disappeared in the first place, unlucky that it came back.

No you (or the hypothetical you) aren't being experimented upon, otherwise you'd have had to fill in a battery of ethical questionnaires and consent forms. You are merely being moved on to the next battery of treatments available now that the first line has failed.

Medicine isn't a precise science and neither is it as effective as anyone wants it to be. It is also far far more expensive to run than you give credit for, the cost comes from the expense of researching the treatments you receive, and the running costs of medical establishments with all the equipment they require.

In the UK it costs £500 a night for a stay in a normal ward with just basic monitoring, no treatment. There's no profit there, that is what it costs per patient. Stay in intensive care for one night and you're looking at £5000 per night, again no treatment, just staying there and being monitored with nothing on top. No profit there either, just cost price. American costs won't be much different.

Those drugs you get, someone has to pay for researching them and the approximately 1000 or so others that get some way along the research pathway before they end up proving useless or dangerous. How much do you think it costs to research those drugs? How much of the profit gets taken away by losing court cases when drugs end up being riskier than initially projected? Entire drug companies have disappeared over the past few decades or have had to be bought out because the market is so tough. And its getting tougher as drugs get more expensive to research and fewer and fewer governments are prepared to pay for them.

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Originally Posted by Fiero 5.7

I worked with a guy that had an irregular heartbeat. He had always had it. His doctor, mainly by working through horror stories to his wife, finally got him into a hospital for a week of tests. End result, after insurance he still had to pay $1500, the doctor still didn't know what was causing it, and hot dogs, cheetos, and cigarettes did not make for a healthy lifestyle. No sh!t Rick, I would have warned you about the cheetos for $100. You can bet your life that the data from all those tests Rick paid for is being used for free by all those that track that condition in search of a profit.

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Are you also willing to put your career on the line and face millions in damages if your opinion turned out to be wrong?

I have to say though that the case you presented is something that is wrong with private healthcare (and I speak as someone who practices it too). The doctor has an incentive to go for expensive tests or procedures because he will get paid some of that. Your friend probably had tests that are either marginally useful for detecting the cause of his problem or totally irrelevant and he doesn't know better, purely for profit. Thats human nature I'm afraid, and something you can't get rid of if you give doctors incentives for generating more expensive tests and procedures. If you want a private free market healthcare system you'll have to live with its side effects.

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Originally Posted by Fiero 5.7

You are correct about following the money and the same applies to medicine. If people didn't go running to the doctor for every littlt thing nowadays, the prices would fall as doctors tried to attract patients. I think the health industry has done a great job of selling itself as something far more knowledgeable and necessary than they truly are.

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You might reduce charges a little but you won't fundamentally change the fact that medicine is an incredibly capital intensive industry. If you want truly cheap healthcare then abandon any pretence at wanting cutting edge treatments and settle for stuff thats twenty years old.

Dylan, in my situation, you said follow the money. Well here, the money is all in the public funded system. The public sector unions that have all the workers in the system are the ones with the most to lose. They do not want any private care, because they assume they alone are capable of compassion in the system. Listen, my mother was a nurse, and worked in the hospital for a very nice wage, but she also worked free lance for a year or two part time (she was in the hospital part time as well) with a nursing service outside of the public system. She was paid maybe 80% of her wage from the hospital BUT when you factor in income tax, the take home pay was a lot closer. So how is it the private sector couldn't do the job cheaper? Sometimes I know they may not, because alas, I know they want a profit, but there is no accountability to the public sector unions. They accept no responsbility for trying to save the taxpayer money, and consider public healthcare a sacred cow, except if they are at contract time, then they consider that right to strike (not nurses, but the support staff) sacred.

You have done a lot to educate and make me think about some of the hitches and conventions in healthcare, but one thing I am sure on is there is still room for more efficiencies in public healthcare, at least here...but the conversation isn't really allowed to start because of the fear of "American style healthcare" AS I have explained, this threat is the 3rd rail of Canadian politics.

