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photopilot
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Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 2:34 am

Political activist Ralph Nader recently outlined the advantages of Canada’s medicare system over so-called Obamacare in the United States to an audience at Western University in London, Ont.:

http://www.thestar.com/opinion/comme...th_care_better_than_obamacare.html

Quote:
Dear America:

Costly complexity is baked into Obamacare. No health insurance system is without problems but Canadian-style single-payer full medicare for all is simple, affordable, comprehensive and universal.

Nader goes on to outline 22 reasons why Canadian style single-payer universal healthcare is better than Obamacare. Makes for interesting reading.

Let's keep the politics out of it and try to only discuss the points Nader raises.
 
Arrow
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 3:03 am

Good luck keeping the politics out of it. I quit commenting on most U.S. Healthcare discussions months ago. Same folks will trot out the same arguments pro and con and no one will convince anyone else of anything. A lot of shouting, very little listening.
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einsteinboricua
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 3:06 am

Quoting photopilot (Thread starter):
Let's keep the politics out of it and try to only discuss the points Nader raises.

Unfortunately, that's quite difficult. I think the bigger contributor of why Canada's health care system is better is that there are no politicians trying to undermine it. Yes, Obamacare has its flaws, yet some prefer to repeal rather than to repair the law.

Another reason Obamacare is not working is the "socialism" label placed on it and how people don't want to be associated with anything "socialist". We can't speak on how great Canada's healthcare system is, or even European ones, yet wish for the worst when the nation tries to implement it over here.

Frankly, I think Mr. Nader could have also offered suggestions on how to improve the system rather than simply compare it with a superior one and wonder why it can't be that great.

Just my   
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AA7295
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 3:14 am

Of course it is!

They didn't have the conservative/Republicans trying to deface the Affordable Care Act in its original form. People fail to remember that this is a halfway point agreed to by Republicans and Democrats. The ACA is lighter version than what was originally proposed.

Also, this is the first step. I hope (and I pray to the universe and all the planetary deities) that the ACA evolves into something similar to what is available in Canada, the UK and Australia.
 
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DocLightning
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 6:16 am

A lot of Americans love to crow about how horrible Canada's healthcare system is. They've never seen it at work.
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seb146
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 6:59 am

Quoting einsteinboricua (Reply 2):
I think Mr. Nader could have also offered suggestions on how to improve the system rather than simply compare it with a superior one and wonder why it can't be that great.

That is the Republican ideal. They keep screaming over and over again how bad ACA is but they do nothing at all to put an alternate plan out there.

I have had to deal with the Canadian health care system in a very minor way. I was stung by a bee. Yes, very minor. I called the Canadian health people. They talked me through it. Nothing bad was going to happen to me. After that was determined, they asked for my Canadian health plan info. They were concerned for my health first and payment second.
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Kiwirob
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 11:48 am

Quoting DocLightning (Reply 4):
A lot of Americans love to crow about how horrible Canada's healthcare system is.

Do they, I've never heard that, I always thought Americans admired it but wouldn't accept it because free is un-American.

Quoting seb146 (Reply 5):
I was stung by a bee. Yes, very minor.

Are you alergic? Otherwise why call a doctor about a bee sting, unless you're alergic wasting a health professionals time for a be sting is really taking the piss.

What do you do when you get a paper cut  
 
WestJet747
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 3:30 pm

Pretty accurate op-ed for the most part, although I do take issue with a few points:

#16 - This is a huge negative. People not seeing bills has lead to most Canadians being totally ignorant of how much their health care really costs. Because of this, we consistently see many people in the ER who really aren't having a medical emergency. If these people really knew what they were costing the system, many would probably be more considerate of our resources.

#8 - There most certainly are deductibles and co-pays (or whatever you want to term them). They do not exist for emergency services, but most medical practices do charge for certain things that are "non-essential".

#2 - Administration of the system is simple on the customer-facing end of the process, but the back-end has been plagued with issues for years. Not to mention the e-Health scandal that rocked Ontario a couple years ago.

Quoting photopilot (Thread starter):
Let's keep the politics out of it and try to only discuss the points Nader raises.

   Not possible in Non-Av (or Civ Av in many cases). But I admire your trying.

Quoting DocLightning (Reply 4):
A lot of Americans love to crow about how horrible Canada's healthcare system is. They've never seen it at work.

"But my step-uncle told me that his coworker's best friend's mother waited in ER for 26 hours before she was seen for her sprained ankle! And then, I read on Fox News that there was that one politician from Newfoundland who flew down to the US for surgery because in Canada all these people die waiting 6 months for life-saving operations! Rabble rabble rabble!"

Joking aside, it's amazing to hear all these doomsday stories from Americans who take articles from any two-bit source at face value. It's the equivalent of saying you're probably going to die if you fly because planes do crash once in a while.
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LittleFokker
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 4:52 pm

There's a 23rd way that Nadar forgot to mention:

"Canada will take care of its citizens even when they are not in Canada."

While my friend from Toronto and I were at college down in Texas, we were having a barbecue one night. He used a little too much lighter fluid, and when he threw the match in, whoosh, a big ol' fireball blew up in his face. As I was driving him to the emergency room, he said no need to worry about the bill, he can mail it home and the Canadian government will take care of it. That was my first exposure to the Canadian health care system, and I've been intrigued ever since.

Good luck finding an American insurance company that would make any out of country mishaps go as seamlessly as that.
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northstardc4m
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 5:15 pm

Quoting LittleFokker (Reply 8):

There's a 23rd way that Nadar forgot to mention:

"Canada will take care of its citizens even when they are not in Canada."

