IT'S TIME FOR UNIVERSAL HEALTH CARE

[quote="georgeob1]In short we have a very generous structure of government subsidies for medial care. However, it does have a hole in it with respect to unemployed or only marginally employed people.[/quote]

There are also, literally, thousands of free clinics run by various organizations across this country. My own church (not really all that big) runs 5 free healthcare clinics in addition to a free legal clinic and several food banks spread throughout the community. One of the larger Catholic churches here has a sizeable fund dedicated to paying 80% of hospital bills for not only their parishoners, but any that qualify.

Clinics are fine, but they are not equipped to handle the more serious health issues.

nappy wrote :



thanks so much !
i prefer to live in a country where all citizes have the RIGHT to healthcare and do NOT have to depend on charity for healthcare .
sorry , i forgot to mention : i've been living in canada for the last 51 years .

btw "My own church (not really all that big) runs 5 free healthcare clinics"

indicates to me that there must be quite a few americans without AFFORDABLE healthcare , or do many americans prefer CHARITY HEALTHCARE over a RIGHT TO HEALTH CARE ?
hbg

sorry.
A church should motivate the people to seek God.
A person who enjoy as a mouthpeace of God should help the people and expose the criminals.
my wife is religious( christian)
I am an Atheist( Born In Hindu family)
Please try to help all and try not to uphold the unchristian barbarism.
Thanks
Rama

Rama, What you propose is not realistic in today's world. Many churches provide "health care" as a way to save souls and to get recruits into their church. It's a given that will not change any time soon.

I also encourage churches and nonprofit organizations to expand their health care and food supplies for the poor. That's one of the few positives about us humans; helping other humans in need.

Though your personal preferences are certainly none of my business, your affirmation of RIGHTS (without noting the real terms of the exchange) suggests to me that you may not have sufficiently thought the thing through.

In Canada you have a RIGHT to as much health care as the national & Provincial governments decide to fund. You purchase that RIGHT (or more properly, entitlement) through higher taxes and acceptance of the availability of care restrictions your government decides are appropriate for you.

Americans have a RIGHT to as much health care as they are willing (and able) to pay for. Poor Americans have a RIGHT to government provided health care services, determined more or less as are those for everyone in Canada. The difference in GDP/capita between the US and Canada is about the annual cost of a good health care policy.

Freedom implies responsibility. The kind of RIGHTS you are talking about involve a surrender of individual freedom and responsibility. I'm not trying to denigrate the Canadian system, or even the wisdom involved in your preference for it. However I believe you are mischaracterizing the situation by confusing entitlements with freedom.

george wrote :



i don't understand why there is any need for (charity) health-clinics (as described by nappy) if "Poor Americans have a RIGHT to government provided health care services" (as described by you) .
do poor americans prefer charity health-clinics over a universal type health care that they could freely access ?

i also fail to understand why some american a2k members have posted that they ar NOT able to purchase health-insurance for children that have certain illnesses .
a small business owner stated that she/he was not able to provide health-insurance for employees because of high costs .
are those posts simply nonsense ?

perhaps i might remind you that "the big three" shifted automobile production to canada because the health-insurance costs in america were breaking their back .

i can assure that if the majority of canadians would want PRIVATE HEALTH INSURANCE the federal and provincial governments would likely be quite happy to go along .
having worked for an insurance company for almost 30 years , i remember the fight ALL insurance companies put up to prevent universal health care from being implemented .
even though i worked for a life insurance company , they all banded together to fight universal health-insurance .
luckily imo they did not succeed .

i also stated that a conservative ontario government tried to undermine the universal system by chocking off the supply of doctors .
while they did not succeed , it'll be a while before sufficient new doctors will have graduated to fill the empty spots .

our system is by no means perfect .
we need more physicians and more hospital beds .
people will always have new demands .
there is a saying : "what have you done for me TODAY ? ' . i'm sure you are familiar with it .
personally i think that we should be paying MORE money into the health-insurance fund , but i'm not a politician running for re-election - so it's easy for me to shoot off my mouth .

let me finish by saying that i very much enjoy the civilized exchange of ideas and facts with you !
take care !
hbg

Trying to expect any perfection in any government mandated social services is not realistic; if we are able to measure perfection at all in government or private endeavors. We need to measure any man-made endeavor in terms of benefit to the majority in any society. If it were not so, schools would have been discontinued long ago.

I agree. More power to him!

