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Old 02-21-2005, 01:20 PM   #1 (permalink)
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Compassion, Canadian Style

Nationalizing Compassion: The Canadian Free Lunch

by Sally C. Pipes and Benjamin Zycher

There are, sadly, no free lunches. That eternal truth is the beginning of wisdom with respect to the view of some that a Canadian-style system of national (read: bureaucratized) health insurance is the answer for the problems and growing costs of the U.S. health care market.

Let us get back to analytic basics. We live in a world in which human wants always and everywhere exceed the capacities of the limited resources available. If everyone could consume all the health care that they would prefer, few resources would be left to satisfy all of the other myriad human needs. But because resources are limited -- there are only so many physician hours, hospital beds, pharmaceuticals, ad infinitum available -- we cannot consume all the medical care that we would prefer. Instead, we are forced to make often-hard choices, as is the case with nutrition, housing, education, and all the rest.

And so all economic systems, whatever they are called and however organized, must find ways to allocate resources among competing uses. In a word, rationing in some form is the common characteristic of all such systems and the eternal misfortune of mankind ever since the debacle in the Garden of Eden. We can ration by price, favoring the nonpoor over the poor. We can let people fight it out: Violence, the oldest rationing mechanism known to man, favors the young and the strong. We can resort to queuing, favoring those whose value of time is relatively low. We can choose to favor beauty, which is timeless, supposedly, but what is incontrovertible are the advantages of the beautiful over the rest of us in the eternal struggle for resources. And so on.

Say what you will about the evils of price rationing in the context of the health care market, but it does offer two huge advantages: It imposes discipline on the consumption of health care and it yields incentives for providers to continue providing in the long run. We do, after all, care about the children, do we not?

Actually, a close look at the hard reality of the bureaucratized health care system in Canada (and the UK and elsewhere) reveals that they care about the kiddies a good deal more than they might care to admit. Resources are limited. Ditto for government budgets. And so choices have to be made, notwithstanding the dual fictions that health care is "free" and that those who need it will not be denied. Someone has to be denied, and guess who that is increasingly: the elderly. Why "waste" expensive procedures and devices and medicines on someone who is going to some eternal reward relatively soon when a far more deserving (read: politically defensible) patient also is on the waiting list?

Alas, it does not, it will not, it cannot stop with the elderly. "Free" health care in Canada means that waiting lists are long, patients deteriorate while waiting, such "cheaper" devices as plastic artificial knees are used in place of aluminum ones, and those who can travel and pay for medical care go to the U.S. And those who cannot? Well, they suffer. As day follows night, health care will be denied the mentally ill, the desperately tiny prematurely born, those whose prospective "quality of life" in someone's politicized view will be inadequate. That is the tragic road toward which nationalized compassion inexorably will lead. This is not because the system is afflicted with correctible inefficiencies or because budgets are not fully funded or because doctors/hospitals/pharmaceutical producers/insurers/bureaucrats/name your goblin are greedy/corrupt/uncaring.

It is because "free" health care cannot overcome the basic and eternal condition of mankind: Wants exceed resources. And that in a nutshell is why a Canadian-style system is not the answer for the U.S. health care problem, notwithstanding the romanticized illusions now prominent in many discussions.

Nor is improvement to be found in a continuation of the creeping bureaucratization of U.S. health care. Instead, ways must be found to discipline demand. The Medical Savings Accounts incorporated in the recent Medicare reform bill are a step forward; they move somewhat toward a system in which people purchase health care services not with Other People's Money, but with their own. More such movement toward market mechanisms is the path toward true reform, which will serve the broad long-term interests of consumers, in that a "cheap" but huge medical sector leaves fewer resources and thus higher prices for everything else.


http://www.pacificresearch.org/press...4-12-06sp.html
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Old 02-21-2005, 01:35 PM   #2 (permalink)
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That's a great article...Now post YOUR OWN THOUGHTS to go along with it!

Edit to add:

If at the end of the day NCB hasn't posted his own thoughts, the thread will be closed.
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Old 02-21-2005, 01:43 PM   #3 (permalink)
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What else would you expect from a neo-con think tank but an essay that supports their position...

Look, here's an article from the opposite side of the discussion: Link

Quote:
Published on Saturday, April 1, 2000 in the Progressive Populist
Revisiting Canadian Health Care
by John Buell

With health costs escalating and complaints mounting, politicians promise us a fresh look at health care reform. One hopes the promise will be kept. One old tale needing reexamination is the now virtually axiomatic wisdom that the failure of the Canadian health system "proves" single payer alternatives won't work. I would argue that, to the contrary, the Canadian experience clearly demonstrates that single payer systems remain the most equitable and efficient in the world. Their crises are due to the attacks of the privatizers rather than to their inherent limits.
Earlier this year, the New York Times ran a feature article in which it argued that "few Canadians would recommend their system as a model for export." The article suggested that the system's inefficiencies had become so great during the '90s that both the provincial and federal governments had been forced to rein in health costs.

Omitted in the Times analysis are two startling facts. Dean Baker, an economist with the Preamble Center, reports that "According to OECD data, in 1997 ... Canada spent 9.3 percent of its GDP on health care. The United States spent 14 percent. Since the United States is a wealthier country, the discrepancy in dollars spent is even larger: $2,095 per person in Canada, compared with $4,090 for the United States. Measured by health care outcomes, such as life expectancy at birth or life expectancy at age 65, Canada's system scores better than the US system."

Canadians are clearly staying healthier for fewer healthcare dollars. Lower levels of poverty in Canada are part of this story, but here in the US uncovered medical costs are a leading cause of personal bankruptcy and poverty. In addition, in a single payer system, where government accepts responsibility for all, there is an incentive to emphasize primary and preventive care. Not only it is generally cheaper to prevent disease than to cure it, prevention of contagious diseases has enormous spillover effects.