While my friend from Toronto and I were at college down in Texas, we were having a barbecue one night. He used a little too much lighter fluid, and when he threw the match in, whoosh, a big ol' fireball blew up in his face. As I was driving him to the emergency room, he said no need to worry about the bill, he can mail it home and the Canadian government will take care of it. That was my first exposure to the Canadian health care system, and I've been intrigued ever since.

Good luck finding an American insurance company that would make any out of country mishaps go as seamlessly as that.

Sorry but that's not the case. If he had supplemental insurance that's fine, but AFAIK none of the provincial systems cover care outside Canada (with very limited exceptions).
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WestJet747
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 5:22 pm

Quoting LittleFokker (Reply 8):
There's a 23rd way that Nadar forgot to mention:

"Canada will take care of its citizens even when they are not in Canada."

While my friend from Toronto and I were at college down in Texas, we were having a barbecue one night. He used a little too much lighter fluid, and when he threw the match in, whoosh, a big ol' fireball blew up in his face. As I was driving him to the emergency room, he said no need to worry about the bill, he can mail it home and the Canadian government will take care of it. That was my first exposure to the Canadian health care system, and I've been intrigued ever since.

It would be nice if this were the case, but it's not even close to being true. Coverage of healthcare services for Canadians abroad are very strictly defined (making them extremely limited) and are covered at the home province rate, meaning that the recipient of the service has to pay out-of-pocket the difference between what the US healthcare provider charged and what it would have cost in Canada (usually a very large difference). I really doubt your friend had his treatment covered unless he had taken out some private insurance before leaving Canada.

To put this into a bit of perspective, even out-of-province care within Canada isn't always completely covered. As a resident of Ontario I am covered by the Ontario Health Insurance Plan (OHIP). But when I visited a clinic a couple years ago in Montreal with an ear infection, I had to pay $100 upfront to see a doctor because I wasn't covered under Quebec's insurance plan (despite being born there). Upon return to Ontario, I was only compensated for 70% of my fee. The remaining 30% was covered by my mother's insurance from work.

Some additional info: http://www.hc-sc.gc.ca/hcs-sss/medi-assur/faq-eng.php
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photopilot
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 9:13 pm

Quoting einsteinboricua (Reply 2):
is the "socialism" label placed on it and how people don't want to be associated with anything "socialist".

Gawd Americans love to throw about that "socialist" word.

So let's ask a couple of questions..... Is the US Coast Guard a "socialist" organization? Well of course not, yet it is paid for by tax dollars so therefore it must be socialist.
What about the US Military (any branch). Everybody pays for it thru taxes, and you could argue that everybody receives benefit from it due the the protection provided to all citizens. Does that make the military a socialist organization? Well also of course not.

So why should medicine/medical care, if it is paid for from tax dollars become "socialism".???? It's nothing more than a blanket insurance policy with all citizens as it's beneficiaries who use that "insurance" to various degrees as per their need.

Quoting KiwiRob (Reply 6):
I always thought Americans admired it but wouldn't accept it because free is un-American.

But don't Americans understand that even if there is a one-payer system, paid for from tax revenues, that doesn't make it "free"? It still has a cost to society, but that cost is shared by all.... just what insurance is supposed to be.
 
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DeltaMD90
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 10:05 pm

Quoting Arrow (Reply 1):
Good luck keeping the politics out of it. I quit commenting on most U.S. Healthcare discussions months ago. Same folks will trot out the same arguments pro and con and no one will convince anyone else of anything. A lot of shouting, very little listening.

Please don't commenting. I know it is frustrating but there are people out there that like hearing different viewpoints. I believe it was a thread on this site talking about how bad/communist the Canadian healthcare system was and the Canadians saying that poster was full of it that made me really start to question our healthcare system. I especially enjoy hearing the Canadian perspective on things since you guys have a lot of similarities to us and we can probably learn a lot from your policies...

Quoting DocLightning (Reply 4):
A lot of Americans love to crow about how horrible Canada's healthcare system is. They've never seen it at work.

They also say that about every other foreign healthcare system and I used to believe it. Like I said above, when I heard the actual citizens of those countries say how great their healthcare system was I started to question the narrative I always heard about it being inefficient/socialist/the devil etc.

There are a ton of working systems out there, I don't know why the US needs to suffer and try and reinvent the wheel here. We can shop around and find the best system for us. Although I beieve the ACA has many flaws, I've lost all hope that the GOP will contribute anything good, all they have done is whined and trolled the whole time. I'm still waiting for the GOP to tone down the immature rhetoric and outlined a very detailed plan that isn't a different flavor of the same old crap we had before
 
romeobravo
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 10:12 pm

Quoting photopilot (Reply 11):
But don't Americans understand that even if there is a one-payer system, paid for from tax revenues, that doesn't make it "free"? It still has a cost to society, but that cost is shared by all.... just what insurance is supposed to be.

No, insurance is paid for by the individual, you pay for your individual risk profile. When it's paid for by tax, the amount you pay for healthcare is determined by the amount of tax you pay.
 
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 10:53 pm

I don't see the point of Nader's grandstanding. It was made blatantly clear by some Democratic senators, that they would not accept a single-payer healthcare reform. As it was, they only barely scraped enough votes together to pass it, and even then it was dicey due to the inevitable lawsuits.

