On 08/14/09 05:20, somebody wrote:
>> Your point?
>
> That both systems/implementations are flawed.

	That doesn't make them _equally_ flawed.

	And while I'm fine with the Canadian model, I do have to ask: Why did 
you bring them into the discussion? The proposed health bill is not 
based off of them, and there are other universal health care countries 
that are ranked above Canada.

> Possible in some life threatening cases. But health care is not just about
> keeping dying people alive. Quality of life should be a big part of health
> care. With limited and mismanaged resources, Canada has no option but to act

	And the current model in the US is _precisely_ what makes the quality 
of life worse. It's pretty much established that people with 
serious/chronic illnesses in the US wait much longer to go to the doctor 
than in most of the countries that have universal health care. And all 
studies I've looked at indicate this as one of the reasons spending per 
capita is the highest here: They wait till it becomes more serious and 
thus it's more expensive to treat.

> retroactively and in panic mode, keep pushing life threatening conditions to
> the front of the long and growing wait lines. In the meantime, some in the
> months or years long list either progress to the point of becoming life
> threatening (a mixed blessing, for then they will be pushed to the front),

	Nice in theory. I see little evidence of this. I have close friends 
who've lived in Canada for over a decade now. They haven't encountered 
this. The long wait times are almost always for things that _can_ wait 
that long.

> Recently publicized story (and sometimes mis-publicized as a life
> threatening case):
>
> http://www.mayoclinic.org/patientstories/story-339.html
>
> Sure, it's not life threatening, but if I were in her shoes, I'd not wait to
> risk blindness either, not should I be expected to, in a developed country.

	A number of points:

1. For each horror story you bring to me from Canada, I'll bring 10 more 
of the current system in the US. Statistics do a much better job at 
telling the story than individual cases.

2. As you pointed out, her case is disputed. It doesn't help that she 
continually lied about her condition to the press.

http://www.cbc.ca/health/story/2009/07/31/medicare-ad-exaggeration523.html

3. Although I think she paid for it - let's not forget that the Mayo 
clinic is a non-profit organization.

> Besides the obvious months and years long waiting lists (6 months for MRI,
> another 2-3 years for surgery is fairly common for knee surgeries, for
> instance), and risks associated with late diagnosis and threatment, the
> inability for a sizeable portion in some provinces of Canadians to have
> access to family practicioners also overburderns an already stretched system
> when patients are more or less left to use emergency rooms for diagnosis.

	I'll grant that. Still: Better to wait than not to get treated at all.

	The ultimate decider is to see the mortality statistics for each 
disease and compare. In some cases, the US was better. But for most 
problems (including, I believe, the two leading causes of death in the 
US), Canada fared better.

> And where exactly do shortage of doctors and nurses come from? Are we saying
> Canadian students are inherently dumber than their US counterparts and
> cannot finish medical school? Of course not, it's mismanagement and/or
> shortage of money. Many doctors and nurses move south of the border because
> they can make more money, work under better conditions (which comes back to
> money)... etc. Like it or not, money is what makes the world go around.

	That's merely because the US is nearby and culturally similar. AFAIK, 
the other industrialized UHC countries don't have a shortage of doctors 
the way Canada does. This isn't simply a problem of government funded 
health care.

	There are other, simpler reasons as well. The US takes foreign educated 
doctors. Canada has much greater restrictions on doctors coming from 
abroad. Hence, it's easy for doctors to leave, but hard to get doctors 
from abroad to come.

> difference may be without distinction anyway. I don't believe Canada's
> health care problems are due to doctors not working directly under
> government payroll. Either implementation could be made to work equally
> well, should there be enough money and good management.

	I'll agree with that.

-- 
Doctor to patient: Although it's nothing serious, let's keep an eye on 
it to make sure it doesn't turn into a major lawsuit.

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