Boil it down

[August1991]

Kimmy, the pink fingers are obviously from the lipstick you wiped off your boyfriend's cheek. Not the tinted pistachios.

(PS. Why do they tint pistachios? Why do they tint pistachios pink? And how do you spell pistacchios?)

[JerrySeinfeld]

Kimmy, the pink fingers are obviously from the lipstick you wiped off your boyfriend's cheek.  Not the tinted pistachios.

(PS. Why do they tint pistachios?  Why do they tint pistachios pink? And how do you spell pistacchios?)

<{POST_SNAPBACK}>

I believe they used to tint pistachios for some sort of trade reason, designating them as an imported nut or something...today some companies just stick with it because people are used to it.

[Argus]

Competition rarely results in price increases. Quite the contrary, in fact....

What I said stands, and you will find nothing in any sane economic philosophy to contradict it.

This is getting just stupid. Argus, it is a basic element of econimics that when more purchasers compete for the same supply, price goes up.

And how are we increasing purchasers? The guy who needs medical treatment needs it whether he has to wait six months or not. There is no increase in purchasers. What we're trying to do is increase the number of suppliers. With more suppliers and competition comes lower prices.

[August1991]

I say a public good is one which the market alone does not provide at welfare maximizing levels. Ergo there is a welfare gain if the state provides it.

There are many reasons people do not get the goods they are prepared to pay for. IOW, there are many reasons markets don't work well (or do not provide "welfare maximizing levels", as you put it). I would not characterize "market failure" as a "public good". Moreover, because "markets fail", that is not ergo a reason the State will do better.

Sweal, maybe this is the key question: According to you, why do we not get a "welfare maximizing level" of health care?

My understanding is that the Canadian health care system has been quite efficient particularly compared to the United States.  Recently, however, we hear that costs are soaring.  Assuming this is the case, does anyone know how Canada compares in terms of this rate of increase?  This information may not be available as valid, comparable statistics on anything are hard to find.  I suspect that regardless of how the system is funded, medical costs are increasing due to our aging population (which consumes more medical resources than other age groups) and the costs for new medical equipment.

<{POST_SNAPBACK}>

Cartman, eureka has made claims such as yours, and posters have provided links on stats. This forum is decidedly and agreeably not ideological, although posters usually have an opinion.

By and large, eureka (and you) are right. Canada spends about 10% of its GDP on health. This percentage has not changed in teh past 10 years. In this, we are an "average" rich country spender on health - but we spend less than the Americans and arguably get more. We appear to spend more than the French but apparently get less.

[JerrySeinfeld]

Competition rarely results in price increases. Quite the contrary, in fact....

What I said stands, and you will find nothing in any sane economic philosophy to contradict it.

This is getting just stupid. Argus, it is a basic element of econimics that when more purchasers compete for the same supply, price goes up.

And how are we increasing purchasers? The guy who needs medical treatment needs it whether he has to wait six months or not. There is no increase in purchasers. What we're trying to do is increase the number of suppliers. With more suppliers and competition comes lower prices.

<{POST_SNAPBACK}>

Its much more complicated than how you guys are trying to boil it down to supply and demand. There are two types of "private" medicine. Providers and insurers. Right now we have virtually no private insurers and somewhere around 30% of our providers are private. So the debate could be: should we allow more than just the single insurer (medicare)? or...should we increase the amount of private PROVIDERS (ie private surgical clinics and hospitals)...etc...or BOTH. The demand in any variation of the above is the same. "Price" is really COST. Which costs more? It depends. Markets aren't the only determinants of price in a single payer system. Anyone who has dealth with a government agency knows about the rampant inefficiencies, which are obviously a "non market" determinant of cost. SO perhaps allowing competition among providers (ie. private hospitals) WITHIN a single payer (medicare) system would allow for competition and less inefficiency ergo lower costs to the overall system. Its way to complicated to simply draw a supply demand graph, otherwise my econ 101 prof would've single handedly solved the health care problem years ago

[The Terrible Sweal]

I say a public good is one which the market alone does not provide at welfare maximizing levels. Ergo there is a welfare gain if the state provides it.

There are many reasons people do not get the goods they are prepared to pay for. IOW, there are many reasons markets don't work well (or do not provide "welfare maximizing levels", as you put it). I would not characterize "market failure" as a "public good". Moreover, because "markets fail", that is not ergo a reason the State will do better.

Not all market failure resolves around public goods, true. The issue of public goods is a specific subtype.