Quoting WestJet747 (Reply 7):
#16 - This is a huge negative. People not seeing bills has lead to most Canadians being totally ignorant of how much their health care really costs. Because of this, we consistently see many people in the ER who really aren't having a medical emergency. If these people really knew what they were costing the system, many would probably be more considerate of our resources.

We've had the same issue here, so a couple of years ago they started introducing telephone triage. In short, you can no longer just turn up at the ER, you have to phone ahead to a call centre staffed by nurses or doctors (depends on the region), describe what has happened, and they will then determine if it warrants a visit to the ER. Of course, this isn't necessary when an ambulance ride is involved.
 
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einsteinboricua
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 11:25 pm

Quoting photopilot (Reply 11):
What about the US Military (any branch).

Nothing says patriotism like the military...and even if paid through tax dollars, that's not the image portrayed to Americans (otherwise, Republicans would actually want to downsize the defense budget)

Quoting photopilot (Reply 11):
So why should medicine/medical care, if it is paid for from tax dollars become "socialism".????

Because we've been led to believe that this is a government takeover, where the government will take away all options and dictate the terms of your medical care.
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LittleFokker
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 13, 2014 11:46 pm

Quoting northstardc4m (Reply 9):
Sorry but that's not the case. If he had supplemental insurance that's fine, but AFAIK none of the provincial systems cover care outside Canada (with very limited exceptions).
Quoting WestJet747 (Reply 10):
It would be nice if this were the case, but it's not even close to being true.

Thank you for correcting me. I wasn't able to ask him at the time, but I would assume that he had supplimental insurance. He is a smart guy, and wouldn't have attended university in the US without making sure all his bases were covered.
"All human activities are doomed to failure." - Jean Paul Sartre
 
WestJet747
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 12:45 am

Quoting photopilot (Reply 11):

Gawd Americans love to throw about that "socialist" word.

So let's ask a couple of questions..... Is the US Coast Guard a "socialist" organization? Well of course not, yet it is paid for by tax dollars so therefore it must be socialist.
What about the US Military (any branch). Everybody pays for it thru taxes, and you could argue that everybody receives benefit from it due the the protection provided to all citizens. Does that make the military a socialist organization? Well also of course not.

So why should medicine/medical care, if it is paid for from tax dollars become "socialism".???? It's nothing more than a blanket insurance policy with all citizens as it's beneficiaries who use that "insurance" to various degrees as per their need.


In theory they are correct. Canadian healthcare is very much socialized. Although the American media have all but labeled socialism as evil, the real definition of socialism is a state-owned system where the input is relative and the output is equal without seeking benefit (a.k.a. profit). If we look at the Canadian healthcare system, citizens pay into it via tax which is relative to their income, and the healthcare service is applied equally to all citizens regardless of their wealth, with the system not profiting from any of it.

Quoting CPH-R (Reply 14):
We've had the same issue here, so a couple of years ago they started introducing telephone triage. In short, you can no longer just turn up at the ER, you have to phone ahead to a call centre staffed by nurses or doctors (depends on the region), describe what has happened, and they will then determine if it warrants a visit to the ER. Of course, this isn't necessary when an ambulance ride is involved.

Have you found this phone-in solution to be adequate? Has it had a measurable benefit? I'm genuinely curious because I've never heard anybody float that idea over here (yet).

Today on the radio they had the CEO of Windsor Regional Hospital who was proposing that there should be billing for every hospital visit. Of course he doesn't mean that the patient should pay, but they should be sent a bill (either on a per-visit or annual basis) detailing the itemized cost of their visit. His hope is that this would shock people into realizing how much their non-emergency really cost the taxpayers, which includes themselves.

Quoting LittleFokker (Reply 16):
He is a smart guy, and wouldn't have attended university in the US without making sure all his bases were covered.

I'm not sure about how things work in the US, but when I went to school in Australia it was a pre-condition of my student visa that I had purchased health insurance for entire length of my study period. So if your friend was going to school down there, it's likely he had private health insurance for occasions just like that.
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Ken777
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 2:35 am

Quoting einsteinboricua (Reply 2):
Another reason Obamacare is not working is the "socialism" label placed on it and how people don't want to be associated with anything "socialist".

And the ironic thing is that it's not near a socialist system - sure wasn't one when it was simply RomneyCare.

Quoting LittleFokker (Reply 8):
Good luck finding an American insurance company that would make any out of country mishaps go as seamlessly as that.

That is the core issue - using insurance companies for core care instead of public pay.

The ACA is still private insurance based, which does significantly total costs. The ACA continues to hide actual costs b running it though employers, with their nanny care costs resulting I'm shrinking wages & salaries.

Because the ACA is very protective of the insurance industry we will (1) not have a public option, (2) not have core care paid through a universal care system and (3) therefore will pay significantly more than people living in other civilized countries and (4) that excessive cost will not deliver anything copse to the bang for the buck in terms of outcomes.

'Tis is pity, but big money talks and those not in the big money will continue to pay more and receive less.
 
Boeing744
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 3:36 am

Quoting WestJet747 (Reply 10):
To put this into a bit of perspective, even out-of-province care within Canada isn't always completely covered. As a resident of Ontario I am covered by the Ontario Health Insurance Plan (OHIP). But when I visited a clinic a couple years ago in Montreal with an ear infection, I had to pay $100 upfront to see a doctor because I wasn't covered under Quebec's insurance plan (despite being born there). Upon return to Ontario, I was only compensated for 70% of my fee. The remaining 30% was covered by my mother's insurance from work.