By contrast, in the private marketplace, HMOs compete in destructive or counterproductive ways -- through the clientele they seek to include or exclude, the amount of service delivered, or advertising. HMO incentives and the patient's need for adequate care point in opposite directions.

Not only does such a system generally deliver inadequate medical care, its purported ability to control costs has thus far proven to be illusory. When the full advertising, profits, and administrative review procedures are counted, "overhead" in our system runs at twice the Canadian level.

Extraordinary medical costs do not explain Canada's economic or healthcare problems. The world economic stagnation of the late '80s and early '90s was accompanied by growing budget deficits in both the United States and Canada. Economists debate the relationship of deficits to economic development, but in both nations a choice was made to address deficits by cuts in government spending, even long-term investment in vital public resources like health care, rather than raising taxes. In Canada's case the decision seemed even more imperative given the vulnerability of the much smaller nation's currency to international speculative pressures. These speculators demanded of Canada, as of many debt-strapped "Third World" nations, that they cut budgets and social services.

Health care became an especially inviting target as increasingly mobile businesses argued that taxes for health care were making Canada uncompetitive with U. S. businesses already eagerly slashing their health care benefits. Since utilization rates for such extraordinarily expensive new technologies as magnetic resonance imagers are hard to predict, provincial governments tended to make the most fiscally cautious short-term decisions. They cut back on hospital beds, trimmed capital budgets for new technologies, and even reduced admissions to Canadian medical schools. But since deployment of new technologies and the development of appropriate supportive personnel takes time, when new treatments demonstrate considerable efficacy and become widely recommended and used for common diseases, dramatic shortages not only will develop, they will be both obvious and hard to address in the short term.

Years of health system starvation have had another unforeseen effect: Canadians have demanded that provincial governments avail themselves of the best American medical facilities. Quebec has ended up paying not only hospital fees but also transportation and housing costs for some of its citizens undergoing cancer therapies in US hospitals. In such cases, costs to the Canadian government are much higher than if adequate facilities had been budgeted for in the first place.

In addition, many other affluent Canadians have simply paid for care out of their own pockets in US clinics and hospitals. Since these citizens are all "full payers," they receive the most prompt and least bureaucratized care the US system provides. Some have now become a political force in Canada arguing for such changes as user fees and/or private hospitals

Nonetheless, despite the cries from affluent and the attacks in the US media, the concept of equal healthcare for all paid for by government still has many defenders in Canada. Many middle and working class Canadians recognize quite rightly that they stand to lose if the public system is replaced by a US-style alternative. In Canada, unlike the United States, the majority of the population still votes in both Federal and provincial elections. Provincial premiers are now pressuring Ottawa to restore adequate levels of funding and the Canadian Prime Minister has felt obliged to declare defense of the system a priority.

If there is a lesson in this tale, it is not the inefficiency of single payer systems. Rather the story alerts us to the ways health care politics is connected to other fundamental issues of social equity.

No health care system works well when it is underfunded, but public systems that pool risks and resources, emphasize primary and preventive care, and avoid unnecessary and counterproductive advertising and administrative costs achieve the best health outcomes per dollar of the public's money. And when the vast majority of the population must rely on such a system, they will demand its adequacy.

But when a rich neighbor to the South can become a default option for the wealthy or for the short-term needs of political leaders, confidence in and commitment to the public system will erode.

Finally, public health care, like any other major public expenditure, all too easily becomes a plaything of private business interests, with bad practices driving out good ones, as long as speculators and multinational corporate executives can run roughshod over the world economy.

Getting this story out, so that healthcare and social justice advocates on both sides of the border can draw on each other's experiences, is a vital task today.
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Old 02-21-2005, 01:44 PM   #4 (permalink)
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Well, my thoughts...

bull's eye.

Its funny how anything that comes out that doesn't support a libral or democrat's position is just "what you would expect from a neo-con think tank" funny huh. They just make this shit up and type it out real nice and disguse it as economics and facts when really its propaganda.

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Old 02-21-2005, 01:54 PM   #5 (permalink)
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Quote:
Originally Posted by stevo
Its funny how anything that comes out that doesn't support a libral or democrat's position is just "what you would expect from a neo-con think tank" funny huh. They just make this shit up and type it out real nice and disguse it as economics and facts when really its propaganda.
Regardless of whether I agree with the article or not... and I would like to think that if that article made a good point I would conceed that point... it *does* come from a neo-con think tank...

From the Pacific Research Institutes website:
Quote:
Our VIsion

The Pacific Research Institute for Public Policy promotes the principles of individual freedom and personal responsibility. The Institute believes these principles are best encouraged through policies that emphasize a free economy, private initiative, and limited government. By focusing on public policy issues such as education, the environment, health care, entrepreneurship, regulation, and technology, the Institute strives to foster a better understanding of the principles of a free society among leaders in government, academia, the media, and the business community.

Through its five research centers, described below, PRI publishes books and studies, provides commentary to leading media, hosts public events, and conducts comprehensive grassroots and community outreach.
I would be truly shocked if they came out in support of public healthcare...

Did I suggest they "just make shit up"? No. Is what they have written to be expected from an organization like this? Yes.
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Old 02-21-2005, 02:10 PM   #6 (permalink)
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Charltan, I started this thread primarily to continue the discussion that we had about the Canadian health care debacle.

