Universal Health Care on Mars? - How best to take care of Martians?

el scorcho · 2004-10-05 20:11:39

Being used to the American health care system (no universal coverage, everyone pretty much fends for themselves), I'm looking for opinions from the Canadian/British/French among yall at New Mars. Universal health care systems have long been criticized for long wait times and enormous taxes, but also praised by virtue of the concept behind them and benefits of their use.

(There is a growing movement for such a system in America, so I would also like some first-hand information so I can form an educated opinion on the subject.)

Therefore, I have some questions:

1. Those of you who live in countries with universal health care: do you feel satisfied with your system or would you prefer drastic improvements or even privatization, such as the American model? And

2. Should future Martian settlements implement universal care? If so, should health care facilities be properties of the government, or implement the single-payer national health insurance model such as the one used in Canada?

Just asking for opinions on this, as again, I live in America and have no experience with national health care. Opinions, please...

RobS · 2004-10-06 00:04:35

1. Universal health care programs are almost universally popular in the countries that have them (when people are polled).

2. The Canadian, French, and British health care systems take up much less of the gross domestic product than the US system (i.e., they are cheaper on average).

3. All systems have their nightmare stories of people dying because they couldn't get health care coverage, either because it was rationed (Canada, etc.) or because they couldn't pay (USA).

4. According to the World Health Organization, France has the best health care system in the world. I believe it. In 2000 I was there and got sick. My wife's cousin--a pediatrician--recommended a friend of his. The physician was very friendly, very thorough, spent more time with me than US doctors, and charged me about a quarter as much. He even spotted a buildup of ear wax in one ear and removed it for no extra charge (when I had a buildup a year earlier my US physician sent me to a specialist, who removed it in about two minutes and charged me almost $200!).

5. If you're going to spend hundreds of millions of dollars--or even millions of dollars--to fly people to Mars, you're going to make sure they stay healthy.

6. The reason the US doesn't have universal health coverage is probably because it would mean making less money per patient. That's the only way the percentage of the GDP can be lower in these other countries. Near as I can tell the health biz in the US is a gigantic money-making racket, and it probably needs more regulation so that it serves people better. Based on what I have seen overseas, it CAN serve people better and cost less.

-- RobS

Cobra Commander · 2004-10-06 05:12:10

An important factor is being overlooked here. Whatever the pros and cons of universal healthcare systems there is one fact that can't be avoided: They are the product of established economies. They come about after a nation has already built itself up and established an economic foundation, preferably a wealthy one. Trying to institute universal healthcare while building a society from the ground up won't work, you haven't reached the stage at which it can be implemented.

Why is this? Put simply, a universal healthcare system is a function of government. Government doesn't produce anything, but rather feeds off the rest of the economy. In order to enact universal healthcare or any other massive government social program, you must first establish the economy to feed it. Colonial Mars will not have a sufficient economy for quite some time.

Pioneers with universal coverage? ???

Grypd · 2004-10-06 06:29:19

There will be universal health service at first. Certainly there will be doctors whose only job will be to provide medical health care to the people on Mars.

1) In Britain our National Health Service is showing some signs of age its getting a bit creaky as it was built in the 1940s and the increases in costs to maintain it and other social welfare has increased and increased. Certainly knowing that if I break my leg I will immediately be taken to hospital and will be seen is a great worry I dont have. The problem comes for health services is that modern medicine is not cheap. Some of the most effective medicines are incredibly expensive and more and more of these appear each year with people expecting the right to have the best medical care. And then you have what should be classed as needed on a health service. Should plastic surgery be on it? Should sex change operations be on it?. Then the universal health care system needs to have a degree of people putting money into it from wages earned but if the base of earners decreases due to a more older and older population then the health service is in trouble.