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Originally Posted by Jag_Warrior

What frustrates me is that my dental plan will not cover braces. I don't need braces. And I don't have a child that needs braces. But what if I marry a woman with crooked teeth, and we have a child with crooked teeth. What then?!

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Ask her why her mouth is open without a d!ck in it. stop now jag.

I once lived in an area where a state issued "certificate of need" had to be in hand before, I thought, a hospital could be built. It may have applied to government financing. It was a long time ago.

A local board was created and construction was begun on a 400 bed community hospital. Everybody was thrilled until the local doctors realized the new hospital was to be a nonprofit hospital. They quickly formed an association and started building their own 300 but expandable to 600 bed unit about 10 miles away. There is nothing like working within or in close proxcimity to a profession to realize there is no nobility in any of them.

The local doctors boycotted the nonprofit unit. If the doctor's hospital was full, patients were sent to a city 35 miles away. A few doctors ignored the boycott and used the nonprofit hospital but not very many. Working at a hospital meant I got to learn quite a bit about how they operate. Doctors were expected to fill x amount of beds a month to maintain their priviiges. Bonuses for exceeding that amount. If a supplier came up with a really good deal on sterile, pre-packaged surgical kits for tonsils, then tonsils was the surgery of the month and each doctor was expected to deliver x amount of tonsil surgeries. Mind you, the nonprofit hospital wasn't playing by those rules. The nonprofit never had enough business to get that cocky.

The nonprofit went bankrupt and closed within 2 years.

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Originally Posted by Fiero 5.7

I once lived in an area where a state issued "certificate of need" had to be in hand before, I thought, a hospital could be built. It may have applied to government financing. It was a long time ago.

A local board was created and construction was begun on a 400 bed community hospital. Everybody was thrilled until the local doctors realized the new hospital was to be a nonprofit hospital. They quickly formed an association and started building their own 300 but expandable to 600 bed unit about 10 miles away. There is nothing like working within or in close proxcimity to a profession to realize there is no nobility in any of them.

The local doctors boycotted the nonprofit unit. If the doctor's hospital was full, patients were sent to a city 35 miles away. A few doctors ignored the boycott and used the nonprofit hospital but not very many. Working at a hospital meant I got to learn quite a bit about how they operate. Doctors were expected to fill x amount of beds a month to maintain their priviiges. Bonuses for exceeding that amount. If a supplier came up with a really good deal on sterile, pre-packaged surgical kits for tonsils, then tonsils was the surgery of the month and each doctor was expected to deliver x amount of tonsil surgeries. Mind you, the nonprofit hospital wasn't playing by those rules. The nonprofit never had enough business to get that cocky.

The nonprofit went bankrupt and closed within 2 years.

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Your story tho tells all of those in Europe that everything they believe about the American system is true.

AS for the non-profit, well if the gov't subsidized it, you would have: Voila, a public healthcare system.

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Originally Posted by Jag_Warrior

What frustrates me is that my dental plan will not cover braces. I don't need braces. And I don't have a child that needs braces. But what if I marry a woman with crooked teeth, and we have a child with crooked teeth. What then?!

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Funny you should ask. My 33 year old wife got braces 6 months ago. (She had couple of wisdom teeth removed and her teeth started seperating). Adult Orthodontia is not covered of course, so we treated it like you might an addition on your house. We went to three different orthodontists with good references and took bids.

It was instructive, one mentioned that the prices also included the retainer she would need after they are removed, so we checked and found the others had not included that in the price and yes she would need them. On the basis of their thoroughness and a 15% discount for lump sum payment up front, we went with them.

Now, does that mean actual market competition is the solution for what ails medical costs? I don't know, but I believe that like the funeral industry, medical practitioners also count on you not knowing the costs, and not negotiating because it's "unseemly"

My daughter was born with a congenital heart defect (repairable, thank Goodness) and had heart surgery at 4 days old. I got bills for all sorts of things from doctors I never met, related to all of this. I started questioning a few things, but was told not to worry about it, I was already at calendar year maximum out-of-pocket, and everything was 100% covered. Now, it may have all been on the up-and-up (i.e. doctors on rounds would review her chart and send us a bill.), but I've always had my doubts.