The Canadian system is full of problems. Old people waiting in hospital rooms until a nursing home room opens up. People waiting 6 months for MRIs. People waiting (and dying) for life saving operations. People escaping Canadian healthcare to come to the US for much needed care. It ain't working for y'all up there. The system is in shambles and the only thing that Ottawa knows what to do is to throw more oney at it (classic liberal response, of course).

It seems to me that socialized medicine is only good for population control, not caring for people's healthcare needs
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Old 02-21-2005, 02:14 PM   #7 (permalink)
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Global problems with healthcare solutions can and will be more readily addressed once the healthcare systems move away from acute, symptomatic processes towards preventative care.

The primary problem with healthcare is that it is used to treat catastrophe instead of long-term methods to prevent catastrophe.

The privatized healthcare system very specifically promotes this backwards method of healthcare treatment by the very nature of the cash incentive. A doctor/pharmacists/pharmaceutical developer/health insurance company is going to prefer the fix-the-symptom, ignore the cause approach. This results in very expensive healthcare - and health industry profits soar. (Health insurance companies don't mind the higher costs of the symptomatic process because for years they milk monthly insurance fees, steadily increasing those fees, and then either deny coverage or price the fees outside the reach of the people who are "suddenly" in need of very expensive surgery).

This is the #1 problem with privatized healthcare. It is the very reason that privatized healthcare must be eliminated if any quality healthcare is desired.

Universal healthcare is in the perfect position to promote preventative care, for the very reason that it does not desire profits so it desires lower costs. The surest method to lower costs is to spend small amounts of money over decades to prevent 50 year old, heavily overweight, cancer and heart attack patients. It is cheaper to spend $1000 a year to prevent a single 50 year old from requiring hundreds of thousands of dollars in health care costs for bypass surgery.

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Old 02-21-2005, 02:15 PM   #8 (permalink)
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Oh here we go again. Socialized medicine sucks and the only way to get good healthcare is to go to a private physician.
Look, I'm sure not all socialized systems are all that great, but if it's done right it can work just fine. It should not be the only option, if people want private doctors they should be able to get one.
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Old 02-21-2005, 02:19 PM   #9 (permalink)
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I would like to throw in a real-life comparative experience. It involves me, and a lady that I met in a forum, from Philadelphia.

- Both of us were diagnosed with breast cancer last december 23. I know because we both created entries in a breast cancer forum and communicated with each other for support.
- my diagnoses was made by my doctor after a mammogram. she orderd it as a baseline for future disgnoses.
- my friend's diognoses was made by self inspection. the difference being that she had a lump, i didn't. If she had a mammogram earlier, they may have detected earlier.

- I was scheduled for and had my surgery on jan 6. She had hers on jan 3. Due to timing of diagnosis, mine was a large lumpectomy, hers was a full mastectomy

- I am now scheduled for 3 weeks of radiation therapy starting tomorrow.
- she is scheduled for chemo, uncertain for how long.

- I am out of pocket for coffee/snacks while my hubby waited for me at the hospital.
- she had to hit her line of credit for $11,000 to cover costs.

Now, I think that situations may not be the same, i did not have to stay overnight, but i still got a private recovery room, plus my hospital (toronto East General) is in walking distance from my house, so no parking, transp. costs involved, while she lived in the burbs, and had to commute plus her's was not day surgery. But I think that the speed and quality of care are comparable.

oh, her reasoning for not having an early mammogram? too expensive.

In my opinion, The canadian system has performed wonders with the resources they have.

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Old 02-21-2005, 02:31 PM   #10 (permalink)
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Janey - That is exactly the preventative health care that is denounced by privatized healthcare systems and promoted by universal healthcare systems of which I speak.

I'm glad to hear you were able to catch the cancer before it became even more problematic.
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Old 02-21-2005, 03:06 PM   #11 (permalink)
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So the article basically says it is better to leave the poor behind than the old?
Improvement?

(assumed that the article is right about leaving the old behind which I don't believe, but I don't know the canadian system. I only know the german health system)
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Old 02-21-2005, 03:37 PM   #12 (permalink)
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Mad wishes for a quick and healthy recovery for you, Janey...

NCB, PRi is a well known Right Wing PR group and Sally Pipes is the CEO, Reporter, Economist, and janitor of the "think tank". Her only credential I could find was a hearty "thumbs up" from Rick Santorum if that tells you anything. This article contains no data, no information, just a bunch of fear peddling about Canada killing it's elderly and babies. Whatever keeps her getting spots on Fox News...

I live and work in the U.S., my employer is based in Vancouver B.C. Believe me when I tell you not one person I work with that lives in Canada would trade me for our Healthcare here. I don't know where you got the numbers you are throwing around - but it isn't true. Nationalized healthcare protects our citizens, it is obscene to lay out the survival of the fittest arguement in your article when we live in the wealthiest nation in the world. Oh, and Rick Santorum is currently receiving the government health insurance plan with your tax dollars that he doesn't think you deserve. Credible .
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Old 02-21-2005, 05:24 PM   #13 (permalink)
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I find the first article kind of funny.

My take on it is "if healthcare in the US was "free" (note to the writer, it's not "free", it's universal) then there wouldn't be enough health care to go around. Because Americans have to pay for health care, and not all of them can afford it, then there is enough health care to go around for those of us who can afford it"

Nice one.

Also, the bit about the elderly somehow not getting enough health care in Canada because why waste resources on them is my favourite bit. When my father was in the hospital, the guy across from him in the room was an older Italian guy who could barely speak english. He was in his mid 70's and had cancer and it was terminal. He wasn't in the hospital for cancer treatment (he had already had that). He was in there because while he was home, he slipped and fell and broke his hip and they were doing a hip replacement.

Now here's a guy who's in his mid 70's, is suffering from cancer and they do a hip replacement anyway. Pretty cold system eh.

