U.S. healthcare expensive, inefficient

[margrace]

That's great, because if you lived in the Champlain area, your wait time for cataracts surgery is now reported at 182 days (or longer):

http://www.waittimes.net/en/wt_data_map.as...IN=11&Mod=0

http://www.health.gov.on.ca/transformation...public_mn.html#

That such wait time web sites exist for each province is inconceivable to American health care consumers, but they are necessary in Canada to stem the tide of critics demanding measurable improvements.

Thats because everyone qualifies on the wait list in Canada.

[Shakeyhands]

ok, I am changing my views on Universal healthcare. A pay model is much better as witnessed by the following article.

http://www.cnn.com/2007/US/08/16/wife.killed.ap/index.html

desperate measures for desperate times....

[Guest American Woman]

Thats because everyone qualifies on the wait list in Canada.

That's a good point (which may explain bush-cheney2004's silence). It would be interesting to see what kind of wait times we'd have in the U.S. if everyone who needed medical care actually got it.

[margrace]

That's a good point (which may explain bush-cheney2004's silence). It would be interesting to see what kind of wait times we'd have in the U.S. if everyone who needed medical care actually got it.

Yes American Woman, I think this has been a straw man argument. Those that have the money for proper health care in the US are astounded at our waiting times, so I would like to know if everyone rich or poor was listed what it would be there.

[bush_cheney2004]

That's a good point (which may explain bush-cheney2004's silence). It would be interesting to see what kind of wait times we'd have in the U.S. if everyone who needed medical care actually got it.

Silent? Guess again....I have already visited this issue before. Canada's wait times are also longer when compared to other nations who have universal access as a goal, and even when the US does poorly on wait times, it is better than Canada:

http://www.pogge.ca/archives/001608.shtml

The wait time issue is a problem in Canada because health care is an entitlement enshrined in the CHA. The provinces now maintain web sites devoted to procedure wait times. The US does not have universal acess, hence no hue and cry over "wait times".

Health care is not a right...everybody who needs it doesn't always get it...not even in Canada, and many of those who do have to wait a spell.

[Guest American Woman]

Silent? Guess again....I have already visited this issue before. Canada's wait times are also longer when compared to other nations who have universal access as a goal, and even when the US does poorly on wait times, it is better than Canada:

http://www.pogge.ca/archives/001608.shtml

The wait time issue is a problem in Canada because health care is an entitlement enshrined in the CHA. The provinces now maintain web sites devoted to procedure wait times. The US does not have universal acess, hence no hue and cry over "wait times".

Health care is not a right...everybody who needs it doesn't always get it...not even in Canada, and many of those who do have to wait a spell.

Yes, I realize that "even when the US does poorly on wait times, it is better than Canada" and that's what my comment is in regards to; Canada is serving everyone who needs medical care while millions in the States are doing without. If everyone who needed medical care in the States sought medical care, of course the wait times would be much worse than they are now. That's the point being made.

But if the U.S. has no cries over wait times, as you claim, it's because here the cries are for getting CARE (and this even as we spend more per capita on health care than Canada does). I'm sure those people going without medical care would rather "wait a spell" than go without. Evidently you don't care that people are going without something as basic as healthcare as long as your needs are met. But heck, we could make our wait times even less by denying even more people insurance and jacking up the prices of medical care even higher.

Edited August 17, 2007 by American Woman

[margrace]

Yes, I realize that "even when the US does poorly on wait times, it is better than Canada" and that's what my comment is in regards to; Canada is serving everyone who needs medical care while millions in the States are doing without. If everyone who needed medical care in the States sought medical care, of course the wait times would be much worse than they are now. That's the point being made.

But if the U.S. has no cries over wait times, as you claim, it's because here the cries are for getting CARE (and this even as we spend more per capita on health care than Canada does). I'm sure those people going without medical care would rather "wait a spell" than go without. Evidently you don't care that people are going without something as basic as healthcare as long as your needs are met. But heck, we could make our wait times even less by denying even more people insurance and jacking up the prices of medical care even higher.

