I think the problem is that media reflects only the voices of the few at the high end of the income scale.  In the real world, people are willing to submit to longer waits for routine medical care when it means that more people will have prompt access to urgently needed care. Ordinary people simply aren't so self-centered that they would rather see another person suffer than to be inconvenienced, themselves. But the only voice reflected via the media is that of the rich, elitist class (which is one reason newspaper sales have fallen so drastically), and tragically, this shapes the world's opinion of this country.

Re: "I have no problem with a Canadian style health care system Tim, as long as it is optional... no sense forcing those who do not want it to go on the government dole."

Wow - so you "hear" without actually finding out and yet believe regardless of fact?!?
Seems to me you just proved the author's point perfectly!
NO-ONE in Canada is 'forced' to go on the gov't dole, as you claim - perhaps you should check reality before opening your mouth and proving you're not capable of reading?
Here in Canada, our health care is available to EVERYONE that is a Canadian citizen - whether they receive some form of social assistance is NOT even part of the equation....
to wit - there is also NO CASH REGISTER in Canadian hospitals or ER's, and we do NOT have to argue with HMO's over whether a necessary treatment is covered, or experimental.

Any other brilliant ideas you "heard" about?
I'd be more than willing to dispel the myth of your ignorance....

Sign me,
Able To Read
(and Understand what I've Just Read)
As for your comment about private care?
That is a (poor) response for those unwilling to undergo de rigeur wait times

Hi Charlie:

Did you go to a private school, or heaven forbid, were you "on the dole", and had to go to a public school? 

My father in law is a veteran...so he and all others that have served this country are "on the dole" when they make use of the "socialized" veterans affairs medical services.

My parents use Medicare, along with all other seniors in this country.  Hmm, they must be on the dole too. 

Sometimes I drive on free roads, opting to be on the dole, instead of taking a toll road.

Social services, and safety nets are there to make our communities better, and not all services (ie. schools, fire departments, and yes even health care) need be lumped into a convenient label of "being on the dole."

Canadians pay for their healthcare...(ie. taxes) but they are actually getting guaranteed coverage and value for their money (I pay $1200 per month---IMAGINE!...lump that together with my taxes and I am much worse off tax/insurance wise than ANY Canadian)...and I still have have huge deductibles and fortunately I haven't had any disputes with my company (very few claims)...but the horror stories in this country are no secret.

Hey, can a system be better than in Canada?  Yes.  Should you be able to opt out?  Maybe.  Is it the dole?  Not in the least, it is simply smart.

Rob

One of the differences between the U.S. healthcare system and Canada's system not mentioned at wikipedia is the big bite private health insurers take out of expeditures in the U.S.

Canada's system saves big time because its administration costs are far less. In the U.S., by comparison, health insurance companies, with their nine figure income CEO'S, take out 30 cents on the dollar before doctors get paid.

Jack, has anyone ever mentioned that you will lose credibility among real students by using Wikipedia as a source?  I had a friend who once changed the entry on Wicca to "a religion practiced by fat teenage girls."  While entries as such do eventually get reviewed and changed, who knows if you are visiting before an entry has been corrected?  Not all bits of false information are that flagrant.

Just a bit of food for thought...

Just curious when that was. That drug you mentioned wasn't approved by the US FDA until 2007. 
My sister had cancer and was a Canadian resident. I cared for her there and I also had the experience of caring for my fiance (who died of leukemia) and my father and mother in the USA (all of whom had good private insurance). The care and treatment my sister got in Canada was far superior and more timely in response I might add.
While I'm sure you can pluck out examples of misfortune under both systems, there is much more evidence (and personally I have my own actual experience as I've cited) prooving the Canadian model as being far better than the American wholy privatized system.
By the way, the evidence out there is that there is far more medical tourism going INTO Canada from the US then the other way around. And that is same for other countries. People are going outside of the US to other countries for vital surgeries and treatments.
When I myself was in Canada and attempted to get seen by someone and get an Rx refilled, I had an extremely tough time finding an MD who would treat me (this was a NON-emergency or urgent issue) and they would not even begin to fill my Rx unless I first saw a Canadian MD. Apparently, there had been so many Americans glutting the healthcare market via tourism there, providers were loathe to treat Americans at all and the Rx policy was changed to reflect that - since the stock pile of Rx's was being depleted and no significant tax revenue was being paid into by all of the American tourists (including myself) seeking medical services/Rx's.

David Gratzer is a biased free marketer. He is a slave to the insurance companies. He has made a living lying and exaggerating things about the Canadian system (telling 1 in a million stories). He was torn apart for his lies when he testified before the House of Representatives committee. He is among the 2% who would prefer the US system to the one we have. Not many other Canadians would ever touch the US insurance run and rationed system.

   Another important cost people don't see, how much less it would cost us all if people could get treatment when a problem started, as opposed to postponing it until the cost will fall into ssdi or some other group (we pay for) when it will no longer be repairable and far more expensive. Why? because many of us don't want a service we cant afford. ie: going to the doctor or buying prescriptions, or worse, paying 25 to 50 % of our weekly income on an insurance that will require a deductible if you ever use it (that you wont have on hand) and will likely deny you in the end anyways... yep, our system is the best in the world, absolutely.. How about this, recently went to the hospital for rabies treatment... the cost, about 6,000.00 but if i paid it at once, they can cut that in half. Hmmm.... doesn't that mean that it was doubled in the first place? Since I was layed off, there was no chance of that, so since I didn't have any government dole to help me out so I could continue to feed and diaper our one year old I had to apply for Charity, which thank god did cover us this time.... Our cost? Pride. Our system is unbeatable... By the way, the treatment required 6 shots, one of which is called RIG (Rabies immuno globin). prior to my treatment I went to another hospital, where the treatment wasn't on hand, but the doctor did tell me that the shots were just over 100 each. The pharmacy bill at the hospital i did get treatment was 4000.00 even. somehow that didnt add up to me, however the additional 2000.00 was for sitting in a chair, waiting, waiting, getting my bp, temp pulse taken, waiting some more and finally getting the shots. over 5 visits... which is required. Sorry I took up so much space

One of the strengths of the Candian system is that everyone has access to a primary physician. Chronic conditions likie diabetes and hypertension can be continuously monitored before they advance to a more serious stage. I've been on blood pressure meds for 15 years, and now, because I am monitored four times a year, and more often when necessary, when it is required my meds can be simply adjusted. In the US, having retired at age 55, 5 years ago, I would likely have had a heart attack by now since, despite having a good pension, I could never afford a primary physician in the US. here in Canada, at age 60, because my BP is constantly monitored and in good control, I have a less than 10% chance of having a heart attack in the next 10 years (by age 70)

Also diseases such as cancer are diagnosed much earlier, when the cancer is usually smaller and easier to treat successfully. This is why Americans treated for cancer in the US are 40.8% more likely to die of that cancer than Canadians treated for cancer in Canada.  This comes from American Cancer Society and Canadian Cancer Society data covering all forms of cancer.

Rights come with responsibilities. If everyone pays into a system that covers everyone, then by definition, the care of everyone becomes a universal right.

I thought that the "government" WAS the people. "We the people" - "For the people" - "By the people".
We elect people to represent us. They speak on our behalf. 

Charlie Reed, I have yet to see any definitive evidence that adopting universal health care in the US will cost people more than what they already pay in premiums, the costs in time wasted dealing with insurance companies, etc. I think people will actually pay less out of pocket than they do now.