I find the US scare mongering on Canadian Health Care kind of funny actually cause you would be very very hard pressed to find too many Canadians who would trade in our system, however flawed, for an American styled Health Care system.

If you love the American system so much, good for you, it's yours. I find it very interesting how Americans never cease to keep attacking the Canadian system for some reason. Why do you care?

I myself have never had any problems with receiving what I would consider to be a good level of service when it comes to health care.

I also can honestly say that I know of no-one personally who has gone to the states to receive and pay for health care. I am sure they are there, but the vast majority of Canadians seek and receive world class health care at home.

And most telling, Canadians live longer and have a far lower level of Infant mortality than the US. Something must be right besides the fresh air.

Check it out yourself at the ciaw world fact book

http://www.cia.gov/cia/publications/...k/geos/us.html

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Old 02-21-2005, 05:26 PM   #14 (permalink)
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Quote:
Originally Posted by NCB
Charltan, I started this thread primarily to continue the discussion that we had about the Canadian health care debacle.

The Canadian system is full of problems. Old people waiting in hospital rooms until a nursing home room opens up. People waiting 6 months for MRIs. People waiting (and dying) for life saving operations. People escaping Canadian healthcare to come to the US for much needed care. It ain't working for y'all up there. The system is in shambles and the only thing that Ottawa knows what to do is to throw more oney at it (classic liberal response, of course).

It seems to me that socialized medicine is only good for population control, not caring for people's healthcare needs
NCB... I figured as much and would love to debate the Canadian healthcare system with you. That said, you started off with an article that, in my opinion, brings little to the debate other than to say that there are other ways to deliver healthcare... and the source is rather weak. If I were to post articles that spout economic "truths" from the International Socialist website I would expect them to be just as soundly mocked...




That said, we in Canada have a *very* strong tradition of equity and social saftey nets... Most Canadians will point to these traditions if you were to ask them what it means to be a Canadian (it wasn't all that surprising that in a recent television program to determine the Greatest Canadian, Tommy Douglas was chosen as the greatest Canadian by popular vote. Tommy Douglas, besides being Kiefer Sutherland's grandfather is best remembered as the man behind the creation of our public healthcare system).

Conversely the US has a strong tradition of Individualism... I don't think too many American would disagree with that statement.

The result is that our nations have chosen different paths.


The fact is, we spend less per capita on healthcare than the US, we are consitently in the top five of the best countries to live in in the world (as ranked by the UN) and have one of the healthiest nations on the planet as well.

I think we can agree upon the following... no system is perfect.

The US system has *many* problems. Please don't tell me it is a perfect system or that everyone is being serviced equally (I'll just have to go and look up the numbers).

The Canadian system has certain issues as well. I won't deny that. I don't think anyone would. That said, I can give you anecdote after anecdote of people like Janey who have had no problems whatsoever with the system (including myself).

I certainly agree that people shouldn't have to wait as long as they do for MRIs in some parts of the nation... but that doesn't mean we should trash the whole system.

Again, just to under score it, we spend less per capita than the US on healthcare and manage to deliver it effectively enough to have one of the healthiest populations on the planet.
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Old 02-21-2005, 05:33 PM   #15 (permalink)
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Here's an interesting site talking about American Health Care

http://www.nchc.org/facts/cost.shtml
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Old 02-21-2005, 06:32 PM   #16 (permalink)
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Quote:
Originally Posted by Charlatan
The US system has *many* problems. Please don't tell me it is a perfect system or that everyone is being serviced equally (I'll just have to go and look up the numbers).
As much as I hate to admit it, the U.S. healthcare system is totally out of control. I cannot believe how expensive insurance costs unless you are subsidized by an employer. I would like to see a better system but I fear we will go down the socialized path soon if something isn't done to control the costs.
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Old 02-21-2005, 06:41 PM   #17 (permalink)
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The big thing Canada and America have to face are our priorities.

We as America put our place in the world very often above the welfare of our people. Now for us it's the king of the hill, we have so many people trying forever to knock us down we're busy pushing everyone else back. This isnt always intended, much of it is economic which the government has little to do with, it's the people themselves trying to make a buck.

The Canadians have never come close to that world power status. They dont care about it either, with their allies fronting the bill of a military powerful enough to stop anyone (UK and US are powerful allies indeed). They can spend lots of its resources because something like 2% of their budget (as of last living there, back in the early 90s... but it wouldnt have changed much) on military defense. They can afford to front a bill of much more progressive and welfare systems.
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Old 02-21-2005, 06:53 PM   #18 (permalink)
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You won't get an argument from me on that... we have always chosen the route of diplomacy over agression... The only nation we really have to fear is the US. No one else would bother invading...

It will be interesting to see if this reality changes as the ice continues to melt in the north, thereby opening the northwest passage to shipping... Canada will need a millitary precense in the north if we intend to maintain sovreignty over the north...

This is probably best taken up in another thread though.
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Old 02-21-2005, 08:13 PM   #19 (permalink)
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Quote:
Originally Posted by flstf
As much as I hate to admit it, the U.S. healthcare system is totally out of control. I cannot believe how expensive insurance costs unless you are subsidized by an employer. I would like to see a better system but I fear we will go down the socialized path soon if something isn't done to control the costs.
Please understand you do pay for it, even when you get insurance through work. It is the extra $5 - 10,000/year that they took from your budgeted salary to pay for insurance.

Look, I love free enterprise, capitalism, making money - all of that.

Please, forget for just a moment the "Big Government" scare tactics and "Canada's killing grampa" rhetoric you keep hearing over and over.

Think about the people you love...