It is interesting that the poster admits you are right about wait times in the US and then starts talking about other countries. Straw argument.

[jdobbin]

Yes, I realize that "even when the US does poorly on wait times, it is better than Canada" and that's what my comment is in regards to; Canada is serving everyone who needs medical care while millions in the States are doing without. If everyone who needed medical care in the States sought medical care, of course the wait times would be much worse than they are now. That's the point being made.

But if the U.S. has no cries over wait times, as you claim, it's because here the cries are for getting CARE (and this even as we spend more per capita on health care than Canada does). I'm sure those people going without medical care would rather "wait a spell" than go without. Evidently you don't care that people are going without something as basic as healthcare as long as your needs are met. But heck, we could make our wait times even less by denying even more people insurance and jacking up the prices of medical care even higher.

Paul Krugman's article in July was interesting.

http://www.zmag.org/content/showarticle.cf...mp;ItemID=13323

On the other hand, it's true that Americans get hip replacements faster than Canadians. But there's a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That's right: the hip-replacement gap is actually a comparison of two government health insurance systems.

American Medicare has shorter waits than Canadian Medicare (yes, that's what they call their system) because it has more lavish funding - end of story. The alleged virtues of private insurance have nothing to do with it.

There is more in the article as well that you might find interesting.

[bush_cheney2004]

Yes, I realize that "even when the US does poorly on wait times, it is better than Canada" and that's what my comment is in regards to; Canada is serving everyone who needs medical care while millions in the States are doing without. If everyone who needed medical care in the States sought medical care, of course the wait times would be much worse than they are now. That's the point being made.

Maybe yes...maybe no. The US has demonstrated the ability to develop excess healthcare services capacity while Canada clearly struggles to do the same because of provincial budgets, medical staff shortages, and legal restrictions on the business of healthcare. The US spends more because Americans want / get more, from boob jobs (make me bigger) to gastric bypass surgery (make me smaller).

But if the U.S. has no cries over wait times, as you claim, it's because here the cries are for getting CARE (and this even as we spend more per capita on health care than Canada does). I'm sure those people going without medical care would rather "wait a spell" than go without. Evidently you don't care that people are going without something as basic as healthcare as long as your needs are met. But heck, we could make our wait times even less by denying even more people insurance and jacking up the prices of medical care even higher.

It doesn't matter whether I care or not. The USA already has universal access programs for seniors, the disabled, renal desease, the poor, etc. The American programs dwarf anything seen in Canada, and still have shorter wait times. America has not implemented 100% universal access by design. Healthcare in the US is big business (15% of GDP).

Why do you think every American deserves access to healthcare? How about housing? Clothing? Food? Transportation? When can the healthcare rationing (a la Canada) start?

[Guest American Woman]

Yes, I realize that "even when the US does poorly on wait times, it is better than Canada" and that's what my comment is in regards to; Canada is serving everyone who needs medical care while millions in the States are doing without. If everyone who needed medical care in the States sought medical care, of course the wait times would be much worse than they are now. That's the point being made.

Maybe yes...maybe no. The US has demonstrated the ability to develop excess healthcare services capacity while Canada clearly struggles to do the same because of provincial budgets, medical staff shortages, and legal restrictions on the business of healthcare. The US spends more because Americans want / get more, from boob jobs (make me bigger) to gastric bypass surgery (make me smaller).

The U.S. spends more because of high administrative costs, yet it serves only a small portion of the people. Americans might, as you claim, "want more," but the government isn't paying for boob jobs and gastric bypass surgery; and the U.S. government spends more per capita than the Canadian government:

The U.S. government spends more per capita on health care than the government does in Canada. In 2004, the government of Canada spent $2,120 (in US dollars) per person on health care, while the United States government spent $2,724. Link

So boob jobs and gastric bypass surgery etc. have nothing to do with the government paying more per capita than Canada.

