Thoughts, essays, and writings on Liberty. Written by the heirs of Patrick Henry.

“But where says some is the king of America? I'll tell you friend, he reigns above, and doth not make havoc of mankind like the royal brute of Britain. ... so far as we approve of monarchy, that in America the law is king.”     Thomas Paine,    Common Sense, January, 1776

November 30, 2006

It Could Be Worse

by Doug Mataconis

For all the complaints one can make about politics in the United States, it pays to remind ourselves that things could be worse, we could live in a country where the public has so thoroughly bought into the big government ideal that there is little hope of things ever changing. For example, take our neighbor to the North:

Ottawa, ON –According to an Ipsos Reid survey among the general public, a majority of Canadian adults rank a patient wait times guarantee as more important than any other of the Government’s priorities. Of the five policy promises made by the Government of Canada during the last federal election, 42% of Canadians said that “a patient wait time guarantee that would reduce wait times for key health services” was the most important to them personally. This compares to lowering taxes (19%), restoring accountability to Ottawa (14%), tackling crime (14%), and implementing a choice in childcare program (9%).

One wonders where making sure the trains run on time fits in that list.

H/T: Club For Growth


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30 Comments

  1. I came across your posting, and as a Canadian, I thought I should add a few words. The patient wait time guarantee, and the other issues mentioned, were all the main parts of the Conservative Party platform in the election they won earlier this year. This guarantee is supposed to be able to say that if you need a particular test or procedure, such as a MRI, it will be available for you within a reasonable time (as determined by doctors). Right now, wait times for these procedures will vary widely between our provinces.
    Health care, of course, is always a big issue in Canada, as it is in your country. Most Canadians, including myself, believe in universal access to medical care, which means that if you are sick you don’t need to pay for for treatment. I find it very sad that in the US you have millions of people who cannot afford the costs of medical insurance, or who otherwise suffer financially for being sick. All medical systems have their share of problems, but I think on a whole the Canadian system is one of the best in the world. Moreover, the per capita costs for medical treatment in Canada is about 1/3 less than in the US, so you are paying quite a lot more for your system, and in terms of overall health, Canadians are better served (for example, Canadians live longer, on average, than Americans, and our infant mortality rate is lower too).
    That said, private medical care is available in Canada, and has been steadily expanding over the last number of years. But most private practices are in specific areas, such as day surgery, which are the most profitable.

    Comment by Peter Konieczny — December 1, 2006 @ 9:43 am
  2. Peter, a few fact checks for you.

    1. No one in the USA is denied access to health care. They may need to go to an urgent care or emergency room to get it, but they will get health care.

    2. As usual, those who want socialized medicine compare apples to oranges, whether that is Canada, Sweden or some other small country. Find a comparable sized country (population, geography, etc.) with comparable industrialization, GDP and immigration rates and we can talk. What’s that? You can’t find one? We’re the only country with 300 million people with an immigration rate like ours, a GDP per capita like ours, etc? Oh, gee. So, let’s talk about what we can do, not how we can be more like Sweden or Canada, which is patently impossible, not to mention foolish and out of touch with reality.

    3. One of the major causes of our issues around healthcare IS that we are socialized. Medicaid and Medicare are major drivers within our system. That said, even if they weren’t, our payer system virtually guarantees that there are no market forces in play, since the consumer is not the person who pays. Hopefully you have enough understanding of economics to see why this poses a problem, and a significant one at that.

    4. You clearly don’t understand the place that government programs and systems like Kaiser have played in creating our current mess.

    Comment by Adam Selene — December 1, 2006 @ 11:36 am
  3. Adam, there is no way we could go back to a payee system now. The cost are way to high. Prescriptions forget it. If you were to have only a cold every now and then, maybe. You think the pharmaceuticals are going to reduce their prices, or do you think folk are just going to give up their drugs. Even generics are high. Maybe you assume that many people have two to three thousands dollars of disposable income, and I would probably think that would be better saved for retirement. That would be the cost of four or five visits a year and maybe three to four prescriptions. Don’t have a child and pray that your prescriptions cost would never cost as much as mine. Believe me when I tell you when you are facing life and death it would be hard to stand on principle and say I can’t accept treatment because the system shouldn’t be this way.

