Reason.tv: A True Tale of Canadian Health Care—Why some patients need to go to the U.S. for surgery

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Many advocates of health-care reform are admirers of Canada's state-run, no-opt-out, single-payer system. Indeed, in 2003, President Barack Obama voiced enthusiasm for such a health-care program.

Proponents of Canadian-style health care should meet Cheryl Baxter, a Canadian citizen who waited years for hip-replacement surgery, only to be told that her operation would not happen any time soon. Instead of waiting, Baxter did what an increasing number of Canadians are doing: She flew to a clinic in the United States, paid out of pocket, and had a life-altering surgery in a matter of weeks rather than years.

Baxter's experience doesn't just throw damning light on Canadian health care. The sort of clinic she went to in Oklahoma suggests a different way of delivering health care in the United States, too: A simple fee-for-service model in which providers openly advertise their prices, service, and reputation. Rather than a frustrating, complicated mess of intermediaries such as employers and insurance companies, U.S. health-care reformers should think about bringing medicine into line with the same dynamics that help deliver great service at great prices throughout most other parts of the economy.

While Canadian health care is certainly cheaper than its U.S. counterpart (health care spending in Canada is about 10 percent of GDP versus 16 percent in the United States), it is not necessarily better or more equitable. As a recent National Bureau of Economic Research comparison concluded, "Americans are more likely to report that they are fully satisfied with the health services they have received and to rank the quality of care as excellent." Not only do Americans have far greater access to basic diagnostic tools ranging from mammograms to CT scans, the researchers found "the health-income gradient is actually more prominent in Canada than in the U.S." That is, wealthy Canadians receive far better care compared to low-income Canadians than rich Americans versus poor Americans.

"A True Tale of Canadian Health Care" was produced by Dan Hayes and Peter Suderman. Interviews were filmed by Alex Manning and the segment is hosted and scripted by Nick Gillespie. Approximately 5.11 minutes.

Reason.tv would like to thank the Independence Institute for arranging and underwriting travel to Canada for Suderman and Manning.

For downloadable versions of this video, go here.

For other Reason.tv videos on health care, go here.

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  1. Yes, another conservative picking on Cananda (or Britain) who do have some problems. Why do you ALWAYS focus on these two, and never on the elements where they beat us. For example, Britain smacks us around on cancer mortality rates.

    When you compare us to every other rich nation, you find that we are among the best for care when you are sick and insured…and piss poor in all other cases – for a 50% higher price.

    1. Chad, can you point me to your source on Britain smacking us around on cancer mortality rates? I just googled “cancer survival rates by country” and got a fair number of articles from around 2007/2008 ranking the U.S. as having the best survival rates, Britain having some of the worst in western Europe, and Canada having a lower but somewhat more consistent survival rate than the U.S. Have there been subsequent studies or reports that showed Britain leaping ahead or America dropping behind?

      1. Ignore Chode. The single-payer doctors were never able to successfully close that fissure in his ass and he insists on pulling numbers out of it constantly.

        “It’ll never heal if you keep doing that.” they tell him, but does he listen? No-o-o-o-o-o-o-o.

        1. Actually, it’s a fistula so it can support his circular reasoning.

    2. When you compare us to every other rich nation, you find that we are among the best for care when you are sick and insured…and piss poor in all other cases – for a 50% higher price.

      So, we have the worst care when you aren’t sick, or don’t need medical care. Other cases, like cosmetic surgery or lasik, our care is piss poor.

      Where do those higher costs come from, Chad? Break those numbers down. The fact is, those numbers are every bit as misleading as the 47M uninsured number or the completely unsubstantiated 40,000 people a year dying because they don’t have insurance that people like Bernie Sanders like to throw around.

    3. I thought you were going to say, ‘”Yes, another conservative picking on Cananda (or Britain) who do have some problems. Why do you ALWAYS focus on these two,” look at France or Switzerland’, but instead you came up with some bogus fact to stick up for Britain. Even Poland is better for some things, and they spend a tiny fraction of what the UK does. Read the Daily Mail Article “Britain, the sick man of Europe:
      Heart and cancer survival rates among worst in developed world read the Daily mail article Britain-sick-man-Europe-Heart-cancer-survival-rates-worst-developed-world

      Socialized medicine can be done right or wrong. Britain does it very wrong

    4. Chad
      What are you smokin’ boy? The British M & M rates are NOWHERE near as good as the U.S. Not in anything! Especially cancer! Get your facts straight! And if you are capable of understanding the article, it disputes your claim of unfairness and discrimination based on socioeconomic status being worse here!

    5. Chad, there was just an article (you can find it via Drudge or RealClearPolitics) last week that had the statistic on US vs UK cancer survival. The US has a 38% higher survival rate.
      Game, Set , Match.

    6. Chad, I don’t know where you are getting your information re: cancer rates but in the most common cancers (like one that may affect you–prostate) the mortality rates in Britain are much much higher. May you get the same treatment the Brits do when you get sick with no option to pay out of pocket and get lifesaving care you need. If insurance and govt were out market forces would keep prices down (like doctor visits) like they were before NIxon. You can be a liberal, but at least know when you are wrong (know “when to fold ’em”).

    7. For example, Britain smacks us around on cancer mortality rates.

      Really Chad, why lie about something so easily googled?

      And here I was thinking you were above the level of a Tony..

  2. Part of the reasons costs are down in those other countries is because of the rationing this woman was a victim of. Furthermore, our political class has shown it may not have the will to hold down costs that way at least against a vocal constituency, as the mammography issue has brought to light.

  3. Part of the reasons costs are down in those other countries is because of the rationing this woman was a victim of. Furthermore, our political class has shown it may not have the will to hold down costs that way at least against a vocal constituency, as the mammography issue has brought to light.

    1. A point worth repeating, if I may say so.

      1. And worth repeating again. The whole mammogram clusterfuck highlighted the attitude that cost should be no object and that no level of spending is too much if it saves one life.

