Obama on the Healthcare ‘Debate’

Apologies for leaving lies.com adrift in the waves of outrage washing back and forth from the folks who get their healthcare-reform information from the likes of Sarah Palin and Glenn Beck. There have been lots of high-profile lies I could have been commenting on, but Cheney-like, I had other priorities.

And look, along comes the Debunker-in-Chief to summarize the grownup response to all the silliness, and save me the trouble of running after every little bit of crazy, in today’s NYT Op-Ed: Why We Need Health Care Reform.

270 Responses to “Obama on the Healthcare ‘Debate’”

  1. NorthernLite Says:

    ANA, AMA, AARP… everyone on the front lines of medical care are on board. The only reason most on the right are opposed is because they want to see Obama fail at this.

    But just like when he won the highest office in all the lands with a name like Barack Hussein Obama seven years after America was attacked by Muslim extremists, he will win this battle too. Let’s face it, he’s just way more intelligent than his opponents.

  2. shcb Says:

    http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw

  3. NorthernLite Says:

    That’s called Continuous Improvement, shcb.

    That’s why we have such a superior system, because our doctors are always looking to make it better. See in Canada, we let our doctors decide the best ways to enhance our care – not politicians. Still universal, er, socialist. Still single-payer, er facist.

    Sometimes I forget to communicate in your language ;)

  4. shcb Says:

    single payer is socialist, it is fascist when you only have the illusion of capitalism but you have socialism in reality.

    try and keep up:-)

    this is all so silly

  5. NorthernLite Says:

    Here’s what you need to be concerned about:

    http://www.cnn.com/2009/POLITICS/08/18/reinhardt.health.inflation/index.html

  6. shcb Says:

    The obvious response is we are talking about two different things here, the cost of the product and how it will be paid for. The cost of care will either be paid by the employee or the taxpayer, who are one in the same. I’m all for reform but I want to go in the other direction, I want to take it out of the government’s hands (to a degree) and out of employer’s hands (to a degree) and put it back in the hands of the employee/taxpayer (to a much greater degree). At this point very few people know how much their health care costs. They only see the pittance they pay, not the total bill, in this new scheme they still won’t know how much they are paying, their taxes will just go up, their paycheck will also go up but not as much as their taxes and/or the price they pay for goods once their and other employers pass the increased cost to the consumer. It seems obvious that government rarely is more efficient than private industry so the costs will go up even more if this bill is passed, my example in the last few threads shows just that, the government will collect 8% from the gentleman in Castle Rock for a product he is now paying 4% of his payroll for.

  7. NorthernLite Says:

    I hear that argument a lot (about dealing with the government [e.g. DMV, Katrina]) and it’s funny, because in Canada whenever the Conservatives push for a US-style system, and they do from time to time until they get creamed in election for mentioning it, the counter argument is that “do you really want to deal with your health insurance claims like you have to with auto/life insurance?”. We really don’t like insurance companies up here. You don’t seem to like government down there. Funny.

    I’m not sure if one is really any better than the other but I do know that in order to cover the entire population at the lowest price the government has proven it can do better than private insurance companies. There is evidence of this all over the world. Just compare the cost and coverage between our two countries alone and you’ll see this.

    Personally, I’d much rather deal with the government than with profit-driven insurance companies. At least the government is accountable to me. Insurance companies are accountable only to their shareholders.

  8. shcb Says:

    Yeah, that is one of those things like what flavor of ice cream do you like, I don’t know if trust or distrust in government is something you are born with or something life experiences mold, but people seem to gravitate one way or the other.

    It is funny that in the US socialized medicine seems to kill politician approval ratings and in Canada non socialized medicine does the same. Different outlooks I guess.

  9. NorthernLite Says:

    Two countries so close in so many ways but you’re right, we differ in some major philosphical ways.

    A few years ago we had some problems with wait times getting too long and what seemed to work is allowing private companies to deliver publicly-funded medical services. At the time the opposite debate was happening here: people would hear “privatize” and get all upset and down there people hear “socialize” and get all upset.

    So I imagine the best solution lies somewhere with a PPP (public/private partnership). The key is the single-payer aspect that keeps costs low.

  10. shcb Says:

    … and a lot of times people just don’t want to change whatever they have even if they don’t particularly like it.

  11. NorthernLite Says:

    Very true.

  12. NorthernLite Says:

    Three cheers for Barney Frank, for finally putting these tards in their place.

    From his town hall meeting yesterday:
    —-

    “You want me to talk about it or do you want to yell?” he asked over and over when interrupted while trying to answer. Continued shouting brought a sterner rebuke.

    “Disruption never helps your cause,” he said more than once. “It just looks like you’re afraid to have rational discussion.”

    And this was awesome…

    While Frank attempted to respond to all questions, he gave up when one woman compared health care proposals favored by Frank and President Obama to policies of Nazi Germany:

    “When you ask me that question, I’m going to revert to my ethnic heritage and ask you a question: On what planet do you spend most of your time?” Frank asked.

    “You stand there with a picture of the president defaced to look like Hitler and compare the effort to increase health care to the Nazis,” he said, adding such behavior demonstrated the strength of First Amendment guarantees of what he called “contemptible” free speech.

    “Trying to have a conversation with you would be like trying to argue with a dining room table,” Frank said to the woman. “I have no interest in doing it.”

    Sweet.

  13. shcb Says:

    as much as I dislike Frank, and as much as I’m on the woman’s side on this issue, good for him. I wish Republicans would do that more often when the same idiots on the left disrupt thier meetings.

  14. enkidu Says:

    http://videocafe.crooksandliars.com/heather/barney-frank-confronts-woman-obama-hitler

  15. enkidu Says:

    and just to refresh your memory wwnj: “NO ONE IS SAYING ANYTHING LIKE THAT”

  16. NorthernLite Says:

    The funniest (saddest?) part was the women in the background yelling to “keep the government’s hand off my Medicare!”. Wow.

  17. shcb Says:

    Enky, you take things too literal and then just beat it to death.

  18. enkidu Says:

    So now things that are literally, factually true are also liberal? Those were your words. This lunacy has been going on for weeks.

    Just watch that clip and decide for yourself which side of this ‘debate’ you want to be on: the screaming crazies or the folks who are trying to fix a broken system, the duly elected representative government that is trying to save you money, trying to cover all Americans and trying do what is right (note, not right wing).

    I’ll say the same thing to you as I said to my mother two days ago: please help us do something positive on health care/insurance reform! We need to come together and fix the runaway price increases, the 50 million uninsured and the denial of coverage to the sick. Every other industrialized advanced democracy has universal healthcare. We can do better than France, better than Canada, better than Switzerland. But we aren’t right now, and this is the change we need your fiscal responsibility to help craft. We need to come to some compromise that covers everyone and lowers costs.

    I would just remove the profit motive from healthcare (ha!).

  19. shcb Says:

    …and with it the incentive to inovate and provide good service

  20. knarlyknight Says:

    Not necessarily so at all. For example, streamlining and otherwise reducing costs provides health service providers the ability to do more with the same revenues, so there is still a strong motive to innovate. Also, the funny thing about “socialized” health care in Canada is that – now get this, it’s so weird: most people are actually in the business because they want to care for people! Care for people = good service. Profits aren’t necessary but they are not bad either – until they get to obscenely high levels (provide your own examples). Good wages are usually enough, but plenty of other incentives to innovate and provide good service can still be central components of a non-private health care systems.

  21. shcb Says:

    But we’re not reducing costs, not without reducing services (rationing) anyway. Obama is saying we will reduce costs but we all (including him) know that won’t be the case. early on in this process the Democrats in congress were saying they wanted socialized health care but not in a down economy because it will cost too much money. Then we have my example from the gentleman in Castle Rock, his health care premiums will double with the streamlined healthcare, streamlined like a brick. That is just the projected costs, Medicare ended up costing many, many times more than it was originally projected. but we’re not reducing costs, not without reducing services (rationing) anyway. So did the Iraq war, why should this be any different. Seriously, can you point to one part of this proposal that will reduce costs? Has Obama offered any specific examples or has he just said “we will reduce costs” so it’s a done deal. Really, politicians never lie, they never exaggerate.(have you noticed how much the violence in Iraq is increasing the closer we get to Obama’s 16 month timeframe?)

    When I say innovation will be stifled I am talking more about inventors and pharmaceutical developers. I think you are right that many doctors and nurses just love what they do, and as long as you pay them a reasonably fair wage they will continue to do it. But people like me really don’t care what we are inventing we just enjoy the mental gymnastics of coming up with a new idea. Money people really don’t care that much either. If there isn’t a pot of gold to go for we will find another industry where there is. We’re kind of mercenary that way.

  22. knarlyknight Says:

    Apples and oranges. The cost reduction I meant was not not the switching from a private to a social system; but rather the on-going cost reductions after the switch has been made. You can be assured that there can still be incentives for cost reductions in the new system. A properly designed social medicare system will have such incentives built in to reduce operating costs as time goes on. That article you linked to for NL on the Cdn system touched on cost reductions that are underway and recognizes that our current system could do more to motivate the adoption of these cost reduction efforts (e.g. paperless Dr. offices).

    Glad to hear that inventors and pharmaceutical developers are safe from socialism in America.

  23. enkidu Says:

    You just aren’t listening to the ‘debate’ very closely if you haven’t heard things like ‘a public option to keep the insurance companies honest’ or ‘almost one third of every healthcare dollar spent goes to insurance company overhead and profit’ or ‘medicare for everyone’

    I think we can improve our system. Rs do not. They are all in on defeating scary brack man at all costs, even if the cost is higher healthcare costs, more uninsured, more dead Americans and the status quo.

    Heck of a job lil ricki, heck of a job.

  24. NorthernLite Says:

    knarly, good column in The Star today going after right-wing pundits who’ve been trying to use our system to scare Americans.

    Why I’d rather be sick here than in U.S.

    - – -
    First, it’s universal. Everyone is entitled to treatment and they get the same level of care as a multi-millionaire. By contrast, in the U.S. the rich can buy top care and jump to the head of the waiting line.

    Second, I visited doctors twice in the last week and never had to haul out my credit card or chequebook before I could see them. Sure, I pay through my taxes, but that’s far better than paying directly for every step of my care. No Canadian winds up bankrupt because he or she had to pay for health care.

    Third, the quality of care I got in the last week was unparalleled. Indeed, polls have consistently shown that more than 90 per cent of us are pleased with the level of care we have received. Top surgeons at Toronto-area hospitals, for example, are as good as any in the U.S., and they treat patients based on need, not the size of their bank accounts. Nurses and other health professionals are well-trained, too, with standards often exceeding those in the U.S.

    Fourth, many of our medical outcomes top those in the U.S. We live longer, our infant mortality rates are lower, our cancer and heart disease levels and the rate of low-birth weight babies, are better.

    Fifth, I only had to wait several weeks to see a specialist. Overall, wait times for many procedures, such as hip replacements, are dropping dramatically now that more money and attention have been focused on the problem.

    Sixth, I feel better knowing that part of my health dollars aren’t going to line the pockets of fat-cat private health insurers, whose profits in the U.S. have equalled the total amount of money that Canada spends annually on health care for all its citizens.

    The way to resolve most of our problems is to spend more money. If anything, we don’t spend enough. Canada spends just 10 per cent of its gross national product on health care while the U.S. spends a whopping 16 per cent.

    If we spent as much as the Americans did, there would be no doubt at all about where you’d rather be if you became sick.

    - – -

    I hope the Dems use their majority and political capital to reform the system without the R’s. Afterall, I seem to remember hundreds of thousands of people taking to the streets to protest to try and stop the invasion of Iraq and a certain president “deciding” what was good for everyone. Obama should do the same with healthcare.

  25. shcb Says:

    Well there you have it, read the article critically see how many times they say, almost as good, adequate, satisfactory, only a few weeks wait, etc, etc. Then he/she says all they need to do to fix the rest of the problems is spend more money, if Canada spends 10 percent of their GDP and we spend 16% remember that we are subsidizing their system with the Canadian extortion of our pharmaceutical companies (someone on one of these threads said Canada “regulates the pharmaceutical companies” yeah, ours). Also remember in that 16% is most every medical advance in the last century. But I really loved the justification, someone is making a profit and it ain’t me so it has to be stopped, God you gotta love liberals.

  26. shcb Says:

    I hope they at least try and do this reform without a single R (except Snow and a few like her, can’t have everything) it would be the best thing for the party since Reagan.

  27. NorthernLite Says:

    I guess you missed this part:

    We live longer, our infant mortality rates are lower, our cancer and heart disease levels and the rate of low-birth weight babies, are better.

    And we spend waaaaay less! Way, way less.

    I know, it’s hard for you to swallow.

    And don’t blame us for your own pharmaceutical companies ripping you off. As I heard an analyst say on Fox yesterday, “if they can sell drugs in Canada, Britain, Australia, etc. at lower prices and still make huge profits, then they can do it here. Unfortunately, they have more power in Washington than our elected reps.”

    That’s not my fault brother.

  28. leftbehind Says:

    As I’ve said before, I don’t want to take sides on this. Anything I throw into the conversation is strictly because I think it is an interesting point for discussion, or adds perspective to something one of you has posted. If health care reform passes, great! If it doesn’t, I’m already covered. I’m sure Canada has a fine healthcare system – I just don’t think we’ll be seeing anything like it here in America in the immediate future.

    In light of the current conversation, this is interesting:

    “Canadians’ Values and Attitudes on Canada’s Health Care System: A Synthesis of Survey Results
    Detailed Findings by Stephen Vail
    January 2001, Source: The Conference Board of Canada, 38 pages

    “Canadians’ confidence in their health care system as a whole has been dropping. An international comparative survey found that the percentage of Canadians who believed only minor changes were required to the health care system dropped from 56 in 1988 to 20 in 1998, while the percentage who agreed the system needed to be completely rebuilt jumped from 5 in 1988 to 23 in 1998.

    “Document Highlights:
    As witnessed in the last federal election, health care has become Canadians’ top national priority. This is largely due to the belief by many—almost 80 per cent of Canadians, according to a 2000 Angus Reid poll—that the system is in crisis.

    “The second in a series of reports, this report deals specifically with Canadians’ values and attitudes as they relate to Canada’s health care system. While Canadians support increasing health care funding by governments, they want spending to be efficient, effective and accountable. There is very little public support for raising taxes to finance increases in health care budgets…”

    You can access the entire report here:

    http://www.conferenceboard.ca/documents.aspx?did=215

    (No doubt, both Enkidu and Knarly will read the entire, 38 page report within the next five minutes, and check back with detailed reports regarding its violent subtexts and open advocation of racism and genocide thereafter – but it’s still interesting)

  29. NorthernLite Says:

    Our system was in trouble in 2001, mostly as our government eliminated our deficit by slashing social spending in the late 90′s.

    However, a lot has changed in the past 8 years as our officials responded to those concerns. As menioed above, recent polls (not from 2001) consistenly show over 90% love our system. I imagine the other 10% work for insurance companies or are extreme right-wing and just don’t think the government should be involved in thier lives.

  30. enkidu Says:

    NL, knarls, I doubt you will do anything to change wwnj’s ‘right is right!1!1′ worldview. It is strange just how far a person can go denying reality, but there is something atavistic about being fearful and angry that attracts a certain kind of person. These yahoos are our Taliban, our AQ, our confederacy of dunces.

    Canada has a world class health care system that covers all its citizens. Shall I repeat the important bit again? All of their citizens. By most objective measures they have better healthcare as well. And cheaper. You can point to anecdotal instances on both sides, but by the measures that count to people’s lives they are doing far better than us and working to improve it. We just got back from Canada (you may have noticed the shortage of UC Dark in the stores) and my ailing father in law has amazing healthcare for free. Yes I said free, because if we stopped wasting trillions of dollars on wars based on lies, we would have more than enough to cover every American. Which is more productive? A $200B/yr war of needless aggression, or a $100B/yr cost to cover all Americans? That is patriotism. That is citizenship. Not screaming “nazi!” “socialist!” “traitor!” when someone tries to improve the system.

    I am beginning to think it might take a couple years to get it all worked out, and I am fine with that. The public option will come to pass, maybe not this year, but before the end of Obama’s second term. He sees himself as the Great Compromiser, the centrist, the deal maker. Right now Rs are just no no no and more no!!! But I bet the smart Rs will try to influence the course of these bills and do the right thing for their constituents. The knuckledraggers, racists and Larouchies can just get used to it. The normal people are leaving you all behind. The wwnj freaks will try a few more terrorist attacks like the one in OK, but they won’t win. Ever.

  31. NorthernLite Says:

    And no, nobody ever likes having thier taxes raised. My taxes haven’t been raised on many years, they’ve actually been cut while our system was improved.

    How about your insurance premiums? Do they go up and down, or just up? . What were you paying 10 years ago for health insurance as oppsoed to now? Genuine questions, as I obviously don’t have any experience dealing with health insurance, but if they’re anything like auto insurance…

  32. Smith Says:

    LB,

    Is that article (http://www.conferenceboard.ca/documents.aspx?did=215) available to non-Canadians? The registration process seems a bit detailed and requires a mailing address.

  33. enkidu Says:

    Smith, the article is from 2001, from a survey of the period from 1988 to 1998. And I am sure we could find other gov surveys or white papers on healthcare to support either side (it’s the best! it’s the worst!)

    But by nearly every metric they have better cheaper healthcare. Plus they cover everyone (which might explain why their metrics are better).

    Health insurance reform. Sounds better than Nazi Socialist Pinko Commie Death Panels.

  34. leftbehind Says:

    Again, NL – I’m not attacking you, nor am I suggesting that the Canadian system is other than a functioning system with some inevitable problems. I’m just throwing some stats out there that I feel are worthy of discussion:

    The Canadian Medical Association released, last month, it’s 9th annual “National Report Card on Health Care.” It provides some food for thought for both sides of this debate:

    Over all, the majority of Canadians polled (67%) are happy with their health care system, although only a quarter (26%, to be exact) find the system “outstanding .” Good numbers, but hardly the overwhelming enthusiasm suggested in some other polls that have emerged recently:

    “Two in three Canadians (67%) grade the overall quality of the health care services they receive in the A (26%) or B (41%) range, consistent with the 2008 findings (66%). However, this year’s sounding shows a three-point increase in the proportion who offer an A rating (26% compared to 23% in 2008), a ten-point increase since 2006 (16%). Similarly, over two in three (68%) Canadians grade their most recent experience with the health care system in their community as either an A (31%) or a B (37%), virtually unchanged since 2008 (68%).” Moreover, “Thirty-nine percent of Canadians grade the federal government’s performance in dealing with health care as either an A (8%) or a B (31%), showing a slight improvement from 34 percent in 2008.”

    However, the following concerns arise:

    “The public remains divided as to whether health care services will get better or worse over the next two or three years with 51 percent saying health care services will get better and 46 percent saying they will get worse.”

