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Politics : Foreign Affairs Discussion Group -- Ignore unavailable to you. Want to Upgrade?

To: LindyBill who wrote (32736)	6/19/2002 11:06:13 PM
From: aladin	Read Replies (1) \| Respond to of 281500

LindyBill We can look at health care from multiple angles. Canadians get much better health care than some Americans. This is true - many americans are not poor enough for medicaid and choose not to buy coverage (or cannot afford it). Most Americans have much better health care than Canadians. This is also true - those with a health plan have better access to services, hospitals and other health care choices than Canadians. Years of Government cutbacks and user abuse have created problems with the Canadian systems. (There are no incentives in the Canadian systems for not visiting the ER for minor stuff etc). A case in point - try to get a catscan or mri in Ontario - you could wait months. John ps Live and work in RTP, NC. Summer at the cottage in Ontario :-)

To: LindyBill who wrote (32736)	6/20/2002 5:44:23 AM
From: frankw1900	Respond to of 281500

The difference in the portion of national income cost between US and Canadian health care is almost entirely in the lower Canadian administrative costs. The system in Canada mostly works OK. You're better of for most things being in a medium sized town near a large center. But that's generally true everywhere. One part of structural difficulty in Canadian care is, as one might expect, with any system with too much govrnment input is that a good part of the system is captured for those who don't actually deliver health care -- low level workers (janitors etc) are paid far more than those paid in private sector. Hospitals cost too much to run. Another is lack of a reasonable user fee. Thus people use the system too frequently for the wrong things. Another is the lack of alternative to hospital emergencies for problems which aren't emergencies. Another, as in the US, too many hospitals in some places and not enough in others but mostly too many hospitals, as in US. In every case noted above money which could used for medical treatment is diverted to non-treatment expenditure and thus the lack of service which some Canadians complain of and the huge concern that medical costs will mushroom and the lack of money to pay medical personnel adequately. For run of the mill medical care the outlook for most Canadians is pretty good. They can afford it and they'll get good treatment but there is a concern this will not continue unless things are tightened up. There is a lot of serious discussion in Canada right now as to how to approach this. Given that the portion of Candian national income spent on health care is less than in US, which is even more inefficient, it's unlikely Canada will adopt the US model in a large way. It's most likely that costs will be attacked piece meal in a pragmatic way - contracting out, specialized clinics (private and public), fewer, more efficient hospitals, user fees, etc. A process already underway and accelerating. Much of the difficulties faced by Canadian medical system are the result of the declining prosperity Canada has faced the last thirty years due to the socialist economic policies of various governments. This may be the single most important and least discussed aspect of Canadian health system's difficulties. As the country moves away from these we'll be able to pay for improvements in the medical system. Do we have good medical care? We live longer than most folk, including US citizens. So perhaps we do. The inadequacies and failures of the system are well publicized, its adequacies and successes less so. The consensus is that it could be improved and should be. I was once asked by US citzen when we were going to join them. I answered, why would we do that? Then we'd have your problems in addition to our own....

To: LindyBill who wrote (32736)	6/20/2002 9:56:16 AM
From: JohnM	Read Replies (1) \| Respond to of 281500

Since I have been complaining about Canadian Health Care here lately, I think it is only fair if I bring up something they are doing right that we might do well to import. That is their approach to school choice. I'm going to take a pass on this debate. As you might guess, I care a bit too much about it, it is at least as far off topic as the health care issues (though we continued to keep those within a comparative framework), and I would too quickly drop into the details. Which would bore everyone to death. A quick comment though. There is strong evidence to indicate that the most innovative school system in the country is the New York City system. Now that runs counter to perception!! Reason. The number of charter schools, run by faculty rather than the school board.