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I generally do not write diaries partly because I view this site as a discussion forum for Americans and I am an interested observer.  I comment from time to time and have often been impressed by the writing skills of the various diarists.  I am also fascinated by the US healthcare debate having lived in a country (Canada) which has had universal healthcare for as long as I can remember.  I say that despite having recollections of the worried look on my father's face when someone in our family needed more than just a visit to the family doctor.  He paid for my birth and that of my brother and sister out of pocket and I know that those bills took years to pay off.  But by the mid 1960's, that worry was gone as universal healthcare was adopted in Canada.  We had been moving down that road for some time before that.  In 1946, the year before I was born,  Premier Tommy Douglas' Cooperative Commonweath Federation (CCF/Socialist) government in Saskatchewan passed the Saskatchewan Hospitalization Act which was a major step in providing healthcare to all Saskachewan residents.  Douglas is considered a Canadian icon for more than being Keifer Sutherland's grandfather.  In 1957, Prime Minister Louis St Laurent's Liberal government passed the Hospital Insurance and Diagnostic Services Act which was a major step in univeralizing healthcare for all Canadians.  This was followed by action by one of our most underrated Prime Ministers, Mike Pearson, who passed the Medical Care Act in 1966 which in effect gave us univeral healthcare.  There have been changes and enhancements along the way but these were the key steps.  We tend to take it for granted but we only have to pay attention to the stories of people without healthcare coming from the US to remember just how lucky we are.  Tonight I read an excellent diary from Pluto regarding the impact of states not accepting Medicare expansion.  I am married to an American who has lived in Canada as long as we have been married (42 years)  She still stops at the receptionist's desk after a doctors appointment to pay after a doctor's appointment and is amazed when she doesn't have to. Both she and I have been treated in our healthcare system for serious or potentially serious conditions as have members of our extended family.  The care has always been efficient and world class and we do not receive a bill other than what we pay in taxes. (in my case for family coverage about $3600 per year including estimated gas and luxury tax levies)  People at incomes less than mine pay less and at the lower income levels pay no income tax for healthcare.  Pluto's diary reminded me of a conversation I recently had with my Teabagger American Brother in Law who said to me "give me one good reason why I should pay for someone else's healthcare"  Having recently read a number of articles about Tommy Douglas and seen a documentary narrated by Paul Gross about Mike Pearson, I had an answer.  I replied, "I'll give you seven"  They are below the fold.

1) People constitute a country's human resources just like a country's natural resources.  You agree with doing everything necessary to preserve and protect your natural resources--why wouldn't you do the same for your human resources
 2) it's part of being a country--we all look out for one another
 3) it's cheaper because in the end you pay anyway for emergency room treatments instead of the far more inexpensive preventative care
 4) it's good for the economy.  By taking the weight off if employers to provide health insurance, we reduce the cost of production and make ourselves more competitive internationally
 5) it makes for a more flexible, mobile workforce when people do not have to hang on to the job they have so they won't lose healthcare
 6) it meets every religious ethical standard.  Christian by way of Christ's teachings regarding caring for the lesser of us etc.  Islam--one of the five pillars, caring for the weak and the poor.  Buddhism, Hindu etc. etc.
 7) it's humane

The response was one of those typical vacant stares.  Another American relative commented rather heatedly that this was socialism and that it was un American.  At one point someone asked if I liked Obamacare and I replied that it was a big step forward but that I had one problem with it.  He asked what it was and I replied that it was "not socialist"  That pretty much ended that conversation.
This subject along with gun control and my obvious high regard for your president has basically ensured that I don''t get invited to family gatherings much anymore.  So be it.

12:02 AM PT: A few further thoughts and some mythbusting
-We can choose our own doctors including specialists.  Referral to a specialist is through your primary care physician and you can state a preference for specialists
-Our system is triaged so the most serious get treated first.  That means that elective type surgery such as most hip and knee replacements will take longer that something like heart bypass or cancer
-Our longest wait for a specialist (my wife and I) was 4 weeks and that was for my hip surgery
-Canadians do go to the US often because they are willing to pay to have immediate service such as knee or hip imaging.  Personally, I know no one who has sought medical care in the US and the stories that are reported are distorted and almost devoid of background facts.
-Many Americans seek care in Canada either because it's cheaper and they have no or inadequate health insurance or because of a range of medical specialties that are available here. (e.g. Shouldice Clinic, Hemangeoma centre of expertise at Toronto Sick Childrens Hospital)

1:50 AM PT: "Dogs are Funny" raised what should be the 8th point (I wish I had thought of it myself).  Universal healthcare is more likely to catch communicable diseases at an early stage and therefore serves to prevent or at least reduce the chances of epidemics or in a more minimal but no less important sense, reduces the chances of an illness spreading through a workforce or community

1:44 PM PT: I've been gone for the day and just returned to find this diary on the rec list. Thank you for that and for all the comments

2:49 PM PT: For those of you who might have missed it, edg has posted an excellent link to the AARP debunking a number of persistent myths about the Canadian healthcare system.

Originally posted to Pierretrudeau on Wed Jun 05, 2013 at 11:41 PM PDT.

Also republished by Community Spotlight.

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  •  Tip Jar (194+ / 0-)
    Recommended by:
    worldlotus, webranding, Blue Collar, tardis10, Another Grizzle, Rosaura, WakeUpNeo, Pluto, One Pissed Off Liberal, Cedwyn, rbaillie, cececville, TexasTom, pierre9045, Chi, leema, simple serf, tegrat, Jazzenterprises, princesspat, peregrine kate, lcrp, LoreleiHI, johanus, Russgirl, OrangeMike, Liberty Equality Fraternity and Trees, Greenfinches, pixxer, Shockwave, Softlanded, annrose, TomP, james321, Angie in WA State, Bob Friend, Siri, FloridaSNMOM, sagesource, cassandracarolina, Chaddiwicker, sodalis, shari, jhb90277, Leftcandid, GoGoGoEverton, Tracker, lurker123, zerelda, foucaultspendulum, tommyfocus2003, Yo Bubba, ladybug53, mslat27, Elizaveta, Gowrie Gal, Showman, rat racer, gongee, puakev, smokem2271, JerryNA, allergywoman, cocinero, hyperstation, el dorado gal, Keone Michaels, MKinTN, profundo, ask, hulagirl, Ed in Montana, Miniaussiefan, pvasileff, Sun Tzu, elwior, alrdouglas, oldpotsmuggler, KellyB, akmk, Amber6541, Powered Grace, bryduck, dotsright, poliwrangler, Miss Blue, Hanging Up My Tusks, meralda, ZedMont, LaFeminista, prishannah, gmats, wordfiddler, engine17, TriangleNC, Unbozo, JesseCW, Habitat Vic, rasfrome, Brooke In Seattle, J M F, ColoTim, martyc35, Dvalkure, jck, skepticalcitizen, Eddie C, also mom of 5, Zinman, legendmn, Susipsych, LucyandByron, la motocycliste, OleHippieChick, taonow, ord avg guy, commonmass, Dodgerdog1, mrkvica, hubcap, SherwoodB, Tennessee Dave, smileycreek, chuckvw, kj in missouri, 3goldens, Anne Elk, FindingMyVoice, Loonesta, lcbo, rbird, RAST, rasbobbo, foresterbob, mitumba, roycej, slowbutsure, Jollie Ollie Orange, splashoil, rapala, enhydra lutris, 207wickedgood, on the cusp, flitedocnm, anna shane, jm214, david78209, BYw, edgery, PrometheusUnbound, edsbrooklyn, Rogneid, anodnhajo, camlbacker, HCKAD, kareylou, samddobermann, Trendar, MsGrin, BlueInARedState, Liberal Thinking, fumie, eagleray, FogCityJohn, Bob Duck, catly, SSMir, bloomer 101, begone, Regina in a Sears Kit House, jdld, Shelley99, radarlady, caul, coppercelt, Wino, Sunspots, cosmicvoop, SanFernandoValleyMom, gilacliff, science nerd, zestyann, NapaJulie, JDWolverton, melo, Calamity Jean, Mary Mike, venger, alice kleeman, jennylind, Mathazar, socindemsclothing, Oh Mary Oh, splashy
    •  Add: Walk in clinics for healthcare = pay $100 (25+ / 0-)

      Visited Canada last year and needed to see a doctor.  Found a walk in clinic, paid $100 for the privilege, picked up prescription and I was on my way!

      Note:  Military in the USA has full healthcare coverage.

      WHY NOT the rest of us?  
      Greed at the top.

      Only people learning truth and then waking up to participate together for REAL positive change will effect the outcome.

      All USA citizens should be covered.
      We pay for it.
      It is our right... (now, about those other rights they are taking away due to whatever excused the TBTF come up with vs. the Constitution and Bill of Rights?)

      Say Yes to Health Care.
      Say Yes to Democracy for ALL.