Sweal, maybe this is the key question: According to you, why do we not get a "welfare maximizing level" of health care?

I'll rephrase your question slightly to be certain of my meaning: Why would privately purchased healthcare not generate welfare maximizing levels of healthcare?

Phrased this way, you see how two of my three main contentions are the answer to that:

-controlled demand is more resource-efficient (health care is a 'natural monopsony'), and

-the benefits of having healthy citizens are externalities in the individual's value calculation, but not external to a civic value calculation (the public goods thing).

[The Terrible Sweal]

So, next step:  would you agree that life-or-death needs of citizens fall within the type of public interests in which in might be legitmate for the state to infringe private interests? 

Yes, I would agree to that.

Okay, so can we agree then that healthcare falls within the concept of life-or-death needs? (I.e. it might be a legitimate area for the public interest to infringe on private interests.)

If so, what would you say is the basic purpose or objective the state might legitimatey assert for taking action?

  The obvious way of looking at it is that healthcare providers are the supply and the people waiting for treatment are the demand. The obvious way of looking at it would be that allowing more healthcare providers to operate in Canada would increase the capacity of the system, (ie the supply.) 

Perhaps, but in either of the scenarios we're discussing, patients have the ability to pay. In your single-payer system, every single person on the waiting-list has the exact same ability to pay for medical services. There *is* demand.

Precisely. The single payer system provides everyone with the same demand power. Under a private purchase system some demand is lost because of some individuals' inability/unwillingness to afford it

While you've used the phrase "monopoly on demand", it looks to me like a more accurate description is that a single-payer system would provide price-control.

Price control as a result, not as a method.

One thing that occurs to me about limiting the participation of private providers is that it provides a means of controlling health expenses-- limit the capacity of the system, and you limit the amount of procedures you have to pay for each year.

Limit the number of providers and you raise the price of the service.

Limit amount you'll spend for procedures and you lower the price of the service.

{"uh, just one more thing, ma'am," the rumpled detective began. "Do you like pistacchios?"  ...

[kimmy]

Okay, so can we agree then that healthcare falls within the concept of life-or-death needs?  (I.e. it might be a legitimate area for the public interest to infringe on private interests.)

Somewhat.

If so, what would you say is the basic purpose or objective the state might legitimatey assert for taking action?

In situations where no amount of regulation could reconcile an individual's right to engage in commerce with the rights of the people around him to life and security.

I shouldn't be allowed to sell sticks of enriched uranium or cars with brakes that fail at random. I shouldn't be able to go buy a hand-grenade or a vial of smallpox culture, even if I just want to put them on my desk to contemplate my own mortality.

I can't bring myself to view private medical services in the same light as hand-grenades or sticks of uranium. To show that selling vials of deadly pathogens is an unacceptable threat to others' right to personal security is a simple exercise. To show that selling medical services to private citizens is a threat to others' right to personal security is contingent about a set of assumptions that I just don't feel are sufficiently supported.

In Sweal-World, you propose a situation where we have a government willing to adequately fund public medical services. Well, why couldn't we adequately fund public medical services while also permitting private citizens to engage in commerce as they wish?

This is Canada, right? The most civilized and prosperous and capable nation on earth, according to the brochures? Ok, then we should be able to build a health system that balances our community-minded values with our individual rights.

While you've used the phrase "monopoly on demand", it looks to me like a more accurate description is that a single-payer system would provide price-control.

Price control as a result, not as a method.

Tomato, tomahta?

Not necessarily, I suppose. Price control isn't a *necessary* condition of a single-payer system. What would the implications of that be?

One thing that occurs to me about limiting the participation of private providers is that it provides a means of controlling health expenses-- limit the capacity of the system, and you limit the amount of procedures you have to pay for each year.

Limit the number of providers and you raise the price of the service.

Limit amount you'll spend for procedures and you lower the price of the service.

If the hypothetical Bupkiss County Health Authority can process 500 MRIs per year, at an average cost per procedure of, say, $1000 each, then the BCHA can pretty predictably budget $500,000 a year for MRIs. Now, say I hear about long waiting-lists in Bupkiss County, and sense a business opportunity. Kimmy Imaging Inc sets up shop in Bupkiss County, and will perform MRIs for the same $1000 each that the BCHA spends on its in-house services, and my clinic can also process 500 patients a year. Woo-hoo! The citizens of Bupkiss County are thrilled! The waiting list will be cut in half! The administrators at BCHA are a lot less thrilled. They've got a tough choice all of a sudden. They now have the *capacity* to cut their waiting list in half, but have they got the money? They could wind up paying for 1000 MRIs this year, instead of the 500 they'd budgeted for. What do they do? Go to the provincial government and ask for another half-million dollars so that they can use this extra capacity? But if that doesn't work, do they continue to process just 500 MRIs per year, letting half their capacity go to waste and waiting-lists run longer? Or cut back on other services to pay for more MRIs? The administrators might find themselves wishing Kimmy Inc hadn't set up shop, because ultimately they don't really have the cash to address their waiting list anyway. Limiting the capacity of the system might create expenses, but it also provides a handy means of controlling expenses.

