IT'S TIME FOR UNIVERSAL HEALTH CARE

We've been hearing an awful lot about how Canadians come to the US to have surgery. What's being ignored are all the Americans who leave this country to have surgery in South America, India, Spain and other places in Europe. I'm guessing more Americans leave the US for surgery than people coming to the US.

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I see no harm in the citizens of Canada or the United States travelling to find cheaper sources of surgery medical treatment. These are free choices and, if they occur in sufficient number, they generate new sources of supply in the country whose physicians provide the service.

The Public Health division of my company has close links to Johns Hopkins in Baltimore Maryland - a large teaching and research hospital. Hopkins operates a very large treatment center in Baltimore expressly for foreigners who come there for treatment. It isn't near any border, but the quality of the care attracts people from great distances. I suppose we could regulate it into the plain vanilla status of a community public health center, but then the country would lose an institution that provides important and innovative research and new treatment techniques.

Centrally directed and designed "systems" for health care, manufacturing, agriculture, the distribution of goods and services, etc have always had a certain conceptual appeal -- they look so simple and always appear to offer so many economies through the elimination of the duplicative efforts individual managers, proprietors, and owners. However, unfailingly they yield mediocrity, rationing,, and poor quality. Worse, they require the force of government to limit the freedom of individual people to chose other sources. I am profoundly skeptical of such systems, and note that the discussions here tend to focus on the promise (as opposed to the fact) of these systems, and a certain revulsion towards the very free market principles that created the wealth of the North Americans and Europeans who populate these threads.

Freedom is better.

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It's been in the news for years that people from Michigan and New York State get OHIP (Ontario Health Insurance Plan) cards fraudulently, and come to Ontario for treatment using those cards.

At last report, the Ontario auditor reported that there are

Quote:

300,000 more OHIP cards than Ontarians

ctv link

I don't believe they're all in the hands of Americans coming to Canada for treatment, but I do believe that there is at least some cross-border traffic.

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I also believe in laissez faire, but there are some things a developed nation needs to consider for the good of the whole. I include universal health care in that group of societal needs that helps everyone. A healthy society is good for everybody, but especially the children who will take our place to continue our way of life. Sickly, uneducated children will only hurt our country.

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ehBeth wrote:

It's been in the news for years that people from Michigan and New York State get OHIP (Ontario Health Insurance Plan) cards fraudulently, and come to Ontario for treatment using those cards.

At last report, the Ontario auditor reported that there are

Quote:
300,000 more OHIP cards than Ontarians

ctv link

I don't believe they're all in the hands of Americans coming to Canada for treatment, but I do believe that there is at least some cross-border traffic.

I wonder how many of those are in the hands of illegal immigrants?

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Not so much of an issue here, c.i.

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cicerone imposter wrote:

ehBeth wrote:
It's been in the news for years that people from Michigan and New York State get OHIP (Ontario Health Insurance Plan) cards fraudulently, and come to Ontario for treatment using those cards.

At last report, the Ontario auditor reported that there are

Quote:
300,000 more OHIP cards than Ontarians

ctv link

I don't believe they're all in the hands of Americans coming to Canada for treatment, but I do believe that there is at least some cross-border traffic.

I wonder how many of those are in the hands of illegal immigrants?

This from a Canadian source pro-amnesty for illegals (ie their estimates probably much too low):

Quote:

.......... some estimates currently place at more than 200,000 illegal immigrants in Canada predominantly living and working in Toronto.

http://www.immigration.ca/permres-gii-amnesty.asp

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Well, while we are on the subject of Canadians, the government there has made itself the principal buyer of pharmaceuticals and has used both its size & market leverage and its power to authorize the production of generic alternatives to shake down the Pharmaceutical companies into much lower prices. A very clever schems and certainly in the self interest of Canadians. However a result is that American consumers are in effect subsidizing the research costs and profits of international Pharmaceutical companies (about half of them American-based) for the consumers in other countries with similar government-contriolled systems.