      •  Another good question or point would be... (25+ / 0-)

        Why should any American risk their life in war for someone else's freedom?

        If we should not pay for someone else's health care just because they are a fellow American then why should any other fellow American risk their lives in war for our right to be free?

        It always blows right winger's minds when I explain to them that the U.S.government already pays twice as much per person as the U.S. does for free healthcare for all.  Shouldn't we be able to get twice as good of healthcare as France without paying an extra nickle in taxes?  I always add to that by saying, I currently pay $500 per month for health insurance so if they increased my taxes by $3,000 or so a year for free health care, I would still be saving a ton of money and I should get three or four times better healthcare than France.

        "Perhaps the sentiments contained in the following pages, are not YET sufficiently fashionable to procure them general favour..."

        by Buckeye Nut Schell on Thu Jun 06, 2013 at 09:33:19 AM PDT

        [ Parent ]

        •  Really good point, Buckeye. I have a couple of (11+ / 0-)

          Republican relatives and, so far, nobody has asked why they should pay for someone else's health care. One of my most Republican relatives is currently serving in the military (has been deployed to Iraq 3 times) and it always boggles my mind to see criticism of Obama, along with glorification of Republican philosophy, on his FB page. Should I ever see that question raised on his FB page I'll be sure to ask why he's willing to risk his life in war for someone else's freedom.

          The world is not interested in the storms you encountered, but did you bring in the ship.

          by Hanging Up My Tusks on Thu Jun 06, 2013 at 11:16:26 AM PDT

          [ Parent ]

        •  BNS - we pay twice as much per capita in the US (5+ / 0-)

          than the rest of the G8 because we train our physicians to practice medicine in a completely different manner, and they do. To change the economics of healthcare in the US we will need to add ten of thousands of additional physicians and train them differently. My fear is that the federal government will try and change the price of healthcare services without any attention at the underlying fundamental costs. That will lead to more physician shortages, particularly for rural and poor patients.

          "let's talk about that"

          by VClib on Thu Jun 06, 2013 at 12:42:57 PM PDT

          [ Parent ]

          •  I disagree (11+ / 0-)

            The cost of medical care is driven by administrative PROFIT.
            Check the profit margins of Blue Cross or other insurers some time. In addition, each insurer has to hire a slew of (underpaid- but it adds up) minions to administer the insurance, and it adds up. Each hospital has to hire admin staff to deal with the insurance companies - adding more to cost.

            Hear whining about malpractice? The cost of malpractice is driven by the cost of fixing the mistakes of the first doctor- which under a Canadian system is much, much lower.

            More whining about rationed care? We have rationed care- right now. Care is rationed by what the patient can afford.

            •  la moto - I completely disagree (1+ / 0-)
              Recommended by:
              Roadbed Guy

              The ACA has capped non medical expenses for big insurance companies at 15%. So with Medicare at 3% you have a savings of 12%. When you add all of the uninsured and people with junk insurance into the single payer pool it will overwhelm the 12% by a factor of two or three. The 12% is a meaningful savings, but it is a small part of why our healthcare costs are two times the rest of the G8.

              "let's talk about that"

              by VClib on Thu Jun 06, 2013 at 01:09:23 PM PDT

              [ Parent ]

              •  Please explain (2+ / 0-)
                Recommended by:
                elwior, JerryNA

                We are talking about NON MEDICAL EXPENSES, which you express as a percentage of MEDICAL EXPENSES. How does adding an uninsured person or a person with junk insurance to the medicare pool increase the PERCENTAGE (not the absolute amount) of non medical expenses?

                •  Under the ACA insurance companies now have to pay (0+ / 0-)

                  out 85% of premiums for actual healthcare. So that leaves 15% for all the administrative costs, including executive compensation. So if the federal government just took over the clients and claims of an insurance company it would have about 12% savings it could spend on new patients. If you add together all of the people in the US who are insured with private insurance you could have a savings of 12% on all of them. That's your pool if all of the participants were the same and everyone continued to pay into the healthcare system at exactly the same rate they do now. (of course that will change but I am trying to hold as many variables constant as possible) With our new pool of 12% of healthcare spending how many new currently uninsured people can we bring into the tent? My guess is that the number of uninsured is at least twice as large as our 12% savings.

                  Real reductions in healthcare expenses start with changing how we practice medicine.

                  "let's talk about that"

                  by VClib on Thu Jun 06, 2013 at 03:20:53 PM PDT

                  [ Parent ]

                  •  this is wrong — you are mixing two things. (1+ / 0-)
                    Recommended by:

                    that 12% you are claiming as saving is only over those with private insurance — not of overall healthcare costs. That is a much smaller amount.

                    Secondly, The low amount you claim for Medicare administrative expenses is deceptive. That is just for the costs of the payouts. The other costs are in HHS, FDA and the Justice Department plus the Congress which butts in too much. HHS does lots of work — which has to be paid for, to set fees and rules and has its owns team of fraud investigators. The DOJ by the FBI has a very active fraud program. Have you been ignoring the all the arrest of networks of criminals, of doctors, nurses and pharmacists primarily who have been ripping of Medicare and Medicaid of millions of dollars. This to the tune of 10% of all Medicare spending. The states run their own Medicaid programs and theft there is big also. In the last Florida election for Governor  the never refuted estimate was made of $3 billion in fraud. It is not much different

                    The private insurers don't have similar amounts of fraud. They can easily eliminate doctors that they suspect of fraud and .

                    The Obama administration has made big strides to get rid of fraud. Some law changes blocked some common frauds but it was and always will be an ongoing fight. And that fight is expensive. Add that to the total of administrative costs.

                    Yes, we must change how medicine is practiced. We must eliminate the sloppy practices leading to very extensive harm to patients and also rein in using  unproven and often potentially harmful treatments. Over treatment is a bigger problem that lack of treatment.

                    I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

                    by samddobermann on Thu Jun 06, 2013 at 10:28:26 PM PDT

                    [ Parent ]

            •  Not to mention... (11+ / 0-)
              More whining about rationed care? We have rationed care- right now. Care is rationed by what the patient can afford
              The insurance companies ration what care you can get every day.  I would trust the government to administer healthcare more fairly than I would a corporation whose profit margin is based on not paying for your treatment.

              "Perhaps the sentiments contained in the following pages, are not YET sufficiently fashionable to procure them general favour..."

              by Buckeye Nut Schell on Thu Jun 06, 2013 at 01:17:57 PM PDT

              [ Parent ]

            •  Not true. Administrative expenses (2+ / 0-)
              Recommended by:
              elwior, Roadbed Guy

              are a small part of the cost of healthcare. It is the underlying costs of the medical care, the drugs, the equipment used and supplies that are driving costs.

              The cost of malpractice is driven by the cost of fixing the mistakes of the first doctor- which under a Canadian system is much, much lower.
              That makes no sense. The high medical CARE costs are because so many doctors and hospital staff commit malpractice — that is make so many stupid sloppy preventable errors that our system is plagued with. It is not the fault of the cost of either malpractice insurance of of court case judgments.

              Although it is changing now, hospitals and doctors who harm a patient get to bill for all the treatment designed to mitigate that harm. Thus sloppy care is enriching and raises the overall costs.

              Other countries don't have nearly as much of the problem of sloppy care that we tolerate.

              We have over 100,000 deaths and many more of harm to patients from infections that they get in the hospital. That is outrageous — and very expensive. We have another 100,000 deaths from other malfeasance of the providers of our medical care.

              Where is your outrage for these expensive costs that all of us pay for?

              One out of three patients in a hospital have serious errors made on them. And this is probably an understatement; dead people don't respond to questions. Furthermore many people are subjected to worthless procedures for which there is no evidence at all but they don't even know can harm them rather than help.

              The high costs of health care plagues even Medicare which is a single payer system. That is why much of the ACA is concentrated on the Medicare and Medicaid programs.

              I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

              by samddobermann on Thu Jun 06, 2013 at 08:10:12 PM PDT

              [ Parent ]

          •  There will be a transitional cost... (10+ / 0-)

            but the main differences in cost come from over priced medicine, financial incentives to treat the symptoms rather than the cause, insurance profit margins, hospitals overpricing to make up for the insurance companies bullying tactics and exorbitant salaries for hospital executives. A fifteen minute consultation and a  half a teaspoon of benedryl at the ER should not cost $300 deductible plus whatever the insurance paid(daughter had a bee sting that swelled up like a balloon when she was three).

            If the U.S. negotiated all medication under a single payer system, forced hospitals to treat the patient and not the symptom, encouraged prevention as opposed to cure, forced new medicines to prove they were better than the existing treatment rather than a placebo and held administration costs down to current medicare levels, the costs would decrease even with adding more doctors.

            Other things that would help would be to charge a processing tax on food for everytime it is processed and use the money earned to subsidizes unprocessed foods.  That would help poor people eat healthier and prevent the need for a lot of medical care.  Provide free clinics in rural areas where people could speak to a doctor without paying $30 a visit and prevent tying up emergency rooms for non-emergency issues.  It would also keep people from waiting until that chest pain becomes a full blown heart attack.