  4. Please make a downloadable copy. Not all of us are in countries that can view Youtube.

  5. She’s Canadian, and therefore likely white, therefore this post (and every comment on it) is racist.

  6. I suffered a life changing injury at work. The private insurance carrier my employer used for work comp denied the surgery needed to try to fix my back. Not medically necessary. That decision was appealed several times with the help of a lawyer and it was upheld by the state. These situations happen here in the states with private insurance just as they happen in Canada with their system.
    Don’t mistake this as an argument for single payer. It’s just a similar example to the story posted.

    1. But in the U.S., you can still pay out of pocket for the treatment. In Canada, it is illegal to pay out of pocket for the treatment… if your public insurance denies you treatment, it is illegal for you to receive that treatment.

      1. Vehical Driver, I don’t know where you get this info. My college aged daughter who was entitled to free care would pay cash all the time because she could never find her health card.

        1. Bullshit. I’m from Canada, and I can verify that it is indeed illegal to get medical care outside of the public system. For a simple reason. If the government allowed doctors to charge fee-for-service up front, then people with money would be able to skip to the front of a waiting list, by opting for private fee-for-service practitioners. They would do like they are doing now, only within Canada.

          Only by banning doctors from offering their services privately, can the government effectively ration limited services.

          However, it IS true that Canada’s supreme court struck down laws barring private health insurance in Quebec, so it’s possible that *some* services might have been opened up to free market competition there.

          1. I am talking about Montreal where my daughter attended university. Yes, she did this several times and I do have the receipts.

            1. So, in that case, yeah, only because Canada’s supreme court declared the bans on private health care illegal.

              But you do realize that that spells the death knell for Canada’s single payer system right? If all the provinces are forced to allow private fee-for-service care, then many of Canada’s doctors will opt to move their services to the private sector, and thus, more available to wealthier indioviduals who can afford it.

              1. No I do not agree with your premise. Most people (except 20 year olds who can’t find their health cards, keys and cell phones) will stay in the public system because it makes economic sense and thus most physicians will receive the majority of their work from that system. You cannot have it both ways. Saying that government run healthcare will destroy all private care here and saying the opposite when there is a public system with some private use. Make up your mind. Will the public system be destroyed when private care is allowed or will the private system be destroyed when there is some public care?

                1. I have found several articles (listed below that) that state for the most part private health care is illegal or unavailable in much of Canada due to their health care system. http://articles.latimes.com/20…..e-canada27
                  http://www.cmaj.ca/cgi/content/full/164/6/825

                  Now to answer your question regarding whether the public option will destroy or build the private industry. Well in my opinion it all comes down to money. The public option offers unrealistically low prices (non-market based) and so it is cheaper for the average individual (if you don’t count the increase in taxes to cover the cost of lowering the price so much). The private industry offers higher prices (market based) that are more expensive for people but won’t increase taxes. Whether the public option will kill the private market is a matter of degree. I think that the public option will kill most private insurance and practice by offering products with much lower up front fees and with no need to make a profit. Think about it, if the government started selling houses for $20,000, do you think any house builders could stay in business? For the most part, no. This is where the degree part comes in, the public option will not kill all private health care just that private health care that most people can afford. There will always be (unless outlawed) private health care for the rich as it is far better (I lived in Italy for 2 years and the only people that went to their public health care were the people who couldn’t afford to go private as their hospitals weren’t as nice, the doctor’s weren’t as good, etc. and all the while they are taxed about 50% of their income whether you use it or not.)

                  So I have to agree with Ms. Meade, many Canadian doctors would move their practices private because they get paid better and can earn a lot more money.

                  1. David, “Think about it, if the government started selling houses for $20,000, do you think any house builders could stay in business?” Let us talk about something that already is in existence. Education is paid for by the government. We all pay taxes and our children can be educated. A private option does exists. Most people will choose the public and regardless of parochial/private choice the public school does remain. The fact is we can have both a public health and private choice and the only difference is that as in schools, the private choice is going to have to offer more bang for your buck.

                    1. But in America, public education is at best a mixed bag. We get routinely beaten by the likes South Korea and Japan in test scores and other academic achievement. In John Stossel’s “Stupid in America”, random kids of Belgium performed better in a test compared top American students handpicked from the best schools.

                      Most parents opt for the public education because (a) it’s free, (b) they’re often bound by the district. Asian parents fake their address so their kids can attend a better school in somewhere else. ALL the time, really. We can’t afford to move to Malibu on a whim.

                      The choice isn’t between private and public. It’s more about the government not trapping us in the public.

                    2. Seraph, I used public/private education to compare public/private healthcare. I know many countries beat the US in scoring but other factors contribute to the success of this country. Btw,”the number of Korean immigrants in the United States grew 27-fold between 1970 and 2007, from 38,711 to 1.0 million, making them the seventh largest immigrant group in the United States”

                    3. It’s not free. I send my kid to public school because I’m already paying for it anyway in taxes. But first I moved to a city where the schools were better than LA Unified.

                    4. Education is paid for by the government. We all pay taxes and our children can be educated. A private option does exists.

                      And public education is uniformly poorer and more expensive per student than private education.

                      The only difference is the poor are stuck in public schools as the resources which would otherwise be available are used by the public schools. Vouchers would fix that but since they would.. they cannot be allowed. If you properly educate the poor.. well some might stop being poor, and what would the victimocracy do then?

                    5. Faithkills, I am for vouchers because public schools would lose the fund per student and would work to improve education. The truth about public education is that many kids will make the most of it (advanced placement, cec etc) and will have access to scholarships for college.

    2. But in the U.S., you can still pay out of pocket for the treatment. In Canada, it is illegal to pay out of pocket for the treatment… if your public insurance denies you treatment, it is illegal for you to receive that treatment.