Shawn (Charlie)...I would LOVE to pay higher taxes to eliminate the $1200 per month I pay now.  Businesses would be more competitive as the burden moves from business too (why is it their burden anyway), to governement and the costs fairly spread across the populace (like the ultimate insurance program should be).  The auto makers have not bee competitive for some time because of health care costs (among others).

And if you are unlucky enough not to  have a job (quite in vogue these days), you would be covered and taxes wouldn't go up---as you don't have much income.

Just my two cents. (or $1200/mo)---(by the way our income is modest, so this monthly cost is HUGE!

wow. just read the replies and um apparently no one read this line: "but as an affluent society We can surely afford to provide it for Our less successful citizens." I think that's supporting socialized healthcare.

Shawn, actually prices do go up when the government gets involved.

Case-in-point, Massachusetts has reported that the cost of health care has more than doubled since the universal health care program has been implemented. 

This is more an activist push that needs a fan to blow away the smoke.

Smoke- "The uninsured numbers will decline if congress passes health care."

Reality fan on- Sure they will, everyone that is a young adult will have to now buy insurance!  Cut out coverage of illegals and skip over children stats and the numbers can look really spun up.

Smoke- "Costs will go down."

Reality fan on- Until anything is refined in the bill, no one knows.  There are documented cases for increase in cost, there are documented cases for decreases in costs.  It depends on the spinner, but what is is what is:)

Reality fan full power- The government will be more involved in your life, if they decide to give themselves power over another entity.  Yipes!

I lived in Ontario (not all provinces have the same healthcare) until I was 25.  I have known both systems and I assure you the system there is far more civilized.  For anyone who has experienced more stress dealing with the inurance company and the barrage of bills (even when you think you have insurance), imagine the relief you would feel if you didn’t have to deal with that.

To my knowledge, the number one criticism of the Ontario Government program is “waiting.”  Well that did not exist when I lived there, but it seems to be more of a problem now.

But here in the US, we have different factors that I believe will prevent that concern.
1) The country already has a massive system (staff and equipment) to administer healthcare.  Why would we suddenly develop a problem of "waiting" if the infrastructure is already there.
2) We have more people in a smaller space.  That allows for the efficiencies that a spread out society (most of Canada) cannot achieve.

Idea:  Establish "USA HEALTHCARE" as a National program and let it be a competitive option to the existing insurance company programs.

In theory, it should run at a lower expense if for no other reason, the lack of need for profit taking (I’ll never understand why we pay insurance companies so they can take great profits while they deny us coverage).

If that theory is correct, natural economics tells us that everyone will flock to the government program, whether they purchase insurance on their own, or have it supplied to them by their imployer.

The "waiting" argument is a straw man, as is rationing. The US system is heavily rationed and there are long wait times in the US.

The heavy rationing in the US system is called  having no insurance, or insurance company denial or recission.

Your long waiting list is called insurance company approval, and most Canadians get tests, treatment, and surgery far sooner than Americans get insurance company approval, so Americans have longer wait times.... sometimes two or three months to get insurance company approval. In Canada there almost never is a wait as long as insurance company approval takes in the US.

No offense, Charlie, but your post is a great example of how important words can be. "Dole" originally referred to the various charity handouts - food, clothes, money - given/distributed to the poor  and the word comes out of the middle ages.  How is it a bad thing to offer nationalized health care when for so many, access to health care is the difference between things like "employment or disability" or even "life or high risk of death"?  That doesn't strike me as a bad thing, wasteful or even, necessarily, as charity.  Seems more like it would be finally recognizing basic health care as the human right it is.

This part isn't directed at anyone in this thread just brought to mind by it.  There's a really interesting discussion on Twitter lately about the true definition of socialism and how the word (and other political terms) have been bandied about in relatively slanderous ways - but using things that have little or nothing to do with their actual meaning.  Ultimately, it leads to the following page which defines the terms using the correct definitions per political science and history: http://bipartreport.com/2009/04/lets-get-our-definitions-straight-tcot-what-is-socialism/  But I bring it up because it's a great example of how charged certain words have gotten in the debates about change and reform and how even words have come to block change and reform - with little or no reference to the words' true meanings.

I think a comment like Charlie's is based more on philosophy than fact. I like business, free-markets and supply demand, but they aren't the answer for every situation.
Why can we get drugs (the EXACT same drugs) cheaper in Canada? 
The crazy cost of our drugs helps to subsidize the cost of drugs in other markets.
When international drug companies can get double and triple for their drugs in the USA, the can "afford" to sell them for less elsewhere.
That is just a piece of the puzzle of course.

You're probably right.  If so, Health care, with all the current PREVENTABLE and AVOIDABLE suffering is a great example of "just because we've always done it this way" or "just because I believe in _____" doesn't make something the right way. 

Personally, I support regulated capitalism for business.  It's been way too clearly demonstrated, way too many times that unfettered capitalism cares only about profit.  At the same time, I also see a need for certain measures that may be considered elements of socialism because I feel it's much better to ensure that so one suffers needlessly - such as how many have for years due to lack of ability to get timely access to appropriate medical care without waiting for miles of red tape for Medicaid or for things to get bad enough to visit an ER.  I just find it baffling how often our society reaches points where we think it's OK to bail out capitalists, that's "social" or "economic" responsibility but it's a bad thing to bail out individuals because they need to learn "individual" or "personal" responsibility".  That always strikes me as hypocrisy.

Charlie I think you've been like disagreeing with yourself. Someone that doesn't want to be on the "dole" can simply donate money to the system.

Drugs identical to what you get in the US are about 40% of the cost because of a wise move by the Canadian government some 15 or 20 years ago. Big Pharma was trying to lobby the Canadian federal government to lengthen their patents (to keep generic drugs out of their market). The Canadian government said "Sure, we'll lengthen your patents .... PROVIDING....  WE control the prices", thus lower Canadian drug prices were originated.

Thank you Lauren - for so succinctly wording the deplorable problems faced by the vast majority of Americans.
I hasten to add that in our 'socialist' system of Canadian Health Care, these problems are non-existent simply because there are no insurance company 'middle-men' as you pointed out - therefore these outrageous prices do not exist. Doctors, radiologists, et cetera bill gov't directly,
therefore there is no crippling expense associated with health care, thus paving the way for a standardized level of care that is applied to all.

I shudder to think what would happen if I ever lived in the States and suddenly became ill. I do recall when a sister had her baby in Atlanta, that it cost thousands of dollars for a mere 3-day stay.
When my daughter was born (which for me was a high risk pregnancy with a number of complications, additional procedures, treatment and medications) it didn't cost me a penny for the planned home-birth attended by 2 midwives, the emergency 3-day hospital stay, meds prescribed while there, or for any of the additional procedures and treatments. All follow-up appointments were also free of charge - if this be socialism?
Bring it on!!!
It seems to me a grave injustice that americans  can buy a tv much more readily than life or death medical treatment.

You have to also realize the insurance companies are not the only culprits in the greed rush... It also falls on health care providers and Rx companies who feel they can charge whatever they want because it's easy money. or if they over charge Everybody, that should pay for the ones that can't pay, who they will continue to pursue anyways to glean whatever they can out of. In the end. we ARE all paying, otherwise we would have no health providers at all.

While that sounds great, I don't want to pay for YOUR healthcare when and if you end up in the emergency room down the line after your private plan has dropped you or you find your circumstances have changed and for some reason you can no longer afford that private plan you had - or perhaps you chose not to get any health insurance at all. I do not want to have to pay for your treatment in the emergency room from some unforseen and unfortunate accident/situation that you were stricken by and unprepared for or chose not to prevent through preventative care practices.