    “Among those who have required the following health care services over the past year, many say they have had to wait longer than they thought was reasonable:
    • A specialist (55%);
    • Advanced diagnostic procedures such as magnetic resonance imaging (MRI) or a CT Scan (46%);
    • A family physician (39%);
    • Elective surgery, that is, procedures that do not need to be performed
    immediately, such as a hip replacement (36%); and,
    • Treatment such as chemotherapy or radiation therapy (22%).”

    Interestingly enough, since the Canadian program is a National program, most of Canadians studied who felt the system worked very well were more satisfied with their regional government’s handling of health issues than with the national government:

    “In all regions, with the exception of Alberta and Saskatchewan/Manitoba, provincial governments receive more A or B grades than the federal government in dealing with health care. This is most notable in Quebec, where 38 percent give the provincial government A or B grades compared to 30 percent giving the federal government such ratings.”

    http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Media_Release/2009/report_card/Report-Card_en.pdf

  35. leftbehind Says:

    “Statistics Canada” tracked patient satisfaction with health care and physician services in both the United States and Canada from 2002-2003. The numbers hover around the same levels for both nations, and probably have some bearing on the American public’s malaise regarding health care reform in general. Were the numbers either spectacularly low in America, or spectacularly high in Canada, I’m sure you’d see wider public support for the Obama plan:

    http://www.statcan.gc.ca/pub/82m0022x/2003001/t/4069108-eng.htm

  36. NorthernLite Says:

    I don’t feel it as an attack, LB. I know we have our problems. I just jumped into this debate when people down there started attacking our system when most measureable indicators show that our system is far better.

    As has been mentioned numerous times:

    Everyone is covered, it costs way less to administer and we live longer.

    We can pull stats and debate polls all day long but those facts will still remain. I’m not saying our system is perfect, I guess I’m just defending it against wild accusations from the American right. But now that the “facist” and “socialist” crap has subsided, I feel better about the debate. It’s funny when your country is called socialist but has the strongest finances in the G8. Our economy actually grew a little in the last quarter.

    Can one of my American friends on here please answer the questions I raised about private health insurance costs? I’m very curious.

  37. leftbehind Says:

    I understand how you feel – you’re proud of your country, and you should be. Nobody likes to hear their country run down by a foreigner with an axe to grind.

  38. leftbehind Says:

    NL – please restate your questions, if you don’t mind. This has become a long thread, and a lot has gotten lost in the shuffle…

  39. knarlyknight Says:

    NL – thanks for the Star column excerpt, that’s the best summary I’ve seen yet. Don’t really get shcb’s criticisms as he says to count the number of times the article uses terms like “almost as good, adequate, … ” So I did, I re-read it and looked for terms “almost as good” and “adequate” They were not there. Besides imagining things, shcb seems to be deliberately warping the discourse here.

    Then Lb refers us to a 2001 Conference Board report from the 1988 – 1998 period for heaven’s sake. Besides being out of date (as others here noted) I’d argue that the fact so much has changed in a positive manner since 1988-98 (i.e. since the problems manifested from the Federal Gov’t funding cutbacks) is a strong testament to the resiliency of the Canadian system. Also, it’s telling that Lb had to resort to an old Conference Board report to get that stinky material – most Canadians know that the CB policy statements need to be taken with a grain of salt (because the members, governors and executives of the Conference Board are primarily vested interests in big corporate interests, despite their claims of neutrality and independence) and that the CB is not exactly considered to be a trustworthy source these days (e.g. “Conference Board of Canada recalls copyright piracy reports, admits plagiarism… Despite initially defending a trio of reports that painted Canada as a nation of copyright pirates, the Conference Board of Canada now admits sections of the report were plagiarized and has recalled them.”

    Yea, Enk, it stinks.

  40. leftbehind Says:

    Knarly – if there is a specific problem with the Conference Board report I’ve cited, please provide citations or links detailing the problem and we’ll take it from there, otherwise, the report remains valid and on the table for consideration. NL has already objected to the vintage of the report, which is why I produced more recent numbers, namely the August, 2009 CMA report. If you are party to any information more recent than August, 2009 (which might be possible: http://forum.prisonplanet.com/index.php?topic=121003.0,) please produce it here and it will be considered.

  41. leftbehind Says:

    Let me make my point clear before the Peanut Gallery gets ahold of it: I’m not taking sides here. I have not come to praise the Canadian system, nor to condemn it. I merely hope to inject a little de-mystification into the proceedings.

  42. knarlyknight Says:

    Lb, Bizarre and stinky that you would consider the outdated (and private / corporate interest biased) Conference Board report still to be “on the table” even after you have provided a better source, CMA, with more recent poll results. The CMA results seem better, does anyone here take issue with them?

    The point of such reports are to find areas for improvement as part of a process of continuous improvement: hallmarks of a well run system.

    FYI – You seem to misunderstand the Federal / Provincial roles and public perceptions of same. I would suggest that the results showing the public having less satisfaction with the federal government on health care is due to criticisms that the Feds receive about their tight fisted approach to their role in funding the overall program (the Feds are not responsible for the administration or delivery of health services) , whereas the Provinces (who are responsible for administering and delivering the program) are viewed as doing a good job with the limited resources provided by the Feds.

    How do the millions of Americans without Health Care rate your system?

  43. leftbehind Says:

    Knarly – When we are talking about “people without Health Care,” we’re talking about people without insurance – it’s important to state that before answering your question. Being without insurance does not bar anyone in America from receiving medical care. Emergency rooms are full of uninsured people at any given time http://www.bizjournals.com/albany/stories/2009/01/19/story3.html,) as are clinics and community health centers of all sorts. Many individual hospitals are also working to accomodate the uninsured: http://www.uticaod.com/homepage/x792882605/Hospitals-try-to-help-the-uninsured

    Thus, there are statistics regarding uninsured Americans, and their attitudes towards the medical care they receive. According to “Statistic Canada,” in polling done between 2002-2003 (more recent stats are welcome, of course,) uninsured Americans polled rated the system thusly:

    Satisfaction with any health care service:

    38.9% – Very statisfied

    40.4% – Somewhat satisfied

    7.3% – Somewhat dissatisfied

    9.1% – Very dissatisfied

    Satisfaction with Physicians Services:

    51.5% – Very statisfied

    27.4% – Somewhat satisfied

    18.2% – Very dissatisfied

    I’m not drawing any conclusions from those numbers, I’m just relating them.

  44. leftbehind Says:

    Knarly – You’re accurate in your assessment of my knowledge of the Provincial / Federal roles in your health care system – this is all second hand to me. Enlightne me: you talk about the Provinces’ having to deal with “limited” funds they receive from the Canadian government. How limited are these funds? In what ways do you feel any scarcity of funds might affect health care in the provinces? Although everyone is covered, are there any chances that higher-level medical needs might suffer when the funds are too scarce? Is scarcity of funds a factor in waiting times for advanced treatment? Are funds ever spread too thin? Please provide statistics (as I’ll be looking for them too – this is a vital point.)

  45. leftbehind Says:

    NL – feel free to jump in as well.

  46. shcb Says:

    That 50 million uninsured number is one of the most disingenuous statistics out there, that number refers to the number of people that don’t have insurance for even one day, it also includes people who have access to affordable health care but choose to not carry it for whatever reason, usually they are young people who feel they would rather go rock climbing or skiing rather than pay for insurance. I’m not going to bother to look up the numbers and provide a link because they will just be po-poed as coming from Fox news or whoever so they don’t count, it’s just not worth my time. The number of people that are chronically uninsured is somewhere around 1 to 5 million people, and some change needs to made there, no argument. That could be fixed by something as simple as including them in Medicare. Another option that has been tossed around is something similar to Obama’s Insurance Exchange where insurance companies would pool the risk on these high risk individuals, this of course would be passed on to all of us in slightly higher rates. Either would work.

    As I recall somewhere around 30% of those in the 50 million fall into that group that can afford insurance but don’t buy it, MSA’s would be a good choice for many of them or simply mandate everyone have insurance like we do with auto insurance, but we don’t need to change our whole system to fix a problem that affects 1% of our population.

  47. NorthernLite Says:

    LB, in a nutshell, the Feds fund a big portion of healthcare, but the provinces actually adminsiter and deliver it. I don’t really know why other than the feds have the funds to ensure that all provinces can provide similar care regardless of their populations, tax base, etc. It’s a program called “equalization”. I gues it could also be called “wealth redistribution”.

    For example, Ontario sends 20 billion more per year to Ottawa than is gets back in servcies so that smaller provinces or territories can provide equal services to their residents.

  48. NorthernLite Says:

    shcb, i’ve read a lot about the number of uninsured. The consensus is to use the Census Bureau’s numbers, which is about 15% of your population.

    The number you’re citing is from an insurance industry study from 2003.

    http://politicalticker.blogs.cnn.com/2009/08/20/cnn-truth-squad-the-uninsured-46-million-or-8-million/

  49. NorthernLite Says:

    My questions about insurance are as follows (open to anyone who wants to answer them, honestly).

    Insurance premiums:

    Do they go up and down, or just up?

    What were you paying 10, 20 years ago for health insurance as oppsoed to now?

    For me, I’ve been paying about the same for health care for 15 years. I actually pay less, due to the recent tax cuts the government instituted.

  50. knarlyknight Says:

    Lb – you seem sincere in your request:
    “Enlightne me: you talk about the Provinces’ having to deal with “limited” funds they receive from the Canadian government.” Etc. So I’ll be sincere in response.

    “How limited are these funds?” I’m speaking in relative terms. When the Feds were eliminating the deficit during the 1990′s, there was a noticable impact on services including wait times. Provinces sought alternative means and revenue streams to deliver medical services, and efficiencies rigourously adopted to cut costs to meet the lower funding. Some provinces explored opting out of the federal program. Public outcry ensued. Some did opt out, in part, for example privatizing optional laser eye surgeries or minor knee surgeries. Fed. Gov. sued prov. govt’s (or was it the other way around?) and eventually the problems got wored out and then the Pendulum swung back and some of the funding was restored bringing wait times to generally acceptable levels. And a result of all that chaos over the past ten – 15 years is a leaner system and a continued focus within the provincial systems on achieving efficiencies.

    “In what ways do you feel any scarcity of funds might affect health care in the provinces?” I’m not so sure there is a critical shortage of medical funding anymore. During the period in question, the worst example I can think of was that not enough of the extremely expensive “new” MRI machines could be purchased (even though their presence reduced costs in the long run) and so the smaller cities and towns went without even while some doctors in larger urban centres got together and purchased some MRI’s in an attempt to function outside of Canada’s Health Act (lawsuits ensued, not sure whether they are still using private MRI’s – but probably not.)

    “Although everyone is covered, are there any chances that higher-level medical needs might suffer when the funds are too scarce?” By “higher-level” do you mean higher cost? The fact is that any society is only willing to spend so much on health care. The differences are in how the money to spend is collected and who does the deciding over what is covered and what is not covered. I understand in the USA that the decision over how much to spend is based on how big a premium people are willing to pay to insurance companies and how much of that the insurance companies want to keep for themselves to reward their administrators for denials of claims for care, and it is primarily the insurance companies who decide what treatments are worth funding. In Canada, I’m not sure how exactly the premiums and tax revenues are allocated t o health care, and the Federal Health Act would specify the medical needs that must be covered (in order to receive funding*) and the Provinces are able to add additional treatments. As examples, I know that some expensive pharma costs for HIV patients are not covered, whereas some medical conditions can be treated with relatively cheap marijuana by a simple doctor’s prescription. No system is perfect.

    * I believe the province of Quebec has their own Health Care system and thus forego all federal medicare funding. Other provinces receive something like 25% of the costs for the treatments that they must cover (whereas before the 1990′s cuts it was closer to 50%). It’s not a simple funding formula and there is an on-going court case as to whether the funds are indeed dedicated to provincial health care plans or if they can go towards a province’s general revenue funds.

    “Is scarcity of funds a factor in waiting times for advanced treatment?”
    Of course it is. With infinite dollars, we could eliminate wait times.

    “Are funds ever spread too thin?” I think a Federal funding increase to restore per capita funding levels to those before the big Federal cuts of the mid 1990′s would solve most of the current public’s dissatisfaction (even with the demographics moving to more elderly), but then that would also stifle a lot of the innovations in program delivery to make do with less funds. That’s just my opinion. Here’s what the Cdn Drs for Medicare say:

    In 1992, Canada spent 10.2% of its gross domestic product (GDP) on health, more than any country other than the United States. In the mid-1990′s, troubled by their large budget deficits, the federal government made huge cuts in transfer payments to the provinces, and provincial governments ended the practice of substantial yearly increases in healthcare funding. Yearly increases in health spending averaged 11.1% from 1975 to 1991, but dropped to increases of 2.5% annually in the late 1980s and early 1990s.

    As a result, increases in health spending failed to keep pace with economic growth, and health spending dropped to 9.2% of the GDP, an extraordinary decrease that did not occur in any other industrialized country. Even after the catch-up spending of the last few years, described shortly, Canadian health spending as a percentage of GDP approximates that of 1992. In the same period, all other OECD countries had increases in health spending of 1.5% to over 2% of the GDP.

    for more, and for enlightenment on Canada’s Health Care, see: http://www.canadiandoctorsformedicare.ca/caseformedicare.html

    “Please provide statistics (as I’ll be looking for them too – this is a vital point.)” Okay, here are some for you, although they are a little dated:

    “In 1999, health administration costs in the United States totaled at least $294.3 billion, or $1,059 per capita, as compared with $307 per capita in Canada. …. The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita.
    A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system…”
    From: Woolhandler, Campbell, and Himmelstein, N Engl J Med 2003

  51. knarlyknight Says:

    BTW – before you think I’m enamored by Canada’s health care system, please note that I am not. It’s more like a grudging acceptance of the least noxious of various unsatisfactory poor alternatives (i.e. private US health insurance companies.) I have a secret. It’s that my medicare coverage is beefed up by “extended health care” coverage from (gasp) private insurers paid by my employer. Had I, or one of my kids to get really sick and have to rely solely on the gov’t approved level of care, we might just choose instead to take a trip up north and set sail on a wayward clump of sea ice. It’s a secret because to admit that is to admit to a sort of snobbery in which one thinks they deserve better care than their fellow person, and that is anathema to our unwritten supposed principles as good Canadians.
    Time for another brew. G’night.

    BTW, everything NL has said on this thread is true. About time you folks answered his questions.

  52. shcb Says:

    As a matter of fact my portion of my insurance was dropped by about $400 per month a few years ago when I picked a different provider, coverage is better as well, at least the prescription program is better. I don’t have any major medical problems to find out what would happen in a life and death situation. I don’t know what has happened cost wise from my employer’s side, but I doubt you know what has happened from your provider’s side (government) either. But wait, we do, remember the article saying the Canadian system is imploding? So costs must be going up in Canada as well.

    But you see the government can move money around easier than an insurance company, hell if things get really bad they can just print more of the stuff. Costs go up, I’m up for reelection and don’t want to raise my constituents premiums, let’s not build that road or let’s cut military spending, or we can cut (fill in the blank). All an insurance company can do is make less profit, but they can’t do that very long or they start to lose stockholders.

  53. leftbehind Says:

    Thanks guys -

    I’m going to crib a paragraph from Knarly’s longest post, because I think it sums up the basic facts of the healthcare debate that are consistantly glossed over and ignored by both sides:

    ” The fact is that any society is only willing to spend so much on health care. The differences are in how the money to spend is collected and who does the deciding over what is covered and what is not covered. I understand in the USA that the decision over how much to spend is based on how big a premium people are willing to pay to insurance companies and how much of that the insurance companies want to keep for themselves to reward their administrators for denials of claims for care, and it is primarily the insurance companies who decide what treatments are worth funding. In Canada… the Federal Health Act would specify the medical needs that must be covered…”

    i.e. whatever the system, there is only so much money and only so many resources to be had. The difference between Canada and the U.S., as I think the statistics pan out and Knarly explains well, is not that either is doing that much more of a spectacular job in providing healthcare than the other; its a matter of who distributes the money and resources (private companies or Government.) The Canadians here, and some Americans, would argue that the Government does a better job of distributing assets fairly to everyone, which is certainly on the table. But it must be noted that the World Health Organization, in ranking the health care systems of 190 nations ranked Canada #30 and the U.S. #37. This puts both nations’ Health Care systems far below such nations as Oman, San Marino and Andorra, which suggests that both Health Care models tread the same tepid water just above the middle of the pack.

    Answers for NL:

    “Insurance premiums:

    Do they go up and down, or just up?”

    There is enough competition among Insurance companies that Insurance Premiums go both up and down frequently for the vast majority of Americans. Employers here, at least everyone I’ve ever worked for, frequently shop for the best rates and go back and forth between the leading companies as often as once a year. When I worked for a large corporation several years ago, we kept the same insurance plan for years, but the rate was negotiated with the insurance company each year, with the understanding that my company would go elsewhere if the rates were not competitive. Now that I am at a smaller company, my insurance company has changed at least once every two years.

    “What were you paying 10, 20 years ago for health insurance as opposed to now?”

    As part of my contract with my employer, I do not pay for my own insurance, nor have I for the last 11 years. Having said that, had I been paying into the system, my rates would be much higher than they were ten or even five (or less) years ago. I must say though, they are not as high as they probably would have been had my employer not regularly shopped around for the best rates.

    “For me, I’ve been paying about the same for health care for 15 years. I actually pay less, due to the recent tax cuts the government instituted.”

    My mom is 81 years old, and has been on medicare at least 16 years. Her premiums have risen every year except the years 2000 and 2008

  54. shcb Says:

    So that admission pretty much justifies my points doesn’t it? One of the main reasons people like the socialized system is because they don’t want anyone making a profit, poor care is less important than jealousy. Thanks for being honest Knarly. As I recall the UK has the same system. I wonder when people are com paring the cost of healthcare I.e. the 10% of GDP vs the 16% of GDP if they are considering those private insurers.

  55. NorthernLite Says:

    So if shcb switched providers and saved $400/month (!) I’m alomst afraid to know what you were paying on top of that $400 a month. So what do you pay annually/monthly for health insurance now? What were you paying 10, 20 years ago for insurance?

    I hope I set you straight on the number of uninsured too. Quit falling for insurance company propaganda, you seem too smart for that.

  56. NorthernLite Says:

    Wait a second, seniors in the US have to pay a monthly premium to receive Medicare???

  57. NorthernLite Says:

    And as LB pointed out, you would think we (Canada, US) could do a heck of a lot better job caring for our citizens than Saudi Arabia (26), Monaco (13) and Malta (5).

  58. leftbehind Says:

    Neither Part A nor Part B pays for all of a covered person’s medical costs. The program contains premiums, deductibles and coinsurance, which the covered individual must pay out-of-pocket. Some people may qualify to have other governmental programs (such as Medicaid) pay premiums and some or all of the costs associated with Medicare. Part C and D plans may or may not charge premiums, at the programs’ discretion. Part C plans may also choose to rebate a portion of the Part B premium to the member.

