From: harelb@math.cornell.edu (Harel Barzilai)
Subject: "STRONG FAMILY VALUES" (III) (2)
Followup-To: alt.politics.elections
Originator: daemon@pencil.cs.missouri.edu
Organization: misc.activism.progressive on UseNet ; ACTIV-L@UMCVMB
Date: Wed, 19 Aug 1992 21:45:09 GMT

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Addenda:
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============================================================ 
Medical costs as percentage of Gross Domestic Product: 

                1980            1989            increase 

U.S.:           9.2%            12%             + 30 percent 
Canada:         7.4%            8.9%            + 20 percent 
============================================================ 


============================================================ 
Percentage of premiums consumed by overhead: 

Private Insurance Companies:              12% (overhead & profits) 

Public payers (e.g. Medicare, Medicaid):   3% 

Canadian provincial insurance plans:      under 1% 
============================================================ 

================================================== 
Billing, administration, and insurance 
overhead as percentage of total spending: 

U.S.:           22% 
Canada:         13.7% 
U.K.            11.1% 
================================================== 



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Even today, the general population often fails to understand its 
inner wants.  The current debate over health care provides some 
useful illustrations.  A case in point is a major article in the 
_Boston Globe_ (Feb. 9) by Thomas Palmer, an outstanding 
journalist, well to the liberal side of the spectrum.  Palmer 
opens by reporting that almost 70% of Americans prefer a 
Canadian-style health-care system, according to polls.  But they 
are wrong, for two reasons. 

The first reason is technical: it was clarified by President 
Bush, who "emphasized the importance of avoiding the problems of 
bureaucratized, universal-care systems like Canada's." It is a 
matter of logic that government-run systems are inefficient, and 
the fact that the highly bureaucratized private sector system in 
the US is vastly more inefficient is therefore irrelevant.  It 
is, for example, of no relevance that Blue Cross of Massachusetts 
employs 6680 people, more than are employed in all of Canada's 
health programs, which insure 10 times as many people; or that 
the share of the health dollar for administrative costs is over 
twice as high in the US as in Canada. <<<NB: Nancy Watzman, 
_Multinational Monitor_, May 1992.>>>  Logic cannot be confuted 
by mere fact. 

More interesting is the second reason, which is "spiritual." 
There is a "difference in outlook" north and south of the border; 
there are "theoretical differences that students of the two 
nations see in the psyches of the average American and Canadian." 
These students explain that the Canadian system would cause "the 
kind of rationing of health care that Americans would never 
accept... The US system rations by price; if you can afford it, 
it's there.  Canadians ration their health care by providing the 
same care for everyone and simply making those seeking elective 
or less urgent procedures wait." 

Plainly, that would not accord with "American-style impatience," 
one "student of the two nations" explains.  Imagine, he says, 
that "no matter how poor you are, you will sit in a hospital bed 
and receive care as the richest in your community.  No matter 
what contacts you have and no matter how rich you are, you can 
get no better than that." Americans would never accept that, we 
learn from this expert (incidentally, the president of a 
health-care consulting firm).  Further insights into the American 
psyche are given by the deputy director of a trade group of 
commercial health insurers.  The 70% of Americans who don't 
understand their own psyches are not sampled; obviously, they too 
need instruction in self-awareness. 

[From _Year 501: World Orders Old and New (part II)_, Z magazine.]

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