[maerF0x0]

> Socializing the whole thing is significantly better.

As a Canadian I highly disagree. And anecdotally many health care providers from Canada agree with my take. People frequently die, or get sicker, as they wait their turn in months long queues or lack of supply due to government quotas.

There is nothing stopping the government from substituting lower-quality, less effective procedures when their MBAs come in an consult about how to reduce costs.

[arcticbull]

Canada has substantially the same health outcomes, or better, than the US. This is simply not true. I'm also Canadian, and have lived under both systems.

My father fell off a ladder and had a pretty severe head injury, and had both an MRI and a CT scan within a half hour, at no cost. Yes, lower-priority conditions may have to wait, but it's also by definition because they're lower priority - and they'll have to wait in America too.

The idea that the Canadian healthcare system is somehow leaving people to wait and die in a way the American system is not, is a falsehood propagated by major American insurers and their lobbying group AHIP. Here's a Cigna executive apologizing for doing just that. [1]

[1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-...

[maerF0x0]

This article has a couple immediately glaring flaws that lead me to not invest the time to deeply analyze it on the whole...

> because of having the kind of health care system you have in making sure that everyone who needs to be treated is treated

That's completely false, Canada has a presupplied quota system set by government forecasting and limited by budgets. If you need treatment you will be treated eventually but you might die or get sicker in the interim.

Using a COVID-19 based article to discuss the merits of single payer single provider completely ignores the massive cultural mentality differences -- the US focuses on individual freedoms, Canada focuses on collective good. This makes a big difference when it comes to adherence things like social distancing and masks. They're taking a multivariate system and claiming it's a single variable that caused the outcome.

Edit: and I might add that it appears that Canada is always intentionally undersupplied such that a moderate wait is guaranteed. Whereas it seems that due to market competition the US system is inherently oversupplied (at least in many areas) such that they can provide to those who can pay essentially on demand.

[arcticbull]

> This article has a couple immediately glaring flaws that lead me to not invest the time to deeply analyze it on the whole...

Good to know you didn't read the article before replying.

> That's completely false, Canada has a presupplied quota system set by government forecasting and limited by budgets. If you need treatment you will be treated eventually but you might die or get sicker in the interim.

Every system in the entire world has a predefined quota. There's no unlimited supply of healthcare resources in any country - and America is no exception. The only difference here is whether these resources are centrally provisioned or not - and whether you ration it based on who can spend the most, or who needs it the most. I vote for central provisioning and need-based allocation.

You are ignoring that once again, there are wait times in America too. The reason I sent you this article is proof that in fact your assessment of the relative strengths of the system isn't grounded in fact. It's grounded in propaganda about the American system. The system you are imagining in America simply does not exist.

> Using a COVID-19 based article to discuss the merits of single payer single provider completely ignores the massive cultural mentality differences -- the US focuses on individual freedoms, Canada focuses on collective good.

This is irrelevant to the quality of a healthcare system and its outcomes. And you are ignoring that 40% of Americans are already covered by socialized medicine. Old people in America love Medicare and have no interest in getting rid of it. 75% of people on Medicare are either satisfied or greatly satisfied, while only 6% are dissatisfied or greatly dissatisfied. This is higher than the for-profit sector.

> Edit: and I might add that it appears that Canada is always intentionally undersupplied such that a moderate wait is guaranteed.

That's a cool, unfounded opinion.

And again, you have ignored the clearly measured equivalence of the two systems in terms of outcomes - while the Canadian system delivers it at literally half the per capita cost and covers everyone.

If you actually look at the data, it's clear. The private care available in America is more expensive and outcomes are either the same, or significantly worse. America has the worst maternal mortality rate in the developed world, for instance. This is quantifiable and you are not utilizing that data, one has to suspect, because it does not support your position. [1]

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801918/

[maerF0x0]

https://fee.org/articles/america-outperforms-canada-in-surge...

Saying America spends more is pretty weak claim because Americans are fatter, more often shot, face worse natural disasters (hurricanes, earth quakes)... Of course they spend more. There are hundreds of variables why healthcare per capital would be cheaper in Canada from CoL to quality of doctors (the ones that remain are ones who cannot compete in the highly paid US Market), to greater public safety net or social goods in all areas resulting in fewer high cost outcomes (eg, Canadians take more PTO)...

