Health care system needs to be reformed - NOW!

[dre]

And the problem with the problem is that there's no public forum to discuss the problem and figure out what to do.

I suspect we're getting more treatments, and better treatments for our money but ... who knows ? If that IS the case, then it may make more sense for us to forgo some politically rewarding, but financially expensive treatments in favour of improving basic problems like ER wait times, and no family physicians in certain areas.

Yeah thats true. A lot of the things they are doing in medicine these days just costs more. We also make it way too hard for doctors to get certified here, and create artificial shortages with overly ownerous certification regimes, and residency requirements when no residency slots are available.

In any case its going to get worse. Costs are expected to increase 8% - 10% per year for the forseeable future no matter whether the payer is public or private.

[segnosaur]

Many systems that rank better than Canada dont have private HC as well.

Please, tell me which ones.

Here's some of the top ranked countries in the WHO health care ranking...

1. France: Allows private health care

2. Italy: Allows private health care and features copays

3. San Marino: Allows private health care

4. Andorra: Government does not pay entire health care bill, patients may buy insurance

5. Malta: Allows private health care

6. Singapore: Private delivery allowed (but with price controls)

7. Spain: Allows private health insurance allowing people to bypass lengthy waiting times

8. Oman: Not a "western" country so I won't include this

9. Austria: Allows private doctors/insurance

10. Japan: Patient has a "copay"

So, tell me, what other western country ranks ahead of Canada yet has an all-public system?

The problem we have isnt with the payer. Its not a public vs private issue. The probably is healthcare costs are increasing fast all across the west.

Talking about public VS private is fun for idealogs on a message board but it complete misses the point.

Actually, no it doesn't.

Yes, health care costs might be increasing. Yes, even with "imperfect" delivery most people will be cared for. But if health care can be made better than it would otherwise be, then we should make that attempt.

[segnosaur]

I just want to point out most the countries you mention on that list Japan, Spain, France etc. Yah 2008 had huge effects on them and I am willing to bet their models are decimated in the age of austerity. Sorry that is just how it is, the world changed in 2001, it changed in 2008 and citing studies from 2000 aren't helpful.

Well, given the fact that we're comparing medical coverage systems at identical times, then yes, studies from 2000 are helpful. Do you have specific reasons to believe that changes since then would invalidate the findings of the 2000 study?

I'd love to have more recent studies. In fact in other health care debates I have quoted more recent data than the 2000 WHO rankings.

Spain isn't the same country anymore it just isn't. I am willing to bet slow and steady wins the race here.

Canada isn't the same country either. Neither is Germany, France, Canada, or the megapower of Togo.

[Sir Bandelot]

Actually, no it doesn't.

"and with a mighty wave of your hand..."

etc.

[Sir Bandelot]

Why are you automatically assuming that a government will actually find and implement those changes when they've had limited or no success so far?

I don't assume the government will do that, not easily to be sure. The government tends to defer such decisions to organizations like CMA, which are among the bloated bureaucratic organizations I referred to. they are the ones who come up with ideas like reducing services, closing beds. Completely preposterous, politically motivated solutions designed to put pressure on the government to ante up more cash. Meanwhile hospital bureaucracy grows and grows. The ultimate conclusion will be a hospital populated by administrators, but providing no health care services.

The reform that is needed might never be realized, but for constant activism by the public, put pressure on politicians to make the right choices. Without this the hand will never cut off its own head.

Ummm... so? I never claimed the problem was severe either.

I admitted that most of the time the system functions successfully. The same can also be said for the U.S. (You know, the private system so many condemn.)

Ummmm.... my opinions are supported by data too. Such as the 'data' that systems that mix public and private health systems (in western economies anyways) rank higher that Canada (where we have greater restrictions on "private" care.)

You like to open with 'Ummmm' a lot, don't you?

Any system requires constant reform. There is no static system that will maintain its integrity for all time. There is always a need for constant maintenance.

There is nothing wrong, actually. Only that we've got a lot of work to do. One does not discard an entire vehicle just because it needs new wheels

[dre]

Well, given the fact that we're comparing medical coverage systems at identical times, then yes, studies from 2000 are helpful. Do you have specific reasons to believe that changes since then would invalidate the findings of the 2000 study?

I'd love to have more recent studies. In fact in other health care debates I have quoted more recent data than the 2000 WHO rankings.

Canada isn't the same country either. Neither is Germany, France, Canada, or the megapower of Togo.