Critically ill patients rushed to U.S. for care
LISA PRIEST

From Saturday's Globe and Mail

January 19, 2008 at 12:26 AM EST

More than 150 critically ill Canadians - many with life-threatening cerebral hemorrhages - have been rushed to the United States since the spring of 2006 because they could not obtain intensive-care beds here.

Before patients with bleeding in or outside the brain have been whisked through U.S. operating-room doors, some have languished for as long as eight hours in Canadian emergency wards while health-care workers scrambled to locate care.

The waits, in some instances, have had devastating consequences.

"There have been very serious health-care problems that have arisen in neurosurgical patients because of the lack of ability to attain timely transport to expert neurosurgical centres in Ontario," said R. Loch Macdonald, chief of the division of neurosurgery at St. Michael's Hospital in Toronto. Those problems, he said, include "brain injury or brain damage that could have been prevented by earlier treatment."

Ontario has the worst problem, though it is not alone.

British Columbia has sent four patients with spine injuries to Washington State hospitals for care from May to September, 2007, though the recruitment of more staff and opening of new beds have helped alleviate the problem. Saskatchewan has sent patients to neighbouring provinces - such as Alberta, which is working at maximum capacity - for specialized neurosurgical services.

But nowhere is the problem of accessing neurosurgery more severe in this country than in Ontario. Since April of 2006, 157 people have been sent to Michigan and New York State hospitals for care. That includes the 62 patients sent so far in fiscal 2007-2008, according to David Jensen, spokesman for the Ontario Health Ministry.

When asked if any patients transported to the United States had died, Mr. Jensen said the "ministry does not specifically record the outcomes of health services provided out of country."

Patients being sent to U.S. hospitals are in the midst of acute medical emergencies, including head injuries, broken necks and hemorrhagic strokes, such as a brain aneurysm that has ruptured.

Unlike other cases where patients have been sent to the U.S. for care - such as radiotherapy for cancer patients - this is the first time doctors have categorically equated delays in obtaining treatment with poorer patient outcomes.

Tim Rutledge, former chief of emergency medicine at North York General Hospital, said physicians are spending "many hours" trying to find neurosurgical services.

"When someone starts to bleed in their head, you don't have a lot of time. You have to take these patients stat," said Dr. Rutledge, who was asked to represent the concerns of Ontario emergency-room physicians before a provincial panel studying access to neurosurgical services. Not only is waiting traumatic for patients and families, he said, but "it's immensely stressful for emergency personnel to watch a patient deteriorate before their eyes while they try to access care." Deterioration, he said, comes in the form of "loss of limb function, seizures and comas."

THE OBSTACLES

Despite the urgency of these cases, patients encounter barriers to accessing care at every turn. The problems include: limited access to teleradiology; limited operating-room time; too few intensive-care beds; a short supply of neurosurgically trained intensive-care nurses to staff them, and too few neurosurgeons.

In some cases, neurosurgeons are available to operate, but with intensive-care beds full, there simply is nowhere to put them afterward.

Even the method of funding neurosurgical services is an enormous disincentive. Neurosurgery is funded out of fixed, global hospital budgets and is viewed as a financial drain. Orthopedic surgeons, by comparison, are seen as money makers: The more operations they do, the more their hospitals are reimbursed.

Tom Chan, chief of emergency at Scarborough Hospital, said the process is frustrating for emergency-room doctors, who are the first to see these patients. Typically, the patients come in having had a seizure or complaining of severe headaches, numbness, confusion, or vomiting.

"My hospital is 20 minutes from the best neurosurgery in the country - if not the world - and we can't get to it," said Dr. Chan, who described the situation as "crazy."

When Alan Hudson, head of Ontario's waiting-time strategy, heard about the problem, he immediately struck a panel to study it. "The solution to fix this is within sight," said Dr. Hudson, a former neurosurgeon and hospital president. "What it requires is some organization."

To that end, the Ontario government in November provided an additional $4.1-million to Toronto's University Health Network, to do 100 more neurosurgical cases by October, 2008.

Catherine Zahn, executive vice-president, clinical programs and practice at the University Health Network, said the additional government funding is having an impact, though she conceded the pace is not sustainable as more neurosurgeons are needed. She stressed that the government and her institution are working together to address the problem.

WARNING SIGNS

And yet, governments were warned of a shortage of neurosurgical services five years ago. In August, 2003, a report co-authored by Chris Wallace, head of the division of neurosurgery at Toronto Western Hospital, said that "increasingly, the resources are not available to handle neurosurgical emergencies."

At that time, in fiscal 2003-2004, fewer than five patients were sent to U.S. hospitals for care. One year later, 10 patients were sent. That number doubled in 2005-2006, according to Ontario Health Ministry figures.