      1. Unless you’re a dog or cat. Then you can get an MRI the next day.

        1. Hilarious, if true. But believable. Veterinary care is free market in Canada.

          1. It’s true, and the situation is little different in the US with it’s highly burdened market. A surgery for an animal that costs hundreds of dollars costs many thousands of dollars for a person. The same with human procedures in the US that are relatively free market like cosmetic surgery and lasik/RK.

    3. We don’t have private free market health care, we have state created oligopolies.

  7. @brotherben:

    Apples and oranges. This woman was denied a service by “universal care” because there wasn’t enough medical resources to go around. Legally, she couldn’t pay for the operation even though she had the money.

    Your case is one of not getting the care because you couldn’t afford it and the insurance co. denied your claim. If the state court backed them up… well then, you’re SOL, and I’m sorry about that.

    1. You make a very good point. If I had the money in hand, there is no law prohibiting me from seeking treatment anywhere in the states. With the current reform bill, all americans will be required to have insurance or pay a penalty tax. Can someone tell me if insurance companies will be forced to allow all medical requests for treatment? I can see where that would bankrupt a bunch of (maybe all) private carriers.

      1. If the ridiculous incessant mandates imposed on insurance plans was addressed, accompanied by responsible consumer use of insurance, then companies wouldn’t face this problem. Third party payer is at the crux of higher medical care costs. Of course, now mamograms will be “free.”

    2. NTRJB, This woman was denied a service by “universal care”. No, she was put on a waiting list. My mother just broke her hip and was taken care of immediately (Quebec health). My father had hip replacement without a delay and was elated with all aspects of his care. Was the hold-up due to other factors? How long was the proposed wait time? Red Deer is the third most populated city in Alberta (each province has a “state” run system). Reason may not be disclosing the full story.

      1. NTRJB???

      2. If you make big donations to your MP, you can usually expedite medical treatment. You just have to make sure you never actually call it a “bribe”, you pretend that the MP is fighting some sort of error by the health system.

        1. Vehical Driver, Wow corruption found in Canada? We don’t have any of that here!

          1. Point being that in a socialized system, your access to care is determined by your political connections.

            Which makes society MORE stratified by wealth and status not less. In the US, you can start your own business, get rich, and they buy all the care you need. In a socialized system, you either have the right political connections (usually determined by the social class you are born into), or you’re screwed.

            I’d much rather have a system where your money is always good, no matter where you were born or who your parents were, than one where only the connected get access to the best quality stuff.

            1. Hazel, “Point being that in a socialized system, your access to care is determined by your political connections.” I just read of a case in the US of transplant controversy> http://www.channelapa.com/2008…..-ucla.html

              Well Hazel, your argument may hold water in North Korea but it does not in virtually all the socialized systems that have democracy. I have lived in Canada, spent a lot of my time Ireland, my daughter lives in England and will be moving to France in January (and is already covered) and of course I live here now. I can tell you in those socialized countries I have received nothing but excellent care. Medical tourism is “projected to grow from $56 billion to $100 billion by 2012. A good percentage of those using this service are Americans who cannot afford care in their own country. That is shameful.

              1. Did you completely forget about the earlier post, or something?

                If you make big donations to your MP, you can usually expedite medical treatment. You just have to make sure you never actually call it a “bribe”, you pretend that the MP is fighting some sort of error by the health system.

                1. “If you make big donations to your MP…” Hazel, I could tell you about tit-for-tat nonsense stories here (US) but the fact remains that I do not know one Canadian who has lost their home due to bankruptcy over medical expenses but I sure as hell have heard of plenty of Americans in that boat. Btw, do you live here or in Canada?

                  1. What’s better? To lose your home to bankruptcy? Or to lose your life because you’re stuck on a waiting list?

                    1. The choice of health care available to all is the best choice. Btw, access to health care is the best option for prevention and thus reducing further disease.

                    2. Ms. Stack,

                      I don’t understand your argument, you say “Medical tourism is “projected to grow from $56 billion to $100 billion by 2012. A good percentage of those using this service are Americans who cannot afford care in their own country. That is shameful.” If they can’t afford treatment in their own country, how are they going to afford to go to another country and pay for care there?

                      Actually, the type of health care matters more in preventing disease than universal access. For example, a young man in his twenties doesn’t have an insurance, does he benefit more if coverage is universal? No, because currently he could pay nothing because the chance of something happening to me are very low. On the other hand, universal coverage is greater for older people who are more likely to be sick and we already have that in the US as well as for the poor (Meidcare and Medicaid).

                      The best thing our country could do to improve health is to lower everyone’s weight down to a healthy level. About 74% of health care costs in the US could potentially be drastically reduced or eliminated in everyone was a healthy weight.

                      So how do we get people to do that? I personally like the Safeway plan (used by the company Safeway). Their plan is to give people incentives to live a healthier life by lowering the cost of their health care insurance. I have included an article written by Safeway CEO where he describes their plan. http://online.wsj.com/article/…..08603.html

                    3. David, “how are they going to afford to go to another country and pay for care there?” In India (considered the most expensive) the cost of medical treatment is reduced by 50%. The doctors are US trained and the service is equivalent to staying at a luxury hotel with your own valet. Medical tourism takes place in many countries and Americans who choose it need disposable income. I have been told by the time you pay your deductible and use your airline points the savings are greater. The truth is that you cannot be working poor and use this resource . I have bookmarked your article to read but I do agree that personal responsibility (weight, drug abuse and so on needs to be addressed).

                  2. Mary, nobody has lost their home because of healthcare costs alone…EVERY case, when more deeply investigated, had MANY reasons for financial problems, including having healthcare costs. Typically financial mismanagement….

                    1. Iggy, welcome to the fray! “EVERY case” is a encompassing word. Prove it! Btw, poverty is a chicken and egg dilemma. Now I feel the need to listen to some Iggy pop.