  59. leftbehind Says:

    A Part A deductible of $1,068 (in 2009) for a hospital stay of 1–60 days.
    A $267 per day co-pay (in 2009) for days 61-90 of a hospital stay.
    A $534 per day co-pay (in 2009) for days 91-150 of a hospital stay, as part of their limited Lifetime Reserve Days.
    All costs for each day beyond 150 days

    ( source: 2008 Medicare & You handbook, Centers for Medicare & Medicaid Services.)

  60. NorthernLite Says:

    Dang, I didn’t know that. I thought your Medicare for seniors was similar to our Medicare, meaning that it’s all covered.

    Well, I guess if I can take anything away from this discussion – and it’s been a good, civil discussion – it’s this:

    As the wealthiest country in the world, and as one of the wealthiest countries in the world, we can both do better. I obviously think that our universal system is better because it covers everyone and costs much less to administer, but we can make it even better and I think the past few have shown that we can. I suspect we’ll be moving up in the rankings this year.

    I think your system needs to be reformed, badly, it’s simply too expensive and leaves 45 million people in the dark. I realize that for a lot of people it works and they don’t want something that works for them to be changed. But you’ve been talking about reform for like decades. If you were spending that much and it was universal it would be a different story. I think the debate in your country is being controlled by the insurance industry and extreme right-wing zealots and a lot of republicans just want to block reform to score points on Obama, which isn’t putting your country first. Healthcare reform was a major plank in both platforms in the last election.

    Good luck with the reform and try to keep the discussion civil and fact-based. Stop the fear-mongering and distortions, both sides, and get something in place to help those 45 million people and countless others that are losing their homes because they or their child need an operation.

  61. leftbehind Says:

    …and, while we’re obviously not going to get a Nationalized Health Care System out of the current debate, I am still confident reform is coming, and soon.

  62. NorthernLite Says:

    I think you’re right. It seems like everyone has calmed down a little and is taking a deep breath and the discussion is turning towards rational debate. Hell, even on here it has. All that nazi, hitler, facist shit really bothered me. I mean, we’re talking about caring for fellow countrymen here for crying out loud.

  63. shcb Says:

    …especially when it comes from the speaker of the house, you expect there to be an idiot or two in an angry mob but you also expect the elected officials to be a little more careful.

  64. NorthernLite Says:

    Yeah, like that idiot who said “pull the plug on grandma” or the other idiot who suggested “death panels”. They’re on both sides.

  65. shcb Says:

    NL,

    I don’t know how much I pay or did pay, I’ll get out some old pay stubs and check tonight. As to the 45-50 million people uninsured, I think my point still holds, I haven’t seen anything in the article that would make me change my mind, 15% of the population is about 50 million, no one is disputing that number in and of itself. Yes there are 50 million people uninsured in America on at least one day of that year, rarely is it the same people that are uninsured because the have lost their jobs, and all those people can get health care some way or another if they need it. The problem is with a few million people, as the article states, they are the anecdotal examples you guys have used, the woman who has cancer, loses her job and can’t get coverage from her new employer because of preexisting conditions, that type of thing. I’ve outlined proposed ways of fixing those problems, ways that have been proposed by Republicans, we have made suggestions, but if they don’t advance a socialistic agenda, they don’t count.

    The statistic is technically correct, it is just misleading. Kind of like my calling Smith a fascist was technically correct but could have been done in a less offensive manner.

  66. knarlyknight Says:

    yea, how about this: “Smith is a nice fascist.” ?

  67. knarlyknight Says:

    Kinda like Palin.

  68. knarlyknight Says:

    … doornails?

  69. NorthernLite Says:

    Well, I’d tend to favour the ‘Truth Squad’ findings over a Health Insurance Study from years ago. In any case, I hope you guys find a way to provide coverage for ALL your people and lower costs for the rest. You’re paying too much for that many people to not be covered.

    And you should write letters asking why drug companies can sell their stuff all over the world at cheaper prices than they can in their own country. That would piss me right off, especially when I see how much the US spends on persrciption drugs.

  70. knarlyknight Says:

    what he said.

  71. shcb Says:

    I’ve explained why drug companies sell their products cheaper to socialized health care countries so many times….

  72. NorthernLite Says:

    So you’re just willing to keep on bending over and taking it from these companies? That doesn’t sound like the shcb I’ve come to know.

    Your blame is misplaced. Instead of getting angry at countries that stick up for their seniors and control drug costs, you should be angry at your government and own drug companies for sticking it to you for so many years.

  73. shcb Says:

    I know it is difficult to come to grips with the fact that your country is extorting private companies in the US but it is and there isn’t anything anyone can do about it. This is one of the problems when the government becomes the producer, the government can make rules to influence the game that the other players can’t. If the drug companies refuse to sell Canada drugs at generic prices (single source for the medical system’s drugs, not individual doctors or hospitals) then Canada declares an emergency, ignores patents and allows Canadian drug companies to produce the drugs at those prices. If the US government imposes trade restrictions on US companies to protect them from this extortion then Canada does ditto. In either case the American companies are forced subsidize the Canadian system and pass that cost onto the American people. It’s just the way it is, but there isn’t any need to write a letter to congressmen, there isn’t anything they can do.

  74. shcb Says:

    This is like the man at the end of the road that buys a tractor so he can plow snow to the main road so he and his family can get to school and work during storms. The other people on the road don’t buy tractors, they spend their money on other things because he always has the road plowed when they get up in the morning. So one day the man is on vacation when a big storm falls and the people are stuck, unable to get out of their homes until the man returns. If we get the same health care as Canada who will subsidize us? And if no one is going to subsidize us how is Canada going to continue being subsidized?

    We want the advanced drugs and procedures so we develop them, in return we would hope those who also benefit would help out a bit. In my example above it would be like if one neighbor offered to buy fuel for the man’s tractor and another offered to brave the cold and drive it. But if neither offers, the man is still going to plow the road because he needs to get out worse than he wishes to punish his ungrateful neighbors.

  75. NorthernLite Says:

    Wow. No comment. Have a nice weekend.

  76. knarlyknight Says:

    Wow indeed. NL I suspect you’re thunderstruck by the fancy Pharma-babble and the tractor analogy’s dumbfounding simplicity. Seems shcb has been swallowing big pharma talking point poison along with his viagra. Please allow me to prescribe him with some counter-bias as an antidote.

    Example:

    Experience in Europe: To control drug costs European countries either impose price controls or limit drug company profits. Yet European drug companies – such as Glaxo, Aventis, AstraZeneca and Roche – are very successful, highly profitable and just as innovative as U.S. companies. From 1990-1999, European-based companies introduced 183 new chemical entities to the world market whereas U.S. drug companies introduced 161.

    Many more antidotes here: http://www.citizen.org/congress/reform/drug_industry/r_d/articles.cfm?ID=7909

  77. shcb Says:

    So you’re not disputing my assertion that Canada is extorting US companies?

  78. NorthernLite Says:

    No, I’m not because I don’t really know if that’s the truth. I would be surprised to know that lil o Canada, Britain, Australia, etc. could actually do that to the mighty US. But if you say so…

    But hey, what about that BC bud we send your way at great prices… :)

    Ok seriously, have a great weekend, summer’s almost over!

  79. shcb Says:

    you too my friend

  80. knarlyknight Says:

    Leftbehind stated earlier that USA is obviously not going to get a Nationalized Health Care System out of this debate. Perhaps this is the reason why, and explains why the “reform” will look so much like more of the same only worse: DIVE ARTISTS – Dems ‘lose’ again on health care

    http://www.buffalobeast.com/138/Surprise.htm

  81. shcb Says:

    The reason is we have the best health care system in the world and we don’t want it screwed up. In the WHO report of 2000 the US was number one in meeting the needs of patients, but that only accounted for 12% of the grade, universality accounted for much more of the final grade so a country like Morocco was rated higher than the US because even though the care was dreadful, it was equally dreadful for everyone. We don’t want dreadful care, and we don’t want to pay for it twice like you are doing. The second paragraph of your article says it all; this whole debate from the left has been about taking profit out of one more segment of the economy, nothing else.

  82. knarlyknight Says:

    If that’s what you have to tell yourself then so be it. Might as well go argue with my table.

    Curious though, where did you here that the WHO ever reported on “needs of patients”? (Let’s hope it’s not another wwnj radio host talking point.) If the WHO actually used that measurement (which I have some doubt after perusing their site) then what exactly does it mean (e.g. “is your pillow comfy Mr. Howell?”)

    And why are you referring to a 2000 WHO report when the 2009 report is readily available? http://www.who.int/whosis/whostat/2009/en/index.html

    And perhaps most importantly, where should “needs of patients” rank in importance against all the other WHO statistics e.g. per capita health expenditures and as a percentage of GDP etc. , Healthy life expectancy at birth, infant mortality rates, etc etc. etc.

  83. shcb Says:

    Well I’m not going to give sources anymore, at least not for a while, all you do is attack the source. It came from a person with a PHD, who is highly respected in the medical field and held a high elected office.

    That is the reason you are going to lose this battle, at least for now. The Americans that are against this bill intrinsically know their individual needs will suffer under this plan and they don’t like that, it’s not because someone is lying to them as your article says. They understand there is some truth and some lies being told by both sides, but they also know they live under the best system in the world. They also for the most part aren’t liberal, they don’t have guilty consciences to the point that they feel they need to pay for their health care twice so they can feel good about themselves. We’re Americans, that is how we are.

    You are right, the WHO report, frequently cited by liberals in this debate, puts more emphasis on how socialized the care is than how good it is, I, like you want good care, I don’t want to have to pay a second insurance premium to get it. What do you think the chances are that when comparing the cost of health care in the US and Canada that that extra insurance is left out of the Canadian health care .

    Look at this sentence from your article

    I thought I was going to write a piece about how stupid it is that the right argues a public option is unfair because private insurance companies can’t compete against it.

    They can’t compete against the government, that is why government has to stay out of private industry. For instance the government doesn’t have the expense of re insurance, it a disaster hits, they can just raise taxes , hide the overrun in the national debt, or print more money. It can lower the cost to the customer to a level that the insurance company can’t be competitive and survive and slowly drive the competition out of business because it doesn’t have to make a profit. And then where are the re insurance companies going to go, none of them can afford to take on the liability of the entire industry, and of course there is no reason for them anyway as I said, so you have bunch more companies out of business. Socialism is so fair.

    It is like arguing with a table, a table that is solid, grounded with four good strong legs.

  84. shcb Says:

    This is the criteria for the responsiveness of health systems.

    The measurement of achievement in the level of responsiveness was based on a survey
    of nearly two thousand key informants in selected countries.23 Key informants were asked
    to evaluate the performance of their health system regarding seven elements of responsiveness:
    dignity, autonomy and confidentiality (jointly termed respect of persons); and
    prompt attention, quality of basic amenities, access to social support networks during care
    and choice of care provider (encompassed by the term client orientation). The elements
    were scored from 0 to 10. Scores on each component were combined into a composite
    score for responsiveness based on results of the survey on preferences for health system
    performance assessment. For other countries, achievement in the level of responsiveness
    has been estimated using indirect techniques and information on important covariates of
    responsiveness.24 To enhance the measurement of responsiveness, WHO is actively developing
    and field testing instruments to measure responsiveness from household respondents.
    This strategy of using household surveys will be supplemented with facility surveys to
    observe directly some components of responsiveness.

    The US had an index of 8.1, Canada was tied for 7-8 place with Norway with a 6.98 index.

  85. knarlyknight Says:

    aaah, there did not seem to be a reference to “needs of patients” but now you’ve indicated “health responsivenes” is the actual WHO term and that is much that same thing, therefore the “table” comment was inappropriate here. My apology.

    However, what you fail to acknowldge is that the “uncertainty range” of the “health responsiveness” estimates are quite large. The range of possible results for health responsiveness measures are 6.44 – 7.54 for Canada and 7.32 – 8.96 for the US. This means it is well within the realm of possibilty that Canada actually scored higher (i.e. 7.54) than the USA (i.e. 7.32).

    That means that you cannot state with any confidence that the US actually is the most responsive, e.g. Canada may well be more resonsive than the US. Especially now: remember, the survey data was taken at the end of a decade of very deep health care funding cuts in Canada and high public dissatisfaction with the results of those cuts. Figures for 2008 would be much higher for Canada – where are those figures?

    BTW, thanks for getting me to the WHO 2000 report, it is worth a look. (e.g. I like the diagrams on page 86, a lot of info at a glance:
    http://www.who.int/whr/2000/en/whr00_ch4_en.pdf )

  86. shcb Says:

    That is an interesting graph, I wish they wouldn’t use terms like purchasing power parity and maximum value, what is that? Maybe it states what those terms mean in the text, I haven’t read it yet. I’m guessing I won’t like any description that has the word parity in it though:-)

    The reason she uses the 2000 report instead of the 2009 report is that this discussion has been going on for a while and the left uses the US is 37th in health care a lot.

  87. shcb Says:

    I don’t mind the table comment, calling me stupid is at least somewhat accurate, better than Enky calling me a racist :-)

  88. NorthernLite Says:

    I don’t think anyone is saying that the care in the US is crappy, and indeed it is among the best in the world. Trouble is, it’s only good for 85% of your population and you spend enormous amounts of money compared to other countries that provide care for their entire populations. I have to believe you guys can find a way to provide coverage for those that can’t obtain it and lower overall costs for everyone else.

    I imagine if we took a big chunk of our population out of our system any problems we have would probably disappear. But that’s not the moral way to run a system.

  89. enkidu Says:

    I looked back in this thread and can’t find where I called you racist lil ricky.
    You’ve been throwing around the word ‘fascist’ and ‘socialist’ quite a bit lately, but I haven’t called you racist in this thread.

    You and lefty are two peas in a pod: making crap up so you feel offended. or whatever the current outrage du jour might be (death panels! socialism! fascism! death book!)

    We don’t cover some 15% of our population: the other industrialized 1st world nations do. We spend more, cover less and have healthcare that isn’t the best in the world.

    I’ll ask again, even if I know the answer is NO! We need to reform healthcare and the free market isn’t doing it all on its own. Can the right wing please help craft something that isn’t a boondoggle? thx

  90. shcb Says:

    We provide healthcare to 100% of our population, we don’t provide healthcare insurance to 100% of our population that is a matter of personal responsibility. Over half the uninsured live in households that make over $75,000 or are eligible for Medicaid or SCHCIPS. The other half need some help. A small number of those remaining, maybe 20% are for the most part uninsurable due to preexisting conditions, our proposal is to use a pool similar the Insurance Exchange in Obamacare to cover these individuals. The rest are primarily people that between jobs, we have proposed two plans for these individuals. The first is MSAs, they would be difficult to institute in the short run and are more of a long term plan that young workers would need to start paying into at an early age. MSA’s also would and are working well for many in the group above that make $75,000. The other proposal is to issue debit cards to pay for catastrophic insurance and some routine care just as we do with food stamps. Most people in the group that are above the poor and below the employed are there temporarily. The cards could be loaded on a monthly basis electronically and only used for medical expenses, when the individual gets coverage they would be deactivated.

    We have proposed many solutions to the few problems of American health care. I have talked about most of them here on many occasions. But you see liberals aren’t interested in fixing health care they are just interested in socialism, removing profit and beggar thy neighbor politics.

  91. Smith Says:

    I haven’t looked at the paper, but “purchasing power parity” usually refers to a manner of equalizing costs or monetary values across disparate economies.

    For example, in the US, $1 will get you a small order of fries at McDonald’s. In a developing nation, that same dollar can get you a large dish of meat, vegetables, and rice. A dollar goes much further in some economies than it does in others. Purchase power parity (PPP) is used to compare costs in countries that place very different monetary values on the same goods. If you analyzed health care costs without accounting for PPP, developing nations would always appear to offer the cheapest care. However, salaries in said nations will be much lower than in the US, so even though the raw number costs are lower, the actual cost relative to income and/or cost of other goods might be equivalent to that of the US. Another example could be rent on an apartment. $200 per month is very cheap for a small apartment in most of the US, but in Kenya, $200 per month might get you a mansion. PPP takes that into account and allows researchers to more accurately compare living costs between countries.

  92. NorthernLite Says:

    Why is the number one cause of persoanl bankruptcy health care costs if everyone is provided care?

  93. Smith Says:

    You can’t go bankrupt from care you didn’t get, so obviously those who are bankrupt have been given treatment.

    Might want to rephrase that question before shcb gives you a longer sarcastic response. Perhaps, “Why is the number one cause of personal bankruptcy health care costs if everyone is provided AFFORDABLE care?” is closer to your intended meaning?

  94. enkidu Says:

    shcb, your first para is reasonable, your second para is the same old politics.
    socialism? Should I be grateful I’m not labelled a fascist for wanted to lower costs and cover everyone? All the other 1st world countries do it. Why can’t we do it better? We can and we will, with or without the party of NO! Even if it takes a couple years and happens in stages.

    I wouldn’t call 15% of our population without healthcare (yeah yeah they can go to a county emergency room for catastrophic care. too late, too expensive) a minor problem. We spend more, cover less and have worse healthcare metrics than other 1st (and 3rd) world countries…

  95. knarlyknight Says:

    Given the PPP reality, maybe the best way to help people with high cost treatments is to fly them to a lower cost country for their care, like Cuba. Think of the money you’d save! Shipping jobs offfshore worked for manufacturing by letting them access cheap labour costs, you might as well let the public access affordable healthcare in developing nations too.
    E.g. Guantanamo could become a hospital for Americans rather than a torture centre.

  96. Smith Says:

    Knarls,

    People already do that.
    http://en.wikipedia.org/wiki/Medical_tourism

  97. knarlyknight Says:

    Yea I know that Smith, but thanks anyway and thanks for the clear response with a link. My comment was more satire than serious (with a wink to “Sicko”), as that suggestion obviously doesn’t solve the problems that healthcare reform is intended to address.

    Which brings me back to the fundamental principle of public policy analysis: 1) Define the problem(s).

    Has Obama done that clearly, i.e. what a re the specific problems that need to be solved? Is it the # of uninsured? Is it the high cost of care per capita? Is it the not so stellar health outcomes? Is it the dominance of the health sector by big pharma & insurance companies?

    And if these problems have been defined clearly, is there bi-partisian agreement that these are indeed the problems that need to be addressed? If not then no-wonder there is such a non-sensical public discourse on proposed solutions.

  98. Smith Says:

    “is there bi-partisian agreement that these are indeed the problems that need to be addressed?”

    Are you being facetious again? If there is anything the discussions on this site should show you, it is that bi-partisanship does not exist in American politics (and probably not in any other political system too). Republicans will oppose any large Dem program, even if it is a good one, just because they are on different teams. It goes the same for Dems and Repub programs. Of course, neither side wants to admit this.