I think this is more of a Quebec issue than a general issue in Canada for healthcare.

I live in Quebec now and have RAMQ. I tried to see a doctor in British Columbia about a month ago, and said I'd have to pay and then submit it to RAMQ. I didn't want to do this for the minor issue, so I waited til my return to Quebec.

However, when I lived in Ontario and had OHIP, I went to that same clinic in BC and they were able to bill OHIP directly. It seems that not all out of province clinics can do this, but some can - just not if you're from QC. I am sure there is a more nuanced explanation for this, but at the same time it is somehow not surprising...  

FYI, the billing issue would never apply to any ER visits. That is fully covered no matter what province you're in/from.
 
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 3:52 am

Quoting WestJet747 (Reply 17):
Have you found this phone-in solution to be adequate? Has it had a measurable benefit? I'm genuinely curious because I've never heard anybody float that idea over here (yet).

We do have Tele Health here in ON. Of course it is not mandatory that you be triaged by them before going to the E.R. But in the case of my toddler, when in doubt, we always call Tele Health first. It's a lot easier then spending a few hours in the E.R.
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WestJet747
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 4:12 am

Quoting Boeing744 (Reply 19):
I think this is more of a Quebec issue than a general issue in Canada for healthcare.

I've never received healthcare outside of Ontario or Quebec, so I wouldn't know off hand if that were true...but being born and raised in Quebec, this wouldn't surprise me in the slightest.

Quoting golfradio (Reply 20):
We do have Tele Health here in ON. Of course it is not mandatory that you be triaged by them before going to the E.R. But in the case of my toddler, when in doubt, we always call Tele Health first. It's a lot easier then spending a few hours in the E.R.

Very true - I had forgotten about TeleHealth. It seems to be a largely underused resource (I've never used it myself) despite all the ads they used to run promoting it.
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sccutler
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 4:32 am

At the risk of being obvious, the Canadian system is inevitably better than the ACA, because it actually provides healthcare; whereas the net effect of the ACA has, thus far, been to (1) increase the cost of health insurance to those who remain insured; (2) restrict or destroy the ability of many to remain employed; and (3) reduce the ability of employers to hire and retain workers, especially at the entry level.
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Arrow
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 4:54 pm

Quoting sccutler (Reply 22):
At the risk of being obvious, the Canadian system is inevitably better than the ACA, because it actually provides healthcare; whereas the net effect of the ACA has, thus far, been to (1) increase the cost of health insurance to those who remain insured;

Single payer systems -- with the government as the insurer -- adhere to a simple actuarial truism that any insurance executive could recite in his sleep. Spread the risk and the costs over the largest possible cohort, which means the entire population. Then calculate unit costs on that basis, and set taxes/fees accordingly. In Canada the health care is delivered by the provinces, so there are 10 covered populations, with the federal government setting national standards and an equalization formula that helps small provinces maintain the standards.

That is the main reason "socialized" medical systems deliver care at a significantly lower cost than private sector systems -- it's the admin costs. If you rely on a plethora of private insurers -- each of which has to make a profit -- the risks and costs are spread over a whole bunch of very small cohorts and the unit costs will be much higher because of it. And of course you have dozens of administrations handling all this instead of just one. All those dyed-in-the-wool free market types down there who hate the idea of the guvmint running something like health care have a very hard time with those stats because they love to argue that the free market is the best way to keep costs low. For widget production, maybe -- but not for health care.

And our system works. I'm home today after a 5-day hospital stay where I was treated for pneumonia. Had trouble breathing last Wednesday, my wife drove me to ER and it took a 5-minute triage assessment, another 5 minutes in a waiting room, and I was taken to a bed -- where the doc was already waiting. Blood tests, chest x-ray, and CT scan all happened within an hour, diagnosis confirmed with the ER doc, my oncologist, a respirologist and a lung specialist all involved. On a wide range of antibiotics right away, a bronchoscopy scheduled for the next day to get some confirmation and check out my lungs for anything else that might be hiding in there -- and I'm home now with a couple of weeks of antibiotics to go and follow-up appointments already booked. Because I am immuno-compromised (leukemia) this was life-threatening and had I not gone to ER when I did -- and had they not acted as quickly as they did -- it could have gone the other way. Needless to say -- I'm very grateful.

I have no idea what all that cost the system -- oodles of dough I'm sure -- but it was 100% covered. My out-of-pocket expenses were the gas the car burned getting there and a few parking meter insertions. Our health care system has all kinds of problems -- mostly trying to cope with us ageing boomers -- and there are needed reforms that are not getting done quickly enough. But my annual insurance costs for all this comes in at about $3000 a year (and that covers my wife too). I have only one complaint -- the food was ABOMINABLE! I'll be writing a little note about that. But you know what they say -- don't sweat the small stuff. I'm still alive.
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DocLightning
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 7:44 pm

Quoting golfradio (Reply 20):
We do have Tele Health here in ON. Of course it is not mandatory that you be triaged by them before going to the E.R. But in the case of my toddler, when in doubt, we always call Tele Health first. It's a lot easier then spending a few hours in the E.R.

Telephone triage (we use it in our practice) is GREAT. Decreases unnecessary ER visits a huge amount.

Quoting sccutler (Reply 22):

At the risk of being obvious, the Canadian system is inevitably better than the ACA, because it actually provides healthcare; whereas the net effect of the ACA has, thus far, been to (1) increase the cost of health insurance to those who remain insured; (2) restrict or destroy the ability of many to remain employed; and (3) reduce the ability of employers to hire and retain workers, especially at the entry level.