That said, I still prefer private as opposed to government run health care. I would like to see insurance treated a more as an emergency type service not unlike home or auto insurance, where people would know costs and pay for basic services out of pocket. I would also like insurance de-coupled from work. I think it keeps people in jobs that sometimes don't like, but feel like they cannot leave because of the benefits they'll lose. It's complicated, and there are no easy answers.

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Originally Posted by Fiero 5.7

As a general rule, one shouldn't be allowed to purchase additional rights or a better set of them.

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Originally Posted by Fiero 5.7

Amongst that, you do not have a right to healthcare but you do have the right to attempt to get all the healthcare you want by purchasing it, begging for it, bartering for it, conning them out of it, and you name it.

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Which is it? How do you explain this paradox?

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Originally Posted by Rollo

Which is it? How do you explain this paradox?

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I don't see a paradox per se. If you believe it to be a right, then you believe that from cradle to the grave, regardless of what you do or don't do, some third party is obligated to care for your health needs even if you never contribute one penny to the system.

Is voting a right or a privilige? You have one vote and the rich guy you absolutely hate has one vote. Neither one of you can go to the government and buy extra votes. Both of you enjoy the privilige of aiding and assisting your favorite candidate beyond casting your one vote for him. But, even if you do volunteer work 40 hours a week for his campaign and contribute thousands of dollars, when you walk into the polls, you'll still only have your one vote.

If health care is a right and the system is obligated to provide for your needs (the very definition of "needs" is a can of worms in itself), then it will attempt to do so fairly. If somebody makes more money and ends up paying more NHS taxes, that doesn't qualify them for any better care than the poorer guy gets. In other words, the extra money he paid in didn't buy him anything extra. Of course, since I don't know how the NHS works and is funded, I could be just talking out my ass here. But, if a man pushed a little harder and made and saved more money and wants to use it to enhance his health care options and services outside the system, then thats his privilige to do so. He might even work out a barter arrangement for additional care.

There will always be people that want more and are willing to work more, save more, and risk more to achieve their goals. And there will always be people that want more and intend to get it by taking it away from you.

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Originally Posted by Mark in Oshawa

AS for the non-profit, well if the gov't subsidized it, you would have: Voila, a public healthcare system.

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In a way, that was the problem. Full control of the hospital was to remain with the non-profit board and not The doctors. So even though the doctors could still scam their patients on their personal charges, the hospital refused to play the bonus game and of course by law, no profit sharing. It was a wonderful hospital, state of the art and no patients were ever turned away. It died of greed all the way around, from the doctors that couldn't milk it to the former patients who felt like they didn't need to pay an honest bill once they were feeling better.

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Originally Posted by Fiero 5.7

There is nothing like working within or in close proxcimity to a profession to realize there is no nobility in any of them.

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Hmmm I'm getting a strong whiff of hypocrisy here.

Fiero, you've been arguing over and over again that healthcare isn't a right, it is something that should be bought. You've talked about the benefits of a market system and how profit motivates hospitals to be efficient.

Then you've seen doctors firsthand playing the game not only by its rules but by the spirit of the rules as you want it to be played and you don't like it.

Which is worse, the doctor who works the system as its meant to be or the guy who demands that the system is the way it is?

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Originally Posted by Dylan H

Hmmm I'm getting a strong whiff of hypocrisy here.

Fiero, you've been arguing over and over again that healthcare isn't a right, it is something that should be bought. You've talked about the benefits of a market system and how profit motivates hospitals to be efficient.

Then you've seen doctors firsthand playing the game not only by its rules but by the spirit of the rules as you want it to be played and you don't like it.

Which is worse, the doctor who works the system as its meant to be or the guy who demands that the system is the way it is?

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I don't think he has a problem with it. The non-profit hospital admins did....