Normally the whole "but if you couldn't plan enough to keep your insurance or at least set aside enough in savings for anything/everything that might happen" rant chaps my hide, esp. when paired with talk of how supposedly everything can be prevented through preventive medicine (it can't - at best, we can minimize our risks of SOME diseases/conditions through preventive medicine), I must admit that Single Payer has a point.  If someone never uses universal health care that would be one thing.  However if there's a way provided by which people can literally "opt out" of the universal health care system COMPLETELY, there really should be some sort of penalty at minimum something akin to the penalties currently applied to adding the optional parts of Medicare "late" without appropriate reason that is considered acceptable by CMS.  It needs to be made clear that "opting out" is a serious, and potentially life affecting decision - not just something about money.

In another thread, I believe Charlie said that he was okay with (public) health care taxes being deducted from his pay. He just wanted to be able to choose his own health care. He also used the analogy of public schools. Where I live, property owners pay real estate tax, and renters pay it indirectly. Some of this tax ends up supporting public schools. My kids went to private schools, but that's fine. We did not "opt out" of paying this tax. We just "opted out" of sending our kids to public school.

It should be the same with a proper national health care system.

The comment about "opting out" (or, I should say, "opting out of universal HCare and thus into a fee/fine/higher tax/whatever you want to call it - to cover use of healthcare services when they are used including the administrative cost for managing this exception - i.e., treatment at a trauma center for unforseen emergency disaster-related treatment, et al) is interesting.
It seems that often what is frequently MISunderstood by holders of this viewpoint - strong objectors to an "everybody in/universal healthcare" type of deal is that in both the public/private healthcare option as well as a single payer system, providers and the entire service network remains privatized. There is a big fear on the part of many that service providers will become government managed and "owned", per se - and that is not how the proposed plans in the USA work at all. 
It's really vital, in getting healthcare reform and dealing with it at all, that we - who all care so passionately about this from all sides of the "debate" - become INFORMED properly on the issue. The fears voiced about government management of healthcare are indeed fears and seem to not be based on actual information. 
Understanding the difference between a viewpoint based on emotion (fear) vs. actual information - especially where healthcare is concerned - is vital. That is how the best healthcare providers function - making decisions which are evidence-based. 

"Government, stay out of my life?"  Wait a minute - why do you work for the government if you want them to stay out of your life?  It's not like the "government" knocked on your door and asked you if you wanted to work for them!  I believe you had to "apply" to work for the big-bad government. 

A little hypocritical, don't you think?

I think I know where Charlie's coming from. When I went to sign up for reduced "Social Security Old Age Assistance Benefits" (sometimes called "retirement") at age 62, the rep suggested that I consider filing for disability instead because I am deaf. I said "no" because I had earned a fairly good wage for more than 35 years, and wanted only to collect the benefits that I had contributed to. They let me do it my way, no problem.

In short Charlie, they let me "put my money where my mouth is".  Even if the U.S. would go to single payer, you will still be able to pay out of pocket. Also private sector health insurance policies particularly "gap policies" will be available--and "personally insured policies" will be available for some time.

Not to nit pick, but isn't there a bit of hypocrisy in there?  You're quite happy taking a government job - that more than likely provides you with government provided insurance (which quite likely is better than most people get through their private employers) - and a government mortgage.  I'd tend to guess (though I'm just guessing) you won't turn down the applicable retirement system either, even if it's Social Security. But you'll turn down health care - and argue about who should have access to any government provided health care - just because you don't want to pay for it.  How's that right?

Maybe some of us would rather not pay for your employment, the insurance (or any other benefits) you're probably getting as a result of that employment, or the mortgage?  Could we not argue those things "dole" or "socialism" too?  Honestly, couldn't it be argued that employment, insurance and mortgages are luxuries but access to basic health care is a necessity for survival and that it should be treated as a human right without regard to things like the person's income, employment status or health?

To jump in here, I think Charlie's arguing for something very different from the standard anti-reform talking points.  He *wants* there to be coverage for the uninsured.  He is *willing* to pay for the program with his tax dollars (as well as everyone else's).  He recognizes this as a necessity.  He's not arguing against the necessity of reform.

But he doesn't want to be mandated to be a beneficiary in the system or change his own coverage in any way.  That's a point that's very different from the knee-jerk "I don't want to pay for anybody else" talking point... and one that's probably worth a lot more discussion.

Charlie, do I have you right?

I understand your viewpoint and concern. Where this becomes a problem is when someone like yourself uses those services that you chose to opt out of - which then ends up being billed to others such as myself. Unfortunately, with healthcare, as opposed to say - the US postal service, it is impossible to project when and if you might use those services. 
If an emergency came up and you were not able to even speak for yourself and you were on the road and you contracted, for example, a deadly influenza and immediate hospitalization and trauma services were required, even if you were taken to a facility and later on found to have private insurance which would be billed, et al, the cost to administer that billing and managing that claim is high - that's one of the huge costs people are paying right now with the privatized system (I know this from both sides of the service fence). The administration costs are huge - sorting through all of the billing in's and out's, et al).
And again, I encourage you to consider what the actual fear is of, for example, retaining all of what you have except that instead of paying a private insurer, your money for healthcare (and a smaller amount of it, by the way) goes instead to a govt. fund (insurance fund, per se - kind of like Medicare) vs. an AIG type of corporation (where your $ is going now). Unless you have no health insurance at all right now... in which case again, there are many, myself included, who think it unfair that we should pay for your care because you choose not to (the point being that no matter what, at some point in your life, you will require some medical service/s - we hope not via accident or misfortune, of course but sh*t happens...).

To Mr. Foley's note about Charlie's concern - I hear you. And I hear where Charlie is coming from on this and it makes sense... and this has now been tested - in Massachusetts... Where we see that in fact, the financial hit to the public has been high because those who are young or in perfect health or near-perfect health, opt out of the public plan and into the private plan (making the public plan much more expensive). 
We see in Massachusetts how those in the private stream have begun to move into the public stream (the premiums have begun to rise for those who ended up using their insurance for some unforseen thing or the premium is raised for whatever reason the insurer chooses to (age is a common one) and they are streaming into the public option which has raised the cost to all in Massachusetts of this system. 
Where healthcare is concerned, the only way costs can be brought down adequately for as many as possible is for the risk pool to be as large as possible - an everybody in and nobody out deal.
While I understand where Charlie is coming from (if I am understanding him correctly), unfortunately - given 'we all do not live on an island unto ourselves', I don't see how this would be possible to implement without saddling the common welfare with the very same high costs that we are burdened with today. 
The comment from she who opted for sending her kids to private school vs. public school but would not opt "out" of financially supporting public schools is of note here - but bottom line, I think it's really important to examine precisely what the fear is and evaluating whether one's fear is based on actual information or fear itself.

Gee Charlie, do you opt out of other government funded socialized things, like police departments, fire departments, public libraries, public schools, toll-free highways(and that's just a  start)? Of course you'll opt out of Medicare and Social Security as well......

Charlie, how would you propose we pay for caring for you in an emergency situation where we don't find out until later that you have a private insurance plan of some sort? Should we bill you later for the use of those emergency services and the cost of that administrative overhead? 
And of the individual who makes same choice as you but is not the responsible citizen you are and chooses not to pay (or ends up in some disaster and can no longer afford their private insurance or chooses no medical plan or coverage from anybody at all and even when billed for their emergency services use cannot pay/chooses not to pay), who should pay the increase in costs for providing for that individual?

