[late]

Given how high the spending is in the US, it seems like cost control measures are essential in any reform.

Clinton's 1993 plan was very similar to what Germany, the Netherlands or Switzerland do.

Reducing spending without fixing the problems won't fix the problems..

Yeah, because we have large pockets of poverty, I prefer single payer. Did you know rural hospitals and clinics have been closing?

[wat0n]

Reducing spending without fixing the problems won't fix the problems..

Yeah, because we have large pockets of poverty, I prefer single payer. Did you know rural hospitals and clinics have been closing?

Do you know there are pockets of poverty in Germany and Europe in general as well?

[Pants-of-dog]

So?

Albertans can demand to pay less taxes.

Provided you with a healthcare services index. You have provided nothing.

What is your argument?

As far as I can tell, the only complaint about the Canadian system is the wait times.

And those are simply due to the fact that services are administered according to necessity. So people with non-urgent needs will have to wait until people who need it more urgently are helped.

The USA has shorter wait times because so few people can afford to access the system.

[wat0n]

What is your argument?

As far as I can tell, the only complaint about the Canadian system is the wait times.

And those are simply due to the fact that services are administered according to necessity. So people with non-urgent needs will have to wait until people who need it more urgently are helped.

The USA has shorter wait times because so few people can afford to access the system.

Why do Germany, Switzerland and the Netherlands manage to provide services according to need and still have much shorter wait times?

[Pants-of-dog]

Why do Germany, Switzerland and the Netherlands manage to provide services according to need and still have much shorter wait times?

Prove they do.

[wat0n]

Prove they do.

https://www.oecd-ilibrary.org/sites/242 ... tType=book

https://worldpopulationreview.com/count ... by-country

[Pants-of-dog]

https://www.oecd-ilibrary.org/sites/242e3c8c-en/1/3/2/index.html?itemId=/content/publication/242e3c8c-en&_csp_=e90031be7ce6b03025f09a0c506286b0&itemIGO=oecd&itemContentType=book

https://worldpopulationreview.com/count ... by-country

Quote the relevant information.

[late]

Do you know there are pockets of poverty in Germany and Europe in general as well?

If you want to offer a counterargument, do so.

I am getting tired of passive/aggressive BS.

[wat0n]

Quote the relevant information.

Most of it is in figures/maps.

Turning to specialist care, waiting times for a specialist appointment also vary significantly across countries participating in the Commonwealth Fund survey (Figure 2.2). In 2016, the difference across countries was more than two-fold: over 60% of people waited one month or more for a specialist appointment in Canada and Norway, compared with about 25% only in Switzerland, Germany and the Netherlands. In many countries, waiting times for a specialist appointment has remained fairly stable between 2010 and 2016, although the survey results suggest that the situation has worsen in Norway, the United Kingdom and the United States.

...

Results from the regular OECD data collection on waiting times for common elective surgery show that they vary even more across the group of 17 OECD countries that report these data (which are based mainly on administrative sources). On average across these OECD countries, the median waiting times for more minor surgery like cataract operation was 95 days in 2018, and longer for more major surgery like hip replacement (110 days) and knee replacement (140 days). However, there are huge variations across countries. In general, waiting times for elective surgery in 2018 were the lowest in Denmark, the Netherlands, Italy and Hungary (where reducing waiting times for elective surgery is a key goal under the 2014-2020 Health Sector Strategy), while they were the highest in Estonia, Poland and Chile.

If you want to offer a counterargument, do so.

I am getting tired of passive/aggressive BS.

The counterargument being that this is not a reason to avoid introducing compulsory insurance.

The Clinton 1993 proposal did contemplate subsidies for those unable to pay for the full insurance, just like Germany, the Netherlands and Switzerland do.

[late]

The counterargument being that this is not a reason to avoid introducing compulsory insurance.

The Clinton 1993 proposal did contemplate subsidies for those unable to pay for the full insurance, just like Germany, the Netherlands and Switzerland do.

Good grief.

That's not a counterargument....

Hospitals and clinics struggle in poor areas, it's not uncommon for health care to be an hour away. Which is not good if you have a serious problem, you're outside what they call the golden hour.

