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Washington State is a (poorly run) nanny state. I work at UW. This past month, in order to qualify for a $125 "wellness incentive" on my health insurance next year, I had to fill out a "well-being assessment" that, among other things, asked me multiple questions regarding whether I felt "empowered" at work. Based on my answers, one of the suggested activities I could do for credit (in addition to the more reasonable "eat five fruits and vegetables" and "walk at least 35,000 steps a week") was "meet with a mentor". Yeah, you guys can't even agree on a budget but you can spend money developing an overly-simplistic computerized system to pretend you're actually caring for your employees...

I wouldn't blame the nanny state for wellness incentives. That started out from the HR departments of the big corporations, as a way to cut health costs. I remember reading about that in BusinessWeek in the 1980s. More recently, I've seen studies of wellness incentives in the New England Journal of Medicine. They vary between being totally useless and having a small effect. Science doesn't know enough about diet to tell you that eating specific foods will improve your health (and cut your employer's health care costs).

(Do you want to have fun? Ask your employer to show you the publications in the peer-reviewed literature to support those "suggestions.")

Of course BusinessWeek didn't want to recommend the non-corporate ways to cut health care costs. http://www.openmedicine.ca/art...

Um... not only is the health care industry the heaviest regulated, but we are actually REQUIRED to buy insurance. Only a progressive would use this as an example of how government control is better.

We have been required to contribute to Medicare through payroll taxes, but it's only recently that we've been required to buy private insurance through Obamacare. While people tell me that Obamacare is better than what we had before, it's still a terrible system. It's very expensive, and the burden falls most heavily on the middle class.

But Obamacare isn't a progressive system. The idea came from the Heritage Foundation, a right-wing corporate-funded pro-free market think tank. All payments go through private insurance companies, which are even more inefficient than the government. (They proved that with Medicare Advantage plans.)

Obamacare isn't socialized government-run health care like the UK, and it isn't a single payer system like Canada. The health industry lobbyists, specifically the Health Insurance Association of America, demanded that Obama exclude any government option (free choice, competition) or they would blow up the whole thing with Harry and Louise ads.

Bottom line: Americans pay about $6,000 a year for health insurance through private insurance companies, Canadians pay about $3,000 a year for health insurance through taxes. http://www.openmedicine.ca/art...

Canada pay an average of about half as much in taxes (scaled to their income), for the same quality and the same service.

From what I've heard about medicine in Canada from locals, this is laughably untrue. Only someone who has never had more than a minor boo-boo could claim the service is the same.

You are completely wrong.

I've talked to doctors and patients who have experienced both the Canadian and US systems, and I've read the literature comparing outcomes for different procedures in the two systems. http://www.openmedicine.ca/art... I read Canadian medical studies every week or two.

If I had a heart attack in front of the University of Toronto medical school, I would be confident that my survival and other outcomes would be just as good as they would be in front of the New York University medical center in New York. At one time, the breast cancer outcomes were slightly better in the US than in Canada, because the US was aggressively diagnosing and treating (sometimes overdiagnosing and overtreating) breast cancer, but by now the Canadians have adopted everything useful that the US was doing. OTOH, the Canadian outcomes for childhood leukemia were slightly better. The Canadian outcomes for diabetes were much better, with better control, fewer amputations, etc.

Gordon Guyatt, a professor at McMaster University, basically invented evidence-based medicine, which is the practice of making medical decisions based on the statistically valid scientific evidence, rather than prescribing drugs because the drug companies are giving you a free trip to Hawaii if you meet their quota.

It is true that American doctors are more aggressive about treatment, and will give you a quick appointment if they have slots available and you have good insurance. OTOH American doctors are more likely to treat patients unnecessarily. An American pulmonologist is more likely to see a spot on your x-ray and give you a lung biopsy. Lung biopsies have a fatality rate of about 1/1,000, and most of them are unnecessary. But in Canada, when you have a life-threatening condition and need a CAT scan immediately, they put you on top of the list and give you a CAT scan the same day.