I would legislation requiring International pharmaceutical companies to limit their price in the U.S. to the lowest price they offer any other government buyer. That would very quickly destroy the bargaining leverage of these other countries and raise the prices they pay, thus restoring the free market.

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ehBeth wrote:

It's been in the news for years that people from Michigan and New York State get OHIP (Ontario Health Insurance Plan) cards fraudulently, and come to Ontario for treatment using those cards.

At last report, the Ontario auditor reported that there are

Quote:
300,000 more OHIP cards than Ontarians

ctv link

I don't believe they're all in the hands of Americans coming to Canada for treatment, but I do believe that there is at least some cross-border traffic.

Very plausible. Government programs are generally very easy to scam, and there is no shortage of people here and elsewhere willing to do so. Corruption of this kind, and analogous scams by providers, are an inescapable byproduct of such government systems. This is a good argument for Canada to abandon its present system.

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george wrote :

Quote:

Well, while we are on the subject of Canadians, the government there has made itself the principal buyer of pharmaceuticals and has used both its size & market leverage and its power to authorize the production of generic alternatives to shake down the Pharmaceutical companies into much lower prices.

i am under the impresssion that any large buyer of goods and services
usually gets a reasonable discount , automobiles , food , larger packages of medication , to cite just some examples .
i was under the impression that the FREE MARKET allows sellers and buyers to negotiate a price that both parties find acceptable .
are you in favour of more GOVERNMENT CONTROLS over the FREE MARKET , george ?

the pharmaceutical companies would likely not be willing to sell to the canadians - or any other buyer - unless the could make a profit , i'd think .
i certainly have not heard of any complaints by big pharma about striking deals with canadian buyers - have i missed something ?
hbg

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They aren't complaining because they can charge U.S. custommers who buy individually whatever they discount to the Canadian government buyer. It is the Canadian government that is abusing its power, particularly that of authorizing production of generics (to bypass patent ownership) to distort the free market. All I am suggesting is that we require the pharmaceutical manufacturers tio give U.S. consumers the same deal that Canada extorts from them. This would very quickly raise prices in Canada, and lower them here.

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Miller wrote:

Quote:
Eliminate the gigantic costs of bringing any new medicine to the market

Without cash, how could there possibly be basic research?

I meant the gigantic bureaucratic/governmental costs.

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[quote="High Seas] This from a Canadian source pro-amnesty for illegals (ie their estimates probably much too low):

Quote:

.......... some estimates currently place at more than 200,000 illegal immigrants in Canada predominantly living and working in Toronto.

http://www.immigration.ca/permres-gii-amnesty.asp[/quote]

I'm familiar with this guy. I'd suspect his numbers are off, but not in the direction you're suggesting.

The current Cdn population is 33,390, 141. The current USA population is 301,139,947 (two quick googles). So the US population is roughly 9x that of Canada.

If we use the 200,000 number for illegal immigrants in Canada, there should be 1,800,000 illegal immigrants in the U.S.A. The google on that gives estimates ranging from CNN's 7,000,000 to upwards of 12,000,000.

The issue/concern re illegal immigration is of quite a different dimension in the U.S.A.

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george wrote :

Quote:

All I am suggesting is that we require the pharmaceutical manufacturers tio give U.S. consumers the same deal that Canada extorts from them.

free market , george , free market !

if the pharmas don't want to sell to canadians , do you think they would be FORCED TO ?
isn't there some law in the united states forbidding large U.S. buyers from negotiating prices with big pharma ? if that is indeed the case , i have to wonder how that law was enacted - i would doubt that american citizens asked for such legislation - or did they ?