    “Bi-partisan” is just a talking point and it is usually used to attack the other side. The opposing side will just claim “we want to create a bi-partisan bill to address this problem, but (the party proposing the current legislation) are trying to block us out.” The reality is that the opposing side has no interest in creating a bi-partisan bill, they are just using that claim to legitimize their opposition to the proposed legislation/act/whatever. As soon as the tide turns, the former minority opposition will suddenly lose interest in bi-partisanship.

    Woe betide those who actually try to engage all sides on the issue. The political machine will chew their proposals up and spit out a “bi-partisan” pile of garbage that no one supports. The opposition will deliberately sabotage the bill with “compromises” the water everything down to the point of uselessness. I am pretty sure the current health care plan is moving in that direction.

    The sad reality of politics is that only those who say “shut up, we are doing this my way,” (aka, “I’m the decider”) actually get anything done. Look how much Bush “accomplished” by taking this attitude. Whether you like his policies or not, he clearly got a lot done. The same goes for Reagan and FDR.

  99. NorthernLite Says:

    And that’s exactly what I think Obama should do with this, climate change and regulatory reforms for the financial services industry. As Slim Shady would say, ‘fuck ‘em all’.

    He and the Dems may pay for it in the end at the polls, but America will be better off for it. And if these changes actually do lower costs substanially for everyone the R’s might be screwed for an even longer time to come.

    What do you guys think will happen?

  100. knarlyknight Says:

    No I was not being facetious that time too, it was more like a momentary loss of common sense and a lots of naivety. Man, did you ever bring me back to a cynical reality fast. (A reality I fully believe, when not suspecting that the political fighting is mere theatre for the public with the general plot decided and determined well in advance by the billionaires, big pharma/military industry/etc. corporations who pay for the campaigns and wall street tycoons/etc.) Either way, things don’t look very good for you guys in terms of real positive change.

  101. knarlyknight Says:

    NL, Obama should do that, but hasn’t he been dissapointing since inauguration with his backtracking and giving in to lobbying pressures and “outrage” from the wrong wingers? I have low expectations, and just glad I’m insulated by virtue of my Canadian status.

  102. shcb Says:

    Thanks for clarifying the PPP Smith, you learn something everyday if you listen. And Smith has the bi-partisanship nonsense fairly correct as well. Rush has said in the past that bi-partisanship is easy, you just have to agree with the other side, partisanship is hard, you actually have to fight to win something. There is a great deal of truth to that statement. The only thing I would add is that partisanship isn’t always my team against your, although it is in many cases. There is also legitimate philosophical differences i.e. my argument that our system is the best because it provides the best care versus your argument that not everyone gets equal care, that is just our outlook on life. The other is different objectives for perfectly reasonable reasons. Younger people raising kids will vote for the new school and not for the new senior center, and retired folks will vote the opposite, until those younger people get close to retirement age.

    Thanks for the nod Enky, my partisan rant is because I hear over and over that Republicans don’t have any ideas, we do, but as the discussion of American politics in the last few comments show we won’t be able to institute any of them until we win again, and then they will be deemed partisan. And so it goes.

  103. NorthernLite Says:

    Knarly, I find it hard to be disappointed in him too much for at least trying to listen to the concerns (the ones that are genuine at least) of some of the citizens. Imagine if the last President did that, how much different the world would be right now…

    shcb, judging by your last paragraph, you seem to suggest that the Dems should just implement their ideas because they “won” (big time, I might add) because that’s what your party does / will do in the future.

    So don’t be upset when they do.

  104. NorthernLite Says:

    And it now looks like they’re going investiagte the torture that took place during the Bush years.

    Hmm, upset the Liberals by being flimsy on the public option… reward the Liberals by going after the scumbags from the last admin.

    Or maybe it’s like “okay, don’t want to work with us on healthcare reform? Scare and confuse the public will ya? Alright, let’s have a close look at what took place in the last admin.”

    Gotta love politics.

  105. shcb Says:

    Bush did listen to the concerns of people, he just acted more on the concerns of people that were more like minded, like me.

    shcb, judging by your last paragraph, you seem to suggest that the Dems should just implement their ideas because they “won” (big time, I might add) because that’s what your party does / will do in the future.

    well not quite, there are a lot more dynamics involved than who won one race in one election. In the presidential election D’s only won by a few percentage points, points they have now lost because of the stimulus package and this health care bill. That’s not to say they can’t win those voters back in the next few years, but they have lost them for now. Every member of the house and one third of the Senators are up for reelection soon, so are many governors and state houses, the president doesn’t want to lose those seats. There are just some political practicalities that have to be considered in Obama’s choices of what fight to fight. He also sold you a bill of goods on many issues. He had absolutely no intention of keeping many of his promises. A candidate can do that to people that are infatuated with that candidate, love is blind.

  106. NorthernLite Says:

    Ha! How many percentage points did W win by in 2000? Like 0.1%?

    I better not hear you start complaining when Obama gets fed up with trying to reach across the aisle and does what you say the party in power should do.

  107. shcb Says:

    He already is, he is pushing as much as he can, it isn’t as much as you want but it is as much as he can. Just as Bush didn’t push as much through as the right wanted, but it was as much as he felt he could. Turns out it was too much in some cases, we’ll just have to wait and see if Obama has already pushed too much through.

  108. knarlyknight Says:

    NL – Although I’d prefer altruistic motives for investigating the horrors inflicted under the previous administrations (now we have at least one mock execution, threatening to inflict pain and suffering with a power drill, and threatening to murder a detainees children all documented)
    I still would be satisifed if what you speculate is true:
    Or maybe it’s like “okay, don’t want to work with us on healthcare reform? Scare and confuse the public will ya? Alright, let’s have a close look at what took place in the last admin.

  109. shcb Says:

    Jennifer Rubin has a good piece on Pajamas today

    As for the idealism, no president has sunk so far so fast. Candidate Obama chastised Washington as a place where good ideas died. He summoned young voters with high-minded slogans and Kennedy-esque rhetoric. Hillary Clinton and George W. Bush were mere politicians; he was the leader of a whole new era in politics.

    Now? Opponents of health care are stooges, evil-mongers, and villains. Citizen activists are to be reported to the authorities for spreading misinformation or ridiculed. The candidate with the superior temperament has devolved into a peevish president exasperated that mere citizens would question his wisdom or stand in his way.

    http://pajamasmedia.com/blog/what-happened-to-candidate-obama/

    In sum, anyone hoping Obama would usher in a new era of idealism, bipartisanship and effective governance must be sorely disappointed. It is now about brute power and bare knuckle politics. The issue of the day now is: Can the president muscle through his increasingly unpopular health care plan by skirting congressional tradition and ignoring any angry electorate?

  110. shcb Says:

    They are just going after the only card that has worked in the last year, but the folks have moved on. It’s just a good old fashioned diversionary move.

  111. knarlyknight Says:

    Yea right, uh huh. Go on finding reasons to scorn and hate. Enk could surely expand on that theme.

    A more realistic view than pyjamas would be that it takes two to make bipartisanship work and the “death panel” type lies are similar vitriol are what would be expected from immature and troubled adolescents.

  112. enkidu Says:

    Funny, I was just listening to a preacher talk about our times this morning. But why have me recap right wing media, just listen for yourself:

    http://crooksandliars.com/david-neiwert/gospel-hate-arizona-pastor-steve-and

    If you can stomach it and you have headphones, listen to all twenty minutes of this guy. note – definitely not safe for work. I think this guy and Ted Haggard should start dating, they seem meant for one another.

  113. shcb Says:

    Hate? Where is there any hate here? My wife has been listening to left wing talk radio lately and she said last weekend that all they do is talk about how hateful the right is, what passage in the Rubin piece is hateful?

  114. enkidu Says:

    Rethugs used the reconciliation process (just 51 votes in the Senate) to shove bushie’s tax cuts for the richest thru… I say if you right wingers aren’t willing to compromise and work together then we should do the same.

    Get the job done.

    btw that pantloadmedia link has the most adorable comment section. It only took until comment #4 to use the word ‘niggardly’ (har har! wink wink! extra points for misspelling it, dumbshits)

  115. shcb Says:

    so Enky can’t find anything, how ’bout you Knarly?

    (the tax cuts were across the board, go ahead, socialize medicine, you have the votes, we didn’t get any help from dems on tax cuts, what’s fair is fair)

  116. shcb Says:

    “…the hard part is partisanship, you actually have to do something”

  117. enkidu Says:

    Yes, I’d like the R’s to drop the partisan poltroonery and actually contribute. Rather than shrieking ‘socialist!’ ‘fascist!’ ‘Hitler!’ and the rest of that bilge. A few comments up you actually had a couple good suggestions. None of those suggestions would even be talked about without Obama pushing for bipartisan healthcare reform. But you guys don’t do bipartisan do you. Rs referred to bipartisanship as “date rape”. The currently elected Rs are all in on a strategy of defeating healthcare of any kind.

    I read the pantloadmedia link and it is just as partisan a source as I would expect you to link to. Describing the pres as peevish and all the other crap is just the usual partisan bs.

    wwnj statements like “the tax cuts were across the board” are treated as having even an iota of truth, when there simply isn’t any.

    The tax cuts went mostly to the very wealthy.
    By 2:1 or more (just in terms of percentages)
    http://en.wikipedia.org/wiki/Bush_tax_cuts

    scroll down to the tax bracket charts

    This is what is so damn frustrating about wingnut ‘math’
    the top bracket went from 38.6% to 35%
    -3.8%
    the second lowest bracket went from 15% to 15%
    +/- 0%
    the tax bracket that has the most Americans, the median income and just about everyone you will ever meet? (the third bracket)
    went down a whopping 2%

    factor in the capital gains and interest cuts and it is even larger

    I expect wwnj to go to his fallback position: Federalist Paper TK421 proves yada yada yada (or it’ll be some fauxnewtz ‘link’)

  118. enkidu Says:

    sorry – that should have been -3.6% not -3.8%

    and just to add another interesting twist: that AR15 toting guy named ‘Chris’ who was strutting around outside the AZ Obama townhall? Looks like ‘Chris’ is a member of the bigot ‘pastor’s’ ‘flock’

    birds of a feather

  119. shcb Says:

    Well Enky, since you’re so enamored by compromise and you like our ideas, I suppose you will be writing your congressmen and telling them you are withdrawing your support for socialized medicine and wish to join your friends, the Republicans, in supporting debit cards and MSAs.

  120. enkidu Says:

    I am not enamored by compromise, but Obama is. I think he is losing some ground because he isn’t leading by hammering this thru regardless of what wingnuts scream. But there are some reasonable ideas. Debit cards? get. a. clue. really. None of your ideas will cover all Americans (you know like how other smaller countries do for all their citizens?) A public option will. Let the insurance leeches give up some of their profits. They went too far and now Change is going to come.

    With the passing of Ted Kennedy last night budget reconciliation is almost a forgone conclusion. Stop cutting deals with wwnjs who are going to vote against it regardless. Do what is right. Without a public option, I doubt I’ll vote for Obama again. I’ll vote for someone more progressive.

    Like Bill Maher said, we have two political parties in America. A party that is good for defending giant corporations, big lobbyists, banking interests and the powerful. They are the center right party called the Democrats. Then we have a batshit crazy bunch of gunnuts and religious zealots called the Rethuglicans. We don’t have a progressive party. But we very much need one.

    Funny how you can’t bring yourself to listen to the hate speech from ‘pastor’ nutbar or his gun totting freakshow ‘flock’ and acknowledge this is the rump party that the rethugs have sunk to: a regional minority of riled up rednecks and bigots. If anyone brought a AR15 to a bush event he would have been arrested, beaten and probably ‘disappeared’. Then tortured.

  121. NorthernLite Says:

    I remember people getting kicked out of Bush events and spending nights in jail for wearing t-shirts that said he sucked!

  122. shcb Says:

    We have a socialist party, Bernie Sanders is a socialist, see you already have somone elected, that is more than Ross Perot ever accomplished. Of course Maher is way off base with his assesment but that is just because of his vantage point.

    http://socialistparty-usa.org/

  123. NorthernLite Says:

    We used to have a federal party up here called the ‘Progressive Conservatives’ which I very much agreed with, however they merged with a right-wing fringe party and dropped “progressive” not only from from their name but also from their policies, much to my dismay. We still have progressive conservatives at the provincial level though.

    So now I’m stuck between choosing from a far right party (Conservatives, or ‘Cons’ as many refer to them as) and a far left party, the Liberals. Of course we have the Green Party and a really, really far left party called the NDP, but voting for them is pretty much throwing your vote away. Well, not really for knarly in BC, I think polls show the Greens at the top with the Libs and Cons. As Cartman would say, gawd damn hippies!

    There is a glimmer of hope though, the new leader of the Liberal Party seems much more to the centre and is trying to bring the party there. He actually lived in the US for many years and taught at Harvard and also spent time in England teaching at Oxford. His name is Michael Ignatieff, you guys ever heard of him?

    He seems to be pissing off people on both extreme sides of the aisle, which to me is a good sign.

  124. NorthernLite Says:

    I almost forgot to say…

    May the Lion sleep tonight.

    No matter what your political views, it’s hard not to admire somebody who had so much but spent his entire life fighting for those who needed help.

  125. enkidu Says:

    wwnj, you really don’t listen to others or read what they write, do you?
    you think you are right (as in correct) because you are right wing.

    I actually like Bernie Sanders quite a bit. Every time I have heard him speak, he is sticking up for the individual. The citizen. The taxpayer. He is an Independent. I thought Ross Perot had some interesting things to say, tho much of the rest of what he said was utter lunacy (rather like Ron Paul). We should have a three or four party system. Greens on the left, Dems in the middle, Rethugs on the right, Confederacy further to the right. Basic geography: coasts, middle, south and wingnuttia. I know wwnj would vote party line Confed…errr.. I mean Conservative.

    I want a Progressive candidate, someone who tosses aside the ridiculously inefficient dog-vs-cat-ism of today’s DvsR partisanship. I admire Obama for trying the middle way, but it isn’t getting the job done. In the end I expect this to go thru and I want a Public Option. A clear majority of Americans also want a public option. I want to control costs. And cover everyone.

    Explain to me again why profit is more important than healthcare?

    Every other 1st world industrialized country has universal coverage.

    Pass the Ted Kennedy Universal Healthcare Act of 2009

  126. shcb Says:

    I listen and read just fine. It seemed the Socialist party would be perfect for you since they already have on elected official in their stable, but if another minor party fits your preferences better that’s fine. Vote third party, get Bill to encourage others that watch his show to vote third party as well, you can get as many people as you want to vote for your far left (progressive) candidate, if they get enough votes they will be elected. It’s going to be a little harder getting a president since the founders had the good sense to create the Electoral College, but you can still get control of congress.

    Your other two questions/statements are a false dilemma and irrelevant.

  127. shcb Says:

    So somehow a D vs R vs P vs C is going to be better?

  128. NorthernLite Says:

    Sometimes having too many parties can hurt your cause too. Up here our left votes are split between three parties (four parties in Quebec) which is how we ended up with a Conservative government, albeit a minority. Because now there’s only one party on the right for those voters to choose from.

    The Mixed Member Proportional (MMP) system is a solution some think would make our system more democratic. Seats are awarded based on the percentage of votes each party gets nation-wide.

  129. Smith Says:

    “So somehow a D vs R vs P vs C is going to be better?”

    This seems strange to me. I thought you were all about free markets? Are you suggesting that having choices is a bad thing? You aren’t suggesting that the government should in some way restrict the free market of ideas and limit consumer choice, are you?

    “harder getting a president since the founders had the good sense to create the Electoral College”

    Oh, apparently you are. How peculiar that you feel that the government should not do anything that might limit consumer choice when it comes to health care, and yet you strongly support the government acting to limit our choices in other areas. I have to ask myself, why would someone who claims to support competition and choice actively support a system of government designed to serve as a barrier to choice? One must wonder if said “advocate of the free market” might have in some way benefited from such a barrier in the last 10 years. Perhaps said institution in some way superseded the choice made by the majority of consumers, and instead forced the market to accept the lesser choice, which just happens to be the preferred choice of the supposed “advocate.” Can anyone here think of such an event?

    Oh, and the SP USA doesn’t appear to have any members in the House or Senate. Would you be so kind as to tell us who the “elected official in their stable” is? Remember, Bernie Sanders is listed as an Independent, but I am sure you are aware of that.

  130. shcb Says:

    Last question first, yes he is listed as an independent, but he considers himself a socialist. Just as there are a couple that call themselves independents but caucus with the Democrats. Most of those distinctions come from the state/federal divide of what might be popular with voters at the state level might not be workable at the national level or visa versa.

    In our system the competition happens in the primaries, the various factions fight it out in those preliminary stages, in my mind that is a good place for those fights. Coalitions are formed before hand, the voter knows what he is getting before the election. In places like Britain the coalitions are formed after the election, I’m not sure how it works in Canada, sounds like it may be a hybrid of both systems. I’m always in favor of competition, it is just a question of where that competition takes place. I like our system. I also find that the two party system tends to moderate things and slow the progress of government some, both good things in my opinion.

  131. Smith Says:

    So, the answer to my second question is that this statement, “it seemed the Socialist party would be perfect for you since they already have on elected official in their stable,” is something you just made up?

    Calling yourself a socialist and being a member of the Socialist Party are two different things. Plato wrote the Republic, but he is not a member of the Republican Party.

  132. shcb Says:

    Thats true but it’s about as close as they’re going to get.

  133. knarlyknight Says:

    good response shcb… yet the converse is also true:

    The closest the Republican Party will get to intelligent thought is about the same as their distance from Plato (i.e. a distance of half the world away and about 2500 hundred years out of sync.)

  134. shcb Says:

    …but we’ll always have candidates that has a chance of winning.

  135. knarlyknight Says:

    Yes, of course you will (if losers like this guy continue to vote:
    http://forumpolitics.com/pics/moran-sign.jpg )

  136. shcb Says:

    But seriously, my broader point was that if you don’t like the candidate of the R or D vote for someone else, or write in a vote, that is your prerogative. Just understand that you more than likely won’t have an impact on the election. If you feel strongly enough about it find an outlet to get your third party candidate elected, start local and work your way up.

    We have this piddly little strip of landscaping at the entrance of our development that costs us about $20,000 per year to maintain. The golf course retirement community across the road has landscaping that probably costs 10 times that to maintain. At our last meeting there was a faction of three or four that didn’t want to pay for the maintenance of our strip anymore, they obviously had been discussing it beforehand because they all had the same talking point that was “we pay our taxes, the county should pay for it”. So I asked them if they wanted to also pay for the golf course’s maintenance, of course they didn’t. I made the point that if the county paid for ours it would have to pay for theirs and in the end we would all pay for both. They never missed a beat, they cornered me on the way out of the meeting and made their point for the third time evidently unable or unwilling (I’m guessing the latter) to see my logic.

    This is the same thing here, we have the system we have, learn to live with it or learn how to change it, once you learn how to change it , do it. Change takes hard work and time, and there are usually unintended consequences that may make the change worse than the status quo, be prepared to accept those realities.

  137. knarlyknight Says:

    shcb,quit being so mature and reasonable, it makes the rest of us look bad.

