guy…@rain.org (Fnord Mustang) says:
>Do doctors no longer have any freedom to choose who their clients are?
Is there a compulsory service clause in Prop. 186? I’m just asking …
Certainly, doctors have booted people out of their offices (and billed
for their time) and I can’t imagine it being different despite of who
the client’s insurance underwriter happens to be … both Canadian and
American doctor friends have told me stories of having done so …
>>… and over 90% of
>>the people of Canada who have had a single payer system for 30
>>years and, their polls show, would not give it up for anything.
>I find it interesting that in Canada it’s against the law to sell beer
>from the neighboring province, as that would contribute to the desruction
>of local culture. It’s easier to buy Canadian beer in southern California
>than it is in Canada.
This is way out of date, based on the old mentality where Establishment
brewers like Molson and Labatt with deep pockets encouraged protectionist
policies that stifled small local breweries by requiring local brewing of
product in each province. New Brunswick’s Moosehead bucked the system by
establishing a small but successful export business and other brands like
Schooner from Nova Scotia have also tried the same with some small degree
of success (you can get Schooner in Baltimore, I’m told). However since
free trade has captured the imagination of the monopoly-minded big Canadian
corporations, support for the local brewing laws has gone (and internal
trade barriers along with them, although not fast enough for my taste with
over half the population still against freer trade) and that capacity is
reconfigured for domestic (smaller breweries) and export. It is now easier
to find the major brands, Labatt and Molson, outside of the NorthEast
because in the past year each one has allied with a major U.S. label to
take advantage of their distribution network (which was a problem to set
up, despite having protectionist state legislation over beer distribution
struck down to conform with the 1989 Free Trade Agreement). The local
culture aspect has nothing to do with this issue, but protectionism for
jobs (which I disagree with) and big brewery support for the mainstream
parties does a whole lot, yet another example of the golden rule at work:
he who has the gold makes the rules.
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
>>>>> "Gary" == Gary L Dare <g…@prairienet.org> writes:
In article <33ss8h$…@vixen.cso.uiuc.edu> g…@prairienet.org (Gary L. Dare) writes:
Gary> jor…@pbssi.srv.pacbell.com (Jeff Oransky) says:
>> Personally, when I see a doctor I prefer the best that I can
>> get. Especially if it is serious. This legislation does not
>> seem to me a way to get the best.
Gary> Maybe I’m wrong because I’m not in California right now and
Gary> not involved with Proposition 186, but this just addresses
Gary> providing insurance coverage to people and not
Gary> doctor-shopping, no?
That’s right. Patients would be free to choose as their doctor
any participating doctor, and the Canadian experience suggests that
well over 90 percent would participate. Patients may also choose
to enroll themselves in an HMO which would be compensated by the
state fund on a capitated basis. In that case, the patient would
have to get all their care through their HMO if they didn’t want
to pay out of pocket. If you don’t like your HMO you get a chance
to disenroll every six months.
If you don’t think that "the best you can get" is available among
participating doctors and HMOs, you can still go outside the system
and pay out of pocket or from private insurance.
Remember that under the current system of private insurance, the
freedom to choose one’s own doctor has narrowed a lot as HMOs
and managed care networks have come to dominate the scene. Prop. 186
should be compared against the situation to which the current system
is likely to lead. This is especially so since Federal efforts at
major reforms have been practically abandoned.
>>>>> "gld" == Gary L Dare <g…@prairienet.org> writes:
gld> Is there a compulsory service clause in Prop. 186? I’m just
gld> asking …
gld> Certainly, doctors have booted people out of their offices
gld> (and billed for their time) and I can’t imagine it being
gld> different despite of who the client’s insurance underwriter
gld> happens to be … both Canadian and American doctor friends
gld> have told me stories of having done so …
Right. There is no compulsory service clause. Sec 25010 says:
Any eligible individual may choose to receive services under this
Division from any willing professional provider participating in
the Health Security System.
I guess "willing" is the key word.
Content-type: text/plain; charset=us-ascii
Content-Transfer-Encoding: 7bit
>>>>> "gld" == Gary L Dare <g…@prairienet.org> writes:
gld> Is there a compulsory service clause in Prop. 186? I’m just
gld> asking …
gld> Certainly, doctors have booted people out of their offices
gld> (and billed for their time) and I can’t imagine it being
gld> different despite of who the client’s insurance underwriter
gld> happens to be … both Canadian and American doctor friends
gld> have told me stories of having done so …
Right. There is no compulsory service clause. Sec 25010 says:
Any eligible individual may choose to receive services under this
Division from any willing professional provider participating in
the Health Security System.
