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June 01, 2010

Why Can't We Be More Like Canada?

Pure. Comedy. Gold:

Pressured by an aging population and the need to rein in budget deficits, Canada's provinces are taking tough measures to curb healthcare costs...

Hey, wait a minute! Wasn't single payer supposed to solve that problem?

Ontario, Canada's most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices...

Because as we all know, every time the government halves prices costs are magically cut in half as well. Theoretically, this process can go on indefinitely, thus cutting costs to zero.

...a few provinces are also experimenting with private funding for procedures such as hip, knee and cataract surgery.

"Not that Canadians have any problem getting timely and effective treatment for these conditions, mind you..."

"We can't continually see health spending growing above and beyond the growth rate in the economy...

Hey, wait a minute! Wasn't single payer supposed to solve that pr... DOH!!!!

.... because, at some point, it means crowding out of all the other government services.

Or they could just hold a reeeeeeealy big bake sale.

"Why are we paying more or the same for cataract surgery when it costs substantially less today than it did 10 years ago?

Because the main advantage of centralized government planning is that it does such a great job of protecting consumers from greedy corporations? No wait! That can't be it! (from the comments):

Cataract surgery once took hours, and it was very finicky. Now it's in and out in 10 minutes. So why should we pay ophthalmalogists the same that we paid them when it took hours? It's not inflation; it's just that technology has made some procedures relatively simple now.

I'm married to an Ontario physician, by the way, and I'm amazed at how STUPID the Ontario government is when it comes to paying fee for service. Gastroenterologists, for instance, make a ton for every scope, because the fee schedule was set when it took hours, too. Now they can do 4 an hour, but they're still paid as if it took 3 hours.

By the way, the document that lists all the fees Ontario physicians can bill is over 2000 pages long. Talk about bureaucracy.

Too funny.

Posted by Cassandra at June 1, 2010 08:37 AM

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Comments

If the government supposedly protects us from greedy K Steet types, I mean corporations, who protects us from greedy politicians, I mean government?

I like the image of health care costing so much money that other government workers are laid off to make up the gap. Sounds like a skit on SNL.

Posted by: vet66 at June 1, 2010 11:58 AM

Considering the fact that Canada has provided universal healthcare for ALL of its citizens for almost 50 years and they still pay half what we pay today, I'd say Canadiens still have alot to smile about.

Posted by: Craig at June 1, 2010 12:18 PM

Except for that whole "We don't have the money to pay for this" thingy, that is :p

Posted by: Cassandra at June 1, 2010 12:20 PM

The article you cite suggests where cuts will be made, such as pharmaceuticals, replacing block grants, and adjusting fees for services that are cheaper now.

I'm sure the gubmint can come up with other options, as well. Their system is far from collapsing.

Posted by: Craig at June 1, 2010 12:39 PM

The article you cite suggests where cuts will be made, such as pharmaceuticals, replacing block grants, and adjusting fees for services that are cheaper now.

Yes, they will cut prices but not costs. Can you say "shortages"? Good, I knew you could.

Posted by: Yu-Ain Gonnano at June 1, 2010 12:41 PM

Yu-Ain, you ignorant slut :p

Don't you know that greed is the method health care providers and insurers use to set prices in a free market system?

They can set prices as high as they want because there is no mechanism to prevent them! And don't listen to all those free market Nazis who argue that a supplier who charges more than his competitors will soon find his customers have left him for the guy who charges less! Why, everybody knows they're all in cahoots. One supplier would NEVER undercut a competitor to win business away!

The only solution to this is to put pricing under the control of centralized planners who know nothing about underlying labor and equipment costs but DO know a "fair" price when they see one! And for you naysayers who are wondering how a centralized bureaucracy can adjust thousands of prices in real time to constantly changing costs and demand levels (not to mention local conditions that affect supply and demand), well you're just mean!

Posted by: Cassandra at June 1, 2010 12:59 PM

On the day that I'm baking six cakes for a bake sale ... to raise funds for medical treatment. ;) I'm having a good time, going out on the deck and play Tai Chi Chuan in the sprinkles while they bake.

Posted by: htom at June 1, 2010 02:43 PM

That's right, Cassandra, in today's global marketplace, competitors are your friend and consumers are your enemy.

Posted by: Craig at June 1, 2010 02:49 PM

Unlike this administration, Craig, I don't see how it is useful to demonize different parties in the economy.

American citizens are consumers, but they are also business owners. They are buyers, but also provide goods and services. So it's seems pretty stupid to me to talk about "friends" and "enemies". Maybe you want the federal government dictating prices when they have less information about supply, demand, costs and scarcity than consumers and businesses, but you have yet to explain why that's a good idea.

Simple minded and emotional characterizations like "friends and enemies" don't describe a fluid situation where legitimate competing interests must be balanced.