-k

[cybercoma]

Competition rarely results in price increases. Quite the contrary, in fact....

What I said stands, and you will find nothing in any sane economic philosophy to contradict it.

This is getting just stupid. Argus, it is a basic element of econimics that when more purchasers compete for the same supply, price goes up.

And how are we increasing purchasers? The guy who needs medical treatment needs it whether he has to wait six months or not. There is no increase in purchasers. What we're trying to do is increase the number of suppliers. With more suppliers and competition comes lower prices.

<{POST_SNAPBACK}>

Actually, a fair argument can be made that you'll reduce purchasers since people will more than likely think twice before burdening the system with a simple cold.

[cybercoma]

Its much more complicated than how you guys are trying to boil it down to supply and demand.  There are two types of "private" medicine.  Providers and insurers.  Right now we have virtually no private insurers and somewhere around 30% of our providers are private.  So the debate could be:  should we allow more than just the single insurer (medicare)?  or...should we increase the amount of private PROVIDERS (ie private surgical clinics and hospitals)...etc...or BOTH.  The demand in any variation of the above is the same.  "Price" is really COST.  Which costs more?  It depends.  Markets aren't the only determinants of price in a single payer system.  Anyone who has dealth with a government agency knows about the rampant inefficiencies, which are obviously a "non market" determinant of cost.  SO perhaps allowing competition among providers (ie. private hospitals) WITHIN a single payer (medicare) system would allow for competition and less inefficiency ergo lower costs to the overall system.  Its way to complicated to simply draw a supply demand graph, otherwise my econ 101 prof would've single handedly solved the health care problem years ago

<{POST_SNAPBACK}>

Are you kidding me? There are tons of private insurers that you're not even thinking of. I work for a company that provides medical benefits to me through Manulife Financial. Manulife Financial isn't the Ontario Provincial Government, they're a private insurer. Just about everyone who works fulltime and gets medical benefits has private insurance.

[August1991]

Sweal, maybe this is the key question: According to you, why do we not get a "welfare maximizing level" of health care?

I'll rephrase your question slightly to be certain of my meaning: Why would privately purchased healthcare not generate welfare maximizing levels of healthcare?

Phrased this way, you see how two of my three main contentions are the answer to that:

-controlled demand is more resource-efficient (health care is a 'natural monopsony'), and

-the benefits of having healthy citizens are externalities in the individual's value calculation, but not external to a civic value calculation (the public goods thing).

<{POST_SNAPBACK}>

Your rephrasing is what I meant, thanks for the precision.

Health care is not a "natural" monopsony but it could be a legal monopsony. (A natural monopsony is the labour market in a one-company town. The Supreme Court decision is evidence that doctors have potentially other employers.)

In the case of health care, is a legal monopsony more efficient (resource efficient) than a free market solution? I'd say no but your idea raises a good question. In whose interest is this legal monopsony? I'd say lazy and incompetent health practioners. [Think about it. They get guaranteed employment on favourable terms paid for by someone else. I too would love to have the exclusive contract to clean the swimming pool of the ex-wife of a rich Los Angeles lawyer.]

As to your "healthy citizen externality" idea, it makes sense for infectious diseases. But what about cigarette smoking? What do I care if someone in Blanc-Sablon goes through a pack and a half of Player's every day? I'm not going to suffer second-hand smoke.

If anything, I'm in favour of smokers. They pay into a pension scheme and will likely never draw from it. [Most medical expenses occur in the last four weeks of life regardless of the cause of death. Whether old age or cancer, they're going to incur medical costs. But pension costs are a different matter.]

Frankly, I don't know exactly what you mean by this "healthy citizen externality" idea. Are you personally prepared to pay money to someone else to be healthy?

And your third main contention?

If so, what would you say is the basic purpose or objective the state might legitimatey assert for taking action?

I shouldn't be allowed to sell sticks of enriched uranium or cars with brakes that fail at random.