I guess "willing" is the key word.
mwil…@ncratl.AtlantaGA.NCR.COM (Mark O. Wilson) says:
>kni…@cup.hp.com (Paul Knight) writes:
>|Jeff, under Proposition 186, you can see any physician that you wish.
>Under 186 you may only see physicians who are participating in the plan.
>(If you want to be reimbursed that is.) This is no different from any
>HMO plan.
No, that would be a PPO plan … an HMO would be much more restrictive
and the doctors on salary. What little I know of Prop. 186 indicates
a fee-for-service environment but it seems to be PPO …
But out of curiosity, might Proposition 186 be a voucher plan where you
get the basic rate reimbursed regardless (or paid direct to the doctor
or hospital) with additional private funding (e.g., insurance, medical
IRA, etc.) to make up the difference? Again, I’m just asking …
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
The reason why MDs are so highly paid is that the profession is a
legally sanctioned monopoly. MDs have certain exclusive priveleges,
the most important being the right to prescribe pharmaceuticals. Like
any monopoly, they have acted to restrict supply in order to maximize
profits. The medical profession does this through their control of the
accreditation of medical schools. That is why you have the spectacle
of ten applicants for each opening in a medical school. Normally, the
number of medical schools openings would expand to meet the demand,
the number of doctors produced would rise, depressing the average
income of the doctor. The most feasible solution to this problem would
seem to be to expand the licensing of nurse practitioners and
alternative medical practitioners such as naturopaths. But you can be
sure the MDs will fight this tooth and nail — all strictly for "the
good of the public", of course.
–
Bernie Simon Amidst concrete and clay and general decay
(bsi…@stsci.edu) Nature will still find a way — The Smiths
tla…@cats.ucsc.edu (Tlaloc Antonio Rivas) says:
>In article <strnlghtCvEqBz….@netcom.com>,
>>In most countries of the world, physicians are not paid the stratospheric
>>compensation they earn here. Instead, a more normal situation prevails where
>>most physicians earn a "reasonable" return, and the few great geniuses who
>>wish to do so may command high fees. There are some Harley Street physicians
>>in London who are not in the NHS, and do very well, for example.
>But in most places, the government has placed stringent cost controls and
>have forcibly kept doctors incomes down. How close it is to a free market
>(which is the only "reasonable" return) I do not know.
No, it looks like you don’t (n.b., I don’t mean to be rude). France
provides universal coverage through a voucher system of a public basic
package: a few (mostly poor) people see a public HMO, the rest take
the equivalent benefit in cash (after deduct/copay) to combine with
private money (private insurance, etc.) and play an entirely private,
floating fee-for-service market. Germany just hands off a cash subsidy
for your private insurance, and that’s all. Holland uses regulation of
private insurance and medicine a la the Republican Chaffee plan. Only
Britain and Italy stand out as countries with a dominant public HMO.
Doctors have different status and standing in other societies; despite
that they’ve always commanded respect, the high American salaries are
a post-WWII phenomenom here. (n.b., no criticism from me on size, etc)
Also, other countries don’t have the malpractice/defensive medicine
atmosphere so part of the higher American salary devoted to malpractice
is cut off the top (that fraction differs by an order of magnitude U.S.
vs. Canada, for one thing). Also consider that the U.S. comprises 1/3rd
of the G7′s population and that’s a hefty market that can generate some
sustainable absolute numbers for advanced specialties in very low demand
relatively speaking. Canadian medical schools regularly train people
who have no sustainable market and know they must relocate to the U.S.
to get at their locals for the numbers; the few Canadians who need
their services will often be referred to those alumni.
>>In the U.S. physicians’ earnings reached the high levels they have been at
>>through a classical technique of monopolists everywhere–preventing entry.
>Agreed. This is completely true.
I think the word you’re looking for is "cartel".
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
Jack_Rom…@qmail4.nba.trw.com (Jack Romain) says:
>jz…@netcom.com (Jim Nakamura) wrote:
>> Fact: We know that single payer has worked successfully
>> in many countries.