Overall i think the main difference between what you're interested in and what I'm interested in -- that which we're calling "superior" differ.

To me a system is superior if it gives better outcomes to those who pay for the service. VS you seem to be claiming that a better outcome is something like the average across all citizens.

To me this is like saying "We all need food, therefore when we go to the grocery store you will be charged the average bill and given what you absolutely need to not die, but not necessarily what you need to thrive. This is how we keep others from starving..."

For me I want to go to the grocery store and receive the best I can get for my money. It's a just system to receive what you pay for and to not receive what you do not pay for. I do also believe in a separate, external to the government, system of charity to cover cases which are truly unfortunate, but also to keep people accountable for their contributions to their own health when able or

Anyways, it seems you're squarely set your values based opinion, and I am on mine. So there's no longer a reason to discuss further.

[dragonwriter]

> Saying America spends more is pretty weak claim because Americans are fatter, more often shot, face worse natural disasters (hurricanes, earth quakes)... Of course they spend more.

“Fatter“ and “more often shot” are at least in part due to choices about the focus and distribution of physical and mental health care, not independent factors (in fact, the political faction most defensive of the ways in which the US system differs from the less-expensive, comparable overall outcomes systems in the rest of the developed world also is prone to claiming that the elevated risk of being shot is primarily a product of defects in the health care delivery system, though they tend to lose focus on doing something about those deficiencies quickly after pointing to them.) If you've got evidence that the health impacts of natural disasters are greater—in a way explained by the nature of the disasters alone and not choices in the structure of the health care system—in the US than any, much less all, of the other advanced economies in the OECD, please point it out, because that would be interesting.

[maerF0x0]

I actually do agree that part of the gun violence equation is mental health care. That doesn't mean socialized mental health care is the best solution to healthcare needs. Simply that having a society which does not value mental healthcare at all is suboptimal.

[arcticbull]

Actually my opinions are data driven.

[maerF0x0]

You cannot apply data without values. If I told you X people die every year from Y, it would be your values that suggest if we should do anything about it.

X could be lots or little, Y could be Covid or the death penalty. Data tells you nothing about the justice of a situation.

[maerF0x0]

> Good to know you didn't read the article before replying.

Didn't read the entire article due to quickly findable glaring issues of quality, yes.

[cwmma]

> People frequently die, or get sicker, as they wait their turn in months long queues or lack of supply due to government quotas.

There are often months long waits for here too, try getting a dermatology appointment, we just also have the privilege of paying for it out of pocket as preventative skin care checks are not actually classified as preventative medicine so it counts towards your deductible meaning you have to pay the first $2000.

[maerF0x0]

pay out of pocket is the nature of the system, so it's not really a point.

What would be a good point is a discussion about if want a society where the people who pay for a procedure get better outcomes, or if we're willing to say to those who pay "You will get a worse outcome because we're also serving those who cannot pay. This comes down to cultural values and ethics.

[arcticbull]

Again, you are ignoring that healthcare outcomes in Canada are generally the same or better and that wait times exist in both systems. [1]

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801918/

[cwmma]

> "You will get a worse outcome because we're also serving those who cannot pay

Vs America where you get a worse outcome due to laborynthian beuracratic rent seeking.

Sounds terrible for Canadians to be forced to make things better for poor people if they want to improve things for themselves.

[llbeansandrice]

> People frequently die, or get sicker, as they wait their turn

This also happens in the US. Plus, if you do happen to get care you can go bankrupt!

>when their MBAs come in an consult about how to reduce costs.

The US is far far past this point already.

[criddell]

Your experience with the Canadian system is going to vary greatly depending on the kind of care you require and where you are. Frankly, the same is true in the US.

> their MBAs come in an consult about how to reduce costs

You don’t think the big health insurance companies in the US do the same thing?

[maerF0x0]

> You don’t think the big health insurance companies in the US do the same thing?

To the multiple peers who point out the US uses MBAs too. I'm pointing out that both systems use MBAs and come to the same conclusions such as "We can save n% by using n-1% less effective drug."

[criddell]

The US MBAs have figured out that procedures should be expensive. The health insurance industry as a whole would rather collect 15% of trillions spent than 15% of billions spent.