My family's health should not show up as a debit or credit in a corporate ledger. I don't want to affect anyone's Return on Share because I broke my arm. I don't want Bill Smith in a purchasing having his promotion riding on whether or not my mother leaves the hospital Thursday or Friday. There shouldn't be a profit margin if I get cancer, but there is today.

Corporations are successful because they make money. Period. It's not reasonable to ask a company to chose between my health and it's health. I don't think the insurance companies are "evil" and that they take advantage of us. We handed them the keys and said make money AND be good to us. The system is flawed at the most basic level. If only we could find a company large enough to handle a task so complex and large on scale, but people didn't lose jobs over quarterly earnings that were missed. That is what our government is for...

If not to provide for the health of it's people than what? Who is going to take care of the huge masses of Baby Boomers that will be this generation's responsibility? Who will take care of the growing number of low income families that are losing their jobs and health insurance every time a factory moves to Mexico? Tell me that a hospital isn't allowed to turn away a patient in need and you have already agreed with Nationalization, that is the point. The money comes from us in taxes or through insurance rates rising an avg. of 15% a year.
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Old 02-21-2005, 11:10 PM   #20 (permalink)
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I think one of the biggest problems is the way our system is set up. There seems to be little or no market pressure on the fees that doctors and dentists, etc charge.

I recently was told by my dentist (new because I just moved) that I may need a root canal and he gave me the name of a gum specialist to evaluate the situation because it is out of his field. The gum specialist agreed that I should get the root canal and he gave me the name of a guy that specializes in those.

So now I have two dentists who have taken x-rays and evaluated me and now I have to go to a third one to do the work. At each step of the way I tried to determine what the costs would be with no luck so far. Each guy has to take his own x-rays (they do not share) and neither could give me any idea what the costs would be ahead of time.

So now I am calling root canal specialists and trying to determine prices to no avail. Each one says that I will have to make an appointment and have x-rays taken again (and be charged of course) before they can ball park the price between $600 and $2000. I am out about $375 already (I did get a cleaning from the first guy's office).

The medical/dental associations will not help in making a cost based choice because they don't advertise prices. So how is one to make a pricing decision? I have asked family and friends and not one has chosen a doctor or dentist based on price. Of course they are covered by insurance and I am not (only $10,000 deductible catastrophic).

Until we consumers start making price based decisions on these guys there is no pressure for them to give quality service at a good price. I understand that some insurance companies have guidlines they have to follow and they may make up the difference by charging uncovered people more. None of the ones I have talked to so far will admit this though. When you call the various offices you only get to talk to the receptionist most times.

This is all just for a damn tooth, can you imagine the difficulty in trying to price something serious like a broken leg? I wonder what criteria these guys use to set their prices anyway? Is it any wonder that costs are rising 10% to 15% more than inflation each year, why should they lower costs?
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Old 02-21-2005, 11:17 PM   #21 (permalink)
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You won't get an argument from me on that... we have always chosen the route of diplomacy over agression... The only nation we really have to fear is the US. No one else would bother invading...
Now was that nessicary to put it in such terms?

Training and giving aid to the young democratic countries isn't aggression all the time.

And invading Canada? Honestly now... why would we want so many French inside our own border? (just kidding chill out)
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Old 02-22-2005, 12:52 AM   #22 (permalink)
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Universal healthcare is in the perfect position to promote preventative care, for the very reason that it does not desire profits so it desires lower costs. The surest method to lower costs is to spend small amounts of money over decades to prevent 50 year old, heavily overweight, cancer and heart attack patients. It is cheaper to spend $1000 a year to prevent a single 50 year old from requiring hundreds of thousands of dollars in health care costs for bypass surgery.
Gee, and all you have to do is install a police state to do it.

http://www.thesun.co.uk/article/0,,2-2005082504,00.html

Thanks, but I'll pass.

Everybody dies.
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Old 02-22-2005, 06:22 AM   #23 (permalink)
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Originally Posted by Seaver
Now was that nessicary to put it in such terms?

Training and giving aid to the young democratic countries isn't aggression all the time.

And invading Canada? Honestly now... why would we want so many French inside our own border? (just kidding chill out)
Seaver... I just re-read what I wrote... You are correct. I could have worded it differently. I apologize.

As for the invading Canada thing... I wasn't trying to suggest the US would invade but rather was underscoring the fact that our only neighbour is the US and if they are all we have to worry about, invasion wise, I'm not all that converned (but we are keeping an eye on you guys... ).
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Old 02-22-2005, 08:37 AM   #24 (permalink)
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Originally Posted by daswig
Gee, and all you have to do is install a police state to do it.

http://www.thesun.co.uk/article/0,,2-2005082504,00.html

Thanks, but I'll pass.

Everybody dies.
No, actually, all you have to do is educate without corporate interests interferring with policy.

But if it's easier for you to dismiss the obvious wise methodology of healthcare with a single unfortunate instance, so be it. Hopefully there are few people with your hangups, then maybe the wise decisions will get made.
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Old 02-22-2005, 10:12 AM   #25 (permalink)
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Originally Posted by Seaver
The big thing Canada and America have to face are our priorities.

We as America put our place in the world very often above the welfare of our people. Now for us it's the king of the hill, we have so many people trying forever to knock us down we're busy pushing everyone else back. This isnt always intended, much of it is economic which the government has little to do with, it's the people themselves trying to make a buck.

The Canadians have never come close to that world power status. They dont care about it either, with their allies fronting the bill of a military powerful enough to stop anyone (UK and US are powerful allies indeed). They can spend lots of its resources because something like 2% of their budget (as of last living there, back in the early 90s... but it wouldnt have changed much) on military defense. They can afford to front a bill of much more progressive and welfare systems.

