[driven]

Originally Posted by Mastrap 

Last week we had a medial emergency in the family. We drove to the nearest hospital, walked in and were seen to immediately. Nobody asked for payment, nobody asked for insurance, nobody asked for a credit card. The staff could not have been more helpful and professional, we received first class care. All ended well, with no worries about bills to arrive.

I lived with 'socialized' (whatever that is supposed to mean) healthcare all of my life, both in Europe and in Canada, and I take it over the private insurance model any day. Public health, like public education, is in the interest of all.

Since you brought up education:
I wouldn't mind seeing education either de-federalized and run by the states, or privatized entirely. That's another good thing that the government has botched up. Without competition organizations tend to fall into mediocrity. Our school systems are no exception.

Originally Posted by ShortcutToMoncton 

On that note, I am in favour of charging small fees for ER services; say, like $5 or something. That's mostly to discourage the many, many people who visit the ER when they get an upset stomach and diarrhea, only to waste everyone's time and be told to go home, take Gravol, drink fluids and rest, and see your damn family doctor.

It amazes me the people who run to the ER every time they fall down, or rush their babies to the children's hospital every time they have a sniffle.

[peeb]

You think $5 would stop that?

[Trygve]

I am American and would like socialized medicine. Maybe that's because I had to leave America 6 years ago in order to obtain health insurance.... after being turned down by every insurer licensed in my state.

[ShortcutToMoncton]

Originally Posted by Trygve 

I am American and would like socialized medicine. Maybe that's because I had to leave America 6 years ago in order to obtain health insurance.... after being turned down by every insurer licensed in my state.

But... didn't you have to become a terrorist to get it?

[Doofy]

Originally Posted by Trygve 

I am American and would like socialized medicine. Maybe that's because I had to leave America 6 years ago in order to obtain health insurance.... after being turned down by every insurer licensed in my state.

This makes the case for a state insurance scheme (where you can't be turned down). Not socialised medicine.

And it looks like you're being overly dramatic. You say you had to leave America but you couldn't get insurance in your state. Couldn't you have moved to a different state?

[ghporter]

Maybe yes, maybe no. It depends on why he was turned down. Just as an example, there are very few health insurers who will write a new policy for anyone who has a diagnosis of HIV infection, and from a business standpoint who could blame them? There's no way they could come close to breaking even on such a policy. There are other health issues, such as cancers, that would cause most insurers to turn down a new customer.

On the other hand, getting to the UAE on a long-term basis usually implies a job offer, and the people who offer such jobs have money to burn (when they hire expats, they tend to pay them in 6 digits $US, and set up contract lengths specifically to avoid US tax liability for those large salaries), so providing health coverage would not be a real problem. It all depends on the person's qualifications-much like buying health insurance.

[Doofy]

Originally Posted by ghporter 

Maybe yes, maybe no. It depends on why he was turned down. Just as an example, there are very few health insurers who will write a new policy for anyone who has a diagnosis of HIV infection, and from a business standpoint who could blame them? There's no way they could come close to breaking even on such a policy. There are other health issues, such as cancers, that would cause most insurers to turn down a new customer.

On the other hand, getting to the UAE on a long-term basis usually implies a job offer, and the people who offer such jobs have money to burn (when they hire expats, they tend to pay them in 6 digits $US, and set up contract lengths specifically to avoid US tax liability for those large salaries), so providing health coverage would not be a real problem. It all depends on the person's qualifications-much like buying health insurance.

Surely, you wouldn't get to the UAE on a long-term basis if you had an illness which if going to prevent you from doing your job?

We need more info.


But, socialised medicine isn't the way. Despite the fact that I pay my "premiums", the local hospital won't treat me. Why? Because I smoke.
Now, the way this is going it'll soon be the case where a hospital won't treat you if you do anything not approved by the doctors. Had 5 beers this week? Sorry, no service. Had a cake last month? Sorry, no service. Use sugar in your coffee? Sorry, no service. Not performed your cardio today? Sorry, no service.
That's one long slippery slope into a place where you wouldn't want to be.

Question: Why do you guys pay 15.3%* FICA? You seem to get a rough deal with that - we pay less and get free health care (as long as we don't smoke, eat cake, drink beer, etc..).

(*self-employed rate)

[Oisín]

What’s the difference between a state insurance scheme and socialised medicine? I thought they were the same.

[Doofy]

Originally Posted by Oisín 

What’s the difference between a state insurance scheme and socialised medicine? I thought they were the same.

My definitions, which I don't know whether anyone else shares:

Socialised medicine uses publicly-owned medical facilities - a one-stop-shop, the whole kit and caboodle.

State insurance pays your bill at the private medical facility of your choice, so in essence works exactly like a private insurance company but without the profit motive.

The latter (insurance) is my preferred system, assuming that the state can't reject you for doing "unhealthy" things. It ensures that the people giving the treatment do a good job (else they'd lose customers). Example: I currently have two doctors - a state provided one (no choice in the matter, paid for out of taxes) and a private one (paid for out of my own pocket). The state doctor gets paid the same salary whether I live or die. The private one doesn't get paid if I pop it. Guess which one I go to see when I'm broken.

