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Tilting at Windmills

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June 28, 2007

CANADIAN HIP REPLACEMENTS....Well, Kevin warned us back in April.

[H]ere's a handy rule of thumb: any time a healthcare article starts nattering on about hip replacement waiting times in Canada, just stop reading. The authors are cherry picking so egregiously it's a wonder their fingers haven't fallen off.

With that in mind, I give you David Gratzer's piece in today Wall Street Journal:

Canadian doctors, once quiet on the issue of private health care, elected Brian Day as president of their national association. Dr. Day is a leading critic of Canadian medicare; he opened a private surgery hospital and then challenged the government to shut it down. "This is a country," Dr. Day said by way of explanation, "in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."

On a more substantive healthcare note, the president and congressional Dems are facing off on whether, and to what extent, State Children's Health Insurance Program (S-CHIP) should be expanded to include more children from middle-income families. Bush is repeating a predictable canard "government-run healthcare," and insisting that his proposed changes to the tax code would cover more kids.

The truth is, the divide isn't between public and private; it's about guaranteed standards. Brad Plumer explains.

Steve Benen 8:03 PM Permalink | Trackbacks | Comments (56)

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Here in Fresno County California, the county promised every married couple employed by the county a free joint replacement every ten years, for each joint for the rest of their lives

As you can guess, one of the major budget items is funding the billion dollar joint replacement industry we created.

Hence, in Fresno county we also have about 50% of our economy undergound, obviously.

Posted by: Matt on June 28, 2007 at 8:17 PM | PERMALINK

Dr. Brian Day is an odd choice for Gratzer to use to bash the concept of Universal Healthcare, since Dr. Day is not only firmly supportive of UHC, but he also wants to see Canada add drugs and dental to their system of national coverage.

Dr. Day simply believes that private HC has an adjunctive role to play in Canada's HC system. If that is the position that Gratzer is supporting, than that marks a sea change in WSJ Opeds. If not, Gratzer should stop dishonestly using Dr. Day to malign the Canadian HC system.

Posted by: Disputo on June 28, 2007 at 8:31 PM | PERMALINK

Yeah, and while we're at it how about those fucking socialized fucking fire and police departments, and roads, and air traffic controllers, and water systems, and sewage facilities, and..............

Posted by: angryspittle on June 28, 2007 at 8:45 PM | PERMALINK

Good Ford Steve. You are going to wear your fingers out typing all these posts.

Posted by: corpus juris on June 28, 2007 at 8:45 PM | PERMALINK

No kidding! He is, all by himself as prolific as we are with a team, CJ!

Posted by: Blue Girl, Red State (aka G.C.) on June 28, 2007 at 8:56 PM | PERMALINK

Since Professor Sullivan seems determined to continue the debate with Mr. Drum about pharmaceutical policy while he is on vacation (or maybe Andy posted that crack about European pharma before Kevin left - I don't know and don't care to look) I will make two points:

#1) I am presently taking a drug for a condition that is not life threatening, not sexually transmitted, and not disfiguring but otherwise none of your business that happens to be made by a Dutch pharmaceutical company. I have taken two of its American counterparts and they were both primitive and had multiple unpleasant side effects - sort of like killing a cow with a long, blunt wooden object. This is truly a wonder drug, enormously effective and with literally no side effects.

#2) Sullivan's post about European pharma manages to fit almost everything that annoys me about the blogosphere into one post. Andy is a smart fellow but I strongly doubt he knows much if anything about the European pharmaceutical business. I sure don't. And as someone who does some reporting I hate this kind of shit: you google your pet peeve of the day and come up with a single f'ing pdf from some organization supporting your point of view and leave it at that. If I was going to write a piece about how pharma works in Europe I would have to spend many, many working hours talking to officials, doctors, public health professors, and so on IN EUROPE before I committed a single word on the subject to print. As a rule, Americans probably more than any other people on earth need more facts and fewer opinions.

