Canada currently has a problem with black-market medical clinics. Doctors are providing medical care to patients for cash, outside of the socialized medical system. Citizens are also traveling outside of the country for diagnostics, surgeries and treatment.
This is illegal in Canada and they have been cracking down. This has caused another exodus of physicians from the country, leaving them with a severe shortage. To respond to this, Canada has expanded the role of PAs, nurses, and some medical assistants to treat patients, deliver children, and prescribe medicines.
If (and probably when) we have a socialized healthcare system, what is to stop doctors from offering their services to patients directly?
Would we go so far as to jail physicians for providing services to patients for cash like Canada?
Our insurance companies are already forcing some of our medical professions to open clinics outside of the healthcare insurance system. We are already expanding the roles of PAs, nurses and medical assistants in our hospitals to save money.
Another question. . . New advances in medicine and disease research are currently financed by the prices you pay for drugs at the pharmacy. Some are quite expensive. The US has lead the world in drug development and disease treatment for decades. When we subsidize the purchase of medicine we regulate the profits. What happens when you subsidize the profit from drug companies? What would motivate them to engage extra resources in research and development if there was no opportunity for increase in profit, and a more significant chance for loss?
One fifth of our uninsured hospital admissions is an illegal alien. Under a socialized medicine system, one would assume, you must provide proof of citizenship to receive medical care. Hospitals absorb this cost by passing it on to you and the insurance companies in the form of increased rates.
Would we still provide free care to illegal aliens? How would the government hospitals pay for this?
Your premise is incorrect. Physicians in Canada are perfectly free to run private clinics. What they cannot do is take patients under the public system and private patients both, except in Quebec.
I'm just guessing, but you probably got that information from right wing talk radio. They like to use lies of that nature to advance their agenda of not fixing our current obviously broken system.
And a note on drug research: Drug companies spend more on advertising than they do R&D. Eliminate advertising and they could cut the price of drugs in half and keep their profit margin the same.
As far as illegal aliens are concerned, many if not most work jobs where they have payroll deduction, they just get the jobs with invalid or stolen social security numbers. Presuming we finance the system through income tax, they'd pay for it that way. Otherwise they would be covered like any other jobless person.
BTW, you talk as if we don't have a shortage of doctors here, when we obviously do in many areas, although in our region the problem is greater in nursing than in actual doctors.
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Originally posted by nathanm
Your premise is incorrect. Physicians in Canada are perfectly free to run private clinics. What they cannot do is take patients under the public system and private patients both, except in Quebec.
You are correct. There are very few physicians that can make a living on running a private only clinic, since medical insurance and reimbursement are illegal except in Quebec where they ruled that would constitute a monopoly, and allow it. This causes many physicians to offer some services under-the-counter or through small clandestine offices. These physicians are prosecuted, in many cases for offering services that the government system denys or delays their patients in recieving.
quote:
I'm just guessing, but you probably got that information from right wing talk radio. They like to use lies of that nature to advance their agenda of not fixing our current obviously broken system.
No, I got it from my uncle who is a physician in Vancouver on our last fishing trip off of Victoria.
quote:
And a note on drug research: Drug companies spend more on advertising than they do R&D. Eliminate advertising and they could cut the price of drugs in half and keep their profit margin the same.
You scared me for a moment there, I thought you were telling the truth.
Since I own most of these stocks I went to my prospectuses and found the advertising budgets. I did a little comparison. You must be listening to too many left wing radio shows (are there any?).
Advertising budgets are equal to around 3% to 5% of earnings compared to R&D which is 17% to 25% of earnings. This advertising budget is about the same as most large companies. Some of the smaller Pharma companies spend over 50% of earnings on R&D and walk a very thin line.
Select companies advertising budgets for 2007:
Pfizer, $1.1 billion ADV ($48 Billion earnings) $7.2 billion R&D
Wyeth, $877 million ADV ($22.4 billion earnings) $3.4 billion R&D
Novartis, $488 million ADV ($36 billion earnings) $5.4 billion R&D
Merck, $1 billion ADV ($25 billion earnings) $4.27 billion R&D
That said, I don't agree with a prescription medication advertising on TV to the end user. You shouldn't have to tell your doctor what to prescribe for you!
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As far as illegal aliens are concerned, many if not most work jobs where they have payroll deduction, they just get the jobs with invalid or stolen social security numbers. Presuming we finance the system through income tax, they'd pay for it that way. Otherwise they would be covered like any other jobless person.
Yes you are correct that they do use stolen #s. They are also required to file a W-4 at the time of employment (here's where the fun begins). I'm not proud of this, but I worked in an industry for years that employed people of questionable immigration status. We had around 300 each year that worked for us. They provided us with their SS# and name (I think we had around 150 Jose Garcias) They filled out their W-4 with the maximum deductions so that we were withholding little or none from their paycheck.
