Manitoba Wait Times Rising for Heart Surgery

[Jack Weber]

I think dre just mentioned the elephant in the room...

I think dre is a huge fan of Hayek/Friedman economic philosophy...

[Michael Hardner]

I think dre is a huge fan of Hayek/Friedman economic philosophy...

Really ? That's good - we need a lot of perspectives on this, and we're sorely lacking in people who have different ideas on reducing costs.

[Dave_ON]

True, but the term is much older than that, dating back to Dutch and British origins / usage.

True it does pre-date the civil war however it was still used in the earliest records to refer to those in the New England area. It was combination of Dutch last names common in the region if I recall. The British even applied it this way in the early days later certain prominent British generals began misusing it.

Canada is poorly serviced for higher fees than in the US...including cable television.

I would agree with you in terms of cell phones. However in terms of POTS and DSL service Canada was well ahead of the US in terms of speed/line quality. In the 90's and most of early 2000 almost all of New England was on old copper wire, in some areas the copper wire was the original set out when the POTS network was first created. It wasn't until Bell Atlantic, acquired NYNEX and subsequently merged with GTE and became Verizon that things started to get better. The new larger, company was able to pool it resources and get their network up to date, by replacing old copper, and installing fibre. If the government hadn't broken up Ma Bell into 7 baby bells they likely wouldn't have fallen so far behind. But mandating competition certainly worked to lower prices, this I won't argue, but it did nothing for quality of service. The parent companies were forced to share their networks with other providers, but still were responsible for all the costs. As such nothing was upgraded because this would cut into profit. In such a competitive market you can't afford to raise your prices to recoup the money invested in infrastructure. Why pay 40 a month from Verizon will Joe Bob's DSL shack is selling the same service for 30? As such the highest available internet speed in most of the US was still 768K, where a large part of Canada was already at the 1.5 M.

No, health care costs will always rise when being chased by private and public insurance dollars. The real competition will come when hard choices have to be made about services, costs, and what/who will be denied limitless access.

Much of the cost of health care in the US is administration. Hospitals have to hire office personal to collect bills that are due, and to chase insurance companies. Much of this cost is cut out of our system as if it's a covered service the health care provider doesn't have to "fight" for every penny they get. Having said that we definitely have improvements to make, I'm not convinced, nor shall I ever be convinced, that getting rid of universal health care and moving to a private pay system is the best solution. Better the devil you know than the devil you don't.

[dre]

They key is to strenthen the JCI which already getting pretty good. Thats the organization that accredits foreign hospitals and doctors. One of the challenges to fully implementing my solution is that North Americans have this misconception that if they go to Thialand, or India, or NewZealand they will be treated in a grass hut by a guy with a bone in his nose. Its simply not true.

Heres where you can read a bit of general stuff about the JCI.

http://www.hziegler.com/locations/middle-east/articles/jci-accreditation.html

Heres an outside the box method of impelementing the the second part of my solution in my previous post.

First of all open up our medical insurance system so that it will pay for procedures done outside of the country. Currently in almost all cases it does not. Then offer to split all savings wih the patients.

So for example...

A patient needs an operation that costs 100 thousand in Canada, but only 10 000 in India at a JCI accredited hospital. Thats a savings of 90 000 dollars. Give the patient half!... 45 thousand dollars, they can use that to arrange their travel, pay for the procedure, and hell... purchase a brand new car! And the healthcare system still saves 45 thousand dollars. This should be a incentive to increase medical tourism, which by the way is already growing rapidly due to rampant price gouging in Canada and the US.

The introduction of competition will also put downward pressure on costs and wages here in Canada, and the reduced burden on the system will reduce wait times.

In any case only allowing health insurance to purchase services inside Canada is blatant protectionism and puts massive upwards pressure on prices. This is where some of the worst deals are globally!

[Dave_ON]

The British used it during the war of 1812, when stymied by Andrew Jackson at Mobile, Alabama. "THESE Yankees know how to fight."

The first recorded usage of the word pre-dates the war of 1812; it was used by the British General James Wolfe. "I can afford you two companies of Yankees, and the more because they are better for ranging and scouting than either work or vigilance." Wolfe was specifically referring to those Americans under his command who were from New England. The term today varies depending on who uses it. In New England it's more of an ancestral reference. In the south it's often has the adjective "damn" in front of it and is generally pejorative. Indeed many southerners may still be unaware that Damn Yankee is in fact two words.

How were they behind us ? Our rates were sky-high years after competition reduced theirs.

Infrastructure and level of service was, and still is to some degree, behind that of Canada, specifically I'm referring to DSL and POTS, as much of the American network was old copper and could barely support 768k in many areas. This was due for the most part to little to no investment in renewing the existing network, a side effect of government mandated competition.

[bush_cheney2004]

.....Infrastructure and level of service was, and still is to some degree, behind that of Canada, specifically I'm referring to DSL and POTS, as much of the American network was old copper and could barely support 768k in many areas. This was due for the most part to little to no investment in renewing the existing network, a side effect of government mandated competition.

This varies by region. Commercial access speeds were certainly not limited to 768K, as the base T1 carrier speed was 1.54 Mbit/s. I have never used residential DSL, and fiber was laid early on in our area, only limited by "the last mile" to residential customers. Fact is, most of the fiber remained "dark" for many years.

There are threads in this forum from Canadians griping about fewer choices and higher costs. That hasn't changed.....

[Dave_ON]

This varies by region. Commercial access speeds were certainly not limited to 768K, as the base T1 carrier speed was 1.54 Mbit/s. I have never used residential DSL, and fiber was laid early on in our area, only limited by "the last mile" to residential customers. Fact is, most of the fiber remained "dark" for many years.

True enough though at that time trunk lines were quite pricey as they required additional equipment in the CO and often additional wiring be run to the location. T1's reduced the loop length issues that are inherent to DSL but not by much. You still had to be relatively close (in terms of length of copper wire between you and the office not geographical distance) to the CO to qualify for that service, if you ever achieved it is another matter entirely.

There are threads in this forum from Canadians griping about.....

Pardon me good sir, we do not gripe we express our displeasure vociferously, and refuse to enact change. There is a substantial difference. I honestly don't think we have an issue with service/price levels here with the exception of cellular communications. I don't mind that Bell owns the Ontario infrastructure as they maintain the network and keep it current with technology. We have two major companies competing to be our sole service provider for everything, Cable Company vs. Phone Company. I think they keep each other in check quite nicely. Choice makes us feel better but is it really producing better results at the end of the day? At the end of the day you're using the same network so your quality of service will be unchanged. Prices may go down but as go prices so goes profit. Companies are less inclined to reinvest money back into the network as a result. Canadians have plenty of choice in political parties and it's arguable that the competition has done little to improve matters. Truth is in business, politics and nature, the strong survive and generally the bigger eat up the smaller.

Edited May 28, 2010 by Dave_ON