  138. knarlyknight Says:

    One question – do you think your founding fathers were working within the system established for them by the British Crown from whence the colonies were established?

    How do you work within a system to effect change if (an arguable if) there are institutions and people “above” who control that system who are infinitely stronger and have no interrest in real change?

    Sorry that was 2. pick one if you wish.

  139. enkidu Says:

    Actually I don’t think it is reasonable to parrot outright lies (them bush tax cuts were across the board… provably, verifiably numerically false). Nor is slinging the word fascist (socialist and nazi) around because we are trying to reduce the growth in healthcare costs.

    He can’t answer simple questions like: why are insurance company profits more important than healthcare for everyone?

    We ridicule Cuba plenty (har har toilet paper shortage?!?! har har!), but they spend a fraction of what we do and have nearly as good healthcare. Every other 1st world country has universal coverage. And spends a fraction of what we do. Despite what the numbskulls have been mislead to believe, covering everyone is not going to mean turning America into the soviet union. It will be a miracle if the wingnuts don’t start shooting before this is all over and a bill passed. And the Edward M Kennedy Public Option & Healthcare Reform Act of 2009 sounds pretty good to me. Let’s bleed some of the profit motive out of something that shouldn’t be about profits: it should be about healthcare. For everyone.

  140. knarlyknight Says:

    Enk, you misunderstand.

    My “mature and reasonable” comment was solely in reference to the posting immediately before mine. Most of shcb’s stuff is certifiably nuts, as Smith seems quite adept at pointing out (and you too I guess, but Smith is more serious about it.) Wait for a bit, I’m sure we have yet to see plenty more juvenile tactics and conveniently self-serving lapses of coherent reasoning from the boy.

    That’s all I wanted to say; ridicule my now resume at your earliest convenience.

  141. knarlyknight Says:

    Is it really true that you can’t get health insurance in the USA if you have been sick for a long time (e.g. Crohn’s disease in the 8th grade)? That’s horrible, it’s like torture. It can’t be true, Americans care for each other don’t they? http://www.youtube.com/watch?v=Mwd4V1v041U&feature=player_embedded

  142. knarlyknight Says:

    Not exactly “District 9″, but it is suited to this audience. Starts slow and gets better so you won’t miss much if you miss hte beginning by skipping forward a minute or two… http://www.youtube.com/watch?v=DXXBCFnhsUc&feature=player_embedded

  143. shcb Says:

    Actually, I answered Enky’s question, it is a false dilemma, you can have both, quality health care and profit, we do now. I was also right in my discussion with Smith, I had a few details wrong but the gist was there.

    Question 1) I think they did try and work within that system for a couple hundred years before the revolution, yes there are times when you have to topple a system, but you do need to be prepared for those unintended consequences. In this case I’m not sure how you would take us to a multi party system with revolt, toss out the whole constitution and start over? I don’t think you are going to have the support. It would seem easier to get three or four congressmen from a third party elected in some quirky state(s) and see if there is a movement out there.

    Question 2) you start out reading “The Art of War”. What I am doing with the HOA problem is identifying what I perceive as the biggest problem. In this case it is lack of accountability. They are not covered by the constitution (I’m exaggerating a bit Smith) and are only covered by a few laws since they are considered a non profit corporation not a branch of government. Since I have little hope of changing the views of the legislature or the courts to change that item I am going to try and get the HOA to add the laws to their bylaws, since the courts have said they have to follow their own bylaws. They don’t because in most cases they haven’t read them but that is a side issue for now.

    I’m starting slow with the Colorado Sunshine Law, I’m documenting all the places they are in violation and the problems it is causing, this month I will confront them a little, in a few months I will place my proposal on the table. Then I will see if I can get someone at the state house to carry a bill for me in the next session to require all HOA’s to follow the CSL. Part of my proposal to my HOA will be, do they want to be a good example or a bad example in the state legislature, you have to twist arms in politics, just smile while you’re doing it. Little baby steps, never confront a stronger enemy head on, use their weaknesses against them and turn their strengths into weakness. It takes a lot of work, and a lot of commitment (and a little luck) but it can be done.

  144. shcb Says:

    One other thing, don’t underestimate the degree the far left has taken over the Democratic party in the last 10 or 15 years, you have been more successful already than you think with people like Soros doing almost exactly what I am doing in my HOA on a national level.

  145. Smith Says:

    You could say the same about the Republican party and the take over by the far-right. Rove, Limbaugh, and the like have been using the same tactics to do it, too.

  146. shcb Says:

    That’s true, I’m not so sure I would agree about Rove, but that may just be because of my political center. I don’t think the country really moved to the right much under Bush. Maybe it did, just not from my perspective. I’m not considering the war in Iraq in that calculation. For one thing that will just move us into a topic we have talked about ad nauseam, and that is something that was thrust upon us, not a well planned tactical move like Soros and if you like, Rove would make. I guess I’m using the Reagan years as my baseline. The brief Newt period around ’94 was more of a turn to the right than the Bush years in my opinion.

    I do agree with your point in principal though.

  147. NorthernLite Says:

    I think the reason for this is because those on the extreme sides tend to be the most vocal and are usually well organized. A lot of people that are more in the middle seem to have a “meh” attitude when it comes to politics. And really I don’t blame them.

  148. Smith Says:

    Yeah, if Reagan is your baseline, then we definitely have a different political center. The Reagan years were probably responsible for the biggest rightward shift, but Bush was a continuation of that legacy.

    I agree that nothing about the actual conflict in Iraq would count as “well planned,” but the build up to it certainly was. I’ll grant that Afghanistan was “thrust upon us,” but I really don’t feel that Iraq was dumped in Bush’s lap. While it doesn’t seem to fit in the context of a long term political strategy, it was definitely something Bush created for himself. Perhaps it was a political gamble. A clear victory would have probably given the Repubs a strong advantage in future elections. Sometimes the dice just don’t fall the way you hope.

    Rove fits well with your “ever confront a stronger enemy head on, use their weaknesses against them and turn their strengths into weakness,” strategy, and he was involved in Repub campaigns during the Gingrich Contract with America period.

    Rove aside, I assume you at least feel that Limbaugh is trying to serve as the unofficial leader of the GOP and push things as far to the right as possible, since you didn’t really say anything about him in your comment.

  149. shcb Says:

    Yeah, I would agree with you about Rush. I also think he is good example of finding a way to change things within the confines of the system, but in a unique way. He used his talents as a showman, similarly Soros used his talents of organization and making money to set up a way to put some seed money out there and start an activist group that would fund progressively more radical groups. They have both found ways to game the system. People like Rove and whoever you want to counter balance him with on the Democrats side are more in the system already, they may be good at what they do but they aren’t changing the way we do things. I’m probably getting off subject or at least going down a road you didn’t intend so just consider that a statement and not an answer if you like.

  150. shcb Says:

    one more thing, Rush is always saying he isn’t the leader of the Republican party and he doesn’t want to be. That tells me that in his mind he is and does.

  151. enkidu Says:

    Well, since wwnj quotes Rushbo (and in complete agreement I might add)… Reagan is your baseline? Ugh, he slewed America so far to the right we still haven’t made it back to center.

    Good luck with your HOA, make sure you scream “fascist!” and that anyone who disagrees with you is a “socialist! also!” maybe throw a reference to how Obama is a nazi, scream “fascism” 3 or 4 more times and that should get your point across. Then play the victim when people laugh at you and shout for you to sit down and shut up. Rinse, repeat.

    I’ll ask again: why are insurance company profits more important than healthcare for all Americans? If the magical invisible hand of Adam Smith were so wise and wonderful, why are almost 50 million Americans without coverage? Why do we spend several times more than other countries, yet get middling poor healthcare outcomes? Why are the very people who would benefit the most from lower rates, expanded coverage and better healthcare so ginned up about absolute nonsense? The same old story: partisanship. One party won’t do what is right for America because they see it as benefiting the other party.

    A public option would force some of the greed, some of the waste, some of the fraud out of the system. Plus making the fines for Medicare fraud 10X to 100X larger, some mild tort reform, eFile and efficiency upgrades, u want co-ops? great. but a national public option would force the insurance industry to work on coverage and benefits rather than stock prices and CEO parachutes. I can already hear wwnj screaming “socialist!” from here…

    A watered down, mangled up compromise bill that gives Rethugs everything they want while giving up the public option would be worse than no reform at all: it’ll just give the insurance thugs more power, more profit and less reason to do a damn thing about 50 million people who aren’t covered now. Obama’s numbers are sinking because he isn’t out there fighting hard for what is right (note, not right wing). I am dissatisfied with his performance: get off the links and start bringing the light of logic, reason and humanity to this and he’ll win. Keep cutting deals with assholes who will vote in lockstep against it and it will fail. Broad bi-partisan support isn’t going to happen, the Rethugs are all in on defeating every O-nitiative.

  152. shcb Says:

    I live in a fairly affluent community, not rich, but upper middle class, most everyone here is a Republican so I don’t need to refer to them as you said. If you don’t like fascism would you prefer me to call the regulation of private industry by government to the point of private ownership being only an illusion as neo-socialism? Either term is fine with me. Or as long as we know what I am referring to I can call it purple pumpernickel, if that is more pleasing to you delicate sensibilities. I’ve said many times I was using the term in a clinical sense, not meaning it as a pejorative.

    I’ll politely and with great patience answer one more time, all Americans have health care, your question is a false dilemma, we can have health care (we can even have healthcare insurance for most Americans) and we can have profits, we do have health care for all Americans, and many illegals, and we do have profits. Now those are facts.

    For the opinion section of our show. If we remove the profit from the system care and innovation will suffer, this will lead to a lower level of care for not only Americans but for the rest of the world that depend on our innovations. Costs won’t go down, they will go up, for a lower level of care, or they will go way up for the same level of care. No one is denying that. Sure they may say in a speech that they will lower costs but then say we may not want to do it now because of the economy, how does that jive? If the costs will go down isn’t a bad economy the time to do it? Half the money to pay for this plan will come from Medicare, that is in the plan, why do we need to raid Medicare when the enrolment is about to increase 30% in the next few years if we are going to be saving money on the remainder of healthcare?

  153. enkidu Says:

    So I suppose you are fine if everyone around you calls you a nazi, a douchenozzle, a tiger-petter or just plain stupid? Delicate sensibilities? Your whaaaambulance is waiting. I was merely suggesting that if you ‘debate’ in person like you do on line, it is no wonder folks laugh in your face at cocktail parties (I recall your lovely bon mot about wanting to smash your bud lite in some woman’s face because she said something you didn’t like… so polite).

    We don’t have healthcare for millions. Whether it is 1 million or 50 million is simply a matter of degree. Oh wait, I forgot again, math is now liberal, just like those pernicious facts! Our outcomes are not better than the other 1st world countries, they are worse. Oh wait, I forgot again and used an actual fact instead of right wing pablum.

    Repeal the bush tax cuts and you will have money left over. Lots of money. The rabid right wing spent hundreds of billions of dollars a year in a boondoggle war (Iraq) with tens of billions of fraud, graft and outright theft, but you are fine with that. You also seem to be fine that you good ol boys bungled Afghanistan. And cratered the economy so badly we’ll be lucky if this isn’t called the Greater Depression. Nope, no responsibility there either! Its all scary brack man’s fault.

    Here is another back-o-the-cocktail-napkin way to fund the roughly $100B cost of providing healthcare to all Americans: estimates are that the total output of the US is $20T per year of which we currently spend about 10% on healthcare for 80% of our population for a total of $2T. I’ve read that roughly 30% of every private healthcare dollar goes to ‘overhead’ and profits. So if we spend $2T on healthcare and $1.5T is private (lets say Medicare/Medicaid is roughly $500B for our cocktail napkin calc) save all of that 30% and you’d have $500B, save just 6% and you’d have enough to fund that $100B.

    Instead the lunatics are babbling about ‘death panels’ and ‘fascism’ and ‘tyranny’ and ‘socialism’ and ‘naziism’ ad nauseam. Instead the wingnuts are bringing AR15s to townhalls. Enough is enough. We can do better than France, better than Canada (my apologies NL and knarls=) better than the dozens of countries that spend less, have better care and cover everyone. Right now we are not. There I go again, using facts instead of right wing nut job bullshit.

  154. shcb Says:

    Good to see the old Enky is back, I was getting worried.

  155. knarlyknight Says:

    “Why do we spend several times more than other countries, yet get middling poor healthcare outcomes?” you answered your own question Enk, it’s because 30% of your health care dollars go to admin expenses and duplication of overhead (compared to less than 2% in Canada) and because all those people who don’t go to a doctor or a hospital because they fear the costs become breeding grounds for influenza and other diseases.

  156. shcb Says:

    We don’t spend several times more and the 30% is wrong as well, but it won’t do much good to discuss it with enky. I’m guessing your 2% is wrong as well.

  157. knarlyknight Says:

    shcb, I checked te source from which it appears that those figures were presented in the video provided earlier, and you are right it’s not 30% (actualy it is 31% administration costs for the US system.)

    You’re also right in that the 2% figure I provided for Canada is wrong, it is 1.3% but that’s an orange to the 31% apple: the comparable number for Canada is 16.7% or roughly half that of the USA. The 1.3% figure was solely the overhead attributable to Canada’s national health insurance program.

    Bottom line is that American admin costs for health care are twice that of the government run progrm in Canada.

    Those results were from a stud almost ten years ago now, I’d bet with all the Canadian health service INNOVATIONS and streamlining of the Canadian system over the past ten years through our process of continuous improvement that the gap in overhead costs have widened even more since then.

    Source:
    http://content.nejm.org/cgi/content/full/349/8/768?excludeflag=TWEEK_element&sortspec=Score%2Bdesc%2BPUBDATE_SORTDATE2Bdesc&hits=20&where=fulltext&andorexactfulltext=and&FIRSTINDEX=0&resourcetype=HWCIT&searchid=1&searchterm=woolhandler&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

  158. knarlyknight Says:

    Also shcb, your blah blah blah about competition in the USA health system fostering more innovation is BS. In a prior link I provided evidence where the number of new drugs developed by regulated European pharma firms was about (if memory serves, and I think it does) 187 in Europe compared to about 150 something in the USA over the same relatively recent multi year time span (5 years?) and the note was that a large portion of the US drugs were variants on existing ones (i.e. improvements or alternatives) whereas the European drugs introduced were more often what could be described as breakthroughs i.e. innovative. And that’s just an example. If you want to keep throwing out the BS that the rest of world depends or is somehow parasitic upon Americas medical innovations you’d better get some decent data to back up it up, because from where I sit it seems that America is coasting along just fine in terms of medical breakthroughs and the rest of the world is contributing at least as much and probably signifacntly more. Where America excels is in finding ways to deny insurance coverage to those who thought they had good insurance, i.e. short term profits for the Execs to get their big bonuses. That’s where your loyalties seem to lie.

  159. Smith Says:

    “If you don’t like fascism would you prefer me to call the regulation of private industry by government to the point of private ownership being only an illusion as neo-socialism?”

    I’d prefer that you call it corporatism, since that is what you are actually describing. Extreme nationalism and rigid social controls are necessary elements of fascism, in addition to the economic aspect. The economic aspect of fascism is corporatism. You cannot have fascism without having all aspects of it.

    Claiming something is fascism just because it has an arguably similar economic system, is like pointing at a Chevy 427 engine and calling it a Corvette. While 427s were available in Vettes, the engine alone is not a Vette, and the 427 was available in other cars too.

    I’m guessing you don’t like saying “corporatism” because it lacks the power of “fascism,” but you really should strive for accuracy rather than emotional impact if you want to have an intelligent discussion.

  160. shcb Says:

    Knarly,

    That is kind of what I thought you would find in the Canadian number. My concern with the 30% number is that last week (early this week?) people were touting that number as 15%, they were aghast that 15% of medical costs were due to profit and overhead, now it is 30%? My God man, something must be done, the profiteers have doubled their larceny in one week! As you know, you would have to see what is in both those figures, just as you found the problem with the Canadian numbers.

    It would probably be difficult to come up with a direct comparison. For instance, take a doctors’ office in the US and a similar one in a socialized system, in the US a doctor has made more money that he spent paying himself, his nurses, rent, utilities etc. that is profit, after a few years he takes that accumulated profit and buys an x-ray machine. So was the money he made those years profit? Yes it was, it showed up on his tax forms and was taxed as such. In the socialized system the doctor opens the business, the government pays him and his staff and reimburses him for other expenses, at some point he asks for an e-ray machine, the government agrees and procures one for him. No profit was made but the outcome was the same, the rent was paid, the doctor and his staff were paid a new x-ray machine was installed. I don’t put much stock in the demonization if profits.

    Smith,

    Corporatism, learned another new word today. Looking at the Wiki definition I don’t think that is quite the right word. It seems you could use corporatism in a free market or socialist system. Anyway it seems corporatism relatives more to who is controlling government that what government is controlling. I’m looking for a term that differentiates between these two types of government.

    a) A government that controls many or most aspects of people’s lives by taking large amounts of their income and redistributing it to everyone else, virtually owning many industries, Mexico’s oil industry for example.

    b) A government that allows private ownership of companies but so heavily regulates them that ownership is only an illusion. Profits are limited, methods of production are limited, many times even the output of the industry is regulated.

    From what I’ve read corporatism could be the front end of either of those governments.

  161. knarlyknight Says:

    shcb,
    The overhead 31% figure for US vs. 16.7 % for Canada apples to apples comparison is from a 1993 New England Journal of Medicine paper. If you want to ignore that because of some vague reference you heard somewhere on Faux news or Rosen or wherever then that’s your willful ignorance and your loss.

    Also, your imagination is running away from you again, but at least your description of how Dr.’s work in Canada was good for a chuckle and an eye roll. At least that provided a sense of where your prejudice against universal medicare come from: misconceptions.

    First off, in general Canadian Dr.’s run their practice much like a business too – paying the same sorts of overhead as you described for the US Dr’s (nurses, rent, utilities, etc.) The main difference is that they can only bill the health system for set guideline fee amounts negotiated collectively to the point where physicians are satisfied. Also, like in the US they can see as many patients as they like, up to reasonable maximums (e.g. I don’t know maybe a max of 8 patients per hour)

    By the way, some medical specialists & dentists are allowed to charge their patients more than the set guideline fee amounts, in that case the patient has to pay the difference. In that situation the patient can look for an alternative provider who does not charge extra. Haven’t run into the extra fees situation much & don’t konw the particulars but it doesn’t seem to be a problem.

    If a Doctor wants to buy a piece of equipment and has staff qualified to operate it that’s normally not a problem. In the case of an X-ray machine, the real issue is why in the world would a Dr. bother to make such a big investment if there’s a medi lab on another floor or just down the street? If every doctor’s office or many of them in a medical building bought their own x-ray machine for use by their own patients, isn’t that a gross underutilization (i.e. waste of resources) if all that’s needed is one machine for every ten or 50 or whatever doctors? That may be one reason for the excessive overhead costs in the USA of 31% – redundancy and high idle rates for capital equipment.

