There is only one im****tant fact about the economy of the United States,
and it ain't the possibility of wars caused by Dick Chaney and his
little friend whats-his-name. It's the health care mess.
Health care is roughly a fifth of everything everybody does, net net,
and this shows up as different numbers in the national accounts of
different countries. Typically health care has a monetarily countable
value of about 10% of the whole monetary economy, with of course a lot
more outside the cash economy. Tooth bru****ng would be one example of
this latter; so would the millions of women home-sequestered by aged or
infirm relatives.
The United States is unique among the advanced industrial nations in (at
least) two ways: it has the lowest life expectancies, both at birth and
at all later stages of life; and it is the only country to allow
commerical insurance companies a major role in the management of and
payment for medical services.
Right-wing ideaologues in the United States used to sneer at Canada for
having "socialised medicine," until their position became so laughable
that a sneer could not be maintained -- even with Botox.
Canada does not have socialised medicine.
Canada has socialised medical insurance.
Canadian medical care is delivered by doctors at the level of private
practice, and by clinics and hospitals very generally. The clnics and
hospitals are sometimes privately, often minicipally or provincially,
owned; in a few cases they are operated by unions or co-operatives. In
all cases the standards of medical care are dictated by individual
doctors, by county medical asociations, and by the various relevant
Royal Colleges and scientific associations.
Payment for medical services is made through Provincial agencies, which
are funded out of Federal and Provincial taxes. The Feds have no
administrative role, although they do lay down some basic rules,
essentially that if some right-wing nut Province were to hand everything
back to the insurance companies, they would be suddenly off the Federal
tit. Each Province negotiates with the various medical societies
(Whenever I say "Royal Society," you are free to read "trade union") and
these negotiations can be as vicious as anything the Teamsters' Central
conference ever stuck to the over-the-road milk haulers, to pick a
health-related example at random.
There are also hammer and tongs fights within the medical societies. I
don't know whether there exists a straight female anaesthesiologist in
Ontario yet -- but if there is, it sure took a long hard fight. Everyone
(except surgeons) has known for years that surgeons were grossly
overpaid, (and surgery grossly over-prescribed) but this has only been
brought under even rough control in the last couple of years. The mills
of the gods may grind fine, but they sure as hell grind slow on some
issues...
I could go on at greater length -- and may have to do so, given the
predictable shower of stupid replies this note is likely to bring. I
won't right now. I simply repeat the im****tant points:
Canada does not have socialised medicine.
Canada has socialised medical insurance.
-dlj.
Hmmm. Did I maybe leave a little thing out? Is the Republican leader in
the Senate a centimillionnaire scion of a health insurance racket that
has recently paid a fine in the many many millions of dollars for some
of its crimes?
But of course it would be gross of me to bring such a thing up: his
stock is all in his sealed trust, isn't it?
Small detail: I mean on this issue the Republican Senate only muddles
with 15% or so of the economy when it comes to health insurance
questions...
-d.
|