>Define success. A recent NPR feature on the French system suggested that
>the government is unfolding a campaign to try to persuade the population
>to use the system less. Similar problems exist in other countries.
Since the French use a voucher system that is not fixed like the
straight cash subsidy (to fund private insurance) used in Germany
and Switzerland, that is not unlike any other private insurance
asking its clients to be reasonable on their claims. (In France,
a few poor people use their public HMO network and the rest take
the benefit as insusurance subject to deduct/copay, combined with
private dollars to play a fee-for-service free market of actual
care.) What’s so unusual, I don’t know … but I will add that
anybody who reads French magazines and newspapers will be aware
that they acknowledge a greater degree of hypochondria in their
society in contrast to the Germans. (France spends a slightly
higher %GDP than Germany.)
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
Jack_Rom…@qmail4.nba.trw.com (Jack Romain) says:
>kni…@cup.hp.com (Paul Knight) wrote:
>> Jeff, under Proposition 186, you can see any physician that you wish.
>> There are no restrictions on your choice.
>Since all physicians are not created equal, certain glittering generalities
>to the contrary notwithstanding, how will access to the better providers be
>allocated?
Good question … from personal experience in four Canadian provinces,
one must still be a good consumer and check around … use connections
that might be useful (e.g., friends in "society", the golf club, etc.)
for information/referrals, as one would do now … the better doctors
locate in more desirable parts of town since people will still tend to
want to see someone closer to home and work … cost scaling outside
of their negotiated PPO rate can be done through services not covered
by the public umbrella plan (even there, the costs are not higher than
one would find in the United States). Equipment is not covered except
in extreme cases. This is a relatively simple pattern and one of the
few I’d expect to be repeatable if copied in the U.S. (others, due to
fundamentally different societies, I would question).
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
g…@prairienet.org (Gary L. Dare) writes:
> Jack_Rom…@qmail4.nba.trw.com (Jack Romain) says:
> >jz…@netcom.com (Jim Nakamura) wrote:
> >> Fact: We know that single payer has worked successfully
> >> in many countries.
> >Define success. A recent NPR feature on the French system suggested that
> >the government is unfolding a campaign to try to persuade the population
> >to use the system less. Similar problems exist in other countries.
No semantic arguments please.
–
No Tijuana insurance!
jz…@netcom.com
S.F., CA
a…@mises.Eng.Sun.COM (Al Date) says:
>Jim Nakamura <jz…@netcom.com> wrote:
>> Fact: We know that single payer has worked successfully
>> in many countries.
>We know that in Japan, doctors will spend no more than 5 minutes
>per patient, and that in Germany doctors take long vacations once
>they meet their quota.
Neither is a public HMO such as found in Britain … nice try.
Both countries use private health insurance with private health
care services. The only "single payer" aspect might be subsidies
paid in cash for people to fund their insurance underwriting and
attain universal coverage.
>In Japan, if a baby dies, it is not considered infant mortality
>unless it is a crib death. In the USA, ANY post-partum death
>or full-term still-birth is counted.
Wait, wasn’t that France? Or was it Finland? No wait, Croatia!
That’s what I heard from someone who told a colleague who heard
from his uncle that got it from a bimonthly bowling friend …
(-;
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
kni…@cup.hp.com (Paul Knight) says:
>The statement that Proposition 186 will bring politics into
>the arena of health care is absolutely true. The health care
>commissioner will be elected by the people of California.
Please note that this feature is not present in the provincial
PPO insurances of Canada, which are government corporations, or
in the French system where the public HMO-or-insurance basic
plan is run by a public utility involving private insurance.
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
zt…@eden.com (Peter Jackson) says:
>There is no evidence from other (much smaller and homogenous) nations that
>practice such schemes to indicate that my reasoning here is very far off
>base. The much bally-hooed GAO stats showing that increases in Canadian
>health care expenditures vs. US expenditures as a percentage of GNP are
>bullshit.
Those figures come from the OECD … it’s good enough for the World
Bank, Citibank, Deutsche Bank, etc. but apparently not Mr. Jackson.
Pity.
>when the GNP figures of both countries are controlled for their
>respective unequal rates of overall growth from year to year, the
>growth of Canadian expenditures actually OUTPACED the growth of US
>expenditures since 1970 in all but the last three years.