            "Perhaps the sentiments contained in the following pages, are not YET sufficiently fashionable to procure them general favour..."

            by Buckeye Nut Schell on Thu Jun 06, 2013 at 01:13:40 PM PDT

            [ Parent ]

            •  Our healthcare system suffers from unchecked greed (4+ / 0-)

              and self-interest. The needs of the people are the last consideration. Many people have been trying for decades to bring about universal health coverage and some of its biggest enemies have been the AMA itself.

              It was argued by economist Irving Fisher in 1916 that Germany's industrial progress, physical preparedness of its soldiers and its comparative freedom from poverty were due in great part to health insurance. It started to gain ground but then the Kaiser blew that opportunity and the very notion of universal health insurance became "un-American". That propaganda still works today with calls of "socialism".

              I wonder how the label of "un-American  would have gone over when John Adams signed an "Act for the relief of sick and disabled Seaman" in 1798. Taxes were collected to build hospitals and provide for medical care for merchant and naval seamen.

            •  You haven't looked at real world problems. (1+ / 0-)
              Recommended by:

              Find doctors for all the rural areas? There are Community Health Centers in most rural areas but you can't put a clinic  in every hamlet.

              What about you?

              A fifteen minute consultation and a  half a teaspoon of benedryl at the ER should not cost $300 deductible plus whatever the insurance paid(daughter had a bee sting that swelled up like a balloon when she was three).
              Why did you run to an ER? Did you call your own doctor? Did you call the nurse line? Virtually all insurers have nurse lines you are encouraged to call. Did you try treating her at home? You could have given her benedryl on your own. Unless the sting was affecting her breathing, which you didn't mention, it was hardly an emergency.

              Most non emergency visits are from people with some form of insurance. Like you.

              A part of the problem is that doctors fob people off and tell them to go to the ER. It is sometimes smart but it is often overdone. Then people with real problems have to wait.

              People need to take control and think about what they can and want to do. You choose to go to the ER.

              You really want government to force hospitals, and by that you mean doctors to practice the way you deem proper? The biggest opponents of that would be the doctors, not all but many. Patients are going to have to demand that; they won't change on their own or by fiat.

              And that goes for medicines. Patients often demand the newest of the new. Too often do they ask if there is any evidence for the drugs that are given. Patients often demand what they just heard about on TV or read on line or in journals. They swear by quack meds. How many times have you heard people extolling homeopathy? Or the herbal substances, most of which is bunk.

              Processed foods are not all bad. And not everyone would agree with you about what is bad or good. Look at the stink that went up about the NY mayor banning super size drinks. Now I think the way the law was written, excluding convenience stores got it tossed out. But that sort of regulation drives people crazy.

              Most first heart attacks are not preceded by chest pain and early treatment won't prevent all of them.

              It is true that if people would eat better and exercise more they would be in better health but that is not always achievable. Many areas are food deserts and people don't have access for healthy foods. And people with 2 or 3 jobs plus kids don't really have time to set aside for those things.

              And often people won't do what they even know they should be doing.

              I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

              by samddobermann on Fri Jun 07, 2013 at 12:04:48 AM PDT

              [ Parent ]

              •  Well, I have apparently struck a nerve... (3+ / 0-)
                Recommended by:
                ScienceMom, Calamity Jean, JerryNA
                Why did you run to an ER? Did you call your own doctor? Did you call the nurse line? Virtually all insurers have nurse lines you are encouraged to call. Did you try treating her at home?
                Yes, I did call our pediatrician and due to how quickly she had a reaction, he advised that we take her straight to the ER.  We were broke so the $300 co-pay was not something we wanted to pay.  
                it was hardly an emergency.
                Thank you Captain Hindsight for that brilliant deduction.  You were not there and you did not see your 3 year old swelling up like that.  I'm glad that you can sit here and judge whether something was an emergency 14 years later when the doctor on the phone at the time who knew us and our child said to take her to the ER.  If she would have died, you would have been the first person to say that it was our fault for not taking her to the ER.
                You really want government to force hospitals, and by that you mean doctors to practice the way you deem proper?
                Well, it seems to be working in just about every other industrialized country in the world.  Not only do the vast majority of those countries enjoy better health care but they also pay less for it.  Give me an example of a country you would like to bench mark with.  What we are doing is obviously not working with skyrocketing cost and thousands of people dying every year from preventable causes.  You tell me what system you think would work.
                And that goes for medicines. Patients often demand the newest of the new. Too often do they ask if there is any evidence for the drugs that are given.
                Do you know why they demand the newest of the new?  Marketing campaigns aimed directly at the patients.  Ever wonder why they advertise prescription medication that people cannot buy on television?  Two reasons really.  One is as long as they are customers to the news media, they will not be targets of them and two, they know that patients will pressure their doctors for the best cures.  80% of pharmaceutical companies R&D budget is spent on tweaking existing medications for new patents.  It does not matter if it is better than the previous drug or not.  It only has to be better than a sugar pill and they can get a patent on it and market it as if it was the best thing since antibiotics.  If the FDA would not approve these medicines unless they could prove they were better than the existing treatment in some way then they would have to spend their money on truly finding new drugs.
                Most first heart attacks are not preceded by chest pain and early treatment won't prevent all of them.
                I have known two people in the last five years who died that experienced chest pain for hours prior to their heart attack.  One went to the ER and was denied treatment due to lack of healthcare (they said it was probably gas and sent him home) and one didn't even go to the doctor because of lack of healthcare.  Maybe whatever study you got your information from missed those two accounts.
                It is true that if people would eat better and exercise more they would be in better health but that is not always achievable. Many areas are food deserts and people don't have access for healthy foods. And people with 2 or 3 jobs plus kids don't really have time to set aside for those things.
                Well said.

                "Perhaps the sentiments contained in the following pages, are not YET sufficiently fashionable to procure them general favour..."

                by Buckeye Nut Schell on Fri Jun 07, 2013 at 04:56:54 AM PDT

                [ Parent ]

            •  Many great points and truths in your comment BNS. (0+ / 0-)
          •  This is true for sure: (1+ / 0-)
            Recommended by:
            we train our physicians to practice medicine in a completely different manner, and they do.
            But I don't see how it follows that by changing that, we'd need more physicians.

            the problem now is the medicine in the USA is mostly practiced on a reimbursement for procedure model - so, physicians have an incentive to pile on the procedures.

            the other model would be to have reimbursement for "keeping people healthy" - in this case the emphasis would shift to preventative care and away from after the fact procedures.  It would be both less expensive AND require fewer (or at least not more) physicians.  which is why they hate the idea, of course.

            •  Roadbed Guy - its supply and demand (3+ / 0-)
              Recommended by:
              Roadbed Guy, nextstep, JerryNA

              As we provide more access for more people we need more physicians to treat them. Even where I live, in the SF bay area, it is nearly impossible to find physicians who will treat Medicaid (we call it MediCal) patients and a growing number won't treat Medicare patients.

              I agree as we change the reimbursement model and that will help, but that requires enrolling people in a plan, like Kaiser, that has an incentive to keep people healthy and provides a mechanism to economically reward good outcomes.

              "let's talk about that"

              by VClib on Fri Jun 07, 2013 at 07:43:34 AM PDT

              [ Parent ]

              •  Yes, your last paragraph is what I was getting at (2+ / 0-)
                Recommended by:
                Calamity Jean, JerryNA

                Medicare spending in Rochester falls in the lowest 15 percent in the country — $6,688 per enrollee in 2006, “which is $8,000 less than the figure for McAllen.” Costs are lower because, among other reasons, Mayo pays its physicians salaries, taking away the incentive to bring in more income with more testing, more operations, more high tech imaging, more, more, more.

                Dr. Gawande then observed: “Most Americans would be delighted to have the quality of care found in places like Rochester, Minnesota, or Seattle, Washington, or Durham, North Carolina—all of which have world-class hospitals and costs that fall below the national average. If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next 50 years) would be solved.


                Again, with the vast reduction in procedures it is not clear to me that the incrementally more people who would be brought into the system would require a huge increase in the number of physicians.

                For comparison we already have about 10% more physicians than Canada - a country that is often touted right here at DailyKos as having better medical care for all its citizens than we do.

    •  It is! Thank you. nt (5+ / 0-)

      I was gonna listen to that, but then, um, I just carried on living my life. - Aldous Snow

      by GoGoGoEverton on Thu Jun 06, 2013 at 09:20:33 AM PDT

      [ Parent ]

    •  It certainly should be. (3+ / 0-)
      Recommended by:
      elwior, 3goldens, Rogneid

      But of course only if the RWs actually listen.

      Thank you for your very informative diary.

