Socialised Healthcare

[Corsair 115]

The point is I can choose if and how much I deal with that nameless/faceless bureaucrat...

Except that is not how the system works in Canada. Doctors make the medical decisions, no bureaucrat anywhere makes any sort of decision about your medical care whatsoever.

These are the responsibilities of the federal government in health care:

• Setting and administering national principles for the health care system through the Canada Health Act;
• Assisting in the financing of provincial/territorial health care services through fiscal transfers;
• Delivering health care services to specific groups (e.g. First Nations and Inuit and veterans), and
• Providing other health-related functions such as public health and health protection programs and health research.

The provinicial and territorial governments are responsible for the administration and delivery of health care. The federal government provides the funds.

The Health Canada web site is the place to go for getting all manner of information and data on the Canadian health care system. This page has an overview of health care delivery in Canada; here's the Federal Role in Health, Federal/Provincial/Territorial Collaboration, Health Expenditures, and Provincial/Territorial Role in Health.

Only if you're incapable of thinking more then a few steps ahead, which I find is a common problem with people who support socialized medicine.

There's been a publically-funded health care system in Canada for about forty years now and bureaucrats have yet to make any decisions about a patient's health care; doctors are still the only ones making such decisions.

 

[CaptainManacles]

The public funds are used to cover services that are medically necessary (as a group, not on an individual basis),

But what if my doctor says they're medically neccisary. If I don't get my chakras aligned, toxins will build up in my body and I may die. Oh noes.

And if my doctor doesn't get to make that call then we're back to the bureaucrat again, though, as I pointed out before, he hides himself behind a few degrees of seperation, he's still there. It just requires a bit of thought to spot him.

 

[CaptainManacles]

I don't see your point here. You're saying that you can choose if and how much you deal with the bureaucracy of your health insurance provider?

The point is that in a free market, you choose which insurance provider to deal with or if you want to deal with one at all.

You're then saying that if you don't like this, someone will set up an insurance provider where you don't have to deal with faceless bureaucrats?

No, that's not what I said, but if you read my post that is pretty clear.

Or you're saying that if you don't like the way your health insurance company treats you, you can change to another company? Maybe. But in the middle of a claim, or with a medical history that indicates you'll be claiming on them for some time to come? Good luck with that one.

And you ought to have someone inspect a house before you buy it as well. Yeah, you're a bit late if you want to change carriers after you get sick. You should be aware of how your policy works before that point.

You know what? I never have to deal with faceless bureaucrats regarding my own healthcare. I'm not even sure what you're talking about as regards the NHS system. I make an appointment with the doctor, I go along, tell her my woes, and she deals with it. End of story. Nobody mentions money, and the only "bureaucrat" I have to deal with is the receptionist who gives me my appointment time.

And as I've pointed out before, you're talking about aesthetics, not reality. Just because someone forces the money out of your wallet before you ever get to the hospital, and has such absolute power that quibling over their decisions is pointless, doesn't mean that you're not dealing with money/bureaucracts.

Rolfe.

omglol11!!!111!!

 

[Rolfe]

But what if my doctor says they're medically neccisary. If I don't get my chakras aligned, toxins will build up in my body and I may die. Oh noes.

And if my doctor doesn't get to make that call then we're back to the bureaucrat again, though, as I pointed out before, he hides himself behind a few degrees of seperation, he's still there. It just requires a bit of thought to spot him.

So, you use your own $17 million to pay for the chakra realignment.

Or you make sure you also have private healthcare insurance with a provider who has agreed that it will fund chakra realignment to the tune of $17 million, if your doctor recommends that.

Where's the problem?

It does happen that the NHS will refuse to fund an expensive new drug which a bunch of patients think they should be getting. It's usually something fearfully expensive with only a small benefit - either a couple of weeks extra for a terminal illness, or (in the case of Herceptin) something which has to be given to a large group of patients, most of whom will get better without the drug, leaving the apparently impressive reduction in mortality as actually only a very small percentage of the total treated. But hey, that last one was conceded, after a high-profile campaign. In fact patients in that position are possibly in a better position with the NHS because they can gang up against the single adversary, rather than everyone having to fight her own lone battle.

I don't suppose there are any statistics comparing the frequency of this sort of occurrence with US insurance companies refusing to pay out for something a doctor has recommended, but simply based on what I've read, I'd suspect my chances would be better with the NHS, most days.

Rolfe.

