By design, a monopoly produces a different kind of worker. Unwilling to have their wages capped and freedoms restricted, the best inevitably leave. Mediocrity, unfortunately, gives rise to fewer malcontents and thus is a prerequisite for stability in the system. Put it this way: if a socialized system wants to survive, it must expunge the most driven and gifted from its midst. When wages, moreover, are tied to a negotiated deal with labour, rather than, in the case of a competitive market, to the individual physician's performance, the position of the mediocre practitioner is further reinforced.
stuart murray, a researcher/economist for the progressive canadian centre for policy alternatives, attended the richmond conversation as a private citizen. he said most people there expressed their strong desire to keep canada's public health care system as is, or to improve it without new elements of private enterprise.
"there is no real sustainability crisis in health care," murray told the tyee. "public health care spending has been flat over time in canada around 7 per cent of gross domestic product. the numbers the government uses to suggest a crisis are misleading.
"the numbers invoked by fans of privatization depend on the fact that government spending on other areas has been cut in the past decade," murray explained, "which makes the health care share of public spending look larger. it hasn't really changed in terms of the share of gdp involved. we can afford to both protect the current system and enrich it, and we should."
murray said that recent research published by his organization effectively refuted the argument that "health care and aging are going to bankrupt the public purse."
Why all the hoopla and arguments over what is going on in Canada? This is occuring in numerous threads. The Canadians have responded that they don't feel underpaid, overtaxed, or lack proper medical care. Why is this such an issue to a couple of American members?
Why all the hoopla and arguments over what is going on in Canada? This is occuring in numerous threads. The Canadians have responded that they don't feel underpaid, overtaxed, or lack proper medical care. Why is this such an issue to a couple of American members?
I have never understood this one. Americans constantly feel the need to tell me that I don't know as much as they do about life in Canada (nevermind the fact that I'm Canadian) and Canadians always argue with me about the US (nevermind the fact that I'm American)...
Interesting. Yeah, "after all, just go to an emergency room" and then not have enough money left to pay for the medications, perhaps do without food for the rest of the month or just don't pay your rent because the hospital will want their money. Now if you're an illegal immigrant you've got it made. Use and abuse the system, who cares, you'll never receive a bill, we can bill someone that doesn't exist. :angryfire
have never paid for any medical service ever provided to me, my sister just had an MRI for back pain and it took her one month from her diagnosis to scan. The more serious your injuries/illness the sooner you can likely be seen. I have never had to ask a patient to show me their insurance, never had to refuse care, never worried about how they would pay for the services I provide. I value this so much more than making money (although I started as a new grad at 27 dollars an hour)
I see so much hatred in the pages of posts I have read on this site, so much bitterness, division and venom. Some of the scariest comments revolve around the ideas of "patriotism" and being "unpatriotic". I don't see anything patriotic about leaving millions of your fellow citizens in financial, emotional and physical ruin because they went and got cancer. I can tell you from deep experience that UHC works and anyone who tells you different is either lying or trying to make you feel better.
Hey guys, we're not talking religion here. Its important to define terms and recognize that this isn't a black or white issue.
First off, we already have a single payor system in the US. It works great. It has resulted in higher compensation levels for some nursing specialties (although some docs don't like it). The problem is that the only people on it are the highest utilizers, consequently it isn't actuarially sound. The current administration has been monkeying around with it and have been doing their darndest to complicate and screw it up. Its called Medicare. Under the basic Medicare program, a patient can see any doc or go to any hospital. With the right kind of supplemental insurance, they have 100% coverage. Meds can be an issue, but if we took just a portion of the money we've been spending in Iraq, we could provide free meds for every man, woman, and child in the US (probably cover the transgendered too!).
I don't think anybody wants "the government" to be making our health care decisions - but having spent a number of years in the health insurance industry, I don't want a "for profit" insurance company making those decisions either!
IMHO, the best solution would be to pursue a universal single payor structure using Medicare as a model. In the private approach, between 25 and 30 percent of every dollar spent in health care is wasted on administrative costs compared to less than 5 percent with Medicare!
The only reason that Medicare is financially unsound is that the only people on it are the sickest, highest utilizing segment of our society and they are paying virtually nothing for it!
On the other hand if everyone was on it - including people like me who are very low utilizers, the system would be solid - and we would be avoiding a lot of the cost shifting that creates artificial pricing structures.
The idea is that people would still have flexibility, still have some "skin in the game", and we would improve access while reducing costs due to waste in administration.
Certainly there would have to be modifications made, but the Medicare model has already established its viability and has demonstrated support for expanded roles for APNs such as NP's and CRNA's and I believe we would see further expansion of nursing roles because of the high quality, cost effective care we are able to provide.
The arguments against socialized health care are hilarious. OK since public healthcare for everyone is such a bad idea, lets also get rid of police protection, fire departments, public schooling, etc. I have a hard time understanding why anyone can defend our current for profit system.