Charlie, if you prefer to have an insurance company bureaucrat between you and your physician, rationing your care for profit, and having that insurance company bureaucrat rather than your physician deciding what treatment you'll have, you're welcome to it.

In Canada, we have NO ONE between us and our physicians and we need approval from NO ONE about what treatment we receive. Government pays at arm's length and has NO say in what a patient and physician decide. In the US however, insurance company bureaucrats ration your care and force you to wait longer for approval than if ever takes us to get tests, treatment, and surgery.

The single payer system as we have in Canada is distinctly better for the average person than the US system is for the average person in the US.

This has to be tongue-in-cheek: "We can disagree in this country without hating each other, it's one of Americas' strengths". Either that or it's the result of superficial analysis and thought.

I have never seen so much hatred of different groups as I have in the US. It's one of America's weaknesses - your Constitution actually allows such hatred to fester, and it poisons young people before they have a chance to decide for themselves.

Ask any non-white person about racism and whether they think it is still rampant in the US today. Do they have extensive personal experience of it or is it just the case that they know a FOAF who's suffered? I'll bet the farm it's the former.

Look at the gay/straight issue. How often do gangs of gay people bully and assault straight individuals they don't even know? Even murder them? Come on.

I have also never seen such hatred for government and their representatives; America teeters on the brink of anarchy and it's slowing progress in comparison with the rest of the world.

I am concerned that if everyone is not
"opted in," then doctors will be able to opt out, as all too many are doing with Medicare and Medicaid now.

So, it seems to me it has to be "universal" to work.

Elizabeth Barrett

And if that trend continues without some sort of reform, even just a vastly improved "safety net", all we'll see is drastically more people unable to afford care unless the trend of doctors wanting all their money up front is changed or more doctors are more willing and more flexible about providing charity care or care on some sort of payment plan.  Why?  Because much of the suffering occurs in the murky waters between those clearly and obviously qualified for what safety nets we currently have or unable to afford to use whatever insurance they might have and those clearly and obviously covered by private insurance provided by an employer or personally purchased (AND able to actually able to afford all necessary copays, deductibles, etc. too) or somehow able to outright pay for all their own medical care.  End up without insurance, wind up with the sort of insurance that doesn't cover anything (or that takes full advantage of stuff like pre-existing exclusions), find yourself unable to pay deductibles or copays, need care only to realize that somehow you don't quite qualify for ANY of the safety nets and you'll find yourself among the many realizing how full of holes the safety net is and how laughable many of the helps are.

Basically, doctors are abandoning the system because even THEY know it doesn't work but NO ONE is willing to work to implement something that DOES. $1600-1700/year doesn't sound all that bad for a year of care to me, only it's a month and a half of income so there's no way I'd be able to pay it out right, up front.  Even as a monthly payment, that would still be out of my budget. 

Exactly, Danetta.  Also, those "conceirge" fees will increase and/or the "menu" of services provided will change over time.

That may be why we RECEIVE said benefits, but it isn't why they're developed here.  Much of the research and development is due to government grants, not investment by the "rich".  Actually, much of the "medical research" I found most beneficial in my lifetime has been experiments allowed within the walls of IHS.

Danetta is absolutely correct. Almost ALL of the "cutting edge" research and breakthroughs in medicine not only here in America but abroad as well has occurred at leading public universities - the UC system is well known for this. 

The words "mediocre" and "universal health care" in the same sentence illustrate that you have an unthinking prejudice against a system you've never even experienced.

The fact is that universal health care is anything but mediocre. People who live under such systems have health and quality of life that is superior to those who don't. The poorest people in the UK, for example. enjoy better health than the wealthiest in the US.

I spent 42 years living under a system of socialized medicine in the UK and 14 years so far under the American system.

During the first 42 years I never once had to worry about asking for and receiving medical treatment. After I moved to the US to live and work my health coverage dropped immediately and only occasionally have I "enjoyed" coverage under medical insurance (because few employers made the coverage available). The cost of buying it myself is prohibitive.

I am constantly amazed at how few Americans can see the truth - that you are being bilked every single day by profiteers whom you defend vigorously. It is government of the people by the corporations for the corporations.

Having worked in the UK's National Health Service (which makes me, I guess, the equivalent of a municipal employee), academia (University of Oxford), the American Pharmaceutical and Medical Device Industries, and a bunch of other industries, I have experience of both "sides" of the argument and believe me, what I used to have you really wouldn't reject once you'd had a taste of it.

Your perception that "rich people" fund the research from which everyone supposedly benefits is incorrect - everybody else funds it.

Our pharmaceutical industry is no longer providing "cutting edge" products, unless you mean products that are found to be dangerous at best, lethal sometimes.  This industry is known for fighting against even providing information about alternative medicine which can help without the potential dangers ("side effects").

Poo!

Elizabeth Barrett

For an excellent discussion on the European provision of social benefits from an American perspective, including healthcare, read this article: Going Dutch How I Learned to Love the Welfare State.  http://www.nytimes.com/2009/05/03/magazine/03european-t.html?pagewanted=1&_r=1&em

My daughter, living in Europe, has shared this same information with me and will never return to the U.S. until our country adopts an enlightened social outlook. 

Charlie, your preemise is wrong. Ona  per capita basis, Canada has far more medical innovations and inventions than the US has.

Two months ago a team at Hospital for Sick Children in Toronto annouced that thay had found a treatment for Muscular Dystrophy that worked in mice, and they were starting human trials.

This week, a team of Candians in British Columbia discovered the gene that causes breast cancer, which may lead to either genetic treatment or a vaccine for breast cancer.

Meeting human rights like that of the right to health care (and health care IS a human right per the Universal Declaration of Human Rights and has officially been so recognized internationally for what will be 61 years in December) isn't government interference, IMHO.  Government interference would be if there was a government agency somewhere actively picking and choosing who gets what care when - like already happens with the average HMO.

But perhaps I just have a vastly different viewpoint.  I've seen people lose family members because they (or at least said family member) weren't eligible for ANY of this nation's various safety nets for reasons as bizarre and inflexible as $20/YEAR or that people of a certain age don't get specific cancers (guess someone forgot to tell the cancer that).  I'm also personally disabled largely because I found that nasty hole between where COBRA ends, where employers can find ways to make employees ineligible for benefits like health care, where "public health" isn't really so PUBLIC since insurance is a requirement and where since I'm childless admitting one of my health conditions really IS a disability was necessary just to get health care - but that meant letting it totally disable me and remaining so disabled for as long as I need health care or until health reform occurs (which ever comes first).  So I know all too well why health care MUST be treated as a right, not a privilege and why as a result providing basic care to all is not "interference".

Charlie, the huge health insurance industry has blown it. The only way we can even begin to tame the monster is to pull in government action

Charlie, I understand what you're saying. I hear this argument all the time from people who do not quite get, or trust, that government is us. I've never understood that, but as a Canadian who now has dual US citizeship, I don't understand why you would want to create a second layer of health care providers for people like you who want to opt out. The whole idea is that everyone is in, period. If you want to assuage your concerns, you could give what you think would be an equivalent amount to charity, rather than forcing us all to pay for an extra layer of bureaucracy.