According to the OECD figures regularly cited in the New York Times
and the Economist, you have it backwards.
>When evaluating the performance of systems in countries like Canada
>and Great Britain, the most important thing to keep in mind is the
>big picture. Queue times for various procedures and treatments and
>the patient/technology ratio in Canada vary greatly from province to
>province and from rural to urban areas.
The Canadian system relies on the randomness of a fee-for-service
environment, which has market size and other geographic variables.
The "system" is a set of provincial PPO health insurances, not the
public HMO as used in Britain. Quebec province has the same number
of people as metro Chicago.
>are the queue times increasing or decreasing over time?
In Canada, they have decreased in a manner with growth of population
as would be expected when small markets become bigger …
>Bear in mind that foreign state-run schemes have benefitted incalculably,
>at no cost to themselves (see my signature), by innovation produced by our
>*relatively* free market, all subsidized by the American health care
>consumer. Imagine if you can how attractive these systems would be
>otherwise.
Research is funded by NIH-type structures, public subsidies and
private charity elsewhere – not health insurance – just like in
the U.S. Also, those "foreign state-run schemes" are usually
subsidy or voucher systems of publicly-subsidized private care
and not the Big Brother national HMO’s conjured up by Americans’
insularity and paranoia.
Everyone knows that with investment in research, the winner gets
to go home with the goodie$. The civilized world extends beyond
your borders … No wonder it’s *Americans* who are
discovering globalization, not the other way around …
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
a…@mises.Eng.Sun.COM (Al Date) says:
>As to Canada, I wish the Canadians well, and I think the
>least we can do as civilized neighbors is to maintain
>a certain level of diversity in the provision of medical
>care on this continent, so that if their system fails them,
>as it does from time to time for some unfortunate souls, that
>they will have some place to go to for superior medical care,
Canadians have had to come to the U.S., a larger country with
metropolitan areas rivalling its two largest provinces by
population, for a century before our insurance changes as
well as the 20-25 years since. Funny you guys never had
before 1970 and understood the limits of small markets.
We do not have a national HMO, just provincial PPO health
insurance funds paying to private doctors and hospitals
>Personally, I think that the Canadians are living on borrowed
>time with respect to national deficit financing, even moreso
>than are we Americans, and I have no desire to push my state
>or national govt even further down the bleak road to bankruptcy.
Thank heavens that we didn’t have any socialist parties in power!
(Seriously!)
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
kni…@cup.hp.com (Paul Knight) says:
>Peter Jackson (zt…@eden.com) wrote:
>: … due to the fact that all of us get ill from time to time and will
>: eventually die making the potential demand for medicine _infinite_,
>The notion that the potential demand for health care is infinite is
>absolutely wrong. If I could get a free prostate exam, or, even better,
>if I could get ten dollars for getting a prostate exam, I would still
>not get an infinite number of them. Would anybody get his leg amputated
>if the operation were free? People get health care when they are sick or
>when they don’t want to get sick.
Hypochondriacs, small in number, can be dissuaded by adding deductibles.
Nuisance calls which can be averted by someone going for a bottle of
aspirin or a box of bandages at the pharmacy instead, cane be squeezed
out with small deductibles.
The price-sensitivity/sensibility of deductibles (let’s not even talk of
copayments yet) was something that the Quebec Liberals (centrist) tried
to reintroduce into their main health insurance plan but that was vetoed
by the federal Conservatives of Brian Mulroney, who control the minimum
guidelines. That happened three years in a row; an interesting tidbit
that even our Tories didn’t consider the above to be a problem …
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
In <jzeroCvE301….@netcom.com> jz…@netcom.com (Jim Nakamura) writes:
| In return for a 2.5% income tax Californians will
| get all their medical bills paid, with no deductibles
| and no copayments. All their prescription drugs will
| be covered, long term care, mental health, and emergency
| dental. Every Californian will be covered. No
| exceptions and no preconditions.
For only a 2.5% income tax. No way.
—
Mob rule isn’t any prettier merely because the mob calls itself a government
It ain’t charity if you are using someone else’s money.
Wilson’s theory of relativity: If you go back far enough, we’re all related.
Mark.O.Wil…@AtlantaGA.NCR.com
jz…@netcom.com (Jim Nakamura) says:
>a…@mises.Eng.Sun.COM (Al Date) writes:
>> We know that single payer means politicized rationing of
>> medical services. We know that any risks you want to take
>> with your own body will become the subject of criminal law.