      3. Canada has awful wait times.

        ER wait times

        http://www.cbc.ca/health/story…..80521.html

        Specialist wait times

        http://www.usnews.com/blogs/pe…..ystem.html

        Reason is being charitable.

        1. Faithkills, the first link is about hospitals in the Outaouais area of Quebec. I was just there (this summer) and found the service to be spectacular. I can tell you that I called from Texas and the receptionist tracked down my mother and gave her a phone (even though I stated I was unsure I had the right hospital). Further, I can tell you when if met with the surgeon post-op (yes, my mother was taken care of immediately) he gave me his phone number in case my mother needed to contact him directly. This study was a comparison of hospitals in Quebec. It does not refer to Canada as a whole. So if I had experience with the hospital that had the worse waiting time in one area of a province, then I am more than impressed with Canada as a whole.

          Your second link refers to data compiled by The Fraser Institute is “a think tank based in Canada that espouses free market principles. Its stated mandate is to advocate for freedom and competitive markets”. One of their goals is to privatize government service and I suggest you google controversy for an interesting read.

          1. The Fraser institute advocates for freedom? How awful that must be for you.. better get to work making sure they don’t succeed..

            Mary those are the facts. Are suggesting that news story is made up? Are you suggesting the Fraser data is fabricated?

            Are you suggesting if it had been fabricated they would not have been called on it?

            There’s lots of information out there about Canada wait times and health care budgets. It’s a chronic issue in Canada. There are news stories every day.

  8. We pay 16% of our GNP for healthcare. I don’t see why that number is in itself such a bad thing. We are the rickest country in history. We can afford to pay a lot of money for healthcare. Healthcare is pretty damned important. More important than say professional sports or agriculture subsidies or any number of other things we spend our money on.

    More importantly, lets say we went the Canadian route and were able to cut our spending on healthcare to 12% rather than 16%. That means we would cut healthcare expendatures by one fourth. I don’t care how magical and wonderful the government is. Even if the market is evil and the government is benevolent (which is not) there is no way that you can cut expendatures by a quarter or more and not screw a lot of people and lower the quality of care.

    1. Once again, per comments on Matt’s article, in order to replicate a Canadian or European model, we would have to become those countries. Because our population, geography, culture, economy, and “freedoms,” this is undesirable and impossible (hopefully).

      1. We have a big country. We have a lot of automobile accidents and people shooting each other. No healthcare system is going to reduce those costs. You can’t reduce costs associated with emergencies (the guy who is shot or wrecks his car). And since the public employees union and the trial lawyers own the Democratic Party, they will never reduce the bureaucratic costs or the legal costs. So, what does that leave? It leaves cutting services to the elderly and chronically ill. That is all “health reform” is; a scheme to steal money and services from the elderly and the chronically ill and give it to the bureacrats and the lawyers and various others of the Democratic Party rabble.

        1. No, all “health care reform,” aka medical insurance reform, is is a political victory for Dems and Obama, hence a larger voting block. If you are for single-payer, fine, or a “free market,” fine, but how anyone could be excited about current legislation is beyond me.

        2. Disagree–the elderly are so politically powerful they will not tolerate any cuts to the services they receive. The people who will really be screwed are the young and healthy. They will be forced to buy insurance and forced to pay exorbitant premiums in order to lower the premiums of the (relatively affluent) elderly and those with pre existing conditions.

          1. The elderly would likely get screwed in a single payer system. Such a system would likely be funded by progressive taxes which wouldn’t fall too heavily on the young because they earn a lot less. Rich people simply don’t have enough money to fund all this stuff. In such a system it is really easy to get support by providing all the healthy people apparently cheap/free routine care, they will hardly notice the rationing because it isn’t happening to them; and they will love the system.

            However, in our system there is little appetite to raise taxes and the old are really powerful. So at the very least we will likely pay for it with bigger deficits that the young will have to pay off or face inflation. As well the individual mandate and effective community rating will impose high costs on the young and healthy.

    2. We could actually cut our health care spending a bunch if we all lived healthier. Look at what it did for Safeway. http://online.wsj.com/article/…..08603.html

  9. Lived and worked in Canada for some time…part of their health care system…would rather wait intil whatever it is is black and about to fqll off than get care from their system ever again…it was like going to a bad DMV for a vacination…including the flickering flourescent light bulbs.

  10. that would be fall vice fqll…see what happens with canadian health care.

  11. I used to go to Canada for beer. Seems like a fair tradeoff.

  12. What the politicians are attempting here is to force more people to pay into the system.

    No doubt there is disfunction in U.S. health care, but I suspect that the perception of disfunction is greater than the reality.

  13. I agree that the Canadian system is unfairly singled out. For more involved procedures, there is a wait list that is ridiculous; for day to day care or chronic conditions, it functions reasonably well.

    Actually, the quality differs from province to province.

    1. If you want to be able to go the doctor every time you have a sniffle, go to Canada.

      If you want to have the latest cancer medications and treatments in a timely manner, come to the U.S.

      If you’d like both, adopt a system that puts the individual back in control of their health care, the best of which is free markets.

      There’s no arbitrary GDP percentage we should spend on health, and we should expect aggregate spending to rise as we get older and richer. However we do pay too much for many goods, and costs need to be controled. The question is how does it?

      Do we trust distant government bureaucrats that will cave to any sizable voter group? Or do we trust individuals to make choices in competitive markets with their own money as a means to discover the relative values of health goods and services?

      Maybe people are dumb, but government bureaucrats are also people; and they are selected by those who are selected by the same “dumb people”. At least in a democracy.

  14. The article neglects to mention a few pertinent issue. For example, some of the provinces reimburse citizens for medical treatments received in the U.S. http://www.medhunters.com/arti…..nada.html]

    In addition, it is commonly known that a cottage industry has developed around clinics that cater to Canadians requesting medical care?at rates lower than standardly offered to Americans.