 

[CaptainManacles]

More choice. No, as I mentioned above, this isn't so. You retain the right to choose to spend your own money on your own choice of healthcare if you want to.

So the government will give you back the tax money that went into the health care system so you can spend it on private care? If not, you really don't have the same choice in how to spend your money.

 

[CaptainManacles]

Except that is not how the system works in Canada.

And you conviently ignored where I provided counter-arguements to this claim.

 

[Rolfe]

So the government will give you back the tax money that went into the health care system so you can spend it on private care? If not, you really don't have the same choice in how to spend your money.

Get real, it's not that much! And in fact there is still benefit. You'll find that your insurance costs are noticeably less because the insurance company knows that it won't have to fork out for an emergency, no matter how expensive.

Yes, you get treated by the NHS if you are run over by a bus, or have a heart attack in the street, or fall over with appendicitis. Guess what? Nobody wants it any other way. You get the best of emergency care whether you're a street-sweeper or an aristocrat. Not only that, if anything goes pear-shaped in that private hospital where you had your elective hip replacement, guess what, the NHS is there to accept you as an emergency transfer and rescue the disaster. All free.

And you'd rather give all that up just for some sort of notional choice to have an insurance company rather than a health board control your provision? Really?

Rolfe.

 

[Rolfe]

Just because someone forces the money out of your wallet before you ever get to the hospital, and has such absolute power that quibling over their decisions is pointless, doesn't mean that you're not dealing with money/bureaucracts.

What on earth are you talking about? There's really very little money "forced" out of my wallet. If I were magically to get my contribution to the NHS back every month, the amount of healthcare or insurance I could then buy with that sum is paltry, I can tell you.

And who has the "absolute power"? My doctor or my consultant says I should get X, I get X. The few exceptions reported relate to very expensive drugs with dubious cost-effectiveness and often dubious effectiveness as well. These occurrences make the headlines, sure, but that's because they're so rare. I don't personally know or even know of anyone who has had anything refused by their NHS region. I've heard just as many stories of people in the US being refused cover for recommended treatments by their insurance company. Correct me if I'm wrong, but I suspect that cover that includes all these very expensive drugs without any quibble might turn out to be a bit pricey, too. Lucky you can afford it.

Have you ever even been to Britain? You seem to be peddling a view of where I am and how things work here which is pretty much on another planet.

omglol11!!!111!!

What?

Rolfe.

 

[Distracted1]

Insurance companies ARE the devil.

 

[fls]

But what if my doctor says they're medically neccisary. If I don't get my chakras aligned, toxins will build up in my body and I may die. Oh noes.

And if my doctor doesn't get to make that call then we're back to the bureaucrat again, though, as I pointed out before, he hides himself behind a few degrees of seperation, he's still there. It just requires a bit of thought to spot him.

The difference is that hospitals and medical care, diagnostic and therapeutic services plus (depending upon the province) drugs and some other services are covered. So if you need those services, you will receive them. And whether you need them is up to you and your doctor. It's not like the insurance system in the US where a bureaucrat a thousand miles away will decide that you don't need another day of IV antibiotics. You know in advance which services are not covered by the provincial health system (like chakra alignment) and have the choice of purchasing insurance to cover those services.

And when it comes to ripping money from your wallet, at least as much (and often more) money, is ripped from your wallet for the public funding of health services in the US as any other country with universal health care. It's just that you (unless you are covered by medicare) do not receive health care for that money and need to provide additional money for your own coverage.

Linda

 

[CaptainManacles]

So, you use your own $17 million to pay for the chakra realignment.

Or you make sure you also have private healthcare insurance with a provider who has agreed that it will fund chakra realignment to the tune of $17 million, if your doctor recommends that.

Where's the problem?

No problem, I just pointed out you were, in fact, dealing with a bureaucrat and you failed to offer any counter-arguements.

No matter how you want to spin it, eventually there is some bureaucrat making all the decisions about what is allowed and what isn't, even if you want to hide this behind a label of deciding what is and is not "neccisary".

 

[Rolfe]

I didn't hide anything behind any label of what is or is not "necessary" (oh, learn to spell, why don't you).

I pointed out that cases where treatment is refused by the NHS are few and far between, so much so that they invariably end up on the front pages with journalists howling for blood. And that in at least one case, a concerted campaign by affected patients was successful in having the drug made available on the NHS.

