Machjo

Like I said, politics have to be taken into account too. The Swedish system is among the best in the world too, and it's a single-payer health care system. But just look at the tax rate in that country. Do you honestly think Canadians would be prepared to see such a tax hike just to have among the best systems in the world? As for the US system, the government is fighting right now to get some kind of system passed. If it can't pass a single-payer system, then woudl it be preferable to abandon altogether or to adopt a two-tier system? In fact, Obama has already indicated support for a two-tier system. I remember reading that the Swedish system is generally consdiered among the most efficient systems, giving the biggest bang for the buck. Looking at it that way, politics aside, looking only at economics, it woudl make sense therefore to adopt the Swedish system. But in reality, would the taxpayer/voter accept that in the US or even Canada? Sure, the Swedish system is a marvellous system, if adequately funded that is. Otherwise, if politics won't allow for adequate funding, then two-tier is still preferable as a way to at least allow some private-sector money into the system to alleviate the pressure on the public system even if it isn't the most efficient system. At that stage, it has nothing to do with logic or efficiency, but with pure politics. Then again, if the Swedish system adopted a two-tier system, chances are no one would opt for a private system simply because if the public system is sufficiently well funded, then everyone is happy with the public system anyway. Looking at it that way, a two-tier system simply allows for a pressure valve when the government of the day chooses not to fund the system adequately.

Well, from my experiences, it would seem that most people have defended the military against my claims about the tax burden for the war in Afghanistan, even though if we suggest more taxes for social services, it's just unacceptable. I have no statistics, but just going on my personal experiences.

Also, I assume the postal service is cheaper than the others too, isn't it?

The question here is political. If the public health care system is short of cash, there are two options: 1. increase taxes, or 2. allow for a parallel private system for those who can afford it. If a candidate in an election can convince the electorate to support a tax increase to pay for this, all well and dandy. Otherwise, the next best option is to allow those who don't want to participate in the public ssytem beyond paying for it to opt out with their own money so as to alleviate the burden for the rest. Sure we could argue that tax increases are necessary. But that is conditional on convincing the electorate. That is not a decision made by the government itself. Now, if the elctorate refuse to raise taxes and refuse to allow private healthcare, then all suffer.

Hey, that's the reality of politics. By the way, the military faces the same challenge depending on the government of the day. Same with the police, same with public schools. If we allow for private participation, then the private sector arms industry, private schools, private hospitals, etc. all face the same challenge of having to react to the demands of the government market, likely to change every four years depending on the government in power, So how do we solve this? Do we nationalize the weapons industry, all private schools, etc. etc. etc.? And if we do that, then how does the government manage the fluctuation in demand for various products and services from election to election whenever a government reduces or increases taxes and spending? Do we lay off excess staff one year and then four years later hire them again and retrain them? How far do we go in banning private sector participation in public sector spending just to protect the private sector from fluctuations in government spending? This would also mean that the government woudl have to suck up the costs involved in these changes instead of the private sector. Yet more bureaucracy to overlook this massive government industry.

But you'll notice that the main criticism is money, cost. Imagine how much more it would have cost if private insurance were banned. Of course sooner or later there is no choice but to either allow for more private care or a tax increase, or a combination of the two. But to ban private care would logically push the cost of public care up, thus increasing costs even more.

Think about it. Most seem just thrilled with the government spending on the military, yet while we've heard of people complaining of long waiting times, seldom do we hear people exclaim that they'd be willing to pay more tax for health care.

Hmmm.... he should have put more thought into that. Instead, I woudl have argued it this way: The US postal service provides essential postal service, but if you're willing to pay the price for more non-essential services, such as faster overnight delivery, etc., then you're free to do so. The parallel with the health care system is that the government would provide essential healthcare while you'd be free to pay the price if you wish for additional non-essential amenities.

Over the years, many Canadians have complained of excessive waiting times for health care delivery in Canada, yet we continue to be loath to pay more taxes unless it's for the military. If we wanted to improve the system, we could consider a two-tier system as a means of bringing more private-sector funds into the system. But many Canadians are opposed to a two-tier system too. If we were looking at a foreing single-payer model outside of Canada that has proven successful over the years, we could took to Sweden's: http://www.sweden.se/eng/Home/Quick-facts/...sh-health-care/ It has an excellent, albeit highly tax-dependent, system. A Lamborgini Countach might be a good car, but it won't go far without gas. If we're not going to fund the system adequately, then for the sake of the ill, we may have no choice but to adopt a two-tier model. One possibility I could see would be to combine the strenghs of the Swedish system with those of the US model with that of the Swedish model, whereby a public system of the Swedish quality would exist side by side with a US-style private system. Whenever the government of the day is prepared to fund the public system adequately, the private system would simply become redundant. And whenthe government of the day is not prepared to fund the public system adequately, then those who wish to pay out of pocket woudl certainly be free to do so as a means of reducing wait-times for the rest. Such a co-existence of the Swedish and US models would likely come out looking something like the Singaporean model, whereby both a private and public system co-exist on all levels. Though I can understand the passion many have for a single-payer system, we must also appraise the political reality in Canada that most Canadians are not willing to pay the taxes necessary to maintain a high-quality public single-payer system anymore, unlike in Scandinavia. If we aren't willing to pay the tax anymore, then we really have no choice but to switch to a two-tier system.

In Sweden, all the central government does besides most funding, is to lay basic guidelines. The details are decided at the local level, and the local leverl can supplement central government funding through its own taxes too. Doesn't even compare to the decentralization here.