Tweaking the ammount of public vs private healthcare is not going to address the real problem... which is...

Health care expenditures have been growing much more rapidly than income in the U.S. and other developed countries for some time. In the U.S., for example, health care expenditures as a share of GDP have tripled since 1950, from 5% then to 15% today.

This isnt a public vs private issue. Its very possible that a good healthcare system could be run 100 private, 100 public, or anywhere in between.

But the real problem is this...

Health care expenditures have been growing much more rapidly than income in the U.S. and other developed countries for some time. In the U.S., for example, health care expenditures as a share of GDP have tripled since 1950, from 5% then to 15% today.

Healthcare costs having been growing faster than income for decades. The key is to understand why, but unfortunately its not easy. Part of it is definately that we have an aging population. Part of it is also because of our lifestyles. And part of it is protectionism, and the fact that we dont value shop for products, medicines, equipment, and professionals in the global market place. Artificial scarcities are being created that put upward pressure on prices.

Now I know its fun for idealogs on message boards to boil every single argument on earth down to "public vs private". Thats just what we DO here. But in this case it really does miss the point. If healthcare costs continue to increase faster than incomes we are going to have big problems, and it doesnt matter WHO the payer is. Whether the payer is the government, private insurers, or your uncle pete - costs are going to continue to rise.

Edited August 25, 2011 by dre

[dre]

I don't assume the government will do that, not easily to be sure. The government tends to defer such decisions to organizations like CMA, which are among the bloated bureaucratic organizations I referred to. they are the ones who come up with ideas like reducing services, closing beds. Completely preposterous, politically motivated solutions designed to put pressure on the government to ante up more cash.

BINGO!

These associations represent their members and they create artificial scarcity by protecting their members from competition. It takes SEVEN YEARS for a foreign doctor to claw his way through an insanely bureaucratic certification process. A huge ammount of them just give up take other jobs. And we arent talking about doctors from Somalia here. We are talking about doctors from countries like France and India where patient outcomes are comparable to our own.

We need to increase the portability of doctors AND patients, and use the same economic principles that we have used to control the costs of everything else to control healthcare caused. It shouldnt be that hard because there IS no real scarcity. Theres way way way more good doctors being trained in the world than ever before, and theres a mountain of doctors that will gladly work on Canadian patients for a lot less than 1/2 a million dollars a year.

[segnosaur]

Talking about public VS private is fun for idealogs on a message board but it complete misses the point.

Actually, no it doesn't.

"and with a mighty wave of your hand..."

The difference is, when you made your claims about "privatizing will accomplish nothing", you were doing so without actually providing any evidence. Hence my statement about proof by "waving your mighty hand...".

On the other hand, the discussion about private and public health care DOES have a point. For evidence, I point to the multitude of countries that have successfully mixed public and private systems, and achieved superior results to Canada's.

Why are you automatically assuming that a government will actually find and implement those changes when they've had limited or no success so far?

I don't assume the government will do that,

But that's exactly what you're doing.

You dismiss any wholesale changes with a suggestion that we "just need to find a better way within the current constructs". If that "better way" hasn't been found after all these decades, why are you assuming it will be any time in the future?

You like to open with 'Ummmm' a lot, don't you?

Its a literary device I use to illustrate when a person makes a statement which is so baffling and contradictory to reality that an extra expression is needed, indicating more or less "How much of reality did you ignore in forming your opinion?"

Any system requires constant reform. There is no static system that will maintain its integrity for all time. There is always a need for constant maintenance.

There is nothing wrong, actually.

Actually, there are things that are 'wrong'... excessive wait times (for emergency rooms, diagnostic procedures and certain specialized procedures), lack of a primary care doctor by many. Yes, MOST people have MOST of their basic needs met. Doesn't mean that everything is hunky dory. And unfortunately no reason to believe the current 'single payer public system' will address those issues.

Only that we've got a lot of work to do. One does not discard an entire vehicle just because it needs new wheels

And no need to stick to your tiny little Toyota Echo (public system) when you could be driving around in a Caddy (combined public/private system).

[MiddleClassCentrist]

Why does everyone assume adding a private component to Canada's health care system means tossing everything out and copying the US system? This is a blatant and extreme red herring. Many European health care systems, which routinely rank better than Canada, have both a public and a private component. When people talk about a private option in Canada, that is the model we should be looking to. One that involves the private sector, saves public money, and improves the overall quality of healthcare.

Canada already has public and private components.

Dental and Eye Health for instance.