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BTW, you talk as if we don't have a shortage of doctors here, when we obviously do in many areas, although in our region the problem is greater in nursing than in actual doctors.
I am very aware of this. Do you wonder why?
After 12 years of college and medical school, my brother makes around $190,000 a year. Not bad. In 1980 a cardiologist (my bro's specialty) would make around $250,000 a year. A good one with a large patient base could make much more. Each year he makes less and less, and the insurance companies make more and more. Now they are telling him how many patients he must see a day and how long he can spend with them. He has to call the insurance company to find out what drugs he can give his patients and what surgeries they can or can't have.
1. Shortage of doctors is man made. Thank the AMA and the immigration laws. They combine to keep a shortage of MDs year in and year out to the tune of nearly 4,000 per year.
Simply math really. If we need X doctors, we only allow Y into our medical schools, only allow Z to immigrate and Y + Z < X; we will have a shortage. Which we have for nearly a generation now.
The problem is as much government caused as anything else.
2. Due to socialized medicine private clinics in Canada are extremely difficult to run. Just like many Americans would rather have cable TV than health insurance, many Canadians would rather wait 6 months than pay for a private clinic. So while it is hyperbole to say doctors can not offer services directly to patients, in practicality that is often the result (accept government employment and you are prohibited from doing so outside those confines).
3. There is a consistent 2:1 ratio in drug companies it seems. I ran the S&P reports on Bayer, Merck, Bristol Myers, and Pfizer. Each had 2 time the administrative expense as R&D.
The problem with the statement that they spend more on advertising is that like all financial statements their marketing revenue is tied to "administrative, sales and other." Considering that most non-research salaries (board, CEO, managers, accountants, finances, in-house counsel) as well as buildings, company planes and on and on... come from this fund. Certainly marketing is NOT half their non-R&D expenses.
I looked for evidence of that statement but never could find any. Plenty of XYZ.blogspot.com talking about it but I was hard pressed to find a source that was a non-blog and a non-advocate.
And even if true, so what? American drug companies still account for most of the private pharmaceutical research expenditures in the world. Are you implying that those companies should then be restricted in what they do with those products? Clearly the system is not perfect and favors treating "popular" illnesses that one can easily profit from, but in many areas this system has proven unbeatable.
I'm very glad we have national laboratories and universities seeking less-profitable drugs and treatments. But I'm afraid every country that has restricted the bennefit of research (marketing and sales) has seen research decline.
To be honest, I've never been into a hospital where they have checked your right to use the service.
I shared a house with a guy from California and he got free moulds of his feet done, had physiotherapy, saw a GP and got subsidised prescription medicine and while he was entitled to it they never asked for proof.
I've also rushed someone to the emergency of one of the best eye hospitals in the world and was never asked for proof they were a citizen or had a right to use the health care.
I can't say that is what the US would set up, but that has been my experience of access to medical services in a country that doesn't have a US style system. I would caution you very strongly to use this though and say 'well that's what will happen here'. The US has the opportunity to create a system that best fits its needs, not merely copy an existing model.
Most of pharmaceuticals R&D budgets are spent on creating new drugs that address health issues where an existing and effective drug already exists. In some cases the existing drug's patent is expiring and in others the existing drug is from a competing company. A lot more money is then spent advertising to get you to switch from the current drug to the new one.
Another fun facet to the current model is that drug studies are currently far from impartial. It is so expensive to bring out a drug that the companies cannot afford to have a drug fail testing.
All of this keeps costs high and actually makes drugs less safe. Drug research could and should be moved outside of the private realm and be done in the academic world and in other government funded labs. Drug companies should focus on the safe manufacture of drugs and not the constant expensive research into mostly needless drugs and the related advertising. The result would be cheaper, and safer, drugs.
The system is broken! On that we can all agree. This happens in a Free-market system. It's like the pendulum on a clock. It swings to the extreme and then people rebel and it begins to swing back. We are already seeing docs, clinics, and some hospitals opt-out of the traditional system. We are already seeing company hire corporate physicians to provide free medical care for their employees rather than pay huge insurance costs.
But before we allow this natural free-market correction, we're gonna punish healthcare, by subjecting it to the worst, most wasteful, and inefficient form of management possible. We're gonna pull it out of the free-market system.
We're gonna give it to the government. We are going to take a huge bureaucratic system and turn it into a bureaucracy, so large and overwhelming that it will require an entire new vocabulary to understand.
We will certainly have to make sacrifices to personal liberty. Other industries will have to follow for the system to function. Once the free-market is eliminated from diagnostics, pharmaceuticals, medical equipment and other industries, the government will have to come in and subsidize.