Which means the govt has to support existing facilities, or create public facilities.

This is like all our discussions, which, frankly, is depressing.

[Pants-of-dog]

Most of it is in figures/maps.

And if you look at it carefully, you see that Canada has shorter wait times than most countries for most things, and the wait times shorten significantly as the procedure gets comparatively more urgent.

So it seems to corroborate the claim that wait times in Canada are only long for those procedures that are not as urgent, because access is determined according to need.

The complaint must then not be about wait times in general, but wait times for elective care.

And even that probably varies. In one of the three big cities, wait times are probably very short.

[wat0n]

Good grief.

That's not a counterargument....

Hospitals and clinics struggle in poor areas, it's not uncommon for health care to be an hour away. Which is not good if you have a serious problem, you're outside what they call the golden hour.

Which means the govt has to support existing facilities, or create public facilities.

This is like all our discussions, which, frankly, is depressing.

All of which can also be addressed by making getting insured compulsory.

And if you look at it carefully, you see that Canada has shorter wait times than most countries for most things, and the wait times shorten significantly as the procedure gets comparatively more urgent.

So it seems to corroborate the claim that wait times in Canada are only long for those procedures that are not as urgent, because access is determined according to need.

The complaint must then not be about wait times in general, but wait times for elective care.

And even that probably varies. In one of the three big cities, wait times are probably very short.

These are national averages.

Note that countries with Bismarck models don't have long wait times for urgent care either.

Reid compared 4 different health care models used in industrialized nations, including: the Beveridge model, the Bismarck model, the National Health Insurance or Tommy Douglas model, and the out-of-pocket model. Designed by National Health Service creator Lord William Beveridge, the Beveridge model provides health care for all citizens and is financed by the government through tax payments. This “socialized medicine” model is currently found in Great Britain, Spain, and New Zealand.

The Bismarck model uses an insurance system and is usually financed jointly by employers and employees through payroll deduction. Unlike with the US insurance industry, Bismarck-type health insurance plans do not make a profit and must include all citizens. Doctors and hospitals tend to be private in Bismarck countries. This model is found in Germany, France, Belgium, the Netherlands, Japan, and Switzerland.

The National Health Insurance model has elements of both the Beveridge and Bismarck models. It uses private-sector providers, but payment comes from a government-run insurance program that all citizens fund through a premium or tax. These universal insurance programs tend to be less expensive and have lower administrative costs than American-style for-profit insurance plans. National Health Insurance plans also control costs by limiting the medical services they pay for and/or requiring patients wait to be treated. The classic National Health Insurance system can be found in Canada.

The final model, the out-of-pocket model, is what is found in the majority of the world. It is used in countries that are too poor or disorganized to provide any kind of national health care system. In these countries, those that have money and can pay for health care get it, and those that do not stay sick or die. In rural regions of Africa, India, China, and South America, hundreds of millions of people go their whole lives without ever seeing a doctor.

One common theme Reid noticed among the health care systems he utilized was that these systems provide health care coverage for everyone, yet spend substantially less on health care than the United States does. Also, he was able to get good care for himself and his family and the bill was nearly one-quarter of what he would be charged at home in the United States. The US health care system has elements of each of the 4 models and provides different types of care and coverage for different sectors of the population, making it disjointed and costly.

The bolded part is one of the major issues with the US' healthcare system.

Also, some of the classical Beveridge systems have some of the longest wait times for urgent care.

[Pants-of-dog]

If wait times are the only criterion at which the single payer system is less than the best, it seems like a fair trade off for universal coverage for necessary treatments that is free at point of service.

Again, my criteria were mortality amenable to health care and coat per capita.

[wat0n]

If wait times are the only criterion at which the single payer system is less than the best, it seems like a fair trade off for universal coverage for necessary treatments that is free at point of service.

Modern Bismarck systems also have universal coverage.

Paying insurance is compulsory and insurers can't refuse to accept potential patients based on pre-existing diseases or demographic factors.

Again, my criteria were mortality amenable to health care and coat per capita.

Still waiting for your evidence on this.

