Canuck Conundrum

Wild Bill Safire addresses the problem of Americans buying prescription drugs north of the border. "[T]his foolish acceptance of foreign price controls means that the U.S. consumer is subsidizing the foreign consumer. Not being dopes, pursuing their economic interest, American bargain-hunters are now buying these drugs where they are sold cheaply—:outside the U.S." His proposals:

The tough-minded approach: Raise overseas sales prices to include the cost of research (which should lower prices here somewhat). If the Canadian government says no, let Canadians who want our products buy direct from the U.S. via Internet or mail at the price that pays for research, as Americans do. If Canada forbids that, let its legislators answer to citizens who want prescriptions filled.

The tenderhearted approach: Our drug companies can accurately estimate the current Canadian-only prescription demand in Canada or elsewhere. They should restrict supply of those products at low prices to that level. When American purchasers compete with Canadians for that limited supply, price controls will come under pressure. Canada can then impose rationing, always unpopular in peacetime; or tolerate black markets; or lift its controls until U.S. bargain-hunters see no purpose in competing with Canadian buyers.

Comments

[Ken]

“The tenderhearted approach”

WTF????????

This is the “Continue to screw the US consumer approach”

[PapayaSF]

I vote for the tough approach.

[Larry]

I think, Ken, that the point of the “tenderhearted” approach would be that it sounds compassionate, but in reality it would force those price controlled regimes to ration the cheap supply and the resulting shortages and black markets would hasten the collapse of price controls in general.

My gripe with the coverage of seniors whining about high-priced prescriptions is that when you actually get the complaining patient to list what expensive meds they’re taking, they mostly list newer, heavily advertised, patent protected drugs.

If patients want to save money, they should restrict themselves to drugs patented in 1987 or earlier. The fact that nobody seems to want to do that implies either that new (expensive) drugs provide more value than the older (cheaper) drugs or that too many patients don’t question their doctor and ask if he can specify lower-cost drugs.

[Tim]

How about the “Protect the Consumers of America” option that removes the monopoly protections of companies that create steep price differentials between G8 countries…

Sheesh.

[chthus]

Larry,

It’s likely that not only do the seniors not often question if there is a generic available (or a similar drug that may have a generic available), but the doctors are often not aware of or forthcoming with this type of information.

I worked in a pharmacy in PA for a while in the mid-90’s at the time of some medicare/medicaid reforms. While I don’t remeber all of the details of the changes, the but the most drastic was that prior to the changes, folks getting assistance would pay the same co-pay for brand or generic drugs, and could request brand even if generic was avaiable. Afterwards, they could only get subsidized for a brand-name drug if no generic was yet available, or if they had their doctor fill out a form explaining why brand was required. People who used to say, “my doctor says I can’t use generic” were finding themselves having to deal with it or foot the bill themselves when the doctors could come up with no good reason why the taxpayers should pay for the most expensive drugs.

Doctors are generally well versed in basic pharmacology and those new drugs available when they get out of med school. As the years go by, they recieve most of their contiuing education from the drug reps, and largely get no mention of when or if generics have moved onto the markets.

The drug companies have every right to talk up their drugs and no responsibilty to push generics (unless it suits their interests). The doctors have to keep up on 101 different areas, so it’s to be expected that the majority of them can’t really know what’s going on in the pharmacy/pharmaceutical industy as well as it’s government interactions. The government, though, if it insists on subsidizing pharms, should have the sense enough to keep costs down by requiring generics be taken when available. You don’t get a mansion with section 8 housing, same should go here.

[Come'On, Now]

I am with Ken. I had this girlfriend who was an RN for a convalescence (sp?) unit dealing with the elderly in a regional hospital. A drug company, which I apologize for not remembering at this time, held an invite only marketing “party” to introduce their new product. This party was held at a swanky hotel banquet hall and fully catered with wetbar. She estimated that the costs to throw the party was at least $75 to $100 a head for approximately 350 guests.

Does the common consumer want to pay for these marketing parties with its built in per pill costs? Anyone up for paying for the costs of seeing so many drug commericials during Friends and ER?