I don't know. Spritually, I agree with Fiero. I question the idea of all of these rights when it comes to entitlements from the state. I understand if we are going to pay for something, healthcare would be right up there, but I do feel too many people in socialized care abuse the system and too many doctors are not really rewarded in ways maybe they should. Then I read Fiero's accounts, and realize it isn't perfect either. I am on the fence. I can see the merits and detriments in both.

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Originally Posted by Mark in Oshawa

I don't think he has a problem with it. The non-profit hospital admins did....

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That is not the interpretation I made, Fiero has criticised the profit seeking behaviour of doctors he has seen in two posts now which is odd for someone who supports the profit seeking nature of private companies to keep his costs down.

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Originally Posted by Dylan H

Hmmm I'm getting a strong whiff of hypocrisy here.

Fiero, you've been arguing over and over again that healthcare isn't a right, it is something that should be bought. You've talked about the benefits of a market system and how profit motivates hospitals to be efficient.

Then you've seen doctors firsthand playing the game not only by its rules but by the spirit of the rules as you want it to be played and you don't like it.

Which is worse, the doctor who works the system as its meant to be or the guy who demands that the system is the way it is?

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Good Afternoon Dylan, sorry I'm late.

I've been known to confuse folks from time to time and part of that is what I am and part of it is what I isn't.

I would describe myself as a realist, with a sometimes uncomfortable side order of pragmaticism. Hypocrisy, although I am unconvinced of my guilt in the manner to which you point or whiff, is a lady that all of us end up having to dance with at one time or another. Still, there is much to be said for hypocrisy. Hypocrisy led directly to rationalization and without rationalizations, human beings couldn't survive.

I'm not sure, but I don't believe I'm one of those that constantly praise the market system but I do appreciate the benefits it offers and saddened by those that fail to acknowledge it's limitations. In addition, I can't remember where I said profit motivates a hospital to be efficient. I think Rollo accused me of that via a misquote. However, back in post #10 I did say that insurance companies and hospitals are both businesses and entitled to make a profit.

I have stated my opinion that I believe that some medical services are over priced and the actual need for constant health care is oversold through a good marketing campaign. Some doctors charge vastly more than their services merit but so do some lawyers, auto mechanics, and building contractors. I asked you to address some questions along those lines and you did, thank you. By the way, the guy in the first paragraph wasn't a joke, he was my Dad. You and I could argue all day long, but at the end of the day you, as a man of integrity and education, would have to admit some services and doctors fees are overpriced and I, as a man of integrity and education, would have to admit that some of the high costs are justified. Even with me thinking costs are too high, nowhere have you seen me advocating the regulation or imposition of artificial price controls on doctors or hospitals. I believe it's the patient's responsibility to explore other options, up to and including, going to a different doctor.

As far as the 2 hospitals go I really wasn't condemning one or the other. I was merely pointing out that working there turned me on to how the game is played. The doctor's hospital was built by the doctor's through a corporation they formed. They invested in their business, built it, and deserved to make a profit from it. They could have lost their butts for starting the construction without a "certificate of need" but the state board ruled that since no public money or money insured by public funds was used for it's construction, it was legally a huge private clinic and a "certificate of need" was not required. Although I don't know what the prices were compared between the two, they were both in business to make a profit, the only difference being the profits made by the non-profit hospital had to be put back into and used for the benefit of the hospital. To say either hospital was above gamesmanship would be inaccurate. This would have been going on about '73-'75. The private pysch hospitals for addiction, depression, etc were just starting to rear their ugly heads. We were on the cutting edge of a new profit center. We converted the entire 3rd floor to a psych floor and the local shrinks started filling it up with disobedient teenagers, wives that, now that the kids were gone, were lost. They didn't know anything about areospace and their husbands didn't know jack about Big Bird. Not to mention the rare patient that was milking the system for a free vacation. Any way, all these people presented such a danger to society and themselves that they were locked up on the 3rd floor, except for lots and lots of supervised field trips and outings, until such time as their condition improved and they could be released back into mainstream society. You'll be glad to know that each and every one of them were fit enough to return to society on the same day their insurance ran out, usually 30 days.

