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Reminder: Government health care is sub-DMV health care

Talk to a leftie and you will often hear how wonderful Canadian health care is. “Why can’t we be like them?” Crowder did an expose of Canadian health care in 2009 that is still relevant:

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Here’s the summary. Canadians pay huge taxes for “free”, “universal” health care. It makes people wait, and wait, and wait. Many people either give up altogether (and their condition gets worse), or go to a private clinic.

That’s how they reduce patients to a manageable number. Economics 101 teaches us that all goods must be rationed by one means or another, and “waiting” for people to quit the queue is how they ration Canada’s public health care.

From Crowder’s anecdotes it seems that Canadians, if they don’t quit, will wait usually about four times as long as Americans. For example, last year I went to an emergency room on a Sunday afternoon. It took 20 minutes to get the triage nurse’s attention, then another hour to see a doctor. In Crowder’s video, they visit a Canadian emergency room on a Sunday. It takes them about an hour and a half to see the triage nurse, and then 5+ hours to see a doctor (except they quit at the 4-hour mark).

Likewise, an acquaintance of mine recently needed a cancer surgery. He got it in weeks; in Canada it would have taken months. This is what Bernie and Hillary want to bring us to.

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11 Comments

  1. In Canada, if you are REALLY SICK you fly to an American hospital, …or die.

    In the Maritime Provinces, if you can afford it you buy supplementary insurance so that in a crisis you get flown to Boston. Otherwise you’re at the mercy of the limited facilities in St. Johns or Halifax; they won’t fly you to Montreal or Toronto to save your life. Too expensive…

    They’re not called provincial for nothing.

    Comment by Ted B. (Charging Rhino) — May 6, 2017 @ 3:49 pm - May 6, 2017

  2. A friend of mine in Halifax had the same foot issue I had. I got my appointment in a week, diagnosis done in the doctor’s office, surgery done two weeks later. I was back to work before she was able to get an appointment. She had to go to another facility to “confirm” the diagnosis. It was 3 months before she was able to have the surgery.

    My first call to surgery date was around a month. Her time almost 6 months.

    Comment by tnnsne1 — May 6, 2017 @ 4:24 pm - May 6, 2017

  3. On the other hand, our healthcare delivery system is a disaster. John Derbyshire has asked, rhetorically, if there is any developed nation that looks at the US system thinking “that’s what we need!”.

    We need new ideas: there are lots of options between Soviet-style delivery and a laissez-faire private system where, without charity, those unable to pay are left to bleed to death.

    As it is now, we have a quasi-public system (Medicare, Medicaid, Indian Health Service, VA, numerous state and local operations at schools, and show-up-at-the-ER) that costs a fortune. The private side is a joke since consumers have no idea what anything really costs and few, aside from the wealthy, can just write a check.

    Options include a basic public system for all with private care available (fee for insurance; actual *insurance*). We need transparent pricing; bans on fee inflation (e.g. drive-by consults); restrictions on public care provided to illegal immigrants that cross into the US to show up at the ER to have anchor babies; and big reductions in payments for conditions easily managed by simple lifestyle changes (why should we pay loads of $$ for some one whose type-II diabetes could be easily managed with practical changes in diet and activities?).

    The public system will need to say “no” to things like $1,000/month Prep regimens. Womyn will need to pay for their own birth control pills (which should be over the counter). Likewise, I’m not convinced that ED drugs should be covered (OTC, maybe?) Public care must be “good enough” and restricted to medically necessary.

    Of course, the left won’t have any of this because any exclusions or restrictions will be classified as racist, xenophobic, homophobic, etc.

    And we on the right need to get it out of our heads that the average person can routinely shop for care. A person experiencing an heart attack isn’t going to be on the phone, riding in the ambulance, calling round for prices on angioplasty; someone diagnosed with metastatic cancer is going to have a lot more on his/her mind than the cost of this chemo drug vs. that chemo drug.