But if the U.S. has no cries over wait times, as you claim, it's because here the cries are for getting CARE (and this even as we spend more per capita on health care than Canada does). I'm sure those people going without medical care would rather "wait a spell" than go without. Evidently you don't care that people are going without something as basic as healthcare as long as your needs are met. But heck, we could make our wait times even less by denying even more people insurance and jacking up the prices of medical care even higher.

It doesn't matter whether I care or not. The USA already has universal access programs for seniors, the disabled, renal desease, the poor, etc. The American programs dwarf anything seen in Canada, and still have shorter wait times. America has not implemented 100% universal access by design. Healthcare in the US is big business (15% of GDP).

It does matter whether you care or not. If enough Americans cared, and voted accordingly, then the government would be forced to listen. As long as people care only about themselves and their loved ones, then Americans, while living in the richest nation in the world, will continue to suffer and/or die.

The American programs do NOT "dwarf" anything seen in Canada because they do NOT cover all Americans. I can't repeat often enough that millions of Americans who need medical care are going without, and if all those Americans DID seek medical care, it would, without argument, increase our wait time. So to be proud of our shorter wait time because millions are going without is about the lowest kind of 'praise' for our healthcare system that one could possibly come up with.

As for seniors, the poor, etc: the government doesn't PROVIDE healthcare for these groups of people, they HELP provide care. Furthermore, what is the cutoff for "poor?" There's a difference between the reality of not being able to afford health coverage or healthcare and what the government classifies as "poor."

Why do you think every American deserves access to healthcare? How about housing? Clothing? Food? Transportation? When can the healthcare rationing (a la Canada) start?

I think every American deserves access to healthcare because I believe in what the Constitution says:

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

LIFE. How does not getting healthcare enter into the unalienable right of life? While our Constitution guarantees life, we have the lowest life expectancy and the highest infant mortality rate of all the developed nations.

As for "healthcare (a la Canada)," why do we have to clone Canada's healthcare system? Who is saying that we have to?

[Edited to add] Thanks for the link, jdobbin.

Edited August 18, 2007 by American Woman

[marcinmoka]

I'm sure those people going without medical care would rather "wait a spell" than go without

You cannot argue with this!

Why do you think every American deserves access to health care? How about housing? Clothing? Food? Transportation?

Weak.(I'm shocked BC2004, generally your arguments hold some weight) Clothing, food, transportation are all constants. We need them day in, day out. Health care, for the most part, is needed for unforeseen emergencies, and thus should be grouped with other services such as policing, disaster relief, fire services.

Unless you are going to argue that access to the fire department should only be dependent on your ability to pay for it's services.

[marcinmoka]

Marcia Angell, a former editor-in-chief of the New England Journal of Medicine, argues instead for a single-payer system, insisting that “private insurers compete not by offering better health care, but by avoiding high-risk individuals, limiting services for those they do cover, and, whenever possible, shifting costs.”

When you spend copious amounts of "health care" dollars on lawyers and bureaucrats who's sole purpose is to DENY peoples claims, there is a mass breakdown in efficiency someone down the line.

Not to mention the practical absurdity of tying down health benefits to ones work. While it may be perceived good by some, it creates a highly immobile workforce, which costs a fortune to placate and might very well accelerate the downfall of certain industries. Hardly a case of economics trumping virtue, no?

As for "healthcare (a la Canada)," why do we have to clone Canada's healthcare system?

I would not argue for this either. We are equally in need of many reforms, such as nominal user fees and some greater competition. But there are other systems that could be used as models.

*Many of the knee jerk crowd will refuse to even contemplate the notion that the American system is infallible, and continue to argue for the epitome of bureaucratic waste and inefficiency that is the their system. America is good, but it is not perfect. Just don't let pride get in the way of rational thinking.

Edited August 18, 2007 by marcinmoka

[Renegade]

I think every American deserves access to healthcare because I believe in what the Constitution says:

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

LIFE. How does not getting healthcare enter into the unalienable right of life? While our Constitution guarantees life, we have the lowest life expectancy and the highest infant mortality rate of all the developed nations.