[segnosaur]

Tweaking the ammount of public vs private healthcare is not going to address the real problem... which is...

Health care expenditures have been growing...

This isnt a public vs private issue. Its very possible that a good healthcare system could be run 100 private, 100 public, or anywhere in between.

I never claimed that health care costs were not increasing, and that they didn't have to be addressed.

However, given a set of costs and an available amount of money, the issue is how to allocate those resources properly.

Yes, control costs... but that shouldn't preclude having the best possible system at that price point.

[segnosaur]

Canada already has public and private components.

Dental and Eye Health for instance.

Yes, you're right.

We also have users that pay for their own drugs (with or without private insurance), privately-run labs doing blood tests, and doctors practices are basically private businesses.

But when we talk about "private vs. public health care" and "single payer", we are using it as a short form to refer to the issue of delivery of basic health care services such as appointments with your M.D., specialists, and hospital visits. (Its just easier than bringing up the whole issue of dental/eye care thing.)

Strangely enough, those "private components" (Dental/eye care) can be obtained pretty much on demand, at least from places near me. No waiting.

[dre]

Yes, you're right.

We also have users that pay for their own drugs (with or without private insurance), privately-run labs doing blood tests, and doctors practices are basically private businesses.

But when we talk about "private vs. public health care" and "single payer", we are using it as a short form to refer to the issue of delivery of basic health care services such as appointments with your M.D., specialists, and hospital visits. (Its just easier than bringing up the whole issue of dental/eye care thing.)

Strangely enough, those "private components" (Dental/eye care) can be obtained pretty much on demand, at least from places near me. No waiting.

On demand, but at some of the highest prices in the entire world if you value shop various procedures. Dental care in Canada is so expensive that theres a healthy little industry developing that helps Canadians find better deals in foreign countries where prices can be as low as 1/10th as what ours are.

[Sir Bandelot]

Canada already has public and private components.

Dental and Eye Health for instance.

Some believe that health care is a basic human right, in an advanced society. Straight teeth and eyeglasses are not...

[punked]

Well, given the fact that we're comparing medical coverage systems at identical times, then yes, studies from 2000 are helpful. Do you have specific reasons to believe that changes since then would invalidate the findings of the 2000 study?

I'd love to have more recent studies. In fact in other health care debates I have quoted more recent data than the 2000 WHO rankings.

Canada isn't the same country either. Neither is Germany, France, Canada, or the megapower of Togo.

Considering the Canadian Economy is much stronger then all these countries now as compared to 2000 it makes a hell of s difference. Expect huge cuts to come in Germany, France, and Japan many of them have already happened. It is different world now you might as well cite a 1950s study. Sorry.

[waldo]

But when we talk about "private vs. public health care" and "single payer", we are using it as a short form to refer to the issue of delivery of basic health care services such as appointments with your M.D., specialists, and hospital visits. (Its just easier than bringing up the whole issue of dental/eye care thing.)

although I agree with MLW member dre... that the real issue is cost not private vs. public, for all intents and purposes what you've just described is available in (select and growing areas of) Canada. I'm most directly familiar with the operations of the Copeman Healthcare Centers... you pay to join and you pay an ongoing yearly fee - above and beyond that, all costs are covered by Copeman as they direct bill back to provincial health departments (there are specific exceptions where costs are charged to members of the Copeman centers (e.g., fitness trainer costs). Of course, by billing back to the provincial health departments, they are... presumably... not technically breaching the Canada Health Act. Certainly, there are many other similar type operations to Copeman across Canada. As alluded to earlier, all professionals associated with Copeman (nurses, doctors, technicians, etc.) and the like, are no longer working within the public domain... no longer available to the general public who haven't paid the join/yearly fees.

[Sir Bandelot]

But that's exactly what you're doing.

No, I'm not.

You dismiss any wholesale changes with a suggestion that we "just need to find a better way within the current constructs". If that "better way" hasn't been found after all these decades, why are you assuming it will be any time in the future?

I already explained my position on this.

Its a literary device I use to illustrate when a person makes a statement which is so baffling and contradictory to reality that an extra expression is needed, indicating more or less "How much of reality did you ignore in forming your opinion?"

It's silly and boring. besides, my opinion of the situation is mine, and yours is your own. You might think it contradictory to reality, but I am pleased to inform you that you are not the arbiter of reality.