> The only rationing comes from insufficient
> funding. If Canada would match our 14% of GDP
> I am sure there would be no rationing there.
It looks like overt "rationing", but there is not HMO public
or public on Canadian soil (outside of native reserves and
military bases). People in the U.S. are quite unaware that
Canada’s population is small and unevenly distributed with
low densities … our population center of Southern Ontario
is on the order of Minnesota-Wisconsin … Quebec province
has the same population as metro Chicago (8 million) while
there are only four cities over 500,000 west of the Great
Lakes. The markets sizes and economies of scale can’t be
matched, and where they can be is why Canada’s federal
government (regardless of who is in power) is gung-ho
for free trade whether the 1989 FTA, NAFTA or GATT.
> But they as a society are content with
> spending only 9% of GDP on health care.
That’s all we’re able to spend in the above scenario.
It is PPO fee-for-service in a random environment.
> Germany spends on 7% of GDP.
Germany has a large, dense population and gains incredible
efficiencies from economy-of-scale. Their system is really
simple anyways, just a regionally-indexed cash subsidy for
people to get private coverage and purchase fee-for-service
health care. That and a common form (which is an issue that
is surprisingly missing from all the ideas whizzing past me).
BTW, my prediction is that the incremental Republican plan of
John Chaffeeis the most likely to be passed (despite starting
as a dark horse) but private insurance will demand subsidies
like in Germany, Switzerland and Holland to underwrite taking
of all comers and waiving preexisting conditions.
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
g…@prairienet.org (Gary L. Dare) writes:
>zt…@eden.com (Peter Jackson) says:
>>Bear in mind that foreign state-run schemes have benefitted incalculably,
>>at no cost to themselves (see my signature), by innovation produced by our
>>*relatively* free market, all subsidized by the American health care
>>consumer. Imagine if you can how attractive these systems would be
>>otherwise.
>Research is funded by NIH-type structures, public subsidies and
>private charity elsewhere – not health insurance – just like in
>the U.S.
Does the NIH provide the return-on-investment for pharmaceutical
and medical device companies? Do these companies, which account for
the bulk of medical discoveries, count on public subsidies and private
charities for sales? It’s the anticipation of income from health care
payments from, yes, insurance companies that drives these innovations.
–
dak
kra…@msai.com (David Krause) says:
>g…@prairienet.org (Gary L. Dare) writes:
>>Research is funded by NIH-type structures, public subsidies and
>>private charity elsewhere – not health insurance – just like in
>>the U.S.
> Does the NIH provide the return-on-investment for pharmaceutical
>and medical device companies? Do these companies, which account for
>the bulk of medical discoveries, count on public subsidies and private
>charities for sales? It’s the anticipation of income from health care
>payments from, yes, insurance companies that drives these innovations.
I was referring to medical procedures like skin cancer of the chest
with interdisciplinary thoracic surgury, etc. But thanks for the
topic of pharmaceuticals because I’d like to point out that the
industry is quite healthy all over including Canada and Europe …
my father-in-law-to-be is a research exec for an international firm
and it’s a profitable market all around; he’s in Sicily right now,
where the firm got a big subsidy from Italy to set up shop with
jobs that route people away from the Mafia. In other areas, drug
research has returned to Canada in the past 3 years with patents
being restored to 12 years from 5 years, and talk of going all
the way back to 17. Or that’s what people at Abbott Labs in
Montreal are telling us on Soc.culture.canada anyways …
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
In article <CvGxE4….@ecsvax.uncecs.edu>, conklin <geo…@nccu.edu> wrote:
>In article <3438ut$…@engnews2.Eng.Sun.COM> a…@mises.Eng.Sun.COM (Al Date) writes:
>>Nonsense. For example, the vaunted statistics on infant mortality
>>are totally skewed by international discrepancies in reporting.
>>In Japan, if a baby dies, it is not considered infant mortality
>>unless it is a crib death. In the USA, ANY post-partum death
>>or full-term still-birth is counted.
> You don’t know what you are talking about. Infant mortality
>only if the baby died in a crib? Dream on. Lies repeated on
>internet does not make them true. Tell me, if the baby died
>while sleeping in a chair is that not infant mortality in
>Japan?