Ask your doctor if this is RIGHT for you!

[Jeff Smith]

It is important to note that there are two
things going on, neither of which is really
well described by “price controls” in Canada.

First, in Canada, the provincial health plans
are basically acting as monopsonists. They are
buying a lot of units, and thus have a lot of
bargaining power. Wal-Mart gets lower prices
too, and that is not a crime, though I am quick
to note that Wal-Mart is not a government.

The second thing that is going on is price
discrimination. Canada is poorer than the US.
Thus, it makes sense for many firms to set
lower prices there, just as theatres set lower
movie prices for kids and seniors. One notable
place where this occurs is cars – there was
even a piece in USA today about it a few years
ago. My Honda Civic, purchased in Canada, cost
a few thousand less (at the exchange rate at the
time) than the same car purchased in the US.
That’s just good business, and Honda then takes
care to keep buyers looking to exploit the
opportunity for arbitrage out of the market.
For example, you have to contact them when you
move in order to move the warranty from Canada
to the US.

Do we really want to make it illegal for drug
companies to price discriminate? Do we want
to make quantity discounts illigal?

Jeff

[Larry]

Chthus, thanks for the feedback. It’s amazing that people will take more of an interest in costs when they’re paying the bill.

Nightline aired a show last week about how one hospital’s emergency room started charging a $200 copay if someone showed up without insurance and without a life-threatening condition. Another doctor objected to that, saying that it took almost as much time and effort to determine whether the patient’s condition was life-threatening as it would take to just go ahead and treat the patient. I was amazed that he didn’t recognize how that attitude creates the problem in the first place through bad incentives.

And, Jeff, Hondas can maintain a US-Canada price difference provided that the difference in price is less than the value of the valid-only-in-Canada warranty, assuming that government regulations don’t also muck up the free market.

You don’t want to make it illegal for drug companies to price discriminate, you just want to make it possible for consumers to take advantage of the situation. Arbitrage is a useful service. It is good when people buy goods where they’re cheap and sell them where they’re expensive.

[nm156]

On the subject of price differences, American couples are, more and more, coming across the border in order to find surrogate mothers. Apparently Canadian surrogates charge less, are paid in Canadian funds, and make use of our health care system for the delivery, thus saving the U.S. couple the cost of paying for it back home. I’ll worry about the drugs when you worry about the moms.

[Kevin Carson]

Jeff,

What you describe is also known as “dumping,” a practice common under what Joseph Schumpeter called “export-dependent monopoly capitalism.”

The idea is that the monpoly prices charged by large firms, thanks to tariffs (or in this case patents), are above market-clearing levels. But the firms have to produce at high enough levels to utilize full productive capacity, or face significantly higher unit costs from idle capacity.

The solution is to produce enough to use production facilities to the full, sell as much as possible domestically at the monopoly price, and dispose of the surplus abroad at whatever price they can dump it. Even though they’re taking a loss on the product they dump outside the U.S., it’s not enough of a loss to outweigh the lowered unit costs from operating at full capacity and the monopoly profits from selling in a protected domestic market.

[nm156]

Or, if you don’t care about mom, just about the drugs, boycott whatever companies seel for less in Canada. I love watching alleged Libertarians getting all bent out of shape over a company making a decision which adversely affects them. Doesn’t the corporation have a right to decide whether or not Canada’s laws are worth bowing to in order to access the Canadian market? If Libertarians are supposed to be about individual, or in this case, corporate freedom, then what’s the problem with them making that choice. And if it’s one you disagree with, you do have options.

[nm156]

That should read: “sell”. Seals are a whole different subject. Sorry.

[Sebastian]

If US drug comapnies start playing tough with foreign price controlled markets, those countries will just refuse to recognize the patents on the drugs that are demanded, and start allowing their domestic drug makers to make cheap knockoffs.

Kevin had it totally right. The reason the drug companies don’t want to play this game is because they still make out selling in price controlled markets as long as they can still charge monopoly prices back home.

[Robert Nabors]

Check out the Anti-FDA rant at http://yarchive.net/med/fda_rant.html
It’s a bit long, but well worth the read.