Actually, there are things that are 'wrong'... excessive wait times (for emergency rooms, diagnostic procedures and certain specialized procedures), lack of a primary care doctor by many. Yes, MOST people have MOST of their basic needs met. Doesn't mean that everything is hunky dory. And unfortunately no reason to believe the current 'single payer public system' will address those issues.

All those things are exactly the work I said needs to be done. There is no problem unique to the Canadian system. The system is not in any more trouble than every health care system around the world. Changing the model only makes it a different system, with the exact same problems. I said fixing the health care system, any health care system, is a huge amount of work and it never ends.

Remodelling is an even bigger task that does not provide any lasting improvement. Behold the crap-sandwich taking place to the south...

And no need to stick to your tiny little Toyota Echo (public system) when you could be driving around in a Caddy (combined public/private system).

The cadillac is an over-priced gas guzzler. Today we want the swift, lightweight, economical system.

[wyly]

Strangely enough, those "private components" (Dental/eye care) can be obtained pretty much on demand, at least from places near me. No waiting.

compare apples to apples...dentists need considerably less training than a MD, so education is much less expensive...and we have 5.7 dentists per thousand compared to MDs at 1.91 per thousand that's why there's no waiting...if we expanded our medical education and helped future MD's with costs we could have 5.7 MDs per thousand as well and no waiting...the same appplies to eye care and optometrists are not MDs'and have less training (4yrs)compared to Opthamolgists who are MDs plus another 5years, most people see optometrists who they mistakenly think are MDs... Edited August 25, 2011 by wyly

[dre]

compare apples to apples...dentists need considerably less training than a MD, so education is much less expensive...and we have 5.7 dentists per thousand compared to MDs at 1.91 per thousand that's why there's no waiting...if we expanded our medical education and helped future MD's with costs we could have 5.7 MDs per thousand as well and no waiting...the same appplies to eye care and optometrists are not MDs'and have less training (4yrs)compared to Opthamolgists who are MDs plus another 5years, most people see optometrists who they mistakenly think are MDs...

if we expanded our medical education and helped future MD's with costs we could have 5.7 MDs per thousand as well and no waiting

We dont need to help MD's with costs and education. Theres a mountain of doctors in the world that would love to practice here. We need way more residency slots, and we need to streamline residency and certification requirements for foreign doctors that meet certain critieria. If we do those things we should be able to flood the market with resources and drive wages/prices down. And for major operations we can offshore willing patients and have the work done in accredited foreign hospitals. This will also reduce strain and scarcity, and save a mountain of money.

[segnosaur]

But that's exactly what you're doing.

No, I'm not.

Actually, yes you are.

One of your early posts, you talked about "Improve accountability and downsize bureaucracy.". But nowhere have you sated why you think that will automatically be done when it hasn't been done yet.

Do you really think governments like government waste? (Hint: probably not, since it looks bad come election time.) And if it hasn't been done yet, there's no reason to expect it to be done in the future.

Come to think of it, you've also never justified another claim you made: Why you expect a public system to die when they bring in a private/public mix, when other countries have managed to maintain mixtures to even better success than Canada.

You dismiss any wholesale changes with a suggestion that we "just need to find a better way within the current constructs". If that "better way" hasn't been found after all these decades, why are you assuming it will be any time in the future?

I already explained my position on this.

Nope. You've given lame analogies that don't fit. You've dismissed arguments with a mighty wave of your hand. Nowhere have you given any sort of justification that we have a reason for things to be "all better" just by tinkering.

It's silly and boring. besides, my opinion of the situation is mine, and yours is your own. You might think it contradictory to reality, but I am pleased to inform you that you are not the arbiter of reality.

The difference is, I've provided evidence to support my conclusions. You have waved your mighty hand (or is it farted? Not sure).

Actually, there are things that are 'wrong'... excessive wait times (for emergency rooms, diagnostic procedures and certain specialized procedures), lack of a primary care doctor by many. Yes, MOST people have MOST of their basic needs met. Doesn't mean that everything is hunky dory. And unfortunately no reason to believe the current 'single payer public system' will address those issues.

All those things are exactly the work I said needs to be done.

They have been trying to do that work for years within the existing framework and have been unsuccessful.

Definition of insanity... doing the same thing repeatedly and expecting the same results.

There is no problem unique to the Canadian system. The system is not in any more trouble than every health care system around the world.

First of all, when it comes to issues like wait times, high costs, etc. there are degrees of problems. One country can be better off than another and still have problems.

Secondly, by any measure I've seen, Canada has NEVER been at the top in terms of health care.