  162. shcb Says:

    Thanks for that Knarly, I purposely didn’t name Canada, in fact I erased Canada and changed it to a more generic socialized system because I don’t know the particulars of the Canadian system but I think what you described is close enough to my description. You just ticked off all sorts of restrictions by government that make your system the poster child for what I have am calling neo-socialism (formerly referred to as fascism, but that has ruffled some feathers). The government doesn’t own the doctor’s office they just tell him what he can do and how much money he can make.

    One possible reason for a doctor to want his own x-ray machine would be someone like my knee doctor. Sure there is a perfectly good department full of gear and staff up the street at St Anthony’s North but you have to fill out a bunch of paper work, wait for an hour, wait a couple days for the results etc. with him owning his own machine he can have a look in just a few minutes. Most of his patents need an x-ray as opposed to my GP that maybe has one x-ray done a day, just guessing. Ditto the MRI in the basement of his building. Great service, no waiting, we’re going to miss that if this plan goes through.

  163. NorthernLite Says:

    The US spends more in healthcare administration costs than most countries spend on providing care for their entire populations.

    If you can’t pass meaningful reform, the existing duplication of exorbitant administration costs among hundreds of U.S. health insurers will remain, along with the necessary profits that private insurers must generate for shareholders – neither of which contribute to Americans’ health.

  164. shcb Says:

    …and replace it with the efficiencies of government? There is an oxymoron.

  165. NorthernLite Says:

    Well, governments around the world are more efficient at administering healthcare than your private insurers are. They spend a fraction of what you do, cover everyone and live longer. Weird eh?

  166. knarlyknight Says:

    Wait for an X-ray? That’s ridiculous. I’ve had lots of X-rays in Canada and never had to wait more than about ten minutes. Again, you are arguing with your emotions and biases without any grounding in fact.

  167. NorthernLite Says:

    There’s nothing stopping a doctor up here from purchasing their own equipment. We have plenty of private clinics here and in fact I use one my myself. Private clinics delivering publicly-funded services. Works well.

  168. knarlyknight Says:

    shcb said, “The government doesn’t own the doctor’s office they just tell him what he can do and how much money he can make. ”

    That’s both ridiculous and for all practical purposes utterly false.

  169. shcb Says:

    The government doesn’t own the doctor’s office they just tell him what he can do and how much money he can make.

    The main difference is that they can only bill the health system for set guideline fee amounts negotiated collectively to the point where physicians are satisfied.

    hmmm, who are they negotiating with?

  170. knarlyknight Says:

    Basically, the representatives of the doctors negotiate directly with the representatives of the patients. Fee rates are determined for each procedure.

    That is far more efficient than the worst case USA scenario. That can be characterized as each and every doctor having to negotiate with each different insurance company for every different procedure that he/she performs on on each individual patient. Yikes.

    Doctors incomes are determined in Canada mainly as a result of how efficiently they can run their practice. In the USA it would seem to be more of a function of which doctors can find the richest patients and charge the highest fees.

  171. shcb Says:

    and the representatives of the patients is the government.

  172. knarlyknight Says:

    For the purpose of establishing fees, of course it’s government.

    For the purpose of patient well-being etc. a patient can represent himself or choose among other entities that serve to represent patient interests.

    For the purpose of establishing fee levels, why would the patient representatives be anyone other than the payor of the fees/salaries ?

    By the way, it’s not the federal government it is the provincial government that represents the patients. So there are multiple fee levels in Canada for doctors. (In the end, the provinces have a strong interest to keep fees paid to Drs competitive or else they start to lose doctors to other provinces, or to the USA.) Any impasses in negotiations are normally resolved by neutral third party binding arbitration (there may be other mechanisms too.) That helps keep the system honest.

    Contrast that to a rigged system where rich patients (i.e. people who may be severely disabled in their ability to negotiate due to acute or chronic sicknesses) have to waste energy during such a difficult time (e.g. maybe they are expecting to die) in order to search out and/or negotiate for the best price / service option with insurance providers / a myriad of doctors.

    That made in the USA formula is perfect for facilitating extortion of the patients and thus maximize insurance company profits and doctor fees.

  173. shcb Says:

    (In the end, the provinces have a strong interest to keep fees paid to Drs competitive or else they start to lose doctors to other provinces, or to the USA.)

    not once their isn’t any competition in the American system

    That’s both ridiculous and for all practical purposes utterly false

    But it does seem like I have a pretty good handle on how your system works, the government controls the industry whether through socialism or neo-socialism

  174. knarlyknight Says:

    Wrong, there’s still sufficient competition among the Canadian provinces even if we exclude the US for the equation. Besides there are always other places in the world that provide high priced Doctors for comparison (e.g. Bermuda, Kuwait, etc.)

    And wrong, it seems like you have a lack of understanding like to a bigotted cartoon character. I’d say there is a nice balance beween controls on price gouging and the freedom of doctors to practice as they wish, where they wish and how they wish (within basic safety limits to prevent quacks).

  175. shcb Says:

    Sufficient competition and nice balance … are of course subjective, you coming from the far left in our country and I’m guessing the moderate left in yours responding that way about a socialized system sounds reasonable.

    So let’s see, the federal government decides how much it is going to budget to healthcare this year, they balance the needs of the people in health care with all the other needs, roads, defense, welfare etc. They also balance this against how much they can charge in taxes and still get elected and all the special interest groups needs. Then they send varying amounts to the provinces based again on needs and political considerations. Then the doctor’s union, under government supervision divides up that pie and decides how much each procedure will cost and how much each doctor will receive for his services regardless of the skill level or experience of the doctor. And you call that a competitive market?

    Now make no mistake, many of these same mechanisms are in place in the competitive market as well, those pressures just tend to come from both sides of the equation more so than in a socialized system. In a socialized or neo-socialized system most of the cards are being dealt by the government, they say, this is what you have to spend, period, ration, do whatever you have to do but that’s all you get (unless there is a chance we are not going to be reelected, in which case we’ll raise taxes or go in debt). In a competitive market the price is set by how much someone is willing to pay and how much someone is will to sell, nothing more.

  176. enkidu Says:

    Funny.

    Funny how wwnj isn’t dead set against some of these essential services:
    - defense (hey let’s privatize it entirely!)
    - fire fighting (sorry, we don’t cover brush fires that are consuming your home)
    - police (roving bands of thugs for hire, that’ll end well)
    - postal service (socializm!)
    - coast guard (don’t you mean Communist Red Guard?!?!)
    - water treatment (who needs clean water, bah!)
    - and to a lesser extent power generation, roads etc etc etc

    Funny that we weren’t hearing howls from the far far right (exemplified here by our dear douchenozzle wwnj) when we invaded the wrong country? Oh wait, it was the numbskull that wwnj voted fer so everything he did was just fine and anything bad wuz them dang liberals fault. also.

    Funny yet common delusion amongst reich wing nut jobs that the rest of the world is just a bunch of leeches and parasites on the giant that is America. Funny how the other advanced democracies can cover ALL their citizens, but the greed, stupidity and partisan foolishness of our system can’t seem to cover the 15% (and growing) of our people who don’t have healthcare.

    Funny, we could sunset the bush tax cuts for the wealthiest and we could pay for the uninsured several times over. Or just squeeze a few percent of the greed (oops profit) out of the damned insurance industry. An MRI in London costs about £200 for a head exam with contrast. Here it varies widely and can be anywhere from $2500 to $5000 and up. Same equipment, same diagnostic ability. Just a hell of a lot less waste, inefficiency and greed.

    wwnjs are for doing nothing (or more giveaways and tax cuts wheee!) while sane folks are interested in cutting costs and covering everyone. The moral choice is pretty clear. Unless you are a partisan douchenozzle.

  177. shcb Says:

    There are some things that make sense to have government either socialize or neo- socialize even though it is less efficient, the inefficiencies are just a necessary evil. Health care isn’t one of them.

    - defense (hey let’s privatize it entirely!)
    - fire fighting (sorry, we don’t cover brush fires that are consuming your home)
    - police (roving bands of thugs for hire, that’ll end well)
    - postal service (socializm!)
    - coast guard (don’t you mean Communist Red Guard?!?!)
    - water treatment (who needs clean water, bah!)
    - and to a lesser extent power generation, roads etc etc etc

    the government postal service has served it’s purpose and should go away, emergency services and the military (including coast guard) should be handled collectively, socialism is ok there, and utilities and roads should be handled in a neo-socialistic way like they are for logistical reasons. Roads are competitively bid by contractors for construction and the maintenance handled by government employees, so we have a combination of free market and socialism there, and that seems to work well.

    No system is totally socialistic, neo-socialistic, or capitalistic, it is a matter of degree.

    I didn’t read the rest of your rant, hope there wasn’t anything important in it.

  178. knarlyknight Says:

    Enk, so true.

    But you forgot torture: recent revelations make a joke of shcb’s adament claims that Abu Ghraib was the result of a “few bad apples.” That demonstrates that his abililty to discern obvious implications from ample evidence is seriously skewed to the wrong.

    So its no wonder that all attempts to inform shcb about the differences between universal medicare vs. private health care fall on deaf ears and the original prejudices remain.

    Someone should make a list of points raised in this thread, e.g.

    American Private Health Care
    – Pros:
    + Drs. can fleece patients at will, make obscene profits off of the sick
    + Insurance companies can make big profits for thier execs.
    + Politicians can get elected on promises to reform the system
    + Politicians gain big $$ from lobbyists for reneging on promises
    + If you can pay for the service, and qualify for it, the service is good.

    – Cons:
    – Health outcomes of population is poor
    – Many people suffer due to inadequate access to services
    – People think they have good insurance coverage, only to be denied the coverage when needed. (see Sicko)
    – Inefficient… high overhead due to duplication of administrations and redundancy of capital equipment leading to under-utilization
    – Premiums keep going up

    Universal medicare (e.g. Canada)
    Pros:
    + no surprise fees, no price gouging by doctors/hospitals
    + no unnecessary suffering – everyone is covered. No Stress.
    + Efficient design, incentives to cut costs
    + Everyone enjoys pre-set standards of service that are at least adequate and that are often great.
    + Premiums (and % your of tax dollar going to health care) are relatively stable

    Cons:
    – no chocalte on your pillow in the hospital.
    – difficult to “opt-out” for those who do not want/need health insurance
    – few opportunities to make obscene profits by exploiting the sick
    – Americans and other nationalities try to take advantage of services without propoerly contributing to it (e.g. those with pre-existing conditions who can’t get private US insurance may enter into marriages of conveniences for citizenship to qualify for Cdn medicare.)

    etc. etc.

  179. leftbehind Says:

    Again, not taking sides, Knarly, but your latest analysis of the Canadian Health Care System sounds more like you’re over-selling Canadian Medicare just to win an argument with SHCB. Your earlier comments (towards the top of the thread) were much more balanced between pros and cons of the system, and were thus were a lot more convincing.

  180. leftbehind Says:

    Why do Americans who want Single Payer Health Care in the U.S. always use the Canadian system as a model, anyway? It’s not all that much better than what we have here. Neither system even made the World Health Organization’s top 25 Health Care systems. Wouldn’t the French system, which the World Health Organization calls the number one health care system in the world, make a better argument for Government run healthcare than Canada, which is only seven points above the U.S. and 25 points below Malta?

  181. enkidu Says:

    lefty, it is called satire. And to answer your question, knarls and NL are from Canada. They have direct experience with their system (so have I btw). My wife is Canadian, her family is mixed American and Canadian. Our little nephew had open heart surgery to fix some valve problems and a hole that was mixing de-oxygenated blood with the freshly oxygenated blood from the lungs. He is doing great btw. Total cost. Nada. No insurance hassles, no getting kicked off your plan. Just world class healthcare without the greed.

    When I mentioned the surgery to my Mom, she went off on a foxnews fueled jag about “how terrible it is up there!” “they are all coming here for healthcare” and “Canadians hate their healthcare system!” After gently trying to dissuade her of these false claims, I just gave up and asked if we could talk about something else… sigh. We are getting a puppy! That was a good dogleg in the convo.

    My wife’s aunt was just diagnosed with cancer in Wisconsin: the tales of her struggles with the insurance company are quite the contrast. They were happy to take her money when she was healthy, but now that she is sick, there is nothing but trouble. And possibly bankruptcy in her future…

    I don’t think we need single payer (none of the proposals have single payer. none), but a public option would help clamp down on the greed. Sorry insurance industry, you blew it. buh bye

  182. Smith Says:

    I think it has less to do with those who want single payer in the US advocating Canada, and more to do with those who don’t want health care reform constantly pointing at Canada and saying “how terrible, we’re all gonna die if we have that system.” The right wing is much better at setting the parameters for debate in the US than the left is. I expect that most left wingers keep defending Canada because the right wing constantly uses it as an example of the inefficiencies of UHC.

  183. Smith Says:

    “none of the proposals have single payer. none”

    H.R.676. It seems to be trapped in committee, but it is a single payer system. I believe Sanders has a similar bill in the Senate.

  184. Smith Says:

    S.703 is Sanders version. It would be a state managed single payer system, or something along those lines.

  185. NorthernLite Says:

    To add to Smith’s point, I imagine that if the Dems were to start advocating a system like the French the R’s would be all over that, even though it is ranked best in the world.

    For some reason you guys seem to really hate the French, I guess for strongly opposing the Iraq War. We all know who got that one right though. Maybe they have HC right too? Sure seems like it.

  186. knarlyknight Says:

    Lb – yes, the Cdn system has faults but not anywhere close to what shcb was characterizing them as being, hence I probably over-reacted and agree I sounded like I was overselling Canadian Health system. E.g. my last post (pros & cons) was tongue in cheek, but at this stage in the thread it would be nice if someone put the points made both, pros and cons, for comparison.

    LB -re: your second post. Besides the obvious (Canada is a convenient comparison given its similarities with the USA in other respects) I’d guess the main reason is simply because the USA spends more than any other country on health care per capita whereas Canada is ranked number ten in spending per capita but achieves an outcome rank that is 7 points higher than the US. So it’s not so much that the outcomes are different, the value in comparisons to the Canadian system is to illustrate that there are better ways to allocate resources than to over-fund bloated, redundant and parasitic health insurance companies.

    If you want to talk about how the French system is superior to most, please do so.

    I’d be interested to learn if I would feel as compelled to defend (oversell) the Canadian example against a supposedly superior French system rather than (defend Canada health system) against nefarious claims that the private American system was better when it is clearly inferior.

  187. shcb Says:

    Does anyone know why the French health care is so highly rated? I’m not being coy here, I’m really curious. From the little I’ve looked at the WHO report it seems there was a disproportionate emphasis on the way health care was paid for (government provided vs the US system) than other factors. For instance the availability on the grounds of race, religion, sex etc. had one country, don’t remember which, first and the next 37 or so tied for second. The US was by far and away number one in meeting the needs of the patient and yet we were something like 39th place overall. Maybe I’ll go back and look at the report closer and see if they give a reason for France being first.

    Our dislike of the French goes back to the beginning of the country but I think the lack of thanks after WWII sort of solidified it, at any rate it goes back much further than this war.

  188. shcb Says:

    …and yet you said you don’t use the Canadian system without suplimental insurance for your own family.

  189. NorthernLite Says:

    Me? I don’t have supplemental insurance. Well I guess do for prescription drug and dentist coverage through my employer.

    My mom is a good, current, real life example of our system. Widowed. Not much money. Diagnosed with cancer 3 months ago. Just finished radiation/chemotherapy. Operation on Oct. 1 to remove tumour. Should be cancer free (fingers crossed) in a few weeks.

    Cost to her: none
    Number of “government bureaucrats” involved: none
    Wait times: none
    Satisfaction with doctors/nurses: extremely high

    Hell, she even got free rides to and from her treatments (I live far away and she’s in a rural town). And even though her treatments are over a nurse still comes to see her twice a week to check on her.

    System perfect? No. Is it saving my mother? Yes. Are we happy? Very.

    Still a little ways to go though.

  190. enkidu Says:

    thx Smith, I misspoke (miswrote?)
    I meant that none of the Dem proposals have single payer. Bernie is a good man, but he isn’t going to win this with his army of one (I).

    perhaps wwnj would like to read up a bit on the Revolutionary War? France helped us out iirc. As to WWII, they had WWI fought primarily on their soil. I can understand why they though they were secure behind the Maginot Line. That the nazis blitzed em with these newfanglty tanks n tactics is part of history. Mostly wwnjs don’t like France because they said the Iraq War was bullshit from Day 1. Reality is so liberal, eh?

    The french paradox may be due to the fact that they work less, have good healthcare, drink a lot of red wine, walk to market, and they make love with ze french mistress. Zat sounds like something to live for, no? Oui.

  191. shcb Says:

    NL,

    no, not you, Knarly said he wouldn’t use the Canadian system for his family.

    good to hear your mom is doing well.

    but the cost wasn’t zero, just current out of pocket cost.

  192. knarlyknight Says:

    Sorry shcb, I was a bit misleading about my extended health insurance that is provided to me as a mandatory employment benefit. If I had a choice, I’d proably not purchase extra-coverage except when travelling outside Canada.

    Universal medicare is actually sufficient for my needs in Canada.

    It’s difficult to determine what exactly the extended coverage pays beyond universal medicare, as the Manulife extended benefits package just explains total coverage including universal medicare as if they were providing all the benefits, i.e. they are sort of taking the credit for the benefits already provided under universal medicare. My guess is that the major items provided by the extended health plan (i.e. not covered under medicare) are: costs incurred while travelling outside of Canada including all emergency and some routine costs , extra dental coverage, private hosptial room, more drug coverage (e.g. brand name instead of generic), and the cost of an ambulance (the flat $50 per trip ambulance fee is not covered by BC’s medical plan). That’s about it.

  193. knarlyknight Says:

    FYI – Budget update day in British Columbia. As it’s relevant, heres a taste of BC life with respect to funding of our Universal health care in a time of budgetary crises ($2.8 billion debt expected) :

    “Even — or especially — in a time of crisis, the people of this province must have confidence the services they need will to continue to be there,” said Hansen. “And with this budget update, we are moving to ensure that the most crucial services are, indeed, protected.”

    The province’s financial strain appears set to trickle down to the pocketbooks of taxpayers.

    British Columbians can expect to pay more for health care — around $6 per family per month next year – as the province raises the Medical Services Program rate.

    The MSP increase of six per cent each year for the next three years will earn the province $400 million by 2011-12, money Hansen said will be used to help fund the province’s ballooning health care budget. The impact to low-income earners, such as seniors, will be offset by a new MSP assistance program, said Hansen.

    “MSP premiums currently account for about 10 per cent of health care costs,” said Hansen. “But rates have not increased since 2002 — even as provincial health spending has risen by 45 per cent. So this increase is reasonable. And, as always, we have built in protections for lower income British Columbians.”