RobertDyck · 2004-10-06 06:57:23

As someone who lives in Canada, I find the system works well. When I was 18 years old I got a cyst on the back of my right wrist. I first had to go to a general practitioner, who recommended a surgeon. I saw the surgeon 3 days after seeing the general practitioner, and surgery was less than 2 weeks after seeing the surgeon. It was day surgery, I was out of the hospital as soon as the anaesthetic wore off. A couple years ago I had a persistent cough; it wasn't bad but it just didn't go away. After a couple months I went to see a doctor, again a general practitioner. He scheduled chest X-rays to ensure I don't have tuberculosis, and drew blood to send to a lab for tests. The result showed it was an allergic reaction, so he made an appointment for me to see an allergy specialist. I had spent a couple hours waiting to see the doctor, another half hour waiting in his examination room; at the X-ray clinic I spent another half hour waiting before the X-ray was taken. A couple days later I came back for the results; I again had to wait a couple hours before seeing the doctor, and a half hour in his examination room before he went over the lab results with me. After I discovered it was just an allergy, I didn't bother pursuing it further.

The system in Canada is that patients never even see a bill. You can see a doctor at any time for anything, but you have to see a general practitioner first. The point is to ensure the general practitioner prevents hypochondriacs from bothering specialists. Studies have shown that the ability for patients to see a general practitioner at any time without worrying about a bill results in finding chronic problems early, when treatment is most effective and treatment cost is lowest. There is a little additional cost for doctors seeing patients for things like cuts and scrapes, but the cost saving for catching things like cancer or tuberculosis early saves more money resulting in a net reduction of cost. Many HMOs in the U.S. have discovered this statistic, and made visits to a general practitioner free: unlimited visits, no deductible, no co-payments.

In Canada there is no limit on which doctor you see. You can see any doctor who has a licence to practice medicine, and operates his practice within the same province as you reside. You must see a general practitioner before seeing a specialist, but if you request a particular specialist then your general practitioner will recommend him/her instead of someone else. Some doctors with an established practice have all the patients they can handle and won't accept new patients, but that's the doctor's decision.

I could give you another personal experience. When I was 22 I copied a manual in the photocopy room at work. It involved cutting pages with one of those cutting boards that have a hinged knife to cut the full width of a page. I cut my finger; it hurt and bled but I thought it was just a stupid mistake and wanted to just use antiseptic and a Band-Aid from the first aid kit. My supervisor insisted I go to the nearest medical clinic. I got 4 stitches, so it was worse than I thought.

Mars will start with a small community, so they won't tolerate an attitude of "he gets treatment but he doesn't" simply because of money. If someone is hurt they must get treatment, and the environment on Mars will be dangerous, at least initially. The medical clinic will have to be staffed and supplied somehow, but medical care will be given based on need, not cash. So some system will have to be established to pay for it. That means whichever organization pays for initial construction of the base, will have to include a medical clinic. How will the initial base be paid for? That remains an outstanding question, and perhaps not for this thread, but I think whatever pays for base construction will also pay for health care.

clark · 2004-10-06 07:01:54

I know something of health care.

Grypd is about right, be it private or universal, all health care schemes are little more than Ponzi schemes. Okay, maybe a bit to harsh, but the basic premise that makes it work is that you have a large healthy population, about 80% or so, that utilizes about 20% of the services of the health plan, while about 20% of your population utilizes 80% of the services.

The only way it works, regardless of who pays, or how, is that a larger portion of your population remains healthy and not need to use the services so their resources can be utilized to subsidize the costs of servicing the smaller population.

All the various private plans out there try to implement different economic cost-sharing to influnce the use of services and stay in the black. The use of deductibles acts as a barrier to service utilization by influencing people to not seek medical services unless absolutely neccessary (all deductible plans takes a loss for the provider). Requiring referrals from general practioners to seek specialist care is another form of barrier to control access to the exspensive services of specialists, thus helping to defray future costs and ensure that only those who have a certified valid reason for extra service are allowed through.