1) Then why did premiums go down
2) Then why do we continue to add jobs?
3) Then why do we continue to add jobs?

My only issue with the Canadian system is that from a physician's perspective, you're always in the target sights. We do have socialized medicine in the USA (Medicare) and Congress keeps almost cutting reimbursement by 30%. What happens if we do go to single-payor healthcare and then Congress decides to do that? Physicians have nothing to do but stop working. And the thing about being a physician is that it's not as if it's easy to just pick up and move countries. There's all the training and licensing that has to be done over again.

If there is some assurance that physician pay will never, ever, ever be cut, then I'd go for it. But I don't see how, short of a Constitutional amendment, that is going to happen.
-Doc Lightning-

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romeobravo
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 8:41 pm

Quoting Arrow (Reply 23):
That is the main reason "socialized" medical systems deliver care at a significantly lower cost than private sector systems -- it's the admin costs. If you rely on a plethora of private insurers -- each of which has to make a profit -- the risks and costs are spread over a whole bunch of very small cohorts and the unit costs will be much higher because of it. And of course you have dozens of administrations handling all this instead of just one. All those dyed-in-the-wool free market types down there who hate the idea of the guvmint running something like health care have a very hard time with those stats because they love to argue that the free market is the best way to keep costs low. For widget production, maybe -- but not for health care.

But that doesn't explain why healthcare costs in the US were comparable with other countries in the 80s.
 
TristarAtLCA
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 9:32 pm

Quoting RomeoBravo (Reply 25):
But that doesn't explain why healthcare costs in the US were comparable with other countries in the 80s.

Who gives a rats arse what something was comparable to three decades ago?

In the here and now, US healthcare costs are ridiculous when compared to any other first world health care system.

Quoting Arrow (Reply 23):
Our health care system has all kinds of problems -- mostly trying to cope with us ageing boomers -- and there are needed reforms that are not getting done quickly enough.

The NHS is also going to need tweaks sooner rather than later. And your right, it's all you old gits fault!!  
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romeobravo
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 10:01 pm

Quoting TristarAtLCA (Reply 26):
Who gives a rats arse what something was comparable to three decades ago?

In the here and now, US healthcare costs are ridiculous when compared to any other first world health care system.

If you're going to draw a conclusion from some data, it's quite important that the data actually supports your conclusion.
 
TristarAtLCA
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 14, 2014 10:52 pm

Quoting RomeoBravo (Reply 27):
If you're going to draw a conclusion from some data, it's quite important that the data actually supports your conclusion.

It does. Goodnight.


filler
If you was right..................I'd agree with you
 
jamincan
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 2:49 am

Quoting DocLightning (Reply 24):
My only issue with the Canadian system is that from a physician's perspective, you're always in the target sights. We do have socialized medicine in the USA (Medicare) and Congress keeps almost cutting reimbursement by 30%. What happens if we do go to single-payor healthcare and then Congress decides to do that? Physicians have nothing to do but stop working. And the thing about being a physician is that it's not as if it's easy to just pick up and move countries. There's all the training and licensing that has to be done over again.

If there is some assurance that physician pay will never, ever, ever be cut, then I'd go for it. But I don't see how, short of a Constitutional amendment, that is going to happen.

I believe the process for determining rates is a bit more complicated than the government simply setting them by fiat; at least in Ontario I believe there is a fair amount of negotiation between the Ontario Medical Association and the Ministry of Health. It's not necessarily a guarantee, but it doesn't currently seem to be a huge problem (although there used to be a significant brain-drain of doctors from Canada, I read an article in CMAJ (I think?) a few years ago that actually showed that net earnings were on average higher for most doctors in Canada compared to the US despite lower gross earnings due to significantly lower expenses).

My mom is an anaesthetist and the problem for the doctors in her hospital isn't the rates they can bill OHIP, but the fact that the Ministry of Health is squeezing hospital budgets which is in turn limiting operating room time and bed availability among other things. It's a really frustrating process that seems rather hopeless and really diminishes morale.
 
photopilot
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 3:24 am

Quoting DocLightning (Reply 24):
If there is some assurance that physician pay will never, ever, ever be cut, then I'd go for it.

So tell us just how exactly a physician's pay is calculated in the USA? Do you just bill whatever you want.... or whatever you feel you can get away with? Or is there a chart of some sort that list pay for services. How does the consumer of medical services in the States know what it's going to cost him/her?
 
Ken777
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 3:25 am

Quoting DocLightning (Reply 24):
We do have socialized medicine in the USA (Medicare) and Congress keeps almost cutting reimbursement by 30%

GPs & Pediatricians need to understand that they have to make major political contributions in order to get rid of those efforts to cut reimbursements. Look at the oil industry - they recently got a $40 Billion tax CREDIT and you have to be pretty gullible to believe that was not related to political contributions.

One problem that some specialists throw at politicians are the games some pay. There was a pretty brutal article in today's NY Times that is worth a read. $25,000 to take off a small white spot on a patient's face is the type of thing that gets some politicians to support those 30% cuts.

http://www.nytimes.com/2014/01/19/he...incomes-soar.html?hpw&rref=us&_r=0

Quoting DocLightning (Reply 24):
What happens if we do go to single-payor healthcare and then Congress decides to do that?

If we go to an intelligent system there won't be a problem. I use Australia as an example because I lived there for 8 years and believe that comparisons can reasonably be made.

