Health Care

Willaim Thurber - PhD Student thurber at FMGMT.MGMT.UTORONTO.CA
Thu Sep 7 12:14:42 MDT 1995

Cindy (+ Paul)
On Thu, 7 Sep 1995, Cindy Brewbaker wrote:
> I must comment on the above statement (Will's I believe).  I'm not certain I
> grasped the "same health tax" statement but the part abt. we "get nothing
> and have a reason to be proud" really touched a nerve.
Welcome back Cindy, and congratulations on your success.  Likewise
welcome back to Sam, very sorry to hear of your misfortune, hope things
turn around down there.
Earlier in my conversation with Paul, I noted that while the health care
tax in[A Ontario (EHT, which is 2% or less plus funding from our sales tax
@ 8%) and New York (Medicaid, which is about 2%) were about the same.  We
can cover more people because our government sets the prices that the
providers can charge.  I noted that similar procedures seem to be 4X as
expensive in Canada as in the US.  Paul, held that the cost to quality
ratio was about the same, a point which I will concede to keep the
discussion going and that "value" is subjective.
Paul claimed that he did not participate in the US system because he
receives no benefit for his medicaid tax.  I responded that not
receiving benefits from Medicaid is a sign of wealth and success and
thus a reason to be justifiably proud.  Although it appears a little
queer to pay for something that you will never use, and be happy but I
guess I'm happy that I did not use my life insurance policy last year
even though I paid for it.  :)
For the record, I have described the system in Ontario like a giant HMO.
Since everyone participates you are free to choose any doctor, any
hospital etc.  Dr. DJ chimed in with an example of our government denied
chemotherapy to a liver cancer patient, then prohibiting that patient
from paying for that care themselves.  I condemned the restriction on the
patients freedom but maintained that a single payer system can cut costs
and thus include more people in the system.
We have also gone past the overuser/hypochondriac problem that we have
with a system that does not incorporate a user fee.  We have tried to
address this with walk in clinics for normal maladies.  I could also add
the old argument that by encouraging preventative care we save lots by early
prevention of chronic conditions, but I am not sure that this can be
clearly supported by the statistical evidence.
> I reiterate your question Will; "what's not to compare?"
Paul suggested that we could not compare the two systems so I'll pass the
buck over to you Paul.
> I would also reiterate Will's comment that our system also is not perfect
> but at least it places a greater emphasis on consumer wants and needs rather
> than what the gov't wants.
Likewise, our system is imperfect but when you have a private insurance
carrier motivated by lowers costs they have an incentive to lower cost by
restricting the quantity and quality of coverage, ie new moms being pushed
out of hospitals early, or my father-in-law initially denied Nupegen(?) by
his insurance carrier to combat the effects of his chemotherapy.
I hope this brings you up to date, I have tried to give you an unbiased
synopsis of the discussion to date, but since I aspire to publish in the the
NY Times :) perhaps others will note my biases and disagree.

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