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[P&R] Public Integrity - The Canadian health care system I disparaged
#2
I feel this is a topic on which the people who express opinions are woefully uneducated. It's a big and complicated one, so I'd like to simply start by making a few notes on some key areas that are almost universally mis-represented in the debate. I wouldn't expect them to be compelling to people who have taken sides politically, but for a thinking person, or one who truly cares, it should be cause to re-think everything you know and believe about health care.

First, regarding equality, opponents of universal health care--the more savvy opponents, anyway, would be quick to point out that the equality measure is in itself bogus, crafted specifically for political reasons. I would be so bold as to take that a step further and say equality itself is a myth. Time and time again, we see Pareto's 80/20 law hold true. I have no doubt that if you could look at who's actually using health care resources in Canada that you'd find 80% of the resources are being used by 20% of the patients.

These won't necessarily fall into neat demographic categories such as the 20% oldest or the 20% wealthiest are using 80% of the resources; though they might be. What I am saying is if you had a complete database of all health services usage and you sorted it by patient according to how much health care they used, you'd find that the top 20% did indeed use up 80% of Canada's health care resources. That doesn't sound like equality to me. Merely a re-shuffling of the deck.


My second point is the conflation of the "health care system" with "health insurance". Or more specifically, the conflation of health insurance with insurance. Because here in the US (and I imagine most countries tangled up in this debate as well), health insurance is an aberration. It's the only type of insurance where the insurance company does not cut a check to the beneficiary.

I won't go into the economic mechanics of it here. Suffice to say, this creates a warped incentive system that bloats the whole system. Insurance companies benefit because they get to write bigger policies. Hospitals benefit because they get to charge outrageous prices knowing that they will either a) be paid by deep-pocketed insurance companies, or b) be written off as losses for patients who cannot pay, those losses insuring the hospital maintains its "non-profit" status.

It's misleading, however, to say that this is what the American system looks like. Americans still like to think we have the freedom of choice. In the US, there are for-profit, cash-only clinics that have nothing to do with the "health care system" that typically charge only One-Tenth what a "mainstream" hospital charges. In many cases, the total tab comes out to less than the insured patient's co-pay.

Moreover, and this is really obscure knowledge that I just happen to have because it ties into what I do professionally, some insurance companies do offer certain riders and living benefit provisions on their life insurance policies--and these are becoming more and more popular--that provide cash pay-outs for critical illness. This allows the patient to take the cash to shop around for treatment, including at cash-only clinics.

Now I'd say insurance + clinics constitutes a health care system, and a totally free market one at that. When has anyone even heard of what I described? When is it ever included in the debates? How many people do you know who would jump on it if you said, "Hey, how would you like health care to only cost a fraction of what it is, and your insurance company to give you a cash pay-out so you don't have to worry if the doctor is on the right network?"


My third and final point is that single payer simply doesn't work. It never has worked. It never will work. It's not even working anywhere right now. We have the illusion of it working. Allow me to dispel it. The waiting list is itself the damning evidence. It's proof that under the single payer system, supply cannot keep up with demand. Oh, they won't ever admit it. Everyone will still get treatment. Just come back tomorrow, or next week, or next month.

But if it takes even One Day and One Hour to supply a Day's worth of demand, then at that rate, after 24 days the wait time will be 2 days. After a year, it will take 15 days, and after 12 years, the waiting list will be 6 months long. If that goes on long enough, everyone who gets sick will be dead before they ever get treatment. In my generous example it may take 2000 years to reach that point, but the real world is not so forgiving. The question is, do you have to wait until that day before you admit that system is unable to provide healthcare at all?
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RE: [Public Integrity]The Canadian health care system I disparaged - by Lunamancer - 09-05-2014, 12:02 AM

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