If a society wants to make health care a right, that's their business. That I know of, nobody in the USA is telling the UK or any other nation they can't have a national health care plan.

In the USA, we have 2 national health care plans now, both broke. Massachusetts has a state plan thats a complete mess. The majority of Americans have let Obama know they don't want his health plan and that is a right they have.

In all honestly, I'm puzzled by the mindset of any individual that thinks they have the absolute right, by virtue of the fact that they exist, to obligate other individuals to care for them.

Lastly, I have no objection to how any doctor conducts himself as long as it is legal. They are free to charge what the market will bear and partake of any incentives offered. Thats business and business is what they are in.

Thyroid and COPD have finally taken me down to where I can't work. I managed to work 3 weeks in Feb, but thats been it. When I told my doctor I no longer had medical insurance he immediately cut his fee to me by 37 % so please don't go thinking I'm down on doctors. Because of years of self-directed investments, I've gotten on quite well without public assistance.

Apparently the healthcare system in Canada is great unless you are the Newfoundland Premier......Then it isn't good enough.

http://www.nationalpost.com/news/story.html?id=2510700

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Originally Posted by anthonyvop

Apparently the healthcare system in Canada is great unless you are the Newfoundland Premier......Then it isn't good enough.

http://www.nationalpost.com/news/story.html?id=2510700

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Believe me Tony...it goes on all the time. The Premier of Newfoundland at least flew down on his own dime. Prime Minister Chretien used to fly to the Mayo Clinic using the plane from the Air Force that I help pay for. But of course...our healthcare system is GREAT. Just ask Danny Williams or Jean Chretien.

Healthcare is truly the 3rd rail of Canadian politics if you threaten it but at some point, the electorate will wake up...

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Originally Posted by anthonyvop

Apparently the healthcare system in Canada is great unless you are the Newfoundland Premier......Then it isn't good enough.

http://www.nationalpost.com/news/story.html?id=2510700

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Medical tourism..check it out.

People from all over the world go to different countries for treatment, including people from the USA.

Most people that go abroad for treatment actually come from the USA. They go to other countries as its cheaper and get the same if not better treatment and care.....

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Originally Posted by steve_spackman

and get the same if not better treatment and care.....

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You Funny!

Sure some American's go offshore for treatment. Most of those go for treatments that aren't allowed in the US.
Those that go for cheaper treatment are idiots because if they had been actually paying for insurance it would have come out cheaper than going offshore.

The thought that Americans go offshore for better treat is laughable. Even a High Canadian Government official came to the US for treatment. He could have seen the best Canadian doctors free of charge but yet he hopped on a plane to the US.

Tony...apparently it was some specialist. The spin doctors are in full spin, but if you are from St. Johns Newfoundland, a not big city in a small outpost that is about 550000 people, you know you are going to need special care elsewhere for some treatments. I guess he figured he would get a little sun and pay for it. Since Danny Williams was a millionaire before he entered politics, he whistled up his private jet and went south. No one is saying, but he has some weird cardiac thing.

I don't care that he is getting treatment in the US, heck, it probably is as good or better than what he got in Toronto or Montreal but the weather would be nicer BUT this is one of the politicians who is always blathering about how good our health care is. Well you know what, if you are going to go out on that limb, than suck it up and stay home. The truth is Tony, we are not using leeches and amputating limbs up here. We have a decent enough healthcare system but the fact remains it could be that little bit better and polticians like Williams keep getting in the way of discussing how we can do that.

Contrary to what you think Tony, it aint a third world country up here and our healthcare is in most cases as good as anywhere, but if you want specialists and the BEST possible care money can buy, than ya, maybe you will end up going to the UK or the US of some place exotic.

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Originally Posted by anthonyvop

You Funny!

