dizzy

market vs. democratic agency. Both are designed for consumer input. And both have developed means to shirk it.

This would be more convincing if you didn't dedicate 3 posts to motivating me toward your 'humor'... They tried it out, but US Medicare wasn't suiting them. From what they have said, medicare covers the golden share of her hospital needs (which are minimal as they are generally not in need of emergency care) but very little of doctor, specialist and drug care. All are covered at 100% in Québec, where we live. I'm sure that $600K could cover a lot in Tennessee. But, then again, a simple surgery could drain most of that.

A lot of people express nationalist vibrato here. And they're not all canadians. intolerable? no. I've discussed this in previous posts. And, let me tell you, as a guy who lost internal body parts and as the son of an aging parent and a father, I've explored the system form many dimensions. Does it need improvement, yes! But, in truth, the system has been wicked good to me and my own. I've had the privilege to experience systems in the US and Europe and, while I can tell to that there are things I liked or disliked about each, I must say that all were good and I think we could learn something from each other if we allowed it for ourselves. Taxes paid? As mentioned before, public and private contributions here amount to half what americans pay so, no. I see provincialism as a good thing. The financial structure is that you have 10 democratically-elected bodies, each working to provide the best possible service for the least amount of money. Quebec, Ontario, Alberta and BC in particular are taking different routes and there are good things to cherry pick from each. This kind of forced innovation has a lot to do with the improvements we've seen over the past 10 yrs - keeping in mind that all these improvements were made while we were getting tax cuts at the federal and provincial levels. I think the best long term solution is to kill the Canada Health Act and close down Health Canada (other than the CFIA and drug approval programs). Keep the feds in their constitutional domain and let the provinces do their thing. Do any of the Canadians out there agree? I have no idea where you attribute the most expensive system in the world claim to Canada. Please quote source so that I can read for myself. Everyone is using other people's systems as a 'gap' as you call it. Again, I call it trade, like cars and toothpicks. When I last went to india in 2007, I met entrepreneurs who were establishing surgical clinics for american medical tourists. Whole industries set up in different countries for americans. But, in a post-national economy, I fail to see why people moving across borders to get what they want or need is a bad thing. Especially if it is not at the cost of individual access.

Like I said, you've got to works if you wants to gain my giggles. As a courtesy, I went back to the post in question. All I found was this one liner: "If that's true, they aren't the sharpest tools in the shed." ...?

I dispute the statement suggesting that more canadians per capita seek healthcare outside of their country than do americans. But I say that with disinterest because, my essential question is, what does it matter? If people are comfortably able to get the healthcare they desire, let them get it where they get it. Medical tourism is a good thing so long as it is achievable. As said before, I agree with you that many canadians are unaware that their provinces consciously incorporate american capacity into their healthcare budget projections. But I'm not sure why canadians would dislike this. What's cheaper, training and retaining the capacity for all canadians across this sparse landscape to have a heart doctor on call, or occasionally sending overflow to a heart centre in buffalo or montana, where the staff are twiddling their thumbs because the guy down the street can't afford to their services? I feel awful for Danny William because he is going to get plowed by the media when he returns. I just don't see the problem with him getting access to care, wherever he chooses. But, if this anxiety is what it takes to keep canadians sufficiently anxious such that they're prepared for healthcare reform, then I'm cool. Any attention is good attention, right?

K, I'm going to pass on the passive-aggressive exchange of smileys. Get back to me when you want to discuss the deets of the post in question.

Good point.

I'll laugh at anything that's funny, honey! If you're upset at the comment about international ignorance, know that really I meant it, but as a cute idiosyncrasy, kinda like how it's both sweet and annoying that canadians are so obsessively polite. On the content aspect of your post, your retort to the experience of two of your compatriots lacks compassion for a well-established flaw with your system. And, while I haven't seen the results of their IQ tests, I can assure you that they are self-sufficient folks who own two homes free and clear, both more expensive than an average owner in either country would hold. This is only a small reflection of how generally entrepreneurial they are in their life engagements. I haven't discussed the deets with them but when they return alongside the winter melt, I'll ask them why they chose this awkward scenario over medigap. I do know they had issues with 'pre-existing' and, despite their financial comfort, this was the best option. BTW, If we're comparing funny and condescending british commonwealth lit about the colonies, check out Vernon God Little. I won't quote because I don't want to give away the ending...

It's not relevant. There's no narrative within the contributions of some here. It's just tit for tat, like a basketball game or a schoolyard skirmish.