Cars with no brakes are subject to civil law and liability. While the State regulates such contracts, the best protection comes from civil suits.

[sticks of uranium? Giggle. Longish anecdote ahead. Since I'm in Moscow now, I'm reminded of a guy who showed me a container of a "secret metal liquid" and wondered what it was worth. It turned out to be mercury and I told him that it's worth about $100. I guessed that mercury goes for a couple of bucks a kilo. I told him not to let his kids play with it and then his wife told him to get rid of the container... anyway. Sticks of uranium. Right.]

At issue here is what constitutes a "legally enforceable contract". Well, you can't sue somebody because you gave them money but they didn't follow through on the agreed assassination. And you can't sue somebody because they promised to give you a million dollars on your 18th birthday and then they didn't. IOW, it is not obvious what constitutes a contract.

Sweal wants to forbid certain certain contracts because he argues such forbiddance will be in the greater public interest. Contract law is all about that precise issue. What contracts should not be allowed? Sweal's idea to forbid private health contracts on grounds of public interest is arbitrary and specious.

Limit the number of providers and you raise the price of the service.  Limit amount you'll spend for procedures and you lower the price of the service.

Silly beyond words.

Its much more complicated than how you guys are trying to boil it down to supply and demand. There are two types of "private" medicine. Providers and insurers. Right now we have virtually no private insurers and somewhere around 30% of our providers are private. So the debate could be: should we allow more than just the single insurer (medicare)? or...should we increase the amount of private PROVIDERS (ie private surgical clinics and hospitals)...etc...or BOTH. The demand in any variation of the above is the same. "Price" is really COST. Which costs more? It depends. Markets aren't the only determinants of price in a single payer system. Anyone who has dealth with a government agency knows about the rampant inefficiencies, which are obviously a "non market" determinant of cost. SO perhaps allowing competition among providers (ie. private hospitals) WITHIN a single payer (medicare) system would allow for competition and less inefficiency ergo lower costs to the overall system. Its way to complicated to simply draw a supply demand graph, otherwise my econ 101 prof would've single handedly solved the health care problem years ago

Thank God we get an intelligent (original?) post. The critical issue with health care is not whether it is a public good or a private good, it is the insurance aspect of its purchase. No one buys health care the way they buy milk, or chicken. Almost everyone buys health care through an insurance scheme. IOW, we buy health care the same way we buy car repairs. There is regular maintenance (sometimes insured through a warranty) coupled with catastrophic accident insurance. This insurance aspect of health care is the whole story.

With that said, Seinfeld, supply and demand still apply. Queues are the signal that prices are too low. Lengthening queues are the signal of government price regulation.

[JerrySeinfeld]

Sweal, maybe this is the key question: According to you, why do we not get a "welfare maximizing level" of health care?

I'll rephrase your question slightly to be certain of my meaning: Why would privately purchased healthcare not generate welfare maximizing levels of healthcare?

Phrased this way, you see how two of my three main contentions are the answer to that:

-controlled demand is more resource-efficient (health care is a 'natural monopsony'), and

-the benefits of having healthy citizens are externalities in the individual's value calculation, but not external to a civic value calculation (the public goods thing).

<{POST_SNAPBACK}>

Your rephrasing is what I meant, thanks for the precision.

Health care is not a "natural" monopsony but it could be a legal monopsony. (A natural monopsony is the labour market in a one-company town. The Supreme Court decision is evidence that doctors have potentially other employers.)

In the case of health care, is a legal monopsony more efficient (resource efficient) than a free market solution? I'd say no but your idea raises a good question. In whose interest is this legal monopsony? I'd say lazy and incompetent health practioners. [Think about it. They get guaranteed employment on favourable terms paid for by someone else. I too would love to have the exclusive contract to clean the swimming pool of the ex-wife of a rich Los Angeles lawyer.]

As to your "healthy citizen externality" idea, it makes sense for infectious diseases. But what about cigarette smoking? What do I care if someone in Blanc-Sablon goes through a pack and a half of Player's every day? I'm not going to suffer second-hand smoke.

If anything, I'm in favour of smokers. They pay into a pension scheme and will likely never draw from it. [Most medical expenses occur in the last four weeks of life regardless of the cause of death. Whether old age or cancer, they're going to incur medical costs. But pension costs are a different matter.]

Frankly, I don't know exactly what you mean by this "healthy citizen externality" idea. Are you personally prepared to pay money to someone else to be healthy?

And your third main contention?