Sure some American's go offshore for treatment. Most of those go for treatments that aren't allowed in the US.
Those that go for cheaper treatment are idiots because if they had been actually paying for insurance it would have come out cheaper than going offshore.

The thought that Americans go offshore for better treat is laughable. Even a High Canadian Government official came to the US for treatment. He could have seen the best Canadian doctors free of charge but yet he hopped on a plane to the US.

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You simply have no idea what your on about do you? I really pity you sometimes.

Here's something that I honestly don't know about, I'm sure you all will educate me.

Aren't you sort of stealing if you are a US citizen and you go abroad for some sort of treatment? I mean that care is cheaper because it's subsidized by that government. And since I, as a US citizen, didn't pay taxes in country X, aren't I stealing from those taxpayers?

Boil the question down a bit: Is treatment in other countries cheaper because it is subsidized by the government? At least to some extent?

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Originally Posted by chuck34

Here's something that I honestly don't know about, I'm sure you all will educate me.

Aren't you sort of stealing if you are a US citizen and you go abroad for some sort of treatment? I mean that care is cheaper because it's subsidized by that government. And since I, as a US citizen, didn't pay taxes in country X, aren't I stealing from those taxpayers?

Boil the question down a bit: Is treatment in other countries cheaper because it is subsidized by the government? At least to some extent?

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There is know reason why you couldn't go to abroad to a Private hospital in the UK.

Although all the doctors training would still have been with the NHS.

Quote:

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Originally Posted by chuck34

Aren't you sort of stealing if you are a US citizen and you go abroad for some sort of treatment? I mean that care is cheaper because it's subsidized by that government. And since I, as a US citizen, didn't pay taxes in country X, aren't I stealing from those taxpayers?

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The key word in that is "stealing", and no you aren't. It is impossible to steal something which is provided to you out of duty.

In the UK, the National Health Service Act 1946 and it's replacement in 2006 (as well as equivalent Acts in Scotland) explicitly state that is the "Secretary of State’s duty to promote the health service".

In Australia section 51 of the Constitution provides that the Federal Government has the power to enact laws with regards "The provision of medical and dental services" and even the National Health Act 1953 states that "the duty is encumbant on the Federal Government to ensure the provision of healthcare services".

Duty in common law extends from a moral commitment, which in this case is by the government to look after its people.

Besides which other than Accident and Emergency departments you'd still be liable as a US Citizen to charges for services.

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Originally Posted by Rollo

The key word in that is "stealing", and no you aren't. It is impossible to steal something which is provided to you out of duty.

In the UK, the National Health Service Act 1946 and it's replacement in 2006 (as well as equivalent Acts in Scotland) explicitly state that is the "Secretary of State’s duty to promote the health service".

In Australia section 51 of the Constitution provides that the Federal Government has the power to enact laws with regards "The provision of medical and dental services" and even the National Health Act 1953 states that "the duty is encumbant on the Federal Government to ensure the provision of healthcare services".

Duty in common law extends from a moral commitment, which in this case is by the government to look after its people.

Besides which other than Accident and Emergency departments you'd still be liable as a US Citizen to charges for services.

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Ok so it's not really stealing. But aren't the costs lower, at least in part, because the government (through taxpayer money) is subsidizing the services?

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Originally Posted by chuck34

Ok so it's not really stealing. But aren't the costs lower, at least in part, because the government (through taxpayer money) is subsidizing the services?

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I'd hazard a guess that the overall costs are lower because:

1. The Government actually owns the hospitals and doesn't therefore need to charge expenses like rent, or rates.
2. The level of bureaucracy and management isn't duplicated nearly to the degree it is in America because there is a single blanket organisation.
3. A single blanket organisation has bigger purchasing power through economies of scale both in terms of hardware and labour costs.

The government for the most part doesn't subsidise the sector, it owns it. Is actually possible for the government subsidise an industry if it owns it?

