Tax the rich and give to the poor?

[Agathon]

Sound familiar? It's what a number of lefties here at Poly preach from time to time using slightly different terminology - you know, the greatest happiness for the largest number of people (as if some happy meter up in the sky is constantly measuring everyone's happiness whenever some left wing policy is put into law).

That would be all well and good if not for the fact that when it comes to politics you are completely delusional, and have proved it better than anyone else ever could.

[Jaguar]

Agathon, don't hold anything back. Tell us how you really feel.

[Vince278]

Taxing the rich: Good idea.
Letting the poor think they can get something for nothing: Bad idea.
Rich people are not the reason poor people are poor. We need to help the poor help themselves.

[Vince278]

Originally posted by Agathon
Americans crack me up.

You have absolutely no idea of how the world works. Instead you sit in your trailers, gorging on lard and watching the diseased, infantilist rubbish your networks spew, congratulating yourself on how no one else is really free as you crack open a bottle of meths while your politicians and big business get together to think up new ways of ripping you off.

Thats it in a nutshell. Come visit sometime.
(Excuse me a moment, my porn download is complete...)

[Aeson]

I think that a flat tax would be a better solution. The higher taxes the wealthy pay eventually are going to come out of the middle class' pockets in the form of lower wages and/or higher prices. That's why the wealthy are wealthy, they know how to get/keep the wealth.

If it were up to me income tax would be done away with entirely though. Go with a sales tax scaling from none on necessities (food, basic housing, medical, education) upwards on luxury items.

I have no real rationalization for this. It would be a pain to implement, and probably just as prone to the loopholes we have now. Regardless of how it was implemented, a similarly designed income tax could work the same. I just want to be able to say "The government in it's infinite wisdom allows the rich to pay as little tax as the poor do for their yachts, jewelry, and sports cars."

[RGBVideo]

/me tries to save the thread from threadjackers... *

Essentually this is income redistribution from the rich to the poor. Socialism in my book.

It's hard to believe, but America is turning into a socialist nation.

You speak like this would be a new menace of somekind, which would soon turn into a national trend. I disagree with that. When keeping in mind that W. has just very drastically lowered the income taxes for the rich on a federal level while keeping the taxes to the poor almost still, it seems just logical that the Dem.-controlled US North Eastern states (okay, NJ exactly isn't a democratic stronghold, but it tends to share the other NE's states views about taxation, no?) are balancing the taxes to represent their views on a state level.

[Agathon]

Have you ever left Topeka, Berz?

Aeson-

A flat tax is no solution. People at the bottom end up making too much of a sacrifice due to diminishing marginal utility. Moreover a progressive tax is good in that it's one way of stopping people from spending money on competitive consumption, which actually benefits them.

[Jaguar]

Aggi: The only industrialized country with completely socialized healthcare is Canada. Let's look at some articles about speedy healthcare there.

Diagnostic imaging across Canada: The emperors still have no clothes
By Andy Shaw

In 1999 Canadian Healthcare Technology reported in these pages that Canada had fallen to near the bottom of the list of industrialized countries in its use of high-tech medical equipment such as MRI, CT, and PET scanners. Now, more than two years and $1 billion of federal government fix-up spending later, our situation is little improved, say prominent radiologists. Indeed, such is the continuing vacuum of modern imaging gear in Canada that, despite being potentially illegal, private diagnostic clinics are rushing in to fill the void right across the country.

In Ontario, where a private Toronto clinic will soon offer $2,500 a session PET scans, the head of the provincial radiologists association, Dr. Giuseppe Tarulli, says the provincial government invited such willy-nilly privatization of healthcare by playing sleight-of-hand.

“In September, the Ontario Health Minister announced $50 million in one-time federal funding for new radiology equipment. But then in effect he clawed it back by reducing the funds available to run the equipment,” says Dr. Tarulli.

What’s worse, adds Dr. Tarulli, the $50 million buys only about 300 pieces of radiology equipment in a province limping along with 2,400 outdated imaging machines.

Ontario is not the lone culprit.

In British Columbia, the provincial government was even more blatant in its misuse of federal dollars, according to Dr. John Mathieson, chief of radiology for the Capital Health Region in Victoria.

“The federal government transferred $280 million for high tech equipment to B.C., but the problem was, it didn’t get a written agreement on what the money was to be spent on,” says Dr. Mathieson. “Right away $190 million of that money was siphoned off to cover health budget overruns. Another $40 million of that high-tech money was put aside to settle a doctors’ wage dispute in Prince George. So only about $70 million out of the $280 million was available for new equipment.”

But this purposeful misspending did not end at the provincial level, adds Dr. Mathieson. “Of the remainder, Victoria got $6 million but $4 million of that got spent on buying new beds. Hardly what I’d call high tech.”