    Comment by VRB — December 1, 2006 @ 2:34 pm
  4. Reminds me of everything people said about deregulating every other industry that has been deregulated. Yes, I actually do think pharmaceutical companies will reduce their prices just as soon as the government stops meddling in the market. Yes, I actually believe that the market is more efficient at allocating resources than a couple of folks in a payer organization are. Yes, I think that our current system creates dramatic over utilization that drives prices up.

    Comment by Adam Selene — December 1, 2006 @ 7:37 pm
  5. Adam,
    Just how much would you think the drug cost would come down, 50 percent, 75 percent, 80 percent. Most drugs I take would have to come down 80 percent before I could afford them. Get real! A drug touted by advertising to increase blood count, price is around $1700 a dose. Since it’s advertised, I would think the drug companies think there are quite a few people who could take this drug. You think they would drop this to $170? Some people could die waiting.

    Comment by VRB — December 1, 2006 @ 8:36 pm
  6. Adam,
    Maybe I have misunderstood. I am assuming that you would abolish insurance too.

    Comment by VRB — December 1, 2006 @ 8:52 pm
  7. First, I think the cost of the FDA and the regulation of the healthcare environment causes a lot more of that price than you, apparently, think. Second, do you think that there will be more, or less, innovation and investment in pharmaceuticals if we deregulate? Third, while I feel for you, and anyone else that needs expensive medication, I have to ask if it is moral to take money out of other people’s pockets? Or, to quote Walter Williams:

    We love government because it enables us to accomplish things that if done privately would lead to arrest and imprisonment. For example, if I saw a person in need, and I took your money to help him, I would be arrested and convicted of theft. If I get Congress to do the same thing, I am seen as compassionate.

    Comment by Adam Selene — December 1, 2006 @ 8:58 pm
  8. Why would I abolish insurance, provided that it\’s actually insurance and my personal choice, rather than this semi-private, collectivized mess that has been forced on me by the will of the majority? Insurance, real insurance, makes sense. What we have now is not insurance, though, and it has been brought about by government intervention, both direct and indirect.

    Comment by Adam Selene — December 1, 2006 @ 9:10 pm
  9. Adam,
    It is not only specialize medications, that have high cost. You should do some research. You did not answer my question about insurance.

    Walter Williams is very clever, but that doesn’t solve the problem.

    Comment by VRB — December 1, 2006 @ 9:30 pm
  10. I did answer your question. I have nothing against true insurance.

    Comment by Adam Selene — December 1, 2006 @ 10:22 pm
  11. VRB –

    What we call “health insurance” in the US today is really nothing of the sort. Insurance, real insurance, means pooling against risk. Modern health plans, due in large part to laws stipulating what must be covered, covers a great many things that cannot be insured at a reasonable price.

    Prescription drug “insurance” is damn near impossible since a great number of people seeking have guaranteed losses, which makes keeping inbound premium greater than outbound losses impossible at the price most would pay for it. What you get instead is “group-buyer” drug coverage, like most private coverage, or subsidy coverage, like Medicare Part D. Both of these distort the prescription market, making the price of the drugs in a free market an unknown.

    A more realistic plan, especially for folks who need specialty meds, would be something like “High Cost” drug insurance. While it’s impossible to insure against someone needing drugs period, it would be possible to insure against someone needing specialty drugs, since relatively few will. Do something like a lump sum payment upon prescription of these drugs, say $170,000 paid out for the blood count drug above, and you’d be on to a workable model.

    The large point is, costs that are incurred as the result of an infrequent event, such as a car accident, are insurable at a reasonable price. Events which occur regularly, such as oil changes, are not insurable at a reasonable price. In the case of medicine, that means only certain things can be covered by an insurance model, which means that other things that we want paid for by our insurers have to be dealt with in other ways, either straight out subsidies from them or bending the arms of doctors by demanding group discounts.

    Since both of these give the insured far more buying power than he would normally have with his income, it encourages the insured to seek services he might not otherwise. This creates high demand, which drives prices up across the board, since the demand has made the services more valuable. This is pernicious in two ways. First, it creates a feedback cycle in which even routine medical care gets very, very expensive. Second, it robs the uninsured of their buying power in the medical market.

    If you couple the latter with the current tax system’s bias towards having employers buy health coverage, you end up in a place where doctors work for health insurers who work for employers, with no one working for patients and the unemployed and self-employed being totally out in the cold if they need health care.

