Speaking as a Canadian, there's still room for improvement with the health care system. Universal health care (although there is much which is not covered) also has two major flaws:
1. There is little incentive for people not to use (and abuse) the system. This shows up as hypochondriacs going to their doctor demanding prescriptions for every sniffle, people with minor ailments in the emergency room, and emphasis on reactive treatments over pro-active & preventative medicine.
2. Although national (actually health care is handled at the provincial, i.e. state, level) buying power can lower costs of many common drugs etc., the cost of new life-saving & life-preserving treatments is often astronomical. Combine this with aging baby-boomers and even the most optimistic predictions are typically dire.
There is also the usual inefficiencies which come with any large government endevour, including misallocation of funds and resources, over-administration and short staffing of care providers, political turf battles and union squabbles. Not to mention that many skilled care providers are tempted to head south in hopes of making more money.
Those with a vested interest in the current system like to trumpet that it's the "best in the world". Me? "Best of the worst," might be a more apt description.
--ericball Fri, 29 Sep 2006 10:31:47 -0400
Well, the guy proclaiming it as good didn't seem to have a vested interest in it.
Also, for points 1 and 2, I don't see why they don't also apply to medicine as managed through HMOs and the like. The difference would seem to be that in the USA, these problems will have to be sorted out through a mishmash of public and private sector efforts, potentially leaving many retirees and others out in the dust, whereas in Canada at least they'll recognize it as a collective problem.
I mean, it's kind of an odd bargain with HMOs; on the one hand we have faith in how the private sector offers incentives and can make nimble-ish organizational refinements that government often can't. On the other hand, there seems to be a risk of incentivizing getting cheap on healthcare... the layers between the people receiving the poor healthcare and the companies who decide who to pay for mean that some of capitalism's classic "buyers vote with their checkbook" doesn't apply.
I wonder how Canada deals with the whole malpractice insurance issue that makes USA healthcare much more expensive.
--Kirk Fri, 29 Sep 2006 11:15:09 -0400
An old boss of mine once deducted that lawyers just aren't as prominent in Canada as they are in the US. He made this deduction from the fact that, in Canada, pedestrians don't automatically have the right away (or, at least, not like they do in Boston). A cop in Ottawa almost ran me down then just about pulled me aside to yell at me for jaywalking.
--The_Lex Fri, 29 Sep 2006 13:22:44 -0400
yeah.
I gotta say, sometimes I'm not delighted with the apparent lobbyist setup cliches: Democrats w/ Lawyers and Republicans w/ Doctors.
--Kirk Fri, 29 Sep 2006 13:32:34 -0400
Speaking of cool bug pictures, have you seen this?
http://maps.google.com/maps?hl=en&t=k&q=Germany&ie=UTF8&z=18&ll=48.857699,10.205451&spn=0.002404,0.006738&om=1--ApM Fri, 29 Sep 2006 13:36:22 -0400
1 & 2 are somewhat controlled in an HMO/health insurance because there is typically a feedback loop - either through co-pay, increased premiums, or denial of coverage.
--ericball Fri, 29 Sep 2006 13:37:45 -0400
You know, Khaneman and Krueger leave out an important consideration, at least in the excerpt you quoted: it's hard to travel, have new experiences, and have leisure time without a pretty substantial income. When I think about the amount of time I don't have because of simple chores like laundry, taking care of the house, etc., and how much more time my boss (who is rich) has due to his ability to hire domestic help, it's tough to take their argument to heart.
--Max Fri, 29 Sep 2006 15:51:30 -0400
ericball:
I don't think that "copay" is incompatible w/ a single payer system. And "increased premiums" and "denial of coverage" aren't such grest answers.
Max: that's why I try to minimize my time spent on those chores-- ah the glory of low standards...
I mean, the time those chores take can be constant whether I'm working more hours or fewer, until I'm at the "pay someone else to do it ALL" level which I ain't.
--Kirk Fri, 29 Sep 2006 17:01:32 -0400
Interesting point to make Kirk: The balance between having standards and enjoying life.
Honestly, though, I'm thinking that working in the computer industry makes that a little easier.
An old boss of mine had an interesting quote, though: "When you do nice things, you find a way to pay for it."
--The_Lex Mon, 02 Oct 2006 07:37:51 -0400
I agree that co-pay isn't incompatible with universal health care, it's just lacking (for the most part) in the current Canadian implementation. (Which leads to my point 1.) I also agree that increased premiums and denial of coverage are even worse answers. However, without those point 2 will doom any health insurance plan. (And there are many, many life-saving / life-preserving treatments which are not covered.)
--ericball Mon, 02 Oct 2006 10:19:40 -0400
Correction: "When you do nice [as in luxurious] things, you find a way to pay for it."
--The_Lex Mon, 02 Oct 2006 10:35:58 -0400