Posted by: Linus on June 28, 2007 at 9:06 PM | PERMALINK

This was a particularly boneheaded day for the Journal editorial page. Besides this iteration of Canada-bashing, the consistently woodenheaded Daniel Henninger calls Clarence Thomas's bizarre opinion in Morse v. Fredrick "one of the most compelling essays I've seen". (Thomas quotes cases from 1837 where judges ruled that students didn't have rights. Hey Clarence, as the second African-American Supreme Court justice ever, can you maybe think of some other things that have changed since 1837?)

Posted by: Rich McAllister on June 28, 2007 at 9:07 PM | PERMALINK

Also from Gratzer's article:

Her client, Lindsay McCreith, would have had to wait for four months just to get an MRI, and then months more to see a neurologist for his malignant brain tumor. Instead, frustrated and ill, the retired auto-body shop owner traveled to Buffalo, N.Y., for a lifesaving surgery. Now he's suing for the right to opt out of Canada's government-run health care, which he considers dangerous.
&&&
It's not simply that Mr. Moore is wrong. His grand tour of public health care systems misses the big story: While he prescribes socialism, market-oriented reforms are percolating in cities from Stockholm to Saskatoon.
&&&
Consider, for instance, Mr. Moore's claim that ERs don't overcrowd in Canada. A Canadian government study recently found that only about half of patients are treated in a timely manner, as defined by local medical and hospital associations. "The research merely confirms anecdotal reports of interminable waits," reported a national newspaper. While people in rural areas seem to fare better, Toronto patients receive care in four hours on average; one in 10 patients waits more than a dozen hours.
&&&
In Britain, the Department of Health recently acknowledged that one in eight patients wait more than a year for surgery. Around the time Mr. Moore was putting the finishing touches on his documentary, a hospital in Sutton Coldfield announced its new money-saving linen policy: Housekeeping will no longer change the bed sheets between patients, just turn them over.
&&&
With such problems, it's not surprising that people are looking for alternatives. Private clinics--some operating in a "gray zone" of the law--are now opening in Canada at a rate of about one per week.
&&&
Market reforms are catching on in Britain, too. For six decades, its socialist Labour Party scoffed at the very idea of private medicine, dismissing it as "Americanization." Today Labour favors privatization, promising to triple the number of private-sector surgical procedures provided within two years. The Labour government aspires to give patients a choice of four providers for surgeries, at least one of them private, and recently considered the contracting out of some primary-care services--perhaps even to American companies.

It is a fact that discontented customers in those nations (Canada, GB, Sweden, Germany, Switzerland) are lobbying to have their systems made more like America's system, with more variations in coverage. And it is true that those systems are facing their own quality control issues. They are also growing more hostile to the idea of providing care for unemployed immigrants. Any proposal to make the American system more like Sweden's, Canada's, Germany's, Britain's, etc, needs to seriously address the growing problems of those systems.

You can show that, in the aggregate, the U.S. spends lots more money for little or no improvment in health. It's a long way from that to a credible claim that any particular modification to our system will be an improvement.

Posted by: MatthewRmarler on June 28, 2007 at 9:50 PM | PERMALINK

Every time I read about the waiting time in Canada for a hip replacement, I have to laugh. First some background. My parents came to New York as part of the group that came from all over the world to run the UN Secretariat. My family grew up in the United States, like the family in "The Namesake" and over time we all became Americans. My parents have a very close association with and love for the United States. When it came time for them to retire they had the choice of New York or the Bay Area. They retired to CANADA! Why? Because of the health care system. Over the 32 years they have been retired, they have received world class healthcare. My mother has had two knee replacements and care for broken back. My father has had three major surgeries and many other ailments that catch up to one when one
reaches their nineties. They live with the security that they can get the care they need, when they need it without worrying about their finances. They pay their taxes AND get value for them!

Posted by: gymrat on June 28, 2007 at 9:52 PM | PERMALINK

Ah, Kevin.

So, you support a failed Canadian policy which favors canine hips over the hips of regular, everyday working people. These are people Kevin, not dogs.

But it no surprise, since your probably one of these wacky PITA types who breaks into lavoratories and releasing all the monkeys.