    Comment by Quincy — December 2, 2006 @ 12:54 am
  12. Adam, I didn’t see your comment when I said you didn’t answer my question.

    Comment by VRB — December 2, 2006 @ 6:21 am
  13. Okay, I see that now. So, a true insurance model, which Quincy describes well, is something I would favor. Our current collective buying model is horrible. It is one of the biggest reasons why our healthcare costs are high and many people are not able to get healthcare outside of ER\’s.

    VRB:

    It is not only specialize medications, that have high cost. You should do some research.

    Would working for a payer count? I\’ve worked with the fraud & abuse, prior auth and pharmaceutical units of a very large payer.

    VRB:

    Walter Williams is very clever, but that doesn’t solve the problem.

    Meaning what? That it IS morally okay to take money from me to benefit someone else so long as you have a majority vote in Congress?

    Comment by Adam Selene — December 2, 2006 @ 8:00 am
  14. Adam,
    First, you would have to accept William’s analogy as true. I don’t think this to be the case and I don’t see it as being morally equivalent. I have heard the same type of an analogy in reference to war; they are using my tax money to murder. You may not want society to be this way, but our society has chosen our government and I think most Americans want a lot of these social programs. Many of the entitlement programs are more than 40 years old, so we have had quite a while to change them. So if this is the case why would they be immoral, those programs would be for the “good” of society, as they see it. I think what you want, is for your libertarian ideas to become a moral philosophy for America; as for some others that want America to adopt Christian values as a moral philosophy. Moral values in a society are not necessarily right or wrong, but what would be good or bad for that society. It might conflict with our personal or religious values.

    Comment by VRB — December 2, 2006 @ 4:17 pm
  15. Just because a lot of people want something doesn’t make it moral.

    Comment by Adam Selene — December 2, 2006 @ 8:33 pm
  16. Moral values in a society are not necessarily right or wrong, but what would be good or bad for that society. It might conflict with our personal or religious values.

    …just like slavery and Jim Crow in the South, Hitler’s Germany, hyper-moralistic Islamic theocrats and so on.

    VRB, the type of democracy that you are advocating is not only misguided, it is dangerous, as history has shown time and time again. Question for you: would you think differently if, “for the good society”, a majority voted to inordinately deprive you of life, liberty or property?

    Comment by Robert — December 3, 2006 @ 9:07 am
  17. And, using VRB’s own argument, is it really “good … for that society” to teach that you can steal from your neighbors by the simple expedient of a majority vote?

    Comment by Adam Selene — December 3, 2006 @ 9:49 am
  18. P.S. I don’t want my “libertarian values” to become what is moral for this society. I want us to stop using democracy to destroy liberty.

    Comment by Adam Selene — December 3, 2006 @ 9:51 am
  19. You assume that what you think is moral is every bodies idea of true moral values. What I am saying that if most people thought what the government was doing was immoral then I think there would be more outrage. It is very easy to not sign up for medicare or Social Security. Most people don’t even see it as a tax. Ask at random, if they would approve of means testing and you will hear, I am entitled to get my money back. They don’t realize that after two years or sooner they have gotten back what they put in.

    Morality is defined as what is the “good.” You are the one who says it is stealing. That is the nature of government, if not then you as an individual would be responsible for defense of your property and there would be no purpose for government. Perhaps that is how you see it, that government has no purpose. When you are taxed, your money will most certainly go to benefit someone other than you, even if the things government do are most basic. This is why I say that William’s analogy is false. I think one would want anarchy, if it were true.

    Comment by VRB — December 3, 2006 @ 11:22 am
  20. BTW, since I am an older person, could I use William’s analogy to say you are stealing my money, because I paying for a military that protects you.

    Comment by VRB — December 3, 2006 @ 11:27 am
  21. You assume that what you think is moral is every bodies idea of true moral values.

    No, actually. I simply don’t believe that you should impose your morals on me.

    What I am saying that if most people thought what the government was doing was immoral then I think there would be more outrage.

    Like all the outrage against Jim Crow laws prior to 1955, or so?

    It is very easy to not sign up for medicare or Social Security.

    Really? How do I keep the government from taking my money for SS taxes?

    Ask at random, if they would approve of means testing and you will hear, I am entitled to get my money back.