OTOH if you don't have health insurance in the US, your access to health care in many states is nonexistent, and hospitals in Texas for example will kick cancer patients out in the street if they can't pay. http://www.wsj.com/articles/SB... There were several studies published in American medical journals in which researchers called doctors' offices, described the symptoms of a life-threatening condition, told them that they were on Medicare or Medicaid, and asked for an appointment. Depending on the studies, about half the doctors refused Medicare and three-quarters refused Medicaid.

The evidence is overwhelming that Canadian health care equals the US system in quality and service, and costs about half as much. Of course if you decide things on the basis of ideology http://www.newyorker.com/news/... rather than evidence you may not be convinced.

Anytime something is "publicly funded" the cost shoot up.

Which is why the Canadian health care system costs half of that in the US, and gets the same outcomes with high consumer satisfaction.

http://www.openmedicine.ca/art...
Open Medicine, Vol 1, No 1 (2007)
Home > Vol 1, No 1 (2007) > Guyatt
Research
A systematic review of studies comparing health outcomes in Canada and the United States

Not really, no. Our system costs twice as much for less effective medicine.

I agree that Obamacare (AKA Romneycare) isn't really the answer but the GOP wouldn't allow an actual comprehensive system to get through the House.

Here's a citation from the peer-reviewed literature that supports your claim.

It's important to realize that when we say that Canada and other health care systems cost half as much as ours with about the same outcomes, that's not an ideological slogan like the Republicans use, but we have science-based facts to back it up.

http://www.openmedicine.ca/art...
Open Medicine, Vol 1, No 1 (2007)
Vol 1, No 1 (2007) > Guyatt
A systematic review of studies comparing health outcomes in Canada and the United States

Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.

Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92–0.98, p = 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.

Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent.

Speaking of ideological slogans from the Republicans:

http://www.nytimes.com/2014/02...
Health Care Horror Hooey
Paul Krugman
FEB. 23, 2014
(Right-wingers convinced Americans that farms are being broken up to pay "death tax" estate liabilities, but there is not one singe example. Now the Republicans are creating Obamacare horror stories, which don't hold up upon fact checking. In the GOP response to the State of the Union address, Rep. Cathy McMorris Rodgers claimed "Bette in Spokane" had lost hergood insurance and was forced to pay $700 a month more. Local reporters found the real Betty, and found out [Bette Grenier had a catastrophic plan, and she refused to look on the ACA web site.] In Michigan, Americans for Prosperity, funded by the Koch Brothers, is running an ad about Julie Boonstra, who has leukemia, saying that her new policy will have unaffordable out-of-pocket costs. But Glenn Kessler of the Washington Post found that she will be saving more than she will be paying in out-of-pocket costs. [The Obamacare out-of-pocket maximum is $6,350. Her premiums were cut in half, from $1,100/mo to $571/mo.])
the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.

You've failed to mention that both systems will let folks with cancer die. Socialist medicine has proven to fail (Canada), and the steps we've taken towards it in USA have failed

Absolutely false. There have been many studies comparing the health care system in the US and Canada, and they all come to the same conclusion: Health care in Canada is just as good as health care in the US, and sometimes better.

Here's one: http://www.openmedicine.ca/article/view/8/1 A systematic review of studies comparing health outcomes in Canada and the United States (Basically it says that the outcomes are the same in both the US and Canada, but the US costs twice as much.)

There's a Wikipedia article comparing the US and Canadian health care systems. They link to dozens of studies, which overwhelmingly come to the same conclusion.

There are also studies comparing the US to other health care systems. They come to the same conclusion too.

There's one exception. When epidemiologists make international comparisons, they have to compare black Americans separately, because their health care is so much worse.

Somebody has to pay for it (before you say "government", where does gov't get its money? That's right, it's your money and my money).

Somehow conservatives think it's a great insight to tell people that their own money goes to pay taxes. Everybody knows that. I'm happy to pay taxes if I get something worthwhile for my money.