Similar tales of being short-changed are being told by other radiologists in other provinces including Nova Scotia and Quebec. Dr. Paul LeBrun, chief radiologist at the Queen Elizabeth II Health Sciences Centre in Halifax says some of his colleagues are working with 34-year-old X-ray machines and estimates that 45 percent of the province’s imaging equipment needs to be replaced.

That would cost $45 million dollars, estimates the provincial health department, which will receive only about $30 million of federal replacement funds. In Quebec, where about $120 million ticketed for medical equipment renewal has also vanished, Dr. Gaétan Barrette estimates that over one-third of the imaging equipment there remains very outdated. As a result, Quebec radiologists voted to charge $4 extra for each X-ray as an equipment improvement fee – despite being faced by a $2,000 fine for contravening the Canada Health Act by doing so. That got the Quebec government’s attention.

Country-wide, Normand Laberge, CEO of the Canadian Association of Radiologists (CAR), estimates that less than a third of the $1 billion dollars allotted has gone to buying and installing new diagnostic imaging tools.

“There is no doubt that some provinces have been playing games with the money and diverting it to other purposes,” says Laberge. “So we were encouraged when we heard (Health Minister) Allan Rock at the Canadian Medical Association annual meeting point the finger at Ontario and chastise it for paying old invoices with the new money. He has asked for detailed reports from provinces on how the money has been spent as a result.”

Laberge says, however, that such reports have been slow to trickle in and are not the solution to the problem at any rate. “In Ontario, for example, where half the radiology work in Canada is done, when you net out what it’s doing, the province is simply not adding new imaging equipment. So there’s no overall improvement. That’s what’s encouraging the private sector to come in.”

Such an invasion of the country’s socialized medicine would be preferable to the alternative of ever worsening degradation, says Dr. Mathieson. He reads from a recent letter of complaint from one of B.C.’s most experienced cardiologists, a specialist who attempted to insert a pacemaker in a patient using an ancient, fluoroscopic imaging machine to spot the pacemaker’s metal end.

“It was next to impossible to see anything...I have never worked with a worse piece of equipment in my career, including cases I have done in small towns in Brazil, Chile, and Uruguay. It is unsafe.”

Dr. Mathieson adds that there are some modern imaging procedures commonplace around the world that either can’t or are rarely being done in Victoria because of dilapidated scanners or new equipment scarcity .

“When I was in my student days in San Diego in the early 1980s, we were routinely doing PET scans for pelvic cancer in women,” he says. “They’ve become the standard in most other places, but we still can’t do them here.”

Dr. Mathieson says he as stopped reviewing professional radiology journals because so much of what is reported by them deals with procedures done on imaging equipment unavailable to him.
While some new imaging technology is now operating in Victoria, its shortage creates a dangerous backlog that is all too common across the country.

“I had a young athlete here with an injured knee who badly needed an MRI,” relates Dr. Mathieson. “But he had to wait four months for the MRI,and by then the knee was inoperable. So he lost his full athletic scholarship.”

In a damning story carried by the Knight Ridder news service in 2000, James Frogue, a healthcare policy analyst for the Washington-based Heritage Foundation, wrote: “Waiting lists for emergency surgeries in Canada are sometimes so long that procedures never take place....The reason: (patients) had waited so long they were deemed medically unfit to undergo surgery without an unacceptable risk of dying. Similar examples, equally shocking, abound.”

Good that our shocking state was noted by a policy analyst. It is, after all, government healthcare policy that creates both the problem and at least hope for a solution.

“For five years, the NDP government here in B.C. stopped all funds earmarked to replace broken medical equipment and shifted them all into wages. So equipment that was already ready for replacement went at least another five years. In effect, government policy was based on the assumption that medical equipment would last forever,” says Dr. Mathieson. “And even now the provincial budget still looks dismal for the next two or three years. So the emperor still has no clothes.”

B.C. health policy makers remain vainly unseeing, says Dr. Mathieson, of a naked truth about healthcare technology: “The crux of the problem is that in the medicare model we have in Canada, there is no connection between supply and demand .”

On the supply side, explains Mathieson, there may be rapid and frequent advances in technology as there have been over the past 20 years in medical technology, but getting the government demand side to respond is a cumbersome and lengthy process. He cites the examples of old imaging procedures eligible for funding in B.C. that are so outdated he has never seen them used. At the same time, payments for CT scans are so out of whack with reality, it actually costs a hospital money to do them. So there’s no financial incentive to use better diagnostics.

Back east, there’s also growing recognition that imaging’s problems within publicly funded healthcare are similarly structural.