    So in effect, although Canadians may have a longer waiting period for certain procedures, the government in Canada has made specific allowances to increase Canadian choice?something many don’t have in this country because they lack insurance. I may also be constructive to learn that 87% of Canadians are satisfied with their medical care system [ibid.}.

    1. In addition, it is commonly known that a cottage industry has developed around clinics that cater to Canadians requesting medical care

      Indicating that there is sufficient demand from Canadians for American medical care for a “cottage industry” to develop.

      The rates are likely lower because they are all paying up front. In my experience, hospitals generally try to rip off the insurance companies whenever they can, knowing that the patient isn’t paying any attention to the bill, and will scream bloody murder if the insurance company objects to sqwat.

      As to provinces reimbursing Canadians for US treatment – good luck with that lasting. If they reimbursed everyone who chose to go to the US, they’d be bankrupted, fast.

  15. Forget the facts! Emotions are the way to go. (Fear being #1 in politics.) We don’t want facts, just tell us what we want to hear.
    [What does “Reason” mean again?]

    Did the doctors in Oklahoma tell her her hip replacement was medically necessary? No, because they just take money to perform operations, no questions asked.
    Where are the facts of this story? About how she couldn’t go to work or go up the stairs or take care of her kids or bathe herself? If those were facts, they would have appeared in the story.
    She was never DENIED coverage (which is what happens in the US insurance rationing system) she was put in a need-based queue. She looks like she’s about 50! What are the odds there are people 75-80 with a greater need than her? 100%?

    If you think the corporate insurance system is a “I get whatever I want, whenever I want it, for any reason” you are an idiot. The fact that you can go to Oklahoma and pay for medicine doesn’t mean that your insurance company will reimburse you; I guarantee you it won’t. If you want to fly to Oklahoma every time you need medical, no one is stopping you. Don’t get private insurance and don’t take the public option.

    For every Cheryl Baxter in Canada, I promise you there are a hundred American stories of suffering or death due to coverage denied (not queued) or no coverage at all.

    1. There is no mention of hardship anywhere in the story. What were the effects of having to wait?
      What was the reason given for her wait and why does that not appear in the story? Maybe the reason was she has Munchhausen Syndrome. I doubt it, but we’ll never know.
      My grandfather had hip replacement at around 70 and 80 years old. Everyone I know who has had hip replacement is OLD. No doubt they are ahead of her on the list and their pain and suffering were much worse than hers. They didn’t tell her she couldn’t have the surgery, only that she’d have to wait.

      1. If you look above at some of the comments, efforts are made to use facts and figures to dispute universal health care. Then look above THAT at the story. It’s sad when the comments are more comprehensive and journalistic than the story.

        1. Well it’s not the case I would make, but emotions do seem to work better with progressives than facts. I assume that was his audience. There’s lots of articles with data showing Canadacare sucks, doesn’t hurt to have an occasional emotional appeal.

    2. So younger people you need hip replacements should just SUFFER until they are old enough to get to the top of the waiting list.

      Glad we cleared that up.

    3. Neither the US nor the Canadian system is “I get whatever I want, whenever I want it”.

      But A) At least in the US, you CAN pay out of pocket and get treatment, even if you don’t have insurance.
      B) How exactly is it more fair for your health care to be dertermined by politics, than the size of your wallet?

      If everyone VOTES for you to be denied life-saving treatment, why is that supposed to be more fair than going to bankruptcy court or paying off $100,000 in debt afterwards ?

    4. Yes Jcalton, that is exactly the point. In America, “If you want to fly to Oklahoma(and pay out of pocket) every time you need Medical care, no one is stopping you” In Canada that is illegal which means that someone IS stopping you.

  16. Yeah. She was only 50. Fuck her. The old folks got dibs! O Canada!

  17. Yay, more health care anecdotes as arguments against reform. For every story like this, there’s one like this: http://www.usatoday.com/news/w…..are_N.htm. Again, no data, just a few isolated cases.

    Ideally, the healthcare debate would be based on data — what works, what doesn’t, what does it cost, what are the trade-offs, and ultimately — why do Canadians pay less than Americans for healthcare, but live longer? Data, please, no “it’s guns and car accidents”-type answers.

    No matter what your stance, I hope you can agree that an important debate made purely through anecdotes (from “I once knew a woman whose private insurer cut off his feet!” to “I once knew a guy who waited 56 years to see a doctor in England!!”) is no debate at all.

    1. http://mjperry.blogspot.com/20…..ancer.html

      People have controlled for “guns and car accidents” because when you make fucking comparisons you have to hold all other things equal. Surprise, surprise when you do this the U.S. actually beats these other countries with lower rates of violent crime, fewer car accidents, less teenage pregnancy (such infants are more likely to die), and that count infant mortality in the same fashion. The health care system isn’t the only thing th at affects life expectancy, that’s just a trick to fool idiots; congrats you fell for it! The only thing that matters is the gains to life expectancy due to the health system, and the very least that should be done is eliminate obvious factors that have nothing to with it.

      You also have to look at the deadweight costs of taxation used to fund socialized health care, not just the nominal costs; while also realizing that it is a cost to be put on a waiting list in pain and possibly not able to work. It’s also a cost when you can’t get the treatment you want even if you can pay for it, that’s rationing. Governments don’t cut costs as much as they hide them. Yes people wait for care in the U.S. in pain, but prices capture those costs amongst others; as people with funds are able to bid them up if there is demand for such care.

      Imagine if the government one day decided to ration apples. If it said only X amount would be sold for a price a dollar less. Did government just lower costs? Or did it screw a bunch of people who could have bought apples and apple sellers? Why not ration all food, setting low prices? We could end world hunger! Right?

