The end is in sight

The numbers are almost zero:

Surprisingly low, in fact, considering there are usually about 20% of people who are outliers. But you can always find anecdotes to support anything you like.

I don't know a single Canadian who went to the US *for* medical care (as opposed to falling ill or being the victim of accident or violence on a visit). I do personally know one American family (originally from SoCal) who drove up from CT (a 9-10 hour drive) a couple of weeks ago partly to take advantage of their not-yet-expired Ontario health cards, as unfortunately their business has gone to sh*t. And good teaching hospitals get international patients all the time, whether funded by insurance, self-funded, or by charity (eg. the Herbie Fund).

It's hardly worth arguing though, there is far too much well-funded reactionary propaganda floating around, and it will only get even thicker and yet more tedious if there is any serious possibility of a change.

Best regards, Spehro Pefhany

If you'd bothered to read the rest of what I had to say, you'd have realised that I don't see the US social security and medicare systems as socialist - more as poor imitations of what a socialist system would look like, deliberately botched in the hope of discrediting the concept.

-- Bill Sloman, Nijmegen

Since the "productive" in the US are paying more per head for their non-universal medical care than their opposite numbers in France, Germany, Sweden, the UK and the Netherlands, and getting a product that is no better, this is a pretty silly argument.

You've forgotten the bit about chosing you parents carefully.

An interesting theory, but no one that has been substantiated by any clinical research.

Your cerebral function is obviously impaired.

The stress test - cardiopulmonary function testing on a treadmill - would have shown up early signs of coronary heart disease (which you've probably got, like pretty much every other elderly male in the western world). You want them to find that early - according to my youngest brother, the doctor, in some 30% of cases the first symptom of coronary heart disease is sudden death, and we haven't yet got a course of treatment that will reverse that.

-- Bill Sloman, Nijmegen

k.

The free market clearly doesn't offer the right kind of negative feedback. The history of bubble markets goes back to the Dutch tulip mania of 1636-37, where governemnt over-regulation seems to have been entirely absent

and the English South Sea Bubble of 1720 blew up in an equally untrammeled free market

by

hat

o-

I could see that the dot.com bubble was a bubble before it burst, but I didn't find it easy to convince my wife that her friends were going to lose their shirts when it did burst.

Nobody wants cradle-to-grave nannying, but there does seem to be an argument for damping down the consequences of the obvious defects in the way our minds are constructed, including boom and bust cycles in the economy.

-- Bill Sloman, Nijmegen

Actually, it's the most expensive part of what we already have in the USA, we're just thinking of doubling it.

Cheers, James Arthur

That's a fact. It's also true that no one--including and especially the doctors--has any idea how much any drug, test, or procedure costs, and they'll as gladly Rx one as the other. Zero cost optimization.

Nor do they need to optimize; no one's spending their own money, so no one cares.

I was glibly Rx'd $7,000 worth of tests for a trivial problem. When I questioned "how much would that cost?" of his idea, the doc didn't know whether it was hundreds or thousands. When I suggested a $70 alternative he said "Sure, that'd work."

And, actually, I didn't need either test--there was nothing wrong, and the thing to be checked was already ruled out by other data. The doc was just CYA shotgunning from the hip because that's what they do. Most people, understandably, would've just gone along.

Most of my medical stories are of this ilk. No American knows or cares how much any medical thing costs--there's no feedback. "Insurance" and Medicare break the feedback loop. _That_ precludes meaningful competition or cost control. No one cares--it's not their money.

I bet we could save 15% of total costs if ERs could insist on a mere $20 up front. That would cull a lot of the inappropriate, trivial, wasteful visits that clog those facilities.

My dad cared. He was a great doctor delivering the best of care, yet extremely careful with other people's money, especially his patients'. His partner made 3x as much money, but Dad got 10x the love.

Cheers, James Arthur

I'm firmly opposed, but for pragmatic reasons, not dogmatic.

I'd be 1000% more interested if any of our social programs showed any sign of being anything other than complete disasters. Alas, they all turn into political tools.

American social programs don't work like Canadians, sitting politely at a lovely table, but like a filled trough, with everyone trying to get his fill before it's gone.

Cheers, James Arthur

He does, we're just not nearly socialist enough.

"A Century of Failure Proves Nothing"!

Cheers, James Arthur

The US has been scared silly of "socialism" for about a century now, and your propagandists have been trying to "prove" that socialism doesn't work for most of that time, while your capitalists have been taking more active measures to sabotage anything that they think is socialist. Their total lack of success hasn't discouraged this foolish and destructive enterprise.

You pay about twice as much for your health services per head as more socialist countries like France and Germany, to get a rather poorer result, so this demented obsession is costing you roughly a trillion dollars a year in health costs alone.

Your inadequate social security network and defective education system leave an appreciable proportion of young males from low income groups with no viable alternative to a life of crime, so you end up incarcerating around 750 citizens per 100,000, five times the European level, which costs you 60 billion dolars per year. If you tried out Europe's more socialist approach to the problem, you could be expected to eventually save nearly 50 billion dollars of that, plus whatever you'd earn from having people who are now in prison out in the community doing useful work.

But you choose to demonise socialsim, and you pay the price for your dim-witted choice.

-- Bill Sloman, Nijmegen

Yeah, that's what I expected.

That's how we do it here in Australia. There are practices where you don't have to pay anything - if you don't mind waiting for a few hours - but most will charge you a fee upfront, most of which you can then get back from Medicare.

health

ire

Your "pragmatism" is based on the few, selected facts that filter through your dogmatic view of the world.

All social programs are political tools. Yours are tools desinged to "prove" that socialism doesn't work.

That's a well-known problem, with well-known solutions. Unfortunately, the solutions weren't invented in God's own country, and people who have a vested interest in there being no good solution are strongly motivated to practice "not invented here".

-- Bill Sloman, Nijmegen

se

s -

ts

al

ce

In fact the most expensive part of what you have in the US is an enormous adminstrative superstructure, closely followed by a bunch of ambulance-chasing lawyers and their symbiotes, the firms that sell the medical system insurance against malpractice claims.

If you adopted the French and German model (invented by the arch- socialist, Bismark), or the even cheaper U.K. national health service, you'd at least halve your expenditure, and save a few lives (albeit mostly in the lower-income groups).

-- Bill Sloman, Nijmegen

The US does about 260,000 heart bypasses a year. That's just 1ppm of our population who need/get it annually.

That's a lot, actually. Rough figures suggest 0.11% could mean as many as one in ten seriously ill Canadians actively seeks care in the US.

I'm not saying that--I imagine most Canadians would stick with their own system. But that figure doesn't make that case.

You might want to dig a bit deeper...

Cheers, James Arthur

Oops...slipped by a "k" --that should be 900ppm !

Cheers, James Arthur

one ?

Hot dog, can i come around and tease you?

in=20

attractive than=20

have=20

Just like the Republiscum before them.

ends=20

it?

cowtowing

=20

=20

Not personally, that goes to Pelosi - Frank - Gramm (of Gramm - Leach

- Bliley infamy)

I am not so sure, some of their ideologues are just insane enough to try to push it through at the literal point of a gun.