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Originally posted by spoonbill
The system is broken! On that we can all agree. This happens in a Free-market system. It's like the pendulum on a clock. It swings to the extreme and then people rebel and it begins to swing back. We are already seeing docs, clinics, and some hospitals opt-out of the traditional system. We are already seeing company hire corporate physicians to provide free medical care for their employees rather than pay huge insurance costs.
But before we allow this natural free-market correction, we're gonna punish healthcare, by subjecting it to the worst, most wasteful, and inefficient form of management possible. We're gonna pull it out of the free-market system.
We're gonna give it to the government. We are going to take a huge bureaucratic system and turn it into a bureaucracy, so large and overwhelming that it will require an entire new vocabulary to understand.
We will certainly have to make sacrifices to personal liberty. Other industries will have to follow for the system to function. Once the free-market is eliminated from diagnostics, pharmaceuticals, medical equipment and other industries, the government will have to come in and subsidize.
If that were the case why does Canada spend only $307 per capita on health administration costs, but in the US the costs are $1,059 per capita. Administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada.
http://content.nejm.org/cgi/content/abstract/349/8/768
Swake, I agree with you to a large extent. I also think that Costco, Walmart, and even insurance companies are now taking steps to tell people that new brand name drugs are NOT always better. There are two parties in the system - the producer and the consumer. Since the producers are motivated by $$$ the intercession parties in this instance should, and are, stepping up (I wish doctors would more too!).
Though, I obviously agree that the system is flawed and would be more than happy to adopt a different system; I just don't believe more government will improve it. Certainly it hasn't improved our schools, our retirement, or most other programs it touches. In fact, where anyone has a choice between government of private nearly everyone choses private.
Our government is incompetent, slow, over-reactionary (omg, terrorists! Apparently forgetting the previous attacks), wasteful, and flippant. I want them in my life as little as possible.
quote:
Originally posted by swake
Most of pharmaceuticals R&D budgets are spent on creating new drugs that address health issues where an existing and effective drug already exists. In some cases the existing drug's patent is expiring and in others the existing drug is from a competing company. A lot more money is then spent advertising to get you to switch from the current drug to the new one.
Another fun facet to the current model is that drug studies are currently far from impartial. It is so expensive to bring out a drug that the companies cannot afford to have a drug fail testing.
All of this keeps costs high and actually makes drugs less safe. Drug research could and should be moved outside of the private realm and be done in the academic world and in other government funded labs. Drug companies should focus on the safe manufacture of drugs and not the constant expensive research into mostly needless drugs and the related advertising. The result would be cheaper, and safer, drugs.
Already been attempted in other countries with dismal failure. You see the push for new technologies, new drugs, a better mouse trap, a more absorbent tampon, etc. is always fueled by monetary reward. No matter what you apply it to.
Your stance was the stance of Communists before they acquired power, when Russia was a blooming scientific power. They moved scientific, drug, technological, and military research from the private sector to government funded university labs. Within 20 years they were so far behind the rest of the world there was no salvation.
Germany
China
Venezuela
Cuba
France
They produce nothing of consequence.
Why would a scientist, an inventor, or a craftsman want to work within a system that offers minimal reward and maximum regulation, when he or she can work in a system with huge rewards, maximum freedom and all the best equipment?
The funny thing is that some of the above companies (France & Germany) have free-market pharmaceutical companies outside of their government programs that rely on the United States to provide their income, and they trade in US markets.
As for your comment about safer drugs, I'm not even going to address that. Compared to . . . well everywhere. . . we have the safest most regulated drug system in the world.
I know it upsets most liberals, but humans are wired for profit (or reward). If there is no reward, their is very little performance. This is a lesson that they don't teach in college because it is not a "sensitive" subject. It's why most of us start out as liberals and then eventually we learn human nature, and adopt a philosophy that makes us happier and more successful.
It's why Communism, Socialism, and Fascism fail every time.
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Originally posted by cannon_fodder
3. There is a consistent 2:1 ratio in drug companies it seems. I ran the S&P reports on Bayer, Merck, Bristol Myers, and Pfizer. Each had 2 time the administrative expense as R&D.
The problem with the statement that they spend more on advertising is that like all financial statements their marketing revenue is tied to "administrative, sales and other." Considering that most non-research salaries (board, CEO, managers, accountants, finances, in-house counsel) as well as buildings, company planes and on and on... come from this fund. Certainly marketing is NOT half their non-R&D expenses.
It points out, though, that the direct correlation that Spoonbill draws between profit and R&D isn't as straight-line as he might like. Just as in any industry, a lowering of profits doesn't simply mean cutbacks; it can also inspire consolidation, streamlining, and finding profit and efficiencies elsewhere. I guarantee that even lowering that 2:1 ratio by a fraction would make a major impact on costs.