Odd. But I was at the library over the weekend, looking up international
crime statistics. One of the books I looked through* mentioned infant
mortality rates, and made the point that the U.S. counts infant mortality
in a much stricter way than nearly every other nation, inflating our
counts. Even after adjusting for similar reporting schemes, they did
agree that we have a high infant mortality rate relative to other
Western nations.
The white population of the U.S. has an infant morality rate that is
pretty typical of other Western industrialized nations. The poor
showing the U.S. makes is because of the black and Hispanic population.
At least some of this is because of poverty, but some of it is because
of the high rates of drug abuse (including alcohol and tobacco) in the
black American population.
*I didn’t write down any of the data, because I wasn’t looking for
infant mortality stats.
># George Conklin; Geo…@NCCU.EDU | Edison did not have a fancy #
># N. C. Central University | internet signature. #
># Durham, North Carolina USA | That means that I cannot either #
># 919 560-6222 (work) | since he didn’t tell me how. #
–
Clayton E. Cramer {uunet,pyramid}!optilink!cramer My opinions, all mine!
Prohibiting law-abiding people from owning guns because they might be stolen
by criminals is like prohibiting women from going out at night because they
might be raped.
mj…@hcsd.hac.com (Mark Jebens) says:
>kni…@cup.hp.com (Paul Knight) writes:
>>The notion that the potential demand for health care is infinite is
>>absolutely wrong.
>As it turns out, this was the major flaw in thinking when National Health
>was set up in Britian. It was assumed that as people became healthier,
>they would need less medical care. Instead, people went to get
>treatment for minor illnesses that they would have braved out before.
Unlike the American HMO’s that are based on NHS methodology, there are
no deductibles in the British public HMO. Not even Thatcher could put
any in place. They just can’t bring themselves to do it …
But a public HMO is not a single-payer insurance, whether as PPO or voucher.
>Their system is extremely over-burdened, even with a massive increase
>in funding over the last decade. The quality of care is disgraceful,
>yet the average person cerishes it because it was better than the care
>they received in the pre-war years.
A parallel private fee-for-service system still exists outside for the
upper-middle and upper classes, so they remain in a two-tier mode as
they always have. But it’s not different from Americans triaged by
their wonder HMO after dumpings hundreds and thousands for subscribing,
and having to get fee-for-service outside on their own nickel because
they need care and that’s too late for buying insurance.
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
schaf…@columbia.dsu.edu (William Schaffer) says:
>I have seen data that show that there are more MD’s in the US.
Small wonder … the U.S. comprises roughly 1 out of 3 people in
the western G7 economies.
>One of the problems is the relatively low number in the primary
>care areas.
You have to realize that in Canada, we have small absolute numbers
in populations … low densities, small markets.
>Classical economics just doesn’t work to explain medicine. Where
>there the highest number of specialists, the costs are the greatest.
Sure it does. A brain surgeon in Moose Jaw, Saskatchewan is lucky
to work once a year … the whole province has about 700,000 people
while next door in Alberta, the cities of Calgary and Edmonton each
have around 750,000 … the specialist market sees higher absolute
numbers in Alberta for the same actuarially predicted demand.
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)
In article g…@vixen.cso.uiuc.edu, g…@prairienet.org (Gary L. Dare) writes:
>mj…@hcsd.hac.com (Mark Jebens) says:
>>kni…@cup.hp.com (Paul Knight) writes:
>>>The notion that the potential demand for health care is infinite is
>>>absolutely wrong.
>>As it turns out, this was the major flaw in thinking when National Health
>>was set up in Britian. It was assumed that as people became healthier,
>>they would need less medical care. Instead, people went to get
>>treatment for minor illnesses that they would have braved out before.
>Unlike the American HMO’s that are based on NHS methodology, there are
>no deductibles in the British public HMO. Not even Thatcher could put
>any in place. They just can’t bring themselves to do it …
The reason the British can’t do it is because they believe that health
care is a right. Making people pay even small amount may cause some people
not to be able to afford the co-payments, thus denying them their rights.
>But a public HMO is not a single-payer insurance, whether as PPO or voucher.
Why is this important? Firstly, this is independent of the point being
discussed. Secondly, the discussion is based on private-supported health
care vs. public-supported care. With PPOs and vouchers, the government
just gets involved in a different way.