Where the system breaks down though is when your high utilization population (the sick) begins to exceed the number of low-utilizers (the healthy population), or the cost to treat the high utilizers begins to exceed the resources genereated by the subsidy granted by the low and non users of the system. This is predominantely why HMO's raise rates or deductibles as they try to increase the resources to service the needs and reduce actual usage of the services.

This problem is further compounded by improvements with science and technology that enable a wide range of capabilities to medical professionals, that ethically, must be provided for (if the capability exsists). This is often exspensive, and further puts strain on the entire system as a small percentage of the population ends up consuming a larger portion of the overall resources.

While universal health care is a great idea, I don't think it would be right for America at this time. The baby-boom generation will destroy it, and we will witness what might happen to America in some of the other advanced nations that are aging. Their population growth is either stagnant or decreasing, which means their will be fewer healthier people working, putting into the system, to pay for the larger costs of the aging population. This will lead to a reduction of services and/or higher costs associated on the services through tax or individual plans that give incentive not to use services.

Health care as currently constructed, is a pyramid, and it can only work as long as the top is smaller than the bottom.

On Mars, there will be universal health care. The value of human life will be such that it will be secure (the costs to just get people there will far exceed any health care costs). However, I think there will be a reappraisal of what can and cannot be provided in terms of universal health care. You get to be well for free, but you don't get a sex change without paying. Things like that.

But then again, what do I know.

RobertDyck · 2004-10-06 07:26:36

I think a national health care system would be good for America right now. The fact that pharmaceuticals are imported from Canada demonstrates the need to reduce costs in the US. Properly run it wouldn't cause a massive cost increase, it would cause a decrease. There are cities where hospitals insist on having all the latest gadgets to ensure they are the hospital of choice. Competition has resulted in redundancy; 4 hospitals have an MRI machine in an area where only 1 or 2 are needed. A coordinated system would permit specializing hospitals within a city so expensive equipment is not duplicated.

When I lived in Virginia, I had moved from Calgary, Alberta. My employer in Alberta was a contracting firm that treated all their contractors as one-person corporations. That meant contractors like me had to pay both the employee and employer portions of CPP (Canada Pension Plan) and UI (Unemployment Insurance, now renamed to Employment Insurance). The Alberta Health system is paid via premiums, so it also meant I had to pay both the employee and employer portions of that. When my employer assigned me to a client in Virginia, Alberta Health was willing to continue coverage for up to 1 year. I still had to make payments, and they would only pay American hospitals the same amount a Canadian hospital would get for the same operation, but they did cover me. Despite all this, my monthly payment was 1/3rd what an American co-worker had to pay for his health plan.

In Canada, sex change operations are not covered by the health care system. There are some people arguing that it should be, but it isn't.

Cobra Commander · 2004-10-06 07:28:11

How will the initial base be paid for? That remains an outstanding question, and perhaps not for this thread, but I think whatever pays for base construction will also pay for health care.

Which brings us back to having to clarify exactly what we're talking about to make sure we're all on the same page. A small base will have medical personnel with the sole purpose of providing needed care to the rest of the crew. This is not "universal healthcare" because the situation is purely occupational. People sent to work on Mars for a given length of time. It's a job.

When we start building a colony the entire equation changes. Early on we may be able to use the same system, wherein doctors are retained at the expense of X to provide treatment to the entire population. However, as the population grows we quickly reach a stage where it can no longer be maintained through external means except by an extremely generous benefactor with other than economic motivations, nor is the local economy robust enough to support it. There will be a long period where universal healthcare is simply not practical on an economic level. It could still be implemented through external means if the motivation is there, but economically it doesn't hold up.

clark · 2004-10-06 07:47:23

Don't get me wrong, a universal health care plan for America could work, we have the semblance of it now with medicare and medicaid. But that is largely a government fail-safe that tries to incorporate itself into the exsisting private infrastructure of health care.