    Lastly, we need tort reform. It’s one thing to sue over actual malfeasance but a lot of these cases are over bad outcomes so, perhaps, we need a system that compensates people (“good enough”) who, despite competent and appropriate care, don’t leave the hospital/clinic “as good as new”.

    Where I work, there is a department that refurbishes big steel parts used in heavy industry. The people in the back get paid you’d expect for semi-skilled shop work ($15 – $20/hr). It’s a small company and margins are thin. We have decent health “insurance” which changes every year given the tendency of insurers to impose yuge rate increases.

    The point here is that employee-only coverage isn’t onerously expensive; family coverage is about $1200/month. I’m pretty sure that shop people with kids cannot afford family coverage so their kids are on Medicaid.

    In reality, though, nothing will change until it implodes. The GOP’s efforts at repealing O-care and the lefts hysterical reaction to *proposed* (not enacted) footling changes indicate that no one is actually serious.

    And, ultimately, the current system is pretty good for those that run it: they’re doing quite well.

    Comment by KCRob — May 6, 2017 @ 4:30 pm - May 6, 2017

  4. KCR – No question that U.S. health care should be vastly cheaper and more efficient. Think about it: the whole point of technology is to lower costs and increase output. Why hasn’t that happened, in U.S. medicine?

    Hint: Big Government. Layer upon layer of anti-market interference, decade after decade. The free-market parts of the U.S. medical system, by contrast, are cheap and efficient, with well-defined procedures having well-defined, affordable prices.

    True, a person can’t shop around when they need an emergency room. But the rest of the time: Yes, they can. And if shopping around is too complex to deal with, services will arise spontaneously (that is, in the market) to help people navigate it. It is part of what insurance companies do (badly) already.

    So frankly, laissez-faire is the one and only idea that we need. If we had it, costs would crash and even poor people would get home visits from their family doctor – as was common until the 1940s or so.

    If we still want to subsidize poor people after costs have crashed, then do it by some sort of welfare benefit or voucher system. But leave people to choose! Let the market to do its work. Get government the hell out of health care.

    Lastly, we need tort reform.

    OK, that idea too.

    Comment by ILoveCapitalism — May 6, 2017 @ 4:54 pm - May 6, 2017

  5. Why is it that in the entire discussion of providing important if not critical services to those who cannot afford it the subject of charity is never brought up?

    Isn’t that what it is for? To provide goods and services to those who cannot afford it?

    Comment by Craig Smith — May 6, 2017 @ 6:02 pm - May 6, 2017

  6. Because, because, the government is supposed to provide all the charity. Isn’t that what government is for?

    Comment by Juan — May 6, 2017 @ 7:54 pm - May 6, 2017

  7. First, health “insurance” is not a simple concept. Most people have no idea of its main components:

    premiums, deductibles, copayments, coinsurance, maximum annual out-of-pocket spending limits, provider networks, covered services, annual limits on services, and noncovered or excluded services.

    Obamacare is imploding and so many people are ignoring the chaos. Their concept of Obamacare is: I get sick, Obama pays. The rest is government talk.

    In the theory of partial differential equations (D’Alembert, 1717-1783) we learn that it is not mathematically possible to maximize for two (or more) variables at the same time.

    Medicaid is welfare and until it overwhelms the local systems of health care, it is just free medical care. Eventually, any large system of Medicaid will lead to Medicaid hospitals replete with VA-type hospital bureaucracies.

    Obamacare, silently and steadily moved as many applicants into Medicaid as possible. In 2015, “including state and local expenditures,we spent $873 billion on fighting poverty in 2015. (Link) Now an increasing number of people are getting national health care with credit going to the “efficacy” of ObamaCare. It is the good old “shell game” writ anew.

    If Medicaid grows in the numbers covered, the need for additional funds for administering Medicaid and providing the care grow with it and it is merely just another underfunded entitlement. Medicaid now gives the states the option to expand their programs to all eligible persons up to 138 percent of the federal poverty level. The DemonizingRats will keep grabbing at its coverage in order to stretch more and more people into its coverage in exchange for votes. The DemonizingRats will try to maximize the variable of how many are being treated for “free.” In order for that to work, the taxpayers will have to endure having their tax burden maximized simultaneously to pay for the “free” health care of others.