I see a major disagreement or at least a very important difference in our viewpoints.  From what I can see, you want to preserve the free market for the sake of the market and "freedom".  I see need to better regulate it because the regulations so far instituted that have been watered down due to industry or business lobbying  became worse or less effective than no regulation at all and paired with the way the "safety net" has over time (since about Reagan) been repeatedly subjected to budget cuts (or subjected to totally cut of its budget like in states such as AZ), and "reformed" in ways that effectively penalize those who need help while failing to patch any of the many KNOWN holes - like the failure to truly help the childless disabled - I see plenty of reasons to both much more effectively regulate the "free market" for the protection of the people and society and to provide governmental basic health as a guaranteed thing FOR ALL because unless it's made an unconditional thing for ALL it will continue to be a patchwork thing that really doesn't serve anyone effectively.

hey danetta,

In a couple countries with universal healthcare there still exists private insurance and private hospitals I see no quam with that and I know if i had the money thats what i would do.

It depends in all honesty and fairness as to how the two tier system is administered - and in the case of our nation how the tiers would be titled.  If the public/universal tier is to be titled anything along the lines of "safety net" as Charlie proposes, the tier is endangered from the beginning and the system may as well not be created.  If the tier is created as a human right, it's not facing dangers like "look at all those entitled poor suckling from the public teet and/or feeding from the public trough rather than getting off their lazy butts, getting real jobs, getting their own bleeping insurance and not needing to use public funded health care" that lead to the system being underfunded, staffed by idiots and other types that shouldn't be seeing live patients and otherwise run in ways from the very beginning that guarantee systemic failure via slow and painful death of the system that's supposed to be helping those who need help most - much like what we already see with Public Health, Medicaid, Medicare, IHS and the various specific programs for the uninsured with particular conditions.

Charlie, Is it the option to choose your MD and PROVIDERS or it the option to choose what is or is not paid for by your healthcare $ the "choice" you want?
If it's a choice of providers - your specific MDs, et al, then you would retain that in most if not all of the govt. managed plans being proposed right now - especially in a "single payer" system.
Again, I encourage you to learn more here as there is a common misunderstanding that any "govt." run healthcare system means losing one's power of choice re provider and that's actually NOT at all how it works. That's not how it works in Canada (I know, I cared for a terminally ill relative there) and myself on Medicare, it's not even how it works now here for those of us already IN a "govt" managed healthcare plan.

The UK has such a two-tier system. The NHS (socialized medicine) provides the bulk of the treatment. Any individual who can afford to can buy and pay for private treatment at private hospitals if they wish, and some do.

However, everyone who works still pays into the socialised medicine system. Unless things have changed drastically, the cost is about 4.5% of pre-tax income, subject to capping (so there's a fixed ceiling amount to be paid).

There are no doctor or specialist copays. There are prescription copays, and that side of things works pretty much the same as HMOs in the US, only cheaper in general. Much cheaper.

When I worked for the University of Oxford we were fortunate to be given a presentation by a rep from the VA system in the US. The VA system is (or was) pretty much the same as the NHS, but with some rather odd restrictions that can produce silly situations (such as a major hospital catering for only a few veterans and prevented from providing health services to anyone else).

The running costs for the VA were on a par with the NHS. That would imply that if you expanded the VA to roughly 4-5 times its present size (and did away with some of the odd restrictions), there would be potentially a universal health care system in the US available to all (not just veterans).

That suggestion seems to be a hot button for some veterans (some hint that if anyone tried to make "their" services available to everyone, there would be bloodshed) so it's obviously not a straightforward solution.

But it could form the core of an American equivalent to socialized medicine, one that is already in place. Whether there is any political will to even try, is anyone's guess.

It's a problem, Charlie, if doctors can "opt out," because then there will still remain a second class system of care.

Elizabeth Barrett

Peter, if the NHS rate is indeed still 4.5%, capped, it beats the snot out the German system, although it probably covers a lot less. Rates for someone living in the German state of Bavaria (I just looked) at 15.5% of income up to the maximum. Remember, it's capped at somewhere in the EUR40,000 range, so for a family of any size it's about EUR 7000 per year.

That cost, on the other hand, for a household, including dental,  prescriptions, and "medically mandated vacation costs" (what the Germans call a "Kur", pronounce it like there is an H in there), it's not all that bad if you're a sole income earner with a wife and a couple of kids. There is a long discussion in Germany of how to rein in those costs, for obvious reasons, since at the 40k mark, you're also at a 46% income tax rate to boot, leaving something like 20k per year for rent, transportation, and so on. And like Canada, curtailing benefits is a political hot potato.

Like Canada, Germany has "use fees" that deter abuse of the system, like an emergency room full of people wanting to know why it hurts when their band-aids get ripped off, but it's $10 or so, and waived for emergency admissions.

In the German systems' defense, it's probably the easiest to implement here. A law stating any health insurance company operating in the USA must offer a minimal plan with specified services and accept everyone, and price controls on the income percentage, would get everyone covered. Germany has a law that if you're employed, you must be covered by someone's plan, but I am not sure if the USA is ready for that.

Additional/Correction to my prior post:

The public insurance rate of 15.5% in Germany is misleading - the employer traditionally (or perhaps by law) pays half, and per the latest figures, the limit on the percentage is an annual income of EUR 44,100. That ends up with a maximum personal contribution for a HOUSEHOLD of 3417.75 per year, or EUR 284.82 per month. Not too shabby.

It is not true that there are additional fees in  Canada. Thye provinces pay with federal subsidies and federal standards to ensure minimum standards across Canada. Provinces that do not meet the standards lose the federal supplement. When Mike Harris was Premier of Ontario and brought in a bunch of Reagan trained hatchet men to cut the Ontario health care system, it wasn't long before the federal government was withholding Ontario's transfer payments.

Most provinces do not have additional fees, only a couple do. Nova Scotia does not have any additional fees at all, if fact Nova Scotia has a provincial drug plan for people who are under 65 and don't have drug coverage from employment. Once such a person pays 3% of their net income, they only pay 20% of prescriptions for the rest of the fiscal year. Those over 65 have a much lower deductable (I think it's $385 per year). I'm retired but won't be 65 for another 5 years.

Are you describing the "county" health services that are the bottom rung of health care in the US?

A socialized medicine system (aka universal health care) is nothing like the county system, and never would be.

I am constantly amazed at the number of people who immediately assume that universal health care automatically implies the worst possible lowest common denominator in terms of quality of service.

This is not a commodity like bread. There's not just so much of it to go around that if it's made available to everyone it's going to be just a few crumbs each. It doesn't work like that.

Even now, medical insurance companies in the US are waking up to the fact that if US hospitals can't (or won't) provide quality, reasonably priced treatments, perhaps other countries can and will - and so we're seeing the phenomenon of Americans being sent to Mexico by their insurers to receive surgical treatment, with routine follow-up care being provided by primary care physicians (unless urgent revision is required, in which case it's back to Mexico).

The UK started down a similar path back in the early 90s when doctors (PCPs) were permitted to arrange contracts with any service provider (hospital/specialist) capable of providing a timely service - even if that meant sending the patient to France, Belgium, Spain or Germany. It dropped waiting times dramatically.

I worked in a research group that monitored 30 practices to see how the new system performed.

Three of the practices were "opt out" controls - they stayed with the standard system in which doctors could only send patients to hospitals/specialists who were local to them. The doctors in those practices were, at the time, ideologically opposed to the new system.

Within a short period we lost the control practices - they all migrated to the new system once they saw the practical benefits. Conversion by demonstration, you might say.

Simply put, there's very little chance that your friend's knee surgery is an emergency.

Who doesn't receive medical care in Emergencies?  Well, a shamefully large number of Americans don't...

Sharon, ah, the old Medicare argument.

And of course the "Canadians wait" argument.

My limited understanding of Medicare is that it is one of the most bloated systems, serving only to make suppliers very wealthy.