Posted by: egbert on June 28, 2007 at 9:55 PM | PERMALINK

Anecdotal noise. We Canadians like our health care system. Imagine: no fuss, no paperwork, no worry. Plus you can look your fellow citizens in the eye. Can you imagine the US rightwing haters acknowledging the existence of others in society?

There are problems here, sure, but which health system doesn't have them?

Posted by: Bob M on June 28, 2007 at 9:57 PM | PERMALINK

gymrat:

Medicare in the U.S.--precisely for retired people--is considered by advocates of single-payer to be an ideal system with no problems. Your anecdote makes little sense.

Posted by: dnc on June 28, 2007 at 9:59 PM | PERMALINK

Those Canucks must have some f*cked up dogs, eh?

Posted by: The Conservative Deflator on June 28, 2007 at 10:02 PM | PERMALINK

It is a fact that discontented customers in those nations (Canada, GB, Sweden, Germany, Switzerland) are lobbying to have their systems made more like America's system, with more variations in coverage

Take Canada off the list, moron. You need mental health care if you make up "facts" like that. Get in the real world.

99.9% of Canadians want to keep their health care system as it is. With fixes, yes. But the US system, no way.

Posted by: Bob M on June 28, 2007 at 10:03 PM | PERMALINK

The hip replacements are just one small part of that article. Is every concern about turning over responsiblity for our health care to the state going to simply be dismissed with "It's all lies?"

There are real issues in doing this in a nation ten times the size of Canada.

Posted by: harry on June 28, 2007 at 10:04 PM | PERMALINK

I have a friend with very good insurance who has waited over a year for a hip replacement and battled his insurer to use new technology. Perhaps if one has cash, it's possible to get a hip replaced in a week or an acute condition, but otherwise, it's pretty "Canadian" at best here in the USA.

Posted by: Rich on June 28, 2007 at 10:05 PM | PERMALINK

"It is a fact that discontented customers in those nations (Canada, GB, Sweden, Germany, Switzerland) are lobbying to have their systems made more like America's system"

It is also a fact that you can say precisely the same thing about every single program of every single kind in every single country. It is a trivially true statement that means precisely nothing. Absent any real data, this is just noise. If I recall correctly, the level of satisfaction with health care is significantly higher in those countries than it is in the United States. Similarly, I believe that here in the U.S., the level of satisfaction with public health care is higher than the level of satisfaction with private health care.

"You can show that, in the aggregate, the U.S. spends lots more money for little or no improvment in health."

It's worse than that, as you well know. We pay considerably more and we get considerably less.

"It's a long way from that to a credible claim that any particular modification to our system will be an improvement."

Which is why few, if any, ever make that claim supported only by that particular bit of data. But then you knew this, too.

Um ... did you have a point?

Posted by: PaulB on June 28, 2007 at 10:10 PM | PERMALINK

By the way, Matthew, the linked article in Steve's post goes that "long way" you mention, citing facts and figures to bolster their claims, which makes your statement even more foolish.

Posted by: PaulB on June 28, 2007 at 10:11 PM | PERMALINK

Ah, Kevin...So, you support a failed Canadian policy which favors canine hips over the hips of regular, everyday working people. These are people Kevin, not dogs...But it no surprise, since your probably one of these wacky PITA types who breaks into lavoratories and releasing all the monkeys.

Egbert, you are just too precious!!! Bless your heart.

Posted by: Blue Girl, Red State (aka G.C.) on June 28, 2007 at 10:12 PM | PERMALINK

"Medicare in the U.S.--precisely for retired people--is considered by advocates of single-payer to be an ideal system with no problems."

Complete bullshit, which is why you can't find anybody asserting that. If you're just going to make shit up, the least you could do is make it a tiny bit credible.

Posted by: PaulB on June 28, 2007 at 10:13 PM | PERMALINK

I like my wacky PITA types with hummus and a nice tapenade.

Posted by: Blue Girl, Red State (aka G.C.) on June 28, 2007 at 10:14 PM | PERMALINK

your probably one of these wacky PITA types who breaks into lavoratories and releasing all the monkeys.