      Being the single intellectual in a village of 1,100 souls ain't much fun, especially when 1,099 of those don't think you're all that smart.--Lucy Marsden

      by Miniaussiefan on Thu Jun 06, 2013 at 10:31:19 AM PDT

      [ Parent ]

  •  Paying for someone else's health care (40+ / 0-)

    They're doing that every time they write a check for an insurance premium and someone else files a claim.

    It'll be their turn next to benefit from the system they're paying into.

    Freedom isn't free. Patriots pay taxes.

    by Dogs are fuzzy on Wed Jun 05, 2013 at 11:58:41 PM PDT

  •  Here's my standard advice when it comes to (23+ / 0-)

    talking with a conservative regarding single payer.  FWIW, I'm a "conservative" and I'm pretty sure I would support single payer coming to America.

    Anyway, start with a basic tenet of being effective and that is to "seek first to understand, and then to be understood."  Applying that in this situation, I would encourage you to ask him what attributes of a healthcare system are important to him.  If he doesn't quite get the question you could perhaps offer some of the attirbutes that are important to you.  For example, if I were asked I would say that probably the three most important factors to consider when looking at any nation's healthcare system are the outcomes that the system produces, the access to the system and the cost of the system.

    Once you have him state the factors that are important to him, you will have essentially won the argument.  Because while there are other factors to consider (wait time, being able to choose your own doctor, etc.) those are the three biggest elephants in the room and while teabaggers may not know it single payer is as a good as, if not better, than the US's system when it comes to outcomes, single payer has far better access and the cost of single payer is significantly lower than the US's system.

    If you get a person to state  what they truly care about you will know what issues to keep presenting to them in the future.  You don't "win" by winning a debate on a particular day.  You win by planting the seed, watering it, nurturing it and watching it bloom into supporting single payer.  This takes a long time and is frequently thwarted by the ignorance and apathy on the part of the teabagger but once you know the aspects that they consider important, you will know the key to getting them to see the light.  

    PS If they happen to favor low wait times to see a doctor that is fairly easily trumped by asking them which is more important, to do something quickly or do something right?  If they think it is to do it right, then they really value the  outcomes of a system more than they value wait times and that favors single payer.

    And if they favor being able to choose your own doctor, well, my understanding of the situation is that in single payer systems virtually all doctors take single payer money.  In the US, doctor's are in networks and while you can go see out of network doctors they require you to pay more.  So when it comes to choosing doctors it would seem that you would have actually more choice under single payer than in our current system.  (But maybe I'm wrong on this issue).

    Anyway, this type of thinking is how I became a "conservative" that supports single payer.  Maybe taking a similar approach to another conservative may help you help them see the light as well.

    We cannot solve our problems with the same thinking we used when we created them. Albert Einstein

    by theotherside on Thu Jun 06, 2013 at 05:00:36 AM PDT

    •  Good Luck With That Logic Thing (11+ / 0-)

      My tea bagger relatives unfortunately have built up a serious resistance to logic, and their defensive wall of simple-minded formulaic mantras is breathtaking.  "Socialism! . . So there!"

      The nurturing idea is nice, but don't forget the need for a sh!!load more sunlight.

      In the U.S., our healthcare is like a privatized navy, owned by lumber companies that tell us we can't make ships out of steel, 'cuz steel sinks.  (Hey, look at that Canadian Cutter go.  But, but, Socialism! . . So there!)

      "After the (job losses) and (austerity) they won't be the same human beings you remember. Slaves?. . let's just say, they'll be satisfied with less" -Naomi Klein's Shock Doctrine, as explained by Ming the Merciless.

      by Softlanded on Thu Jun 06, 2013 at 09:11:59 AM PDT

      [ Parent ]

      •  Socialism (3+ / 0-)
        Recommended by:
        Calamity Jean, JerryNA, Softlanded

        I heard a little piece on the radio the other day about how younger folks have a positive association with the word socialism.  They also have a positive association with the term "Big Government".  
        So hopefully the teabaggers will can keep screaming socialism/big government over and over again because it is driving the youth away from the right.

        •  Golden Rule: Question Your Elders (1+ / 0-)
          Recommended by:

          Particularly those who haven't figured out that newfangled internet thingy, and/or can't be bothered to look stuff up to better understand the complexities of the world.  People who do, and therefore stand a better chance of knowing a little something about socialism, see the positive qualities. Unfortunately there are those who have only a Fox-grade education, (and much more likely to be obsessively fascinated by shiny metal objects and balls of lint); those folks automatically soil their undies when hearing the word 'socialism' without knowing a damned thing about it.

          Follow the logic, if you will:  

          Socialism is bad because everything costs more without free market competition.  

          We can't have single payer healthcare like they do in Canada, (even though it costs way less) because it's socialism.

          "After the (job losses) and (austerity) they won't be the same human beings you remember. Slaves?. . let's just say, they'll be satisfied with less" -Naomi Klein's Shock Doctrine, as explained by Ming the Merciless.

          by Softlanded on Fri Jun 07, 2013 at 04:00:57 PM PDT

          [ Parent ]

    •  Um, how about doing what I did once? (7+ / 0-)

      Don't mention single payer at all. Just say, "You know, it'd be great if they just opened up Medicare to everybody." I got a guy in my office last year who wanted to rant about Obamacare at me, but that's what I started off with and he agreed with me, before saying insane crap about how bad the ACA was.

      •  That would have been the smart thing. (5+ / 0-)

        Medicare For All. Start by letting employers buy into Medicare for their employees and individuals buy in for themselves. Adjust the payroll tax by a couple percent to pay for increased enrollment and then start dropping the enrollment age by 10 years every 2 years until everyone is covered as those 65 and older are now.

        A waist is a terrible thing to mind.

        by edg on Thu Jun 06, 2013 at 11:49:34 AM PDT

        [ Parent ]

        •  You do not understand what Medicare is. (2+ / 0-)
          Recommended by:
          elwior, ScienceMom

          Medicare B requires premium payments and has a rather high 20% copay. But the premiums cover only 25% of the costs so the rest comes out of general tax funds. And those costs are what is breaking the federal budget.

          Furthermore Medicare doesn't cover prescriptions at all nor does in cover dental, eye or hearing care when needed.

          In addition, for prescription coverage you must buy a private policy and if you want some coverage of the copays and deductible you have to buy another private insurance  — that is if you don't go with Medicare advantage plans which cover some but not all of that.

          In order to cover everyone you would have to raise taxes by a substantial amount — but that would leave those other costs set out above. If you fold them in?

          The only way we would get to single payer which only 3 countries have (aside from the Scandinavian countries which I don't have the facts on) would be to do it like the Canadians did, one province (state) at a time. And people would have to withstand the hysterics when all the doctors said they would pack up and leave. In the first province they did leaving just a skeleton crew. But they came back in a few days.  But Americans are way more prone to hysterics.

          I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

          by samddobermann on Fri Jun 07, 2013 at 12:26:46 AM PDT

          [ Parent ]

          •  Yes, I do. (3+ / 0-)
            Recommended by:
            Calamity Jean, JerryNA, edg

            And it's a damned sight better than the nothing I have now, and the no coverage of anything. Plus, have you ignored everything we learned during the health care debates a few years ago? Costs would go way DOWN with younger and healthier people in the program.

            Speaking of hysterics...

            •  No, total cost would NOT come (0+ / 0-)

              down by the payment of claims for more people. The AVERAGE cost will decrease but the total cost will increase — drastically.  

              The premiums paid for Medicare part B are about $100/month per PERSON. Your (and my) taxes adds about $300 per person.

              That is $400 per person. So a family of four would cost at those rates a minimum of $400 per month and the tax monies would have to pay the rest. That would get them covered for medical visits and some equipment but nothing more.

              Now that per person cost would be averaged down by including more healthier people — but not by any 30% as claimed by the particular special interest group touting it. (They require all physicians be employees but now have add ACOs — but as employees and some other details) so let's just look at a 30% reduction. That would be $70 per person IF the government paid $210 per person. (but those costs would go up if there were no private insurers to pay at higher rates which cover for the lower rates paid by Medicaid and Medicaid.

              But that leaves premiums at $210/month for a family of 4 who would have an admittedly small deductibles. But they would have 20% copays. That is higher than a lot of insured who have copays of 10% or often less.

              You wouldn't sneer at copays once you ran up some $50,000 in medical bills. Your 20% copay would be $10,000.

              But that doesn't touch any HOSPITAL and cancer drugs.   expenses. Nor does it touch prescriptions. Those would be extra. And those would be very expensive. Right now

              The only thing the current Medicare payroll taxes cover is the hospital/cancer drug coverage. That is a very important part to most people. That is the Medicare trust fund that is running out of money. But that is based on the assumption that most people pay into it for all their working years until 65 and then beyond if they continue working. That would have to increase if people were to draw from it from birth.

              The copay for hospitalization is ~ 1,050 for from one day to 60. Want to pay that for a kid with a concussion who needs observation?