If so, what would you say is the basic purpose or objective the state might legitimatey assert for taking action?

I shouldn't be allowed to sell sticks of enriched uranium or cars with brakes that fail at random.

Cars with no brakes are subject to civil law and liability. While the State regulates such contracts, the best protection comes from civil suits.

[sticks of uranium? Giggle. Longish anecdote ahead. Since I'm in Moscow now, I'm reminded of a guy who showed me a container of a "secret metal liquid" and wondered what it was worth. It turned out to be mercury and I told him that it's worth about $100. I guessed that mercury goes for a couple of bucks a kilo. I told him not to let his kids play with it and then his wife told him to get rid of the container... anyway. Sticks of uranium. Right.]

At issue here is what constitutes a "legally enforceable contract". Well, you can't sue somebody because you gave them money but they didn't follow through on the agreed assassination. And you can't sue somebody because they promised to give you a million dollars on your 18th birthday and then they didn't. IOW, it is not obvious what constitutes a contract.

Sweal wants to forbid certain certain contracts because he argues such forbiddance will be in the greater public interest. Contract law is all about that precise issue. What contracts should not be allowed? Sweal's idea to forbid private health contracts on grounds of public interest is arbitrary and specious.

Limit the number of providers and you raise the price of the service.  Limit amount you'll spend for procedures and you lower the price of the service.

Silly beyond words.

Its much more complicated than how you guys are trying to boil it down to supply and demand. There are two types of "private" medicine. Providers and insurers. Right now we have virtually no private insurers and somewhere around 30% of our providers are private. So the debate could be: should we allow more than just the single insurer (medicare)? or...should we increase the amount of private PROVIDERS (ie private surgical clinics and hospitals)...etc...or BOTH. The demand in any variation of the above is the same. "Price" is really COST. Which costs more? It depends. Markets aren't the only determinants of price in a single payer system. Anyone who has dealth with a government agency knows about the rampant inefficiencies, which are obviously a "non market" determinant of cost. SO perhaps allowing competition among providers (ie. private hospitals) WITHIN a single payer (medicare) system would allow for competition and less inefficiency ergo lower costs to the overall system. Its way to complicated to simply draw a supply demand graph, otherwise my econ 101 prof would've single handedly solved the health care problem years ago

Thank God we get an intelligent (original?) post. The critical issue with health care is not whether it is a public good or a private good, it is the insurance aspect of its purchase. No one buys health care the way they buy milk, or chicken. Almost everyone buys health care through an insurance scheme. IOW, we buy health care the same way we buy car repairs. There is regular maintenance (sometimes insured through a warranty) coupled with catastrophic accident insurance. This insurance aspect of health care is the whole story.

With that said, Seinfeld, supply and demand still apply. Queues are the signal that prices are too low. Lengthening queues are the signal of government price regulation.

<{POST_SNAPBACK}>

It IS an original post, and thanks. But there is the concept of "price/demand" elasticity to consider. In economic terms, Health care is "perfectly price inelastic". ie. no matter what the cost, people will continue to demand it. At least on the "catostrophic" side of the equation. Raising the price won't drop demand.

[Guest eureka]

You betray the bias that mudies yoyr reasoning, August, when you say "at last an intelligent, original post."

As Cyerbercoma pointed out there are many private insurers and they cover a sizeable part of the healthcare spectrum.

Then, anyone who can committ the "Anyone who has dealt with a government agency" fallacy is not posting intelligently but from prejudice.

[August1991]

But there is the concept of "price/demand" elasticity to consider. In economic terms, Health care is "perfectly price inelastic". ie. no matter what the cost, people will continue to demand it. At least on the "catostrophic" side of the equation. Raising the price won't drop demand.

Demand for health care is not price inelastic. To be more precise, the demand for different types of health care show different sensitivities to price changes but in general, price influences the choices.

What we are really talking about here is alternatives. Given a choice, some people choose differently and price is one factor in the choice. Some people choose to go the doctor annually, some every six months and some only if they feel seriously ill. Hugo has argued that people in the US without medical insurance prefer the cash and accept the risk.

When people cross a busy street, they are making a similar choice.

-----

But even if people wanted health care regardless of the price, that does not explain lengthening queues and waiting lists. They are due to the various government restrictions on health care services. It is no accident that our health system is filled with waiting lists and life in the Soviet Union was also filled with waiting in queues.

You betray the bias that mudies yoyr reasoning, August, when you say "at last an intelligent, original post."

I may betray my bias, but I don't know how that muddies my thinking. Galileo had good reason to believe the earth moved but that didn't stop him from being objective.