This situation has never affected me, or anyone I know, or even "a friend of a friend". I think the probability of it affecting me is remote. You seem to be implying that anyone going into hospital for treatment is being assessed and graded and possibly refused treatment by "faceless bureaucrats". I assure you they are not.

Who is this bureaucrat you think is interfering with my healthcare? What is his job title and where is his office? I assure you, there's no such person. Apart from the (once again) very rare situation I described above, what my doctor says I should get, I get.

If I want to take out insurance to go above and beyond this, either to get very expensive and possibly not NHS approved drugs, or (much more likely) just to get treated faster and more conveniently, then I can. Some of them even cover crackpot woo. Though I'd anticipate just as much trouble with the insurance company as with the NHS if we really started talking about a very expensive and marginally beneficial drug, quite honestly.

But the basic care is there, for what is a ludicrously small slice of my income, and it covers a lot more than basics. Most people never bother with extra insurance, even the rich, and are happy with their lifelong care.

You're still not getting the point, though Linda has pointed it out more clearly.

Even in a non-universal system, the poor still have to be treated, unless you're returning to utter barbarism. You are paying for that in your taxes. I don't know how it compares, but I wonder if in fact you are paying just as much for no return to yourself, as I'm paying for my share of the NHS?

What is it you're getting from the system you like so much, that you're so wedded to it? Because I'm not seeing anything.

Rolfe.

 

[qayak]

It is quite obvious that Captain Manacles has absolutely no idea what unversal healthcare is. He doesn't realize that the government is far more accountable than any private insurance proivider. That by law, the government has to treat all citizens equally and so you do not have to argue with anyone to get a treatment, they are obligated by law to provide it regardless of cost. Whereas a private insurer will simply stall and refuse to pay until you either forget about it and go away, or die.

He also doesn't realize that you are free to add on to this basic coverage in any manner you choose and with any provider you choose.

But, c'est la vie. I would really like to compare costs and services provided between my healthcare and his/hers.

 

[NoZed Avenger]

I can take a look after I am home from work this evening, though my sources from my coursework in the nineties may be a bit problematic.

I have spent between 20 and 30 minutes tracking down the liver transplant study that I mentioned, with no luck. It was referenced on a blog that I do not regularly read, but that was linked by one that I do in the last week to ten days. I do not remember what or wher, as I was only reading it because I took some upper level coursework in health economics prior to law school, and was interested in the study.

I don't want to spend any more time on it, because I suspect this thread will end up similar to the last few that I participated in on the subject. I don't mind people thinking that the American system is worse (as I have stated, reasonable arguments can certainly be forwarded); I simply am kind of tired of the tone that indicates that any American suspicious of handing over health care ot the government is an idiot, has been mislead, or is dishonest (or some combination thereof).

 

[Corsair 115]

And you conviently ignored where I provided counter-arguements to this claim.

Your counter-arguments consisted of a slippery slope argument and some vague commentary about a bureaucrat making medical decisions. Those do not constitute facts.

I, on the other hand, provided links to the appropriate web site where you can get official and valid information. In other words, facts.

You're welcome to criticize the Canadian health care system, but please ensure such criticism is done on the basis of actual facts and not innuendo, supposition, speculation, and political leaning.

 

[Wildy]

Excellent point. In Australia we never use the word "socialised" (with due respect to wildy) but public health, public housing, public welfare etc are well accepted facets of our society. I'm not making a judgement about the US here, but even though we are both "commonwealths" there seems to be a greater sense of the common good here. I am happy to be contradicted here.

If I didn't say "socialised" how would I get the Americans here?

If "removing the profit motive" slows the development of medical technology (and yes, government money is just a fraction of private industry, and wouldn't you want both?) then the net effect is more misery and death vs. what would have been, as the cumulative effect of lagging tech builds up, year after year, decade after decade.

But does supposedly "removing the profit" slow the development of medical technology? And are such systems designed to remove the profit? Here in Australia we can still get private health insurance, we can go to private hospitals, there is nothing stopping us.

Consider: If socialized medicine slows technological development by only 10%, then, if this had been done in 1900, we'd only have about year 1997 tech instead of 2008 tech. What does that add up to in quality and length of life?

What about a 30% slowdown? Anyone think they're getting such a deal in 2008 getting "free" 1978 level medical care?

And if that slowdown didn't exist? Wouldn't that mean that you would have medical treatment at a rate so high that nobody could afford it?