One study that I saw from 2005 (by Harvard U and the Kaiser Foundation) found that healthcare costs rose by an average of 2.5 percentage points more per year since 1970 than GDP. So it outpaced our economic growth every year for the last 35 years. Up to that point in 2005, the study estimated, we had dedicated 16% of our GDP to healthcare costs. And it was only rising.
R&D itself isn't necessarily as virtuous a process as we might like, either. Most of the big pharma companies rely on big "lifestyle drug" successes (Levitra, Cialis, Lipitor, etc) for their profit margins, rather than an drug that targets, say an illness that effects a relatively small segment of the population (in which the profit margins are much smaller).
I can't speak authoritatively about Canadian healthcare, and though I respect Spoonbill's uncle's point of view, I've been searching high and low for information on black market clinics and haven't been able to come up with anything illuminating at all. Spoonbill, if you've got an article or anything to reference, I'd be much obliged.
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Originally posted by si_uk_lon_ok
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If that were the case why does Canada spend only $307 per capita on health administration costs, but in the US the costs are $1,059 per capita. Administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada.
http://content.nejm.org/cgi/content/abstract/349/8/768
So glad you brought that up! You are right. Canada has a very efficient system of medical coding. Their review system does not rely on quick results like ours. That's why diagnostics and other procedure that require review take so long in Canada.
We on the other hand have the Medicare and Medicaid system, in which each doctor in the US. has a person on staff that does nothing but prepare, code and submit documents to the federal government for reimbursement. These documents are then reviewed just like the IRS system. If there is a discrepancy in the coding they are rejected or researched by a nurse or government consultant. (medical code books are huge phone-book like volumes)
My Brother had discrepancies as small as $6.00 go to review, costing hours of time in the submission of records, and in one case he had a review nurse show up at his office for a $22 discrepancy on a patients medicare submission. She spent half a day reviewing the case, and the patients records before she found his assessment to be correct. 2 months later he received his reimbursement.
Spoon, man, we were having a nice discussion here and you completely drove it off into the ideological ditch.
Can we maybe continue civilly, without you telling me I'm gonna start crying if we don't collectivize our farms RIGHT NOW?
Well Wevus, if nothing else Spoon is pointing out what a horrible job our government is doing in it's foray into health care. I don't think he was trying to, but if he was... it would be a really bad case for handing MORE health care responsibility to the government.
A "free market" has led us to where we have the least efficient health-care system on the planet.
We spend substantially more money per capita than any other nation on earth (44% more than number 2 Switzerland) and end up with one in six people completely without any health coverage at all and the leading cause of bankruptcy is medical bills.
More than one fourth of Americans already are on government insurance of some sort and every other developed nation has some sort of nationalized health care. There are some areas where government does a better job than private industry. This is one of them.
"My doctor is wonderful. Once when I couldn't afford an operation, he touched up the X-rays."
Joey Bishop
"Doctors are the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you too."
Anton Chekhov
"The New England Journal of Medicine reports that 9 out of 10 doctors agree that 1 out of 10 doctors is an idiot."
Jay Leno
"It's no longer a question of staying healthy. It's a question of finding a sickness you like."
Jackie Mason
The US has a life expectancy that ranks 27th in the world for life expectancy and has 40m people without healthcare, yet per head the cost per capita of health is the highest in the world. Switzerland the country that spends the next highest spends 71% of the US total and has the 4th highest life expectancy.
I've experienced health care in the USA and in the UK. There were both very good and I have no complaints. However I know that if I were to lose my job in the UK and slip on some ice on the way home I wouldn't be ruined. I know that if I'm hit by a bus, I'm given the best healthcare available not the one I'm covered for.
Somethings wrong with the system as is. If someone can come up with a version that means that 40m Americans can receive health care and less money is spent on administration I'd want to hear it. If the solution involved more government I'd listen to it too, I think we need all the possible options put on the table and considered. The government has done some amazing achievements before and I think it will do it again, so lets not ignore all the possible solutions.
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Originally posted by cannon_fodder
Well Wevus, if nothing else Spoon is pointing out what a horrible job our government is doing in it's foray into health care. I don't think he was trying to, but if he was... it would be a really bad case for handing MORE health care responsibility to the government.
Hey, I'm cool with having that discussion -- and FWIW, I agree with that premise -- but he just kinda went on a page long rant about Communism/Socialism/Fascism/Liberalism/blah and how everything is killing the precious precious free market which is like the Hand of God Itself, able to make all men whole.
I'm trying not to be an ideologue here, and keep things rational. All I'm asking him to do is try to do the same.
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Originally posted by we vs us
quote:
Originally posted by cannon_fodder
Well Wevus, if nothing else Spoon is pointing out what a horrible job our government is doing in it's foray into health care. I don't think he was trying to, but if he was... it would be a really bad case for handing MORE health care responsibility to the government.