I dispute you can interpret a right to life, as a right to free healthcare. It is true that the Consitution grants each American the right to Life, but it does not say that everyone has the rigth to have others fund it for them. You should have no more expectation that the public fund your "pursuit of Happiness" than to fund your right to life.

[bush_cheney2004]

You cannot argue with this!

Of course I can argue with "this", and will continue to do so.

Weak.(I'm shocked BC2004, generally your arguments hold some weight) Clothing, food, transportation are all constants. We need them day in, day out. Health care, for the most part, is needed for unforeseen emergencies, and thus should be grouped with other services such as policing, disaster relief, fire services.

Unless you are going to argue that access to the fire department should only be dependent on your ability to pay for it's services.

Not logical ("weak")...if clothing, food, and transportation are all constants, those needs should certainly be met for all by government every day. Yet they aren't. The American Red Cross (disaster relief) is funded by donations.

Access to a fire department is dependent on local government / tax base or private volunteers. It is not guaranteed by government. My own family pays for private fire protection for a lake cabin. If an owner does not pay dues, his/her property burns to the ground while other (paying) properties are protected.

[bush_cheney2004]

I dispute you can interpret a right to life, as a right to free healthcare. It is true that the Consitution grants each American the right to Life, but it does not say that everyone has the rigth to have others fund it for them. You should have no more expectation that the public fund your "pursuit of Happiness" than to fund your right to life.

Agreed..there is no such right enumerated. To do so would put a burden on the rights, labor, and freedom of others. There is no way in hell that one can successfully argue that the US government must provide a triple organ transplant.

However, Americans do have the "right" to die (if they keep the media out of it).

[bush_cheney2004]

*Many of the knee jerk crowd will refuse to even contemplate the notion that the American system is infallible, and continue to argue for the epitome of bureaucratic waste and inefficiency that is the their system. America is good, but it is not perfect. Just don't let pride get in the way of rational thinking.

The American system is not designed to be infallible..it is designed to be profitable. Still, America should never consider Canada's bastardized approach, making it one of the worst universal access systems in the world.

[bush_cheney2004]

Not to mention the practical absurdity of tying down health benefits to ones work. While it may be perceived good by some, it creates a highly immobile workforce, which costs a fortune to placate and might very well accelerate the downfall of certain industries. Hardly a case of economics trumping virtue, no?

Really? Americans are still more productive than Canadians with this awful burden.

Mobility? That's funny, because many more Canadians move to the US for better employment fortunes than in the other direction. Why would they leave Canada for such "practical absurdity".

Ironically, maybe there is more to life than "free" healthcare, eh?

[bush_cheney2004]

The U.S. spends more because of high administrative costs, yet it serves only a small portion of the people. Americans might, as you claim, "want more," but the government isn't paying for boob jobs and gastric bypass surgery

Patently false...the "US government" does pay for bariatric surgery and breast reduction surgery when proven to be medically necessary (Medicare / Medicaid). Also, the IRS allows tax deductions for significant medical costs (like bariatric surgery).

[marcinmoka]

Not logical ("weak")...if clothing, food, and transportation are all constants, those needs should certainly be met for all by government every day.

Yes. It is weak. Who said that constants should be covered by the government? I argue against this. They should only be prepared to help in cases of the unforeseen.

Mobility? That's funny, because many more Canadians move to the US for better employment fortunes than in the other direction.

How literal an interpretation. Unfortunately, "mobility" does not only refer to "vroom, vroom, get in your car and drive mobility", but concepts such as income mobility, and the opportunities of workers to transfer into other sectors.

In other words, in times of restructuring, a worker at a auto manufacturing plant will be easier to"persuade" out of said job and into re-training and/or a different sector if they have the guarantee of health coverage regardless. Besides reasons of quality, there is a reason we have an influx of auto sector activity (Toyota) while 2.5 hours south on the 401, the opposite is taking place. Toyota realizes the advantages of having a more dynamic workforce, should the need ever arise.