The issue is whether you would rather pay $5,000 in taxes, or $10,000 in private insurance premiums, for the same health care. I'd rather pay $5,000. Who would rather pay $10,000? Hands?

Under capitalism, people who can afford it pay about $10,000 per capita per year to insurance companies for health care (depending on the year you measure).

Under socialism, people pay about $5,000 per capita in taxes for health care of the same (and sometimes better) quality. http://www.openmedicine.ca/article/view/8/1

http://www.openmedicine.ca/article/view/8/1
http://www.commonwealthfund.org/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx
http://umaine.edu/ble/files/2011/01/US-healthcare-system.pdf

That covers three different dimensions for measurement, and we lose in every one.

If the US really had better treatments and outcomes, then you would think their life expectancy would be higher than Canada, but it is not: http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Also for the majority of afflictions you are far better off in Canadda than the US: http://www.openmedicine.ca/article/view/8/1

So, for comparable or less outcome, for this the US spends twice the amount per capita and per GDP than we do in Canada.

Personally my child was born 10 weeks premature. He required a top teir hospital and round the clock monitoring for about 8 weeks before being discharged. He also requires a number of medical tests up until he is 2 for monitoring of side effects to check his development. There was no waiting ever for anything that he needed. I've read online of people in the US that went through the same thing and their bill ended up being close to half a million dollars or more. The majority of which would have been covered but still. All I had to pay for was parking.

My father also went to the hospital complaining of weakness. They checked him out and immediately prepped him for surgery for a pacemaker. He received what they said was a $50k pacemaker, top of the line. No wait, no bills.

No the Canadian system is not perfect. Yes there are wait times for non life threatening conditions, so yet it definitely needs improving. But given my experiences with the Canadian and American systems (my sister is American - when she went into labour they would not send an ambulance until she gave them a visa number), makes me firmly believe our system is the correct way to go and I would never trade it for a private system like the US. Obama is on the right track - he just has to ignore the uninformed idiots and keep pushing.

Everyone needs normal health care, and a few will at some point require catastrophic care for an unusual condition. In the first case, there is no mutual benefit to spreading out the costs; all you've done is add overhead. In the second case, rationally-priced insurance should result in the same average cost for everyone, barring significant individual health risks.

Actually, that's not true. There are many ways of comparing free-market health care with government-provided health care, and in every case free-market health care costs more. One dramatic example is Canada, which spends about half what the U.S. does for about the same outcomes. http://www.openmedicine.ca/article/view/8/1

Selling health insurance to individuals has enormous administrative costs. If you look up the annual report of a health insurance company, you'll see that they have a "loss ratio" of no more than 85% -- which means they're spending 15 cents of your premium on administrative costs and profits. Your doctor gets the remaining 85 cents, and he has to spend another 15 cents on the administrative costs of dealing with the insurance companies. So your premium dollar only pays for 70 cents' worth of health care. (Actually it's even less.)

For reasons too complicated to go into here, people get worse health care when they have to pay for small medical expenses. "Normal" health care can be a $1,000 biopsy to see whether you have cancer. A lot of people can't afford $1,000. A lot of people can't afford $100 for a mammogram. Look up the Rand Health Insurance Experiment in Wikipedia.

I've gone through these statistics extensively. I've already quoted a couple of studies http://www.openmedicine.ca/article/view/8/1 here, and I can explain why you're wrong.

Cost per capita -- well, we've got more money than other people do (ha ha, except for being in debt up to our eyeballs), so this is not by itself compelling. And of course, note that socializing medicine is likely to increase our debt even higher than our eyeballs.

As that Guyer paper said, we pay a higher percentage of our GDP on health care than anyone else in the world. When you examine why, you find out that 30-50% of every dollar a customer pays to a private insurance company goes for administrative costs and profits. (Actually the administrative costs cost us more than the profits.) In addition, when government delivers medicine directly, as it does in the Veterans Affairs system, the cost is much lower, and the outcomes are just as good (sometimes better).