I say it’s time to get rid of the FDA. In the time it takes a company to get a single drug through the FDA, ten years have passed (and ten years worth of victims are dead), and millions of dollars have been spent.

Take out the millions of dollars and ten years requirement, and maybe we’ll develop drugs that will be in the history books again. I read about the polio vaccine when I was younger. Can you think of a modern drug that your children will read about? Maybe Botox…

-Robert

[s.m. koppelman]

Mr. Dean:

You say to-may-to, I say to-mah-to. Do you really think any private pharmaceutical company is selling its products at a loss to industrialized nations’ healthcare systems? Apart from selling off surplus inventory, wouldn’t that be irrational?

Wouldn’t it improve the bottom line to let Canada and Europe produce their own patent-violating generics instead of producing product for them at a loss?

Nonsense. No pharmaceutical company is selling their products to national healthcare systems at a loss. They might itemize certain things to show loss pricing, but surely you understand that they’re selling a basket of goods to Canada, not individual drugs, and that basket is being sold at a profit, year in and year out.

Back to my ketchup analogy: Let’s look at the wholesale side of the business. The owner of an independent small-town grocery store in Whoville might pay 80 cents for a 16 oz. bottle of ketchup. The new Wal-Mart on the edge of town gets the same bottle of ketchup for 60 cents, and sells it at retail for much less than what the corner store can charge.

When everyone switches to shopping at Wal-Mart and the corner store closes down, can Heinz cry foul, that Wal-Mart has near-exclusive access to the Whoville market? Does this cause Heinz to operate at a loss?

You’ll insist to the end that the choice is between socialized medicine and medical R+D. I don’t buy it. Plenty of medical advancements have happened outside the current dual regime of drug patents and trade barriers. The Soviet Bloc and postwar Europe and Japan all managed to do plenty of innovating in spite of socialized medicine.

I’d say a wealthy society that cannot guarantee a satisfactory level of healthcare for all of its citizens is failing its citizens.

[Russ D]

Koppelman,

That ketchup analogy makes absolutely no sense. The restaurant is not re-selling small bottles of ketchup. It is merely giving the customers another vessel to dispense the “complimentary” ketchup rather than putting a 6 gallon container on every table or having a centralized ketchup dispensing station.

Besides, the restaurant has a choice of ketchup manufacturers as catsup is not (to the best of my knowledge) government protected by patents.

And the governments conveniently allow themselves to buy in bulk, while the end users are not allowed to.

[Jason Ligon]

koppelman:

You are simply incorrect. It is rational to sell to Canadians at a net loss for the historical investment but at a marginal profit, IF the alternative is not to sell to Canada at all or, worse, have them copy your drug so you see literally nothing. Remember, the first pill costs $400 million, but the next one costs $.05.

[R. C. Dean]

Do you really think any private pharmaceutical company is selling its products at a loss to industrialized nations’ healthcare systems? Apart from selling off surplus inventory, wouldn’t that be irrational?

Not if the choice is between no income (with the patent broken) and a little income (patent intact, selling at the monopsony price).

I’d say a wealthy society that cannot guarantee a satisfactory level of healthcare for all of its citizens is failing its citizens.

What do you mean by “society”, “guarantee”, “satisfactory”, and “healthcare”?

The idea that “society” (read: the state) has some obligation to “guarantee” anything beyond liberty to its citizens may, indeed, be the root of evil in the modern world. The most horrible abuses in history, with a body count of 100 million and counting, can be traced pretty directly to this idea. A million petty tyrannies are also justified by this idea. It is a bad idea, and we will all be better off when it is purged from polite discourse.

The Soviet Bloc and postwar Europe and Japan all managed to do plenty of innovating in spite of socialized medicine.

Are you seriously arguing that a government-controlled system will generate more creativity and innovation than a private one? Spare me.

[s.m. koppelman]

Are you seriously arguing that a government-controlled system will generate more creativity and innovation than a private one? Spare me.

No. Where did I say that? I just said that a government-controlled healthcare system doesn’t bring creativity and innovation to a halt, as you argued in posing your false all-or-nothing choice of innovation “or” universal healthcare.