Dr. Wallace's report mentioned four main areas of concern and made eight recommendations to improve access to neurosurgery and to "plan for the unplanned."

"It has started to reach capacities that are not tolerable and that's what has caused the groundswell and the concern," Dr. Wallace said in an interview. He described the situation of travelling to the U.S. for care as "intolerable for the critically ill."

Two more reports on the difficulties of accessing neurosurgical services followed. An October, 2003, report by Charles Wright found there was a significant shortage of neurosurgeons in some centres. Two years later, a report by the Institute for Clinical Evaluative Sciences said demands were being met by very few surgeons with high workloads, which is not sustainable.

Now, a fourth report, authored by James Rutka, appointed by the provincial government to head the neurosurgery expert panel, has listed about 20 recommendations to solve the problem.

The report by Dr. Rutka, chairman of the division of neurosurgery at the University of Toronto, was provided to government in late December. It recommends a two-phased approach: allocating additional neurosurgical services to one hospital to address emergency out-of-country transfers immediately, and increasing capacity in more centres in Ontario.

At the danger of heaping sophistic pedantry upon you, I would point out that "to have a right" can be a moral statement as well as a legal one. Compare Webster's second definition of the term right: "being in accordance with what is just, good, or proper".

What I understand Hamburger to be sayingis this: Universal healthcare is in accordance with what is just, good, or proper, and he prefers to live in a country whose legal rules reflect this. If that's what he's saying (and I'm sure he will protest if I've put words into his mouth) you may still disagree with him, but I don't see why he shouldn't have thought this position through.

He's also living in a country that is ignoring the 'legal rules', then. If you do just a little googling, you'll find that private clinics and hospitals (supposedly illegal) are popping up all over Canada. Might not be long before they have a system similar to yours and ours.

"... just, good and proper...". Why stop with health care? What about food and housing? education? entertainment? Where is the logical divide? Surely 'thinking it through" a bit should have revealed the answer.

Very true, but at least they can serve as a starting point for health care and a referral point should more advanced care be needed.

Americans have the RIGHT to purchase health insurance and with this insurance they have the RIGHT to seek out health care practioners to provide health care services to them. Their access to these health care practioners will be determined in part by whether or not the practioners will accept the health insurance provided and whether their specific practice can accomodate them based on both time and space.

There are no logical divides, only a practical one.

We have good empirical evidence, admittedly short of absolute proof, that free markets work more efficiently than their alternatives in food, housing, and entertainment. To ensure that basic needs are met, the government may need to subsidize the poor through food stamps, the Earned Income Tax Credit, and the like. But it needn't change the market structure in any of these industries.

We also have good evidence, also short of absolute proof, that free markets in healthcare work less efficiently than some of their alternatives. We have a fairly sound theoretical understanding why this is so. (For details, Google "adverse selection".) That makes a decent case for altering or abolishing the free market in healthcare and trying one of the alternatives that work more efficiently elsewhere.

But to come back to your question about the logical divide, there is none. Whatever the product, it is "just, good, and proper" for the government to ensure that everyone's basic needs are met. How it does that is a matter of pragmatism not a logic.

what about "healthcare" for those people who don't ascribe to "usual" medicine. there are a number of people who refuse to accept medical care from an actual md, and instead use crystals and herbs and whatnot. are we to pay for these alternatives as part of this plan - even though there is no evidence they work? if we say no, it would only be a matter of time before someone says that we are violating their religious freedoms and we *must* provide these things for them.

Neither privat nor the compulsary insurances cover that.

Though most private and many compulsary pay e.g. for accupuncture, quite a few alternative practitioners.

And of course both kind of innsurers pay the 'kur' ('drinking the waters'/treatment at a health resort).


(There are nearly 300 insuring companies in the compulsary sector and I don't know how many in the private. Each have their "special offers".)

I am familiar with and do understand the adverse selection principle. I agree it does indeed corrupt the socially tolerable workings of a free market for health care services. I am also familiar with the very adverse side effects of government operated systems such as those in the UK and Canada - I don't think they are a net improvement, particularly in view of their collateral effects on other aspects of the society & economy. Moreover, I think they would work less well here than in those countries.

Beyond that I am troubled by the defects of the "system" we have, and, despite a strong personal conviction that systems of any kind imposed from above are generally undesirable if there is a practical alternative, do think seriously about the tradeoffs in some national insurance scheme such as exists in Germany. That's what motivated my questions.


(Damn, that was hard!)

Well, if "if that jackass Clint could do it so could you" :wink: