The False Promise of Canada's Health Care System

[Muda69]

On 10/4/2019 at 10:07 AM, Wabash82 said:

 

 

The whole "poor doctors will make less money" argument is odd from you, Muda, since you traditionally have argued for market-based approaches that, if they succeeded, would presumably have a similar affect on average income for doctors. (For the same market-based reasons that doctors made significantly lower incomes before employer-based group health insurance came along.)

With regard to the smokers getting lung cancer thing: if have group health insurance through your employer, you are already subject to that exact sort of cost shifting arrangement now. While insurers can and will impose premium surcharges on smokers in the group pool, those surcharged do not offset the additional actuarially-determined cost of having those people in the pool, and they this spread that cost to everyone else in the pool. 

Even uninsured smokers who contract lung cancer cost you money under our current system, because they still get treated under hospital "charity" programs or state emergency medical cost plans, and those charges are eventually "shared" with you via higher taxes, and higher overall medical costs at the hospitals.  

The moralistic aspects of this are interesting to hear from you as well. While slippery slope arguments are often illogical, I can't imagine you have absolutely no vices or habits (eating or otherwise) that are not associated in some degree with some negative health consequences. Yet you foist the potential cost of your vice or habit on others in your group health coverage pool.  Why should they have to carry part of the risk of your poor decision-making?

 

Because in a true market-based system  I would get to choose, not the federal or state government.   Is our current system perfect?  Heck no,  but it just happens to be marginally better than the socialist system that Canada has.  I desire to move to a health care system that is more market-based, not less.  A step towards that, as I have stated before, is to stop tying health care insurance as a perk/benefit of employment.  Employers should stop providing me with a 'health insurance plan'  but instead take that $ and put in in my pocket, so I can 100% choose what health insurance plan to purchase.  That way little to none of the cost of that insurance is hidden from me,  just like with my automobile insurance,  my home owners insurance, etc.

 

 

 

 

 

On 10/5/2019 at 11:02 AM, DanteEstonia said:

That says more about how higher education is structured in the USA than about how “special” doctors are.

Should medical professionals make more than educational professionals in the USA?  Why or why not?

 

[DanteEstonia]

1 hour ago, Muda69 said:

Should medical professionals make more than educational professionals in the USA?  Why or why not?

 

It’s whatever the “market will bear”. Both don’t have nearly as good of an ROI as a CDL.

[Muda69]

14 hours ago, DanteEstonia said:

It’s whatever the “market will bear”. Both don’t have nearly as good of an ROI as a CDL.

Yet you and other socialists want to take the "market" out of the equation when it comes to compensation for medical professionals.  The federal government will in effect get to set the salaries.  And the feds will start by cutting their pay by upwards of 40%.

 

 

[DanteEstonia]

28 minutes ago, Muda69 said:

And the feds will start by cutting their pay by upwards of 40%.

What makes you assume that?

[Muda69]

9 minutes ago, DanteEstonia said:

What makes you assume that?

Good grief Dante, have you actually even read any of the quotes I have posted in this thread?  

First this:  

Quote

...

Perhaps more important, no other country has socialized and then attempted to downsize a health-care system as large as ours. Supporters of the Sanders-Warren plan have pointed to a conservative scholar’s low-end estimate of its cost to argue that it would reduce total spending on health care. But that estimate assumed that the government would be able to force health-care providers to accept a 40 percent cut in pay. Nothing in the history of federal spending on health care suggests this is possible. If anything like it happened, it would surely lead to reductions in the number of providers, increases in wait times, and the like.

...

 

And this:

Quote

...

Today, Medicare enrollment totals more than 58 million Americans. Sanders's bill, however, would expand Medicare's payment rates to the coverage of more than 300 million U.S. residents.

Projecting a dramatic 40 percent reduction in provider reimbursement relative to private insurance, Charles Blahous, a former Medicare trustee, observes, "The cuts in the Sanders M4A bill would sharply reduce provider reimbursements for treatments now covered by private insurance, which represent a substantially greater (more than 50 percent larger) share of national health spending than does Medicare."

...

 

Edited October 8, 2019 by Muda69

[DanteEstonia]

20 minutes ago, Muda69 said:

Good grief Dante, have you actually even read any of the quotes I have posted in this thread?  

First this:  

 

And this:

 

And they all go back to a biased Mercatus study.

[Muda69]

35 minutes ago, DanteEstonia said:

And they all go back to a biased Mercatus study.

Links please.

 

[Muda69]

Maternal Care Scandal in Britain’s NHS Reveals Human Costs of Socialised Medicine: https://mises.org/wire/maternal-care-scandal-britain’s-nhs-reveals-human-costs-socialised-medicine

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If the current Democratic primary has illustrated one thing, it is that the fascination with socialised medicine in the American political conversation continues to double and redouble with each passing year. However, given the often-repeated slogan that the US is supposedly the only rich country without universal healthcare, conspicuously little attention has been paid to the actual experiences of those other countries, and whether or not adopting socialised medicine turned out to be as benevolent as US politicians are taking for granted.