      You leftists don’t even know what the word rationing means. Is food rationed in this country? Nope, because so long as you have money you can walk into a store and buy what you want. Are cars rationed? Nope. Rationing is when government tells you you can’t buy something or you have to get in line because it thinks people are buying too much of something to suit some alleged public purpose. Ratioining is coercion, markets don’t ration, governments do. Don’t give me some stupid response now about health insurance companies blah blah blah, we don’t have free health insurance markets. States tell companies who and what to cover, and don’t let people buy insurance across state lines like virtually every other good and service where it is possible and economically feasible to do so.

      Why do we keep having to have this debate about rationing and price controls? It didn’t work in the past, and it doesn’t work in the few areas it remains in now. Such as the various price controls effectively set by Medicare and Medicaid. Hospitals pass the costs onto people with private insurance, while doctors have all but stopped seeing Medicaid patients, and many aren’t taking on new Medicare patients. But we have free market health insurance in America, that “fact” is needed to build up a ridiculous straw man to prevent any real reform away from more corporatism and socialism.

      Finally, irony of ironies when I clicked on your link it said “document not found”. That pretty much sums up the “facts” in favor of socialized medicine.

      1. Tim, “because when you make fucking comparisons you have to hold all other things equal.” “Are cars rationed?” Yes. I drive a car that costs more than average. When I was younger, I bought a used car that I could afford. No doubt you can manipulate this fact with your shell game chart and the result will be : public choice sucks and the US is #1.

        1. Ah it’s a shell game to control for causes of death not related to the health system. Great facts! Lets try an analogy, John ran faster than Jane this year; therefore John’s training program is better than Jane’s. Is that necessarily true? Or would you have to control for things like gender and initial skill level? Maybe Jane has a disability, or maybe Jane is 13 or 53 while John is 18.

          While you perfectly illustrate how you don’t understand rationing, there is no government authority saying that you can’t buy whatever car you can afford. By that reasoning, anything that people can’t afford is “rationed”, destroying any actual meaning to the word other than that we live in a world of scarcity. Rationing would be if government decided people spend too much on cars, therefore government only lets people buy cheap used cars; you know to keep prices down.

          You’re really proving your ignorance here, you ought to stop while you’re ahead.

          1. Tim, “Ah it’s a shell game to control for causes of death not related to the health system. Great facts!” Wow Tim. You are right and everyone one else is wrong. I have seen dozens of charts from all over the world that have the same results on health care: WE SUCK. Tim your chart is a shell game but since you want to bitch I will grant you that you have a pretty chart. Go draw on it.

            1. And they don’t control for causes of death not related to the health system, that’s called fact based analysis you idiot.

              1. Tim, “And they don’t control for causes of death not related to the health system”, because it is NOT related to the health system. That’s called correct analysis you pompous ass. I would have called you a my bitch but I hate to repeat myself.

      2. Tim, remove the “.” this site appends to my URL above and it works. It will take you to a US Today article about older Americans moving to Mexico(!) for medical care until Medicare kicks in. My point is that it’s just as anecdotal as the stories of Canadians seeking healthcare in the US. No real numbers, just stories.

        The rest of your post is pretty breathless, so I understand you won’t be swayed by any new information, but I do note the lack of any data whatsoever in your post. Nothing like, say, this: http://ccforum.com/content/12/…..?highres=y

        I don’t care what sort of solution is the right solution, but I’m still looking for a good, data-backed explanation of why Canadians pay less and get more.

        1. Phil, I found two that I bookmarked but it is always important to consider the source.

          http://blogs.harvardbusiness.o….._heal.html

          http://healthcare-economist.co…..ada-vs-us/

        2. I don’t care what sort of solution is the right solution, but I’m still looking for a good, data-backed explanation of why Canadians pay less and get more.

          They don’t. They have poorer outcomes all the way across the board.

          You do understand the difference between life expectancy and medical outcomes right? Life expectancy is due to lifestyle choices. Eat better. Exercise more. Engage in less crime. Don’t smoke. Those are things you can do for yourself.

          Look at medical outcomes.

          Now you could speculate that the poor outcomes in Canada put a pressure on people to engage in better lifestyles because they know their odds are poor if they do get sick. But that doesn’t make me want to emulate them..

  18. Canada actually does have a two-tier system. The wealthy get better medical treatment because they can always go to the US. Or else, pay off an MP to get bumped up. Recall the story about how NFL players got swing flu vaccines ahead of everyone else.

    1. Reminds me of this story : “Goldman Sachs, Citigroup got swine flu vaccine drawing criticism that the hard-to-find vaccine is going first to the privileged”

      1. I have no problem with it going to people who are willing to pay through the nose to get it first.

        But of course, you know that swing flu distribution is controlled by the government, not the market.

        The difference? GS and Citigroup probably are getting it for the same price as everyone else. It’s controlled by the government, they’re still priviliedge, and they’re NOT paying extra for the priviledge.

        1. Hazel,”I have no problem with it going to people who are willing to pay through the nose to get it first.” Really, the point is both groups did not deserve the shots first. I don’t care if it came about with political donations or just plain “me first” politics. There is tit-for-tat bull on both sides of the border.

          1. Like everyone, Hazel I assume has a problem with government using coercion to give some people privileged access to goods and services that others don’t have without reason, for example it makes sense that first responders or others in critical positions be vaccinated.

            What I assume Hazel doesn’t have a problem with is some people paying a premium to get a good first in free markets that all have access to. In a free market, such people got rich by convincing millions of people to voluntarily part with their money in exchange for quality goods.

            1. It seems you can’t understand such simple distinctions. Again, stop while you are ahead.

              1. Tim, go back and play with your silly chart. Today, it will say: Tim you are right and just tell people to stop!
                Btw, I am a virgo and what will my chart say today?

                1. Nice job showing you have no respect for the facts, and just want to mislead with fallacious statistics!

                  1. I have plenty of respect for facts but I do a little thing called thinking. I understand your method (“simple distinctions”) and consider it spurious.

          2. So, if in both cases, priviliedge people get the shots first, and in system A (free market) they pay more for it, but in system B (government run) they don’t, how does that make system B more “fair”.

