It was only yesterday that I said, There are people in this country who are really not in a position to save up anything. Every penny they earn is necessary just to keep body and soul together. Turns out every

In Canada, in contrast, medical school is much less expensive, and doctors saleries are much lower.

Given that set-up, it’s no surprise that Canadian doctors are often tempted to practice in the USA. In every occupation, people are attracted by the prospect of higher pay.

Of course, Canada is an exception - the US has trade barriers limiting the numbers or simply forbidding doctors from most other countries from practicing medicine in the US. If we didn’t have those trade barriers, the marketplace would force doctor pay down, and American medical schools would be forced to find ways to lower tuition or go out of business.

I don’t ever wait to see my doctor. But then again, that’s because I pay him cash, because I’m too poor to afford to “insure” my health.

Yes, “we” were told this back fifteen and twenty years ago, too. “We” probably wonder why it is, with our Thank God It’s Not Canadian health-care system, that we too have waits for specialist vists (hell, for generalist visits). I never waited as long in Canada to see a doctor as I do here.

We’re told that doctors are fleeing Canada in droves, and you have interminable waits for specialist visits or surgery…

Why do things by half measures? Move to Papua New Guinea, the paradise of the free market!

But what do I know: I’m a Canadian and I know nothing of the joys of private insurance.

I still think that single-payer is the way to go.

http://www.pnhp.org/facts/what_is_single_payer.php

If not, there ought to be enforceable caps upon the profits of drug companies and insurance companies. They already use tax dollars to fund their efforts in the first place. Why should we have to shovel Medicare and Medicaid funds directly into their greedy maws to get them to do their damn jobs, particularly if this money comes with no regulatory strings attached other than that they “provide care” ? What’s to stop them from providing piss-poor care to the patients and pocketing the difference ? Besides which this “solution” does nothing to adress the woes of folks who don’t qualify for these services in the first place.

If we can’t have caps, we ought to at least give city, state, and county governments the right to collectively bargain for lower rates and drug prices just as Unions do now. Even my Union was facing a battle royale every time contracts came up as prices kept rising;More and more costs in the form of paycheck deductions and higher co-pays were being borne by the members as the years went by, though this was nothing compared to the cost of COBRA, as I tried to point out above before Robert tried to divert me into helping him re-enact the Cold War so he could get his usual trollish jollies.

Tim Nesbitt, Oregon’s head of the AFL-CIO, was hostile to Measure 23 when it was before the voters, over the objection of several members of his own executive board. I still think Nesbitt is an asshole. Not only because he reinforced the “I got mine” attitude that makes it hard for Unions to look like they give a damn about any worker outside their charmed circle, but because if every institution in the state could bargain in the same way the Unions could, it would likely act to stabilitze skyrocketing costs;Maybe even drive them down. “We must all hang together or we will certainly all hang separately,” –isn’t that how the old saying went ? :D

At this point, Pharma and insurance companies own the debate, and they own the public servants who are supposed to be looking out for us. That has to change.

There is also the consideration that all government employee’s get insurance, which sort of goes hand in hand with the implication that it’s both necessary and in many ways a ‘right’. We could play games with words about rights, but ultimately I think Alsis hit the nail on the head by addressing the social contract. Do we all have a right to be covered under the implied necessary social contracts that our country views as valuable, or not.

The government is already paying for at least 50% of health care expenditures in one form or another. Direct payouts through entitlement programs are most of it but certainly not all. The question is how much any of us taxpayers is getting in return, and it doesn’t seem like it’s much, and it’s virtually nothing for those who pay taxes but don’t have insurance.

If we want health care to be a right all we have to do is make it one. There’s nothing sacred about our current concept of rights.

HSAs sound like an interesting idea, but only for healthy people of middle income and above, so they can self-insure themselves and be able to take a very-high-deductible policy in case of serious health problems. It’s less useful for people who need to watch every penny, who expect to need much medical care, and encourages people to not get early treatment, since they’ll pay out of pocket. Here’s a good example of HSAs in practice insuring public employees.

As the article says, HSAs weaken insurance pools by drawing out healthier people, or people who believe they will be healthy, increasing premiums for people who choose standard health plans.

National health insurance will do exactly the opposite, by spreading the risk over a larger group of people - 290 million. The basic rule of insurance is that larger pools mean smaller risks - why not make a pool of everyone in the United States (or even include other countries to make the pool larger still?)

And I’m going to propose a law, similar to Godwin’s Law, decreeing that anyone who mentions Cuba in response to comments about social democracy or national health care loses the argument. People who bring up apocryphal waiting periods in other countries also lose the argument.

Get a life.

One idea I’ve seen bandied about is that the gummint should blow off Medicare and Medicaid and instead make whacking great contributions to the HSAs of people beneath certain income thresholds. That way the poor folk have complete control over their health expenditures (thus preserving self-budgeting), aren’t left without assistance, and can’t spend the money on whiskey and guns.

Where that runs into a problem is that it creates an imbalance in the terminal care for poor elders and rich elders. One reason the managed systems of Europe have a better cost structure is that they don’t spend gazillions trying to keep 90-year olds alive. With this system, we’d still have rich elders blowing through huge amounts to hold on for another six months, but poor elders would be unable to afford that care, HSAs or no, and would just die. That might cause emotional distress in the hyper-egalitarian set - and, of more concern to me, among the families of poor elders. (”Why are they just letting grandma die?!??”)

Whenever the bloodshed, misery, poverty and oppression caused by left totalitarianism are mentioned in a discussion, at least one leftist will mischaracterize the statement in a desperate attempt to spin away the mountains of corpses his or her philosophy has littered through history.

Although that corollary might not have been exactly what you had in mind.

The Canadians still use this system, for all I know–they certainly did fifteen years ago when I lived in Ontario.

That systems change is not proof of failure; all systems change over time, after all.

The French are adding some cost-containment, which will make their system less great in some ways but more affordable; on the other hand, the basic thing I admire about their system, which is that every single person can afford the medical care they need with much less waiting and bureaucracy than I’ve seen in the USA, will remain true. And I’d much rather have a doctor as a gatekeeper than a HMO looking for excuses to deny me treatment.

Going back to my original point, the international evidence makes it clear that universal, mostly government-paid health care is possible and has been made to function well in the real world.

HSAs are an interesting idea. They’re still pretty new to me, so I’m not sure what I think of them yet, but on the face of them they seem better than much of our current system. A lot would depend on how they were implemented, of course.