Hey, I'm cool with having that discussion -- and FWIW, I agree with that premise -- but he just kinda went on a page long rant about Communism/Socialism/Fascism/Liberalism/blah and how everything is killing the precious precious free market which is like the Hand of God Itself, able to make all men whole.
I'm trying not to be an ideologue here, and keep things rational. All I'm asking him to do is try to do the same.
Wow! I didn't think that was irrational. We are talking about socialized medicine right? I was just offering the natural progression of taking that path.
I'm sorry if that makes you uncomfortable, but you can't have one without progressing toward the other. Once the government begins to act as a provider, the people naturally want to be provided for. It's just what happens. We have already been slouching in that direction with other social programs.
A democracy cannot exist as a permanent form of government. It can only exist until a majority of voters discover that they can vote themselves largess out of the public treasury. – Alexander TytlerIt's not an endlessly expanding list of rights – the "right" to education, the "right" to health care, the "right" to food and housing. That's not freedom, that's dependency. Those aren't rights, those are the rations of slavery – hay and a barn for human cattle. – Alexis De Tocquiville
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Originally posted by spoonbill
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Originally posted by we vs us
quote:
Originally posted by cannon_fodder
Well Wevus, if nothing else Spoon is pointing out what a horrible job our government is doing in it's foray into health care. I don't think he was trying to, but if he was... it would be a really bad case for handing MORE health care responsibility to the government.
Hey, I'm cool with having that discussion -- and FWIW, I agree with that premise -- but he just kinda went on a page long rant about Communism/Socialism/Fascism/Liberalism/blah and how everything is killing the precious precious free market which is like the Hand of God Itself, able to make all men whole.
I'm trying not to be an ideologue here, and keep things rational. All I'm asking him to do is try to do the same.
Wow! I didn't think that was irrational. We are talking about socialized medicine right? I was just offering the natural progression of taking that path.
I'm sorry if that makes you uncomfortable, but you can't have one without progressing toward the other. Once the government begins to act as a provider, the people naturally want to be provided for. It's just what happens. We have already been slouching in that direction with other social programs.
A democracy cannot exist as a permanent form of government. It can only exist until a majority of voters discover that they can vote themselves largess out of the public treasury. – Alexander Tytler
It's not an endlessly expanding list of rights – the "right" to education, the "right" to health care, the "right" to food and housing. That's not freedom, that's dependency. Those aren't rights, those are the rations of slavery – hay and a barn for human cattle. – Alexis De Tocquiville
Maybe if we have a free market we'd end up having to sell off all our roads, sewage lines and power lines. You'd need insurance to get the fire brigade to put out your house fire, the police would be like security guards only found in malls and posh neighbourhoods and the military would be mercenaries. Maybe I should be allowed to sell myself into slavery, or rent out my body, or allow people to harvest my organs while still living if I was a bit short of cash. Maybe starvation would be a market response to over supply of labour.
You can not leap to the extreme and say what if, what if. The natural progression arguement isn't a proper arguement. Please try and be rational on the topic.
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Originally posted by swake
A "free market" has led us to where we have the least efficient health-care system on the planet.
We spend substantially more money per capita than any other nation on earth (44% more than number 2 Switzerland) and end up with one in six people completely without any health coverage at all and the leading cause of bankruptcy is medical bills.
More than one fourth of Americans already are on government insurance of some sort and every other developed nation has some sort of nationalized health care. There are some areas where government does a better job than private industry. This is one of them.
Have you ever dealt with Medicare or Medicaid? You realize compliance is 35% of the cost and fraud is estimated to be up to another 33%? So of every dollar spent only 32 cents is actually for health care. That's a good system? That's the government doing a good job?
If you look back, when did all this start to happen? When our government stuck their stupid head in the system to start with. In the good 'ole days that a certain someone pops in to rant about every now and then, there was no medicare, medicaid, or other BS. When the government started making obscene compliance demands the cost of health care went up and insurance companies started capitalizing on the screwed up system.
IMHO the current government attempt at health care is a miserable failure and an example of what we need to get away from. But I digress...
- - -
I agree that other countries have socialized medical systems that work well. But here, in the United States, our government's attempts at jumping into health care have been a disaster. Costs are higher to the taxpayers than anywhere else, the benefits are lower to the recipients, it's a huge pain the donkey for everyone (compliance for the doctor and what to do for the patient) and it's effectiveness is marginal at best.
Add the associated fraud, the fact that our country has the least healthy lifestyle of anywhere in the world, and that we demand the latest and greatest at all times (the imaging systems in most of the world are America's last generation of products) and that spells trouble.
Socializing medicine under the Swiss model might work (I fully admit I'm no expert on foreign health care systems and thus must admit they seem to work better), but any adoption of socialized medicine under the current model is not only a horrible idea, it is impractical and simply not feasible.