            It isn’t. Putting the government in charge does not improve fairness. it merely substitutes ability to pay for political influence.

            1. In both cases you will have a certain percentage of corruption and therefore this fact negates the corruption for
              the purpose of this discussion. This leaves “system A (free market) they pay more for it, but in system B (government run) they don’t, how does that make system B more “fair”.” Well in system A they do pay for it themselves and most often at a discount because of group insurance and employer contributions and people who are not in that advantageous position are worse off. In system B, (the public option) all people are covered and pay for the system through taxation and most importantly ALL can participate in health care. The public system “the community as a whole” is the fair system by definition.

  19. Mary Stack

    I, too, don’t care if it was campaign bribery or just “me first” politics. The point is that corruption like this comes in where government controls it

  20. For saving money on Auto insurance, first select good company for that. You can search on internet the available sites of insurance. Then compare all of them for choosing best company which can provide good service as well as reasonable price. I have also followed these steps when i was looking for insurance company. I took policy from online-autoinsurance.net.

  21. For saving money on Auto insurance, first select good company for that. You can search on internet the available sites of insurance. Then compare all of them for choosing best company which can provide good service as well as reasonable price. I have also followed these steps when i was looking for insurance company. I took policy from online-autoinsurance.net.

  22. Fiscal Meth, Corruption is not subject to government. Private business is just less transparent and accountable to a smaller percentage of people. I prefer the devil I know….

    1. Only the government has the power to make laws that force everyone to use the same service. If you admit that a government-run system would be subject to abuse and corruption, so that some people would still have better access to health care, why do you think it’s better than a private system.
      At least in a private system, nobody is FORCED to use the corrupt company. They have the option of choosing a different one.

      1. Hazel,”Only the government has the power to make laws that force everyone to use the same service.” No, only the government has the power to make laws that allow EVERYONE to receive service. “At least in a private system, nobody is FORCED to use the corrupt company. They have the option of choosing a different one.” I don’t think you have ever had the privilege of purchasing private insurance because you would know that the fact that they set the rules (including refusing you as a client) is akin to forced to use a corrupt company. At least in public care the rules will be standardized and the accountability will be greater.

  23. So an anecdote is your basis of judgement in comparing two countries’ healthcare systems? And this magazine is called “Reason”?

  24. The economic illiteracy in congress continues.

    fiscally unsustainable Medicare…expanded.
    fiscally unsustainable Medicaid….expanded.
    another GSE like Fannie and Freddie….that’ll go well.

    taxpayers paying for Abortion….that’ll play well to voters.

    The bill needs to be killed.

  25. The economic illiteracy in congress continues.

    fiscally unsustainable Medicare…expanded.
    fiscally unsustainable Medicaid….expanded.
    another GSE like Fannie and Freddie….that’ll go well.

    taxpayers paying for Abortion….that’ll play well to voters.

    The bill needs to be killed.

  26. As a former resident of the most northern county in Idaho, adjoining Canada, I saw many Americans go north to take advantage of that awful health care up there. Many of these folks were about as red politically as you can get.
    Another point that might get folks to think about the cost of health care. If you look at the tie between employment and health ‘benefits’, guess what happens when health care costs go up? There is a correlation between the cost of care and the lack of wage increases. It’s not really a ‘benefit’ when an employer ‘pays’ for health insurance: it is wages that you will not receive. Untie that knot, and people can see the true cost of health care.

  27. Hi People, I am from Austria, a country with a public health system.

    For me its difficult to understand your discussion. The lady in the story above was placed on a waiting lists, because doctors considered that other cases were more urgent. Where is the problem? if you are seriously ill, you get treated quickly. if you have minor problems, you wait a bit longer.

    in both canada and the us, only one person can get served first. others have to wait. in the usa the decision is made based on the size of your wallet, in canada or austria medical need is decisive. sounds much better to me…

    I am a big admirer of the us in many regards, but when it comes to health care, i think you are on the wrong way. you can pick as many numbers or stories as you want, in the end, in my country we pay less for health care and live severall years longer. you pay more and live shorter – no statistic can convince me, that thats a superior system….

  28. of course you can always pick out on statistic, on one desease, where you a better than another country. but when you ad everything up, you still pay 16% and canada pays 10% for health care. and what do you get in exchange: life expactancy:

    canada 81,25
    britain 79,2
    us 78,1

    even bosnia has a higher life expectancy than the us. difficult to understand for me, how you can be happy about so little value for your money.

    1. As others have pointed out (again and again – not just here and now but for years and all over the place), simplistic arguements like this do not stand up to any level of scrutiny.

      There are many factors involved in the cost of healthcare other than the reimbursement system. The US pays more because of many reasons that have to do with choices we make about our lives and lifestyles. On the negative side, we are generally less careful with our bodies than our counterparts in other countries – we are more obese, smoke more, use more dangerous drugs, have more traffic accidents, and commit more acts of violence than the countries usually held up as examples of “better” healthcare systems. Obviously, this creates a need for more usage of the healthcare system and thus much higher costs.

      Also, on the positive side, we are committed to the best available technology and treatments. We have – on a per capita basis – much more access to recent model imaging and diagnostic equipment, robotic surgical devices, etc, etc, etc. Again, this is costly.

      On the positive and negative side, we have policies that promote the development of new drug treatments by assuring high prices to those who develop them in the US but then allow those same companies to sell those drugs at production cost levels (allowing them to recoup all their development costs in the US).

      As for life expectancy, again, anyone with half a brain can see that healthcare is not the only – or even main – factor in average life expectancy. Again, look at those differences in violent and accidental deaths. Factor those out and the US is right at the top in life expectancy. Factor out foolish choices individuals make (smoking, obesity, etc) and who knows what the numbers would be but the point is that it is not healthcare that drives those numbers.

