From: brownfield!jbrow (Jim Brownfield)
Subject: Re: National Health Care
Reply-To: <jbrow@glv.com>
Organization: Encompass
Date: Tue, 25 Aug 1992 23:20:17 GMT

In article <1992Aug25.172444.27444@news.columbia.edu>  
gld@cunixb.cc.columbia.edu (Gary L Dare) writes:
> <jbrow@glv.com> writes:
> >By this, I take it that *every* Canadian gave their consent to this
> >system.  If not, then I suggest to you that calling it anything but
> >theft is just to make the ones that wanted the system feel better.  Of
> >course, if every Canadian gave their consent, then why did you need
> >the government to enforce it?
> 
> We've had over 7 elections in the past 20 years, and no party has seen
> fit to campaign against public health insurance ... in fact, everybody
> considers doing so political suicide (a handful of extremist *former*
> Tory MP's stand to bear mute witness to this fact) ... also, our voter
> turnouts are in the high-80%/mid-90% voluntarily, so elections can be
> taken as very reasonable plebescites rather than a sordid collection
> of special interest and extremist groups who bother to go and vote.
> One of the reasons for the success of Mulroney's Conservatives has
> been to grab a moderate social market position when the post-Trudeau
> Liberals (as in Churchill and Paddy Ashdown, if you are familiar with
> any British references -- not Jerry Brown) nudged slightly left and
> flirted with grabbing moderate leftists who traditionally supported
> the New Democratic Party.  The federal Liberals have been fighting to
> regain their old social-liberal/fiscal-conservative space from the
> federal Tories since.

Whether its 51% to 49% or 90% to 10%, its still theft.  When you have a system  
where people can opt out on the payment side as well as the service side, you  
will have a moral system.

> 
> >Of course, the "severe economic downturns" might be caused by the
> >"severe taxation" brought on by your social policies (and this is the
> >same here, in the U.S.). 
> 
> Canada spends more on maintaining infrastructure ... if you ever go up
> there, you'll see that much of it looks like it came out of the box
> last week.  We have a skewed population distribution so to maintain
> any semblance of a unified nation, there are tremendous costs to just
> maintain contact between the different regions.  Our private sector
> has not been as savvy, with few exceptions such as Northern Telecom,
> and is only now grappling with freer trade.  You must really want to
> think that all Canadians are communists on welfare, when 9 of our 11
> governments are controlled by avowed pro-free enterprise parties ...

I'm not familiar with Canadian telecommunications, but I know that in America  
and Europe, governments have been the largest impediment to advancing  
telecommunications.  In the U.S. the technology for high speed networking has  
been around for at least 15 years, but tariff codes that restrict competition  
between the phone companies and cable television have severly slowed progress.   
Now that the telephone companies have high speed twisted pair technologies on  
the horizon, they want the restrictions removed.  But alas, the cable companies  
don't want the possible video competition, etc.  And we thought we lived in a  
country with a free market :-(.

[stuff deleted]

> >
> >In a free market, the PEOPLE *are* the ones that determine your 
> >compensation.
> 
> I thought that American doctors are presented with take-it-or-leave-it
> fee schedules imposed upon them by insurance companies, not real people.

If the doctor has made a voluntary deal with an HMO, he has agreed to accept  
what they pay.  But generally, the patient carries the insurance, and the  
patient is responsible for the bill.  A doctor may accept in full what the  
insurance company pays, but he/she is not obligated in any way to do so.  I  
just pay my bill directly, and if it pushes me over my yearly deductable, I  
turn it over to my insurance.

> 
> >If by your remarks, you mean the PEOPLE will vote to determine doctor 
> >wages...  
> 
> And now, a backgrounder to the news ...
> 
> Ontario and British Columbia are the first and second-largest English
> speaking provinces, comprising ~40% of our population and both having
> New Democratic admistrations.  The B.C. government is waging a political
> dispute with B.C. doctors over their fee schedule by introducing a cap.
> If you paid attention to my FAQ, Canadian doctors are private and paid
> by fee according to a schedule that their guild (College of Physicians
> and Surgeons, effectively provincial arms of the CMA (AMA)) negotiates
> with the public health insurance office -- it is usually a rubber stamp
> process.
> 
> What Ken means is that the voting public will determine whether they
> will support the NDP for a second term after they make such a move to
> true socialized medicine (right now, everything is market except for
> basic medical coverage) or whether a more moderate party will take
> over.  As further historical background, B.C. used to be polarized in
> an extreme way such that provincial wings of the federal moderate
> parties (Liberals and Progressive Conservatives) were ineffective
> because their extreme right-wingers joined in a provincial coalition
> called Social Credit while the party moderates were involved solely in
> federal issues.  It was not much of a choice between them and the NDP
> as the few provincial Liberals and Progressive Conservatives always
> managed to neutralize each other, until the Socreds finally imploded
> in scandal to give the NDP a deserved victory.  The happy news is that
> the B.C. Liberals (Churchill/Ashdown) emerged to head the Opposition
> in provincial parliament and would remove this heineous salary cap if
> the NDP ever actually imposes it (I think it's a bluff), by winning
> the next election.
> 
> gld

Interesting.  I know that doctors generally work very hard to get where they  
are.  Hopefully, they won't be limited in salary after they have made this  
investment (which still does not imply that a CMA or AMA deserves a medical  
monopoly).

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