You can pay $4,000 a year in taxes as the Canadians do, or $8,000 a year in insurance premiums, as we do.

Of course, if you spend money, and cut taxes until you don't have enough to cover your spending, as the Republicans do, you will increase your debt.

Infant mortality rate -- I read that most comparisons of the USA's infant mortality rate to that of other countries are unfair and misleading, because we have higher standards and report it differently. For example, when many preemie infants are lost, the USA classifies as an infant death where other countries would classify it as an abortion. That kind of thing.

You read wrong. Doctors are pretty smart. They want to compare how well they're doing so they can identify areas of improvement and excellence. The infant mortality rates of all developed countries are based on the same definitions. Even if you did include premature infant deaths, the numbers are so low it wouldn't change the rankings.

When doctors study American infant mortality rates, the most striking statistical pattern is race. Blacks, hispanics and native Americans have much higher infant mortality than whites. The south Bronx has higher infant mortality than many third-world countries.

Race is probably a proxy for income. The U.S. has one of the most unequal societies in the developed world. Our Gini index is about that of Brazil.

Life expectancy -- I grant the statistics, but I question whether socialized medicine is necessarily the causative factor.

All studies find that life expectancy is correlated with income (and race). But in unequal countries, even the wealthy have lower life expectancies than people in more equal countries.

It seems that socialized medicine is part of the whole package of greater equality and better social services for all that leads to longer life expectancy, but it's hard to separate it.

Yes, you are correct, Canadian health care costs half as much as U.S. health care, and the outcomes of the Canadian system are at least as good -- possibly better. This has been demonstrated repeatedly in scientifically rigorous comparisons in peer-reviewed journals.

http://www.openmedicine.ca/article/view/8/1

A systematic review of studies comparing health outcomes in Canada and the United States

Gordon H Guyatt, PJ Devereaux, Joel Lexchin, et al.

Background: Differences in medical care in the United States compared with Canada, including greater reliance on private funding and for-profit delivery, as well as markedly higher expenditures, may result in different health outcomes.

Objectives: To systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.

Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.

Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92-0.98, p= 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.

Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent. ....

The United States also spends far more on health care, i.e., approximately 15% of its gross domestic product versus about 10% in Canada. In 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003.

http://www.nejm.org/doi/full/10.1056/NEJMsa022033

Costs of Health Care Administration in the United States and Canada

Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D.

N Engl J Med 2003; 349:768-775 August 21, 2003

Results

In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.

Why is it desirable that an operation provides a positive return on its investment?

Because otherwise you are making the world a worse place. By return, I don't just means dollars and physical wealth. I include anything that someone would be willing to pay for with their own wealth. I would pay to have my life and assets protected by police, and I do so pay via taxes.

I looked up von Mises in Wikipedia http://en.wikipedia.org/wiki/Austrian_school and I was suprised to see that the Austrian economists don't believe in empirical evidence. If you don't either, then there's no point in reading further, because this won't make any sense to you.

I don't hold the school in high regard precisely because of this.

But the facts are that despite whatever your theory predicts, there are many services that the government can provide far more cheaply and efficiently than private enterprise.

The best example is health care. The Canadian health care system costs about half as much per capita as ours, and the outcomes are about as good (sometimes better). http://www.openmedicine.ca/article/view/8/1 If Americans could buy health care at the price, quality and service of Canadian care, it would be the most popular health insurance in the U.S.

Americans couldn't get Canadian healthcare prices because US health care is more expensive. There is something of a tautology here. There are a variety of things that drive up the cost of health care in the US. What I consider first and foremost among these factors are the incentives to consume more and more expensive health care, such as employer insurance mandates and Medicare. Obamacare had a vast subsidy system that would contribute heavily to rising health costs. These incentives don't magically go away with a Canadian-style system.

Paul Krugman has provided lots of good arguments and data to show that government does a better job of providing health care than the private sector.