You really don't want to release a monkey that's been sitting on the john. Trust me on this.

Posted by: harry on June 28, 2007 at 10:20 PM | PERMALINK

harry, that made me snort.

Posted by: Blue Girl, Red State (aka G.C.) on June 28, 2007 at 10:22 PM | PERMALINK

Here's all you need to know about Brian Day.

Posted by: Robert McClelland on June 28, 2007 at 10:23 PM | PERMALINK

Thanks for the link, Robert. I loved this response to the "hip replacement" argument:

Fact: Access to veterinary care for animals is based on ability to pay. Dogs are put down if their owners can't pay. Access to care should not be based on ability to pay.
Posted by: PaulB on June 28, 2007 at 10:26 PM | PERMALINK

Well damn, PaulB. I was going to excerpt that same passage - I would have been horribly embarrassed if I had not hit refresh before posting!

Posted by: Blue Girl, Red State (aka G.C.) on June 28, 2007 at 10:31 PM | PERMALINK

For those of you who like to see actual data, here are some
wait times in Southern Ontario (courtesy of the Ministry of Health and Long Term Care):

Elapsed time for 90% of patients to receive procedure (Fall 2005 data)

hip replacement - 174 days
knee replacement - 127 days
CT scan - 29 days
MRI scan - 23 days
cardiac bypass surgery - 5 days
cataract surgery - 6 days

Make of it what you will, but wait times are not measured in years.


Posted by: Platypus on June 28, 2007 at 10:36 PM | PERMALINK

I'd comment about great minds thinking alike and all that but, really, that one just jumps out at you, since it highlights the stunning dishonesty of the comparison. I'd almost wish for a snarkier statement, though: "Dogs are put down if their owners can't pay. Is Dr. Day proposing this alternative for people, too?"

Posted by: PaulB on June 28, 2007 at 10:36 PM | PERMALINK

"Dogs are put down if their owners can't pay.
Unless they need a hip replacement; then they go to the head of the line, displacing someone's granny.

Posted by: Qwerty on June 28, 2007 at 11:23 PM | PERMALINK

Bob M: 99.9% of Canadians want to keep their health care system as it is. With fixes, yes.

Make up your mind: "as it is", or "with fixes"?

I wrote: more like America's system, with more variations in coverage

which is the way they have been moving.

Posted by: MatthewRmarler on June 28, 2007 at 11:47 PM | PERMALINK

"Make up your mind: 'as it is', or 'with fixes'?"

Notice how far either of those statements is from your own statement, Matthew?

By the way, do you have any support at all for your assertions that some countries are moving to systems "more like America's system?"

Posted by: PaulB on June 28, 2007 at 11:57 PM | PERMALINK

In Matthew's world, every conservative endeavor is a success so there's no room for any naysaying, whether it be the occupation of Iraq, the elimination of racism and prejudice, our fantastic health care system, or equal pay for women.

And he would be correct were it not for the escalating violence in Iraq, the continued existence of racial bias, the tens of millions of uninsured and underinsured and the previously insured who are now bankrupt -- and women making .80 for every dollar a man makes.

Yes, were it not for the tedium of facts that prove the contrary, Matthew's arguments would be absolutely irrefutable.

Posted by: trex on June 29, 2007 at 12:13 AM | PERMALINK

You can show that, in the aggregate, the U.S. spends lots more money for little or no improvment in health. It's a long way from that to a credible claim that any particular modification to our system will be an improvement.

That's our Marler! Cast vague, preemptive aspersions on the entire body of "particular" statements that someone might at some point might make, throwing up your hands at the hopelessness of everyone else's pie-in-the-sky ideas. Meanwhile, once again fail to to offer any alternative or have the courage to come right out and endorse the status quo. Attaboy, Matty!

We'll take your position to be this: "The system doesn't work, but any modifications to it won't work, so I conclude that...the system doesn't work, but any modifications to it won't work, so I conclude that...the system doesn't work, but any modifications to it won't work..."