We pay on average more for healthcare per citizen than other countries do, so of course it is only natural to believe that our system is working. That is why our life expectancy and health are so much better than other countries... err wait. That argument doesnt float, how about this one--"Socialized health care is one step away from Communism!!!!!" There that is a lot better.
These insurance companies are a joke. Our healthcare dollars are simply making executives millionaires. Oh yeah, that congressman or rep that "loves his mother" probably loves his millions now.
I love the "lets get rid of police and fire protection" argument.
Read the Constitution, the preamble lays it out for you "ensure domestric tranquilty" ..."provide for the common defense"..."promote the general welfare."
If the founding fathers intended for everyone to live and breathe off the government teat then they would have said "provide for the welfare of all..." or words to that effect, you know; instead of "promote"
We need police and fire departments to "ensure domestic tranquility".
You want government funded healthcare? Fine, I say. Provide it. On the condition that other welfare programs are cut to pay for it, and that people can still choose the healthcare that they want; and if they do not choose government care; then they get a great chunk in tax credits back.
Also, since folks are wanting to model European health care models, why don't go ahead and model their education system as well?
In most countries there; you perform and move up; or you sent off to learn a trade commensurate with your academic performance. If you do well you go all the way to Doctoral studies on the government dime. But if you prove to be less than stellar academically... you get a construction/labor training school and its off to work you go. Or you can provide your own education after that... if you want to pay for it.
Life, Liberty and the Pursuit of Happiness does not mean that any of the three are guaranteed to be made available by the government.
I love the "lets get rid of police and fire protection" argument.
Read the Constitution, the preamble lays it out for you "ensure domestric tranquilty" ..."provide for the common defense"..."promote the general welfare."
If the founding fathers intended for everyone to live and breathe off the government teat then they would have said "provide for the welfare of all..." or words to that effect, you know; instead of "promote"
We need police and fire departments to "ensure domestic tranquility".
You want government funded healthcare? Fine, I say. Provide it. On the condition that other welfare programs are cut to pay for it, and that people can still choose the healthcare that they want; and if they do not choose government care; then they get a great chunk in tax credits back.
Also, since folks are wanting to model European health care models, why don't go ahead and model their education system as well?
In most countries there; you perform and move up; or you sent off to learn a trade commensurate with your academic performance. If you do well you go all the way to Doctoral studies on the government dime. But if you prove to be less than stellar academically... you get a construction/labor training school and its off to work you go. Or you can provide your own education after that... if you want to pay for it.
Life, Liberty and the Pursuit of Happiness does not mean that any of the three are guaranteed to be made available by the government.
I like that idea.
We will all benefit when needs are met. Then those who prove their ability and willingness to earn a higher education will not be prevented from rising to the best of their ability because they cannot afford it.
Hey guys, we're not talking religion here. Its important to define terms and recognize that this isn't a black or white issue.
First off, we already have a single payor system in the US. It works great. It has resulted in higher compensation levels for some nursing specialties (although some docs don't like it). The problem is that the only people on it are the highest utilizers, consequently it isn't actuarially sound. The current administration has been monkeying around with it and have been doing their darndest to complicate and screw it up. Its called Medicare. Under the basic Medicare program, a patient can see any doc or go to any hospital. With the right kind of supplemental insurance, they have 100% coverage. Meds can be an issue, but if we took just a portion of the money we've been spending in Iraq, we could provide free meds for every man, woman, and child in the US (probably cover the transgendered too!).
I don't think anybody wants "the government" to be making our health care decisions - but having spent a number of years in the health insurance industry, I don't want a "for profit" insurance company making those decisions either!
IMHO, the best solution would be to pursue a universal single payor structure using Medicare as a model. In the private approach, between 25 and 30 percent of every dollar spent in health care is wasted on administrative costs compared to less than 5 percent with Medicare!
The only reason that Medicare is financially unsound is that the only people on it are the sickest, highest utilizing segment of our society and they are paying virtually nothing for it!
On the other hand if everyone was on it - including people like me who are very low utilizers, the system would be solid - and we would be avoiding a lot of the cost shifting that creates artificial pricing structures.
The idea is that people would still have flexibility, still have some "skin in the game", and we would improve access while reducing costs due to waste in administration.
Certainly there would have to be modifications made, but the Medicare model has already established its viability and has demonstrated support for expanded roles for APNs such as NP's and CRNA's and I believe we would see further expansion of nursing roles because of the high quality, cost effective care we are able to provide.
My 2 cents.....(probably more like 200 cents!)
I agree with most of your post except this: Medicare receipients are not cruising along for free. They are making a premium to have Medicare part B right straight from their social security checks or SSDI checks. I am one of these "freeloaders".
Lest me remind you I have worked since the age od 13 (actually receiving paychecks) until 2 years ago when a doctor misdiagnosed me for 4 monts causing me my career, complications in my health and he's still working! So other than that little dittie of a concept I agree with your other points made in your post.
HM2VikingRN, RN
4,700 Posts
http://thetyee.ca/news/2007/07/06/convonhealth/