I disagree with Cobra that you need some type of advanced economy to make it work. You need a base population willing to pay a set amount to pay for the doctor and supplies. That's it. What you also need though is a large healthy population that can subsidize the costs of treating the sicker people. It's like a swing set. Alone, we can't buy the swing set. Together, we could, but there are only so many swings for us to share. If we take turns, it works. If we all get on at the same time, then it breaks. Please don't quibble with my analogy.

Certain models of health care coverage work for different areas. Some work well for cities. Those same models are absolute failures for rural areas. America is a big place, with a diverse population, and trying to find a one=size fits all will not satisfy everyone.

While you mention drug coverage, I can mention Canadians who come to the US to jump the que because they don't want to wait in line in Canada. Both models have problems.

Where will it all lead? Well, I've had a conversation once with some others here before, and there was general disagreement, but I will tell you again: Health care will pretty much be the same, the only difference is that responsibilites will shift. People will take a larger role in their own health care needs, secondary providers (RN, midlevels, etc.) will take on a greater role of providing services once only held by general providers, and doctors will be reserved for the high need cases or ones moved up the ladder by the secondary providers.

More HMO's, be it government or private, are working actively to educate their populations on treating themselves, evaluating themselves, doing their own research. There has been a sea change in the patients that now come into to see physicians, they are generally telling the physician what the problem is and asking for advice on which solutions they have discovered themselves. They are asking about their own persrciptions instead of relying on the physician to make that determination.

This reduces the time needed with a physician, so now a physician can see more patients, teaches self reliance as the best doctor is usually yourself (usually...), and leads to a general satisfaction as people feel in control of their own health.

The main reason universal health care will fail though is simple math. You need more healthy people who don't use the system than sick people who do. Period. There is no getting around this. Which is why there are endless debates on who can be called sick, and what is considered an illness. Eventually, unless the base of the pyramid can be maintained relative to the top, the system will implode.

BWhite · 2004-10-06 12:17:58

In my opinion, a huge problem in America is the utter lack of sensible preventive treatments and the media promotion of frankly unhealthy lifestyles in the name of profit.

We spend billions of $$$ (hundreds of billions of $$$) for by-pass operations on smokers and obese people. Don't misunderstand, I do not favor rationing and my human compassion goes out to the overweight person who needs heart surgery.

But, a very real cost of selling super-Size portions at McDonalds is higher health care costs.

Cobra Commander · 2004-10-06 12:25:10

But, a very real cost of selling super-Size portions at McDonalds is higher health care costs.

And it logically follows then that a universal healthcare system gives us a sound economic reason to meddle in the affairs of others. I'm payin' for your coverage buddy so put that cigarette out, don't take one more bite out of that greasy burger and don't even think about riding that motorcycle without a helmet. In fact, step off that deathtrap right now, bucko!"

Somehow I like the idea of being left to do whatever stupid unhealthy thing I want and having to pay for it myself far more than some well-meaning fiscal nanny, which is where such a scheme is ultimately heading.

EDIT:: Not that I'm necessarily opposed to some moderation in food intake and a generally healthy lifestyle, I just don't think that government regulation is the way to do it.

There's a sly fascist way that makes people want to do so of their own free will, but that would require some deeper changes.

clark · 2004-10-06 12:47:58

What you are both pointing out though is the inherent problem and the very real solution to the pyramid health scheme. You can supersize to your hearts content, and have universal health coverage- as long as the population living an unhealthy lifestyle is smaller than the population of healthy people. However, if a majority of the people are living unhealthy lifestyles, there will be higer utilization, which drives up the costs to provide the neccessary subsidy for resources (or of course triage the care services).

There isn't a solution to this problem because the system itself is the problem. All one can do is is twiddle and tweak, plugging as many holes in the dam to stave off the inevitable.

Canada, they have rationing of services in the form of wait times for certain procedures. America gets around that by having a private system where economics ration who gets what and when. It's all going to come to head in either system though when the older generation puts a strain on the health care system that it can't cope with. Why do you think medical rates are rising? More people are using the system. Fewer people are having to pay a larger amount to subsidize it all.

