Health Care

Willaim Thurber - PhD Student thurber at FMGMT.MGMT.UTORONTO.CA
Thu Sep 7 10:08:16 MDT 1995


>         Larger number of successful procedures performed resulting in fewer
>         post-operative complications and minimal inpatient recuperation time,
 
I can't find the figures, but if you can find them please let me know.
For the sake of argument let us assume that there is a significant
difference and that you place a marginal value on that difference equal
to 4X the cost of Canadian care.
 
To my point of monopoly, since there is no competitive pressure not to
spend money in a free market driven by insurance funds, a monopoly
provides the insurer with the power to dictate to the market what the
price will be.  Remember your micro economics, you can choose price or
quantity, as long as the insurer sets a price that is high enough to
attract doctors into the system it can set price without repercussions.
We have no shortage of doctors but some waiting lists for services.
 
>         The argument is cost control, not justified intervention.  Strawman
>         not allowed!  The stupid and/or wiley cause costs to soar, to the
>         taxpayers'/bill payers' lament!
 
Two sides of the same issue, if the stupid cause prices to increase to
you, then the government is justified in preventing these people from
harming you by introducing cost control through its monopoly power.  I do
not suggest that the monopoly must be government run, but my recent
experience suggests that private insurers have an incentive to disallow
claims in the name of profit.  Dr. DJ's story suggests that our govm't
plan is not exempt from these pressures either.
 
 
> |The US system limits costs because the free
> |market limits the number of people covered.
>
>         Then it is a plus for the Us system, no?
 
Not in my book, good health to me is a right (a subsection of the right
to life and liberty)
 
> |Yes the migration of physicians is true to a limited extent.  One of the
> |reasons a health care program in the US will indirectly help health  care in
> |Canada.  But I am not sure that the greed motive is strongly
> |correlated with the skill level of a practitioner.  BTW Doctors are on
> |average the most highly paid members of our society.
>
>         Perhaps, without a source of market-based health care to the South,
>         Canada's program would fail.
 
You have an interesting point but I am not sure I understand, can you
elaborate?
 
>         No mention of greed in my argument--profit is not greed, profit is
>         making at least a penny over cost.  Anyone who doesn't make a profit
>         should not be in business (unless his/her business is going deeper
>         into poverty!).
 
Greed is an ugly word and I knew I would regret using it.  But you
implied that Cdn Doc's are starving, profitless, dweebs.  In fact they earn
$100-200K.  True, this is less than US Docs but is a far cry from
profitless.
 
>         The payroll tax for medicaid that I pay does not pay for my health
>         care.  My health care is provided by a system of my own choosing.
>         That is a choice I am free to make and you are not.
 
As previously noted we pay the same health tax, you get nothing and have
a reason to be proud of that (because it is a sign of success in the US)
I on the other hand get cradle to grave coverage.  What's not to compare?
 
> |>         Or, the freedom to say, "Thanks, but I don't want to be part of
> |>         this system anymore--I'm going elsewhere!"
> |
> |Most of the time, why would we want to?  Break an arm go to the hospital
> |and get it fixed.  No dealing with insurance claims, our job is to work
> |on our own recovery.  The incident Dr. DJ relates is inexcusable from the
> |standpoint of the freedom to be able to pay for a non-covered service
> |yourself.  I am sure we are on common ground here. Our system can be improved
> |but in this very rare case the solution remains within the bounds of a monopoly
> .
>
>         "Why would we want to" is another strawman--the argument is freedom
>         that we have that you don't!  I've made the point.
>
 
Guilty as charged.  A by-product of my enthusiasm for this system, if it
were perfect "why would I want to" is valid.  I apologize for a) precluding
a better system and b) incorrectly assuming our system was perfect.
 
--Will



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