              Prescription coverage — by private insurers also have premiums and again they are subsidized by the general tax funds. Could they be cheaper by centralized purchasing? Possibly. Could the government force them down to the levels paid by the VA? Some perhaps but what could very well happen is the pharma combine would just refuse to sell many in the US. And they will pressure patients to pressure their legislators to maintain high costs. It would certainly work based on the past.

              The reason I mentioned dental, eye and hearing is to remind you all that Medicare coverage doesn't touch large areas of what we deem health care. These would be out of pocket or up to private insurance paid for out of pocket.

              Single payer is not a panacea. It doesn't affect the two biggest problems: quality and cost. It spreads costs over a larger group but if the the underlying cost drivers are not attended to healthcare will continue to spiral out of control.

              And we must attend to quality. Right now Americans are far more likely to be harmed and even killed by the medical care than are harmed or die from lack of care.


              I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

              by samddobermann on Sun Jun 09, 2013 at 05:59:46 PM PDT

              [ Parent ]

          •  What? (0+ / 0-)

            Copays are immaterial. The couple % payroll tax increase covers the increased costs. Medicare Part D covers prescriptions. Dental, eye and hearing are not part of Medicare.

            Your comment is totally lacking in knowledge and logic. You are creating things such as dental coverage out of whole cloth, you are ignoring Part D prescription coverage, and copays are an existing feature so why on Earth would that change.

            That was a totally useless comment and I don't have a clue why you felt compelled to write it. You're comparing some kind of imaginary insurance to my suggestion about expanding Medicare.

            In future, if you have nothing do contribute, don't.

            A waist is a terrible thing to mind.

            by edg on Fri Jun 07, 2013 at 04:34:53 PM PDT

            [ Parent ]

    •  Very well stated. (4+ / 0-)

      I don't always agree with 'theotherside', but I do here 100%.  As Softlanded said, unfortunately some in my family are immune to logic and the thought process.

    •  Excellent post. (2+ / 0-)
      Recommended by:
      Amber6541, elwior

      Being the single intellectual in a village of 1,100 souls ain't much fun, especially when 1,099 of those don't think you're all that smart.--Lucy Marsden

      by Miniaussiefan on Thu Jun 06, 2013 at 10:34:56 AM PDT

      [ Parent ]

    •  Good points! Also, great quote in your sig line. (1+ / 0-)
      Recommended by:

      Mother Teresa: "If we have no peace, it is because we have forgotten that we belong to each other."

      by Amber6541 on Thu Jun 06, 2013 at 11:15:24 AM PDT

      [ Parent ]

    •  They are afraid of the one size fits all issue (2+ / 0-)
      Recommended by:
      OleHippieChick, JerryNA

      When we eventually arrive at single payer in the US if we are smart we will take one lesson that it took the UK decades to learn. That is to allow a completely parallel private pay system to operate along side the NHS. Everyone pays for single payer, but for those physicians and patients who want a more personal level of service let them pay privately. Once the UK NHS started to allow private pay much of the criticism of the NHS stopped. People who were unhappy had an alternative choice, which is good.

      "let's talk about that"

      by VClib on Thu Jun 06, 2013 at 12:47:39 PM PDT

      [ Parent ]

  •  Is it too late to move to Canada? (13+ / 0-)

    I've only been considering this for a couple years and now I'm in my 50s.  I'd bring my own job--online teaching for a college in the US for ten years now.  That's not acceptable in the UK (to "bring your own job") but I wonder about Canada?

    Seriously, I wish I had come to this idea decades ago.  I can work from anywhere, so I'd definitely move.  I disagree with virtually 90% or more of everything my fellow Americans believe in.

  •  Reason 8: Because we'll pay for your care when YOU (14+ / 0-)

    get sick and can't afford your medical bills

  •  I loved the segment in 'Sicko' where Michael (18+ / 0-)

    Moore interviews Canadian relatives for their opinion of Canadian healthcare.

    They said they worried when visiting the States because of what might happen if they got sick or injured.  As I recall, his uncle or a friend hurt his shoulder golfing in the the US and waited until he got back to Canada to get treatment.

    At the very least, we need to have universal catastrophic coverage with a baseline of services available to all.  If you need elective treatment and can't wait, you can always go see a doctor on your own dime.

  •  Single Payer Saves Money- Saves Lives! eom (14+ / 0-)

    “... there is no shame in not knowing. The problem arises when irrational thought and attendant behavior fill the vacuum left by ignorance.” ― Neil deGrasse Tyson, The Sky Is Not the Limit: Adventures of an Urban Astrophysicist

    by leema on Thu Jun 06, 2013 at 08:24:52 AM PDT

    •  There is no evidence that it would save lives (1+ / 0-)
      Recommended by:

      overall. Not if you don't improve the underlying medical care system.

      Medicare patients get killed by their care too often. One third of all patients in hospitals have a serious medical error made.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Fri Jun 07, 2013 at 12:32:04 AM PDT

      [ Parent ]

      •  Are you willfully blind, Sam? (1+ / 0-)
        Recommended by:

        People on Medicare tend to be older (by definition), sicker, and have more medical conditions to treat at the same time.  Statistically speaking, people on Medicare are in the hospital more frequently for more serious conditions than the rest of the general population.  Therefore, they will have more errors made.  This does not excuse the errors, and ALL medical errors must be reduced.

        However, that is a big red herring when it comes to the many millions of people who have no access to any medical insurance, and therefore practically no access to any medical care at all.  Let me repeat that, since you seem to have appointed yourself the resident skeptic of all things on this page: MILLIONS OF PEOPLE HAVE NO ACCESS TO ANY MEDICAL CARE.  Getting them Medicare or single-payer health care will save many of their lives, even if there is a chance of some avoidable medical errors.  Why?  Because they will die without treatment which they cannot now get.  Do I need to repeat this using smaller words, or type slower?  Or will you find some other random and irrelevant excuse?

  •  Some items - such as pharmaceuticals (3+ / 0-)
    Recommended by:
    shari, JerryNA, elwior

    can be a major expense (and aren't covered under "universal" health care).

    In fact, about 1/3rd of medical expenses in Canada are paid for privately (so, 'single payer' seems like a poor name for the system).

    The "universal" meme is easier for my to buy, since it seems like everybody gets at least * some * level of care.

    •  Some pharmaceutical are paid. (20+ / 0-)

      I am officially low-income, and so the Canadian government absorbs about $400 a month for the drugs prescribed to me, after I pay a deductible that amounts to about $25 a year.

      The most obvious and troublesome gap in the Canadian health care system is that it does not include dental care (except for some forms of major surgery that can be classified as medical). And, of course, the dentists are a pack of greedy swine, the way some of the doctors would be if they were allowed. I'm still waiting for a government with the nerve to put dental care into the national  health insurance scheme whether or not the dentists like it. It would mean a sharp fight, but for a determined government, not a very long one (since the government could threaten to allow unrestricted immigration of qualified foreign dentists, for instance).

      "They smash your face in, and say you were always ugly." (Solzhenitsyn)

      by sagesource on Thu Jun 06, 2013 at 09:16:35 AM PDT

      [ Parent ]

      •  I was mostly referring to BC, which I am (7+ / 0-)

        most familiar with - but other provinces are apparently more generous with paying for prescription drugs (the situation is discussed in detail in this pdf).  It seems like provinces have a lot of leeway here - perhaps something like states seem to have under ObamaCare - to pay for more or less at their discretion.

        I was not aware of the dental situation but that could explain the stats I saw that only 2/3rds of health care costs in Canada were paid for by the "single payer"!  That is if dental is included in the overall umbrella of "health care" (and I don't see why it shouldn't be).

        •  I do live in BC.... (7+ / 0-)

          ...Vancouver, to be precise. It may have something to do with my income level, which is very low. My doctor also had to have a monumental fight with the bureaucracy, which he fortunately won, to include one standard drug that he wished to prescribe for me, since someone had inexplicably decided it was unnecessary.

          "They smash your face in, and say you were always ugly." (Solzhenitsyn)

          by sagesource on Thu Jun 06, 2013 at 09:24:38 AM PDT

          [ Parent ]

          •  Well good for you! (6+ / 0-)

            The context for me was that I have a second cousin twice removed (just making that up, she's related somehow in a way that I can't really figure out or at least describe succintly) - in the Kamloops area (not that that's all that relevant) - who was recovering from breast cancer and her physician prescribed a drug that was going to cost about $200 per month, like forever, which she could afford but it would have definitely been a burden and have affected her lifestyle

            Anyways, she was pondering whether to take it or not and was asking my opinion, which I told her not to do because I have no medical training.  But out of curiosity I looked it up on the internet/Pubmed and it looked like it was the real deal and so later, when she told me she decided not to take the drug - I urged her to reconsider.  And told her some specific reasons why she might want to take the drug, which came totally out of the blue for her (i.e., her physician hadn't mentioned any of them).    But small town USA also suffers from not having the most competent MDs in some cases, so I won't hold that against the Canadian system . ..