American economics as a trend is easy to follow since WW2. Any industry that serves the age bracket of the baby boom generation succeeds. Why, they are the largest segment of the american population. They drive the economu- the invisible hand.

Brown shirts aren't going to solve this either. Government mandated exercise programs have historically been failures. Plans that require certain behaviours are generally considered in violation of liberty and free choice, and seen as opporessive.

As for haing to pay for your own mistakes, that's a fallacy. The fact remains, you live stupid, spill your brains on the pavement, we all end up paying for it. Be it in the emergency room, or in the services that we have to pay to go pick up your body. You smoke, get cancer from too much sun, whatever, and we pay through higher premuims when you can't work anymore and go on the dole. We can't cut out the emergency services or the dole since that creates public threats to saftey and just goes againt common decency.

I've looked at a lot of different models for HMO delivery and they all rely on the same basic premise- take money from here to pay here, and use whatever creative means you can to reduce usage to balance it all out.

Cobra Commander · 2004-10-06 13:13:31

There isn't a solution to this problem because the system itself is the problem. All one can do is is twiddle and tweak, plugging as many holes in the dam to stave off the inevitable.

I agree, this isn't really arguable. Common ground to stand on...

Brown shirts aren't going to solve this either. Government mandated exercise programs have historically been failures. Plans that require certain behaviours are generally considered in violation of liberty and free choice, and seen as opporessive.

My point was that no government mandated program will work, however if a large enough segment of the population can be convinced to want to live healthy it can have a positive impact. While it was not my intent to advocate a policy as I don't think a fascist-esque approach will work today in America, the real point is that to succeed in behavior modification we need to think of it not as a legislative issue, but a marketing challenge.

As for haing to pay for your own mistakes, that's a fallacy. The fact remains, you live stupid, spill your brains on the pavement, we all end up paying for it. Be it in the emergency room, or in the services that we have to pay to go pick up your body.

It's a question of degrees. If I decide to put some money in a bank instead of buying an new car I'm costing everyone by keeping money out of the general economy, weakening sales, and contributing to job loss elsewhere and therefor an increase in social services spending, meaning taxes. No man is an island, as they say. It's all a matter of where you want to draw the line.

On a more mundane level, the current health insurance scheme has many of the same inherent problems of a government-run system, only private. Every fat, smoking drunken slob drives up costs for everyone else. Unless everyone covers 100% of their own expenses we'll always have some degree of... health communism. ???

We can't cut out the emergency services or the dole since that creates public threats to saftey and just goes againt common decency.

Well, we could introduce some sort of predator, then it would work itself out.

Which illustrates another point. Humans currently live outside of design specifications in a sense. Much of our problems in the healthcare field are the direct result of us, in a sense, living too long. We've created an artificial environment for ourselves without the natural checks, it's unstable in many respects and we'll likely never find a perfect balance for medical care because with age, disease and injury we're in many ways constructed to fully recover with relatively minimal care or die in short order. The entire premise of the medical field is to expend resources in a futile effort to prevent the inevitable.

clark · 2004-10-06 13:34:21

Maybe the Christian Scientists are on to something. :laugh:

While it was not my intent to advocate a policy as I don't think a fascist-esque approach will work today in America, the real point is that to succeed in behavior modification we need to think of it not as a legislative issue, but a marketing challenge.

And health care is largely doing this. You have various nutrional programs, drug intervention treatment, smoking cessation, discounted prevenative care, ongoing tracking of infectious disease, health care pamplets, internet sites on healthy living, etc. This is really one of the few areas that can have a tremendous effect, which routinely gets stymied by the various interests who, for one reason or another, don't want that kind of marketing campaign spread- be it from the beef industry, the crabohydrate conglomerates, or the religious we're-right preventing a more comprehensive health education related to sex.