    The MSP hike was quickly criticized by health care unions, which described it as another tax on patients.

    Health care funding, the province’s largest expense, will rise six per cent each year and largely maintains the level promised in the pre-election February budget.

    (Buy the way, the 45% increase in spending since 2002 is in large part due to ridiculous unsustainable cuts to health spending that the BC liberal government made in 2002 – so in large part it is just a return to status quo levels of funding after a few difficult years of adjustment within health boards, hospital administration, etc. (yes wait times were affected and the public screamed until that was fixed.)

  194. J.A.Y.S.O.N. Says:

    I think America had an excellent relation with the French up until the mid-20th century. “Lafayette I have returned” and all that. I really blame de Gaulle’s 5th Republic for souring American-French relations. The manner in which the US was rebuffed by France and the adoption of the stance of being a hostile competitor to the US stings in the American mind as a betrayal. I’m not saying right or wrong here, but thats just my historical analysis. Neither side seems willing to bury the hatchet as of yet.

  195. shcb Says:

    BTW – before you think I’m enamored by Canada’s health care system, please note that I am not. It’s more like a grudging acceptance of the least noxious of various unsatisfactory poor alternatives (i.e. private US health insurance companies.) I have a secret. It’s that my medicare coverage is beefed up by “extended health care” coverage from (gasp) private insurers paid by my employer. Had I, or one of my kids to get really sick and have to rely solely on the gov’t approved level of care, we might just choose instead to take a trip up north and set sail on a wayward clump of sea ice. It’s a secret because to admit that is to admit to a sort of snobbery in which one thinks they deserve better care than their fellow person, and that is anathema to our unwritten supposed principles as good Canadians.
    Time for another brew. G’night.

    My emphasis

  196. Smith Says:

    “I meant that none of the Dem proposals have single payer.”

    That’s incorrect too. The first bill I cited, H.R.676, was introduced by John Conyers Jr., D-MI.

  197. knarlyknight Says:

    Damn brew.

  198. knarlyknight Says:

    Maybe both our countries should look at France’s model.

  199. leftbehind Says:

    …or Italy’s or Malta’s, or Singapore’s. It strikes me that too much energy gets spent arguing the comparative merits of mediocre systems. Maybe that’s why the American public has not been more enthusiastic about Obama’s healthcare scheme; they are encouraged to look to Canada as a model and, yeah, it’s marginally better on some levels than the American system, but it’s not all THAT much better than what we already have and, compared to a lot of other countries (Oman? San Marino?) it’s way, way sub par. No disrespect, but I can’t help but feel that a lot of Canadians, for their part, are defensive of their Health Care system for no better reason than most Americans are protective of their own – it’s what they know, it’s what they’re comfortable with, it works for them most of the time and they’re not solicitous of abrupt change.

    On a similar note, Michael Kinsey has written a good op-ed in the “Washington Post” which you all should read:

    “The reason Americans have turned against health-care reform, after electing President Obama in part for promising it, is simple: Despite protestations to the contrary, Americans don’t like change. You wouldn’t know it, of course, if you listen to politicians in high-pander mode, or to talk radio hosts of the right or TV pundits of the left. Or, for that matter, if you listened to the president of the United States. You would think that while we might disagree about what kind of change we want, Americans are in total agreement that the current situation is intolerable in all areas and that change — big, immediate change — is essential. Americans do agree about this — in the abstract. But as soon as it seems that change might actually happen — as soon as we leave the abstract for the particular — we panic. We suddenly develop nostalgia for the comforts of the status quo. Sure, we want change — as long as everything can stay just as it is…”

    http://www.washingtonpost.com/wp-dyn/content/article/2009/08/27/AR2009082703254.html

  200. shcb Says:

    So many solutions, not just in healthcare but in other aspects of life as well, sound good in and of themselves but on further review they have too many unintended consequences or are difficult to implement. Take the MSAs I’ve been selling in this debate, they would be great, portability, ownership, etc. How do you get them started? Their success depends on there being a nest egg of a few thousand dollars to cushion normal doctor visits. The obvious place would be young workers that are still on their parents insurance. But how do you flip a switch and say we are going from whatever we have now to MSAs? It would be almost impossible to do.

    The Obama plan sounds great on the surface; I can have any procedure done for free. But we all know that won’t happen, we know how government works.

    We know there are problems with these socialized health care systems, so why are we trying to fix the system with the best care in the world by adopting a system with a different set of known problems. Try something new, or fix the minor problems in baby steps, but if you’re a politician you don’t get your name in the paper for baby steps.

  201. Smith Says:

    “The Obama plan sounds great on the surface; I can have any procedure done for free.”

    Has he proposed a new plan? The plan I have looked at promises no such thing.

  202. NorthernLite Says:

    shcb, I’m not sure what knarly was trying to say there. He can spend all the money he wants on private insurance but it’s not going to get him treated any faster or any better than anyone else here. People here are treated based on the seriousness of their illness – not by their ability to pay out of pocket. That’s a violation of the Canada Health Act. If people feel they need to pay out of pocket to ‘jump the line’ then they can go south and do it, which some do.

    A lot of people do have extended insurance for things like he mentioned (out of country travel, private hospital rooms, enhanced drug coverage).

    Does the US provide free flu shots every year? Or do you have to have insurance to receive one?

  203. leftbehind Says:

    Flu shots down here can be had with insurance, or paid for on-the-spot (cash, check or charge) by the customer. I’m sure there are myriad programs providing shots for those who don’t have either the insurance are the cash.

    In regards to your last post – if treatment is provided on the basis of how serious your illness is rather than your ability to pay, who decides how serious your illness is? Based on what criteria? Who decides how far back in the line you are? Does the government’s ability to pay for a certain procedure at a certain time have any bearing, even if the patient’s ability to pay does or not?

  204. leftbehind Says:

    …and are flu shots free in Canada, or are you paying for them through your taxes, rather than paying on site?

  205. NorthernLite Says:

    LB, doctors decide your treatment based on your sickness, based on their expertise as a doctor.

    And it’s not like it ever gets to the point where “oh, we’re out of money, sorry, you’ll have to die.” Money never runs out, if we need more cause more people are sick, we spend more. Still, just a fraction of what you spend per person.

    Yeah, flu shots (and various others) are free (covered).

    I think that’s another aspect of the debate that seems to be getting overlooked – prevention. When the government has a stake in your well-being, they tend to (ours anyways) focus a lot on preventitive measures (stop smoking programs, immunizations, banning trans fats, etc.) to keep us healthy.

  206. leftbehind Says:

    So everyone gets the care they need, as soon as they need it, and money is almost never a problem, correct?

  207. NorthernLite Says:

    I think that’s fair to say. That’s been the experience of me and my family. The “money is almost never a problem” statement may not be the right thing to say, money can be a problem, as knarly said above it looks like BC needs to raise more money for their health services in that province. What I was getting at is that nobody is ever denied the care they need because the healthcare account is ‘empty’. Just doesn’t happen that way.

  208. leftbehind Says:

    But, money aside, if it’s fair to say that every Canadian gets what they need in a timely fashion nearly every time they call on Medicare, then why is Canadian health care rated only 30th in the world by the World Health Organization? Isn’t a health care system that does that good a job providing top notch care for over 33,000,000 people worth more than whatever’s going on in Andorra? France provides healthcare for nearly twice that many people, and was ranked number one to Canada’s number thirty. Why? What’s Malta doing that you guys can’t?

  209. leftbehind Says:

    …and where does the Canadian Government get the money to pay for your shots?

  210. NorthernLite Says:

    I have no idea man. Like I said, I’m just basing this on my and my family’s experiences and what I know of our system. I have no idea why those others are ranked so much higher than us (both CA and US) as I’m not familar at all with the ranking process and the criteria/measurements used.

    Immunizations are funded just like any other government program – through taxes.

  211. NorthernLite Says:

    Now I see that the WHO is longer going to rank health systems because of “the complexity of the process”. Go figure.

  212. leftbehind Says:

    So the shots aren’t free, you’re just paying for them in advance before you go get them, whether you actually get them or not, right?

    Look, I’m not trying to bust your chops here, I’m simply asking questions that anyone should ask when someone tries to sell them anything, and I think that, in defending Canadian Healthcare against SHCB, you’ve become a salesman for it and you’re not presenting a fair portrayal of the reality of the system. I’m glad your personal experience with Canadian Medicare are good – I wouldn’t wish any less for you. Despite your anecdotal testimony however, the numbers (W.H.O. ranking, patience satisfaction statistics – I’m sure there are more) don’t add up to the picture you’re trying to paint.

  213. Smith Says:

    “So the shots aren’t free, you’re just paying for them in advance before you go get them, whether you actually get them or not, right?”

    You also pay for roads in advance whether you use them or not. While your assessment with regards to taxes is true, it is not really representative of how the average person evaluates the costs associated with their use of government provided services. You rarely hear people complain about how much they had to pay to drive down the highway, unless their is a toll associated with it. In general, tax funded services that incur no costs at the time of their use are typically treated as free when people choose to speak of them. I have no qualms with being pedantic, but I really don’t think you are demonstrating much with that line of argument. The fact that government programs are funded through taxes should not be news to anyone (with a possible exception for “cut and spend” Conservatives).

    Additionally, the US already uses tax money to pay for health care costs under the current system, more so than Canada. So, in a sense, you are still paying for that flu shot under the present US system, even if you don’t get it. And if you do get it, you get billed for it again.

  214. NorthernLite Says:

    Oh no worries, I’m not taking it like that at all. I’m not trying to sell anything though… I’m here to defend my system against gross misinterpretations by the American right :)

    So you pay a monthly insurance premium (which btw I’m still wating for you folks to tell me how much you pay per month) and then if you want a flu vaccination you have to pay on top of that, out of your pocket? Is that right?

  215. leftbehind Says:

    I’m not the one trying to tell everyone I’m getting shots for free when I’m not, am I, Smith?

  216. leftbehind Says:

    NL – I pay for my flu shot the same as you do, from the sounds of it. The only difference is, I pay upon receipt of the shot.

  217. Smith Says:

    “I’m not the one trying to tell everyone I’m getting shots for free when I’m not, am I, Smith?”

    You seem to have overlooked part of my comment in which I discuss the common use of “free” with regard to government funded programs. I have reposted it here for your convenience, LB.

    “You also pay for roads in advance whether you use them or not. While your assessment with regards to taxes is true, it is not really representative of how the average person evaluates the costs associated with their use of government provided services. You rarely hear people complain about how much they had to pay to drive down the highway, unless their is a toll associated with it. In general, tax funded services that incur no costs at the time of their use are typically treated as free when people choose to speak of them. I have no qualms with being pedantic, but I really don’t think you are demonstrating much with that line of argument. The fact that government programs are funded through taxes should not be news to anyone (with a possible exception for “cut and spend” Conservatives).”

  218. leftbehind Says:

    ..and not to be rude, but it isn’t much of your business how much I pay for my insurance. National averages are available online, and more can be gathered from them than anything I can tell you.

  219. leftbehind Says:

    Smith – either the shot is free or it’s not. You can talk it to death all you want, but it’s a lot simpler than you’re trying to make it sound. NL said he got free shot and he doesn’t.

  220. Smith Says:

    For someone who claims not to be taking sides in this discussion, you seem to be getting awfully worked up over it, LB.

  221. leftbehind Says:

    ..which strikes me as particularly disingenuous, Smith, considering he is attempting to persuade others to action based on the information he provides. Don’t you think that if someone is attempting to encourage someone else to pursue as important a course of action as the adoption of a health care system, he should at least be asked to clarify the difference between somthing that is free and something he pays for? Or do you?

  222. Smith Says:

    “NL – I pay for my flu shot the same as you do, from the sounds of it. The only difference is, I pay upon receipt of the shot.”

    A more accurate statement would be that you pay for it the same way NL does (through taxed-based government subsidies) and then also pay for it again out of pocket and/or through insurance upon receiving the shot. The US government does pay for health care under the current system, which is a simple truth you seem to be glossing over.

  223. leftbehind Says:

    I’m asking questions, Smith, as well as playing a healthy bit of Devil’s Advocate. Does that bother you?

  224. Smith Says:

    How much do you pay for the roads you drive on?

  225. Smith Says:

    “I’m asking questions, Smith, as well as playing a healthy bit of Devil’s Advocate. Does that bother you?”

    And I am clarifying the actual costs of your flu shot under the current American system. Does that bother you?

  226. leftbehind Says:

    I dunno, how much do you pay?

  227. leftbehind Says:

    …and the cost of the flu shot is hardly the point here. The point is whether or not either NL or I are getting anything for free and neither of us are. He said he was, I’ve never made any such statement. Or have I?

  228. Smith Says:

    So, you mean that you don’t consider the amount of your tax money that is spent on roads when you think about your transportation costs? It is almost as though you are treating this government funded service that you pay for with your taxes as though it is free. How strange. Surely it is not the case that “free”, when applied to government services, is generally intended to mean that no additional fee is levied at the time of use. I mean everyone always considers tax funded government expenditures when calculating how much they spend per month, right?

  229. leftbehind Says:

    Maybe you can answer a question for me, Smith. Given the current debate regarding Canadian-style healthcare versus the American system, shouldn’t defenders of the Canadian system be asked to defend that system as vociferously as any defender of the American model?

  230. shcb Says:

    From what I’ve seen the flu shot you pay for is because of the convenience of getting it in the grocery store or for a nurse come to your place of work, it you want it covered by insurance you can go to your doctor and get it. I think the flu shot is a special case that really isn’t a good example of either system. Also, you don’t have to get so off topic as using roads as an example. If I don’t get a flu shot or a hip replacement I have in some manner still paid for it whether an insurance company pays for it using my premiums or the government pays for it using my taxes.

  231. shcb Says:

    nothing is free

  232. leftbehind Says:

    The great sage falls silent

  233. shcb Says:

    I was reading a little of the 2000 SHO report, and unless I read it wrong they said the ranking could be off by as much as 80%, then what is the point? I guess that is why they aren’t going to rank anymore. There is a lot of good information in the WHO report but an actual rank depends so much on your objectives and philosophy. I think they are doing everyone a service by just getting the data and letting others decide what to do with it.

  234. Smith Says:

    shcb,

    “If I don’t get a flu shot or a hip replacement I have in some manner still paid for it whether an insurance company pays for it using my premiums or the government pays for it using my taxes.”

    I actually mentioned the tax part of this twice, but LB seemed less than interested in discussing it. The road discussion was intended to address the difference sense of “free” and “cost” used when most people think about their personal use of government provided services. Oh, and I was inspired to use roads in particular because they were brought up earlier in this discussion. And yeah, flu shots probably aren’t the best representative of health care.

    “nothing is free”

    I agree with this, at least in the true sense of “free”.

    LB,

    “shouldn’t defenders of the Canadian system be asked to defend that system as vociferously as any defender of the American model?”

    From quickly scanning over this thread, I really can’t find any example of you asking someone to defend the American model. It seem to me that, despite your persistent claims to the contrary, all of your comments have suggested that you are, in fact, taking sides against the Canadian model. If you are going to take a clear side, you should embrace it, rather than making the rather disingenuous claim that you are positioning yourself outside of the debate. I still don’t see how your laboring of the point that the government pays for things with taxes in any way challenges the Canadian model. It seems like pedantry for the sole purpose of scoring cheap points. You also seem to bristle at my attempt to make an equally pedantic argument against your “point.” You can’t use such a pointless tactic to make your point and then get annoyed when someone else uses a similar form of “debate” against you. So, either you can introduce pointless semantic debates sparked by asking questions to which you and everyone else already knows the answer, or you can avoid such nonsense and engage in an honest debate in which you clearly state the side you are so obviously taking. You seemed to use data to make your points earlier in the discussion. Perhaps you should try doing that again, it makes for a much better discussion. And cut the “I’m not taking sides” garbage.

  235. Smith Says:

    “The great sage falls silent”

    How dare it take me more than 5 minutes to respond to your valuable insights. It is not as though I have anything better to do than spend my whole day ensuring that I am able to promptly respond to your nuggets of wisdom. You’re going to be really disappointed soon, because it is quite late in the part of the world in which I currently reside, and I shall be going to bed very soon. Try not to cry too much while I am gone.

  236. leftbehind Says:

    Smith – I don’t to ask anyone to defend the American model here. The only person who’s defending it is SHCB and he’s been roundly challenged by everyone else. Or don’t you think so? And since when is questioning the Canadian system a defense of the American system? Are the Canadian and American systems the only models around? If so, we really need to find Door Number Three, and fast. Maybe it’s in Malta…

  237. leftbehind Says:

    …and don’t worry, I don’t think I’d ever mistake you for a “great sage.” You’re good, but if you were that good, you’d have come up with better than you have.

  238. leftbehind Says:

    In what part of the world do you reside, Smith? How many levels above Canada is your health care system?

  239. NorthernLite Says:

    Actually I said “flu shots are free (covered)”. Those were my words, meaning that it is covered by my plan – taxes. I agree, free is the wrong word to use, but I did qualify it with (covered).

    Look, I only jumped into this debate when my country started being targeted, which I found absurd because although our system is far from perfect, it ranks higher than the US, we live longer, spend way less and everyone is covered. If you look back through this site, you’ll see that’s when I jumped in and that’s been my defence all along.

    I’m not trying to sell anyone anything, like I said: I’m defending my country from some really wild misinterpretations.

    So I guess this is what I’m taking from this discussion:

    I pay my taxes and all my health care is covered.

    A US citizen pay taxes, insurance premiums and sometimes also out of pocket for health care.

    I also note a little bit of agitation when I ask to know how much health insurance premiums are. Sorry I’m not trying to be nosey and I know that’s personal information, but please know that it was a genuine question so I could try to understand your system and its costs a little bit better. But I’ll look up the average premiums on the Net sometime.

  240. leftbehind Says:

    That’s all very genuine, and I’m sorry that I came off the way I did.

  241. shcb Says:

    I’ll look at a pay stub tonight and let you know what my part of the premium is, as I recall it is around $200 or $250 per month for the three of us for health, dental, drugs and a small life and disability plan. For that we have a $10 copay, $5 copay for drugs, and things like prventative dental (every 6 month cleaning) and preventative physical once a year free (no copay, don’t jump on me).

    A crown on a tooth is about $300 out of pocket, the cost of my daughter’s wisdom teeth removal was nothing out of pocket (I don’t know why). I don’t recall paying anything out of pocket for the few operations we’ve had, a gall bladder removal, two ortho knee operations and one hernia. Those are all pretty minor with the gall bladder the only one that required an over night stay if we paid anything it was in the very few hundred dollars or I would remember.

    I do have my policy in my brief case, I made the joke the other day that it would probably be there until my next of kin cleaned out the case. Might be a good reason to look it over and see what coverage I actually have.

  242. shcb Says:

    I have no idea what my employer pays

  243. shcb Says:

    Smith,

    I was coming to your defense on this one, we’re on the same page.

  244. NorthernLite Says:

    And I’ll admit, I do pay a lot in taxes every month.