Quote:

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Originally Posted by Rollo

I'd hazard a guess that the overall costs are lower because:

1. The Government actually owns the hospitals and doesn't therefore need to charge expenses like rent, or rates.
2. The level of bureaucracy and management isn't duplicated nearly to the degree it is in America because there is a single blanket organisation.
3. A single blanket organisation has bigger purchasing power through economies of scale both in terms of hardware and labour costs.

The government for the most part doesn't subsidise the sector, it owns it. Is actually possible for the government subsidise an industry if it owns it?

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How does the government own anything? Answer, it doesn't. The taxpayers do.

1. The government doesn't own the hospitals, the taxpayers do. Therefore the taxpayers are paying to build, maintain, etc. the buildings. In effect, the taxpayers are paying the rent.

2. You don't think there is a high level of bureaucracy involved in government work? What planet are you on?

3. Ah, so the the government has "buying power". Is that why toilet seats cost $600?

The government does own the system, but that doesn't mean that it doesn't still cost something. That appears to be the dirty little secret here. Sure medical costs (when looked at in isolation) are lower in countries like Canada and the UK than they are in the US. But when you add in the tax burdon associated with the medical industry I would bet the TOTAL costs are close to the same.

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Originally Posted by chuck34

1. The government doesn't own the hospitals, the taxpayers do. Therefore the taxpayers are paying to build, maintain, etc. the buildings. In effect, the taxpayers are paying the rent.

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Wrong.
The Government DOES own the hospitals, specifically through the legal person of the Crown, via the NHS. Not only is the Crown the legal owner of the hospitals but it also owns the land upon which it sits, and the buildings themselves.
There is zero rent because as the owner of the land, buildings and the services inside, the Crown doesn't pay rent, rates or taxes to itself.

Quote:

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Originally Posted by chuck34

2. You don't think there is a high level of bureaucracy involved in government work? What planet are you on?

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In the UK there is ONE NHS which runs and overseas the lot. Sure, there is a level of bureaucracy but again I wager that the total number of administrators and managers on a per capita basis is far less than the great swathe of HMOs and hospital owners in the US, which as separate entities certainly do not share the same administration.

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Originally Posted by chuck34

3. Ah so the the government has "buying power". Is that why toilet seats cost $600?

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http://www.diy.com/diy/jsp/bq/nav.jsp?a ... egories%3C{9372171}&fh_refview=search&fh_search=toilet+seat& fh_refpath=facet_159016185&fh_secondid=10246484&fh _eds=%C3%9F&ts=1265251670419
I could get a whole toilet for 130 quid. $600 for just the seat? You're getting done.

Quote:

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Originally Posted by chuck34

But when you add in the tax burdon associated with the medical industry I would bet the TOTAL costs are close to the same.

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According to the OECD the average spending per person (USD):
US - 7290
Can - 3895
Oz - 3137
UK - 2992

By rights if the costs were the same, the Dept of Health in Britain running on a US cost basis should be £240bn instead of the £98.7 billion which it currently costs.

Quote:

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Originally Posted by Rollo

Wrong.
The Government DOES own the hospitals, specifically through the legal person of the Crown, via the NHS. Not only is the Crown the legal owner of the hospitals but it also owns the land upon which it sits, and the buildings themselves.
There is zero rent because as the owner of the land, buildings and the services inside, the Crown doesn't pay rent, rates or taxes to itself.

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So the Crown has some magical pile of money somewhere that hasn't been taken or "earned" from sources, that it uses to pay people to build and maintain the buildings? That's cool, you'll have to explain how that works.

Quote:

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Originally Posted by Rollo

In the UK there is ONE NHS which runs and overseas the lot. Sure, there is a level of bureaucracy but again I wager that the total number of administrators and managers on a per capita basis is far less than the great swathe of HMOs and hospital owners in the US, which as separate entities certainly do not share the same administration.

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So you are honestly telling me that the government is run more effeciently than private industry? Wow, I've never seen that before, how does that work? You're really going to have to put up some sort of numbers to prove that one to me. Not that I'm saying that insurance companies are some sort of beacon of efficency, far from it, but the government? Really?