Posted by: shortstop on June 29, 2007 at 12:27 AM | PERMALINK

I rather lost track of the false reports and exaggeration some time ago. People do take care of developing problems too. Here in Alberta a pilot joint-replacement fast-track program was considered a success and is being expanded.

Posted by: opit on June 29, 2007 at 1:06 AM | PERMALINK

The US healthcare system is often compared to canadian and british healthcare. From what i've read about these, they don't look so great. I would suggest getting a close look at the french system which is a mixed public-private solution and one that works really well. I have tried both and frankly the french system is much much better. It's got problems too but overall the service it provides is really remarkable.

Posted by: Greg on June 29, 2007 at 3:27 AM | PERMALINK

For the latest in know-nothing opinionizing to discredit universal health care, check out Stephen Hunter's ultra-lame review of "Sicko" in today's Washington Post.

Posted by: Virginia Dutch on June 29, 2007 at 8:52 AM | PERMALINK

"Yeah, and while we're at it how about those fucking socialized fucking fire and police departments, and roads, and air traffic controllers, and water systems, and sewage facilities, and.............."
____________________

Angry hits on the essence of the debate: Is providing healthcare a core function of government? No one but the most radical libertarian argues that government has no role in making lives safer. The question is where to draw the line. How far should we go in turning turning from personal responsibility to government care? For that matter, how is healthcare different from food and housing?

It's an interesting theory, that government should be the primary provider of individual needs. That's quite aside from the questions about how well it can work or if it can be afforded.

Posted by: trashhauler on June 29, 2007 at 9:00 AM | PERMALINK

why doesn't someone blindside Bush and ask him apropos of nothing: "how would you rate the medical care our soldiers are getting?"

he would undoubtedly gush.

the follow-up would then be: "but that healthcare is ENTIRELY run by the government. from a soldier's point of view, there's NOTHING free market about it. it's free and there's only one provider-- the military healthcare system. soldiers (and their families) show up and get treated. no forms, no payment. so aren't you saying that, at least for the military, socialized medicine works?"

Posted by: Chris on June 29, 2007 at 9:45 AM | PERMALINK

First of all, artificial joints have a limited life span, so often surgeons want their patients to delay replacement surgery for as long as possible so they don't end up with a worn out, irreplaceable artificial hip in later years.

Secondly, in Canada the time you have to wait may sometimes be longer than you would like, but it is always a function of how badly you need the treatment, as opposed to how much money you have. This means granny on her pension won't have to wait in line while younger, fitter people with less pain but more money get to jump the queue in front of her.

Posted by: A Hermit on June 29, 2007 at 9:59 AM | PERMALINK

Oh, by the way, the above data on wait times for things like MRI's is a bit misleading if read the wrong way. Those are AVERAGE wait times; meaning it includes the times for elective procedures and non-critical diagnostics.

If you have an acute condition or injury you'll get treatment very quickly. My sister-in-law blew out her knee on a ski slope (in another province), had artheroscopic surgery the next morning. Mom's cancer surgery? One week from diagnosis to surgery.

Is Canada's system perfect? Of course not, and Moore might exagerate a little in his film but not nearly as much as Gratzer and the chicken little's who howl about wait times and the evils of "socialized" medicine. The real distortions and misrepresentations are coming from the privatizers.

Posted by: A Hermit on June 29, 2007 at 10:13 AM | PERMALINK

chris wrote:

"but that healthcare is ENTIRELY run by the government. from a soldier's point of view, there's NOTHING free market about it. it's free and there's only one provider-- the military healthcare system."
________________________

That's not exactly true in this age of Tricare. Much of the military healthcare system is outsourced to civilian providers. Emergency care is usually first rate, routine stuff less so. Retirees go to the back of the line, as might be expected in a system designed to maintain a fighting force.

Still and all, a pretty good system for the 3-4 million who have access to it, courtesy of the taxpayer. Don't know how much it would cost for 300+ million people.

Posted by: trashhauler on June 29, 2007 at 10:15 AM | PERMALINK

It is a fact that discontented customers in those nations (Canada, GB, Sweden, Germany, Switzerland) are lobbying to have their systems made more like America's system, with more variations in coverage

Wow, they're lobbying to have large numbers of their fellow citizens be tossed onto the street to receive no or inadequate health care? How...American of them.