2. Small slowdowns add up, cumulatively, to be massively murderous de facto, on a scale Hitler and Stalin never dreamed. This is not hyperbole, is my point. Tens to hundreds of millions of needless deaths, to say nothing of poorer quality of life due to non-existent treatment.

However, if you have treatment that costs way more then what the average person could afford wouldn't that mean that you would still have these "tens to hundred of millions of needless deaths"?

But it won't slow down the tech? Sorry, hundreds of "economic experiments" last century demonstrate otherwise.

Care to provide sources?

I suppose a corollary would be that, had Canada, Australia, Western Europe, and other advanced societies not been engaged in socialized medicine "to remove the evil profit motive" (and other business-hampering endeavors), our global medical tech would be even higher than it is today. And hence, we're living in a sub-optimal world already.

So in other words because the government tries to ensure that the standard of health amongst its citizens is high, and the cost of such standard is low, means that we are dragging the world down?

I wonder how many people today are dying who would not, in such a world? We'll never know, barring a set of massive "ancestor simulations", but, by that point, it will be a moot question.

I wonder how many people would die in a world where most people can't afford to get proper treatment?

But what if my doctor says they're medically neccisary. If I don't get my chakras aligned, toxins will build up in my body and I may die. Oh noes.

If you have a doctor that says that then I guess you should probably go and see another doctor, preferably a competent one. Or as has been mentioned you could get private health insurance that covers that.

And if my doctor doesn't get to make that call then we're back to the bureaucrat again, though, as I pointed out before, he hides himself behind a few degrees of seperation, he's still there. It just requires a bit of thought to spot him.

No matter how you want to spin it, eventually there is some bureaucrat making all the decisions about what is allowed and what isn't, even if you want to hide this behind a label of deciding what is and is not "neccisary".

Isn't that what happens in the US though? The doctor says what you need and then your insurance company, who are basically private bureaucrats, say whether you can get said treatment or not?

 

[CaptainManacles]

I didn't hide anything behind any label of what is or is not "necessary" (oh, learn to spell, why don't you).

I pointed out that cases where treatment is refused by the NHS are few and far between, so much so that they invariably end up on the front pages with journalists howling for blood. And that in at least one case, a concerted campaign by affected patients was successful in having the drug made available on the NHS.

But then NHS is still the entity making that decision in the end. It doesn't matter that their decision is "allow everything", the policy is still in the hands of a bureaucrat, as much as it is in private healthcare. I may, for example, want to participate in a more restrictive system that would have lower costs, but I do not have that option under socialized medicine.

 

[CaptainManacles]

What on earth are you talking about? There's really very little money "forced" out of my wallet. If I were magically to get my contribution to the NHS back every month, the amount of healthcare or insurance I could then buy with that sum is paltry, I can tell you.

The money comes from somewhere. Ultimately it all comes from the taxpayer. Under privatized healthcare I choose where that money goes, under yours, you are forced to send it where they tell you. Unless you are figuring there is some kind of magic money tree that is supporting your health care system.

What?

It was just so very close to ROFL, I couldn't help myself.

 

[CaptainManacles]

It is quite obvious that Captain Manacles has absolutely no idea what unversal healthcare is. He doesn't realize that the government is far more accountable than any private insurance proivider. That by law, the government has to treat all citizens equally and so you do not have to argue with anyone to get a treatment, they are obligated by law to provide it regardless of cost. Whereas a private insurer will simply stall and refuse to pay until you either forget about it and go away, or die.

He also doesn't realize that you are free to add on to this basic coverage in any manner you choose and with any provider you choose.

But, c'est la vie. I would really like to compare costs and services provided between my healthcare and his/hers.

It's obvious you haven't even tried to grasp the arguements against universal healthcare. That you think being able to add on private coverage is relevent speaks volumes of your ignorence on this issue.

 

[Wildy]

But then NHS is still the entity making that decision in the end. It doesn't matter that their decision is "allow everything", the policy is still in the hands of a bureaucrat, as much as it is in private healthcare. I may, for example, want to participate in a more restrictive system that would have lower costs, but I do not have that option under socialized medicine.

I don't really understand what it is you are trying to say.

Are you trying to say that universal healthcare is bad because don't don't get to choose what treatments you don't want to be able to choose?

As well as that wouldn't you prefer a bureaucrat that says "OK" all the time to suggested treatment then a bureaucrat telling you that certain life saving treatments will not be covered because it wouldn't be cost effective?