    So, Bentham’s dream of “the greatest good for the greatest number” crashes and burns yet again. There is a huge difference between “a chicken in every pot” and an unending banquet 24/7/365.

    Now add “open immigration” as another variable.

    Our society has gone deep into the concept of the welfare state. It would cost $177 Billion per year to move all Americans out of poverty; yet, we spend $361 Billion per year on 13 U.S. welfare programs.

    The Federal Safety Net is made up of a complex array of programs. They are generally independent of each other and attack a single aspect of poverty such as food or rent. Each has specific regulations, goals and benefits to try and help the poor. They are each administered by large government agencies with thousands of federal employees. Taken as a whole they represent a challenging matrix for the poor to use and for the American taxpayer to understand. (Link)

    Meanwhile, we have people choosing to go to medical school and nursing school and a multitude of universities providing medical education and research and the pharmaceutical companies chipping away at methods for relief, management and even cures. All that, more or less, being the free market at work.

    The “free market” in providing medical care is hobbled by the double bind or “what people in the open market will pay” and what the insurance company will pay against the need to make a profit for the providers. Now the government is imposing itself into the equation in the belief that it can all be reasonably mapped out for the scattered population of remote Utah and the gang-banger turf in Chicago alike.

    Nationalized healthcare is directed coercion on the health care providers which is accomplished by administrative law carried out by myriad bureaucracies each competing with one another for superiority and attempting to deplete the budgets of competing bureaucracies in order to protect their own turf.

    The simplicity of the “health savings account” is in the assumption that each individual can make his own best medical decisions. We have all watched the misuse of food stamps and we can pretty much count on drug addicts selling their “health savings account” for heroin if there is any possible way to do it.

    When you give “charity” (“health savings account”) you have no control over how the recipient will handle the responsibility of spending the money wisely.

    The rule of law is a form of mutual agreement which is theoretically agreed upon by the society. Those who do not act responsibly are “coerced” to do so by the rule of law. Then we enter the realm of the entitlement which comes down from above and there is no obligation or even recognition of personal responsibility. We will never lay the heroin addicts out on the hillside to be devoured by the wolves.

    When the main forces in setting up national health care are professional politicians, for-profit hospitals, the insurance industry, big Pharma, the Chamber of Commerce and the American Bar Association, what should the average check-out clerk at the 7-11 expect his health care to be?

    In the final analysis, socialism is the process of making things simpler than possible. Socialism works best when the people are corralled and herded.

    Ask any socialist about health care and you will immediately be told about “the safety net.” The “safety net” is making sure the young, the disabled and the elderly can live “full and healthy lives in their communities.”

    Until nationalized health care is firmly in place, the march toward the socialist state is impeded. When the freedom to choose your medical options is overtaken by the state, only the very wealthy with be able to have the luxury of choice. Meanwhile, the taxpaying class will have the biggest tax increase in history. It will be a combination of
    premiums, deductibles, copayments, coinsurance, maximum annual out-of-pocket spending limits, provider networks, covered services, annual limits on services, and noncovered or excluded services. And it will be Y-U-G-E.

    Comment by Heliotrope — May 7, 2017 @ 11:06 am - May 7, 2017

  8. @7: Helio, excellent analysis as usual.

    Mark Steyn has pointed out that nationalized healthcare fundamentally changes the relationship between citizen and state.

    I do think my earlier comments stand, however. Scott Adams coined the term “confusopoly” to describe an industry that benefits from consumer confusion. 7-11 clerks and engineers alike find the system incomprehensible (unless one makes a hobby out of trying to decipher it).

    http://blog.dilbert.com/post/160305585086/the-healthcare-confusopoly

    Our system is already awash in administration. A recent article in the HuffPo points out that many doctors (and nurse based on what relatives tell me) wish they’d done something else. (I get the feeling that anything run by lawyers, politicians, and MBAs turns to crap). The following estimates administrative costs in the neighborhood of $500 billion/year.

    https://hc-reform.com/2015/01/15/health-care-waste-administrative-costs/

    I think a solution palatable to all is impossible. As I said, the system works well for those running it: they’re raking it in.

