
When you buy insurance where you live, it is based on the local rates.
Tourists coming from, say, Utah will find that there is a difference
in what their insurance will cover FOB Provo and what they get stuck
with at Lenox Hill or Mount Sinai if they fall ill in the Big Apple.


It would depend on where you live, downtown Toronto or Mile 101,
British Columbia (just like Cheyenne, WY vs. Boston, MA).  Again,
geography rears its ugly head.

Since our health care providers are private, they depend on an
adequate market size in order to sustain enough business.  Since
our health care professionals have equivalent take-home pay to 
their American cousins, it's not that they're being paid too
little to provide services.


I have only hear Americans say that it's illegal ... but I could be
wrong, just have never heard it from a Canadian source.  our private
insurance has recently balked in Quebec when the Liberals proposed
privatizing some aspects of routine care ... also, our insurance was
put in place when no NDP (Labour) governments were in power in any
province to derail the effort 'cos they wanted real socialized
medicine.


No, it is optional ... as it is optional for doctors to accept it.
There are isolated religeous communities in particular that ask for
exemptions (and one e-mail from a Christian Scientist in Edmonton
verified for me that it is indeed negative option).  I guess that you
can argue that there is a right to having a particular insurance, but
so far I've not come across that up north ... and I take pains to keep
tabs with news from home.


Believe me, they probably had orgasms when they figured that out.  And
according to my sister the yuppie, they pat themselves on the back to
the point of ungraciousness at Chamber of Commerce luncheons.


I actually have doubts that any new ones have emerged since WW I ...
no, scratch that ... there are a few in Western Canada, and *quite* 
a few in Quebec as part of the post-1980 Quebec Miracle (out with the
nationalism, in with the French capitalism).  La Groupe des Cooper-
antes built a new tower by the Eaton('s) store at Les Terraces, and if
you were able to catch Urban Angel on CBS's Crimetime you'd see it as
the well-lit one with double-turrets at the top.  As for Ontario,
which still dominates and anchors business up north ...

Canada is a very old-money kind of place, and the 1989 Free Trade
Agreement saw a lot of odd alliances: labour unions and establishment
old money who wanted to preserve their traditional monopolies on one
side, and entrepreneurs and internationally oriented businesses and
professionals on the other.  The final Trudeau administration and
the first Mulroney government had a high percentage of nouveaux
riches who knew what it was like to make your own money, and that
motivated the McDonald Commission under Trudeau which set up Brian's
initiative (Macaroni was against free trade 'til he did a head count
of his caucus after the 1984 election).


Well, you have to realize that in our society that's like saying
that "it's not really national defence" because you can't hire
your own Rambo squad instead or even opting out as a pacifist.
(BTW, there are always pacifists in the news arguing about their
portion of taxes, but never people arguing over health insurance
alternatives ... and we're talking about a press that is hostile
to whomever is in government, regardless of party; one of their
few redeeming characteristics, it seems (-;).


The only way to hit at the Canadian system is transient periods of
high demand, which is more a function of the doctors monopoly's tight
fist on the licencing.  An obvious difference is that in such a
transient period, the rationing is of the nature of a mob battling
over Cabbage Patch Dolls^TM as we've seen recently as opposed by
rationing by ability to pay ... but the former is a *transient*
situation and if a large body of insured patients were to deluge the
California health infrastructure, the same would result --- rationing
among the insured population.  With smaller markets, there is much
less flexibility when dealing with our insured population than
California (which by the way, has 1/3rd more people than Canada in a
MUCH more dense area).  So he is correct in that the resources are
fixed (for a particular time window, or as a function of the doctors
monopoly licencing according to the market steady state) in either
case.  As for being "refused treatment" the government of the day
would be shredded to tatters if something like that were to happen;
Canadians can be geographically bad, too, not realizing that their
health care is private while only their insurance isn't ... too many
people have bought into socialist trype that we have socialized
medicine.


Right, as I've pointed out above ...


Either way, the transient situations are hard to deal with since the
changes in the private medical care resource take place at a slower
rate than the ability of people to fall sick esp. in the light of
disasters (e.g., Chernobyl) or bad luck (a sudden wave of heart
disease). A doctor needs 4-6 years of training, plus internship 
and specialty training.


That's why I've argued for deductible and copayments rather than
education, which is what most Canadian fiscal conservatives are
arguing for (the leftists?  "Ah, just let 'em spend!" --- yeah,
right!).  Also, note that only a few provinces cover prescriptions
under some high dollar threshold ... in most, it's your private
insurance that covers it just like in the U.S.  Still, it all
adds up in the OECD measures.


We get the Sabres' feed as a replacement game on ESPN tonight (the
Devils' local metro NY coverage supplants the main ESPN game).


Yeah, it's a sad story and Saskatchewan Tory leader Grant Devine
has been on a nonstop PR campaign to save his sorry butt.  The
Sask NDP have taken a neo-conservative turn like Hawke, Gonzalez
and Mitterand did.


The medical IRA would have limited use, as you'd need a lower
catastrophic threshold else there'd still be a drain on the public
purse if someone exhausts their IRA.  Also, Singapore has a much
more autocratic mentality which has seaped down into its masses
(if Singaporeans that I've met are any indication ... I don't
mean any disprespect here) where they'd let you just die.


That's true ... the question is how much leeway is there between
the U.S. approach and the second-most capitalist approaches of
Canada, France and Germany.


Yes, many ... and pretty close to a lot of smaller towns or not too
far from a bigger town.  Just take a look at a detailed atlas ...
or better, take a flight from Pittsburgh or Rochester to Toronto.
My first time across Lake Ontario to NYC, I was amazed by the
increase in density ... and the Toronto region is the densest 
in all of Canada.


It's about time!  I've ragged on my own doctor friends as to why they
don't invest in their own private practices ... in the end, it's their
money.  But they choose to spend it on America's Cup pipedreams, and
that's none of my business.  As for "provincially owned" ... for sure
it's against the law in Canada for governments to be directly involved
in the provision of health care except in the military or native reser-
vations.  What that term actually means is that the facility gets by
on public grants to meet shortfall from *lack of use* ... no kidding.
Medical practice itself is much more conservative up north.  My own
best friend did two clerkships at the Mayo Clinic in Rochester, MN,
and is no stranger to high tech medicine ... but his boat comes first.


No, it's probably socialist whiners who are offended that we have
private practices ... and always have.  They can all take cash
anyways ... so why not have a particular facility?  The Canadian
big government mentality often imagines government where it does
not even exist ...

Since the French and Germans have become more entrepreneurial and less
laidback without sacrificing their culture and values, then Canadians
can do the same.  As I've pointed out above, the law states that it is
illegal for the *government* to provide any health services except for
the military and natives.

Look, nobody stopped the clinic when they planned on the MRI ...
nobody stopped them when they bought it.  Nobody seems to be stopping
them from using it, either.  Much ado about nothing.  Thank goodness
that hockey playoffs have started ...


I'm certain there is exaggeration somewhere, because the GAO study
of Canada cited often on USENET did not find access to MRI to be a
problem.  I'll bet the doctor is relying on people having listened 
to American trash talk on cable so that he can puff his chest a bit.
There are already a few treatment regimens for knee injuries without
relying on MRI ... unfortunately, I've had a few. )-;  And I'm not
a banker. (-;

gld