But he doesn't understand why the system is broken. You need insight not just data. Krugman used to be a good economist. Now he's a flak and apologist.

In health care, the problem with the free market, is that it's administratively more complex, which makes it more expensive.

You said "free market", more on that later.

If administration is such a costly issue, then government should help fix the problem by removing its regulations and mandates on insurance.

Doctors complained in a recent article in JAMA that dealing with private insurance companies is the most stressful part of their job. Doctors spend about 15% of their staff time administering private insurance payments.

So what? Don't accept customers with onerous insurance policies. Save yourself hassle, a pile of money, and you can focus more on the customers with sane insurance companies. It's a "free market" right? NO.

That's the thing the government health care boosters ignore. Health care in the US is just as heavily regulated as any other country. Doctors often aren't free to pick and choose (especially those at hospitals). Similarly, the insurance market is heavily limited in what sort of insurance policies it can provide.

For future reference, "free market" refers to markets with very low regulation.

As a final comment on this part, long ago, health insurance used to be sanely priced. What changed? It wasn't the insurance companies. They're still here and much the same as they were fifty years ago. We still have hospitals and doctors. Medical care costs didn't run up much faster than inflation because there was a "free market."

Instead, the key factor is that government has provided or mandated a lot of expensive, medical goodies to people who wanted them. We, of course, still have to pay for them.

Maybe Ayn Rand is "wrong," in whatever sense you mean, but you have yet to provide an example.

While we are at it, the federal government is more efficient the private industry almost all the time.

I don't understand why people make this claim, but I see it over and over again. There are several things to remember that completely undermine this. First, government doesn't have to provide a positive return on investment. A business has to make a profit in order to continue to exist, a government agency or regulation does not.

Why is it desirable that an operation provides a positive return on its investment? For most government services, it isn't. How can the police, court system, primary school system, and health care system turn a profit? Do you want the police to charge victims a fee before they investigate a crime? Do you want to limit elementary and high school education only to those who can afford it? Are you going to limit health care to those who "create value" and let the others die if they get multiple sclerosis or leukemia and can't afford to pay for the health care they need to save their lives?

I looked up von Mises in Wikipedia http://en.wikipedia.org/wiki/Austrian_school and I was suprised to see that the Austrian economists don't believe in empirical evidence. If you don't either, then there's no point in reading further, because this won't make any sense to you.

But the facts are that despite whatever your theory predicts, there are many services that the government can provide far more cheaply and efficiently than private enterprise.

The best example is health care. The Canadian health care system costs about half as much per capita as ours, and the outcomes are about as good (sometimes better). http://www.openmedicine.ca/article/view/8/1 If Americans could buy health care at the price, quality and service of Canadian care, it would be the most popular health insurance in the U.S.

Paul Krugman has provided lots of good arguments and data to show that government does a better job of providing health care than the private sector. One example is Medicare advantage. When the private insurance sector started to manage Medicare, they said they would save money. They now say that they can't continue to manage Medicare without a 15% premium over what government Medicare costs. Those are the facts. Of course if you don't believe in empirical facts, that won't convince you.

In health care, the problem with the free market, is that it's administratively more complex, which makes it more expensive. Unlike Medicare, private insurance companies have an army of clerks to figure out their contract arrangements with each patient and doctor. For these administrative costs, they charge you at least 15% of your premium dollar (and some of them complained because they couldn't charge 45% of the premium dollar). Medicare charges 2-3%.

Doctors complained in a recent article in JAMA that dealing with private insurance companies is the most stressful part of their job. Doctors spend about 15% of their staff time administering private insurance payments.

So after the insurance company takes 15 cents of your health care premium dollar in administrative costs, your doctor has to take another 15 cents to administer his insurance payments.

Bottom line: Government delivers health care more efficiently, at lower cost, and equal quality, than the private market. Ayn Rand was wrong.

Are you saying socialized education and medical care is better?