Dogmatic ideological rigidity might help you sleep at night, but it’s seldom the best way to approach problems.

[joe]

Adequate funding for R&D, and adequate access to medical care for all, are both necessary elements of a reasonable and decent health care system. Maximizing one interest while ignoring the other is bad policy, no matter which one is being shut out.

[Sebastian]

“Dogmatic ideological rigidity might help you sleep at night, but it’s seldom the best way to approach problems”

I would agree with you on this, but Government run health care is a bad idea. If you don’t believe this, just look at how wonderful our public schools are.

As soon as you monopolize a limited resource, you have to allocate it, and that’s going to mean rationing. Normally this is done throught he price system. Some people find government rationed health care to be a social good, but I think there are better ways to do it than having the government running hospitals and buying drugs.

[linden]

I think you are all forgetting that it’s not just Canada that is the problem. It’s other First World countries that can afford to pay more but don’t, so Americans subsidize their drugs/health at ludicrous prices.

If Americans begin importing cheap drugs from other countries, this will seriously hurt research and development. Aka no new drugs.

[Ayatollah Usoe]

The issues I read above are basically symptoms of having an FDA in the first place. To get FDA approval, the pharma discloses how to make the product. So patent protection is a necessary step when disclosure is required.

Coca Cola did not patent its product. Its recipe is secret. But since it has no FDA regulators requiring disclosure, it can keep that secret and exploit its IP for far longer than a 20 year patent life.

Without an FDA, companies could go the Coca Cola route, and consumers would avoid generics, going with name brand reputations. But consumers would choose, rather than having governments impose price controls, and then having foreign price controls imported into the U.S.

[Damo Suzuki]

“If Americans begin importing cheap drugs from other countries, this will seriously hurt research and development. Aka no new drugs.”

So, as an individual, I can’t import cheap drugs? Why I shouldn’t pay the best price available to me? For the health of the state? Should I sublimate my self-interest for the stockholders of PharmaCo? Why should I subsidize the interests of innovators if my damn kidney is falling out?

Canada, here I come. Hail Elizabeth Regina!

[s.m. koppelman]

Does Bill Safire really think drug companies are selling their products in Canada and overseas at a loss?

Does anyone?

Maybe — horrors! — the prices at which drugs are sold to Canadian and European national health services are market prices arrived at through a meeting of the minds between buyer and seller. Only instead of the buyers being individual consumers with no bargaining power, or private insurers that can pass high prices on to consumers via service cuts and premium hikes, the buyers here have both the leverage (in size) and the incentive (as sole payer for public healthcare, with an externally fixed budget) to push back at the drug companies and buy at a much lower price.

Safire’s using the same approach here that’s long been used to vilify labor unions: when market leverage is applied by a large, powerful company to keep wages down or prices up, it’s a triumph of the free market. When leverage is applied is applied by a large, powerful entity respresenting consumers or workers to keep wages up or prices down, something’s terribly wrong.

Humbug.

[Pedro]

What’s the problem, here? Is it illegal for you to come up here and buy drugs? If so, yell at your own government. Christ, you should be thankful that Canadians are so willing to subsidize your drugs and take advantage as much as you can.

[xray]

Sebastian: Name one drug patent that the Canadian government has violated in order to blackmail the pharma industy to lower prices. That’s just a claim used by drug companies who want Uncle Sam to take care of their businesses for them. The fact is the big companies fight hard to lock up deals with single-payer systems all over the world – once you’ve outbid your competitors on the tender, you have your own little monopoly.

[joe]

If the pharmas weren’t turning a profit by selling drugs at Canadian prices, they wouldn’t sell them.

[Jason Ligon]

koppelman:

The only reason the national health services can negotiate the prices they are getting is to force the US consumer to fund all of the R&D and all of the almost drugs inherent in this product.

Drug companies are absolutely selling to foreign parties at a loss, because selling at a hair over the marginal production is still useful as long as the real costs are paid elsewhere.

If we did the same thing Canada did, their drugs would cost quite a bit more or they wouldn’t have them at all.

