Renegade

Good idea. I would actually institute it a different way. People pay 20% of the cost of their medical procedure. Minimium $20, Maximum $1000. That is going to be unenforcable. How do you know something is someone's fault. If someone had one cigarette in their life and they get cancer later in life, can you prove that it was the cigarette? More severely limit the expensive procedures which are available. Allow people to buy supplemental insurance to cover these procedures if they so choose. Cap the amount of healthcare dollars spent on an individual in any year. Put in a yearly deductable. (ie you pay ALL of your medical costs up to the deductable limit)

You miss the other pont, that EI also ensures a lack of freedom. People have no ability to choose their abilty to participate in the plan. Lack of freedom is a bad thing. No?

I think you need to distinguish between a "right" and universality. Since the service is offered to every resident, its is universal. It is not however a "right". The services offered can be changed simply by legislation. The same is true of police or fire services. A government can decide not to provide fire services and that it should be provided by volunteers. A goverment however, cannot simply pass legislation which contrevenes a citizen's rights, neither in the US nor Canada, except in some very exceptional circumstances. Neither in Canada nor in the US is free access to healthcare defined as a right.

Out of curiousity, how much does insurnace cost you (if you actually purchased it)?

The average person could afford such a policy. Do you have any evidence to suggest they can't? I am not suggesting a one-size-fits-all policy. People would purchase the maximium coverage they could afford. A high-risk indivdual would likely only be able to afford a policy which provides reduced coverage. Of course there will be a segment of society who could not afford to pay. That woud be handled in the same way as the segment of society who cannot afford to pay for their shelter. A mimimal level welfare benefit. Of course those who do not pay for their own medical care should not be entitled to the same level of care as those who do.

If this is true, then pure math will tell you that this is unsustainable situation. The money for someone's retirement and healthcare have to come from somewhere. If as you says the vast majority can't cover their own costs during their working lives, that money MUST come from an increasing population base. Surely you must agree that situation cannot continue infdefinitely. BTW, your statement above all but agrees with my earlier assertion about self-sufficiency (ie that some poeple don't cover their own healthcare costs) But isn't that the reason I purchase insurance. It is not that I gamble that I won't deveop such a conditon, it is that I anticipate that I might develop such a condition. As long as I pay my premium to obtain coverage, insurance should pay for the treatment of the affliction until it is cured or I'm dead. Let me propose something, what if a "Lifetime Medical Insurace" plan was offered, with predefined premiums and coverage for the duration of my existance? Would that meet the needs of most people? Probably. People would be assessed for risk early in life, and would have certainty on the premium and coverage later in life. Note that I'm simply proposing that such a plan could be offered, not suggesting that it be mandatory. There is absolutely something wrong with such a system. What is wrong is the removal of individual choice and freedom and the ablity to pick a model which best suits one's individual needs. Depending upon how you define what a "basic level of care" is, I think this is one area we probably can agree. What I object to is the free-for-all buffet-of-any-healthcare-procedure-at-any-cost-to-the-taxpayer system we have today.

It is a zero-sum situation. If 99% the older segment is not capable of paying their premims, someone else is making up the shortfall on their behalf. Your statement would imply that the older segment is consuming healthcare resources they are not capable of paying for (this is probably true). But during their working lives they did have the fiscal capacity and should have banked it to pay for their aging years. The number cited (from numerious other threads on this topic) for the cost of healthcare for a senior is $8K-$10K yearly average. I absolutely do think that everybody ought to plan to pay such a cost when they are older. And no, I don't think you need to be "extremely wealthy" in order to affod such a cost. Yes I am aware that the cost will go up as new medical procedures are invented. But no, I don't think that everyone is entitled to medical coverage that allows them to live to 150 simply because it becomes technologically possible at some point. This "social contract" you speak of for healthcare has not been around long enough to prove its viability. It has depended upon a small aged population and a large young working population. This is a Ponzi scheme which cannot go on indefinitely. As a larger and larger segment of the population ages, and as more and more expensive medical procedures abound, time will tell whether the smaller and smaller working population base, who will be compelled to make a larger and large overcontributon without a guarantee of future coverage, will see this as the most rational choice.

So, does that background contradict anything I've stated?