Yet our lifestyle is predominately the result of the life we must lead- most families have two people working outside of the home, which tends to lead to greater instances of eating out, and eating less healthy. 40 hour weeks and overtime with child rearing or night classes to get ahead deprive people of available time to get out and exercise. We can go on about what your socio-economic status means in determing your health since the poorer you are, the less available fresh fruit and vegtables tend to be (this is especially true for the inner cities) which leads to higher instances of geographicly specific areas where the majority of the unhealthy people live in one area, which over taxes the local services. Failure of mass transit, coupled with some of the other things above just compund the problem and prevent the use of underutilized medical facilities and resources.

We can go on about the legeslative requirements that create a morass of bueracracy for health care services. This drives costs up as well. It's all a freaking nightmare. Entire armies of people assemble papers and numbers for auditing agencies. Reams of notebooks and graphs and charts relating 5 year tracking surveys to prove that you do what you say you're doing. Oh, never mind. :laugh:

Anyway, people will all die off and it will sort itself out. Release the veilocoraptors!

BWhite · 2004-10-06 15:35:17

Anyway, people will all die off and it will sort itself out. Release the veilocoraptors!

When I was at the Moon-Mars Blitz, one night at dinner a fellow told me that Bejing is actively pushing smoking on its citizens, even to the point of subsidizing cigarettes.

He did appear to speak fluent Mandarin (according to someone else who claimed he also spoke fluent Mandarin) and claimed some expertise on present day China.

Anyway, the alleged rationale was to kill people off before they could collect social welfare benefits for the aged.

BWhite · 2004-10-06 15:40:11

Yet our lifestyle is predominately the result of the life we must lead- most families have two people working outside of the home, which tends to lead to greater instances of eating out, and eating less healthy. 40 hour weeks and overtime with child rearing or night classes to get ahead deprive people of available time to get out and exercise. We can go on about what your socio-economic status means in determing your health since the poorer you are, the less available fresh fruit and vegtables tend to be (this is especially true for the inner cities) which leads to higher instances of geographicly specific areas where the majority of the unhealthy people live in one area, which over taxes the local services.

I recall reading about a doctor at Cornell who discovered that mammals born to underweight or malnourished mothers had their liver and pancreas "tuned" to be less able to strain out fats and cholesterol.

If born into a famine setting, such tuning would be advantageous as it helps the body preserve such nutrition as is available.

Now, take a mother on crack, who smoke cigarettes and is functionally malnourished, even if she eats plenty of junk food. Her baby is born with organs tuned to be less able to screen out fat and cholestrol and is then fed a diet of KFC, Burger King and McDonalds.

Voila! Obesity and heart disease.

Josh Cryer · 2004-10-07 05:11:58

When we're colonizing Mars, we'll have all sorts of nifty cures for all sorts of things, and this silly question about health care will largely be moot. People will be taking care of themselves.

RobertDyck · 2004-10-07 07:26:08

I seriously expect to colonize Mars within our lifetime. The earliest possible launch time for the construction crew of the first base will be 2018; it'll probably be a few years after that. How much change has occurred during the last 14-18 years? I don't expect change to be significantly different in the next 14-18 years. Experience has shown the best solution for any medical problem is prevention, not cure. That means health problems caused by diet are cured by altering diet, not by any magic pill. Considering the effort required to recycle oxygen on Mars, I don't think we'll have a problem with smoking. At first food production will be vegetarian, so low fat intake. The initial Mars base will have food production planned by trained dieticians and agriculturalists. The later colony will simply have what's available, but it'll be a long time before beef or pork is available. With a diet of veggi-burgers, fish, potatoes, bread, and various vegetables, do you think Earth's obesity problem will exist on Mars? I could get into details like casein cheese and veggi-pepperoni to make pizza, but the point is low-fat will be a financial necessity.

dicktice · 2004-10-22 19:22:22

I just came home from work, via my family doctor's office, where I dropped in to request my flu shot. Doc's receptionist/nurse/wife took me in to his vacant office, whipped out a dosage-needle and stuck it into my arm, all within five minutes. She was entering the data in my folder, where my health card data resides, as I was leaving. The people in the waiting room weren't the least inconvenienced by my coming and going. How pathetic, to observe via the political "debates" how frightened the U.S. is of Universal Health Care!