Here in Canada, for instance, even though the PPOs are run by a government
corporation, there is no way anyone could possibly claim that they are free
of government influence. There is the constant treat of imposition of user
fees and in BC, the government is trying to reinvent their system. A former
BC Health Minster frequently says (paraphrasing), "It is interesting that
while the Americans are moving toward a Canadian-style health care system,
the Canadian system is going south."
>>Their system is extremely over-burdened, even with a massive increase
>>in funding over the last decade. The quality of care is disgraceful,
>>yet the average person cherishes it because it was better than the care
>>they received in the pre-war years.
>A parallel private fee-for-service system still exists outside for the
>upper-middle and upper classes, so they remain in a two-tier mode as
>they always have. But it’s not different from Americans triaged by
>their wonder HMO after dumpings hundreds and thousands for subscribing,
>and having to get fee-for-service outside on their own nickel because
>they need care and that’s too late for buying insurance.
So you are advocating that American abandon one system that doesn’t work
for another one that doesn’t work? The 90% of American that do have
health insurance or who can afford doctors on their own have the best
health-care in the world. This is acknowledged every day by promenient
Canadians, who in turn would not give up their inferior health care to ensure
that 100% of their population never goes without.
The question that must be answered is this: "Is guaranteed health
care a right of a resident of the United States, just as primary school
education is considered right?"
Mark Jebens
mj…@hcsd.hac.com
- Hide quoted text — Show quoted text -
In article <CvIIzt….@optilink.com> cra…@optilink.dsccc.com (Clayton Cramer) writes:
>In article <CvGxE4….@ecsvax.uncecs.edu>, conklin <geo…@nccu.edu> wrote:
>>In article <3438ut$…@engnews2.Eng.Sun.COM> a…@mises.Eng.Sun.COM (Al Date) writes:
>>>Nonsense. For example, the vaunted statistics on infant mortality
>>>are totally skewed by international discrepancies in reporting.
>>>In Japan, if a baby dies, it is not considered infant mortality
>>>unless it is a crib death. In the USA, ANY post-partum death
>>>or full-term still-birth is counted.
>> You don’t know what you are talking about. Infant mortality
>>only if the baby died in a crib? Dream on. Lies repeated on
>>internet does not make them true. Tell me, if the baby died
>>while sleeping in a chair is that not infant mortality in
>>Japan?
>Odd. But I was at the library over the weekend, looking up international
>crime statistics. One of the books I looked through* mentioned infant
>mortality rates, and made the point that the U.S. counts infant mortality
>in a much stricter way than nearly every other nation, inflating our
>counts. Even after adjusting for similar reporting schemes, they did
>agree that we have a high infant mortality rate relative to other
>Western nations.
>The white population of the U.S. has an infant morality rate that is
>pretty typical of other Western industrialized nations. The poor
>showing the U.S. makes is because of the black and Hispanic population.
>At least some of this is because of poverty, but some of it is because
>of the high rates of drug abuse (including alcohol and tobacco) in the
>black American population.
>*I didn’t write down any of the data, because I wasn’t looking for
>infant mortality stats.
>–
>Clayton E. Cramer {uunet,pyramid}!optilink!cramer My opinions, all mine!
Infant mortality statistics seems to have moved from
the abstract scholarly world to the Reader’s Digest (really).
There are many studies of why our infant mortality rate is high.
Europe knows how to count dead babies too. Even taking into account
any possible differences in reporting, our rate is still high.
The U.S. white population has a rate similar to but not quite
as low as most of Europe. African Americans have a higher rate, but
hispanic populations have a rate similar to whites. As I
recall my NSF seminars on demography, the native American population,
which has socialized medicine by the way, has an infant mortality
rate similar to whites up until discharge from the hospital. After
that it jumps up again, reflecting the results of poverty.
Being young (i.e. the mother being under 18)
probably does not cause a rise in infant
mortality by itself. Combined with lack of access to health
care, fear of going at all, an lack of coverage for pregnant
"children" in a parent’s policy, there alone is enough reason
to expect a rise.
The best estimates are that the differences between the US and
Europe on infant mortality as a whole is half social and half
access to the medical system. The correlates of poverty
remain even in the British system, by the way.
It takes a great deal of effort on the part of any human
population to keep infant mortality rates low. Keeping young
children healthy takes work too. High tech is not always
the answer either.