    In other words, most people don’t think it’s moral to take their money and give it to someone else. They only find SS palatable because they believe they are getting their money back.

    They don’t realize that after two years or sooner they have gotten back what they put in.

    If this were true, SS would not be in financial trouble as retirement age folks increase in number.

    Morality is defined as what is the “good.” You are the one who says it is stealing. That is the nature of government, if not then you as an individual would be responsible for defense of your property and there would be no purpose for government.

    I always thought moral was defined as good too. Funny thing, though, is you appear to be defining moral as good for some people, even if it is bad for others. That’s an interesting definition of moral. You also appear to be of the mindset that the government, by the mere virtue of receiving 50%+1 of the vote, should be able to do things which are not moral for individual citizens to do. It is moral for an individual to defend their life, liberty and property, ergo it is moral for the government to defend my life, liberty and property. Robin Hood was a criminal when he stole from the rich to give to the poor.

    When you are taxed, your money will most certainly go to benefit someone other than you, even if the things government do are most basic. This is why I say that William’s analogy is false. I think one would want anarchy, if it were true.

    Not at all. I can think of many ways that we could provide funding for government activities that do not involve income taxes. In fact, our government did just that for the first 130 years, or so, that it existed. Washington, Nevada, Alaska and many other states seem to work just fine without income taxes. Are there necessary, moral, functions for government? Yes, there are. Defending the country from attack, protecting my life, liberty and property from foreign and domestic enemies, interacting with the governments of other countries, providing a basis for trade and currency, those seem to be moral functions of the government. Do they include a military that can invade other countries, a social services institution that can regulate our daily life, police forces capable of defeating many of the world’s armies, and so on? I don’t believe so. Do you?

    BTW, since I am an older person, could I use William’s analogy to say you are stealing my money, because I paying for a military that protects you.

    You could, indeed.

    Comment by Adam Selene — December 3, 2006 @ 11:49 am
  22. I checked back to see the response to this article – I am glad you have a lot of debate. As a Canadian, I don’t have a great deal of knowledge regarding the US health care system, so I would be happy to be corrected on any factual errors. First off, to Adam, you state that it is always possible to see the emergency room or urgent care center for treatment and you will not be denied access. This sounds odd to me, since I assume that the hospital will still demand payment for its services, for example if you break your leg, they are not just going to set the bone and apply the cast for free? Would I be correct in thinking that every hospital will have a limit to any charitable work they do – I would assume that they are not going to go after a homeless person for cash he does not have, but if you do have a job (albeit lowpaying) you will have to pay for their services?
    I also was wondering how does these emergency services deal with non-emergency cases. For example, I have a 8-month son, and we have went to the doctors on four or five occasions for him to have check-ups and get immunization shots. How does this get handled in the US with people who cannot reasonably afford this expense (and there are always people at this level, so it cannot be just dismissed out of hand)? Does your government agencies cover expenses for children, especially since immunization shots are required for a child to attend a public school?
    Moreover, does this kind of system encourage preventitive health – how do you handle things like annual check-ups, routine mammograms for women older than 35, PAP tests, etc.? I would be astonished if these kind of services get done in an emergency room setting, since it would make for a lot of overcrowding and a waste of resources.
    I was wondering how widespread are the use of health plans in the US? I believe that nearly everyone who can afford to sign up for one is part of one, and I would guess that 3/4 of your population have some sort of plan. How much do they cost on average, and is their a wide variety to choose from? Does the price reflect the kinds of services they cover? If there are a lot of various plans and providers, how does this work with doctors – this is a really important point – the paperwork to deal with dozens of different providers must be a terrible mess and very inefficient. Or are most doctors just affiliated with one provider, meaning that if I want to be with a particular doctor, I need to be in a specific plan? This is a real key to providing quality health care, and the simplification of bureaucratic matters is a highly desired goal.

    I should state that I do work as a medical secretary, for a family doctor, so I have an understanding of the complexities of working in the health care industry. In our practice, the doctor handles the billing paperwork, and I would say he devotes about 2-3 hours a week on this. We have a few patients who are outside of OHIP, the provincial health plan we all use, perhaps 3 or 4 people a week – these include visitors to Canada, a few refugee claimants, and people who live outside of Canada, but come here for medical services (we have a couple of patients who live in the Carribbean, but when they come up here to visit family or for business, will also come see us to have a check-up). Also OHIP does not cover every service – for example we charge patients $10 for a sick note, and if you need an exam as part of getting a license to drive a truck (the big rigs, not a 4×4 or anything like that) the going rate is $100. But this is a real minor part of our practice, and the doctor just handles it all as a cash payment (we dont take credit cards or debit payments).

