From: gld@cunixb.cc.columbia.edu (Gary L Dare)
Newsgroups: talk.politics.misc
Subject: Re: Bush plan on Health Care?
Summary: Just the same bogosities about Canada for the ignorant ...
Date: 10 Sep 92 00:25:20 GMT
Reply-To: gld@cunixb.cc.columbia.edu (Gary L Dare)
Distribution: usa
Organization: Curious Goods (formerly Louis Vendredi Antiques)

ddavis@cass.ma02.bull.com (Dave Davis) writes:
>
>On the McLaughlin Group [last Sunday] I heard (I think)
>M. Kondrake state that Pres. Bush had a health care
>proposal 'out there'. 

Yep, sounds pretty "out there" ...

clarinews@clarinet.com ((May/Standard Broadcast News)) writes
in clari.canada.newscast:
Re: Newscast of the hour (18) Sep 9 4 pm EDT
>	
>	(Bush-Health)+
>	The Canadian medical care system has become a campaign tool for 
>U.S. President George Bush. Once again while campaigning, he has referred 
>to the Canadian system as a reason for NOT having national health care in
>the United States - something advocated by the Democrats under Bill
>Clinton. Bush said many Canadians have to go to places like Cleveland to
>get a heart bypass - because in Canada they have to wait at least six
>months. (18)

The information used by American critics about "dying in line" come
from a study by Vancouver's conservative Fraser Institute (and thus
the cited references to British Columbia) commissioned more than a
decade ago, when even Americans waited nearly 6 months for bypass
operations (which is said to be overdone in the States anyways).  A
follow-up Fraser study in response to how their American cousins used
their old numbers exists but has been conveniently ignored by people
who "can't get at it" although it has been available for almost a
year.  Current queue times are ~3 months, and only so because
emergencies get bumped to the front ...

CNN had a hard time finding convincing evidence of the mythical massive
queues for their focus series on Canada's medicine in early June, 1992.

The rest of this article is a summary I post around USENET explaining
what the real Canadian health care system is like.  This dispels spins
by both the American right and "left" on what our system does ... it is
a hybrid public/private system like in richer European countries.  The
follow-ups are being sent out of this newsgroup to an appropriate place.

Also, the Summer 1992 edition of France magazine (available from most
college French departments and branches of the Alliance Francaise)
describes their system, which is very very very similiar to Canada's
(and may have been the basic model we chose; I don't know the history
here ...).



Canada has a public health insurance system ("PHI" in Americanese)
funding private doctors, and public and private hospitals.  They are
paid on a per-procedure basis according to a fee shedule as per any
insurance plan in America.  Doctors' guilds in each province negotiate
the fee schedule, and their offices run the standard billing software
(97% are billed to the provincial plan).  Each province is in effect
an HMO, with every resident having access to choosing their own doctor
and hospital in that province (outsourcing to bigger, richer provinces
upon approval of the insurer/HMO).  France and Germany also have PHI;
all three are known as fiduciary in legalese (i.e., not an arm of the
government to pound on particular people, a fave American paranoia;
it's just a passive pool that pays bills from earmarked tax funds).

The fee schedule is for the provincial HMO, but doctors in some
provinces can charge higher rates in cash, too, and let the patient
get the reimbursement.  No doctor is obligated to bill the provincial
HMO, but if you're in Canada it'd be stupid not to ...  you'll find
the odd loner who is bogged down by ideology and goes the cash-only
route.  Since our doctors run private practices with billing software
(97% of the database entries are to the provincial health fund) they
can take cash.  In fact, a couple of my medical friends have said that
they'll only take cash from Americans (and let them sort things out
with their insurance) because they have been weasled by American
private health insurers when presenting bills for their clients.

Oh yeah, there is also private insurance in Canada for stuff that is
not basic medical (bandages to brain surgery).  This gives you perks
like one would get in a premium U.S. hospital like private room, a
cellular telephone, etc.  Private insurers are happy that it's all
they have to sell to individuals and for corporate bennies, and if the
Tories or Liberals ever dared to "go American" the political moneymen
at London Life, etc. will raise holy hell (friends in insurance tell
me that, anyways) before flashing their political donation money.

On the other hand, Great Britain runs a National Health Service
(NHS)tm which is closer to what Americans call "socialized medicine".
Doctors are salaried out of the public purse and a bureaucrat oversees
the use of services (gee, doesn't this sound familiar? (-;).  NHS is
not PHI.  However, according to The Economist magazine there is a
seperate and private medical sector operating in competition to NHS.

While I cheer the U.S. for being a leader in creating free markets
around the world (trade harassment of imports aside), the medical
coverage issue is ideologically polarized, too overly simplified (see
paragraph #2), and what we call "not invented here" in engineering ...
Canada, France and Germany are not valid labs to gain experience from
although their doctors and hospitals are (or can be, in the latter
case) private.  The terrorist Georges Habash was treated at a private
hospital in France last spring, but its regular customers pay it out
of their public health.  However, I am aware that the US public and
government have a more hostile relationship than we know in the rest
of the West ...  I'm not proposing any solutions for you guys, just
trying to set the record straight.

[My own prediction is that the U.S. will go to a system where basic
coverage is covered by a public pool, but brokered by private firms
who will offer what we call "private supplementary" up north on top of
it all (basically, filling out what their current policies are).  The
same class differentiations in the U.S. and Canada will remain due to
the presence of "private supplementary" and those who can pay for it.
Unless the private sector bails out of basic, like they did in Canada.]

gld
--
~~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare				
> gld@cunixB.cc.columbia.EDU		Oct 26/92: Just say "OUI!"
> gld@cunixc.BITNET			(Let's worry about the economy!)
Newsgroups: talk.politics.misc