Thanks for your comments.
A major problem for all health services whether public or private is rationing. How much to spend on a terminally ill patient - or, one who is almost terminally ill.
Should the money be spent on the youngsters and their mothers, or on a 75 year old who needs a transplant?
There again, what do you do with someone who doesn't respond to any treatments? Kick them out? Keep them around, occupying a bed that might better be used on someone who does respond to treatment?
Such decisions must be left to doctors rather than accountants or politicians and perhaps the test of a good Service is one where decisions are made medically - including the decision not to continue treatment which is expensive but can do little good.
I'm glad I don't have to make such choices.
When we lived in Ontario, our medical needs were supplied through an insurance system called PSI (Physicians Services Incorporated).
It was run by doctors and the treatment was not expensive and even included house calls. Hospital needs were supplied by the Blue Cross.
It was a good service without the bureaucratic structure that inevitably bogs down a national system.
Harry
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pete :
On Tue, 27 May 2003, Harry Pollard <[EMAIL PROTECTED]> wrote:
Hi!
Here's a different look at a Health Service. It's by someone who quotes libertarians so is probably a libertarian.
He doesn't mention the $400 million necessary to get a new drug approved by the FDA - something that stops small research firms from doing it themselves. They have to work trough one of the monsters.
Also, I'm sure he would support Patents and Copyrights - a major problem in the provision of cheap drugs. One notes that the Administration and the Congress (both parties) think in terms of paying the exorbitant drug prices by taxes to relieve patient costs. (That's guaranteed to raise prices.)
Incidentally, half of drug research is carried out by universities and small firms. This while the large drug companies spend more on their advertising than they do on research.
However, some interesting questions are raised by the article - including a criticism of Canadian services. Is it true? (No nationalism please!)
Well, no one else has taken a shot at this, so I guess I will, at least the confused assessment of the Canadian system...
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Solutions: There are free market answers to America's health care crisis
by Jonathan Trager
America has a health care problem that has developed into a full-fledged epidemic.
Over 40 million Americans currently lack health insurance. Skyrocketing health care costs eat up about 15% of the nation's total productivity. Thousands of businesses have dropped their employee health care benefits.
How did the American health care system become so diseased?
Prior to the 1960s, America had a health care system that many considered the best in the world. Most Americans could afford to pay for health insurance; hospital procedures didn't cost a week's pay;
A _week's_? more like a coupla month's...guess this guy's writing from the gold plated viewpoint.
charity hospitals were available for the poor and indigent; and doctors even made house calls.
Then the federal government stepped in with programs and regulations that would allegedly make health care more accessible. Since then, prices have gone up at a feverish pace, and increasing numbers of people are unable to afford coverage.
The ballooning cost of health care has been met by cries for even more government intervention. In the past year, politicians have proposed a Medicare prescription drug benefit, a "mental health parity" bill to force insurers to cover mental illnesses, and a "Patients' Bill of Rights" to give individuals more power to deal with health maintenance organizations (HMOs).
But further government intrusion into the health care market would be a cure worse than the disease. For a case in point, just look to America's northern neighbor.
Under Canada's "free" health care system, tax revenues fund all health care. There are no user fees. No insurance companies. No health care management organizations. At first blush, it sounds like the perfect patient paradise.
Well, every sentence in that paragraph is completely wrong. So I guess we can gauge the value of the rest of the article from that. Health care is not free, and there is indeed insurance. In fact, that's what the whole system is about - public health insurance. You pay monthly premiums, which pay for part of the system. The systems are run by the provinces, so each one is different, within the limitations set by the feds for the form of the administration necessary in order to qualify for the federal subsidy. This is one of those classic federal/provincial battlegrounds, where the provinces refuse to be obligated to dedicate the federal money specifically to the designated program, but since the feds reduced transfer payments across the board in '94, the provincial programs have been struggling to get along with as much federal money as they can get. So each province has a medical insurance plan, and if you can't make the payments, you can fill out the forms to demonstrate that you have inadequate income, and you will be given premium assistance, up to complete coverage of premiums. If you don't meet the criteria, you have to pay the full premium. The provinces are free to fashion their systems within the federal constraints, which includes the option of small user fees, which are however politically unpopular. Hospital stays are managed diferently than medical care, and not subject to the same level of constraint. Most provinces have a built in subsidy for hospital stay, but there remain substantial user fees, which can be covered by a simple extension beyond the basic medical insurance.The reality is quite different. Canadian politicians may have been able to dispense with the for-profit system, but they have been unable to repeal the laws of supply and demand.
According to the Canadian Fraser Institute, hospital waiting times have increased a dramatic 51% since 1993, when the median wait for Canadian patients to receive treatment was already 9.3 weeks.
This is directly due to the federal government's retreat from
general transfer payments, which go to general provincial coffers.
This was in order to combat the federal deficit, which had nothing to
do with the medicare system. It is not possible, because of the
way the funds are sunk into general provincial budgets, to easily
show what's going on, but if you take the time to go through all
the numbers, you can show that the medicare system manages all right,
in terms of funds vs expenses, if it were separated out. But the provinces have been struggling with their whole budgets because of the reduction of the federal portion, and as they manage
their medical systems from the same budget as everything else,
they can shave funds from the medical system to support other
programs. Thus provincial systems, which had run perfectly well
for 25 years prior, started to have difficulties starting in '94.
Trying to blame this on the principle of public health care is
a simple outright deceit. Again, lies, and half truths to support
an ideological agenda which ultimately comes down to: I don't want
to have to share in the support of people who are less well off
than myself, because I'm a self centred greedy bastard whose soul
is as foul as sewer, but I'm going to couch my venal motives in
a lot of fancy language to try and create an antiseptic impersonal
justification to snow the ignorant, who, like me, want some nice
soft fluffy words to aaesthesize their conscience so they can go
about accumulating material wealth to try to satisfy the unending
pain in their souls that comes from not experiencing the joy that
comes from willingly helping others less fortunate than themselves.
There, see how symetrical that is?
Hope you liked the rant, it's easy to get me going when the target
is so transparent, and the words "Fraser Institute" inspire my contempt.
**************************************************** Harry Pollard Henry George School of Social Science of Los Angeles Box 655 Tujunga CA 91042 Tel: (818) 352-4141 -- Fax: (818) 353-2242 http://home.attbi.com/~haledward ****************************************************
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