    I also want touch on your claim Adam that it is impossible to compare countries on health care. I respectfully disagree here – first off, countries are compared on a wide variety of social and economic factors, for example productivity, and the governmental and business communities agree that they can be considered accurate in a general broad sense. Life expectency and infant mortality are standard benchmarks around the world – everyone considers them important, everyone country wants to improve them (hopefully!), and its relatively easy to measure them. While the US might have unique characteristics, that can be claimed for every other nation on earth (by your reasoning their is no way we could compare Canada to Sweden, or even Norway to Sweden). Moreover, sure the US is a big country in terms of population, the differences between it and other Western nations, like Canada, UK, Germany, France, Australia, etc., over matters like ‘industrialization, GDP and immigration rates’ dont vary widely at all. Furthermore, we also share a lot of the same social and cultural characteristics and influences. Instead of thinking that a comparison would be like apples to oranges, I would think it is more like comparing Navel oranges to Valencia oranges. Also, by claiming that the US is so different from other nations it effectively allows for one to avoid dealing with problems and importing solutions used in other countries by saying ‘we are not like them, so it can’t work here’. Instead of emphasizing differences, we should all look to the similarities with each other, and use this as a base to improve each other’s respective systems, in this case health care. For instance, in many parts of western Europe they have extensive use of electronic records by family physicians (we started this at our own practice last year). While the conversion process of going from paper records to electronic ones is certainly not a simple and easy endeavour, we are seeing on a daily basis real improvements and efficiencies here. In the end, it is leading to improved health care for our patients. Now, while electronic record keeping is widely used in countries like the Netherlands, less than 1/5 of family doctors have them in Canada, and about 1 in 10 in the US do. I think that governments need to encourage this use among doctors, which ultimately involves subsidization and other incentives, otherwise it will take far, far longer, to have doctors sign up for it. These kind of incentives are still not available in my part of Canada, although they are just now being implemented, and I would hope to think that in some parts of the US, state or local governments are encouraging the practice. I don’t see what differences exist between the US and other countries that would prevent American doctors from doing this – you certainly have the infastructure for this, having computers, reliable internet access, and a well-educated health work force that could easily adapt to electronic records. I would think it would be very difficult to successfully implement this practice to Ecuador, or rural parts of India, but certainly not the US or any other western nation.

    Sorry for rambling. I really enjoy the conversation here. one last question: how are flu shots handled in the US? Do you pay for them, or are they covered by your Federal or State governments?

    Comment by Peter Konieczny — December 3, 2006 @ 12:04 pm
  23. Peter, I can answer a lot of your questions. I work in the healthcare industry also, and have for years.

    Would I be correct in thinking that every hospital will have a limit to any charitable work they do – I would assume that they are not going to go after a homeless person for cash he does not have, but if you do have a job (albeit lowpaying) you will have to pay for their services?

    Many of our hospitals are religious charities, for example: Catholic Healthcare West, Adventist, Providence Health & Services and Franciscan Medical, to name a few. They often provide free, or very low cost, healthcare, senior care, immunizations, etc. In fact, I just attended a fund raiser for a catholic healthcare system that was raising money for their senior services hospice and assisted living programs. These programs receive NO government funding at all. They use means testing to charge their beneficiaries.

    That said, if you need to go to an ER for services and you have a job, the hospital will bill you. If you don’t pay the bill, they will send it to collections. I don’t say this is a great way to do things, in fact it’s a pretty bad way to do things. But, socialized, government provided medicine is a solution that also is bad. You want to make the cost of a doctor’s visit affordable without having to wait 18 weeks to see a specialist, or having to decide which eye will be saved and which won’t? Bring free markets back into the equation. The reality is that semi-socialized or completely socialized solutions ensure over-utilization of scarce resources. The cost must be paid somehow, and the results in Canada, the UK, France, Germany, etc. are plain to see. Government bureaucrats making decisions for all of us based on what they believe is best.