I would expect it to be dissolved when a proper national program is enacted.  There will be no need for 2 systems.

I still have many friends and family in Ontario, so I am reasonably up-to-date on things there.

- Yes, the issue of a bit of waiting has developed over the years, but IMO, there are reasons for this that are not relevant here in the US.

Certain areas of the country struggle with medical infrastructure and a much dispersed population.  Where was this person from in Canada? 

Even though this poor chap was waiting a bit, did you ask him, if he had a choice, would he give up his healthcare system for:

- huge deductibles, constant co pays, denials of service due to preexisting conditions, families going bankrupt over medical bills (100% unheard of in countries with national programs), the shock of thinking you have coverage, only to find out the fine print says you don't, being dropped by his insurance company after getting ill, and so on and so on.

I too know a story of a man in Ontario that was waiting for a knee surgery, because he wanted to go to the hospital close to his home. They could get him in "right away" at a hospital about an hour away, but he apparently suffers from "entitlement syndrome" and felt he should get the surgery at the closer hospital.
His is the same personality that would whine his story (less the details that made him look like an *ss) to someone from the US with a sympathetic ear. Be careful what you choose to believe, it may be BS.

Let's be honest, no other country has the wealth of the USA, and we already have the infrastructure to provide healthcare for all, in a civilized, low stress manner.

The USA likes to act as if something CAN'T be any good if it wasn't invented here. (unless we want to buy imported cars, electronics, etc.).

As an ex-pat of Canada, I can honestly say that universal healthcare is the ONLY thing I seriously wish I still had (and I have Blue Cross/Blue Shield here).  I fear going to the doctor here. Does anyone else feel anxiety every time they have to check if they are "covered" for that?

Mike--
"As an ex-pat of Canada, I can honestly say that universal healthcare is the ONLY thing I seriously wish I still had (and I have Blue Cross/Blue Shield here).  I fear going to the doctor here. Does anyone else feel anxiety every time they have to check if they are "covered" for that?"

I also feel the anxiety, and I'm on Medicare (due to age). It's also a matter of not knowing how much is it? How much will I owe? When will the final bill reach me?  I had two out-patient imaging procedures this past November. Last week, I got the (hopefully) final segment of three separate bills for each procedure (the hospital, the MD that read it, and some other department whose relationship to the whole mess wasn't clear). The delay wasn't caused by Medicare, it was caused by the hospital.

Medical record and billing non-systems on the part of facilities and practitioners should become a priority for any federal plan. 

Sharon,I cared for my sister in Canada under the Canadian system. She had liver cancer, was treated in the Canadian system and died there. I cared for relatives in the American system who had good private insurance - both those relatives died (in the American system) as well. I have to say the care was far superior and more cost effective in Canada and I say this having worked, like you, in healthcare as well - for Dr's as well as for the insurance co's.
And yes, knee surgery and knee problems are not "emergency", et al issues - as you likely know being a healthcare provider (perhaps - from what you've shared here) yourself.
I spent quite some time caring for my sister in Canada and living, while there, with Canadians. The wait time fear is largely American urban legend based on little real evidence and accurate information.

I would venture to say say that the Canadian you talk about would NOT be able to AFFORD to even see a primary physician in the US. They would NEVER be able to AFFORD to CONSIDER surgery in the US especially. Waiting a few months in for a knee replacement in Canada is far preferable to waiting 30 years in the US until that person gets Medicare to be able to afford the surgery.

You're right on that :)

I used to feel that way. I came to realize that it was a 'cop out'. I wouldn't call Barack Obama an "idiot" or many others whom we either elected via voting or not voting. It's a lot easier and more comfortable just dismissing all - be they corporate leaders or elected officials - than trying to actually bring about real "change"... which is what this whole site is all about, seems to me.

I'm not so sure about that.  I've run into more idiots - and actually worse still, GREEDY IDIOTS - in corporations than in government unless you're specifically looking at local, CORRUPT, government or similarly corrupt/incompetent governmental agencies (like the State of WA DSHS).  Idiots are NOT the sole provenance of government nor is greed the sole provenance of corporations...

OK, I agree that Obama is not an idiot.

Frederick, you're comparing what's often RURAL Canada with what's more typically URBAN or SUBURBAN United States.  Of course a more remote area is going to have fewer doctors and fewer facilities and as a result people are going to have to wait for procedures no matter what their coverage.  That happens HERE too, even WITH insurance. Try visiting more rural states, like NM for example.

Plus, there's a human component that pays dearly for the U.S. system - those who, for whatever reason, aren't insured and who as a result don't get ANY access. Do you have any concept whatsoever of how many our system allows to become disabled - or even to DIE - because it's simply cheaper than granting health care to all and politically more expedient and more palatable than trying to work out a system that WOULD provide care to all.  And people DO face death or disability regularly.  I'm disabled to a good degree because of how the system operates and I've seen people die because they fell through every possible crack even in the safety nets.  Our system isn't even humane.  We treat pets with more compassion and dignity - and at least strays are compassionately and gently put to a painless end to their suffering.

I'd GLADLY pay more in taxes or more in copays if it in any way improved my access to medical care and particularly if it improved that of those I've also seen suffer.  There are things much more important than money - even from my side of the poverty line (and I have to look up to see it).

As a side note, since when does union membership preclude an author from the right to an opinion or from the right to any particular opinion?  Are you trying to imply that because of Mr. Foley's union membership he has to fight to uphold the current system? That sounds rather closed minded and personally like a load of hogwash.

Do you consider Toronto Canada a rural area?

Do you not think that special interest groups like the unions which donate millions of dollars to campaigns do not influence the outcome?
It will be the same with health care!

Look at NYS where I live and the NYSTU!
Highest School taxes next to California, highest pay for Teachers and administrators and poor educational results!

That's no hogwash--its facts --and we are losing our population due to high taxes created by union organizations!

I'm actually not a union member, but whatever.

Could you give us the name of the emergency heart ailment or the operation, please?

Frederick, what I stated I felt was "hogwash" was your belief that Mr. Foley had no right to believe as stated in this article or at least no credibility because of his standing with a union.  What on earth does a union connection have to do with someone's right to an opinion?

And the long winded my tax pain's bigger than I think yours probably is serves no rational purpose - plus it's wrong.  WA has pretty high taxes, just not as personal income and I moved here by way of California - but that doesn't have diddly to do with the topic at hand.  Nor does the rest of your tax rant. 

And I know enough about Ontario to know much of it IS rural, even just outside Toronto.

You're not the only one with experience in Canada with someone quite ill. See my comment above re my personal experience with same however my conclusion was different. My sister died of cancer there and was treated there and her care was exceptional and the response was immediate. And I have plenty of experience in the USA to compare this to as I also cared for 2 other terminally ill family members under the American system with good private health insurance.
And Mr. Foley's comment re knee surgery says it all - highly unlikely that your friend's knee surgery/knee problem was an EMERGENCY.

You claim that Canadians pay 50% of their income in medical taxes but then seem to say that 50% of the taxes they pay go to medical care.

Which is it? Or is it the case that the ceiling on personal tax is 50% (which is not the same thing), but either way, what is the actual percentage of tax that goes to medical costs? Please clarify.

In the UK it is (or was) about 4.5% of pre-tax income - far less than the figure you claim for Canada - and capped.

In Australia, with a population of about 22 million people in a country about three quarters the size of the US, they too have a socialized medicine system - how could they even support that if the Canadians have to pay 50% of their income (and they're about 34 million)?

Your claims lack credibility.