The question is, how tired are we of subsidizing Canuck healthcare?

[Anonymous]

Interesting enough. Never thought about Canadian price controls being a large factor in price differences between US and Canada.

Now, does anyone know why prescription drugs are so got dang cheap in Mexico? Mexican pharmacies make the Canadians look like highway robbers. So what gives?

Thanks.

TWC

[Jason Ligon]

joe:

They sell them in Canada to recoup production costs, not to make a profit. A horrifyingly close to 100 percent of pharma profits come here in the US.

As long as the Canadians get their deal, we get screwed.

The kicker is that unlike the jolly fine bulk purchasing power model people here are trying to float, what the Canadian government does on a continual basis is threaten to ignore international patents if they don’t get their way. Lefties everywhere say, ‘good for them!’ as though anyone would choose to give one cent of money to invest in a company that produces a 400 million dollar pill that can be duplicated by anyone for $.01.

The point is that all this talk about this being a free market result is hot air to make people feel justified in getting what they want at someone else’s expense.

If it is such a slam dunk, protected by your government, make bagillions of dollars in profit industry, why bother having any other investment in your portfolio? I challenge every one of you folks out there who believes that the industry is so protected and makes such exhorbitant profits to put your money where your mouth is and dump your entire retirement portfolio into pharma. You can’t lose, right?

[joe]

“As long as the Canadians get their deal, we get screwed.”

Only is “we” are forced by our government to pay the higher American prices. Wouldn’t the free market answer be to let Americans buy cheap re-imports, so the pharmas will raise their Canadian prices by negotiating a better deal? If the Canadian government were faced witht the choice of having more expensive drugs, or none at all, which do you think they’d decide?

[Jason Ligon]

As an addition to my post above, higher drug prices could mean the end of the Canadian health model, as the value proposition quickly falls away in the face of higher costs. The system being a religion to most Canadians I have ever dealt with, I am doubly concerned that anything to save it might be justifiable.

[Mac Daddy Hoon]

It is pretty evident to me the drug company are making a little bit too much money. On average U.S. industries experience a net return of 3.3% whereas the top 10 US pharmaceutical companies have a net return of 18.5%.

Being an MBA student I see the results of our drug regulation system on a daily basis.

Totally off topic, but I am completely struck by the delicious irony of an MBA student actually claiming that a company is making too much money.

[dhex]

a friend of mine is a field rep for a large pharmaceutical company. she was hired out of college for her excellent grade, communication skills and the fact that she looks fantastic in a business suit. young, attractive reps are sent to doctors to take them on spa trips, golf outings, fancy dinners, etc. this is the rule, not the exception, at least for this company.

i always keep this in the back of my head when dealing with my doctors, all of whom prescribe generics whenever possible and helped me out considerably for the 8 months i had no health coverage. but there are a lot of docs out there whose “education” on a set of new drugs is dinner with a hunk or hunkette and some flyers.

[Kevin Carson]

Jason Ligon,

Either patents are a legitimate form of property, or they are grants of monopoly privilege created by government fiat. If they are the latter, then they are illegitimate. The consequences of abolishing them are beside the point. Calling drug R&D a “public good” doesn’t make it right to fund it by putting a gun to my head–either by taxing me to pay for R&D tax credits, or by forbidding me from producing and selling the same product without a license.

That’s what *I* would call “making money at someone else’s expense.” But of course, we all know its only food stamp recipients who do that; big corporations did it all through rugged individualism, the John Galt way. As Cool Hand Luke said, “Them pore ole bosses need all the help they can get.”

As Robert Nabors says, doing away with the incredibly inefficient and costly FDA process would go a long way toward offsetting the loss of monopoly prices. I’m all for putting out all the research data on drugs under development, and letting the consumer decide whether the risks are worth it. I’m also for integrating stuff into mainstream medicine that members of the White Coat Priesthood have either not heard of, or are afraid of prescribing because it violates the “standards of practice” enforced by the local licensing mafia. E.g., Co-Enzyme Q-10 for CHF, grapefruit pectin for cholesterol, etc. These things are very cheap, and quite effective. But since the drug companies don’t make mega-bucks off them, not a lot of research gets done in that direction, and the largely drug company-influenced med school curricula and “standards of practice” ignore them.