      Speaking of those numbers, you do realize that life expectancies are estimates – with a plus or minus factor (similar to a poll). So, by the way, the difference between the US and Canada is not statistically significant – the real eventual lifespans could average out in favor of the US without the estimates falling out of the margin of error.

      One last point, read the WHO report on healthcare (the one that ranked the systems) and read the caveats. While Canada and US data is pretty comparable, they point out that records are not so reliable. Lots of countries leave out data (especially but not limited to infant mortality data – http://health.usnews.com/usnew…..2healy.htm )which has a major statistical impact on life expectancy numbers.

      Simplistic thinking like yours is a tedious impediment to genuine improvements in healthcare in the US or anywhere.

      1. its like when buy a mercedes and your neighbour buys a KIA, you d ecpect to get better quality. and if in the first year you have 5 breakdowns, and your neighbour none. that might be due to “other factors” than quality of the product (maybe your driving style?). but if year after year, in a statistic of thousands of mercedes and kia drivers, mercedeses have more problems than kias, its just very likely that it has something to do with product quality. and howevermuch you are fond of your mercedes – common sense suggests you should reconsider your decisions.

        and so while its possible, that the lifestyle of americans is responsible for tehir life expectancy – its not very likely.

        its just very unlikely, that americans are the unhealthiest people in the world. for example, levels of smoking or drinking are much higher in many european countries.

        its also not one country (whos people might be extremely health-conscious) that does better than the us in health care, its dozens of countries.

        public systems and private systems have been tested all over the world for decades now and you might also find it interesting, that while the us thinks about changing to a public system, i have not heard of a a single country with a public health systems that seriously considers abolishing it. in my country – austria – you would not get 5% of the people voting for the abolishment of the public health system. maybe that should also make you think twice.

      2. mone more comment. i read some of the articles mentioned above . They try to show that while canadians pay less for health care and the live longer, there h.c. systems is still not better.

        the articles are not convincing, they factor in some influences that improve the performance of the u.s. system (like road accidents, or crime deaths), while not factoring in a single influence that would benefit the canadian system. still the only come to the conclusion, that after those adaptations, the two systems perform about equally.

        that is really very unconvincing. out of the thousands of influences on life expactancy, they could not find a single one that decreases l.e. in canada as opposed to the us? sounds like bias to me. for example, it is well known, that cold weather has a negative impact on general health. look also on income, income per capita has definetely a positive influence on life expactancy, still dozens of much poorer countries outperform the us in life expactancy.

        and even after that biased reasearch, they did not manage to demonstrate that the u.s. system is superior? more food for though, i would say….

        1. FOOD FOR THOUGHT: Thank you for the delicous dinner.

  29. What many are missing is the fact that over 80% of all new pharmaceuticals are from the U.S. Most of the medical advances the WORLD owes to the rise of care was either developed and/or perfected in the US. How would the rest of the world compare to the US if we did not share these findings with them. Why did they develop here in the US?? Capitalism!! It cost a drug company BILLIONS in R&D for EACH new drug. How will they recoup that investment?? If you take away the incentive to pursue possible new treatments and technologies they will be fewer and farther and farther between. In addition, instead of a hip replacement what if you needed bypass and had to wait 2-3months on average. Some patients with a blocked coronary artery will die BEFORE treatment. In some areas wait for general surgery in Canada is 398days!! Some areas a ct scan take 155 days. What if you have headaches from a malignant tumor, want to find out 155 days AFTER your doctor decides to order a CT scan. I hope you are still alive. Go to this link and not only look at the averages, but the ranges as well. View both the portal for the public as well as for the docs.

    http://www.health.gov.on.ca/transform…..it_mn.html

    1. Your link did not lead me to wait times. Drug research is a red herring http://www.citizen.org/publica…..fm?ID=7065

  30. For the person from AUSTRIA, how many significant medical breakthroughs came from there in the last 40 years as compared to the US and how would your health care compare to the US if for the last 50 years we only could use the treatments/technologies developed from our own countries. Food for thought???

    1. oh, i would admit anyday that the us is top when it comes to R&D, but i think it wouldnt be fair to attribute that only to the lack of a public health system, the us also excels in economics, physics, chemistry and so on. attitude towards science and performance at the universities, is something we can learn a lot from the us.

      dont get me wrong, im not suggesting that we are better at everything than you are. i would also think that the canadian model – as discussed here – is a bit extreme in the sense that it does not allow any form of private medicine. in my country f.e., everybody has to pay in the public system, its like a tax with high earners paying a bit more and poor people paying less. than, if you can afford it, you can buy some additional private insurance wich gives you advantages (for example in the public hospital you get a single room and better food – but not a better or faster medical treatment). additonally, you can pay out of your pocket for medical services for a doctor or at a private hospital (but not at state run hospitals), which usually will give you better service, faster access and so on. but when you have something really serious, you better go to a public hospital, since they are bigger and therfore have more experience in performing complicated operations. doctors do not have to work for the public insurance system, but most do, since it is the biggest source of income for them. it is true, the most succesful doctors can afford not to work for the public insurance system and you have to pay for them out of your pocket, which still gives rich people a better service than average earners. i think its ok, because high earners have already contributed to the public system and if they than pay additionally for a private doctor, thats good for everyone.

      so, i think you dont have too choose from a state-monopoly without any choices or a pure private system, that doesnt give coverage to the weakest within a society. there are combinations of them, that work quite well in many countries. thats all i am saying. and since you are a country that excels in many thing, i find it suprising, that you are happy with a health system that is so obviously worse than many others, that have already been tried and tested for many years.

  31. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won’t get the full deal by just doing regular skill english reading for those books. In other words, there’s more to the books of the Bible than most will ever grasp. I’m not concerned that Mr. Crumb will go to hell or anything crazy like that! It’s just that he, like many types of religionists, seems to take it literally, take it straight…the Bible’s books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on…the Bible’s books were written by people with very different mindsets

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