And then is the issue of nutrition……
–
# George Conklin; Geo…@NCCU.EDU | Edison did not have a fancy #
# N. C. Central University | internet signature. #
# Durham, North Carolina USA | That means that I cannot either #
# 919 560-6222 (work) | since he didn’t tell me how. #
mj…@hcsd.hac.com (Mark Jebens) says:
>g…@prairienet.org (Gary L. Dare) writes:
>>But a public HMO is not a single-payer insurance, whether as PPO or voucher.
>Why is this important? Firstly, this is independent of the point being
>discussed. Secondly, the discussion is based on private-supported health
>care vs. public-supported care. With PPOs and vouchers, the government
>just gets involved in a different way.
The title of this subject deals with Proposition 186 in California,
to implement what some Americans believe to be a single-payer.
>There is the constant treat of imposition of user fees …
Correct, Marc-Yvan Cote of the Quebec Liberals tried for three years
in a row to implement $5-20 token deductibles and was rebuffed each
time by the Mulroney Conservatives (who were their allies; sorry to
the American audience for our getting into Canadian politics but it
may be enlightening to a few of you) … and the reasonable practical
idea was to make some people run to the corner Pharmaprix (what they
call Shoppers Drug Mart there) for a box of bandages or a bottle of
aspirin rather than make a doctors appointment for a "free" one.
>and in BC, the government is trying to reinvent their system. A former
>BC Health Minster frequently says (paraphrasing), "It is interesting
>that while the Americans are moving toward a Canadian-style health
>care system, the Canadian system is going south."
And this is coming from a member of the New Democratic Party, the left
wingers who run around claiming to have invented our "system"? Also,
I’d hardly call the B.C. system typical with the mass unionization of
hospitals (which themselves remain standalone and independent in the
face of a monolith) under the previous NDP regime of Dave Barrett.
Just because the left finally got its claws in and are trying to
make the Ontario and B.C. insurance more than that, and restrictive,
should not be taken as an indictment when at the same time, the very
same principle is allowing Alberta to move to a more voucher-like
stance having "private clinics" whose services are reimbursable
and can extra-bill — but made possible because they renounce
all other perquisites involved in accepting the public insurance
such as having their malpractice covered, etc. The very same
federal guidelines, yes …
>>>Their system is extremely over-burdened, even with a massive increase
>>A parallel private fee-for-service system still exists outside for the
>>upper-middle and upper classes, so they remain in a two-tier mode as …
>So you are advocating that American abandon one system that doesn’t work
>for another one that doesn’t work?
That blurb was put in for education because a couple of other writers
have already mentioned here and in Soc.culture.canada that most people
in the U.S. are under the belief that i) everyone else has a public
HMO like Britain and ii) whatever they use, it is monolithic. That
is not the case at all. As a non-HMO, the Canadian single payer or
the continental European voucher (benefits or cash) are cash-based
systems oriented on value of service.
>This is acknowledged every day by promenient Canadians, who in turn
>would not give up their inferior health care to ensure that 100% of
>their population never goes without.
Since the system is public insurance with private medical services,
you can’t control the doctors and the hospitals. Since it’s the
same medical infrastructure throughout North America, how is it
that the Canadian care is inferior … for markets of their size?
[I'm originally from Winnipeg, by the way ... lived in quite a few
places since then ...]
On the other hand, you can log into Victoria Freenet and read the
local B.C. boards … Karen Gordon is very loud about crushing the
private sector and believes it to be public enemy #1. Even those
who want to socialized the actual health care (not just insurance)
acknowledge that the care is private sector. And if not, then why
do they have the ability to opt out? [In other words, accept the
public insurance payment voluntarily, and with perqs.]
>The question that must be answered is this: "Is guaranteed health
>care a right of a resident of the United States, just as primary school
>education is considered right?"
Despite protestations of the left that health care is a right, it is
a nonpartisan stand (including the Reform Party) that access to health
care through the provision of insurance benefits is good policy.
gld
—
~~~~~~~~~~~~~~~~~~~~~~~ Je me souviens ~~~~~~~~~~~~~~~~~~~~~~~~~~
Gary L. Dare g…@prairienet.org
"Support NAFTA – Eat Mexican!" uk…@freenet.victoria.bc.ca
(El Teddy’s ad, NYC) (formerly g…@columbia.edu)