I have worked at a  union job in Canada for 33 years and I have never been taxed 50% or even close. You are WRONG! 

I ran my own business in BC for six years, and my personal tax burden was approaching 50% in years my business did really well. Add 20-30% corporate tax, and well, I sold my accounts and took a job in the states.

Was it all to support the medical system? Absolutely not.

I also understand they dropped the BC provincial income tax rate to where the aggregate is now in the low 40's as a result of people voting with their feet. Alberta has no provincial income tax, and so is competetive with Virginia (both lower than the District) so that could have been my other choice.

Dear Frederick,

We all know that they do not pay 50% of their income in taxes up in Canada---regardless of what Fox new tells you. 

As for your comment "One had a serious heart condition that would have been operated on in the US within 24 hours and it took him 4 months to get the operation--thank goodness he made it."   My Dad has insurance and lives in the Tampa Bay area and several months later still can't get his heart surgery.  He'll probably end up fighting the insurance company until the day he dies of his next heart attack!

This is a total fallacy. Canadians after taxes (which includes health care) have disposable income of 82% of their gross pay. Americans after paying taxes+health insurance+copays have disposable income of 81.8% of their net pay.

I made a typo should have read:

This is a total fallacy. Canadians after taxes (which includes health care) have disposable income of 82% of their gross pay. Americans after paying taxes+health insurance+copays have disposable income of 81.8% of their gross pay.

My mother in law lives in Toronto.  She is 65 and works solely for private supplemental insurance on top of the socialized system.  No one in the media ever discusses that there are Canadians working well past retirement for insurance just like here in the US.

 When my father in law was sick, and they found tumors in his lungs, the Canandian response (in Toronto) was to wait 6 months for further testing.  My husband is a doctor here.  If my father in law had lung cancer he would be dead before he could have further testing.  How's that for a cost saving measure?

He came to the US and paid for further testing out of pocket.  When he finally died of idiopatic pulmanary fibrosis, his hospital (one of the best in Toronto) had one nebulizer per floor, he often had to wait well past his perscribed time for medical treatment.  My husband flew home to the us, purchased a nebulizer here and returned to Toronto, so his father could spend his last days slightly more comfortable.

I'm very sorry your family went through a difficult time.  However:

1.)  Your father-in-law did not have lung cancer.  He had idiopathic pulmonary fibrosis, which is notoriously difficult to diagnose, is not yet well understood in the medical community and whose current treatment options are largely on a case-by-case basis (http://pats.atsjournals.org/cgi/content/full/3/4/330)

So essentially you've told us that Canadian doctors got it right, but if they'd been wrong, it would have been bad.  Uh, all right.

2.)  We can go all day with stories of people receiving delayed care or being denied care in the U.S. so let's go to the larger numbers. 

According to the National Cancer Institute, there were 215,020 new incidents of lung cancer in 2008 and 161,840 moralities from lung cancer -- a 24.7% survival rate.

According to the Public Health Agency of Canada, there were 23,300 new incidents of lung cancer in 2007 (last year we have numbers for) and 17,653 moralities -- a 24.2% survival rate.

The point of this morbid inquiry -- if the delays in care were so bad, don't you think it would show up as more than a 0.5% difference in survival rates?

Thank you Jan for your helping to better inform us (though I will put aside the somewhat distasteful "attitude"). 
Yes, and the Canadian system came into being province by province (which is why it is how it is - re care being 'dependent upon what province' one resides in).

You are correct regarding the 30 cents figure. Actually, at this point in time, latest figures have that as higher (Reinholdt recently cited higher stats re this - and from your post, it would seem that you have some expertise here so you'll know who Reinholdt, one of several notable healthcare economists, is - or perhaps you don't?).
I have to note that 4 fingers point back at yourself, though. Not every bureaucrat is surfing the web all day and not working for the change everybody else here is working for/towards. Yes, please - let's not move forward any more pot calling the kettle black.
As someone else commented here, we can disagree but spewing and swaggering at each other can cut off vital communication and prevent important facts from being considered.

As I understand it, the Canadian system is one in which the federal government issues payments to the provinces that have low tax revenues (equalization payments). It may not be administered at the federal level, but it is nonetheless a federal system, and differences in levels of service between provinces are minimized.

The discussion of services provided by other countries simply proves a point: we are not talking about some hypothetical nirvana of health care that some country might achieve if it had the will, we are talking about how other countries, with smaller populations and lower income levels, have still managed to create a variety of superior (i.e. not inferior) health care systems that many Americans believe - or are told - cannot be done.

One of the things I discovered in the US is the massive disparity in charges for things like tests. A couple of years ago I had a blood panel done at a local hospital and was billed $220 by the hospital.

Later, when I became unemployed, a doctor took pity on me and referred me to a service that he used. The cost for the same panel was $20, which is what the GP was billed.

Movies like Sicko can be eye-opening for those who are willing to be informed. Sadly, many Americans look for reasons to keep their eyes tightly shut, and I don't know what it will take for them to finally take notice of the huge mountain of evidence that supports the notion of socialized medicine.

For a country that regards itself as being predominantly Christian, the American response to the question "Am I My Brother's Keeper?" still appears to be a resounding "NO!"

Feel free to leave whenever you feel want or need to do so.

I do however feel the need to agree quite strongly about any universal health care implemented in the U.S. being nationalized or at the very least having firmly enforced national standards.  You mentioned the problems you're aware of with Canada's system, but on a related note one thing I can vouch for is that a HUGE problem with our nation's "safety net" (including public health, Medicaid and Medicare Savings Programs) are that many of the rules vary from state to state and in some cases even county to county.  Just trying to navigate the system is enough to drive one bonkers - and that's even someone like me who's got a degree in political science and experience in volunteer work helping people find the help they need.  There's no excuse for the help not to be standardized.

Sure I can see variances like you mentioned.  Like longer wait times for specialists or even not having certain specialists in more rural areas.  For example, where I once lived in New Mexico, for one type of specialty, the only doctor of that type outside IHS (Indian Health Services) came two hours per week, twice per month.  I'm sure anyone can figure out the wait times to see him.  My appointment was requested in either January or early February and I saw him in May - which was apparently "lucky" and only due to someone else's cancellation.

To clarify my earlier statement, I mean *many* mandated systems.  Medicaid and Medicare Savings Plan rules for example vary greatly both in *exactly* what they are from state to state and *even more* from state to state in how implemented, plus *further* variation from state to state in what Medicaid covers.  Public Health aka "County Health" by definition, should be available to to the PUBLIC - yet in many areas, as stated, INSURANCE is required to use it.  If it's PUBLIC HEALTH, seems like it should be required to be open to seeing the many people who DO NOT have insurance - a group that includes vast numbers of the disabled who do not or at least who do not yet qualify for Medicaid - and there's no reason why this couldn't be done on some sort of REASONABLE sliding scale. And believe it or not, in some areas, Public Health doesn't exist and/or seemingly required specialties don't exist in any way. 

For example, did you know that as of 2003, the only PUBLIC mental health care in NM was provided via the state mental hospital?  Which means if you lived in NM and needed mental health care but didn't need an involuntary or criminal stay, you generally were on your own for care.  Washington State last I heard was cutting off access to Public Mental Health to anyone with Medicare - which will leave many here in Washington without access to mental health care, especially in rural areas.  But this is delving off into what I know from personal/family experience about how desperately this nation needs to properly provide widespread access to mental health care and why I started the related petition so I'm probably going off topic here.