Meanwhile, back in the real world, away from Marler's brain-damaged fantasies....

Posted by: Stefan on June 29, 2007 at 10:23 AM | PERMALINK

It is a fact that discontented customers in those nations (Canada, GB, Sweden, Germany, Switzerland) are lobbying to have their systems made more like America's system

I'm sure there are. About a few hundred of them. Meanwhile, it is a fact that a majority of discontented customers in America are lobbying to have our system made more like Canada's, Great Britain's, Sweden's, Germany's, and Switzerland's systems.

Posted by: Stefan on June 29, 2007 at 10:50 AM | PERMALINK

Well, if we are going to do anecdotes on Canadian healthcare, then I will relate one of my own.

I work with a colleague who has emigrated from Canada (Nova Scotia). His grandfather is dying of prostate cancer. He told me that when the problem was first discovered by the grandfather's general physician, there was a delay of half a year before the specialist could see him. In the intervening time, it has been discovered that his condition is terminal. Now, it isn't clear that anything could have been done immediately after the first diagnosis, the grandfather became deathly ill and was admitted on an emergency basis just before his appointment with the specialist, but there is something seriously wrong with a system that can't get you into see a specialist in a shorter time than that on a routine basis.

Posted by: Yancey Ward on June 29, 2007 at 11:21 AM | PERMALINK

Those wait-time statistics do not include the number of Americans who have to forego care.
...If you look at waiting times, you'll see that relatively few Americans wait more than four months for surgery, which helps folks claim that America doesn't ration care, and makes our system look pretty good on the waiting times metric. Here's what they don't tell you: When you look at who foregoes care, the international comparisons reverse themselves. About 23% of Americans report that they didn't receive care, or get a test due to cost. In Canada, that number is 5.5%.
Worse, the American number is understated, as in order to know you need a surgery or further care, you need to go for an evaluatory visit, and as it happens, many Americans -- including 36 percent below average income -- aren't even seeking that. And it's this group -- which is largely low-income, and I'd guess, largely urban -- who would, in another country, be experiencing terrific wait times. Here, they never get care at all. The studies misleadingly write them out of the waiting statistics, making it look like America has low wait times when the relevant population is simply never getting care at all....

Posted by: Mike on June 29, 2007 at 12:27 PM | PERMALINK

I'm sorry no one believes that Canadian healthcare is not that great. Everyone has access to healthcare, which is great. But the care they have access to is not great. Literally every week there is a story in the Canadian press about poor care, especially in emergency rooms. I know for a fact that knee surgeries in Canada involve a six-month wait. You could ask a Canadian and if they're not too "polite" they will tell you the truth about their very shoddy healthcare system. Let's learn what we can from them about access and they can learn from us about quality.

Posted by: bellhop68 on June 29, 2007 at 12:27 PM | PERMALINK

Sorry bellhop, but you're full of it. I'm Canadian and you're wrong. Don't quit your day job. You can't even make troll yet.

Posted by: Bob M on June 29, 2007 at 2:05 PM | PERMALINK

The studies of health care in Canada show good satisfaction with the care the person being polled has gotten, but dissatisfaction with the care overall. This weird disconnect is probably due to the fact that rightwing "think" tanks in Canada have been pushing the "system is broken" line for nearly 30 years now and their efforts are paying off.

On the hip replacement front, just as in the USA, elective surgery involves waiting times. If the hip replacement is not elective, for instance after a fall, they do it right then. I've seen this secondhand as I was with my girlfriend's mother when she broke her hip in a fall and saw a room full of old ladies with broken hips, all of whom got a hip replacement within days.

(Interestingly, I find it easy to find info on waiting times for other countries re medical procedures online, but very difficult to find any for the USA. This could mean there simply are no waiting times, but this is not true, and we know this isn't true, so it seems we just don't like to look critically at our health care system. Maybe that's why people aren't up in arms about paying twice as much for similar or poorer service.)