  245. shcb Says:

    we all do :-)

    but what the hell, you would just drink it if it weren’t going to taxes

    BING!!!

    we should socialize the liquor industry!

  246. knarlyknight Says:

    shcb – bada bing. You mean you should socialize America’sliquor industry. Canada’s has been government controlled for eons.

    It’s a cash cow; the high prices are more than enough to drive a person to drink (tea). Some provinces now allow private liquor outlets to operate in “competition” with government liquor stores. These private stores buy the liquor from the government at regulated (high) wholesale prices, generally offer more convenience (better hours, more cold beer), & pay their employees less than clerks at the government stores but …wait for it … they are not allowed to sell the liquor at prices below that charged in the government stores. Hence, we have a healthy U-brew industry for beer and wine.
    For more on socialized booze, go to: http://www.bcliquorstores.com/en/about

  247. shcb Says:

    200 for the whole provence? I have the choice of 4 on my way home (going two different directions), I only live about 10 miles from the plant and half of that is dirt roads.

    Sounds like Utah, at least in the past (haven’t been there for a while) all the “package stores” were owned by the state and you had to have a friend in town or a secret decoder ring to find them.

  248. knarlyknight Says:

    A few comments…

    LB – you ask “But, money aside, if it’s fair to say that every Canadian gets what they need in a timely fashion nearly every time they call on Medicare, then why is Canadian health care rated only 30th in the world by the World Health Organization?” The answer is that it is ranked 30th out of 191 countries, or in the top 15 percentile. That’s not bad, that’s good. (True, the USA at 37 is not far behind. At that point you can’t ignore the money aspect any more, it is the key issue, as in: Why do Americans spend about 3 times more per capita for a lower outcome?)

    LB – you asked: “France provides healthcare for nearly twice that many people, and was ranked number one to Canada’s number thirty. Why?” I think it’s because they drink more red wine. However, this 1993 paper provides a more detailed overview of France’s system back then:
    http://content.healthaffairs.org/cgi/reprint/12/3/111.pdf Here’s an excerpt from the conclusion:

    The French consult their doctors more often than Americans do, are
    admitted to the hospital more often, and purchase more prescription drugs.
    Despite wide disparities among French social classes in mortality and in
    patterns of medical care use, when judged on basic outcome measures (life
    expectancy and infant mortality) and polls of consumer satisfaction, the
    French health care system comes out ahead of the U.S. system.
    French national health insurance allows for free choice of providers and
    clinical autonomy of physicians even more so than in the United States.
    French physicians are never asked to play gatekeeper functions and are not
    subject to the kind of utilization review and quality assurance bureaucracy
    that has transformed the working lives of American doctors. But this
    freedom has at least two consequences. First, for patients, direct payment
    for most ambulatory care, the growth of extra-billing, and out-of-pocket
    payments amounting to almost one-fifth of personal health care expenditures
    are the quid pro quo for universal national health insurance with no
    restrictions on patient-demanded services. Second, in exchange for more
    clinical autonomy than American providers now enjoy and a national
    health insurance system with universal coverage, French physicians and
    other providers have learned to live with lower prices and lower incomes
    than their American counterparts receive.

    LB – you accuse NL: “Despite your anecdotal testimony however, the numbers (W.H.O. ranking, patience satisfaction statistics – I’m sure there are more) don’t add up to the picture you’re trying to paint.” That is wrong. The WHO numbers (look at each individually, they’re consistently in the top 10 or 20 percentile ) show Canada’s results to be very good compared to the other countries and we beat the USA while spending only 1/3 of what the USA spends per capita. Our worst ranking, it seems, is “general level of health” in which we score 35th out of 191. So despite our great health care system we’re not too healthy overall. Go figure. (Maybe us dumb Canucks don’t look after ourselves so well because we know we can depend on our great health care system to fix us up?)

    SHCB – you suggested option of “…or fix the minor problems in baby steps,…” Roy Romanow answered that in a video link I provided above – I’m not providing these links for my edification. Romanow even included an analogy you’d like: you can’t cross a chasm with baby steps, you either take one great big giant step or you fall/fail.

    NL – In BC people usually have to pay for flu shots unless they are in a high risk group.

    SHCB – I have 2 government stores slightly out of the way on my 13 km (8 miles) drive home from a downtown office plus one private outlet right on the route with lousy parking. If I need to pick something up I go to the private store with the attractive young ladies that’s about a mile past my house and then backtrack.

  249. Smith Says:

    “Smith,

    I was coming to your defense on this one, we’re on the same page.”

    I thought you were. My comment was not intended to be argumentative, just an elaboration of my position.

  250. shcb Says:

    well, you all probably know where I’m going to take the government vs private liquor industries discussion to don’t you? :-)

    good night, I won’t subject you to that painful discussion.

  251. shcb Says:

    or good morning in Smith’s case

  252. knarlyknight Says:

    correction – it’s a 4 mile drive home, 8 is the round trip.

    shcb yes I know where you’d be going with govt / private liquor industry discussion, and I’d probably agree mostly with you. Yet consider two items – (1) although I don’t have a good logical explanation as to why we need government controls and such high taxes on booze (Cdn. booze is about double the US price, right?) , perhaps that is simply a pay for use tax on alcoholics, and if alcoholics are going to blow all their cash on booze then it’s right for a big chunk of that cash to go back to the government to pay for some of the services (police, ambulance, detox centres, hospitals, child welfare, etc.) that have to pick up all the pieces shattered by those alcoholics. Taxing booze makes people pay for the costs they impose on society. Just a thought; it relates to the concept of taxing health/environmental/social “bads” as much as possible and removing taxes fom the good things. (And you can trust me to decide what’s “bad”, right? ;-)

    And (2) on the issue of liquor outlets (excluding bars) being on every corner in a free market environment vs. one every mile or so (depending on population density) in a tightly controlled market , doesn’t the competition drive prices down to the lowest level possible for existence of the owners and workers in the former system (forcing excess fims out of business in the process) while benefitting the consumers and doesn’t the latter system allow for (a) more efficient use of capital (e.g. no redundant i.e. barely surviving, sales outlets) and (b) more thoughtfully designed (lower cost) distribution networks, both ultimately resulting in higher profits and wages (standards of living) within the regulated liquor distribution retail sector?

    I grew up in an environment where booze was both easy to get yet regulated in terms of when and where you could get it and quite curtailed in terms of drinking in parks or other public places. I like that bit of “structure” & control exerted over my society (despite utterly contradicting my libertarian beliefs about personal responsibility). Proposals to provide more liberal access to booze rings alarm bells with me; it’s like I fit the comments above that people don’t really like change. When I travel to places where you can get booze everywhere, I love it, yet I don’t want the same where I live, although I’d appreciate much lower prices.

  253. Smith Says:

    “A crown on a tooth is about $300 out of pocket, the cost of my daughter’s wisdom teeth removal was nothing out of pocket (I don’t know why).”

    It’s been a while since I have looked at any specific coverage of wisdom teeth, but I believe some plans treat wisdom teeth removal as surgery instead of dental work. The crown may not have been covered (or covered to a lesser extent) because it was treated as dental work. The wisdom teeth procedure may have been covered in the same way as the other operations you mentioned. Or perhaps it is included in the “preventative dental” clause. I can’t remember what my plan was like when I was living and working in the US.

  254. shcb Says:

    Smith,

    I’m sure you’re right, about a year after the procedure the dentist’s office called and said they needed my medical insurance information because they needed the medical insurance company to deny coverage so the dental would cover it. I’m almost certain it wasn’t visa versa. I’m sure that went into someone’s statistics of a claim that was denied even though it was ultimately paid.

    NL,

    My share of the insurance premium is $47.22 for dental and $123.88 for medical (monthly). As I said I have no idea what the employer portion is, which gets to the point of LB and Smith’s discussion.

    Knarly,

    1) I’ve never been a fan of “sin” taxes, maybe that is the libertarian in me as well, this is also a big gripe of socialized health care, it gives the government a legitimate reason to make those calls. Then where does it stop? Ban rock climbing, bungee jumping and skydiving?

    2) Of course it drives the cost to the lowest possible price, that is the purpose of the free market. That doesn’t mean it drives establishments to the same level however, in a given industry there can be great differences in the quality of service and products, as long as there is a market. The wages paid can vary greatly. That is what a free market is all about. Yes some firms will be forced out of business, that is the creative destruction of capitalism, mediocrity is rewarded with failure. That doesn’t mean that person that owned that business is a failure, they may have just picked the wrong business to go into, or they picked the wrong location, the nest time around they do a better job and society is rewarded more than if the government had perpetuated their mediocrity.

    a) that’s none of government’s business, the business owner that invested in that failed business didn’t know it was going to fail or that the market was already saturated how does the government know? A market that was saturated two years ago may be prime now, who in government is wise enough to make that call? The only way government can be successful is to error on the side of caution and then you are under utilizing capital.

    Last paragraph, well said, that’s why they make strawberry, chocolate and vanilla.

  255. NorthernLite Says:

    I actually like our socialized beer and liquer system. Instead of just one or two walls of selection, “The Beer Store” and the “Liquer Store” selections we have here would make your jaw drop.

    Entire stores dedicated to only beer or liquer. Think of them as Walmarts for booze! Plus, here in Ontario they’re pretty much found on every corner.

    And… (shcb, you’ll love this I’m sure ;) the profits from all those sales help fund our health care, education, social services, etc.!

  256. Smith Says:

    The nicer liquor stores in the States tend to have significantly more that one or two walls of items. Of course that is not the case for all of them, but there are large, well-stocked liquor stores in the US.

  257. shcb Says:

    Ah, dueling liquor stores, here is the one I go to, it is on the way home and it is has quite reasonable prices.

    I wonder how those profits that go to pay for healthcare are accounted for in the comparisons of the cost of healthcare in the US an Canada?

  258. shcb Says:

    oops forgot the link
    http://www.davecoliquors.com/

  259. NorthernLite Says:

    The profits just go into the provincial treasurey and are just added to the overall revenue of the government. It doesn’t change the number of dollars we spend on hc. The government collected ‘x’ amount of dollars last year through taxes, crown corporations, etc. and spent ‘x’ amount of dollars of healthcare, education, etc.

    Re: Daveco… Now that’s what I’m talking about! That’s a nice store!. That’s what all are liquer stores look like. Most Beer Stores are basically just giant warehouses staked to the cieling with pretty much every beer under the sun. Is anyone else getting thirsty?

    I’ve been to a few “party stores” in Michigan and they were dives with a very limited selection of booze. But being able to buy a case of beer at 2am is cool and something I can’t do here (legally). And by that time you don’t really care what kind it is anyways!

  260. leftbehind Says:

    Knarly – thanks for the info on the French System. Out of all this, I think my interest has been most piqued by the French system and the systems of some of the “less-likely suspects” who scored high on the WHO list. I’d really like to know what’s going on in places like Malta and Oman that they should score so highly. I really feel like we’re really missing the point of the whole debate if we don’t get beyond a sparring match between the Canadian and American systems, which both seem mediocre to me when we consider what the rest of the world might have.

  261. knarlyknight Says:

    Here’s my store, quaint in comparison to Daveco:
    http://www.hillsideliquorstore.com/

  262. knarlyknight Says:

    LB – Malta sounds like a mediterranean paradise. The CIA fact book indicates some economic difficulty, high deficit in 2009.

    However, a quick perusal of their health care site impressed me, lots of preventative services and loads of free consultations available, even anonymously, check it out here: http://www.gov.mt/servicecluster.asp?s=46&l=2

  263. shcb Says:

    I’m going to tie all this together so it may get confusing. Daveco says it is the “worlds largest liquor store” it may be, but what is it using for data to make that claim? Number of bottles, square footage, value of inventory? How did it get the data? Is there a database including the stores in Mozambique?

    Similarly, how did the WHO decide France was first and the US 37th? To find out read from about page 26 to 39 of the 2000 report and you will get at least an idea, it is largely a matter of priorities, I know the WHO priorities don’t match mine and I doubt they match many people’s. With a statement like “the correct value for any indicator is estimated to have an 80% probability of falling within the uncertainty interval” I don’t think they a have much better idea if they are right than Daveco knows it is the worlds biggest liquor store. Providing my notion of what “uncertainly interval” is correct.

    Now to NL and the profits going to the provincial treasury. No problem with his statement, but what I was asking for is how is that accounted for, not at the provincial level but as it is reported in whatever report we are reading. For instance is the cost of health care the amount that was collected by the industry? Add up all the incomes of the doctors and hospitals and there you have it. Or is it the amount an entity(s) spent. Since they are including the profits of insurance companies I would assume that is what they are using. I can see this being a way to make the cost seem lower than it really is. The question is asked “how much is health care in Canada (fill in the blank for your favorite country)” the minister says “the health ministry spent 12% of our GDP” and that is what gets reported, but along the way liquor taxes were raised to pay for the cost of drunks on the system, tax on hunting licenses were raised to pay for gunshot wounds, auto taxes, fatty foods, cigarettes, and on and on. My question is, is that being accounted for equally when we say the US pays twice what other countries pay. We probably do pay more than others, that is our prerogative, it’s our money, and we have the best care, that costs money, but is the difference as much as we are being led to believe?

    BTW Daveco is huge and not the norm, I just happen to live close.

  264. NorthernLite Says:

    I’m not really sure I understand, shcb. Like I said, our government (yours too) collects a certain amount of money each year (from all sources) and spends a certain amount each year on healthcare, defense and so on.

    I seriously doubt a government could hide a significant amount of costs from the official opposition, the media, watchdog groups and the public in general.

  265. knarlyknight Says:

    shcb – I’m assuming WHO uses sophisticated statistical methods in developing those estimates and also have to make assumptions & guesses along the way. At least they are honest about their confidence levels!

    For the pedantic, a simpe explanation: WHO gives a point estimate (best guess). Then to indicate how realistic they think that guess is, they provide both a low estimate and a high estimate. They pick the low & high estimates to to establish a range in which the actual number has an 80% chance of occuring, i.e. they think there is a 10% chance it is higher and a 10% chance it is lower. For countries with good data the range between high and low is small, for countries where data is not available (requiring more guessing) the range will be larger.

    That’s a very sound way of presenting information. They have an infinitly better idea of whther they are right or not than does Daveco. You can make decisions on WHO type data knowing clearly what the risks are of each of your your input data items being wrong. That is far better than Daveco or even your administration’s assertions in 2002/2003 that there was certainty (proof positive) that Saddam had hidden WMD’s in Iraq.

    By the way, stop saying that the US has the best care when all the evidence says otherwise.

  266. shcb Says:

    Enky,

    Thanks for the explanation, I’m not a mathematician, and it didn’t make sense that the would have an 80% margin of error, but to the layman that is the way is sounds, having a 10% margin of error sounds better. That is what you are saying isn’t it? As far as we have the best health care in the would, that is using my set of priorities, not someone else’s. WHO says our system is the most responsive. Our life expectancy is only a fraction of a year less than Europeans (from memory, it may be a little over a year, but it isn’t much), and if you take out auto accidents and homicides from both statistics we live longer. We tend to kill ourselves in cars and others with guns more than other countries but that certainly isn’t our health care system’s fault. If you do manage to live to 65 we outlive other countries by a significant margin and we live better lives than other countries because we fix up the old geezers better (except for Japan in all the above). Being as how I’m inching to that age faster every day, that is important to me. I was just talking to a colleague in Holland that is just a few weeks from retirement, seems I am having that conversation more and more often, oh well. So yeah, I’m pretty confident making the remark we have the best system, the most expensive, but the best.

    NL,

    Maybe you’re right about the cost comparisons, I’m just curious. I’m not saying anyone is hiding anything, it is just how it is being reported, like the infant mortality rate. In some countries they aren’t counted as a live birth until they are a day old, here they are counted from the first minute. So our rate seems high. But no one is hiding anything, they say right up front how they are counting. It does make comparisons a bit more difficult. As long as this debate has been going on and as much talk radio as I’ve listened to I would think I would have heard someone say there was a problem with the accounting of the different countries and I haven’t so you’re probably right.

  267. knarlyknight Says:

    OT : shcb – you might like this short video of VW’s Phaeton assembly line in Dresden. I bet them workers get good health care…

    http://www.youtube.com/watch?v=nd5WGLWNllA

  268. shcb Says:

    That was pretty cool, of course there isn’t anything new there just stylized a little, but what the heck, if a little glitz sells cars, glitz on brother, glitz on. When he said how quiet the plant was I had to chuckle a little. A few decades ago the Japanese were saying the same thing when they, well, actually we but they did a better job, came out with JIT manufacturing. They would give tours through the plant how clean and organized everything was and how they didn’t warehouse parts, the parts they needed were delivered that day. But what was happening was parts were being made in small, dingy cramped and dirty plants all over Japan and the world for that matter, shipped to Japan where they were warehoused by another company with say Toyota their only customer, sometimes across the street, then once or several times a day a delivery was made to the assembly plant. It was all smoke and mirrors, nothing had really changed.

    Sure there aren’t 1000 ton presses here, they are somewhere else, no smoke belching foundries, they are somewhere else, the conveyor is a conveyor with maple screwed to the belt, but it is still a conveyor. Robotic forklifts, had em for decades, ditto torque recording wrenches. This is kind of like saying electric cars don’t pollute, they do, it’s just somewhere else. Actually this plant uses more resources and energy because the parts are being transported on the little cho cho (probably from a warehouse in a dirty industrial compex) rather than staying on site.

    And there isn’t an auto worker in America that doesn’t have health care, of course there isn’t an illegal alien or bum that doesn’t have health care either, but every auto worker has insurance as well as health care, that includes the auto workers that don’t auto work anymore.

    But it was fun to see anyway, thanks.

  269. knarlyknight Says:

    Thanks for your cynical comments, I see the light…
    On your side with the electric cars, but perhaps pollution away from the cities is not so bad plus it’s easier to limit pollution from one big plant than 1,000,000 cars. but we seem to be on hte same page.
    not so sure that the bums in America will agree with you that they have any sort of decent health care at all, but I’m not interested in arguing about that.

    Cheers.

  270. shcb Says:

    There is a lot of validity to controlling where the pollution is made. In China they had a system where the busses would drive under overhead lines that would power them and then lower the bars on the top of the bus and power themselves in areas that didn’t have the wires overhead, I don’t know if this is common in metro areas, I tend to avoid cities, or if this was just a Chinese thing. I’m also not sure if the bus was diesel powered offline or electric. There is also the matter of an electric motor being more efficient than a reciprocating motor. I mean whose idea was it to make something go up and down to then turn something else round and round. We used to routinely replace thousand pound oilfield engines with 10 or 20 hp electric motors. It looked silly when we were finished, this little electric motor where once there was a huge single lung thumper. But in the gas fields those old gas engines would run off well pressure (or gasoline, diesel, hell just about anything that would burn) so there was no fuel storage or transportation or electric lines that had to be run. I still believe storage of large amounts of electricity is the key, not the generation or end use.

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