Quote:

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Originally Posted by Rollo

http://www.diy.com/diy/jsp/bq/nav.jsp?action=detail&fh_oneslice=true&fh_view_siz e=10&fh_reffacet=categories&fh_location=%2f%2fcata log01%2fen_GB%2fcategories%3C{9372171}&fh_refview= search&fh_search=toilet+seat&fh_refpath=facet_1590 16185&fh_secondid=10246484&fh_eds=%C3%9F&ts=126525 1670419
I could get a whole toilet for 130 quid. $600 for just the seat? You're getting done.

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Your link doesn't work for me, but I'm assuming that you are giving me a link to some sort of do it yourself, go buy a toilet and put it in your house type of deal? That's not what I'm talking about at all. I'm talking about the government buying things at outragous prices.

http://councilfor.cagw.org/site/Page...etinv_gotwaste
"Since our founding in 1984, CAGW has helped expose such high-profile symbols of federal profligacy as the Department of Defense's $640 toilet seat and $436 hammer and the National Park Service's $797,400 outhouse."

Quote:

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Originally Posted by Rollo

According to the OECD the average spending per person (USD):
US - 7290
Can - 3895
Oz - 3137
UK - 2992

By rights if the costs were the same, the Dept of Health in Britain running on a US cost basis should be £240bn instead of the £98.7 billion which it currently costs.

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I have no idea what the OECD is, can you give me some info on them, or a link to where you got these numbers? I am highly sceptical of this.

But even if these numbers are correct, does it take into account quantity and quality of care? I mean does the US number throw in all the plastic surgury, and other elective surguries that Americans have? Or how about the cost of quality? I can probably get somebody to cut out my appendix with a knife making a big insision and yanking the thing out. Or I can do it with a scope, no scar, and little recovery time. Which do you think is more expensive?

Chuck, the OECD number is interesting...but I do think there is a bit of a controversay how those numbers per capita are arrived at.

My contention is that some of the cost of publilc healthcare systems is hidden when those numbers are calculated. As you illustrated, the US Gov't has overspent wildly at times for things like Toilet seats, and I can tell you that the Canadian gov't isn't that stupid.....but god knows they can be close.

I have through this thread wavered one way or the other on the merits of public/private care, but I do know that public healthcare isn't the pancea for all ills, but it isn't leeches and amputations either....the Danny Williams going to the US controversay up here had some of the top Cardiac doctors in Canada up in arms. He isn't getting anything done that Mt. Sinai hospital in Toronto isn't doing or any number of top flight Cardiac hospitals.

The one thing people do have to realize tho is this Premier is coming from a sparsely populated and remote part of Canada. For any major specialists, he almost has to get on a plane, and if a poor father in St. John's needed the same care, he too would have to leave home...but in the poor father's case, it would be to Montreal, Toronto or Ottawa and NOT Florida..

Quote:

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Originally Posted by chuck34

So the Crown has some magical pile of money somewhere that hasn't been taken or "earned" from sources, that it uses to pay people to build and maintain the buildings? That's cool, you'll have to explain how that works.

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The Crown is technically a corporation sole, that is, it is a separate legal enitity consisting of one office and one officer. The person who operates both the office and the corporation is the Crown*.
It is the Crown who owns both the NHS and the land and the buildings etc for which the institution sits inside.

Obviously if the Crown operates and owns the NHS, it isn't going to assess itself for land taxes, rates, income tax, payrol tax etc, which every private entity ergo the company which owns a private hospital would be liable for.

So no. The Crown does not have "some magical pile of money somewhere", and not does it need to because the expenses which it would need to pay out of this magical pile of money never exist either.
You've presented a converse error which is a formal fallacy.

People are still paid and buildings are still maintained because these are "real" events arising from "real" circumstances.

*NB: The Crown operates itself. The Monarch is a separate legal person.

Does the Crown generate no income? Who actually forks out real money to pay for real building and land maintainence?