[s.m. koppelman]

Jason:

A standard 16 oz. bottle of Heinz ketchp sells for $1.29. A gigantic vat of Heinz ketchup at a restaurant-supply store sells for $6.

If a restaurant takes some empty 16 oz. ketchup bottles and refills them from the gigantic vat, will Heinz cease to be profitable? Are those small bottles of ketchup subsidizing the restaurant and foodservice industries? Or does Heinz have both a profitable $1.29-retail small-bottle ketchup business and a profitable $6-two-gallon-vat ketchup business?

If the vats of ketchup weren’t profitable — or the capital tied up in their production and distribution could be better used in some other ivestment — surely they’d stop selling vats of ketchup and would move their resources elsewhere. Like into municipal bonds.

You seem to be arguing that every time a restaurant refills ketchup bottles from a vat, they’re driving up the prices of small bottles of ketchup.

[Dave]

This is always a touchy subject. The current patent system in place for drugs is not working well at all. It is pretty evident to me the drug company are making a little bit too much money. On average U.S. industries experience a net return of 3.3% whereas the top 10 US pharmaceutical companies have a net return of 18.5%.

Being an MBA student I see the results of our drug regulation system on a daily basis. Many of my former classmates are now working in prescription drug sales. Their job is basically to wine and dine doctors and put those pretty little brochures in waiting rooms. Pretty silly that many of them are getting paid $70,000 plus a year.

Now don’t even get me started on how wasteful our current health insurance system is…

[Dave]

My point being with the previous post. Drug companies are making too much money here. So the system needs to be changed to reflect this.

[Larry]

Well, nm156, if the Canadian government chooses to pay for all health care, including care for surrogate mothers, it should be no surprise that people will take advantage of the situation.

And with respect to patent rights, it is certainly true that any country could decide to do away with patent protections just like they could do away with copyright protections. That’s not really the issue in this discussion, though.

[joe]

sm, thou hast suggested that socializing medical costs can create greater efficiencies, and thou art cast out from this place.

🙂

[nm156]

You’re right, Larry. So if prescription drugs are cheaper up here, and the manufacturers are okay with it, look elsewhere for your gripes. Try the manufacturer, or your own government.

[R. C. Dean]

Well, joe, I have to say that the track record of socializing costs to create efficiencies is so overwhelming, why would anyone oppose it?

s.m., you might have a point if the Canadian government was operating purely as a bulk purchaser. It is not. First, it is a monopsonist, exercising control over access to a market that would be illegal for a restaurant. Second, it is an extortionist, requiring pharmas to sell drugs below actual cost (which includes development costs) or lose their patent.

For a pharma, the choice in the Canadian market is between no positive cash flow (patent stolen) a little positive cash flow (selling at production cost). In a functioning market such as the ketchup market, there are no such dilemmas. Sadly, Canada does not have a functioning pharma market because it does not protect the pharma’s property rights and does not permit competition.

Globalize the Canadian model, and you get stagnant pharmaceuticals. Globalize the US model, and you get astonishing advances in medical care. Which would you prefer to globalize?

[Jason Ligon]

Kevin,

I don’t think that patents are an either/or propositon as you suggest. A patent of limited duration does not grant it the status of physical property, and the term intellectual property tends to distort this point. After calling something IP, the way is opened for arguing that IP is an illegitimate form of property and so on, as is your predisposition.

The patent is currently the only way for an investor in any product whose research or development costs dwarf its marginal production costs to realize a return on investment. If you want writers to write, programmers to code, and drug developers to develop drugs, you had better come up with a way to allow them to be paid for their initial production.

I know it is all the current rage to presume that open source development is the answer, but I just don’t buy it. Such a model changes software production (or whatever) to a charitable process. It IS through the charity of software programmers that we would receive our code, and not through their persuit of their self interest.