Yes

Than why is Canada slowly privatizing after decades of socialized medicine?

Please document

Why is Britain and France running constantly in the red budget wise?

This is an odd question to ask if you are defending the US system(that sentence is such a great opportunity for you)

Why are taxes in countries with socialized medicine and or education so much higher than elsewhere without any increased benefit seen via graduation rates?

Having met many US CS graduates the question should be 'Why do countries with socialized medicine and or education produce such a higher quality of graduate than those from one particular user pays country?'

Graduation rates mean absolutely nothing when some of the graduates that get through the US system appear to need remedial math.
A user pays system seems to generate a higher sense of entitlement amongst graduates(*sniff*why are those H1-B people stealing our jobs*sniff*?(Guess what sort of social system these people mostly learnt(OMG) their trade in?))?
The more bums on seats that get their diploma the more money the university makes and when the student is a profit centre nothing much else matters.

As for compassion, the state is a soulless thing that has no compassion. The state would sooner set you up in prison for not paying your taxes than give you a free handout. There is only one source of compassion and it seems to be anathema to most /.ers.

I haven't written off the possibility that God exists. I hope that if he does then the so-called 'rapture' happens soon as for me it will be rapture(the state of mind resulting from feelings of high emotion; joyous ecstasy). PLUS seeing all those written off SUVs would make me smile.

Socialized health care and education do not work. Get over it or go try and build your own socialist paradise.

I suspect that is an opinion based on someone's fear of those Godless communists. I also have no need to build a so called socialist paradise. AU has its problems but I didn't need indoctrination from birth to make me say that I wouldn't swap it for anywhere else on Earth. Get over it.

I think openmedicine.ca started that way...

Actually, a whole bunch -- http://blog.openmedicine.ca/node/223 . Given the rising cost of health care, this will certainly be a growth industry.

something will make things worse

If you have evidence showing things will get "worse" that isn't based on anecdotes and an irrational fear of "socialism", then by all means present it. Unfortunately for you, there is plenty of evidence showing things will in fact get significantly better if we switched to a publicly run system. Paper after paper has been written showing real gains in efficiency that would save the average American thousands of dollars a year. But hey. don't let reality and facts get in the way of your gut beliefs.

It's better than the American health care system, so that would be a plus compared to going to the USA.

You don't have to go all the way to Europe to find an example of socialized health care. Try up North in Canada. Canadians generally like to complain about the short comings of medicare. The popular perception amongst Canadians and Americans alike seems to be that, if you're able to afford it, care in the U.S. is better. However, some studies have shown that this isn't the case at all, and the quality of care is actually about equal or even better in Canada in some areas. This seems difficult to believe when you consider how much less Canada spends per capita on healthcare than the U.S., and even more so when you consider that, for that money, they cover everyone. However, bear in mind that, in addition to the advantages mentioned above, we don't have an entire industry of insurance-men and lawyers riding piggy-back on top of our hospitals the way they do in the U.S..

Socialized healthcare works. I'm glad we use it up here and will never vote for a politician that even dares to dream dismantling it. That being said, Canada's system has some drawbacks which you should study and try to avoid. It's a tad off topic, so I won't go into too much depth. However, one of the biggest problems with socialized healthcare is drawing the line between necessary procedures/drugs that everyone is entitled to and procedures which they have to pay for themselves, while at the same time not making it inordinantly difficult to pay for those procedures.

If you want perfect teeth in Canada, you pay for it. Braces are not deemed a medical necessity. However, private dentist clinics are everywhere so this is not a problem. Lots of companies offer dental plans, and you can also buy private insurance very similar to medical insurance in the U.S.. Finding a place that will do esoteric cosmetic surgery that has no non-frivolous applications can be difficult. Facial reconstruction? No problem. Labia sculpting? Good luck. Also, good luck finding a company plan that includes boob-jobs. (To be totally honest, there is one bar in town that has gained notoriety for it's policy of funding breast augmentations for employees. Let's consider them an exception to the rule.)