In their single payer system everyone who is working is paying a Medicare Tax so everyone can get treatments within that system, either free (like at a hospital) or for a minor fee at for a Doctors visit.

That approach takes out the cost shifting that is killing our medical economics. I'm always amazed that conservatives cannot understand cost shifting, how bad it is and how important it is to eliminate it.

Now, in addition to that single payer system Australians are free to buy private insurance. Because cost shifting hasn't exploded costs the private insurance there has an 80% discount when compared to US costs. Overall cost are far less per person and the delivery is good- better outcomes than in the US in some areas.

Quoting DocLightning (Reply 24):
And the thing about being a physician is that it's not as if it's easy to just pick up and move countries.

You might be surprised. A friend of ours is married to a Doc and they recently spent a year with him working in View Zealand - and could have stayed longer if they wanted. There are some differences in the name of Brand meds and you don't have to call 1-800-MOMMIE-MAY-I to get authorization for a test or treatment.

You may also find that you have access to treatments that have yet to be approved in the US. When my wife started working in a US hospital (in '69) one of the docs who was the "CF Doc" in town asked her about standard treatments in Australia for CF. He blew his top when she said "X" drug had been the standard for years - and he got mad because they had just been approved for his patients.
 
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seb146
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 3:54 am

Quoting photopilot (Thread starter):
Nader goes on to outline 22 reasons why Canadian style single-payer universal healthcare is better than Obamacare. Makes for interesting reading.

Many Democrats/progressives wanted single payer. But, in order for some right-wingers/Republicans to even consider voting "yes" on ACA/Romneycare/Obamacare, they had to compromise.

Also, ACA is still run by the for-profit, money before health health care companies.
You bet I'm pumped!!! I just had a green tea!!!
 
sccutler
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 4:04 am

Quoting DocLightning (Reply 24):
1) Then why did premiums go down

They have not. They are increasing. Dramatically.

Quoting DocLightning (Reply 24):
2) Then why do we continue to add jobs?

The better question might be, "How many more jobs might we add without this remarkably costly (and ineffective) new taxation scheme.?"

NB: Sending more money to the government will not create jobs.

---

None of this to suggest a more-efficient means of healthcare delivery (and the financing therefor) has not been needed; the ACA simply does nothing to achieve that laudable goal.
...three miles from BRONS, clear for the ILS one five approach...
 
CPH-R
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 4:12 am

Quoting seb146 (Reply 32):
But, in order for some right-wingers/Republicans to even consider voting "yes" on ACA/Romneycare/Obamacare, they had to compromise.

The Democrats were never going to get a single payer option anyway, since both Joe Lieberman and Ben Nelson were categorically against it.
 
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seb146
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 4:53 am

Quoting sccutler (Reply 33):
NB: Sending more money to the government will not create jobs.

Neither do tax breaks for the "job creators" that we heard about for way too long.

Quoting sccutler (Reply 33):
Quoting DocLightning (Reply 24):1) Then why did premiums go down

They have not. They are increasing. Dramatically.

Right. Because private companies are still in control. Their profits need to come before the health of Americans.

Quoting CPH-R (Reply 34):
The Democrats were never going to get a single payer option anyway, since both Joe Lieberman and Ben Nelson were categorically against it.

Yep.
You bet I'm pumped!!! I just had a green tea!!!
 
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hOMSaR
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 7:00 am

Quoting seb146 (Reply 32):
Many Democrats/progressives wanted single payer. But, in order for some right-wingers/Republicans to even consider voting "yes" on ACA/Romneycare/Obamacare, they had to compromise.

Which was a waste because, in the end, they didn't vote "yes" for it anyway.
I was raised by a cup of coffee.
 
ltbewr
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 7:29 am

Government managed medical services in Canada came about from the Great Depression in the 1930's that also affected the USA and people not being able to get health care at all in their then largely private system.
There is no doubt both the Canadian and USA systems each have their advantages and disadvantages as to access to care. But there are also other issues that make our systems different and in some ways the Canadian system is better beyond this list of Mr. Nadar.

In the USA is our right to sue for medical malpractice, which I suspect is far more limited in Canada. The fear of malpractice in the USA causes many doctors to do too many tests, make references to specialists, prescribe more drugs than needed to protect themselves. The costs of malpractice insurance is extremely high, with some specialist like OBY/GNC's, paying obscene amounts and declining to take certain patients like female lawyers.

Another big issue, in part noted in Mr. Nadar's comments, is that people have a much different attitude as to government in the USA vs. Canada in terms of trust, responsibility and acceptance of government running health care.

In Canada, I suspect there is much better management of the number and location of hospitals, expensive specialized equipment like MRI's to maximize utilization and costs. I also suspect there are few 'private', profit making hospitals and a much different relationship with those owned or managed by religious faith groups (especially Catholics). Certain procedures may be limited by provincial budgets and those with money may opt to have less critical procedures done in the USA to reduce waiting times.

Certain procedures like Abortion may not be as available in some provinces as broadly than others, but then birth control is cheaper and easier overall to obtain.

Cultural diffrences between the USA and Canada. There is a less violent culture, especially as to guns in Canada vs the USA. I also suspect Canada has a far lower rate of teen pregnancy vs. the USA overall due to sound sexual responsibility education and far less economic differences from the richest to the poorest.

Correct me if I am wrong, but in Canada, doctors do not leave medical schools with massive debt, it is subsidized by the governments so a doctors can charge less.

The Canadian government likely has standardized procedures to reduce wasteful spending including simpler billing and rates.
 