Ironically, maybe there is more to life than "free" healthcare, eh?

I am glad you felt the need to point this out. Thank you!

Of course I can argue with "this", and will continue to do so.

So right now YOU are suggesting that it is better FOR ME, in MY SITUATION, to forgo entirely getting a medical procedure rather than waiting for one. I guess you can argue "this". The world is your oyster. Enjoy!

While I respect individualism and concern for your best interest, it can't hurt to realize not everyone is in your situation. Just a suggestion, though rather hard to fathom.

Access to a fire department is dependent on local government / tax base or private volunteers. It is not guaranteed by government

So any "government" at the municipal level is not actually "government". Okie. Modern day emergency services are by and large, governmental institutions, despite largely non federal funding structures. You little anecdote about a private cottage, cute, but unfortunately, it is but an anecdote.

The American system is not designed to be infallible..it is designed to be profitable

Profitable in the short term for a select few, but in the end, it is the tax payer who is getting the shaft since it is they who must pay for that which would hurt the bottom line of the HMO's. Private venture is a generally a beautiful thing, but only when it is well conceived. Generally private ventures CREATE efficiencies. If administrative costs are anything to go by, someone is getting the short end of the stick.

Sorry for the re-post, but what are your thoughts on this:

Marcia Angell, a former editor-in-chief of the New England Journal of Medicine, argues instead for a single-payer system, insisting that “private insurers compete not by offering better health care, but by avoiding high-risk individuals, limiting services for those they do cover, and, whenever possible, shifting costs.”

[Guest American Woman]

The U.S. spends more because of high administrative costs, yet it serves only a small portion of the people. Americans might, as you claim, "want more," but the government isn't paying for boob jobs and gastric bypass surgery

Patently false...the "US government" does pay for bariatric surgery and breast reduction surgery when proven to be medically necessary (Medicare / Medicaid). Also, the IRS allows tax deductions for significant medical costs (like bariatric surgery).

Let's take another look at YOUR claim, which is what I was responding to:

The US spends more because Americans want / get more, from boob jobs (make me bigger) to gastric bypass surgery (make me smaller).

You said the U.S. spends more because Americans WANT more, so I was responding to "boob jobs" and "gastric bypass surgery" that people want, not that people need. In other words, elective surgery. Of course the U.S. government pays for bariatric surgery and breast reduction surgery (providing the person qualities for the government programs-- again, not for everyone) when proven to be medically necessary, but that's not "wanting" it, that's not under the catagory of "wanting more," that's needing it. So please keep your end of the discussion honest, because 1) the U.S. governement does not pay for elective surgeries (people's "wants") so that is not included in the cost per capita, as I correctly stated and 2) repeating: unlike the U.S., Canada pays for medical procedures that are medically needed for all of its citizens.

As for tax deductions, that has nothing to do with the cost per capita of health care.

The fact is, our administrative costs are higher. That cannot be refuted. We pay more for less. That cannot be refuted. Our wait times are less because not all of the public is served; millions are going without. Fact is, if everyone who needed medical care GOT medical care, our wait times would be longer. That also cannot be refuted.

[bush_cheney2004]

Yes. It is weak. Who said that constants should be covered by the government? I argue against this. They should only be prepared to help in cases of the unforeseen.

Now you are speaking in circles....pick one thought and stick to it. Most medical care in the US is routine, not an emergency. Please try again.

How literal an interpretation. Unfortunately, "mobility" does not only refer to "vroom, vroom, get in your car and drive mobility", but concepts such as income mobility, and the opportunities of workers to transfer into other sectors.

In other words, in times of restructuring, a worker at a auto manufacturing plant will be easier to"persuade" out of said job and into re-training and/or a different sector if they have the guarantee of health coverage regardless. Besides reasons of quality, there is a reason we have an influx of auto sector activity (Toyota) while 2.5 hours south on the 401, the opposite is taking place. Toyota realizes the advantages of having a more dynamic workforce, should the need ever arise.