Posted by: QrazyQat on June 29, 2007 at 2:10 PM | PERMALINK

Those wait-time statistics do not include the number of Americans who have to forego care.

Exactly. You have to factor in the 40 million or so Americans whose wait time is, effectively, until the end of time, because they will never ever receive care. Once you add 40 million cases of infinity into the stats, suddenly our numbers don't look so good.

Posted by: Stefan on June 29, 2007 at 3:25 PM | PERMALINK

Sorry Canadians, I've seen your healthcare system up close. It's just not that great and you know it. Read the papers up there. Be honest and with yourselves. Canada has a lot of great ideas and providing healthcare for everyone is one of them. Of course, administering a system like this to 30 million passive Canadians is a lot easier than administering it to 300 million Americans plus another 12 million illegal aliens.

Posted by: bellhop68 on June 29, 2007 at 3:29 PM | PERMALINK

You have to factor in the 40 million or so Americans whose wait time is, effectively, until the end of time, because they will never ever receive care.

About 47 million. Almost one in six.

And counting.

Posted by: shortstop on June 29, 2007 at 4:39 PM | PERMALINK

"Sorry Canadians, I've seen your healthcare system up close"

Gee, who could possibly argue with such a well-reasoned and well-supported argument like this?

Posted by: PaulB on June 29, 2007 at 9:56 PM | PERMALINK

Secondly, in Canada the time you have to wait may sometimes be longer than you would like, but it is always a function of how badly you need the treatment, as opposed to how much money you have. This means granny on her pension won't have to wait in line while younger, fitter people with less pain but more money get to jump the queue in front of her.

Well, no, it's not always a function of "how badly you need the treatment." It can also have something to do with where you live. Waiting times can vary from province to province. Moreover, queue jumping isn't all bad. Most countries with state-funded/mandated universal healthcare systems allow for queue jumping. Canada is the odd bird out here. That is, most rich countries have enough sense to allow domestic queue jumping rather than see those healthcare dollars (or Euros or Pounds) flow across the border. On the whole I deem Canada's healthcare system marginally superior to the USA's (because of its comprehensiveness and low cost). But such a system will never be enacted into law in the US. The United States is much more likely (fortunately) to follow a French or Australian model. Or maybe not. Because it would certainly appear that Canadians are slowly being dragged (often kicking and screaming, to be sure) -- just like the citizens of other rich countries -- into a future where private capital plays a more significant role in the provision of healthcare.

It is indeed difficult to see how the United States can continue indefinitely with a system where profit-seeking insurers play such a dominant role in paying the nation's medical bills. But it isn't hard to imagine a system where the profit motive plays an important, secondary role. Just look at the France of 2007, or the Canada of 2019.

Posted by: Jasper on June 29, 2007 at 10:58 PM | PERMALINK

Of course, if the Canadians put the same percentage of their GNP into health care as the US,people would probably get their hip replacements before they even knew something was wrong with their hip.

Posted by: Eric on June 30, 2007 at 10:33 AM | PERMALINK
…I know for a fact that knee surgeries in Canada involve a six-month wait….bellhop68 at 12:27 PM
It's too bad you don't cite any studies for your claims, however, I would like to point out that broken knee/hip/anything surgeries are done on a PDQ basis; replacement and repair due to arthritis and other slow degenerative diseases are less urgent and take longer. This is true everywhere. Also interesting are patient satisfaction surveys …Dissatisfied Canadians or Britons are much talked about. But there’s little mention of the satisfaction level of Americans. The Commonwealth Fund’s survey, for instance, shows that, in 2005, 42 percent of Americans doubted whether they could get quality health care. At a series of town hall meetings in Maine, facilitators asked participants to discuss dozens of complex health care policies but excluded single-payer as an option. (See Tish Tanski’s article. Only after repeated demands by participants was the approach that cuts out the corporate middle-men allowed on the list…. Posted by: Mike on July 1, 2007 at 5:53 PM | PERMALINK

Good Day!!! www.washingtonmonthly.com is one of the best resourceful websites of its kind. I take advantage of reading it every day. Keep it that way.

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