            •  Sounds very possible. (4+ / 0-)
              Recommended by:
              meralda, Roadbed Guy, Amber6541, elwior

              You're dealing with a bureaucracy, and one of the most important factors is whether your doctor is good at -- or better still, enjoys -- working the system to your advantage (and his, too, of course). That's not ideal, of course, but I'm not entirely sure how you would get around the human factor here.

              In the case of my medication mentioned above, which was initially not approved, approval depended on having a doctor who was prepared to make an obnoxious nuisance of himself on the phone to various personages up to the Deputy Vice Minister level. The squeaking wheel gets oiled the soonest, as they say. (He also told me that the approval panel had bureaucrats and pharmacists on it, but not a single doctor, so he had some difficulty explaining why this particular drug was necessary.)

              Your cousin's doctor may have been an excellent physician but not sufficiently up on his Machiavelli to be fully effective here (he may also have lacked the requisite contacts, living outside the main urban centers). A friend's sister had a similar experience with cancer -- she had (IIRC) inflammatory breast cancer, which has a very high fatality rate due to the fact it doesn't present the way other breast cancers do and is usually mistaken for an inflammation or infection until after it's too late to treat effectively. After she had both breasts and quite a bit else removed (cosmetic surgery to restore the breasts is paid by the government, btw), her doctor wanted to put her on an experimental drug that was not yet approved by Health Canada and so not subsidized, and which was infernally expensive. Fortunately, her doctor knew the right people to lean on, and she ended up receiving the drug for free as part of the company's "field testing" to obtain Health Canada approval. She recovered successfully and has been cancer-free for six or seven years now, and counting.

              "They smash your face in, and say you were always ugly." (Solzhenitsyn)

              by sagesource on Thu Jun 06, 2013 at 11:00:06 AM PDT

              [ Parent ]

  •  I recommend "The Healthcare Movie" (13+ / 0-)

    a documentary (there's a one hour version and a 1/2 hour version) that does a good job of comparing the histories of the two systems. Made by a Canadian/American couple. There's a trailer on youtube and an interview with the film makers. We show it quite often at our Health Care for All events.

  •  The Healthcare Movie is a must see about... (13+ / 0-)

    ...the differences between the Canadian Single Payer system and the dysfunctional and ultra expensive one we have here.

    Daily Kos an oasis of truth. Truth that leads to action.

    by Shockwave on Thu Jun 06, 2013 at 08:55:11 AM PDT

    •  BTW I lived in Canada a whole year (4+ / 0-)
      Recommended by:
      OleHippieChick, mrkvica, elwior, JerryNA

      I got sick, I went to doctors and they took care of me.

      Here I pay through the nose and I have issues.

      As an example, here an angiogram costs $914 in Canada $35 and you pay nothing out of pocket.

      Daily Kos an oasis of truth. Truth that leads to action.

      by Shockwave on Thu Jun 06, 2013 at 12:37:29 PM PDT

      [ Parent ]

    •  The problems here is doctors (2+ / 0-)
      Recommended by:
      elwior, Roadbed Guy

      want to have take home pay that puts them in the top 1% and the hospitals are empire building and competing on getting the fanciest equipment and having the most posh buildings — as well as the highest compensated executives — well they need to keep up with the doctors.....

      Our system is most expensive because the of the way doctors practice here. You can't change that by the payment system alone. A huge contributor of excess costs is the excess use of procedures including very profitable things like colonoscopies.

      But single payer in and of itself won't change the costs or the over treatment. That would require a very heavy hand of government regulation. What do you say if all the doctors who do certain things opt out? Can you yell louder than all those yelling about death panels, government regulations and the screaming of doctors?

      But a lot of stuff in the ACA is designed to slowly, steadily change that.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Fri Jun 07, 2013 at 01:14:09 AM PDT

      [ Parent ]

  •  I was in Vancouver (7+ / 0-)

    a couple years ago and had a breakfast-table conversation at a B&B with some Canadians. Healthcare came up and they were just flabbergasted when I told them what I paid for health insurance (under COBRA, so not employer subsidized). That was like a bad dream for them: they couldn't even contemplate that kind of cost. I didn't even get into all the out of pocket costs that insurance premium left uncovered. Or mention things like the lengthy phone calls I'm having now trying to iron out who pays, and how much, for an auto accident my wife was in 6 months ago (two insurers are involved, which is a recipe for endless complication).

  •  As an American Airman serving at NATO HDQT's (13+ / 0-)

    in the late '60's and '70's, I was able to see a Belgian civilian doctor (I think free of charge) along with my fiancé - to test for rubella.  We would have had to go to England to have the abortion.  She was fine.  Belgians have been proud of universal health care (as are the French - who have the best system in the world) and, like most social democracies with an intact social contract that recognizes the dignity and minimum humanity of all people in their country - whether poor or rich, disabled, sick, young or old, mentally challenged, all workers & professionals, etc, in Solidarity - to form a more solid social contract and maintain their countries' excellent social services.  I also met many Belgian pensioners living in fine government housing and receiving adequate pensions.

    As a veteran I am very angry that many of my brother and sister civilians - and even some veterans - in the US are denied universal healthcare at a reasonable cost.  Unconscionable!  It brings shame to the Republican Party.  It shames the United States.  There is no excuse/reason for this idiocy.  Healthcare is a basic need for humans/citizens in a civilized society that values everyone's dignity.  Basic.  No excuse for this.

  •  I lived under the New Zealand system (8+ / 0-)

    and happily, happily paid higher taxes because I could see where and how my dollars were being spent. I was covered, my pregnancies were covered, my children were covered. Their dental was covered. My husband was covered for follow-up surgery on an injury he received overseas! We simply felt looked after - not entitled (in the sense that the Rs use the word).

    If you had to be first in line for elective surgery or had to have a private hospital room, you could elect to buy insurance. But you weren't ever neglected if you couldn't afford a policy.

    It wasn't a perfect system, but it was so very much better than the US.

    Health care was so much less stressful. Maybe the Affordable Health Care act is a step in the right direction, but not knowing what that's going to cost, what the new system is going to look like until October, is currently causing stress.

    I'm already paying for policies for my self-employed husband and my daughter who holds down a job, so priced herself out of medicare - but doesn't make enough to buy her own policy. We're not sure that the prices on these policies are going to go down very much on the system or offer much better coverage.

  •  Yeah, illnesses don't respect your libertarian (7+ / 0-)

    "I don wanna pay for no healthcare for them Mexicans" idea. Germs spread regardless, dumbass bagger.

  •  My case for universal health care? (13+ / 0-)

    If my sister were Canadian, she most likely wouldn't be dying of stage IV Melanoma right now at age 46. She would probably have gotten that damn mole removed as soon as a doctor saw it during a regular check up. She could be making plans to visit her grandkids instead of appointments for radiation to try to shrink the cancer that is now in her bones to go with the lesions in her lymph nodes, liver, pancreas, and lungs.

  •  The case gets stronger every's just that (3+ / 0-)
    Recommended by:
    meralda, prishannah, elwior

    the only real possibility to get there was one step at a time, with Obamacare being step one.

  •  Is dental covered in Canada? (2+ / 0-)
    Recommended by:
    elwior, Roadbed Guy

    I rarely see discussions mentioning this.

    Nuance is lost upon those who choose not to look.

    by poliwrangler on Thu Jun 06, 2013 at 11:09:20 AM PDT

    •  No, it's not covered. (2+ / 0-)
      Recommended by:
      mrkvica, elwior

      Some employers offer extended benefits for dental care and prescription costs (which also are not covered).

      Luckily for my partner and I, we are able to purchase extended health benefits similar to what we had with our employer before we both retired.

      Costs $200 a month and is tax deductible.

      We opted not to go for dental coverage because it is just too expensive. My dentist charges me less than she would if I had a dental plan.

      Go figure.

    •  It is in Britain to some extent, if I remember. (1+ / 0-)
      Recommended by:

      Dentures are provided and are not custom-made. National Health teeth look a bit picket fence, but they do work. National health spectacles too, I believe (John Lennon used to wear some).

      Voting is the means by which the public is distracted from the realities of power and its exercise.

      by Anne Elk on Thu Jun 06, 2013 at 03:06:30 PM PDT

      [ Parent ]

  •  Oh, this was the embryonic policy that Obama (4+ / 0-)
    Recommended by:
    mrkvica, elwior, HCKAD, Calamity Jean

    aborted before discussions on health care/insurance began.  Too bad the country didn't have the chance to learn something about single payer as a result of the national debate that would have ensued had Obama permitted it on the table.

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Thu Jun 06, 2013 at 11:35:49 AM PDT

  •  Great diary. Platform item "F 1": (4+ / 0-)
    Recommended by:
    gmats, Truedelphi, mrkvica, elwior
    F. Health Care
    1. Universal Health Care

    The Green Party supports single-payer universal health care and preventive care for all. We believe that health care is a right, not a privilege.