Yes...we know...Toyota, Nissan, and Hyundai have all invested far more in new production capacity for the USA than in Canada over the past ten years. I guess those "less mobile", right to work states are very competitive after all.

So right now YOU are suggesting that it is better FOR ME, in MY SITUATION, to forgo entirely getting a medical procedure rather than waiting for one. I guess you can argue "this". The world is your oyster. Enjoy!

While I respect individualism and concern for your best interest, it can't hurt to realize not everyone is in your situation. Just a suggestion, though rather hard to fathom.

Correct, I don't care how you solve your own problems. Life is a bitch, then you die.

So any "government" at the municipal level is not actually "government". Okie. Modern day emergency services are by and large, governmental institutions, despite largely non federal funding structures. You little anecdote about a private cottage, cute, but unfortunately, it is but an anecdote.

A private fire department is not government. "By and large" will not save you from your logical error.

Profitable in the short term for a select few, but in the end, it is the tax payer who is getting the shaft since it is they who must pay for that which would hurt the bottom line of the HMO's. Private venture is a generally a beautiful thing, but only when it is well conceived. Generally private ventures CREATE efficiencies. If administrative costs are anything to go by, someone is getting the short end of the stick.

Then we should dispense with all administrative costs for your favorite type of organization....GOVERNMENT. Gee, I love it when people paint themselves into a corner.

Sorry for the re-post, but what are your thoughts on this:

Marcia Angell, a former editor-in-chief of the New England Journal of Medicine, argues instead for a single-payer system, insisting that “private insurers compete not by offering better health care, but by avoiding high-risk individuals, limiting services for those they do cover, and, whenever possible, shifting costs.”

Duh! Ya think? High risk individuals should pay higher premiums, or be uninsurable. Next case.

[margrace]

So Bush_cheney is like the pharasees of the bible all for one, himself. Greed and being the top dog are all he cares about. No use talking to someone so self centred and would wish to have others to look down on.

[bush_cheney2004]

As for tax deductions, that has nothing to do with the cost per capita of health care.

No it doesn't, but it is figured into a person's strategy to pay for health care procedures. I'm sure you are aware of health care reimbursement accounts, which use pre-tax dollars.

The fact is, our administrative costs are higher. That cannot be refuted. We pay more for less. That cannot be refuted. Our wait times are less because not all of the public is served; millions are going without. Fact is, if everyone who needed medical care GOT medical care, our wait times would be longer. That also cannot be refuted.

Of course it can be refuted. If there were profit to be had in providing all people in the US with medical care, it would have been done years ago. This has never been an agument about capacity, but rather an argument about who pays. In Canada, because the provinces fund CHA delivery with a mix of federal and provincial sources, they are constrained, so people wait...and wait...and wait. Those with cash say "screw this" and buy private care.

Health care is like any other service delivered to market....why would the rules change for you? If you want CommieCare, figure out how to convince Congress and the majority of Americans. You are not getting my vote.

[bush_cheney2004]

So Bush_cheney is like the pharasees of the bible all for one, himself. Greed and being the top dog are all he cares about. No use talking to someone so self centred and would wish to have others to look down on.

Correct...go pray for yourself. Greed is good.

[Drea]

Now you are speaking in circles....pick one thought and stick to it. Most medical care in the US is routine, not an emergency. Please try again.

So very few people in the US ever suffer heart attacks,... just routine mole removals and the like? Well jeez, all the emergency rooms should be shut down then!

High risk individuals should pay higher premiums, or be uninsurable. Next case.

What is "high risk" exactly?

The little girl with MS... she should be uninsurable and left to die because she was born "high risk"?

The roofer who falls off a ladder and breaks his back... he should be uninsured because he is "high risk"?

The only people covered by medical in b-c's world are wrapped in bubble wrap and imperfect babies are killed at birth. Lovely world. Good thing it's only in your mind.