[Unthinking Majority]

In the UK, there is both a nationalised health service and private medicine. You can beat the NHS queues and waiting lists just by paying. That option always exists.

That's 2-tier healthcare where having money gets you better service and health outcomes. Doesn't exist in Canada, and the public is against it because it creates inequality. But maybe it gets better outcomes, I have no idea.

Socialising the health service doesn’t close off options, it opens them up.

How does a single-payer fully socialized system open options? You're limiting options in order to provide equal care to all where those with money can get better care.

And, if it’s properly funded, it’s a more efficient system. How much does the USA spend on health services per capita, and how much does the UK spend? And what are the relative outcomes, for an average person?

I'm not arguing that full private is better than universal, I'm just arguing there's still problems with socialized systems. The problem is there's nothing to force governments to fund the healthcare system adequately. Voters flipping between 2 or 3 parties where none of them want to fund the system properly because raising taxes is political suicide isn't working in Canada. The governments are already hemorrhaging debt. People want the socialized system but also don't want to pay for it.

Ontario, Canada's largest province, is the most indebted sub-sovereign borrower in the world. Canada as a whole has the same population as California but Ontario alone has more debt than Cali. Providing healthcare for all is very expensive.

Canada is now implementing a national socialized pharmacare, dental care, and childcare programs, but they don't even have enough money at the moment to pay for basic healthcare services. Good luck paying for everyone's prescriptions and daycare.

[Unthinking Majority]

And if you look at it carefully, you see that Canada has shorter wait times than most countries for most things, and the wait times shorten significantly as the procedure gets comparatively more urgent.

So it seems to corroborate the claim that wait times in Canada are only long for those procedures that are not as urgent, because access is determined according to need.

The complaint must then not be about wait times in general, but wait times for elective care.

And even that probably varies. In one of the three big cities, wait times are probably very short.

That's a bunch of nonsense.

[Pants-of-dog]

How does a single-payer fully socialized system open options? You're limiting options in order to provide equal care to all where those with money can get better care.

It opens options by allowing the patient to visit any medical institutions or doctors they want throughout the whole (in our case) province.

That's a bunch of nonsense.

It is what the evidence presented seems to show.

[Potemkin]

That's 2-tier healthcare where having money gets you better service and health outcomes. Doesn't exist in Canada, and the public is against it because it creates inequality. But maybe it gets better outcomes, I have no idea.

This is Britain we’re talking about - one of the most class conscious societies on Earth. The upper classes wouldn’t be seen dead standing at a bus stop, let alone lying on a bed in an NHS ward. It had to be a two-tier system, otherwise our upper classes wouldn’t have allowed it to exist.

How does a single-payer fully socialized system open options? You're limiting options in order to provide equal care to all where those with money can get better care.

That second sentence makes no sense.

I'm not arguing that full private is better than universal, I'm just arguing there's still problems with socialized systems. The problem is there's nothing to force governments to fund the healthcare system adequately. Voters flipping between 2 or 3 parties where none of them want to fund the system properly because raising taxes is political suicide isn't working in Canada. The governments are already hemorrhaging debt. People want the socialized system but also don't want to pay for it.

Ontario, Canada's largest province, is the most indebted sub-sovereign borrower in the world. Canada as a whole has the same population as California but Ontario alone has more debt than Cali. Providing healthcare for all is very expensive.

Canada is now implementing a national socialized pharmacare, dental care, and childcare programs, but they don't even have enough money at the moment to pay for basic healthcare services. Good luck paying for everyone's prescriptions and daycare.

Canada seems to have the same problem as the USA - a voting base who demand stuff but refuse to pay for it. Good luck with that….

[Rancid]

Did you know rural hospitals and clinics have been closing?

Fuck'em.

[wat0n]

Canada seems to have the same problem as the USA - a voting base who demand stuff but refuse to pay for it. Good luck with that….

Stuff like healthcare services.

You should tell this to @late.

Anyway, the best systems in Europe, like those of Germany, the Netherlands or Switzerland, are not socialized - the best ones are heavily regulated by the government and subsidized, but still feature a large role for the private sector. This has the advantage of not creating monopolies, which in turn lead to inefficiencies, but can still take advantage of pooling.