You may want to re-read some of your history. when it has really counted, Canadians have been there in spades. We've had big navies, fierce troops, and the draft at one time or another. But countries evolve. Currently, there is no need to spend money on a standing military to defend ourselves from.... ummm who? A military force that can repel an invasion of the only possible country that can mount an offensive? That would be the US, and who can stop that military force? nay nay, I say!

so you may say we don't care about it, and it would be wrong, we do care about it, but the money can be better spent on special forces that can be surgically deployed such as a strong Coast Guard (like Charl is positing) or peace keeping forces, anti terrorism brigades. search and rescue etc.

Even so, our spending on health care is far below what Americans budget. and remember the economies of scale involved. Our country has to budget for infrastructure costs based on a huge geography - second only to Russia's - using a tax base wich is derived from a population roughly equivalent to that of the State of California, or new York. No wonder we got to be experts in communications (hardware, software and social). It is fitting that the telephone was invented by Alexander Graham Bell!

Last edited by Janey; 02-22-2005 at 10:14 AM..
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Old 02-22-2005, 12:31 PM   #26 (permalink)
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Originally Posted by Seaver
Quote:
Originally Posted by Charlatan
You won't get an argument from me on that... we have always chosen the route of diplomacy over agression... The only nation we really have to fear is the US. No one else would bother invading...
Now was that nessicary to put it in such terms?

Training and giving aid to the young democratic countries isn't aggression all the time.

And invading Canada? Honestly now... why would we want so many French inside our own border? (just kidding chill out)
/shrug, the USA was the last nation to invade Canada. =p~

Quote:
Originally Posted by Seaver
The Canadians have never come close to that world power status.
3rd largest navy in the world after WW2. Single largest troop convoy to ever cross the Atlantic. First non-European power to push back a major European power on European soil in modern history.

No, Canada has never been the most powerful military on Earth.

As for healthcare:

Healthcare is a service for which when they need it, people are usually willing to pay basically anything for it. As a market, it has a very low price elasticity of demand. If all healthcare providers doubled in cost, consumption wouldn't halve.

To keep price elasticity up for individual providers, you either need to regulate or provide lots of price competition.

The costs are also extremely unpredictable on an individual scale. This means it makes sense to get insurance.

Insurance then dictates prices to health care suppliers. This is a form of price competition.

There are information asymetries in favour of the consumer of health care insurance. Which means that elective consumption of health care insurance has to be priced extremely highly.

Which is why you get large corperatized health care plans without the option to leave them. This reduces the information asymetries (all employees of a corperation are closer to the general statistical universe than a single elective consumer).

All of this can lead to the old fashoned 'you are fucked' if you aren't part of a corperatized health care plan.
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Old 02-22-2005, 12:42 PM   #27 (permalink)
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Originally Posted by Yakk
As for healthcare:

Healthcare is a service for which when they need it, people are usually willing to pay basically anything for it. As a market, it has a very low price elasticity of demand. If all healthcare providers doubled in cost, consumption wouldn't halve.

To keep price elasticity up for individual providers, you either need to regulate or provide lots of price competition.

The costs are also extremely unpredictable on an individual scale. This means it makes sense to get insurance.

Insurance then dictates prices to health care suppliers. This is a form of price competition.

There are information asymetries in favour of the consumer of health care insurance. Which means that elective consumption of health care insurance has to be priced extremely highly.

Which is why you get large corperatized health care plans without the option to leave them. This reduces the information asymetries (all employees of a corperation are closer to the general statistical universe than a single elective consumer).

All of this can lead to the old fashoned 'you are fucked' if you aren't part of a corperatized health care plan.
This doesn't look good for the new HSA (Health Savings Accounts) business, where you put money away each year (untaxed) to be used for healthcare combined with a very high deductible insurance plan (some as high as $10,000). If you do not pay close attention to what you get charged for medical/dental services you can go through your savings rapidly. I think the idea of these accounts is great but how do we shop for the best prices/service?
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Old 02-22-2005, 01:22 PM   #28 (permalink)
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Originally Posted by flstf
This doesn't look good for the new HSA (Health Savings Accounts) business, where you put money away each year (untaxed) to be used for healthcare combined with a very high deductible insurance plan (some as high as $10,000). If you do not pay close attention to what you get charged for medical/dental services you can go through your savings rapidly. I think the idea of these accounts is great but how do we shop for the best prices/service?
Hopefully such a scheme will lead to more price competition between providers.

But really, when you go to a doctor, that doctor knows so much more about what is wrong with you and how much it should cost than you do it isn't funny. Plus you are often extremely desperate to get the problem fixed (be it cancer, a heart attack, or anything else), I doubt you'll be doing all that much price shopping.

On the other hand, possibly having way more people buying health care with 'their own money' will change the incentives for health care providers enough.

This HSA does have the effect of encouraging Americans to save more, as does scaring people about the state of social security. I'd suspect most people's HSA will rapidly evaporate shortly after you get your first serious illness. The net effect of increased savings, however, will possibly have a net benefit to the US economy, especially given the current dismal rate of US saving.

A private health care system also has the effect of scaring people into being more productive. "Not dieing" is a good incentive to get rich.
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Old 02-22-2005, 06:49 PM   #29 (permalink)
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Originally Posted by Yakk
But really, when you go to a doctor, that doctor knows so much more about what is wrong with you and how much it should cost than you do it isn't funny. Plus you are often extremely desperate to get the problem fixed (be it cancer, a heart attack, or anything else), I doubt you'll be doing all that much price shopping.

On the other hand, possibly having way more people buying health care with 'their own money' will change the incentives for health care providers enough.