Johns Hopkins had a great article on this a few years back:
quote:
"As in previous years, it comes back to the fact that we are paying much higher prices for health care goods and services in the United States. Paying more is okay if our outcomes were better than other countries. But we are paying more for comparable outcomes," said Anderson, who is also the director of the Johns Hopkins Center for Hospital Finance and Management.
http://www.jhsph.edu/publichealthnews/press_releases/2005/anderson_healthspending.html
Curiously, they didn't offer any explanation as to why we pay more. Surely it has nothing to do with medical schools limiting the supply of MDs, our MDs being the highest paid in the world, or anything else in their industry. [;)]
si_uk_lon_ok you confuse society with socialism.
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si_uk_lon_ok
Maybe if we have a free market we'd end up having to sell off all our roads, sewage lines and power lines. You'd need insurance to get the fire brigade to put out your house fire, the police would be like security guards only found in malls and posh neighbourhoods and the military would be mercenaries. Maybe I should be allowed to sell myself into slavery, or rent out my body, or allow people to harvest my organs while still living if I was a bit short of cash. Maybe starvation would be a market response to over supply of labour.
You can not leap to the extreme and say what if, what if. The natural progression arguement isn't a proper arguement. Please try and be rational on the topic.
It will be an interesting experiment. Socialized programs in other countries only work because they rely on the US to provide most of the pharmaceutical and medical advances. Once we slow or stop the development of new drugs and medical advances, it will be interesting to see how the rest of the world fares.
If people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny. – Thomas JeffersonThe American people will never knowingly adopt socialism, but under the name of liberalism, they will adopt every fragment of the socialist program until one day America will be a socialist nation without ever knowing how it happened. – Norman Thomasand finally:
Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society. As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all. – Frederic Bastiat
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Originally posted by spoonbill
si_uk_lon_ok you confuse society with socialism.
quote:
si_uk_lon_ok
Maybe if we have a free market we'd end up having to sell off all our roads, sewage lines and power lines. You'd need insurance to get the fire brigade to put out your house fire, the police would be like security guards only found in malls and posh neighbourhoods and the military would be mercenaries. Maybe I should be allowed to sell myself into slavery, or rent out my body, or allow people to harvest my organs while still living if I was a bit short of cash. Maybe starvation would be a market response to over supply of labour.
You can not leap to the extreme and say what if, what if. The natural progression arguement isn't a proper arguement. Please try and be rational on the topic.
It will be an interesting experiment. Socialized programs in other countries only work because they rely on the US to provide most of the pharmaceutical and medical advances. Once we slow or stop the development of new drugs and medical advances, it will be interesting to see how the rest of the world fares.
If people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny. – Thomas Jefferson
The American people will never knowingly adopt socialism, but under the name of liberalism, they will adopt every fragment of the socialist program until one day America will be a socialist nation without ever knowing how it happened. – Norman Thomas
and finally:
Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society. As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all. – Frederic Bastiat
I know the difference between society and socialism. Asking the government to do get involved in healthcare is not socialism any more than asking the government to deliver our mail or look after our prisoners is.
My previous post was highlighting the major problem with your posts, that you can not get an idea and run with it to the extreme.
There are plenty of, in your mind, 'socialist' projects such as social security which have not lead to socialism so why should health care? The UK, France and Canada all have government administered health systems and do not have socialist governments. Do you have any example of health care leading to socialism?
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Originally posted by si_uk_lon_ok
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There are plenty of, in your mind, 'socialist' projects such as social security which have not lead to socialism so why should health care? The UK, France and Canada all have government administered health systems and do not have socialist governments. Do you have any example of health care leading to socialism?
My friend, that is only because it is no longer in vogue for people to refer to themselves as socialists. That does not make the countries you mention any less socialist. A socialist system can, and usually does exist under the guise of democracy. History teaches us that democracy must be the primary ingredient in the creation of a socialist society.
Your difficulty, and the difficulty of modern socialists is their discomfort with referring to themselves as what they are. . . socialist.
They push for the philosophy, and the programs but refuse the title.
There is no difference between communism and socialism, except in the means of achieving the same ultimate end: communism proposes to enslave men by force, socialism -- by vote. It is merely the difference between murder and suicide. – Ayn Rand, LA Times, 9/2/62
Democracy is indispensable to Socialism. – V.I. Lenin
Democracy is the road to Socialism. – Karl Marx
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Originally posted by spoonbill
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Originally posted by si_uk_lon_ok
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There are plenty of, in your mind, 'socialist' projects such as social security which have not lead to socialism so why should health care? The UK, France and Canada all have government administered health systems and do not have socialist governments. Do you have any example of health care leading to socialism?