I also don’t like the FDA’s role, but again I am struck by the weight those opposed to patents give this particular cost. There are plenty of other risks involved in development, and those would have no way to be offset in the absence of patents.

Finally, there are two kinds of people in the world: those who believe that there is something in their organic garden that will cure cancer all by itself, and those who believe that medicine in this day and age is an enormously complex process because human physiology is enormously complex. I am in the latter camp. Of all the fanstastic unpatentables out there, you can count the number that have passed a double blind efficacy study on one hand or so. I would also note that there would be no more incentive to invest in an unprofitable drug when all drugs are unprofitable than there is incentive to invest in grapefruit pectin now. Instead of raising the value pectin, you would be encouraging no more investment in Lipator than is currently in medicinal grapefruit.

[Jason Ligon]

nm156:

It is a bit more complex than that. Does society owe everybody a bandage to keep them from bleeding to death? Okay, how about a neurological procedure that only a few can perform that will prevent a brain hemorrage? An experimental drug that cost $1 billion to develop, and will grant an aging person another year of life?

If society owes everybody all of these things, what about things that haven’t been developed yet? What if the same policy that allows everyone to get brain surgery for ‘free’ has an opportuninty cost that delays the development of a cure for cancer by a decade? Do we get to add in the number of dead that would have been saved to the number of people the government has killed?

[nm156]

True no insurance does not mean no healthcare. You just have to mortgage your home to have that unexpected miracle. No thanks.

[nm156]

Oh, and it is not about what the government owes me. It is about what the people have decided their government should provide. We (Canadians) want a safety net for our fellow citizens, both in terms of healthcare, as well as unemployment insurance/welfare. Personally, I think portions of it should be opened up to the so-called two-tiered philosophy, but I stop short of scrapping it altogether because, for the most part, it works.

[R. C. Dean]

Noboody has yet told me “What do you mean by “society”, “guarantee”, “satisfactory”, and “healthcare”?”

Once you get done with healthcare, we can move on to all the other essentials that society owes me, such as food, shelter, education, etc. If society owes me these things, doesn’t society owes me the best healthcare available, a tasty and varied diet, comfortable and spacious living accomodations (with furniture, of course – you don’t expect me to sleep on the floor, do you?), a college education at a highly regarded school (and post-grad if I want).

And really, you can’t function in modern society without transportation, so I guess society owes me transportation as well.

Once you start down the “society owes me” road, there is no logical stopping place.

“Society owes me” is the root of all collectivist regimes, which in turn have reaped a bloody harvest these past two centuries.

I am not saying that there is no place for a safety net, or that a society with such a safety net is not the better for it. I am just saying you need something a bit stronger than a priori assertions about what society owes you.

Instead of “society” owing you, try saying “my neighbors” owe me, or, even better, I owe my neighbors, and see how that feels. Yeah, your neighbor who just got back from a month in Cozumel- you owe him health care for the bug he picked up there. Get your checkbook out.

If the poor schmucks can’t afford their own insurance, fuck ’em.

A common fallacy, this – the belief that no insurance means no health care. It is utterly false.

[joe]

“A common fallacy, this – the belief that no insurance means no health care. It is utterly false.”

Absoluty. You always have the option of…

1) skipping out on the bill, and having the hospital pass on the cost to the government.

2) the government can refuse and the hospital can shut down. This will, of course, happen almost exclusively to those hospitals located in the poorest neighborhoods.

3) Or you can just not get treatment, die or become incapacitated, and your kids go on welfare

4) or, no welfare, and the kids croak, too.

Pick one, Mr. Capitalist.

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IP: 62.213.67.122
URL: http://fitness.weight-loss-central.org
DATE: 01/09/2004 12:43:22
Underestimation is a two-way street.

[Tenzer Heather]

EMAIL: [e-mail]
IP: 203.162.3.146
URL: http://preteen-sex.info
DATE: 05/19/2004 10:58:31
Suits and religions rupture if you force them on.

[Schlesinger Diana]

EMAIL: [e-mail]
IP: 198.77.192.221
URL: http://preteen-sex.info
DATE: 05/20/2004 01:02:28
Assassination is the extreme form of censorship.