“ We haven’t managed diagnostic imaging as a whole sector,” says Dr. Henry Phillips, a former clinician and now medical consultant to the Provider Services Branch at the Ontario Ministry of Health and Long-term Care. “Traditionally, hospitals here get funding for radiology as part of their block operational grants to run the hospitals. Then there’s separate money for radiology in community clinics. So we end up with friction between them and competition for available funds. We need to fund all of radiology from a single envelope. That way we can also get into province-wide life cycle management of equipment.”

Without such centralized control, an estimated 16 million examinations done annually in the province cost taxpayers about a half a billion dollars a year . And that sum has been increasing at about 5 per cent a year – a growth rate, says Dr. Phillips, that all parties recognize as unacceptable.

“So after a single funding envelope, our next recommendation is that we need a co-governance structure, possibly a separate organization, to effectively manage this pool of funds. That would involve representation from the Ministry of Health, the Ontario Hospital Association, and the Ontario Medical Association,” says Dr. Phillips, who has filed a report to that effect with the Ministry.

“We’ve also recommended that we use cost-based accounting, so that we pay fees that cover the costs, that we place heavy emphasis on quality and standards, and that we institute evidence-based decision making to see if new technologies such as PET scanning should be introduced into clinical care in the province,” says Dr. Phillips.

He points with pride to a recent pilot project that assessed the readiness of PET scanning for insuring in Ontario. The report reportedly said, not yet.

Not the kind of approach to imaging’s calamitous state that Dr. Mathieson would applaud, however.

“If you wait for outcome or impact studies to really prove the benefit of a new technology, you’ll wait years for anything to get introduced,” says Dr. Mathieson, “And besides, you can go to the RSNA (Radiological Society of North America) in Chicago every year and find out what 60,000 radiology users and researchers have found out about what works and what doesn’t. Some things just obviously work and you don’t need a study to prove it. From the time the X-ray machine, for example, was first introduced at a medical conference, it took only about three months before it spread around the world and everybody was using it.”

Nonetheless, Laberge of CAR believes the more systematic albeit plodding, co-operative approach favoured by governments will win the day and eventually breathe life into our moribund imaging technology.

Oh, wait, my mistake! That's about how slow their healthcare system is, not how fast. I apologize for the mistake.


My sister was born with an occipital encephalocele and several other birth defects, so she has had neurosurgery eleven times now. If she has a headache for more than a few days, it is a sign of a possible shunt failure, and she needs an MRI scan immediately. The last time it happened, we were able to get an MRI scan the next day. My sister would have died several times over by now if she lived in Canada or France. I'll keep my privatized healthcare, thank you.

[Urban Ranger]

Originally posted by Jaguar
Oh, wait, my mistake! That's about how slow their healthcare system is, not how fast. I apologize for the mistake.

Oh gee, it's like MRI scans are as cheap as apples, right?

[MikeH]

US becoming socialist?!

[Jaguar]

Originally posted by Urban Ranger


Oh gee, it's like MRI scans are as cheap as apples, right?

For us, yes, because we have catastrophic health care coverage. So anything above $2500 is paid for by insurance. And we wait only a week at most.

[Agathon]

Aggi: The only industrialized country with completely socialized healthcare is Canada. Let's look at some articles about speedy healthcare there.

Eh? Not another Canadian right winger complaining about health care. These are the same cretins who endlessly whine for tax cuts and then wonder why things like healthcare and public transport face cuts. Just like the former Conservative government in Ontario who cut taxes and spent so that the Liberals have had to raise taxes again and cut services just to stay afloat.

When healthcare is funded properly, there are no such problems. If people are stupid enough to vote for governments who tell them they will cut taxes and ensure adequate provision of social services, they are sadly mistaken.

And what this guy isn't telling you is the vast number of frivolous MRIs that go on in the US. A complete waste of time IHMO.

Did you know that the US has more than ten times the number of mammography machines it needs to give every woman in the US the recommended number of mammograms. What a complete waste of resources.

And Canada's health care system is single payer. A lot less socialist than the UK, Australia or New Zealand for that matter. I take it that you are aware of the difference.

BS about your sister too. If she had that and lived here she'd be right at the front of the queue. People who screw up their knees performing silly carnival stunts have to wait like all other non-urgents.

[RGBVideo]

A flat tax is no solution. People at the bottom end up making too much of a sacrifice due to diminishing marginal utility. Moreover a progressive tax is good in that it's one way of stopping people from spending money on competitive consumption, which actually benefits them.

...wtf?

[MikeH]

Anything ABOVE $2500?!

You have to pay $2500 out of your own pocket for an MRI?!

[Aeson]

Our healthcare system could certainly use some improvement. I basically am uninsurable at this point. I don't particularly care as I'd rather die than be on meds or go to a Doctor or Hospital anymore... but it probably sucks for other people in similar positions who get ill/injured and want help.