I meant it in the sense of that what they produce in film & television actually makes money and sells to international audiences. I think the top grossing english canadian movie was men with brooms, which cost $7.5 million to make and grossed about $4 million. But I wasn't clear (late night/early morning post) and you're right. In terms of the arts and in music and literature, there are amazing things going on across Canada. Even in Alberta!

Alberta is the land of milk and honey and I don't begrudge its wealth. I'm grateful for the money it brings into the federation. But there's no intellectual capital there. Quebec is a world leader in aerospace, mass transportation, biotechnology. It has the only self-sustaining cultural industries in Canada. So, while I'm grateful for the incredible wealth produced from alberta's piece of earth, of the two provinces it's Quebec that gives us our 'first-world' stature. Both provinces bring a distinct worldview into our society. Canada has one-third of the world's brain power on alternative energies. When we do finally begin to wean ourselves from oil and coal, we should be in a good position to replace the economic loss.

I do agree that it is an untouchable, exaggerated in forums like this where there's some cross national goading at play. We see that on different issues in every country. I'm unsure what will come of healthcare reform in the US. I'm looking at my neigbhour's empty home as I write. They're seniors and american citizens who would like to retire fulltime to their home near knoxville. Instead, they're sitting on a $600K home here so that they can keep their 6 months + a day. All because of healthcare... It sounds like you've got a good thing going on and, to be frank, so do I. This system has always treated me very well (including for a couple of near death adventures, and a lost kidney and spleen to show for it ). I haven't had to but if I need to, I can afford the out-of-pocket for private access. I expect that most of these options will soon be covered in my and many other's private health plans. But not everyone in either of our fair countries has that option and that means something to me. Exercising an opportunity to improve does not mean that things are bad. not my point, but also not really my concern... just an observation. I'm not surprised. I've got love for my american peeps, but they are the only people in the world who are actually proud to be ignorant of the world outside of their borders Eliminating pre-existing and out-of-jurisdiction exclusions would be a big start... but under-coverage and overutilization are also considerable problems, even for those with insurance. The need for tort reform is overstated but another nice-to-have.

I think the fuss over Danny heading south is ridiculous, but I'm glad it happened. The patriotic fervour and chauvinism is needed if we have any chance of getting healthcare reform back in people's minds. It doesn't really matter because change is already in the works, thanks in part to court influence, but I think it's important to have my fellow citizens involved in the discussion. Healthcare might not be a right, but it's definitely a strong thread in the fabric of our political identity. It took me awhile to decipher your response on this point until I realized that you're talking exclusively from the american pov (which, seeing from your posting habits, I find consistent but also a little weird given that this website is called mapleleafweb.com...), so I'll respond to that. Clearly, americans also want to improve their system. I think that Canada offers some overall good directions on the broader determinants of health. I agree that France presents a better option with respect to public/private medicare, but also one that would be very hard to integrate into american culture. Think of the taxes! Obama really did give you a good option on first draft with the variant on the swiss model. The present bills are so diluted that you'll likely get a program that offers you more pain with little gain.

Lowell Green is so absurd that he's really quite funny to listen to. Michael Harris is one of the more reasonable voices I've heard on talk radio anywhere. I'm not a huge fan of rob snow, but I do like his monday and tuesday political panels, more to hear the individual party's particular spin. They do have a webstream if the issue is reception in your workplace.

They won't necessarily hurt him by switching their vote, they'll do it by showing up to vote. Like 2004.

The only numbers I've seen are statistically miniscule. Plenty of americans (also statistically minimal) travel in the opposite direction, primarily for drugs or nonessentials such as lasik, or to other other countries for hips, knees, hearts, cancer treatment, etc. My question is, why do people care? This not a national security issue, it's just trade. I know there are some fantastic facilities in the US and it's no mistake that some setup along the border. The provincial plans act as purchasing pools that can secure a good price and establish expectations for standards of care that I can't as an individual consumer. Just like they do with providers in Canada.

The religious right may make obama pay in the polls, but revoking don't ask, don't tell will have very little negative effect within the US military.

Anyone can make changes if they get the provinces and the people on side. Unfortunately, Mulroney was not able to for the Charlottetown and Meech Lake Accords, but he did try.