As Cyerbercoma pointed out there are many private insurers and they cover a sizeable part of the healthcare spectrum.

Until the Supreme Court decision, private providers of health care were operating in legal limbo. They had to opt out of the provincial health system and their future existence was uncertain. I am not aware of any private health insurance in Canada excepting add-ons or upgrades to the public insurance scheme.

Then, anyone who can committ the "Anyone who has dealt with a government agency" fallacy is not posting intelligently but from prejudice.

You make a fair point, eureka. Not all government offices work like the proverbial post office. After all, NASA put a man on the moon.

-----

I thought Seinfeld's post was original because it moved the discussion to the key point about health care: health care insurance.

Perhaps my judgment of the "originality" is biased since I share Seinfeld's view that catastrophic State health insurance combined with private providers of health care services might be a good mix. More important though is to allow the provinces to experiment and see what works best. The Supreme Court decision moves us in that direction.

[Guest eureka]

As I have posted so often, August, the distinction between Canada and several European countries is not in the provision of private healthcare but in what is or is not private. Canada has as much, and in some cases more, private healthcare, than those countries.

Private insurance is commonplace in Canada and always has been. Whether yu call it add-ons does not change its status. It exists.

[JerrySeinfeld]

Its much more complicated than how you guys are trying to boil it down to supply and demand.  There are two types of "private" medicine.  Providers and insurers.  Right now we have virtually no private insurers and somewhere around 30% of our providers are private.  So the debate could be:  should we allow more than just the single insurer (medicare)?  or...should we increase the amount of private PROVIDERS (ie private surgical clinics and hospitals)...etc...or BOTH.  The demand in any variation of the above is the same.  "Price" is really COST.  Which costs more?  It depends.  Markets aren't the only determinants of price in a single payer system.  Anyone who has dealth with a government agency knows about the rampant inefficiencies, which are obviously a "non market" determinant of cost.  SO perhaps allowing competition among providers (ie. private hospitals) WITHIN a single payer (medicare) system would allow for competition and less inefficiency ergo lower costs to the overall system.  Its way to complicated to simply draw a supply demand graph, otherwise my econ 101 prof would've single handedly solved the health care problem years ago

<{POST_SNAPBACK}>

Are you kidding me? There are tons of private insurers that you're not even thinking of. I work for a company that provides medical benefits to me through Manulife Financial. Manulife Financial isn't the Ontario Provincial Government, they're a private insurer. Just about everyone who works fulltime and gets medical benefits has private insurance.

<{POST_SNAPBACK}>

They only insure procedures NOT covered by medicare. I am talking about private insurers competing with medicare. ie. Buy insurance for EVERYHING then if you need the procedure youcould get it done privately using your insurance and skip the line up, or publically using medicare.

[JerrySeinfeld]

Has anyone on here looked at other models? I took a very cursory look at Frances model. It is impressive. From what I gather, everyone (universally) participates in a public insurance scheme like medicare in Canada. But the public insurance only "routine" medicine. Then you "top up" your insurance privately to cover catostrophic care. I think it was around $50-100 / month. Also, when you go to the hospital you have a choice between waiting in line at public providers or going to private clinics right away. So it is a mixed private / public system. I am sure it's not perfect. Every system has it's flaws, but it's worth looking at. In fact, that's exactly what Ralph Klein is doing in Alberta right now. He is gathering somekind of "health symposium" and studying other health care systems in developed countries like france, the UK, Germany etc. Now what is wrong with that?

The most interesting thing about the Supreme Court decision was that it clearly states (lines 61-65 of the ruling) that there is no evidence to suggest that a parallel private system would harm the public system in any way. The strange part of the whole ruling was the reaction by Paul Martin. He (again) pretended it didn't happen, clearly stating "we will not have two tier medicine in this country". Um, yes Paul, we will. If you're gonna agree with the courts on SSM, you gotta show some consistency and agree with them on health care. Live by the sword, die by the sword It's unfortunate that the conservatives, too ran for shelter under the "save medicare" umbrella. I thought it was a real opportunity for them to shift the debate in their favor and, set themselves apart from the status quo Liberals and sell the idea to Canadians that some degree of privatizatoin isn't all bad. Heck, we already know we have it: even Paul Martin's doctor is private. I thought the conservatives blew that opportunity to open up this discussion once and for all.

I'm glad the court made this ruling, because now (hopefully) we can have have a legitimate debate on the issue without the political rhetoric.