So what your saying is that 99% of the population cannot manage their finances over their lifetime so that they balance the times when they are low risk to offset the tmes when they are high risk? You're saying that the ones who are low risk today benefit because they are financially incompetant and cannot plan for higher premiums? Personally I don't believe this to be true, and if there was a segment of the population that was that incompetant, then they are the architects of their own fate. Yes that is true with life insurance, but in return the insurance company gives the policy holder some cetaintity. For example in a whole life policy, the premiums and coverage is predefined. No such certaintity exists with government run public healthcare. When an individual is young and low-risk he will pay high "premiums". He is not given any certaintity that in 30 years that he is given any coverage at all. That is completely at the whim of the govenment and population priorities at the time. There are two choices: 1. an unwritten "undersanding" that my premiums when I am high-risk (at some point in the future) will offset my overcontribuions when I am low risk 2. leave it to my own control to manage my premium contribution so that the times I am low risk offset the times when I am high risk. For me there is no question that 2. is the preferred choice.

Not in my experience. I save about 30% through my association plan. Do you have evidence to cite as a comparison between mandatory group, optional group, and individual plans? Of course an individual's risk proifle will change with time. I never stated or believed it would not. I would propose that the premium be reflective of your risk profile. If one's risk profile changed, so would their premium and so would their beneft For the most part, that is how most insurance schemes work.

If an insurance company charged me higher rates as an individual, I would simply buy under a group umbrella. You seem to assert that healthcare is a special case. I don't see why. I buy P&C insurance through the insurer associated with my professional association. It is not mandatory that I purchase through them, yet I do because I get preferrential rates over what I could get as an individual. It has nothing to do with the mandtoryness of the coverage. Well you are finally zeroing in for the reason for the mandatory participation. It is due to political support so that one segment (the majority) can impose its will on the other. The cost savings are not simply because of the volume that a mandatory plan implies, but because one segment subsidizes the other. As long as the subsidized segment has enough political clout, mandatory plans will be in place to prevent the other segments from opting out.

No there are many other reasons you would seek to purchase insurance outside a specific group context. For example the group you may be associated with may have a particularly high risk profile, however you may not individually share that risk profile. Further you also may be part of a group which has a far lower risk profile. The generalization you assert that the only reason you purchase insurance outside a group context is if you have elevated risk, makes no sense to me. Yes, I agree that there is economic incentive to create mandatory plans. I never disputed that. That justification can be used pretty much everwhere. No doubt the unit cost of a TV can be reduced if we forced everyone to buy one and exactly the same model.

The numbers don't show that it is the manditoryness of the plan that results in reduced risks. How do you know for example it is simply not a volume discount? How do you know that rather than the risk actually being reduced, the insurance company simply has cost savings based upon the fact that they don't have to assess risk individually? Let's take your example of 10 individuals. Presumably their behaviuour and health do not change based upon their membership in the group or not. Thus their claims to the insurance company will be the same regardless of if they belong to the group or are simply individualls. The net cost to the insurance company is the same in either case regardless of if it collects higher premiums from individual policies or lower premiums based upon group coverage. If the net cost is the same, how can an insurance company legimitately claim that mandatory group coverage lowers risk and thus costs?

Personally, I wouldn't take an insurance companies statement as evidence without some justification as to the reason why Again we have nothing but your conclusioon of the insurance company's statement as evidence that this is true. Given that an inurance company has a vested interest in generating as much premium revenue as possible, and a mandatory plan helps insure that, I find it hard to take the insurance companies statement at face value.

"hundreds of thousands in extra taxes"???? Are you kiddng me? Given that she has said that she has never earned more than $15000 in any year and was not working for part of her adult life, she would have contributed almost nothing toward her medical costs. The reason she is so defensive for the system is that it is a great deal for her. Complete coverage at virtually no expense.

I wasn't referring to the US system I was referring to the Canadian one. In our system the cost of the medical system comes from general revenues which for the most part come from taxes. Yes, I missed that point as the hub of your argument. I makes no sense to me that mandatory group policies would somehow lower the risk of the group and thus result in reduced cost. Please explain why this woudl be so, and do you have any evidience that this is true? I am not at this point disputing your assertion, I just don't see any evidence of it nor do I see how you've come to that conclusion.