    Our current health care system lets tens of thousands of people die each year by excluding them from adequate care, while its exorbitant costs are crippling our economy. The United States is the only industrialized nation in the world without a national health care system.

    Under a universal, comprehensive, national single-payer health care system, the administrative waste of private insurance corporations would be redirected to patient care. If the United States were to shift to a system of universal coverage and a single payer plan, as in Canada style="color: black;"> and many European countries, the savings in administrative costs would be more than enough to offset the cost of additional care. Expenses for businesses currently providing coverage would be reduced, while state and local governments would pay less because they would receive reimbursement for services provided to the previously uninsured, and because public programs would cease to be the "dumping ground" for high-risk patients and those rejected by health maintenance organizations (HMOs) when they become disabled and unemployed. In addition, people would gain the peace of mind in knowing that they have health care they need. No longer would people have to worry about the prospect of financial ruin if they become seriously ill, are laid off their jobs, or are injured in an accident.

    Greens support a wide-range of health care services, not just traditional medicine which too often emphasizes "a medical arms race" that relies upon high-tech intervention, surgical techniques and costly pharmaceuticals. Chronic conditions are often best cured by alternative medicine. We support the teaching, funding and practice of holistic health approaches and as appropriate, the use of complementary and alternative therapies such as herbal medicines, homeopathy, naturopathy, traditional Chinese medicine and other healing approaches.

    Greens recognize that our own health is also intimately tied to the health of our communities and environment. To improve our own health, we must improve the quality of our air, water and food and the health of our workplaces, homes and schools.

    The Green Party unequivocally supports a woman's right to reproductive choice, no matter her marital status or age, and that contraception and safe, legal abortion procedures be available on demand and be included in all health insurance coverage in the U.S., as well as free of charge in any state where a woman's income falls below the poverty level. See section A.1. Women's Rights in this chapter

    We recommend the following actions:

    1. Enact a universal, comprehensive, national single-payer health plan that will provide the following with no increase in cost:

        A publicly funded health care insurance program, administered at the state and local levels, with comprehensive lifetime benefits, including dental, vision, mental health care, substance abuse treatment, medication coverage, and hospice and long-term care;
        Participation of all licensed and/or certified health providers, subject to standards of practice in their field, with the freedom of patients to choose the type of health care provider from a wide range of health care choices, and with decision-making in the hands of patients and their health providers, not insurance companies;
        Portability of coverage regardless of geographical location or employment;
        Cost controls via streamlined administration, national fee schedules, bulk purchases of drugs and medical equipment, coordination of capital expenditures and publicly negotiated prices of medications;
        Primary and preventive care as priorities, including wellness education about diet, nutrition and exercise; Holistic health including homeopathy, naturopathic medicine, traditional Chinese medicine, Ayurvedic medicine, herbalism and medical marijuana;
        More comprehensive services for those who have special needs, including the mentally ill, the differently abled and those who are terminally ill;
        A mental health care system that safeguards human dignity, respects individual autonomy, and protects informed consent;
        Greatly reduced paperwork for both patients and providers;
        Fair and full reimbursement to providers for their services;
        Hospitals that can afford safe and adequate staffing levels of registered nurses;
        Establishment of national, state, and local health policy boards consisting of health consumers and providers to oversee and evaluate the performance of the system, ensure access to care, and help determine research priorities; and
        Establishment of a National Health Trust Fund that would channel all current Federal payments for health care programs directly into the Fund, in addition to employees' health premium payments.

    •  Good luck in finding a country (1+ / 0-)
      Recommended by:

      in which to place all that.

      And ask Steve Jobs about the benefits of "the use of complementary and alternative therapies such as herbal medicines, homeopathy, naturopathy, traditional Chinese medicine and other healing approaches."

      Oh wait, you can't.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Fri Jun 07, 2013 at 01:35:02 AM PDT

      [ Parent ]

  •  I am so glad you did write this (6+ / 0-)

    excellent diary. As an American living in Canada, I have had this discussion often but didn't formulate my position as simply and effectively as you did.  After my own serious health care experience though, even the most vocal anti-socialist Americans in my acquaintance could see the advantages, even if they were never going to admit it publicly. With good insurance, they paid 20% of the costs for a similar diagnosis; I paid for parking. I hope that the ACA will be the first step in Medicare for all in the US.

    I am also one of those physicians who will go the distance to advocate for patients. As good as the system is, it needs to recognize, and usually does on appeal, that there are situations where the standard coverage is inadequate.

    Never separate the life you live from the words you speak - Paul Wellstone

    by meralda on Thu Jun 06, 2013 at 11:39:05 AM PDT

  •  Stats on Canadian usage of American health care. (5+ / 0-)

    A study of Canadian utilization of US healthcare showed about 46,000 Canadians per year receive medical treatment in the US (see: Leaving Canada). The study was performed by a very conservative organization with a decided bias toward denigrating Canadian healthcare, as is evident from the very first sentence.

    Another study shows that nearly 18,000,000 Canadians visit the US each year (see:  Visiting US). Yet only 46,000 receive medical care in the US each year, and of those who do seek American care, only 20% came to America specifically for that purpose. The vast majority, 80% received US care because they were injured or became ill while visiting the US on vacation or business  (see: Canada Myths).

    A waist is a terrible thing to mind.

    by edg on Thu Jun 06, 2013 at 12:04:34 PM PDT

  •  Medicare For All Would Solve The Problem (3+ / 0-)
    Recommended by:
    Truedelphi, OleHippieChick, elwior

    Those who want to keep the insurance they have could.  Those who want supplemental insurance could still have it, but everyone regardless would have universal healthcare.

    "Don't Let Them Catch You With Your Eyes Closed"

    by rssrai on Thu Jun 06, 2013 at 12:04:48 PM PDT

  •  Universal healthcare also adds security in (7+ / 0-)

    retirement. Here, we're all one major illness away from bankruptcy. We each need two retirement accounts. One to live on and one to pay for the inevitable health crisis.

  •  Thank you for such clear and concise writing. (1+ / 0-)
    Recommended by:

    I am going to copy your diary and memorize it.

  •  Mr Trudeau, You were a bright and shining (1+ / 0-)
    Recommended by:

    Light back during the long years of the Vietnam War. I remember how your nation took in would be vets who did not want to participate in that dirty little war for profit. Thank you for everything you did for those Americans.

    The people of the USA want many things - Universal Single Payer HC among them. (When the question is stated properly, over 70% of all Americans want this.) But our bought and paid for Congress and Executive officials do not want this.

    Follow the money. The woman who helped Rahm Emanuel draft the wording of the 2,000 page ACA now has a comfy executive level position inside "Wellpoint," for her "services." Rahm Emanuel himself now is the mayor of Chicago. Neither the President or any person in Congress who voted for the ACA need ever worry about having a job or money (or a platinum level health insurance policy!)  from that point  forward. Just as Bill Clinton signed off on the Bank Modernization and Reform Act, and then went on to receive some $ 100,000 for every speech he ever gave in front of a Corporate Podium, so too can  those ACA-enablers expect a life of relative ease.

    When over the next few years, Americans realize that in some places, the annual premium cost has almost doubled since the ACA pasage, and additionally now each insured person has at least a $ 5,000 deductible to be paid out of their own pocket, perhaps we will get back to the drawing board and get ourselves a product that is actually of value to someone other than the Political Class, and the CEOs at Big Pharma and Big Health Insurance companies

    Offer your heart some Joy every day of your life, and spread it along to others.

    by Truedelphi on Thu Jun 06, 2013 at 12:46:56 PM PDT

  •  On protecting natural and human resources (5+ / 0-)
    Recommended by:
    mrkvica, elwior, HCKAD, Calamity Jean, JerryNA
    You agree with doing everything necessary to preserve and protect your natural resources
    Republicans believe in doing everything necessary to make a buck off our natural resources, their continued viability be damned.

    Quidquid id est, timeo Republicanos et securitatem ferentes.

    by Sura 109 on Thu Jun 06, 2013 at 12:58:15 PM PDT

  •  #4 Economics (3+ / 0-)
    Recommended by:
    elwior, HCKAD, JerryNA

    Health care costs contribute to the rising prices of manufactured goods in US. If your making widgets, and your employer offers insurance, he must be able to provide benefit out of his profits. The fact that US is only industrialized nation that does not insure the welfare of it's citizens speaks volumes to the capitalist corporate control of government.

  •  Confused about your number of $3600 (1+ / 0-)
    Recommended by:

    As a fellow Canadian I am confused about this part of the diary:


    The care has always been efficient and world class and we do not receive a bill other than what we pay in taxes. (in my case for family coverage about $3600 per year including estimated gas and luxury tax levies)  People at incomes less than mine pay less and at the lower income levels pay no income tax for healthcare
    Are you just saying $3600 is the total amount your family pays in income taxes a year?  That makes sense.  However, one could interpret your statement as meaning that this amount was instead just the portion of your taxes which went to health care.   And if it is the latter, I was wondering how you came up with that number.

