From: gld@cunixb.cc.columbia.edu (Gary L Dare)
Subject: Re: National Health Care
Reply-To: gld@cunixb.cc.columbia.edu (Gary L Dare)
Organization: Curious Goods (formerly Louis Vendredi Antiques)
Date: Sun, 23 Aug 1992 18:43:54 GMT

Jim Brownfield <jbrow@glv.com> writes:
>gld@cunixb.cc.columbia.edu (Gary L Dare) writes:
>> 
>> Guessing games about how Canada is set up (politically, geographically,
>> etc.) can be amusing until one realizes that an American audience often
>> does not have any sources to check their veracity ...
>
>Truthfully, I'm happy that Canadians are *happy* with their system,
>but I could care less how "well" National Health Insurance works in
>Canada.  I can probably produce as much documentation that says there
>are severe problems with the system as you can produce positive
>documentation (I had an analysis from the Cato Institute, among
>others, but I usually toss them after I read them).

I have seen some of that documentation (roundly denounced by a parade
of Canadian doctors on CNN's early-June focus series as propoganda),
including this month's Readers' Digest article in the domestic edition
by a British doctor who touched down in Canada long enough to get
citizenship and then headed down to Dallas as a private hospital
administrator ... in fact, the presentation read like a someone with
an axe to grind against *Britain's NHS.* It's the usual "flattening"
of Canada into a shapeless grey mass without any regional/population
distinctions, false allusions to our having a "socialized" National
Health System (it's just insurance!), and the use of dubious numbers
that if they actually are accessible in the U.S., that is due to the
fact that they are old enough to be quoted second-hand from other
articles (a 6 month waiting figure for MRI in *Toronto?* Come on!).
Also, a disingenious mention of one year heart bypass queues in
Newfoundland (an obvious old figure; a past girlfriend from 1987-88
was a Newfoundland M.D.  visiting NYU Hospital and she quoted me a
much, much lower figure in passing conversations -- not bad when 
your provincial capital is smaller than most college towns).

The article even fumbled handling of the only valid criticism (and
that of any actual concern to Canadian doctors) of our system, and
that is to add a market-based efficiency of token $5-$20 deductibles,
which were proposed by the Quebec Liberals but shot down by Mulroney's
federal Conservatives.  There was no distinction made as to just who
proposed what, and a doctor's story on serial hypochondriacs (who my
doctor contacts consider a blow to professional pride, more than a
mere waste of money) was buried on the opposite side of the article.
I'm willing to bet that thiss not in the Canadian edition, otherwise
doctors in Canada would be going ballistic to find that trash in their
waiting room magazine piles.

The article also mentioned that senior executives, the wealthy, etc.
can jump queues or have their cases speeded up by calling their own
contacts within a hospital ... if this is a complaint, then excuse 
me! because this is how American hospitals work, so why not Canada's?
Doesn't seem too socialist to me here ... private hospitals have their
own donors for capital costs, equipment and facilities just like in
the U.S. ... so what if the wealthy can pay their way through using
charity, they help to set up private hospitals like Mortimer Davis
Jewish General in Montreal, Toronto Mount Sinai, and L'Hopital-St.
Boniface Hospital where my own family is affiliated ... Canada's
system is just insurance to pay for patients' procedures, the rest 
is our own business, and that includes getting on the grapevine to
our friends when it is necessary.

>If you are happy with the system, great! :-) However, since you
>already have your system, and apparently, there are no Canadians
>arguing against it here, 

That's because Canadians have no need to argue against a mythical
government-run system that we don't even have ... it's just the health
insurance.  We know what our system is like, and most Canadians accept
the lies and distortions the same way we have for decades shrugged off
Americans deplaning in fur coats in July, or tourists disappointed at
not seeing singing Mounties and fur trading posts a la the old Nelson
Eddie movies, or asking whether we live in igloos ... I guess because
my ancestry is Chinese (2.5 generations) and I grew up with doctors
around me as acquaintances since my parents were very active in their
ethnic community (you know, we're overrepresented in the medical field
(-;) and continue to have them around on a social basis, all of this
speculation and silliness just bugs me after a while ...

We used to get upset when Americans said that we were just like the
U.S. but "why aren't you in the Union?" ... now, we're upset for being
set up as a Sovietic gulag because we do health insurance differently
and set apart radio airtime for domestic artists to compete against
one another (because they don't have a free market to go and freely
play wherever they want on this continent ... U.S. Immigration hates
guitars ...).
 
>the argument appears to be to use the Canadian model as an example
>for the U.S.  I believe this would be disasterous!  Most of the U.S.
>problems in health care exist because of *TOO MUCH* government
>interference in the medical, and insurance industries, not because 
>of too little.

My presentation has been to clarify exactly what Canada has in the way
of health care, which is a North American system with a single-payer
insurance.  We implemented it with a passive, earmarked public fund
for a universal risk-pool; the insurance runs on autopilot, while the
rest is between doctor and patient (plus, throw in the population and
geographic realities).  From what I've seen working and living here in
the U.S., the government isn't doing anything but talking while it is
private citizens and private insurance that are slugging it out.  The
pressure is building from the public and from Corporate America to do
something about the situation -- having Kaiser HMO act as a de facto
National Health Service (using the U.K. term) for Hawaii isn't so hot,
according to a posting by Kristin at U. of Hawaii (could she repost?).
But given the sorry history of American public enterprise coupled to
the much more widespread corruption down here (insurance ripoffs are
rare to find up north), that is why my guess would be that a future
American passive, earmarked public fund for a universal risk-pool will
be brokered by existing health insurance firms who will fill out the
balance on top with their current offerings (this is what we call
private supplementary in Canada and France, but bought seperately
over-the-counter).

gld
--
~~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare				Elections 1992-93:
> gld@cunixB.cc.columbia.EDU		* Jean Chretien (Canada)
> gld@cunixc.BITNET			* Perot^H^H^H^H^H Elvis! (USA)
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