Kiwirob
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 11:45 am

Quoting RomeoBravo (Reply 25):
But that doesn't explain why healthcare costs in the US were comparable with other countries in the 80s.

Profit taking would be my answer. With a socialised not for oprofit system you don't have to worry about paying big bucks to CEO's, lobbying groups and shareholder returns.

Quoting DocLightning (Reply 24):
And the thing about being a physician is that it's not as if it's easy to just pick up and move countries. There's all the training and licensing that has to be done over again.

I'll think you'll find Doc the you could pretty much move anywhere you like, my GP here in Norway is from the US, he moved here a couple of years ago with his Norwegian wife. If you want to practice medicine in New Zealand Doc we would welcome you with open arms, all you need to know is here, Practising in New Zealand, you'd end up at the front of the immigration que and we'd even legally let you marry your man!
 
romeobravo
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RE: Canadian Health Care Better Than Obamacare

Mon Jan 20, 2014 10:03 pm

Quoting KiwiRob (Reply 38):
Profit taking would be my answer. With a socialised not for oprofit system you don't have to worry about paying big bucks to CEO's, lobbying groups and shareholder returns.

But you're falling into the same mistake TristarAtLCA is making. Healthcare was for profit in the 80s, yet healthcare expenditure was comparable to other developed countries.

Obviously, there must be a different reason for the heightened costs today.
 
sccutler
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 21, 2014 4:56 am

Quoting seb146 (Reply 35):
Neither do tax breaks for the "job creators" that we heard about for way too long.

You may well be correct - the practice of favoring one group of taxpayers over another for reasons of political expediency appears... unsavory. Assuming (for the sake of discussion) that inconsistent tax breaks and complex tax policy are bad things does not in turn mean we should not endeavor at every turn to reduce the overall tax burden.

Money diverted to government is rarely well-spent.
...three miles from BRONS, clear for the ILS one five approach...
 
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seb146
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 21, 2014 5:04 am

Quoting sccutler (Reply 40):
Assuming (for the sake of discussion) that inconsistent tax breaks and complex tax policy are bad things does not in turn mean we should not endeavor at every turn to reduce the overall tax burden.

Money diverted to government is rarely well-spent

Some local government allow Wal-Mart to have the sales tax they collect if they open a store.

I agree that spending billions on a war ship that will not survive a battle is insane, but the military department insisted on it. However, for things like education and health care, those are very important.
You bet I'm pumped!!! I just had a green tea!!!
 
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DocLightning
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 21, 2014 7:17 am

Quoting ltbewr (Reply 37):
In the USA is our right to sue for medical malpractice, which I suspect is far more limited in Canada. The fear of malpractice in the USA causes many doctors to do too many tests, make references to specialists, prescribe more drugs than needed to protect themselves

The elephant in the room that nobody wants to talk about is physician incompetence. A lot of the tests and treatment that people attribute to "defensive medicine" actually INCREASE malpractice risk.

Some of the things I've seen I would love to pick apart on the witness stand.

"Dr. Smith, I see that you ordered blood cultures and administered ceftriaxone, but then discharged the child home. Did you think that this patient was septic?" (This is done all the time, and there is no correct answer to my question. If the answer us "Yes," then the follow-up question is: "Then why did you send him home to die?" If the answer is "No," then the follow-up question is: "Then why did you order a lab used to identify the responsible organism in sepsis and administer a broad-spectrum antibiotic used to treat sepsis?")

We need to improve the quality of medical education and also licensure testing. I see too much medical incompetence that never gets any action.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
TristarAtLCA
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 21, 2014 11:04 am

Quoting RomeoBravo (Reply 39):
But you're falling into the same mistake TristarAtLCA is making.

I have not made any mistake.

While I'm sure your numbers are accurate, could you post a link to the figures you are basing your statement on.

Quoting RomeoBravo (Reply 39):
Obviously, there must be a different reason for the heightened costs today.

The are a multitude of reasons why healthcare costs have spiralled. This is a pretty in-depth article (there are six sections) and the section on prescription costs and drug patenting is quite interesting. Or in the pregnancy section the new mother who was charged for her room post birth and discovered that the hospital also seperately charged her baby for sharing the same room and the nursery the child never used. These are just a couple of examples.

I wonder how many hospitals used so many 'revenue streams' in the 80's?

http://www.nytimes.com/2013/06/02/he...-world-in-health-expenditures.html
If you was right..................I'd agree with you
 
sccutler
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RE: Canadian Health Care Better Than Obamacare

Tue Jan 21, 2014 6:41 pm

Quoting seb146 (Reply 41):
Some local government allow Wal-Mart to have the sales tax they collect if they open a store.

Some local governments will grant all manner of tax abatements in exchange for agreements to build/open/operate some productive enterprise or another. You should see the band-over the City of Arlington, Texas gave Jerry Jones to build JerryWorld (now known as AT&T Stadium). I guess that, if the local populace approves of the choices their locally-elected representatives make, they can do that. You'd hope that the proposed enterprise could stand on its own two feet, so to speak, justify its existence on its core value.

The collection, dilution, consumption and redistribution-in-dribbles committed by the feds? Not so much; essentially no direct accountability.

Quoting seb146 (Reply 41):
However, for things like education and health care, those are very important.

I'd suggest that these items, paid for by local governments using locally-collected funds and implemented by locally-elected officials, are fine. Again, by the federal government? Reeking of corruption and cronyism, and doomed to fail in most instances.