My friend, that is only because it is no longer in vogue for people to refer to themselves as socialists. That does not make the countries you mention any less socialist. A socialist system can, and usually does exist under the guise of democracy. History teaches us that democracy must be the primary ingredient in the creation of a socialist society.
Your difficulty, and the difficulty of modern socialists is their discomfort with referring to themselves as what they are. . . socialist.
They push for the philosophy, and the programs but refuse the title.
There is no difference between communism and socialism, except in the means of achieving the same ultimate end: communism proposes to enslave men by force, socialism -- by vote. It is merely the difference between murder and suicide. – Ayn Rand, LA Times, 9/2/62
Democracy is indispensable to Socialism. – V.I. Lenin
Democracy is the road to Socialism. – Karl Marx
No the reason they aren't called socialists is that they aren't socialists. You are doing the tired right wing ploy of calling centralists and liberals, socialists when they blatantly aren't. If you think the UK, France or Canada are socialist, you must think the whole world is socialist. The USA spent 35.4% of its GDP on public spending, the UK 38% and it provided free health care. That hardly makes the UK look socialist to me, especially if you took of health care spending is 8.3% of total GDP. In fact the US looks more socialist than the UK.
Using your definition is supporting social security and the US postal service socialism? How about the government building and maintaining roads?
And I can't believe you're quoting Marx like that. Do you mean we should not have democracy in an attempt to prevent socialism?
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Originally posted by spoonbill
You are correct. There are very few physicians that can make a living on running a private only clinic, since medical insurance and reimbursement are illegal except in Quebec where they ruled that would constitute a monopoly, and allow it. This causes many physicians to offer some services under-the-counter or through small clandestine offices. These physicians are prosecuted, in many cases for offering services that the government system denys or delays their patients in recieving.
No, you can buy private health insurance in Canada, just as you can in the UK, Australia, or most any other country with a similar system. (Well, I don't know about France, but at least in those countries you can)
That's not to say that there are a lot of doctors to see, given the ban on having your fingers in both pies.
In Quebec, it wasn't about being a monopoly, it was about Quebec not allocating enough funds to see that everyone got quality health care in a timely manner, at least from what I've read.
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That said, I don't agree with a prescription medication advertising on TV to the end user. You shouldn't have to tell your doctor what to prescribe for you!
Sorry about the incorrect numbers. I saw ones for a few selected companies and stupidly assumed that it would be similar across the entire industry.
At least we agree that TV ads for drugs are in no way a good thing.
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After 12 years of college and medical school, my brother makes around $190,000 a year. Not bad. In 1980 a cardiologist (my bro's specialty) would make around $250,000 a year. A good one with a large patient base could make much more. Each year he makes less and less, and the insurance companies make more and more. Now they are telling him how many patients he must see a day and how long he can spend with them. He has to call the insurance company to find out what drugs he can give his patients and what surgeries they can or can't have.
While I can't speak to your brother's specific case, I do have to wonder whether the issue is declining billing or increasing costs, and if it is increasing costs, where the costs are increasing.
I am quite aware of the pressure insurance companies put on doctors, essentially dictating what they can charge for their services and the increasing cost of being compensated by the insurance companies, as well as the increase in medical malpractice insurance costs, which seem to rise drastically each year despite there not actually being a rash of stupidly high jury awards.
I'll have to double check, but I seem to recall that the average payout for medical malpractice claims hasn't increased in many years, although there are some extraordinary cases with big numbers that get thrown about in an attempt to push so called tort reform.
And just as a question, are there more cardiologists in Tulsa now than there were in 1980?
I think we both agree that the system is broken as it stands.
Just FWIW, Ayn Rand's theories tend to do quite poorly when put into practice in the real world, at least when they're not tempered by a social safety net, one part of which is providing everyone with health care without regard to their ability to pay.
One thing I've always wondered is why people don't grasp that if there are a bunch of poor people going around sick because they can't see a doctor, that you are much more likely to fall ill from their disease.
And spoonbill, are you really saying that the money our government spends on drug research actually produces no results whatsoever?
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No the reason they aren't called socialists is that they aren't socialists. You are doing the tired right wing ploy of calling centralists and liberals, socialists when they blatantly aren't.
I apologize, didn't realize it was a ploy.
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If you think the UK, France or Canada are socialist, you must think the whole world is socialist. The USA spent 35.4% of its GDP on public spending, the UK 38% and it provided free health care. That hardly makes the UK look socialist to me, especially if you took of health care spending is 8.3% of total GDP. In fact the US looks more socialist than the UK.
Well for the most part, the rest of the world is socialist. like wagons lashed to a cart, the engine for the rest of the world is the United States. You cannot categorize our public spending numbers that way. Much of what we spend in that category is infrastructure.
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Using your definition is supporting social security and the US postal service socialism? How about the government building and maintaining roads?