WHO overall rankings: France at the top

WHO rating of responsiveness: U.S. at the top

London study: Sweden at the top

All of those countries allow at least some private delivery. Why do you think that is?

Changing the model only makes it a different system, with the exact same problems.

Its possible to change the degree of a problem. If you cut wait times in half, you still have a problem of wait times, but its not as severe.

Remodelling is an even bigger task that does not provide any lasting improvement.

And behold the mighty wave of the hand. The claim that there is no "lasting improvement" from changing to a private/public system.

If you don't think public/private systems will provide any improvement, why are the top ranked systems in the WHO study private/public mixtures?

Behold the crap-sandwich taking place to the south...

And behold the crap of someone who is unable to read/understand.

At no point have I ever stated we should go to an all-private system. (Bonam echoed my sentiments exactly when he stated: Why does everyone assume adding a private component to Canada's health care system means tossing everything out and copying the US system? This is a blatant and extreme red herring.) Yet here you are dragging up the U.S. system even though nobody here is suggesting that that is the way we want our health care system to go.

Oh, that's right, you did say that it was the "thin edge of the wedge", but at no point have you stated why you think Canada is so incompetent that it can never manged a public/private health care mix even though such mixtures are common in the world.

[Sir Bandelot]

Actually, yes you are.

Actually, no I do not.

Oh, that's right, you did say that it was the "thin edge of the wedge", but at no point have you stated why you think Canada is so incompetent that it can never manged a public/private health care mix even though such mixtures are common in the world.

Others in this thread have already answered your questions and I am satisfied with their answer. Just because you are addressing me, I don't need to repeat what's been said. We've moved on from those points. I could go back and copy/ paste the points but such cyclical arguments are simply too boring for me.

[wyly]

We dont need to help MD's with costs and education. Theres a mountain of doctors in the world that would love to practice here. We need way more residency slots, and we need to streamline residency and certification requirements for foreign doctors that meet certain critieria. If we do those things we should be able to flood the market with resources and drive wages/prices down. And for major operations we can offshore willing patients and have the work done in accredited foreign hospitals. This will also reduce strain and scarcity, and save a mountain of money.

we've had this discussion before, foreign MDs are not certified in Canada because they are not qualified...they must pass the same rigorous requirements that canadian MDs must go through... we are only now beginning to hear about those MS patients requiring follow up treatment/surgery in canada at our expense of botched surgical procedures in foreign hospitals...

[Sir Bandelot]

And behold the crap of someone who is unable to read/understand.

I think you fail to understamd the significance of my US reference. I meant, they are trying to change their model and the struggle they're in goes back and forth, based on partisan ideology. They are making little progress. recently there was a court decision that puts "Obama care" in complete jeapordy. THAT is the crap sandwich I refer to.

And by the way, I don't appreciate the ad-hominems. If you can't discuss without them, go away

[segnosaur]

Re: Why Sir Bandelot thinks Canada can't maintain a public/private mix...

Others in this thread have already answered your questions

Nope, they haven't.

If you think they have, then point me to their posts.

...and I am satisfied with their answer.

That's because you're satisfied with a "mighty hand wave", no actual evidence needed. (Well, as long as its something that supports your own opinions.)

Just because you are addressing me, I don't need to repeat what's been said.

You never have to do anything in an on line forum. You have the ability to respond to or ignore any question or point that's been raised.

However, I have a right to keep bringing up the point that at no point have you (or anyone else) given any reasoning or evidence why the Private/public mixture that is so successful in other countries will not work here.

We've moved on from those points.

So, ignoring a question is considered 'moving on'?

I could go back and copy/ paste the points...

Or you coud, you know, actually answer the questions.

Why do you think Canada is unable to maintain a public/private partnership when other countries have managed to do so successfully for years/decades?

Why are so many of the countries that are ranked hire than Canada (in various ratings) mixtures of public/private systems?

Why do you think keeping the same system will result in improved output when it hasn't happened lately?

but such cyclical arguments are simply too boring for me.

Yeah, I know, actually coming up with, you know, evidence and data and stuff can be SOOO boring. Much more enjoyable for everyone involved for you to waive your mighty hand, and expel a massive fart from your rear. More convincing too.

Edited August 25, 2011 by segnosaur

[dre]

Actually, yes you are.

One of your early posts, you talked about "Improve accountability and downsize bureaucracy.". But nowhere have you sated why you think that will automatically be done when it hasn't been done yet.

Do you really think governments like government waste? (Hint: probably not, since it looks bad come election time.) And if it hasn't been done yet, there's no reason to expect it to be done in the future.

