2010-09-09

Health Care: An Inexact Emotional Science

Ok. After all the debating and squabbling about North American health care systems, here's what I perceive to be difference between the two countries: One is controlled by insurance companies who ration from the private side (even though HMC's exist) and the other is decided by bureaucrats (even though semi-private clinics and increasingly private ones exist) who ration from the public side. Neither is compassionate (although the common belief is since we offer to one and all, we're progressive and compassionate. But as we now see, it's not that simple) in its orientation but rather a cost-centric system. And this is just plain a reality since health care is a service someone has to pay for.

Pick your poison.

In Canada, for its part, because it's essentially a public monopoly, the unions hold a disproportionate amount of power. This affects our cost structure. I don't know how much this impacted the short staff crisis we're currently witnessing. We've been cutting doctors and nurses at an alarming rate.This, in turn, leads to horrific wait times.

We're also told or, worse, assume, decisions are based on empirical evidence by whoever makes these decisions.  And how to begin that! It's filled with so many contradictions (where emotions and science collide) at this point good luck explaining it to the voting public.

The truth is, health, as I've stated many times, is an economic and political issue now. More and more, we base our decisions on what the bottom line is and how many votes it'll garner. Hence, why so many head-scratching decisions that don't necessarily reflect the needs of both health care providers and staff and patients alike.

We have the money we're told. Obviously, it's the management then the problem, no?

I'm ok with absolute private hospitals for, if anything, it takes those of us who can afford it away from the over-stressed public option. If I take my kid, for simplicity sake, to a private doctor for, say, an ear ache, that's one less person with a minor issue in the public line for a kid who has a serious issue like a broken arm or femur. So I welcome the government's pragmatic decision to allow me that option.

Some will counter that this will ultimately lead to the destuction of the public system. How? Not everyone can afford to spend $300 an hour for a visit. To me, if anything, it can only help it. This is the same type of specious logic as claiming Obamacare will destroy American health care despite legitimate concerns. Runaway costs are far more dangerous to the public system than a minority of people heading into the private system. There's little logic in preventing this option.

Who's getting bang for buck? I think it's impossible to tell really. And comparing health care systems around the world tells us little since it very much reflects the intricate and unique needs of different societies.

There are no universal truths or magic potions to a perfect system.

10 comments:

  1. I think unless you've witnessed our system first hand, you shouldn't judge it.

    Some people here get diagnosed with an illness, and they would be better off hiring a lawyer at this point. Private insurers will drop you in a heart beat over the little things the minute they have to pay out. I would rather wait for hours with a bone sticking out of my hand in a public system because... well... I've done that while well insured in our private system.

    We pay more and get worse healthcare. Those are facts.

    Now, what you mentioned is the answer to it all. Private options need to be available. Society works on the basis of incentives, and having money will always carry benefits in a proper economy. I don't know if I buy that it's better for those who won't have access to it (especially if you live next to one and the next nearest is a mile away)... but I still see it as socially just.

    But honestly, no exaggeration: imagine being diagnosed with a debilitating disease here. Not only are you sick, you may be indebted for the rest of your life, or denied treatment outright (as hospitals will do so if your insurance drops you and you have no visible way of paying). Not only the poor, but the middle to upper-middle class would often kill to be on a waiting list, rather than writing angry letters, making tearful phone calls, and hiring legal representation when they become ill.

    There's really no comparison: socialization is the only sane way to handle something like medical care. You can (and I would say should) have parallel private options, but you really need that baseline level of care and security. Even if you had people dying on waiting lists, you'd still have better results than here.

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  2. [Also, last time I was hospitalized in Philadelphia, I was mailed an 870 dollar bill for a two block ambulance ride. I think I should be able to report them for kidnapping and extortion. If you're ever hurt in Philly, take a cab.]

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  3. Again, Ginx, read carefully. I took care not to be judgmental and you essentially gave more details about my observation.

    Where was I judgemental? All I did was make a personal observation and that was it and moved onto the Canadian system.

    Although I've twice been to a doctor in the USA.

    As for the last paragraph, I don't know is socialized medicine is the "only" sane option. I went to a hospital in Cuba and it was great. Except there was no medicine and furnished with old equipment and furniture. No joke. Doctor was nice as hell too.

    I accept the final compromisde with the provisions you mentioned. Isn't that what I said in the post? Only in Canadian.

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  4. That isn't compromise. It's socialized medicine without outlawing private insurance. I wasn't even aware of any non-communist country that does so (like Cuba, perhaps). I know France and Germany have private insurance alongside socialized medicine, I guess I just assumed most did.

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  5. Canada has that.

    It's also a very convuluted system that's becoming more and more complex to manage.

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  6. "In Canada, for its part, because it's essentially a public monopoly, the unions hold a disproportionate amount of power. This affects our cost structure. I don't know how much this impacted the short staff crisis we're currently witnessing. We've been cutting doctors and nurses at an alarming rate.This, in turn, leads to horrific wait times."

    By the way, this is the main issue. How to get back the doctors we cut.

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  7. I don't understand the specifics of your system regarding how doctors would be cut as a result of socialized medicine. I certainly don't see how unions would effect this; if anything, I would have predicted powerful unions would result in higher government expenditures and higher taxes.

    Have I mentioned I hate unions? They shouldn't exist when the government is doing its job, because the government is the representation of the people. Unions are just extra-governmental thugs. I would call them gangs, but I think that's insulting to the hard working people out there distributing drugs and pimping out prostitutes.

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  8. They get cut when the state is pressured to save money. Rising expenditures, wherever they come from, led to draconian decisions.

    Call it socialized or whatever, rationing took place and patients paid the price. In some hospitals - not clinics - HOSPITALS, there's but ONE doctor doing a 5pm to 5am shift.

    At least we agree on unions being nothing more than an extra-paramilitary thuggish outfit.

    It's HORRIBLE in the construction industry.

    Get this: We ordered bricks for my day care. But we can't use them until my brother-in-law passes the order on his account because he has a "permit."

    So a batch of bricks sit for one day because of useless union red tape.

    That shit costs the economy money somehow, someway.

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  9. hey!! you have a wonderful blog. thanks for sharing your life and experience here. keep it up and never give up. you can do it.

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