Yes! Social Security and Postal Service are socialism. They have nothing to do with defense, law enforcement, or infrastructure support! Do you know that the postal service no longer provides overnight services? They offer the service and you put your fruit-cakes in the little post office overnight box, but FedEx has the overnight contract to deliver the product to the receiving post office. Why? Because they are cheaper and more efficient.
Government building and road maintenance are infrastructure expenses.
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And I can't believe you're quoting Marx like that. Do you mean we should not have democracy in an attempt to prevent socialism?
Not at all, but we must all act as vigilant gate keepers and make sure we protect our democracy. It is inevitable that democracy eventually collapses into socialism, but if we are wise, we can help to delay the process.
Democracy is the only form of government that can be removed without violence. By its nature it bates its own destruction. Our comfort makes it easy to sleep.
Ok, how about these quotes as we slouch forward?
"Comrades! We must abolish the cult of the individual decisively, once and for all." [Nikita Khrushchev , February 25, 1956 20th Congress of the Communist Party]
"All our lives we fought against exalting the individual, against the elevation of the single person, and long ago we were over and done with the business of a hero, and here it comes up again: the glorification of one personality. This is not good at all." [Vladimir Lenin, as quoted in Not by Politics Alone]
"We must stop thinking of the individual and start thinking about what is best for society." [Hillary Clinton, 1993]
"We can't be so fixated on our desire to preserve the rights of ordinary Americans ..." [President Bill Clinton, 'USA Today' March 11, 1993: Page 2A] We must be asleep!
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Originally posted by spoonbill
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No the reason they aren't called socialists is that they aren't socialists. You are doing the tired right wing ploy of calling centralists and liberals, socialists when they blatantly aren't.
I apologize, didn't realize it was a ploy.
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If you think the UK, France or Canada are socialist, you must think the whole world is socialist. The USA spent 35.4% of its GDP on public spending, the UK 38% and it provided free health care. That hardly makes the UK look socialist to me, especially if you took of health care spending is 8.3% of total GDP. In fact the US looks more socialist than the UK.
Well for the most part, the rest of the world is socialist. like wagons lashed to a cart, the engine for the rest of the world is the United States. You cannot categorize our public spending numbers that way. Much of what we spend in that category is infrastructure.
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Using your definition is supporting social security and the US postal service socialism? How about the government building and maintaining roads?
Yes! Social Security and Postal Service are socialism. They have nothing to do with defense, law enforcement, or infrastructure support! Do you know that the postal service no longer provides overnight services? They offer the service and you put your fruit-cakes in the little post office overnight box, but FedEx has the overnight contract to deliver the product to the receiving post office. Why? Because they are cheaper and more efficient.
Government building and road maintenance are infrastructure expenses.
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And I can't believe you're quoting Marx like that. Do you mean we should not have democracy in an attempt to prevent socialism?
Not at all, but we must all act as vigilant gate keepers and make sure we protect our democracy. It is inevitable that democracy eventually collapses into socialism, but if we are wise, we can help to delay the process.
Democracy is the only form of government that can be removed without violence. By its nature it bates its own destruction. Our comfort makes it easy to sleep.
Ok, how about these quotes as we slouch forward?
"Comrades! We must abolish the cult of the individual decisively, once and for all." [Nikita Khrushchev , February 25, 1956 20th Congress of the Communist Party]
"All our lives we fought against exalting the individual, against the elevation of the single person, and long ago we were over and done with the business of a hero, and here it comes up again: the glorification of one personality. This is not good at all." [Vladimir Lenin, as quoted in Not by Politics Alone]
"We must stop thinking of the individual and start thinking about what is best for society." [Hillary Clinton, 1993]
"We can't be so fixated on our desire to preserve the rights of ordinary Americans ..." [President Bill Clinton, 'USA Today' March 11, 1993: Page 2A]
We must be asleep!
Ok, you're simply too much!
I think we are waaaaaaay apart on this issue.
By the way, democracy inevitably leads to socialism. That is only the case if you sign up to the Marxist doctrine of stages to communism. Which you seem to have done. Most people conventionally sign up to the alternative to Marxism in the 'The stages of economic growth: the non communist manifesto' by Rostow.
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Originally posted by spoonbill
Not at all, but we must all act as vigilant gate keepers and make sure we protect our democracy. It is inevitable that democracy eventually collapses into socialism, but if we are wise, we can help to delay the process.
Democracy and socialism aren't mutually exclusive. In fact, they are orthoganal to each other. One is a system of deciding who gets to be in charge. The other is an economic system.
As long as you conflate the two, we can't have productive discussion on the topic.
FWIW, there are now existing plenty of what you would refer to as socialist states with democratic elections. There have also recently been many authoritarian states with nearly unfettered free markets.