Come to think of it, you've also never justified another claim you made: Why you expect a public system to die when they bring in a private/public mix, when other countries have managed to maintain mixtures to even better success than Canada.

Nope. You've given lame analogies that don't fit. You've dismissed arguments with a mighty wave of your hand. Nowhere have you given any sort of justification that we have a reason for things to be "all better" just by tinkering.

The difference is, I've provided evidence to support my conclusions. You have waved your mighty hand (or is it farted? Not sure).

They have been trying to do that work for years within the existing framework and have been unsuccessful.

Definition of insanity... doing the same thing repeatedly and expecting the same results.

First of all, when it comes to issues like wait times, high costs, etc. there are degrees of problems. One country can be better off than another and still have problems.

Secondly, by any measure I've seen, Canada has NEVER been at the top in terms of health care.

WHO overall rankings: France at the top

WHO rating of responsiveness: U.S. at the top

London study: Sweden at the top

All of those countries allow at least some private delivery. Why do you think that is?

Its possible to change the degree of a problem. If you cut wait times in half, you still have a problem of wait times, but its not as severe.

And behold the mighty wave of the hand. The claim that there is no "lasting improvement" from changing to a private/public system.

If you don't think public/private systems will provide any improvement, why are the top ranked systems in the WHO study private/public mixtures?

And behold the crap of someone who is unable to read/understand.

At no point have I ever stated we should go to an all-private system. (Bonam echoed my sentiments exactly when he stated: Why does everyone assume adding a private component to Canada's health care system means tossing everything out and copying the US system? This is a blatant and extreme red herring.) Yet here you are dragging up the U.S. system even though nobody here is suggesting that that is the way we want our health care system to go.

Oh, that's right, you did say that it was the "thin edge of the wedge", but at no point have you stated why you think Canada is so incompetent that it can never manged a public/private health care mix even though such mixtures are common in the world.

The problem is that youre proposing a solution without even identifying and understanding the problem first.

Any real meaningful reform has to address the fact that healthcare costs are growing faster than income, and NO SYSTEM is going to be healthy in the long term unless we tackle that issue. So theres a number of things we need to look at.

Demographics - Maybe the stress on our system is temporary because of an aging population and part of it is just weathering the storm until the old people die. Maybe the system is fine, its just under temporary duress.

LifeStyle - Maybe some of those countries that place ahead of us have healthier lifestyles. Maybe if we are going to be 20 lbs overweight and eat processed food with way too much salt and sugar, and spent 5 hours a day sitting in front of the TV then no system can save us.

Portability - Theres a glut of good medical professionals being trained around the world, not a shortage. We make it very hard or impossible to marry up patients with the most cost effective resources.

Resource Allocation - How much of our overall spending is allocated towards providing access to basic care VS cutting edge medicine and research.

Medical Assocations, and how much clout they have - Theres a blatant conflict of interest here that should be addressed.

Regional Certification Boundaries - In many places the various medical associations have lobbied for, or created a network of regional boundaries specifically to decrease portability. Radiologists are a good example because radiology scans can be sent electronically to be read anywhere in the world. But in many cases the associations make it impossible to even send a radiology scan to be read by a radiologist in another hospital in the same city, never mind another city, or state, or country.

Malpractice Law.

Etc.

Etc.

We need to look at all these things and figure out to which degree each is responsible for out of control costs. The problem is its hard work to figure this stuff out, and we seem unwilling to approach the issue from the top down and really fix stuff.

[segnosaur]

The problem is that youre proposing a solution without even identifying and understanding the problem first.

Any real meaningful reform has to address the fact that healthcare costs are growing faster than income, and NO SYSTEM is going to be healthy in the long term unless we tackle that issue. So theres a number of things we need to look at.

Once again, I'm not denying that increasing costs are a problem and need to be addressed. However, that does not mean the issue of how to best administer health care services at a certain price point is one that should also be ignored.

Even if we manage to hold the line on costs, heck, even if we manage to reduce the costs, we still want to make sure we allocate resources in the most optimum way. Its the same way if health care costs us $1 per person, $5000 per person, or $1 million per person.

Continually bringing up increased costs is an issue that has to be addressed does not change the fact that at any given price point allocation can be adjusted to optimize the system.

Heck, even if we managed to control costs. Even if we cut medical costs in half and they never ever increased in our lifetime, it would not eliminate the need to discuss the best way to deliver health care services.