Can you be more specific on what you mean by "subsidises to corporations" or "direct payment of services"? As far as I know payment for medical services by the government comes from general revenues. Exactly! That reinforces my contention tht low risk people subsidize high risk people in group coverage. If, as you contend that in group coverage that even low-risk people are better off, then it would not be rational for them to opt out even if allowed to do so. Employers, and government, force coverage in cases where they need the low-risk individuals to subsidize the high-risk ones. I didn't necessarily mean an indivdual purchasing insurance would do so without any group affiliaton at all. Group membership aligns the individual's profile to the group. Individuals generally belong to a variety o groups and, will choose the group wihch give them the most enconomic advantage in coverage. An example of this is home and auto insurance. There is a variety of groups I belong to, (for example through my employer, through my Univeristy Alumini, through my profesional association, etc). No group forces me to take home and or auto through them, but each has an affiliation with an insurance company which provides preferential rates based upon the risk profile assigned to the group. I choose the policy based upon the group which gives me the best rates. There is no doubt that this gives me better rates than if my only group affiliation was with the population at large and the coverage was mandatory.

No it is not really that different. Insurance is insurance. The fact that there is a higher risk of claim is simply reflected in higher premium cost. Almost everyone makes an auto insurance claim at some point and the premiums paid reflect that. This makes no sense mathmatically. If your contention is that even "low risk" individuals do not cover their own true cost (relative to risk), then who does? The insurance pool is fixed. For some of the individuals not to cover the cost of the risk means that others in the pool must. It makes no sense to assert that no-one in the pool covers their cost. Not at all. The reason people are forced to contribute is because a politicial decision is made that it is deemed unacceptable to withold medical services from someone in need of such services, even if they of their own volition they opted out of the system. To prevent people people from abusing this tolerance, people are not allowed to opt out. It benefits some but not all. One reason for the savings it eliminates the cost of assessing risk individually, however those who pay high premiums and have low risk are unfairly penalize in such a system. A healthy individual earning a high income would be better off purchasing individual health insurance even when the cost of assessing risk are factored in. I've stated what I mean by self-sufficiency. To me it means covering the cost relative to risk, and it makes sense in health insurance just as much as in any other insurrance. If you have a preference for another term for the same concept, I'll happly use that instead.

Of course sharing risk is the point of insurance. Self-sufficiency comes about when the cost of contribution to the shared pool is commensurate to the risk that individual introduces of making a claim from the pool. I would consider a homeowner who pays his house insurance premium self-sufficient. I would consider a homeowner who needs someone else to pay their home insurance premium not self-sufficient. If the individual contribution is commensurate with the risk, then there is no need to force an individual to part of the insurance scheme so long as the pool is large enough. If the indivdual contribution is not commensurate with the risk, then those whos risk is low relative to the contribution will look to opt out if allowed.

It is a pity your self-sufficiency does not extend to providing enough to cover for your own healthcare. As to what I will do at 72, I have no idea. I expect I will be working at something not necessarily because I need to but because it may be something I want to do.

Have I? I assume then I was bang on in reading your logic. Sorry to disappoint you but I don't work for any insurance company. What group of freeloaders do you work for?

Since you are unlikely to get a straight answer, I will clue you into the logic of the anti-private medical care advocates: In our current system the healthier and wealthier subsidize the weaker and poorer. If a private system was offered, then more of the healthier and wealthier would choose that as an option rather than the public system. With continued use of the private system, the healthier and wealthier would have less interest in investment of government funds in a public system. Based upon this, the government would invest less and less in a public system and with time it would degrade, thus accelerating the pace of abandonment by the healthy and wealthy, until finally the public system is simply a place of substandard care for those who can't afford private care. Besides the pressure exerted by consumers, there would also be pressure by the healthcare staff. The best and brightest would move to the private system where they could get paid more, leading to substandard care in the public system. Further the increase wage competition from a private system would force costs up in a public system further increasing pressure to reduce service. Or so the logic goes...

I'm having difficulty understaning how a senior who have worked, in some cases 60 years, is living on less than $1000/month. CPP was enacted in 1966, so presumaby they have 40+ years of contribution to CPP, in addition to OAS and GIS. Please explain.

No I don't think we should stop anyone from going anywhere they wish for treatment. Do you think we should stop US medical staff from coming here to treat Canadians (on a paying basis)? Of course. User should pay some of the cost of the medical care they consume.

It would appear that you and I have interpreted the scenario differently. My response was meant to address the situation of where a potential immigrant contracted the virus while in Canada prior to applying for immigration. (for example someone visiting Canada or on a work permit). I fully agree that once they have been granted residency, it shouldn't be revoked because they acquired the virus.