Oh. I forget - "enemies" have no legitimate interests.

Posted by: Cassandra at June 1, 2010 02:56 PM

The efficiency of FEMA and the compassion of the IRS I believe was the prediction.

And while "data" is not the plural of anecdote, I seem to recall that a number of Canadians come south of the border because of the waiting time for procedures like cardiac catheterization, and that one province was/is being sued because it denied a 56 year-old-man a hip replacement because he was unlikely to pay the costs back in taxes. This despite his previous contributions to the system and his future earnings potential. His suit alleges denial of basic human rights because of his being told to just deal with the pain and to not try and seek treatment elsewhere.

Yes, there are very good parts of the Canadian system. There are also some major flaws and abuses too. I'll keep the current US version, thank you much.

Posted by: LittleRed1 at June 1, 2010 03:32 PM

competitors are your friend and consumers are your enemy.

Of course, who is your competitor is largely depends on who you are.

As a consumer, other consumers who are competing against me for limited supply of stuff are naturally *my* competitors. They raise prices and as such could be called my "enemies" while the business considers us both its "friends".

But this also works the other way around.

As a business, other businesses having to struggle for the limited supply of consumer's cash against each other are naturally *their* competitors. They lower prices and as such could be called the business' "enemies" while the consumer considers them both its "friends".

Much in the way that comedy is what happens to you and tragedy is what happens to me, whether competitors are "friends" or "enemies" depends on whether you are the one competing or being competed for.

Posted by: Yu-Ain Gonnano at June 1, 2010 04:02 PM

Cassandra,

"competitors are your friend and consumers are your enemy"

Simplistic, yes. Inaccurate, no.

When major health insurance companies lobby Congress for the right to deny coverage to their clientele because they have the sheer audacity to get sick, how better to describe it?

LittleRed1,

The fact that Canadians have the option head south and pay for treatment that would take longer to get in Canada is good thing...for Canadians.

As far as "I'll keep the current US version" goes. What choice do you have?

Posted by: Craig at June 2, 2010 07:28 AM

When major health insurance companies lobby Congress for the right to deny coverage to their clientele because they have the sheer audacity to get sick, how better to describe it?

Gee... I don't know. As a predictable consequence of the free rider problem? Or in the case of existing customers, as a feature of contracts they voluntarily signed?

But the world will be a much fairer and better place when government force replaces freedom of contract.

The fact that Canadians have the option head south and pay for treatment that would take longer to get in Canada is good thing...for Canadians.

Yes, the world will be a much fairer and better place when no one has choices. Sure, some people will die when they would have lived with faster treatment, but you can't make an omelet without breaking a few eggs, can you?

Posted by: Cass at June 2, 2010 10:48 AM

Simplistic, yes. Inaccurate, no.

Under what possible rubric could it be accurate given that a single person could be both a competitor and consumer?

Multiple Personality Disorder?

Posted by: Yu-Ain Gonnano at June 2, 2010 11:02 AM

Craig, the choice is between the current, flawed but functional system, and the one Congress and the President are so gung-ho for. I am doing my bit to support the states that are suing to block the Health Care Reform Law of 2010.

Posted by: LittleRed1 at June 2, 2010 03:10 PM

Insurance companies don't penalize customers for the audacity to get sick. They decline to cover bets they believe they haven't made, though the customers may disagree about the terms of the bet.

Insurance companies are not charitable operations who are supposed to care for the the sick out of compassion. (That would be the function of friends, family, churches, and philanthropists.) If we went back to thinking of planning to pay for our own medical care through a prudent combination of savings and actual insurance (meaning a pooling of unknowable risks, not a cure to the problem of people who were sick before they tried to get insured), we'd have a more rational and predictable system, and one that wasn't so often accused of an irrelevant "heartlessness."

Posted by: Texan99 at June 4, 2010 09:05 AM

We don't have to be more like Canada. They're just across the border.

Posted by: Ymarsakar at June 4, 2010 01:50 PM

"Now they can do 4 an hour, but they're still paid as if it took 3 hours."


Yeah, but wouldn't it be simply degrading if Doctors were paid by the hour?


Not as degrading, I suppose, as if Doctors were able to set their own fee schedules.


About that "insurance" thing: Insurance is a hedge against future damage. So if you've got a history of heart problems, we're probably not going to write you a life insurance policy. Things have been that way ever since there were insurance companies. Lots of people, since the 30s and 40s (at least), have been denied insurance coverage because they've been a "bad risk".


You don't get to buy auto insurance while your car is wrapped around a tree. You don't get to buy fire insurance while your house is a smoking ruin.


The Obama-liberal "single-payer" concept isn't insurance. It's a way to get everybody to pay for everybody else's misfortune.


That's what they want - but they ought to just call it that, instead of pretending it's "insurance".

Posted by: ZZMike at June 5, 2010 02:47 PM

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