Palomar · 2004-10-22 20:26:40

I just came home from work, via my family doctor's office, where I dropped in to request my flu shot. Doc's receptionist/nurse/wife took me in to his vacant office, whipped out a dosage-needle and stuck it into my arm, all within five minutes. She was entering the data in my folder, where my health card data resides, as I was leaving. The people in the waiting room weren't the least inconvenienced by my coming and going. How pathetic, to observe via the political "debates" how frightened the U.S. is of Universal Health Care!

*Healthcare in the U.S. is Big Busine$$. The corporate fat cats prey on the general public's fears, manipulate them with scare tactics. I've known of at least 1 physician who wasn't above manipulating and frightening people into trooping back into the office for more checkup$ and additional blood test$ because their cholesterol was just mildly elevated (205 or 210, instead of a perfect 200), and she somehow managed to talk people with NO complaints referable to intestinal troubles and no family history of intestinal cancers into getting flexible sigmoidoscopies...which, in 1990, went for $75.00 a pop.

IIRC, the "logic" trotted out against universal healthcare here in the States is that it'd take decision-making away from patients. :hm: The HMOs have taken EVERYONE'S decision-making powers away, practically. Staffers in HMO offices -- who have zero medical training, let alone a license to practice medicine -- can override a physician's orders! We've already lost our decision-making power.

Would love to see a system like Canada's on *Mars.* I'm genuinely happy for anyone living in a nation with good, dependendable universal healthcare.

The U.S. scene is chaos and an utter joke...pathetic.

-end rant- :laugh:

--Cindy

Cobra Commander · 2004-10-23 00:13:08

IIRC, the "logic" trotted out against universal healthcare here in the States is that it'd take decision-making away from patients.

That, and a very real concern that any American universal health care system would be a directly government-run system, an expanded medicare, bound by all sorts of mindless regulations, budget problems, fraud and inefficiency. There are better ways to do it, but that's the paradigm generally looked at by many who would implement a universal system. It's become largely a rhetorical tool, most politicians who raise the issue do so purely for political gain, they have no actual workable plan nor any intention of enacting one.

Also, the Canadian system is not a 100% standalone program. Drug costs are low in large part due to the fact that there's an open market in the US. The drug companies elect to sell their products to Canada at a substantial reduction because the Canadian market is small enough to be "absorbed" by the much larger American market. Implement the same sort of artificial pricing in the States and the drug companies will be severely hit. R&D will face substantial cuts, in the long run harming everyone. It's not fair that the American people subsidize the Canadians, but that's in essence how it works.

You're welcome.

RobS · 2004-10-23 00:36:50

As someone has observed, the problem with the current health care system is that most of the time health care decisions are made by 23 year old insurance company bureaucrats, not by doctors! The government wouldn't be any worse.

I fear the current US system is unreformable, though, because of the entrenched special interests and the widespread American paranoia of the government.

-- RobS

RobertDyck · 2004-10-23 04:14:50

First, in Canada medical decisions are made by doctors, not bureaucrats. The government determines how much a doctor gets paid for a particular operation, not whether the operation is necessary. Patients can see any doctor they want in the province.

A few years ago pharmaceutical companies demanded patent protection in Canada be extended for more years. Once the patent expires generic copies are made at lower prices. Pharmaceuticals are kept reasonably priced in Canada in exchange for extended patent protection to harmonize with US law. They know damn well that if they try to increase pharmaceutical prices to equal the blatant gouging US customers are subject to, Canada will restore the shorter patent period.