    Health plans in the US are, generally, provided through your employer. Very few people purchase their plans directly. Over the years, people have demanded health plans that cover everything and demanded that they be insulated from the true cost of such plans. Whether that cost is paid by the employer or the government doesn’t particularly matter, what does is the removal of the consumer from the market place. The inevitable consequences are obvious when such choices are made. The failure to see that it is not an either/or question is the norm, of course.

    Actually, Adam is fairly correct when he says that you can’t easily compare Canada and the US, as a general rule. With about 9 times the population of Canada, that alone makes it difficult. On simpler statistics, such as infant mortality, it is possible to make comparisons. On the much more complex questions you pose, not really. You are suggesting that we can compare entire economic systems directly and I would suggest that statistics and chaotic systems show that we cannot.

    As far as issues such as childhood immunizations go, no child in the US should ever not be immunized. If they cannot afford to pay for the immunizations, parents can take their children to the local social services office and get the immunizations for free, or very low cost (not actually free, they are paid for with tax money).

    While the conversion process of going from paper records to electronic ones is certainly not a simple and easy endeavour, we are seeing on a daily basis real improvements and efficiencies here. In the end, it is leading to improved health care for our patients. Now, while electronic record keeping is widely used in countries like the Netherlands, less than 1/5 of family doctors have them in Canada, and about 1 in 10 in the US do. I think that governments need to encourage this use among doctors, which ultimately involves subsidization and other incentives, otherwise it will take far, far longer, to have doctors sign up for it.

    In other words, although it is not cost effective and doesn’t pay for itself, the government should spend my money on electronic record keeping? If it was cost effective, healthcare would adopt it. In fact, most hospitals are going down that road, or already have, in the US right now. A doctor’s office, on the other hand, probably cannot afford it yet without tax subsidies. Those tax subsidies are part of the increased cost of healthcare. The issue isn’t whether the US (or Canada, for that matter) has the infrastructure to implement electronic health records. It is whether it is cost effective, or not. Included in that calculation should certainly be the potential for privacy and security violations, which you appear to ignore.

    Comment by Eric — December 3, 2006 @ 12:49 pm
  24. [...] Now, I am not advocating drug use, or any particular expression of individual liberty for that matter. I am, however, advocating maximum individual liberty…even for those who seem to have very little regard for it. I agree with Adam Selene, who wrote: “I don’t want my “libertarian values” to become what is moral for this society. I want us to stop using democracy to destroy liberty.” [...]

    Pingback by The Liberty Papers»Blog Archive » Hypocrisy — December 3, 2006 @ 1:29 pm
  25. Adam,
    I was speaking of medicare and SS benefits.
    Such as in the civil rights movement, Libertarians as a small minority could engage people in the public debate if you wish to change attitudes. This is if you would step off your highly intellectually perfect pedestal and admit human fallibility.

    Comment by VRB — December 3, 2006 @ 3:31 pm
  26. Dear Eric: In regards to your point
    1) “…having to wait 18 weeks to see a specialist, or having to decide which eye will be saved and which won’t.” – I think if that is your image of Canadian medicine, you are very much misinformed. Dealing with specialists from our practice, we generally get patients booked within 3-4 weeks. If the case is urgent, it is not hard to squeeze someone in with a couple days notice. There are exceptions, of course. For routine colonoscopies, our usual specialist is now booking in mid-January, but these are routine checks; if we have an issue for this patient, he generally seems them about a week after they get the referral. Sometimes particular doctors take a long time, but it is always possible to see someone else with a shorter waiting time. For instance, we have one patient with diabetes who wants to see an ophthamologist she has seen before. He did not have a space for her until June 2007. Now, she is still going to see him, but if she wants, I could book her with our usual ophthamologist within 3-4 days. In another recent case, I had one patient who was looking to see her gynecologist for some minor procedure. I talked to Gyn’s secretary, and got the response that she would be looking for at least a year for this particular patient, because the doctor was too busy with baby delivery for the forseeable future. of course, that does not mean the patient is going to wait that long – we have another 4 or 5 specialists we can refer her to, so she will be seen sometime in January.
    As for that about choosing one eye over another, I don’t think that kind of thing ever happens in Canada. When problems over treatment get mentioned in our media, it is usually due to the government having not approved of a particular treamtent or drug, usually because it is either still in early stages or too costly. For example, here in Ontario we had an issue where parents of autistic children were demanding to get intensive behaviour intervention therapy, which costs as much as $50 000 annually per child. In our province, we have about 1000 autistic children who want this service. The government feels that this cost is just too large so it is not funding it. This has led to complaints and many see it as a failure of system, but I just don’t think that the American system would be better – you just don’t have the capacity in your charitable services for this, and I doubt that any health plan would cover such a huge cost.