I agree with most of this. The one exception is to acknowledge that wait times also exist in the US for everyone but the rich. There's also the very big issue of exclusion due to 'pre-existing conditions'. The spectrum of insurance options in the US is broad and, indeed, each comes with its own advantages and disadvantages. At my income level (let's say upper middle income) and for those who make less, I see nothing to gain from the status quo or proposed structures for insurance provision. Despite being a fan of two-tiered healthcare, I guess I have two sets of major concerns based on the American experience. The first is with respect to bureaucratic waste. HC administration in the US consumes 25% of healthcare spending. We're not talking profits here, but money consumed in filing papers to determine eligibility and to process claims. Our system can maintain lower admin costs because it is single payer. What I'd like to research is the difference in size-of-bureaucracy between (privately insured) dental and (publicly insured) doctor services here. My second, bigger concern is with respect to overutilization. That doctors overprescribe and engage in a disproportionately high number of invasive procedures because it is more profitable to do so (irrespective of the benefit to the patient) is probably my biggest concern. That it seems to happen to the point of financial and physical abuse in the medicare program is criminal. I do expect that overall spending in Canada has to rise for people to get the service they want, but I expect a more modest adjustment of $500 per capita, primarily to invest in early detection technology and to bring back a few more specialists to accomodate people in less-populated regions. Our intervention-stage load is sufficient and, while more specialists might be nice overall, it's really not the problem. What I would also like to see is an increase in authorities for registered nurses. I don't need to see a doctor every time I want to discuss my cholestoral levels or get my kids runny nose checked out. A nurse would do. When I get my travel shots updated, I go to a privately-run travel medical clinic where someone considerably less qualified than a nurse uses a computer to crosstab one's health issues with each vaccination's side effects. It costs me $15 for the visit and my insurance company pays for the drugs. quick, easy, cheap. We should also give pharmacists (who frankly know much more about the products they're handling than do doctors) authority to prescribe certain drugs and renew others. I believe that they have already begun this in BC. FTR, One thing I'm not afraid of is profit incentive. Some of the debate in Canada seems to hang on this point. But, let's be honest; our single payer system is already engaging mostly private entities. If that doctor is running his own proprietorship, then we can claim that the insurance payments amount to 'income'. But, in the real world, most of their practices are run by incorporated bodies, so we already have a profit motive in play. Most of the debate on both sides of our border is crippled because we keep obsessing on each other's programs. I'd rather look at places like germany for our reform and I believe that obama was looking to switzerland, not canada, when he developed the original plan. EDIT: BTW, thank you for climbing down from the flag pole.

I'm gonna pass on responding to flag waving rhetoric. Let me know when you want to discuss the details.

I respect their frustration with the bad press but everyone needs to chill a bit. The nationalism around this issue is framing the debate more than the operational realities. One of the things that I find particularly good about the Canadian system is that it is plugged into opportunities by geography. For example, southern Albertans are more likely to go to Montana for overflow, because it is the shortest a-to-b line. We don't know whether Danny left for specialist expertise or because the cue suggested a more immediate opening somewhere in the states. When we know this (and whether he's traveling on his own dime or the provinces), we'll be better able to judge.

You've hit my nerd funny bone. Unfortunately, I can't go back to the CANSIMs sourced in the tables because they cost money and you haven't yet proven whether or not you're worth me spending my coin . But I'll be honest right now, when you get into the realm of PPP-adjusted GDP or PDI, deflated for CPI, the game we're playing is so purely academic that we would be able to go back and forth all night with sources that perfectly contradict the other. I am curious why we're still fussing over the 'absolution of canada continental unification organization's' interpretation when I provided yummy OECD and CIBC data. What did you think of those? And also my previously supplied info that fully 10% of americans' private disposable income is spent on healthcare? That's on top of public and employer contributions. Getting back to the OP, what does any of this say about the launching point, which is that the US spends twice as much? You had mentioned earlier that americans don't want or wouldn't necessarily benefit from a canadian system. I'd agree in that I think our system is also in transition. But I don't think that the Canadian system was ever on the table. One of the shortcomings of the debate on healthcare in the US is that soundbite culture has framed much of the debate around canadian-brand healthcare. In truth, the system Obama originally proposed was much more like the swiss model.

Yeah, I need to sit back and rethink my position. I'm less convinced of it than when I began participating in this discussion.

I'm confused. The source listed for the numbers on disposable income is only listed as http://www.csls.ca/ Did you find the actual stat from which they extracted the 29% difference in disposable income?

I'm not doing your homework for you! (teasing). But seriously, the source references in their research are pre2005 - some to 2007 - (not unusual as most governments' stats are updated every 5-10 yrs). The other info links I provided are from the OECD and CIBC, and provide much more recent data. Damn, I swore I would get sucked into this shell game because I wanted to stay focused on the healthcare issue...