I saw part of a documentary this week. It was on creation of the Canadian healthcare system. Tommy Douglas was leader of the Saskatchewan NDP, and Premier of the province. He instituted the system in that province, and had quite a fight. Doctors threatened to leave the province, farmers were afraid their children wouldn't have access to healthcare because all the doctors left; in the end it was not only instituted, but the federal NDP introduced it. They were the 3rd party in parliament, but succeeded in introducing universal healthcare federally. It all started with one courageous political leader; head of the government of a poor farming province. Saskatchewan has a population about equal to North Dakota, its largest city is the same size as Fargo, and the south-east corner actually borders on the north-west corner of North Dakota. Imagine the Governor of North Dakota leading introduction of a national healthcare system to the federal government in the US; that's what happened in Canada. It happened before I was borne, but I noticed several American Presidents have attempted to introduce a national healthcare program unsuccessfully. Does America have any leaders today capable of making something like that happen?

RobS · 2004-10-23 07:56:11

Leaders to make it happen in the U.S.? Unlikely, because Americans are too easily manipulated by pharses like "don't get the government involved" and "don't give the poor people a handout." The former is the residue of our revolution and the latter is selfish individualism mascarading as Christianity.

-- RobS

New Mars Forums

Announcement

#1 2004-10-05 20:11:39

Re: Universal Health Care on Mars? - How best to take care of Martians?

#2 2004-10-06 00:04:35

Re: Universal Health Care on Mars? - How best to take care of Martians?

#3 2004-10-06 05:12:10

Re: Universal Health Care on Mars? - How best to take care of Martians?

#4 2004-10-06 06:29:19

Re: Universal Health Care on Mars? - How best to take care of Martians?

#5 2004-10-06 06:57:23

Re: Universal Health Care on Mars? - How best to take care of Martians?

#6 2004-10-06 07:01:54

Re: Universal Health Care on Mars? - How best to take care of Martians?

#7 2004-10-06 07:26:36

Re: Universal Health Care on Mars? - How best to take care of Martians?

#8 2004-10-06 07:28:11

Re: Universal Health Care on Mars? - How best to take care of Martians?

#9 2004-10-06 07:47:23

Re: Universal Health Care on Mars? - How best to take care of Martians?

#10 2004-10-06 12:17:58

Re: Universal Health Care on Mars? - How best to take care of Martians?

#11 2004-10-06 12:25:10

Re: Universal Health Care on Mars? - How best to take care of Martians?

#12 2004-10-06 12:47:58

Re: Universal Health Care on Mars? - How best to take care of Martians?

#13 2004-10-06 13:13:31

Re: Universal Health Care on Mars? - How best to take care of Martians?

#14 2004-10-06 13:34:21

Re: Universal Health Care on Mars? - How best to take care of Martians?

#15 2004-10-06 15:35:17

Re: Universal Health Care on Mars? - How best to take care of Martians?

#16 2004-10-06 15:40:11

Re: Universal Health Care on Mars? - How best to take care of Martians?

#17 2004-10-07 05:11:58

Re: Universal Health Care on Mars? - How best to take care of Martians?

#18 2004-10-07 07:26:08

Re: Universal Health Care on Mars? - How best to take care of Martians?

#19 2004-10-22 19:22:22

Re: Universal Health Care on Mars? - How best to take care of Martians?

#20 2004-10-22 20:26:40

Re: Universal Health Care on Mars? - How best to take care of Martians?

#21 2004-10-23 00:13:08

Re: Universal Health Care on Mars? - How best to take care of Martians?

#22 2004-10-23 00:36:50

Re: Universal Health Care on Mars? - How best to take care of Martians?

#23 2004-10-23 04:14:50

Re: Universal Health Care on Mars? - How best to take care of Martians?

#24 2004-10-23 07:56:11

Re: Universal Health Care on Mars? - How best to take care of Martians?

Board footer