Do you vote for the local health board every provincial election?

Again, the false dichotomy. You seem to be suggesting that it would not be possible to increase taxes on the rich and allow them access to private healthcare. You seem to be suggesting that it must be one or the other. Why such an insistence on this false dichotomy?

Another thing yuo'll find if you read up on the link for Sweden avbove, is that their system is more democratic too, decentralized at the county or even municipal level, with the health board elected every foru years at the same time as the national government. Democratization of the health system might explain the greater success rate. It's closer to the general population. Also, the health board is responsible for overall health of the community, and so I take it that means it can also make recommendaitons regarding pollution and other factors in the local environment, thus making fora more wholistic approach. I'm not necessarily against a one-tier system, as long as it's so wll done that no one would be interested in paying out of his own pocket anyway. And the best way to ensure that is to allow people to pay out of their own pocket and then when people do, take that as a warning sign. You'll also notice that the Swedish model intertwines medical care and income due to illness. It's indeed an impresive and high-quality system, but I doubt the Canadian taxpayer would be prepared to pay the money for such a high-quality system. I can't see it being politically feasible, and so the next best thing would seem to be the French or Singaporean models.

As far as I know, transport is not a constitutional requirement. So time to scrap the roads I think. Wallstreet would love it. Buy a lane and charge a fee for it.

Bold added. Why not as they wish? If they're paying for it, does it matter?

http://en.wikipedia.org/wiki/Health_in_France I won't type it all here because the link is detailed enough as it is. You can also look here for other models: http://en.wikipedia.org/wiki/Two-tier_health_care You can look up the Singaporean model as a good one too, ranked sixth in the world: http://en.wikipedia.org/wiki/Healthcare_in_Singapore If you absolutely insist on a strictly public system, then consider Sweden's: http://en.wikipedia.org/wiki/Health_care_in_Sweden It is not a two-tier system, but unlike Canada's, it's more decentralized, but is fully funded by public funds. Another diffrence is that Sweden has a high tax rate and consdierable government funding of healthcare. Sweden's is considered high quality too. However, it would seem that a purely public system works well only if sufficiently funded, otherwise it woudl be preferable to go to two-tiered. Then again, I don't see why we could not go two-tiered and increase taxes and government funding simultaneously. This way, the rich could opt out if they wanted to, but would likely choose not to owing to both the quality of the public system and the high taxes making it difficult for the rich to do so. I really don't see why it must always be so black and wite all the time.

I'm not necessarily against increasing taxes on the rich, but you seem to be proposing a false dichotomy. You seem to be suggesting that we can either increase taxes and restrict private health care, or free private health care and forfeit taxes on the rich. If that is what you're suggesting, that is a false dichotomy. Why would it not be possible to double taxes on the rich as you say, and still allow them to pay for their own private health care if they want to?

How would allowing private healthcare dismantle public healthcare? In fact, have you not considered the possibility that we could adopt a two-tier system and also increase taxes and government funding for public health care? The two needn't necessarily be mutually exclusive. Let's consider the Swedish school voucher system introduced in 1992 for instance. Even though to the Canadian eye it looks akin to Republican-style school voucher proposals, it is very different on a number of fronts: 1. It has many restrictions, such as all participating schools can't charge more than the values of the voucher, 2. all participating schools must accept students on a first come first serve basis, and 3. they must still implement the national curriculum. yet, in spite of the idea of a voucher being akin to a US Republican idea, let's not forget that the Swedish government still funds its voucher system more generously than we fund our schools. And since it allows private investment, that means that in addition to government funidng, private funding goes into the system too. So we shouldn't think so much in terms of black and white, capitalist and socialist. Though Sweden is generally considered more socialist than the US when it comes to government spending, the Swedish government owns a smaller %age of the GDP than the US does, even though Sweden is generally considered among the most socialist democracies. We should't think that the relationship between private and public must always be confronttional.

Of course there's a double standard. If we want a publicly funded health care system, then we'll need a highly educated pupulation. This might not necessarily mean total government control but certainly more government funding. In Sweden for instance, they use a school voucher ssytem, with about 10% of elementary and high schools being privately owned. But it is unquestionably very generously funded by the government. France and Singapore, and many other countries allow for private participation i their medicare, but government funding is also very high. Sweden's healthcare is one-tiered, but again, very well funded. But to pay for the healthcare, we need a solid tax base, and that means invensting in education too. This does not mean socialist dogmatism though.

If you should oppose private schools, then parents sending their children to them would then have to send them to public schools, thus stretching public funding even more thinly. So, would you be prepared to pay higher taxes to compensate for the additional strain on the school system of prohibiting parents from sending their children to private schools? And what about college and university? Would you be prepared to pay a substantial tax hike to fund a public higher education system funded 100% through public funds?

But in the end, it's the people who choose this kind of government fully cognisant.

But the subs themselves aren't. Why not put the military up on Wall Street?

What I meant was, should we prohibit people from paying their own way through college just to ensure all are equal? It could be done, but only through either a very emaciated system or through a major tax hike for the government and more government funding. To allow people to pay for their own education but not healthcare is an inconsistent argument. What about private elementary and secondary schools? If you're consistend, then you oppose that too, right.

Absolutely. That's why I say the US should privatise its nuclear subs.

Are you saying the poor in France and Singapore aren't getting the care they need because those are two-tier systems? As for what we tried to do in this country, doyou have the same feelings towrds education? Should all post-compulsory education be publicly funded? If you're consistend, you'lll say yes, otherwise some other motive will have to be suspected.