v140pxgt@ubvmsd.cc.buffalo.edu (Daniel B Case) writes: >gld@cunixb.cc.columbia.edu (Gary L Dare) writes... >>>>Again, they can't force a private entity to spring to life to pay them. >>> >>>So the government, by sheer economic force, has basically cleared the  >>>basic-care market for itself. The only way to test this would be for  >>>some really daring person to start up, from scratch, in Alberta and/or  >>>Quebec, a health insurance company offering basic care. >>> >>>Crazy? Yes, but that's almost how MCI got started. >>  >>However, the concept of risks is well known by insurance actuaries >>and no private firm can get the kind of amortization that the public >>pools can get.  And since health insurance gets spent, that doesn't >>sit well with the insurance CEO's ... and you get a situation like >>in the U.S. where rates keep going up to catch up. > >See what I mean? It's a government monopoly.  Sure ... because it's a non-market phenomenom and the free market can't solve it.  Even our private insurance says that ....  >>And remember ... last year Quebec proposed giving the least risky >>parts of basic care to the private sector ... and they balked. > >Like you said...why should they?  .... and wants no part of it.  >>>By your own arguments, if you don't want the provincial plan, >>>you're basically up a creek. >>  >>Yes ... but in our culture, arguing against it is like arguing >>for national defence by means of warlords. > >True. According to polls I've read (usually in the sort of simpleminded  >stuff you were initally responding to) something like 60% of Americans  >would like Canadian-style health care, whereas only 3% of Canadians  >would like it our way. I'd be interested to know why there are that  >many (3% of Canada's population is about a million or so people).   Canada is saturated by American media.  While pundits come on cable and talk about how awful our health care is supposed to be, what people experience up north ends up not differing from what they see portrayed on American television in movies (i.e., same infrastructure, different insurance make-up).  Yet they know not of any insurance problems, and have no idea of what an HMO is ... but having lots of British TV as well, they know that they don't like NHS.  >Someone must have a reason to argue against it, valid or not-what  >kind of people are they?  The polls that you refer to, for the Canadian data, are from the annual July 1st polls conducted for Macleans (our major English newsmagazine) by Decima Research ... Decima president Allen Gregg is considered one of the world's top poll researchers, and Mulroney's Conservatives have relied on him to keep in power in the face of impossible election situations.  The American polls are Harris polls, and have been reposted on USENET a few times and probably will again. I'm sorta suspicious myself, 'cos maybe Americans want universal coverage like Canada --- I honestly doubt that most Americans realize that we have private doctors and public and private hospitals (i.e., similiar health care infrastructure) and our "system" is basically pure insurance without HMO's.  >>Given recent turnarounds by the HIAA (endorsing universal coverage) >>and hostility to corporatist HMO's within the AMA, and the complete >>silence vis a vis Canada-bashing by the AMA, I suspect that they're >>keeping the "secret" about Canada up their sleeve. > >Exactly. Wouldn't you?  Until the idea of managed competition arose, there was no direct threat to stand-alone private practice.  In the 1960's, the AMA fought HMO's as corporatized socialist medicine ... part of the reason why we have only insurance, and no HMO's in Canada 'cos that was part of the deal cut with the CMA.  >>>I've also read that the three biggest American HMOs can be compared >>>straight up against some of the smaller Canadian provinces (in the >>>Maritimes) and they spend something like $300-500 less per patient. >>>Maybe it does help. >>  >>The American HMO's can still "cream" and they probably cover a smaller >>geographic area than even our smallest provinces.  Geography, again. > >Some of them are spread out across the whole country, I think.  But each site is probably compact, and the clientele are creamed. And don't forget that HMO's place caps on your coverage, and often won't tell you about additional procedures you could get otherwise (despite that you might be willing to pay for it).  gld