This HSA does have the effect of encouraging Americans to save more, as does scaring people about the state of social security. I'd suspect most people's HSA will rapidly evaporate shortly after you get your first serious illness. The net effect of increased savings, however, will possibly have a net benefit to the US economy, especially given the current dismal rate of US saving.
I am going to go out on a limb and predict that if things do not change and soon, within 10 years the U.S. will have socialized medical care like Canada.

When halfway intelligent people cannot figure out how to choose medical care using price as one of the criteria there is no incentive for prices to be reasonable and they will continue to rise.

A system where there is essentially no competition will eventually either be run by the government or controlled in some other way somewhat like anti-trust enforcement. My experience in shopping for medical care and insurance for my wife and myself has shaken my somewhat Libertarian beliefs.
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Old 02-22-2005, 07:13 PM   #30 (permalink)
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Man I didnt mean to piss off you Canadians so badly when I said you were never really a world military power.

And yeah, I know we were the last to invade Canada... but honestly that was almost 200 years ago by now... and it wasn't Canada back then... it was England :P.
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Old 02-22-2005, 08:54 PM   #31 (permalink)
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Originally Posted by Seaver
Man I didnt mean to piss off you Canadians so badly when I said you were never really a world military power.

And yeah, I know we were the last to invade Canada... but honestly that was almost 200 years ago by now... and it wasn't Canada back then... it was England :P.
Not quite, it was Canada, but it was a British colony. And you were a bunch of chickens taking on Britain when she was busy fighting with Napoleon.

As Charlatan stated the only country that we have to worry about invading Canada is the USA.

So many americans like to pat themselves on the back and say, "if it weren't for us, you guys would be invaded"

To which I respond, "the only country that is a threat to Canada is the USA, so will you protect me from you?"

The USA could invade Canada and take over the government with relative ease. Of that I am certain. Even if we spent the same percentage of our GDP on our military as the US does, we could not repell a US invasion because we are a country of 31 million people. (The US currently spends 3 x's in terms of percentages of GDP on their military compared to what Canada spends.)

But, you would never be able to keep us. All we would have to do is resist and eventually you would suffer defeat.

Canada is like Russia in WW2, vast, cold, and stubborn. Eventually, we would win and restore the boarder, of that I am sure. Korea, Vietnam, Iraq have all proven that America can not win a war even against a 3'rd world country. Unless you drop nukes, you can't win it would seem. I really doubt that the USA would nuke Toronto with NY state some 40 miles due south.
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Old 02-22-2005, 09:10 PM   #32 (permalink)
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The main concern I have with state-run health-care here in the states is the sheer size of our populace. The cost would be ginormous. I could only assume that we would be dependant on the current medical-pharmacutical infrastructure to provide the products and labor involved; which I'm not sure could be done without enforcing huge price-regulation on everything from the factories producing the medical machines, CAT-scans and such, to the doctors wages. That is a huge number of people who would almost certainly be apposed to any such move.

Are there any countries with somewhat similar populations that have attempted any such plans? Is 31,859,845 to 288,904,213 a viable comparison nonwithstanding how entrenched the business of health is in this country? I'ld be interested to see what the biggest country with this kind of plan is. How do we handle intellectual property in the field? Off to google I go........

-fibber

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Old 02-22-2005, 09:29 PM   #33 (permalink)
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Originally Posted by fibber
The main concern I have with state-run health-care here in the states is the sheer size of our populace. The cost would be ginormous. I could only assume that we would be dependant on the current medical-pharmacutical infrastructure to provide the products and labor involved; which I'm not sure could be done without enforcing huge price-regulation on everything from the factories producing the medical machines, CAT-scans and such, to the doctors wages. That is a huge number of people who would almost certainly be apposed to any such move.
I agree that almost everything the government does can probably be done cheaper and better by the private sector. However the medical and insurance industries seem to have this game rigged. The only thing that seems to be controlling costs is their decision as to how much more they want to extract from us this year.

I believe that we are partly responsible for not considering costs when choosing health care but it may be too late at this point. I have yet to talk to anyone who chose their doctor/dentist after evaluating their costs like I am trying to do now. The system is probably beyond our ability to control it in the private sector.
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Old 02-22-2005, 11:02 PM   #34 (permalink)
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Originally Posted by james t kirk
I find the first article kind of funny.

My take on it is "if healthcare in the US was "free" (note to the writer, it's not "free", it's universal) then there wouldn't be enough health care to go around. Because Americans have to pay for health care, and not all of them can afford it, then there is enough health care to go around for those of us who can afford it"

Nice one.

Also, the bit about the elderly somehow not getting enough health care in Canada because why waste resources on them is my favourite bit. When my father was in the hospital, the guy across from him in the room was an older Italian guy who could barely speak english. He was in his mid 70's and had cancer and it was terminal. He wasn't in the hospital for cancer treatment (he had already had that). He was in there because while he was home, he slipped and fell and broke his hip and they were doing a hip replacement.

Now here's a guy who's in his mid 70's, is suffering from cancer and they do a hip replacement anyway. Pretty cold system eh.
Sounds admirable. Could you post the locations of a few Canadian hospitals?

I'd like to pass them along to a few "undocumenteds" in LA.

You don't mind, do you?
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Old 02-22-2005, 11:47 PM   #35 (permalink)
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Not quite, it was Canada, but it was a British colony. And you were a bunch of chickens taking on Britain when she was busy fighting with Napoleon.

As Charlatan stated the only country that we have to worry about invading Canada is the USA.

So many americans like to pat themselves on the back and say, "if it weren't for us, you guys would be invaded"

To which I respond, "the only country that is a threat to Canada is the USA, so will you protect me from you?"

