Calling All Non-US Readers

By Robert Fischer | Published: December 28, 2007

Brian and I have been discussing health care over at “Take Their Power Away“, and so we got to talking about some foreign health care systems, and we hit a point that’s kind of interesting. I was wondering if those people from outside the US (particularly those Germans who seem to like this blog so much) would mind chiming in.

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  • Joe

    Can’t help you with what the Germans are up to, but Canada has a half-assed public health care system. Its not working here. I don’t have a family doctor, and have not seen a doctor in over 20 years. I could not get one if I wanted one, and this is incredibly common, there’s simply not enough doctors to go around. Wait times both in emergency rooms and for treatment are insanely long (part of the emergency room problem is of course all the people without doctors who have to go to the emergency room for stuff they would otherwise go to their doctor for). It is still much better than the US.

    Privatizing our health care wouldn’t help. People pretend that competition would create an incentive to provide better care, but that’s just silly. People don’t lower their demand for health care because the price goes up, like people would lower their demand for a commodity if its price went up. When gas costs more, I drive less. When not dying costs more, I still want to not die. They can charge whatever they want, because you can’t put a price on your life or the life of your family. Supply and demand is not at work here, so trying to have a deregulated private health care system can only be decribed as moronic. Its actively refusing to accept the plain facts, and placing blind faith in the god of the free market to save you.

    The way to improve the Canadian health care system is by better government involvement, not less government involvement. Pay doctors more, and pay them based on the quality of their work, not the length of time they have been employeed. Fire the ones that are incompetant. While nurses are currently overpaid, we could leave their pay as-is and simply start mandating that they be competant. Don’t provide quality care? Then you don’t have a job, simple as that. And of course, dealing with the patent nonsense that makes so many drugs so expensive, despite their development having been funded with my tax money in the first place.

    None of this will happen though because of voter apathy. Nobody wants to know enough to vote intellegently. They just want to keep voting the same idiots in over and over, just changing from blue to red and back whenever they feel the need to “punish” the last party that was in power for being a little too obvious with their corruption. People willingly and actively vote for the party that promises to spend the most on health care, when the dollars spent does not correlate to care given. Its just easier to look at who promised a bigger number than to consider the details of an actual plan for change and make an informed choice.

  • http://www.linkedin.com/in/robertfischer Robert Fischer

    This is actually my concern about privatizing our system. We’ve already got two major federal systems — welfare and social security — that utterly fail to achieve what they were laid out to do, even to the point of being counterproductive. I don’t have a lot of hope that another one will be any better. I would really like it to be, but there’s just not much hope. And the Canuckian system is part of the reason why.

  • Brian

    Actually, Social Security works just fine. The only “problem” with it that I’ve heard about is the myth that it’s about to go bankrupt- which is bullshit. And the main problem with Welfare is decades of Republicans demonizing the program, forcing it to spend most of the money spent on it to make sure that no one who doesn’t absolutely deserve benefits gets them. And since no policing system is ever perfect (no matter how draconian), there are always those that slip through the cracks, which are then held up to demonstate the ineptness of the system. And if there aren’t any handy slip-ups, we’ll just make them up- Reagans “Welfare Queen”, for example, was made up of the whole cloth.

    This is the advantage Universal health care has. No policing necessary. If a human being comes in needing treatment, we treat them. Low overhead.

    Some people will game the system. They’ll come over from Mexico to get free treatment at our hospitals. Oh wait, they already do. My response: so what? The extra money it’ll cost to help some people who may not technically deserve it is nothing compared to the cost it’ll take to keep them out.

    Actually, I’m enough of a bleeding heart liberal that I worry about the people who aren’t close enough to the border to sneak over and use our hospitals. But that’s a different debate.

    And there is the racism aspect. This is non-trivial. This isn’t what you think, but I gaurantee it’s what other people think. We could have had single-payer universal health care 60 years ago. Truman proposed it back in 1948. It got shot down- by South White Democrats like Strom Thurmond, who were worried that socialized health care would require them to desegregate the hospitals. Racism isn’t a cancer, it’s a madness. A madness that causes us to cut off our own nose to spite our face.

    If you want to know what the difference between the US and the rest of the industrialized world, this is it. It’s not that they don’t have minorities, they do. Lots of them. It’s that they’re not batshit crazy, like we are. They’re capable of going “wait, this is insane”, and backing off doing something sensible. They don’t allow fear and hatred to override common sense.

  • Brian

    Joe: Canada also has a problem that Germany, France, and (to a large extent) the US doesn’t- not many people and lots of land. Canada is 33 million people spread over 9 million square kilometers, for an average population density of ~3.6 people per km^2. France is 63 million people spread over 640K square kilometers (hey, 640K ought to be enough for anyone…), or ~98 people/km^2. The US is 300 million people spread out over 9.1 million square kilometers, or ~32 people/km^2 (site: CIA World Fact Book). Granted, the situation isn’t as bad as it sounds- most of the Canadian population is concentrated near the US border (in preperation for the invasion…), but Canada still has a population density issue to deal with that neither France, Germany, Japan, nor the US would have to deal with. Providing health care in the Northern Territories has got to be an incredible money-sink. The US would have similiar problems with Alaska and parts of the mountain west- Wyoming, Montana, Idaho, places like that. But we have ten times the number of people to spread the costs over, and, glancing at a map, a lot less problem area to deal with.

    Although I do like the proposal that if Texas doesn’t STFU, we split Alaska in two and make Texas the third largest state.

    More seriously, voter apathy and disenfranchisement is a huge problem- not just for health care, but for everything. And worse yet, it’s a self-fullfilling prophecy. If people think the system can’t get fixed, they won’t fix it, and guess what? The system won’t get fixed. Q.E.D.

  • Joe

    Robert: Yes, I bet the US would end up with a broken health care system that doesn’t work, a lot like we have up here. And as I said, its still much better than what you have now.

    Brian: The population density really isn’t an issue. Like you said, the vast majority of people live in a very small area. And even in the northern areas where there’s very few people, its not like people actually live several kms apart. They live clustered close together in small communities. It only takes one doctor to service one small community. I live in the most densely populated part of Canada (southern Ontario, near Toronto). There’s simply no doctors because they all move to the US to get paid significantly more.

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