    Comment by KCRob — May 7, 2017 @ 1:43 pm - May 7, 2017

  9. KCRob, I totally agree.

    I shall now reminisce in full blown uselessness. In 1900, there were two and three generations under the same roof taking care of one another. Doctors made house calls by horse and buggy. Surgery was almost a death warrant. No antibiotics. Midwives birthed babies. Social organizations ran retirement homes. There were old folks homes where you got a clean bed and three squares a day. You did your own wash until you had to depend on volunteers. But the community stuck together and vagrants were run out of town.

    Now we have all manner of mobility and incredible medicine. We also have a huge vagrant class on welfare and snow flakes terrorizing their parents.

    I can no longer sensibly sort out what is relevant and what matters from the flurry of rights and entitlements that people have no earthily reason to expect, but they demand them anyway.

    In my little Ohio town we had a huge barn which had been masterfully built by the post and beam craftsmen who were Mennonites. In the 1950’s, it’s interior was subdivided into separate units and about a slew and a half of Roye family relatives lived in it. The laundry line seemed to stretch 1/2 mile. There were huge gardens. Junk cars were communally kept running. It what like an indoor Gypsy camp. But those children got to school on time and many found a way from life in the barn to small houses of their own. Some of the family was cross-eyed stupid, but they could rake pavement or muck out stalls or walk a lawn mower.

    Those were NOT the good old days in terms of standard of living, but they WERE the good old days in terms of the quality of life. Charity was there when needed. Church rummage sales provided the funds. In my large family, boots that were too small to be passed down within the house went to the school where the principal fitted them to a student in need.

    We have largely lost that. Not entirely, of course, but in general. We have given people the expectation that a great deal is available in housing, food, clothing, medical care, utilities and spending money if they settle into a welfare existence.

    For many, the cost of leaving that kind of safety net is not much different from you setting out to double your income in the next month. If everyone could do it, they would. So, we have created the DemonizingRat plantation society and no one knows how to unscramble those eggs.

    Comment by Heliotrope — May 7, 2017 @ 2:31 pm - May 7, 2017

  10. @9 – so true.

    I’ve wondered if there was such a thing as too much affluence. The answer, IMHO, is yes.

    PS: I’ve added “cross-eyed stupid” to me repertoire of adjectives.

    Comment by KCRob — May 7, 2017 @ 6:07 pm - May 7, 2017

  11. Employer-provided health insurance sounds easy, but the Devil is in the details. For a dozen years, I worked for a small architectural practice in Philly. Two of the partners’ wives were nurses at the local university hospital, so they had insurance through their wives. The third partner was covered by his wife’s teachers’ union plan. The office manager was covered by her husband’s job at the Temple University. The chief draftsman was in the Army Reserves and covered by the then-equivalent of TriCare. And the other three draftsmen had coverage through tgeir spouses. Thus leaving me being the only uncovered person in the firm.

    The firm’s insurance carrier couldn’t set-up a “company policy” were only one of the company’s 9 employees was to be covered. Plus, since I was the only company employee that lived out-of-state in New Jersey, they couldn’t cover me anyway since they could only provide insurance to residents in Pennsylvania. And as a PA. business, they couldn’t buy insurance in NJ since they had no corporate-presence in NJ. …To add insult-to-injury, the firm couldn’t directly-reimburse me with pre-tax dollars to buy my own coverage since they didn’t provide the same benefit to other employees.

    And since I wasn’t COBRA, I couldn’t get individual coverage in NJ since you had to be part of a “group” to establish a plan in the first-place.

    Comment by Ted B. (Charging Rhino) — May 8, 2017 @ 11:39 am - May 8, 2017

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