The Canadian system was started in 1947 and sorry - but according to all of the historical records, was province based up until 1957. It was 10 years later that it moved from province-based to national-based. There is a good chronology on the web and also, I've heard Sen. Mark Leno discuss history of the Canadian system. I also lead 1 of the Obama healthcare community discussions where a Canadian attended and told us about the history of the Canadian system.
Some links:

History of the Canadian system - http://209.85.173.132/search?q=cache:c5PiWeBj16cJ:www.healthcoalition.ca/History.pdf+History+of+healthcare+in+Canada+being+province+by+province&cd=3&hl=en&ct=clnk&gl=us&client=safari

Film clip with Canadian nurses discussing healthcare in Canada: http://www.youtube.com/watch?v=2J9Qs9pszuE

This is exactly right. Only 2% of Canadians would prefer an American insurance run health care system.

The easiest way for a Canadian politician to get elected is if he can convince voters that his OPPONENT would introduce an American style health care system.

Although a good theory, it's just not borne out by the numbers.  The United States military budget is truly huge, accounting for nearly 45% of the military spending in the world.  It is more than double the amount spent by all nations in Europe combined.  It is nearly 10 times as much as the next closest single country, China.  #3 on the list is France -- yeah, I was surprised too -- who also manage to cover every citizen with basic health care, and with 98% of the population also buying additional private coverage on top.  If we just spent 9 times as much as every other country on our military instead of 10 times, it's doubtful we'd be compromising our security, and we'd also be able to afford universal health care rather easily.

Also, the simple fact is that the problem is that the US spends doesn't spend enough on health care -- it's that it spends that money poorly.  Canada spends about $3,500 per person.  We spend about $8,000.  Yet they're healthier, have a higher life expectancy, lower infant mortality rate and provide everyone with quality health care.  We, on the other hand, are frankly getting ripped off considering how much we're over-paying. 

In this one case, there's no real competition between guns and butter. 

No, it is PER CAPITA that the US pays $7400 per person, and Canada pays $3800 per person.

Unfortunately this "sacred cow" is also a huge problem. The system wasn't perfect to begin with, so who should make changes for the better? Bureaucrats or elected officials? To what degree should each?

Well sure you guys may have a longer waiting period to see a specialist or something but at least you have a line. If people in America would wake up and realize that our tax dollars pay for the most advanced medical facilities in the world and yet millions of us cant afford to use them because of greedy ceo"s in the pharmaceuticals and the insurance company's denying people care that they need so they can make a profit. Its insane to me that people complain they don't want government telling them what doctor they can see when the insurance you have. [if your lucky enough to have insurance.] tells you what doctors you can see, what treatments you can have, or if your even worth treating because it might be more profitable to deny you care all together.

The Canadian health care system is not perfect. It only looks perfect next to the insurance run health care system that Americans have. They have insurance company bureaucrats between them and their physicians, rationing their care for profit. That insurance company bureaucrat, not their physician, decides what treatment, if any, they'll receive. The average Canadian has far better health care than the average American.

I have the same health care as the Premier of my Province and my Member of Parliament.

Few if any Americans can say they have the same health care as the Governor of their State and their Senators.

It sounds as if Jan is one of the 2% of Canadians who would prefer the insurance run and rationed American system. The other 98% of us far prefer what we have right now and would never touch the American insurance run and rationed system.

The other thing is that having ONE system would make providers justify their charges.  Some stuff REALLY needs explaining too - like the add-on of $600 someone mentioned above for simply not having insurance to bill (jeez, shouldn't that make the bill LESS for saving the provider a step?) or the "standard rate" a neurologist once charged me for "follow up" appointments (meaning 10 minutes or so at most of asking me questions and doing exams and supposedly caring what the answers and exam results were - and in between bothering to read my chart)...BTW, the rate was $380 for those never the full 10 minute appointments and it was soon quite obvious he neither listened to me nor read my chart because it took two appointments and one phone call for him to make it clear he was talking of conditions I didn't have and to then try to prescribe a medication from my allergy list.

Having ONE system will also help to improve quality of providers. Or at least it could and certainly SHOULD do so since there would only be ONE system overseeing everything, rather than how many bazillion or so insurance companies and plans across the various states along with the various licensing agencies and certifying boards that may care (but often don't care at all or at least don't care enough).

Regarding "add-ons" and different rates for insured/non-insured.
My ex-wife needed a surgery.  Discussing the insurace part of the process, the surgeon was very honest and admitted hospitals, doctors, etc. bill the insurance companies as much as they think they can get away with.
They know the insurance companies will knock down their compensation, so they "shoot for the moon" so to speak.
Just another piece of the puzzle as to why this system is so truly broken...serving so few while costing so much (in comparison to healthcare elsewhere in the civilized world).

I envision a system where everyone starts with the same coverage.  One can purchase additional benefits via add-on insurance if they are so inclined.
Example 1: every American needing a hospital stay qualifies for a shared room.  Those who purchase additional insurance can get a private room (if the facility offers this).
Example 2: very American needing medicine for a particular issue, will be prescribed the one the government has approved and will pay for.  Those who purchase additional insurance may be able to get only name brand versions of the drug (they can afford it and are willing to buy add-on insurance so they can "get the best" for themselves and their family.
It's like everyone gets the Chevy, which it truth is perfectly fine.
The "entitled" can get themselves Cadillacs (when available).  This solves healthcare for all, while maintaining the class-warfare that we love so much (a little sarcasm there).

What's funny (in the twistedly odd sense) is that they'll admit they do so to the insured but they won't admit they also do so to the uninsured - yet they do it just in case the uninsured person doesn't ask for charity care or asks and doesn't qualify because in either case they can try to collect on the bill and if they bother, they have the right to collect on the full amount billed (and YES medical providers, particularly hospitals, are increasingly starting to do things to collect on unpaid bills even where it's clear the bills weren't paid because the patient couldn't pay - including stuff like garnishments).  Actually, in a few cases, hospitals have even been taken to court for trying to bill their cash patients (including uninsured patients) MORE than those covered by insurance.

To be clear, I'm not actually pushing one solution over another.  I've noticed I do talk about the public plan out of proportion to the other solutions, but that's largely a factor of there being a lot more to respond to every week on it -- conservatives bash it, influential Democrats in Congress praise it, research groups release studies on it, etc.  I think I don't spend a lot of time talking about people who endorse it, but I do spend a lot of time batting down the fake or mistaken attacks.

By contrast, it's been somewhat of a wasteland for media coverage of a single-payer option or the Wyden-Bennett option, to say nothing of the health care plans of other nations, although I have written about all of the above.  If more people started attacking those plans, I'd be writing a lot more.

Still, this is a decent rebuke and I'll continue to try to find more opportunities to write about other under-covered options when I can.

Thank you, Tim, for your open-mindedness. It's true, the single-payer solution preferred by a majority of Americans and a majority of American physicians is being killed simply by the media colluding with policy-makers to render it invisible.  

Lauren,

Awesome insights. However, acknowledgement of a lack of open and honest discussion is dismissed as a "distasteful attitude."

It's hard to remain "tasteful" when you've been at the receiving end of this stuff for 7 years.

It's also great you raised the point of health protection rather than care. One reason Canada spends so much less, although it covers almost everybody, is that there is a greater focus on prevention rather than dealing with the lack thereof.

Canadian health care is also far superior to what Americans have. After all, we, in Canada have physicians helping us make medical decisions. Americans have insurance company bureaucrats making their medical decisons for them, and the physician just has to go along with what the insurance company bureaucrat decides.

The insurance company bureaucrat probably is a high school graduate to be dictating these medical decisions to a fully trained physician.