In a sense, it is hardly surprising that so little attention has been paid to real world examples of universal healthcare, such as Britain’s National Health Service, given the histories of underperformance, scandal, and perpetual crisis associated with many such systems. Were the advocates of ‘Medicare For All’ to leave the cosy confines of rhetoric and confront the historical record of socialised medicine, they would find the story so far to be anything but a simple matter of giving high quality healthcare to needy people.

A new page was added to this troubled history by the recent revelation, courtesy of a leaked internal report, of what is being called the worst maternity scandal in the history of Britain’s NHS. The report revealed that, in a single NHS trust over the period 1979–2017, unchecked clinical malpractice and neglect by doctors, midwives, and hospital bosses led to the avoidable deaths of at least 42 babies and three mothers, while 50 more children suffered permanent brain damage as a result of being deprived of oxygen during birth. The report also identifies 47 other cases of substandard care. These are only the preliminary findings from a set of 600 cases currently under investigation, with most of those cases still awaiting assessment, so the final numbers can be expected to be higher.

Although these cases occurred over a 38 year time period, it is worth bearing in mind that these are the findings from just one of the 470 NHS trusts, the subsidiary administrative units that oversee NHS operations in a particular geographical area or specialised function. The report examined cases only from the Shrewsbury and Telford Hospital NHS Trust, which consists of just two hospitals, one maternity unit, and one community clinic.

Senior NHS sources are already calling this the worst maternity scandal in the history of the NHS, a title which had previously belonged to the Morecambe Bay scandal. That previous scandal, which came to light only four years ago, revealed the avoidable deaths of 11 babies and one mother between 2004–2013, in a single NHS hospital.

It is certainly tempting to believe that these terrible cases are an aberration, confined to just one or two hospitals, and based on the random mistakes of just a handful of individuals. However, the truth is that negligence and poor performance like this are a systemic problem rooted in the economic nature of government-run industries, and the perverse incentives they face.

If a government begins providing a given service free at the point of use, this will tend to crowd out private provision of that service, even if private provision is not outright banned, as politicians such as Elizabeth Warren have advocated banning private health insurance in the US. In Britain, for example, even though private health insurance is entirely legal, only around 10.5% of the population actually engage with the private insurance market at all. This is partly due to governments’ unique ability to divert huge quantities of real resources toward themselves using the non-voluntary methods of taxation and fiduciary media creation, which precludes those resources from being used by private providers in a way which might have more fully satisfied consumer preferences. Patients are also less likely to pay for private healthcare if they know they can get some degree of healthcare for free from the government, even if that government healthcare is of far lower quality, starving the private sector of the resources and economies of scale needed to provide higher quality healthcare cheaply. This resource starvation is even more extreme in ethically sensitive sectors such as healthcare, with many British doctors expressing guilt and moral revulsion at the idea of working privately, even part-time, rather than for the NHS. All of this results in chronic inefficiency: poor services being provided at high cost, as can be seen in the NHS’s abysmally low ‘bang per buck’ in terms of healthcare outcomes compared to money spent.

Another economic problem inseparable from government provision of services free at the point of use is its removal of incentives to prioritise the desires and well-being of the customer. Some readers might be skeptical that this problem would apply to healthcare: sure, removing profit, loss and payment by customers in an ordinary business might diminish the ‘customer is king’ attitude, but surely healthcare workers feel morally bound to provide the best care possible, regardless of economic incentives?

Sadly however, healthcare workers are not immune from such economic forces, as was illustrated clearly by this recent NHS maternity scandal. Far from being a result of innocent mistakes and unfortunate circumstances, the leaked report points to negligence and a complete disregard for the well-being of patients as having caused many of the avoidable deaths. The report highlights a failure to monitor high-risk mothers and newborns, as well as a “chronic inability to learn from past mistakes”, and a general culture that is “toxic to improvement”. The report further points to “a distinct lack of kindness and respect” shown toward bereaved parents and families, with multiple examples of deceased babies being referred to by the wrong name, or described as “it”. In one particularly shocking case, the body of a deceased baby, after having received a post-mortem examination, was simply left to decompose “for a period of weeks”, to the point that the mother was unable to see her child for a final good-bye before burial.

This shocking indifference to patients and hostility to improvement is an inescapable consequence of the economic incentives introduced when government crowds out competition and provides services free at the point of use. It remains to be seen whether American voters will lend their support to the nationalisation of healthcare that their politicians are increasingly advocating. However, if such a policy is pursued, the voting public should not be under the illusion that the final outcome will be as simple and benevolent as they are being told.

What a horrible, horrible tragedy.  And the root cause was a socialist system.