NetNews Usenet Archive 1992 #31/NN_1992_31.iso/spool/comp/os/os2/advocacy/11493

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From: [e-mail] (Luc Bauwens)
Subject: Re: Is Microsoft the next
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Date: Sun, 03 Jan 93 22:10:00 GMT
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In article <[e-mail]> [e-mail] (Charles Kincy) writes:

Stuff about medical system in Canada.  I wonder what this got to do
with comp.os.os2.advocacy...   So, see the follow-up line,
redirected to soc.culture.canada.

>In article <[e-mail]> [e-mail] (robert heuman) writes:
>>
>>I will note, however, that there is a substantial difference between
>>the US and Canada when it comes to MRI and other high-tech, high
>>expense facilities.  In Canada ALL treatment hospitals are PUBLIC and
>>are expected to share high-cost facilities, rather than buy their own
>>where the volumes do not warrent.  In the US there are a lot of high
>>tech set-ups, but primarily at PRIVATE hospitals, and the charges for
>>their use are exorbitant.  Check out the PUBLIC hospitals and see if
>>the ratio of MRIs and CTScanners is any higher than in Canada.  I
>>rather doubt it.
>
>Hey, ok, I will grant this point to you...but:
>
>>There is one last point to be made.  Canada is larger than the US with
>>approximately 10% of the population of the US.  In addition, most of
>
>Right.  See, this is the problem.  Canada has about the same population
>as California.  What makes you think that the US tax base is capable
>of providing medical care for almost 300 million people?

If anyrthing, it would seem to me that with a larger population, econmies
of scale should be achievable.  Furthermore, a denser population also
allows for cheaper service.  Even if that were not the case, why wouln't
costs at worst scale with population?

>[...]
>
>>BTW, my son's total treatment for osteogenic sarcoma cost me C$56.00
>>including 4 operations, regular MRIs and CTScans, chemotherapy,
>
>It cost you more than that.  What is your GST rate up there?  20%?
>Not to mention all the other taxes you are paying.  How much in
>taxes do you pay, sir?  How much of it do you think is going towards
>your "inexpensive" medical care?

I pay 7% of GST and 0% of provincial tax, which is *less* than the 8.25%
sales tax in California...

>>possible insurance would be bankrupt by now.  Even with good
>>insurance at the start, their employer, particularly if small, would
>>have been dropped from a group plan insurer within a year or so,
>>leaving the parent or patient without coverage.  Seems to happen with
>>a fair degree of regularity in the US.... CANNOT happen in Canada.
>
>CANNOT?  What happens if your country falls upon hard times?  Then
>what?

No relationship.  The basic equation of economy is that product = spending.
If the medical spending of a country is x, then the net product of the
medical sector is also x.  There would be *no economic benefit* of
trying to reduce medical costs in a recession.  If anything it
would make the recession worse.  (Might want to control the increase in
costs, though.)

Furthermore, the total costs in Canada amount to only about 8% of the
GNP or something like that, less than in the US (11%?).  If you take into
account that the Canadian system covers almost 100% of the population
vs. (what in the US?), then the Canadian system is clearly much more
cost-effective.

>Now that we've examined a few problems with the Canadian system,
>let me suggest that what works in Canada probably will not work in
>the US.  A nationalized health care system increases exponentially
>in cost as the population increases.

Why would that be?  And if you were right, then perhaps you should
cut your country into millions of small villages and perhaps everybody
would live forever :-)...

>Besides, the US government is a lot less centralized than the
>Canadian government is.

Wrong.  Canada is quite decentralized.  Probably more than the
US.  Furthermore, the average population of the Canadian province is less
than half the average state population in the US.  Furthermore, medical
care fall within the *provincial* responsibility.

>  It's designed to be inefficient.  Unfortunately,
>that means socialized health care in the US would cost oh, so much more.

I won't argue with your claim that the US government may be designed
to be less efficient than the Canadian one.  I wonder why one would
want to *design* a governement to be inefficient, though.  As for
the result, you probably know better than I do :-)..

Two more points: in the Canadian system, health care is provided by *private*,
non-government medical organizations.  It's merely the *insurance* business
that's run by the provinces.

And you can have universal, governement-garanteed health care entirely
run by private organizations, and even have them compete against each
other.

It seems to me that the major problem of medical costs in the US is
that it's in effect a monopoly totally controlled by the medical
profession, that over the last twelve years has transformed itself
from what was then a bunch of individual practitioners with a traditional
sense of medical values, into corporate medical organizations purely
profit-driven and in conditions of virtual monopoly.  And the only
way out is to put togrther some kind of a player that's powerful enough
to put the health business under control.

I don't say that the best way to do that is necessarily the Canadian
system.  But in Canada right now, that problem does not exist.

Furthermore (and this is a key to the issue of cost-effectiveness),
the Canadian system does a great job at spending enough money where
it's most cost-effective: in preventative medicine.

And yes, there may be some basis to the argument that 8% of the
GNP to medical costs is still too much.

>   [...]
>
>Trying to use a Canadian solution to an American problem is laughable.

I guess I read you here...   :-)  Indeed, wouldn't that be too much...

>Another thing to be considered:  Canada has little in the way of
>military.  I wonder how well Canada's health care system would work
>if it didn't rely on America for defense?

Defense against whom?  Why would Canada have to defend against the enemies
(real or otherwise) of the US?

LB