    As for electronic record keeping, our office bought it without any subsidies – start up cost about $20000, with annual maintenance at $5000. I am not sure if we can quantify finacial savings, especially in the short term, but we did not just get this system to benefit us. Our doctor, and everyone other physcian I know, was not motivated to enter the medical profession for money (although it does pay well), but for a desire to help others. There are a lot of other easier ways to make money. A doctor wants to see the best treatment possible for their patients, and this is another tool to help them get there. I think doctors are more generally reluctant to go to electronic records for reasons other than costs, such as avoiding change to their routine.
    As for security and privacy issues, this has not been a concern for our patients, but our system is considered to be well-protected. Funny enough, as part of a health group we are affiliated with, we ask patients to sign up for a program that allows us to share patients medical information with other doctors in our group, and I think of the 2700 or so people we have asked, only 2 or 3 have turned us down citing privacy, and these are all crazy people. In return all our patients get to all a 1-800 number and be able to talk with a doctor after-hours, which has helped to cut down on emergency room visits.

    Comment by Peter Konieczny — December 3, 2006 @ 3:47 pm
  27. Peter:

    I think if that is your image of Canadian medicine, you are very much misinformed.

    Either the statistics often provided in the media, from Canadian government sources, are wrong, or your clinic is atypical. If the average is 4 months, then some, of course, have to be shorter, and some longer.

    As for that about choosing one eye over another, I don’t think that kind of thing ever happens in Canada.

    Not everything is about Canada. In England there is a huge outcry right now because a patient with Macular Degeneration that is still operable will only get the treatment for one eye, not both. This is fairly typical for choices made for me by someone else.

    When problems over treatment get mentioned in our media, it is usually due to the government having not approved of a particular treamtent or drug, usually because it is either still in early stages or too costly.

    So, a government bureaucrat should be able to make those choices in my place? This is why the UK decided to only save one eye, by the way. Insisting that couldn’t happen in Canada is foolish, it obviously could and you would have no recourse that I can see.

    VRB:

    This is if you would step off your highly intellectually perfect pedestal and admit human fallibility.

    Interesting, it is precisely because of human fallibility that I do not want government bureaucrats making choices about social services, medicare, Social Security and so forth. I’m curious why you resort to this tack at this point rather than continuing to address the points we were discussing?

    Comment by Adam Selene — December 3, 2006 @ 6:46 pm
  28. “BTW, since I am an older person, could I use William’s analogy to say you are stealing my money, because I paying for a military that protects you.”

    The key difference I would point out is that the Constitution specifically authorizes a military; not a federal healthcare system.

    Comment by Ryan — December 3, 2006 @ 9:49 pm
  29. Adam,
    What did Jim Crow have to do with this argument. I guess it was an analogy, so I made another.As a response to what blacks did to confront what they thought was immoral, as oppose to what Libertarians do. When there have been candiates in my area, I hardly hear anything from them. Our media does give them opportunities to speak.
    Quite often, discussions on the net are very intellectual.

    Comment by VRB — December 4, 2006 @ 6:41 am
  30. Jim Crow is an example where the majority deemed something moral, and even made public arguments about it being moral, yet we look at it through a slightly different lens of perception and see the immorality of it. The point? Arguing that the majority likes something, therefore it’s moral is a poor argument.

    Our “media” rarely gives libertarians air time, and the vast majority of the time when they do, they identify them as conservatives.

    There’s nothing wrong with internet discussions that get “intellectual”, so long as we remember that there is also a real world out there. That said, I don’t believe change is brought about by pragmatic middle of the road approaches. That just brings more of the same with a few small tweaks; i.e. conservativism. I’m not a conservative, I have no desire to be such. I advocate liberal change.

    Comment by Adam Selene — December 4, 2006 @ 7:35 am

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