Healthcare Reform Thread

[Ramo]

What you wrote sounds like a non-sequitur to me. But I don't care enough about whatever argument you're trying to make to follow up.

Again. If you don't believe him (and former Pres of the Canadian Medical Association seems credible to me), give me another source.

[Ben Kenobi]

Again. If you don't believe him (and former Pres of the Canadian Medical Association seems credible to me), give me another source.

Your source says 70 percent of the dollars go to public health care. This fellow is 'estimating' which is a key word for 'talking out of his ass'.

It's to his benefit to play up privatisation to scare Canadians into putting more health care people into unions and become salaried employees.

What I am telling you is that the way it works is that the clinic bills the government. The only thing that makes these workers 'private' is the fact that the clinic pays them rather then them under a union contract with the government. That's it. The government still fully funds them.

[Ramo]

I am not talking about funding. Neither is he. Please stop polluting this thread.

[Ben Kenobi]

Fine. Define for me what counts as 'private health care'.

I have sources. I just don't have a clue what you consider to be private health care or not.

[Arrian]

I found this article interesting, and well worth the read:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=1

-Arrian

[Ramo]

Any institution that's not administered by the government. Private practices, labs, clinics, hospitals, whatever.

[Ramo]

I found this article interesting, and well worth the read:

http://www.newyorker.com/reporting/2...?currentPage=1

-Arrian

Yeah, that's a good'un.

[Arrian]

The major point it makes is the whole discusison of who should pay for care (private health insurance, government health insurance, patient) is secondary.

The scary part, for me, was having read it and sitting there trying to come up with a way to do what the article argues must be done... and not having a clue as to how to do it.

-Arrian

[Ramo]

The main point in the article is this health outcomes are very poorly correlated with costs. Even if you look at just the US, you have huge variations in cost with very little to show for it. So you can save huge amounts of money without an appreciable loss in public health (and in the process, boost the safety net). The key is to create an incentive structure that allows this to unfold. That's going to be difficult. But examples of other countries (specifically, all the other countries) show that a stronger public role (at both the insurer level and the delivery level) can be useful in containing costs.

As for specific points he made, the suggestion to salary doctors was a good one.

[Arrian]

That's going to be difficult.

Which is what scared me.

I do like the idea of salaried docs, yeah.

-Arrian

[notyoueither]

I'm still waiting for a source contradicting this.

Dr. Albert Schumacher, former president of the Canadian Medical Association estimates that 75 per cent of health-care services are delivered privately, but funded publicly.

http://www.cbc.ca/news/background/he...s_private.html

Like Schumacher, I was characterizing administration of health care in general, not specifically large-scale facilities (FWIW, the Wiki entry on Canada's Medicare characterized the hospitals as mostly "semi-private"), as largely private. Dunno what your point here is, but I still don't see any source contradicting Schumacher.

Again, I'm not arguing that we should adopt the Canadian system (Ben quoted Zkrib). I was using the Canadian example specifically to characterize what "single payer" actually refers to.

That's because Schumacher's statement is bafflegab. Bull****, in baser terms.

I've explained to you that doctors (private entities who deliver services) are either paid by the public system, serving the very rich, or out of business.

You may consider the 99% of doctors whose sole paymaster is the public system to be private if you wish. I consider them contractors who are paid on piece work, and they are as much part of the system as the nurse employed directly by the local health authority (government agency).

As for wiki, and how most hospitals are run by semi-private organizations. You seem to think this is an important distinction. It is not. Orders of nuns and various charities ran some hospitals many years ago. They have continued to manage hospitals that are 100% at the whim of government for funding. When the government decides a hospital is too expensive it is closed, no matter who runs it. In short, these are still public institutions despite the formalities of who serves on the boards.

There are some very few really private institutions. By that I mean privately owned, operated, and are not dependant on government for a cheque at the end of the month to keep the doors open.

In short, Canada is the nightmare of single payer. That single payer decides everything of consequence, and forbids people find alternatives, like insurance to be able to patronise a practice or institution that is truely private. If that is the example you wanted to press for, to compare with for plans in the US, congratulations. The only example Canada can give to Americans is why keeping the government at bay would be a good idea.

That is also why I said it is best to ignore Canada. I find it really difficult to believe that the US would **** up so badly you ended up from the extreme where you are to the extreme we have.

[notyoueither]

At any rate, here is a source that might explain a bit more, or confuse greatly.

As I've tried to indicate, there is a lot of BS flying around Canada about our health care system. Curiously, this government link counts private laundry services for public hospitals as being in the realm of private health care delivery. It's ****ed up. I tried to tell you.

http://www.parl.gc.ca/information/library/PRBpubs/prb0552-e.htm

[Ben Kenobi]

Any institution that's not administered by the government. Private practices, labs, clinics, hospitals, whatever.

Ok, I'll see what I can find.

NYE.

[Ben Kenobi]

That's going to be difficult. But examples of other countries (specifically, all the other countries) show that a stronger public role (at both the insurer level and the delivery level) can be useful in containing costs.

It's called RATIONING. You might have heard it from time to time. The true measure is efficiency, what you get out for what you put in. Americans pay more but get a hell of alot more out then we do.

[Ramo]

Like Schumacher, I was characterizing administration of health care in general, not specifically large-scale facilities (FWIW, the Wiki entry on Canada's Medicare characterized the hospitals as mostly "semi-private"), as largely private. Dunno what your point here is, but I still don't see any source contradicting Schumacher.

Again, I'm not arguing that we should adopt the Canadian system (Ben quoted Zkrib). I was using the Canadian example specifically to characterize what "single payer" actually refers to.

That's because Schumacher's statement is bafflegab. Bull****, in baser terms.

I've explained to you that doctors (private entities who deliver services) are either paid by the public system, serving the very rich, or out of business.

You may consider the 99% of doctors whose sole paymaster is the public system to be private if you wish.

Yes. That's exactly what I'm going to do. From what I understand, Canadian health care is largely fee-for-service/visit. Beyond using its scale to bargain with providers, it does little to control costs. Compare this to, say, the NHS, which salaries GPs to a much larger extent (and fee-for-service playing a smaller role). It also has one of the leanest health sectors in the developed world (to turn it into a world class system, arguably, all it needs is funding comparable to, say, the OECD mean), as opposed to the comparatively bloated Canadian sector. For a primer on why this distinction is important, see the article that Arrian cited.

When the government decides a hospital is too expensive it is closed, no matter who runs it. In short, these are still public institutions despite the formalities of who serves on the boards.

How often does the state actually close a hospital? How does that compare to the size of the health sector? Without numbers, that isn't a particularly meaningful comment.

If that is the example you wanted to press for, to compare with for plans in the US, congratulations.

WTF, dude? How many times do I have to tell you that I do not like the Canadian system? Hell, I'm pretty sure I've told you this in previous threads. And yes, that's "threads" as in plural.