    We may have democracy, or we may have wealth concentrated in the hands of a few, but we can't have both. - Former Supreme Court Justice Louis Brandeis

    by RageKage on Thu Jun 06, 2013 at 02:12:38 PM PDT

  •  This is one good reason for universal healthcare.. (2+ / 0-)
    Recommended by:
    elwior, JerryNA
  •  Australia adopted essentially the Canadian system (3+ / 0-)
    Recommended by:
    elwior, HCKAD, JerryNA

    in 1975 and has never looked back. Not even the most conservative politician in Australia would advocate a return to the haphazard system in place before that time. One thing Australia does have is supplemental health insurance. If you want to buy extra insurance, you can get a few extras like private rooms at fancier hospitals, etc. But the purpose of the system is to ensure that all citizens get decent healthcare. It's not Rolls-Royce, more Chevrolet.

    Voting is the means by which the public is distracted from the realities of power and its exercise.

    by Anne Elk on Thu Jun 06, 2013 at 03:02:41 PM PDT

  •  To anyone who opposes a universal public system (4+ / 0-)

    To anyone who opposes a universal public system of healthcare: you're insane, and likely could use some universal, public healthcare.

    I'm Canadian.  Want to know how positivvely Canadians think of our health care system?  Tommy Douglas--father of Canada's healthcare system--was voted as The Greatest Canadian ever.  Not even Terry Fox could beat him, and Fox is much more widely-known.

    When you can come out of ahead of an ultra-popular martyr who died while doing something incredibly noble that caught the imagination of a nation and a planet, you must have done something really, REALLY good.

  •  Well, 6 out of 7 ain't bad. "Look, it's (3+ / 0-)
    Recommended by:
    elwior, Calamity Jean, JerryNA

    Christian!" is never a valid reason to do anything.

    That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

    by enhydra lutris on Thu Jun 06, 2013 at 04:38:42 PM PDT

  •  Competitive Advantage (2+ / 0-)
    Recommended by:
    elwior, JerryNA

    What Competitive Advantage do Americans and American business get paying twice as much for healthcare as other nations? Maybe if we had better results but for the most part we are mediocre.

    We need to continue to resist the notion that bullying is some sort of rite of passage. Bullying is killing our children, whether they are gay or "different" in other ways.

    by 207wickedgood on Thu Jun 06, 2013 at 04:44:01 PM PDT

    •  But it is not the financing system that (0+ / 0-)

      makes the cost of healthcare high in this country.

      If that were true the costs of medicare would be low. It is a single payer system. And its costs are the highest compared to other countries.

      Yes, we have a mediocre system— and more people die each year from preventable medical errors than ever die from lack of care.

      Our big problems are cost and quality of the underlying provisions of the care itself — and is poor quality. We are very good at high tech interventions — if infections don't kill you first.

      A big part of it is our own fault.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Fri Jun 07, 2013 at 03:09:49 AM PDT

      [ Parent ]

      •  Insurance, urgency, and lack of transparency. (0+ / 0-)

        Single-payer plans essentially control costs or have a strong negotiating position.  One single payer plan, Medicare, within a bewildering mix of hundreds of other plans has a much weaker position.  Even so, Medicare medical costs are lower than other plans.

        Urgency means you cannot shop around for medical care, unlike buying a car or a refrigerator.  You cannot usually go to a competing hospital, especially not redirecting an ambulance.

        Lack of transparency means your doctor's office will not tell you what they charge you or your insurance for a procedure (except for Medicare).

        Yes, we have a mediocre system, but you keep confusing the system we have now with what single payer plans Actually Do BETTER Now in other countries.

        •  few other countries have (0+ / 0-)

          a single payer system. They have universal coverage systems but most go with private insurance or a mix of public private.

          Switzerland and Japan have purely private system though they will be government pay for the few that cannot pay.

          France has a mixture with extremely liberal benefits.

          So single payer is not necessarily  the solution.

          Even with a single payer like Medicare is a major problem is when doctors order unnecessary tests, hospitalization and procedures. Even if you had a catalog of the cost of each thing how would you know where or not you needed some thing?

          Watch the 60 Minutes video, The Price of Admission
          which reran on 6/9/13.
          Steve Kroft investigates allegations from doctors that the hospital chain they worked for pressured them to admit patients regardless of their medical needs.

          Watch it then tell me how single payer will combat it. By itself it won't change a thing. Although the DOJ and the ACA have eliminated some types of fraud there are so many new ways of gaming the system that the DOJ and HHS investigators are swamped. They have to build cases that will survive teams of high powered, highly paid lawyers doing everything they can.

          And in some cases of egregious fraud the former CEO goes on to be Governor of Florida. It is rare that you can prove that the fraud goes up to the top.

          "Medicare medical costs are lower than other plans." But they are paying out ~ 10% to fraudulent claims in that the claims are for tests, hospitalizations and procedures that are NOT medically necessary — even thought they were "ordered" by a doctor.

          I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

          by samddobermann on Mon Jun 10, 2013 at 09:41:13 AM PDT

          [ Parent ]

          •  You are arguing that Medicare is imperfect. (0+ / 0-)

            It is imperfect.  It can get better, yes, and there are gubmint burracrats (local term) who are making it better.  Improvement would happen even faster if reactionaries from the GOP didn't sabotage it.  Our mish-mash of private for-profit insurance is much less perfect.  I'm trying to make things better for more people.  You seem to be arguing for a status quo where tens of millions of people are uninsured, have no access to normal, routine health care, and many tens of thousands die.  Sorry, I'm not buying it.

  •  Excellent, Mr. Trudeau, please help us again with (2+ / 0-)
    Recommended by:
    elwior, alice kleeman

    your sharp insights and clear logic.

  •  I am amazed that someone could have family (3+ / 0-)
    Recommended by:
    elwior, rbaillie, JerryNA

    members that receive universal healthcare and not be totally envious of them (unless you were extremely wealthy).

    When they get sick or injured and the bills start arriving, they'll likely feel quite differently.

    Thanks for sharing your story with us.

  •  awesome points! (1+ / 0-)
    Recommended by:

    The system is maddening in every way! I am a mental health provider. Right now I do not take insurance at all. Some of my folks pay 5:00$ and some pay 100.00$. I accept payment at time of services. As it stands it takes hours of paper work, done and redone to get paid. And if you get paid it is likely months after services. I have given up on yhe system for now...and until universal comes around this is how it will be.

  •  Thanks for information on Canada's system. I've (1+ / 0-)
    Recommended by:

    seen videos in the past detailing their healthcare system and I never get tired of hearing about it.

  •  A universal system save a lot on paperwork (0+ / 0-)

    and doctors/hospitals/clinics wasting time negotiating with insurance companies, which have nothing to do with health care.

    The billing department of a Canadian hospital is a fraction of the size of the billing departments of a same-sized American hospital.

    It's the planet, stupids!

    by tsunami on Fri Jun 07, 2013 at 05:26:25 PM PDT

  •  Tourists who come to America (1+ / 0-)
    Recommended by:

    from Europe or Canada often buy special insurance packages to cover them in case there is a medical emergency and the tourist might have to visit a bank-breaking emergency room at an American hospital. The American hospital bills they receive are totally shocking expensive in their eyes.

    It's the planet, stupids!

    by tsunami on Fri Jun 07, 2013 at 05:29:39 PM PDT

  •  About half of all bankruptcies in America (0+ / 0-)

    stem from huge medical bills. This is so wrong. That's like kicking a person after a medical setback.

    It's the planet, stupids!

    by tsunami on Fri Jun 07, 2013 at 05:31:02 PM PDT

  •  Another advantage: government wants healthy people (0+ / 0-)

    As another government expense to be scrutinized, single payer seeks to minimize its costs. Specific actions in my province:
    a. Free immunizations for infants and school children, including HPV vaccine for pre-teen girls. Reduce childhood infections and hospitalizations.
    b. Free flu immunizations for seniors and others at higher risk of hospitalization.
    c. Aggressive HIV/AIDS detection and treatment to reduce infection of others.
    d. Quit-smoking subsidies and public advertising.
    e. Free pre-natal care prevents costly medical interventions at birth and for the newborn.
    f. Free family doctor access - most diseases are cheaper to treat if they're identified earlier.
    I'm sure there are more but they all fit under the broad concept of a population's good health is a cost-saving measure.

    To put this in an American context: MedProv Insurance Company wants to select the best health care risk, i.e. 25 year old healthy single male equivalent at every age, and has the means to "create" this best risk in part through its own actions. (QUESTION: Does this help explain why the U.S. is so much more expensive and so less productive in terms of mortality?)

    Contrast with the U.S. governments' Medicare and Medicaid approach: Hurry up and die.

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