Another, somewhat chilling aspect of socialized medicine is that the state has to do cost/benefit analysis when deciding what procedures to perform. If an ninety-year-old in the U.S. can pay for hip replacement surgery he or she will get it if it kills them. In Canada, the cost of the operation, the risk to the patient, and the low benefit (a ninety-year-old is statistically unlikely to get much use out of a new hip) may mean that the patient won't get anything other than a wheelchair. This is not a system in which the patient is always right.

Here's a comparison of Canadian vs. U.S. health care from a peer-reviewed medical journal, by Gordon Guyatt, who is one of the world's top experts on comparing health care systems. The article points out that the U.S. health care system costs about twice as much per capita for the same or worse results.

http://www.openmedicine.ca/article/view/8/1

Open Medicine, Vol 1, No 1 (2007)

A systematic review of studies comparing health outcomes in Canada and the United States

Gordon H. Guyatt, P.J. Devereaux, Joel Lexchin, Samuel B. Stone, Armine Yalnizyan, David Himmelstein, Steffie Woolhandler, Qi Zhou, Laurie J. Goldsmith, Deborah J. Cook, Ted Haines, Christina Lacchetti, John N. Lavis, Terrence Sullivan, Ed Mills, Shelley Kraus, Neera Bhatnagar

ABSTRACT

Background: Differences in medical care in the United States compared with Canada, including greater reliance on private funding and for-profit delivery, as well as markedly higher expenditures, may result in different health outcomes.

Objectives: To systematically review studies comparing health outcomes in the United States and Canada among patients treated for similar underlying medical conditions.

Methods: We identified studies comparing health outcomes of patients in Canada and the United States by searching multiple bibliographic databases and resources. We masked study results before determining study eligibility. We abstracted study characteristics, including methodological quality and generalizability.

Results: We identified 38 studies comparing populations of patients in Canada and the United States. Studies addressed diverse problems, including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies that included extensive statistical adjustment and enrolled broad populations, 5 favoured Canada, 2 favoured the United States, and 3 showed equivalent or mixed results. Of 28 studies that failed one of these criteria, 9 favoured Canada, 3 favoured the United States, and 16 showed equivalent or mixed results. Overall, results for mortality favoured Canada (relative risk 0.95, 95% confidence interval 0.92-0.98, p = 0.002) but were very heterogeneous, and we failed to find convincing explanations for this heterogeneity. The only condition in which results consistently favoured one country was end-stage renal disease, in which Canadian patients fared better.

Interpretation: Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent.

Further reading on the Canada vs. U.S. comparison is:
http://www.washingtonmonthly.com/features/2000/000 7.marmorsul.html
Canada's Burning!
Media myths about universal health coverage
By Theodore Marmor & Kip Sullivan

Gordon Guyatt et al. just published "A systematic review of studies comparing health outcomes in Canada and the United States," in volume 1, issue 1 of Open Medicine, a new Canadian journal with an editorial board composed of some of the world's top medical experts, and a staff that just quit or got fired from Canada's formerly top medical journal.http://www.openmedicine.ca/article/view/8/ 1 The review's conclusion is:

"Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent."

The article also says that, in 2003, Americans spent an estimated US$5,635 per capita on health care, while Canadians spent US$3,003.

The journal Open Medicine is another story. John Hoey, editor of CMAJ, the journal of the Canadian Medical Association, was fired last year by the CMA, and most of the staff resigned. http://content.nejm.org/cgi/content/full/354/19/19 82 http://www.cmaj.ca/cgi/content/full/174/1/9 http://www.cmaj.ca/cgi/content/full/173/12/1435 Hoey sent reporters to buy morning-after pills in pharmacies around Canada. They found out that pharmacists illegally asked for personal information, which was entered in their computers. The Canadian Pharmacists Association complained to the CMA, and the CMA censored the story. The CMAJ staff now founded this new journal, Open Medicine, and they have loaded the first issue with the best studies they could get.