The USA could invade Canada and take over the government with relative ease. Of that I am certain. Even if we spent the same percentage of our GDP on our military as the US does, we could not repell a US invasion because we are a country of 31 million people. (The US currently spends 3 x's in terms of percentages of GDP on their military compared to what Canada spends.)

But, you would never be able to keep us. All we would have to do is resist and eventually you would suffer defeat.

Canada is like Russia in WW2, vast, cold, and stubborn. Eventually, we would win and restore the boarder, of that I am sure. Korea, Vietnam, Iraq have all proven that America can not win a war even against a 3'rd world country. Unless you drop nukes, you can't win it would seem. I really doubt that the USA would nuke Toronto with NY state some 40 miles due south.
Chill out with the pissing contest buddy, the US doesnt want to invade Canada. The last time they did was 200 years ago, when we were still enemies of the crown.

If you read my post I never took an anti-Canada tone, nor of either is better than the other. I'm not even going to bother pointing out the mistakes in your post, it's not even worth it, just lets try to guide this back to my origional post about the differences in priorities.

Canada can afford to put its priorities on the peoples welfare because it is friends with the most powerful country in the world. Its only border is with a country that has no interest in warfare with it. They can afford to spend more on other areas, while we are preoccupied with international defense (not to say Canada doesnt send help with us 90% of the places we go).
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Old 02-23-2005, 02:32 AM   #36 (permalink)
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Originally Posted by Seaver
Canada can afford to put its priorities on the peoples welfare because it is friends with the most powerful country in the world. Its only border is with a country that has no interest in warfare with it. They can afford to spend more on other areas, while we are preoccupied with international defense (not to say Canada doesnt send help with us 90% of the places we go).

This is a good point. Can we quantify and verify this? What does each (Canada & US) spend per capita on defense and healthcare as a percentage of GDP? Or use whatever measure is logical.

I think some people have already touched upon this in the thread but I would like to see it narrowed down a bit further so we can roll up our sleeves and focus a bit.

1. Is the health care in Canada a "success" and is it right for the US?

2. Privatization vs. Public funded

3. Is this health care system too costly? Per capita? Overall? Better for the long term?
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Old 02-23-2005, 02:37 AM   #37 (permalink)
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Add:

Another consideration is maybe we should focus on our own domestic issues for awhile instead of wasting billions abroad. For example: schools and health care for Americans before Iraqis. Lets put our own house in order before we meddle in others' affairs. Or maybe we should privatize the military to make it more efficient. If we're going to privatize SS, health care, and education, we might as well privaitize defense. I think we spend a huge amount there, I would like to get more bang for our buck. It seems like we "waste" alot of money.
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Old 02-23-2005, 05:41 AM   #38 (permalink)
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Originally Posted by Seaver
Man I didnt mean to piss off you Canadians so badly when I said you were never really a world military power.

And yeah, I know we were the last to invade Canada... but honestly that was almost 200 years ago by now... and it wasn't Canada back then... it was England :P.

Hmmm. maybe you should consider before you post then. We have a very proud military and national history. The fact that our history involved evolution rather than revolution shouldn't be a point to be ashamed about. There is a very strong continuity between the Canada of 1812, and the Canada of 2005. when I was a child I was a young girl, now I am an adult, and I have a different name (through marriage - a legal change) but nobody is going to argue that I wasn't me back in my youth.

I am sure that you would get your back up if anybody slagged your proud history in a similar, unthinking, manner (unfortunately the tone of this thread is quickly headed in that direction...)
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Old 02-23-2005, 05:59 AM   #39 (permalink)
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Guys... take it easy on Seaver. His slight was minimal compared to some Americans view of Canada... More to the point, he makes a good point about our ability to focus on delivering services to our citizens rather than focusing our money on military conquest.

Canada has a great military tradition... it is grossly underfunded at present BUT the real point is we've never really wanted to be a military superpower. We arm ourselves as needed...
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Old 02-23-2005, 08:02 AM   #40 (permalink)
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I never tried to imply Canada never does anything abroad. I know everything from WWI to Afghanistan has been there. My dad was a US Navy pilot serving in Canada during the first Iraq war, he was a major contributer in the planning of the Canadian Air Force's actions during the war (no planes lost btw).

I never, if you read my posts again, dogged Canada on anything militarily. I just stated the fact that yall spend MUCH less on national defense than we do.

Quote:
This is a good point. Can we quantify and verify this? What does each (Canada & US) spend per capita on defense and healthcare as a percentage of GDP? Or use whatever measure is logical.

Canada
• After adjustment for inflation, Canadian Department of National Defence (DND) spending increased 3.5 per cent between fiscal years 2000-01 and 2001-02. Expenditures rose from $12.281 billion to $12.713 billion in 2001-02 constant dollars.

http://www.ploughshares.ca/content/MONITOR/monj02i.html

United States
The U.S. military budget request for Fiscal Year 2005 is $420.7 billion

For Fiscal Year 2004 it was $399.1 billion.
For Fiscal Year 2003 it was $396.1 billion.
For Fiscal Year 2002 it was $343.2 billion.
For Fiscal Year 2001 it was $305 billion. And Congress had increased that budget request to $310 billion.
This was up from approximately $288.8 billion, in 2000.


Now these are a little scewed higher for America because we front the vast majority in Afghanistan and Iraq at the moment, but you can see my point. Canadians made a concious choice, and have the ability to, spend MUCH less on the military. Why? Because they have no threats at this time by anyone who could muster any serious threat to them.

And you might want to look at the state of affairs, we've been neutral or allied to Canada for MUCH longer than enemies.
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