Quoting Arrow (Reply 23):
Single payer systems -- with the government as the insurer -- adhere to a simple actuarial truism that any insurance executive could recite in his sleep. Spread the risk and the costs over the largest possible cohort, which means the entire population. Then calculate unit costs on that basis, and set taxes/fees accordingly. In Canada the health care is delivered by the provinces, so there are 10 covered populations, with the federal government setting national standards and an equalization formula that helps small provinces maintain the standards.

Sorry I missed this. Agree or disagree with the government's role in delivering health care, the system you describe is, for want of a better term, honest. The ACA here in the states? Not a chance... and worse, it's mathematically unsound.
...three miles from BRONS, clear for the ILS one five approach...
 
Mir
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RE: Canadian Health Care Better Than Obamacare

Wed Jan 22, 2014 1:39 am

Quoting DocLightning (Reply 24):
My only issue with the Canadian system is that from a physician's perspective, you're always in the target sights. We do have socialized medicine in the USA (Medicare) and Congress keeps almost cutting reimbursement by 30%. What happens if we do go to single-payor healthcare and then Congress decides to do that? Physicians have nothing to do but stop working. And the thing about being a physician is that it's not as if it's easy to just pick up and move countries. There's all the training and licensing that has to be done over again.

To be fair, isn't that just economics? If Congress cuts reimbursement beyond the point that doctors believe viable, they'll stop working and there will be a shortage of doctors. And nothing will get Congress to move quicker than a populace angry about not being able to go to a doctor - they'll bump up reimbursement in short order and things will be back to normal.

-Mir
7 billion, one nation, imagination...it's a beautiful day
 
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WarRI1
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RE: Canadian Health Care Better Than Obamacare

Wed Jan 22, 2014 1:54 am

Lieberman was also a member of Parent's Music Resource Center. Rolling Stone magazine stated that she "is an active proponent of the V-Chip and [has served] on the board of the PTC."[3]

She worked for the lobbying company APCO Associates, which serves many pharmaceutical and health care corporations, as well as four major drug companies. In March 2005, Lieberman was hired by Hill & Knowlton as "senior counselor" in the firm's "health care and pharmaceuticals practice." Her work with the pharmaceutical and healthcare industries led to controversy over her involvement with the Susan G. Komen for the Cure Foundation.



We might come to the conclusion this is why we did not get Sen. Lieberman's support. Another scumbag to me. Aren't they all?
It is better to die on your feet, than live on your knees.
 
BMI727
Posts: 11300
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RE: Canadian Health Care Better Than Obamacare

Wed Jan 22, 2014 2:05 am

Quoting DocLightning (Reply 24):
My only issue with the Canadian system is that from a physician's perspective, you're always in the target sights. We do have socialized medicine in the USA (Medicare) and Congress keeps almost cutting reimbursement by 30%. What happens if we do go to single-payor healthcare and then Congress decides to do that? Physicians have nothing to do but stop working. And the thing about being a physician is that it's not as if it's easy to just pick up and move countries. There's all the training and licensing that has to be done over again.

Oh, then you get screwed. Along with pharmaceutical manufacturers, medical device manufacturers, etc. all around the industry. That is, after all, the point.

There are laws against monopolies in pretty much every other industry, but some people want to intentionally create one in healthcare. The rationale behind creating a monopoly is specifically to have leverage against suppliers, which includes doctors.

But, I'm sure you're a good doctor and you can make it up to a GS-15 eventually, which would net you ~$130,000 per year. Not so hot for a doctor.
Why do Aerospace Engineering students have to turn things in on time?
 
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seb146
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RE: Canadian Health Care Better Than Obamacare

Wed Jan 22, 2014 6:05 am

Quoting BMI727 (Reply 47):
Oh, then you get screwed. Along with pharmaceutical manufacturers, medical device manufacturers, etc. all around the industry. That is, after all, the point.

Why should big pharma make billions off of pain, suffering, and death? This is, after all, a Christian nation. That is, according to the loudest amongst the right wing. Profit for death kinda flies in the face of God and Jesus, but they don't want you to see that.

Quoting sccutler (Reply 44):
I'd suggest that these items, paid for by local governments using locally-collected funds and implemented by locally-elected officials, are fine. Again, by the federal government? Reeking of corruption and cronyism, and doomed to fail in most instances.

Generally, states pay for public education and state run health care. However, they are through things like lottery dollars and property taxes. People keep voting down increasing property tax and then complain how public schools are a disgrace. The "union" workers have to buy their own school supplies in order to teach, so it is not the unions.

Quoting sccutler (Reply 44):
The collection, dilution, consumption and redistribution-in-dribbles committed by the feds? Not so much; essentially no direct accountability.

People get up in arms over things like a Wal-Mart or a sports stadium paid for with public money but then say "well, what are you gonna do" and go on with their lives and keep voting the same people into office. That is the real tragedy in all of this. The "informed" electorate don't understand they do have choices. Not the people big corporations put out there, but other real choices.
You bet I'm pumped!!! I just had a green tea!!!
 
BMI727
Posts: 11300
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RE: Canadian Health Care Better Than Obamacare

Wed Jan 22, 2014 6:10 am

Quoting seb146 (Reply 48):
Why should big pharma make billions off of pain, suffering, and death?

Actually they try to make billions trying to avoid those things, but why should you start dealing in reality now?

The answer is that it's their business, which is the same reason doctors tend to do pretty well versus just eking out a living.
Why do Aerospace Engineering students have to turn things in on time?

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