(not on topic : quite a few canadian citizens are unhappy about canadian RAW MATERIALS - lumber and oil in particular - being sold to the united states . they think that canada should be selling FINISHED PRODUCTS instead , since a better profit could be made and more people could be employed in the processing of such raw materials ; but here too , the free market allows corporations to export those RAW MATERIALS FREELY ! )

perhaps the FREE MARKET isn't really that beneficial ?
(some are saying : "we want a FAIR MARKET , not necessarily a FREE MARKET ! )
hbg

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I think you are deliberately missing the point. The Canadian government uses its power, both as the only authorized buyer of pharmaceuticals in Canada, and as the licensor of generic manufacture of patented drugs, to extract price concessions from pharmaceutical companies that are well below the market price. Other countries have done this as well. A result of all this is that countries such as the United States, which do not interfere with the market for pharmaceutical production and sales, pay a much higher price - in effect subsidizing those of consumers in countries with exclusive government buyers. We should simply counter this efffect by demanding the best deal offered elsewhere, thus rendering this tactic void.

If Canadian manufacturers of finished wood products wish to enter the U.S. market they certainly can do so. Canada enjoys a very positive balance of trade with the United States - one large enough to overcome the fact that with the rest of the world, Canada is a net importer. Canadians do seem to whine more about these things though.

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george :

honestly , i'll try one last time !

are the u.s. pharma FORCED TO SELL TO CANADA ?

does U.S. legislation forbid american buyers from negotiating prices with big pharma ?
hbg

BARGAINING FOR DRUG PRICES
you can read it here :

Quote:

In his State of the Union address this year, President Bush urged members of Congress to work with him to help control the rising costs of medical care. Just months ago, however, the president worked with Congressional leaders to block attempts to control the fastest growing health care cost: prescription drugs. The Medicare prescription drug benefit that the President signed into law and lauded in his speech omits any effective mechanisms to lower prescription drug prices. Instead, the President and Congressional leaders drafted the law with the intent of emulating the private market practices that have brought us to where we are today - exploding prescription drug costs that are increasingly borne by patients due to health insurers' restructuring of drug benefits. Even if the Medicare program experiences similarly unsustainable costs, the new law expressly forbids the secretary of Health and Human Services from acting to ensure reasonable prices under the drug benefit.

is the above incorrect , misleading or not the true story ?

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hamburger wrote:

george :

honestly , i'll try one last time !

are the u.s. pharma FORCED TO SELL TO CANADA ?

does U.S. legislation forbid american buyers from negotiating prices with big pharma ?
hbg

No, U.S. and other pharmaceuticals are not forced to sell to the Canadian government. Instead, if they do not consent to the government's terms they are faced with a Canadian prohibition of sales in the country and, in many cases, action by the Canadian government to authorize Canadian production of generic substitutes for patented drugs. This is hardly the action of a free market. It transfers cost to countries that do not engage in such practices.

The U.S. generally avoids such market controls as a matter of long-standing economic policy. It is true that U.S. consumers could conceivably form buying cooperatives to negotiate better prices from pharmaceutical companies. However, without the coercive force of government, they are not likely to be effective.

The remedy I propose is also contrary to American practice, but in this case I believe it would be fair, simple, easily enforced and instantly effective in restoring balance to the free market.

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gungasnake wrote:

Miller wrote:
Quote:
Eliminate the gigantic costs of bringing any new medicine to the market

Without cash, how could there possibly be basic research?

I meant the gigantic bureaucratic/governmental costs.

If you eliminate NIH funding, then you'll basically eliminate most of medical research in the USA.

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georgeob1 wrote:

Instead, if they do not consent to the government's terms they are faced with a Canadian prohibition of sales in the country

Would this cause any kind of problem for them?

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georgeob1 wrote:

Instead, if they do not consent to the government's terms they are faced with a Canadian prohibition of sales in the country and, in many cases, action by the Canadian government to authorize Canadian production of generic substitutes for patented drugs.

A really interesting report shows e.g. that in the USA are quite more generics sold than in Canada.

Generally, generiss are internationally only allowed after the patents expired. Are you really certain that the Canadian government sponsors illegal acts and even without legal action by the patent holders?

And speaking about patents (and trademarks): the USA doesn't consider Aspirin® to be a trademark ....

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IT'S TIME FOR UNIVERSAL HEALTH CARE

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