[Oisín]

We have socialised medicine, then. But they don’t reject you. They’re not allowed to.

Practising doctors are a different matter, though. They’re technically practising privately, and are paid on a per-patient basis, but it’s the state that pays them, so in a way that’s your state insurance scheme. Their salary is of course paid through taxes, but there is a free choice of doctors, so you can choose whichever doctor you like. There’s no such thing as a truly private doctor, where you pay out of your own pocket, though there are private hospitals where you pay out of your own (or your private health insurance’s) pocket.

An extra twist with the hospitals is that if a public hospital can’t treat you within some specified time (three months, perhaps? Not sure. Or perhaps it depends on the diagnosis), then they have to refer you to a private hospital, where the state then pays for your treatment there instead.

[analogika]

Originally Posted by Oisín 

What’s the difference between a state insurance scheme and socialised medicine? I thought they were the same.

The difference is whether the state mandates that public insurance companies must exist and provide a certain set of basic services for a fixed range of income percentage per month, and these insurance companies pay the doctors' bills, or whether the state itself pays those bills from taxes.

Germany has mandatory insurance.

[peeb]

Socialized medicine, strictly speaking, is where the state owns the health care facilities, and pays the doctors. In the US it is used by the right wing to mean any kind of rational health care system which would result in reduced profits for insurance giants and pharma industries and better, cheaper care for patients.

[analogika]

Originally Posted by peeb 

Socialized medicine, strictly speaking, is where the state owns the health care facilities, and pays the doctors.

That is true here, for clinics and hospitals (though there are, of course, private clinics).

Private practises are, well, private, and fees for basic services are covered by the insurance companies.

Basic fully-covered services vs. exotic services would be something like standard amalgam tooth fillings vs. ceramic inlays. Generally, you'll have to pay the difference yourself - though coverage of various alternative medical procedures like acupuncture etc. will vary depending upon the diagnosis (or course) and the insurance company. Psychotherapy and acupuncture are increasingly considered standard services and fully covered by basic insurance.

[Don Pickett]

Originally Posted by driven 

Since you brought up education:
I wouldn't mind seeing education either de-federalized and run by the states, or privatized entirely. That's another good thing that the government has botched up. Without competition organizations tend to fall into mediocrity. Our school systems are no exception.

I'm not sure what you mean by this: schools are run by local governments.

[analogika]

So are almost all schools, world-wide.

[driven]

Originally Posted by Don Pickett 

I'm not sure what you mean by this: schools are run by local governments.

Exactly ... and as such ... you don't have choice as to which school your child goes to. They have a captive audience. I'm ok with the government making quality standards, but leave it to private industry to actually implement it.

Oddly ... at the university level the government leaves quality to private industry (accreditation) ... there are 5 private accreditation bodies in the USA. Only distance education is government accredited at the college level. We are the ONLY country in the world that does that. (But I digress).

I'd like to see schools run privately. I'd like to see people given tax credits for the tuition spent.

[Spliff]

Atheist,

Why do you want to move to a culture-less, boring country like Canada? Seriously. Any country in Europe has got to be better than Canada.

We're America wannabes, aping their TV and envying their football league. We're complacent and dull. Our wages are low, our house prices ridiculously high.

There are better places to live than Canada.

[Don Pickett]

Originally Posted by driven 

Exactly ... and as such ... you don't have choice as to which school your child goes to. They have a captive audience. I'm ok with the government making quality standards, but leave it to private industry to actually implement it.

You do have a choice as to which school your child goes to. If you don't like the local public schools in your area, then you can send your kid to a private school.

I'd like to see schools run privately. I'd like to see people given tax credits for the tuition spent.

I wouldn't. There's a big myth in this country that private schools, or privately run schools are better, but it's quite often not true. I went to public schools up until college, and the private schools in the areas were never the better school. In Atlanta, where I went to elementary and middle school, there were some private school which were as good as the public schools, and some which were worse. And, in Connecticut, where I went to high school, kids were sent to private school when they couldn't hack the public schools. Even where I live now, in NYC, private schools vary widely in quality. Some are better than the public schools, some are worse, and some are just as good. But sending your kid to one is not a guarantee that s/he will get a better education.

Additionally, citing the private college system isn't a very good thing right now, as tuition cost increases at most colleges have been running at double the rate of inflation, annually, since the 1980s, and I don't think you can argue that the quality of the education has increased with the cost. At present you have a generation of just graduated kids who have enormous amounts of debt, which it will take them years to pay off. If you really wanted schools to be privately run you'd still need some sort of government oversight in order to ensure accountability, and then you're right back where you are.

The DoE, like most government agencies, actually has very little power. It can set standards and deny funding, but it really can't force a school system to act a certain way. The problems with public schools in the U.S. don't actually have much to do with the schools. They have more to do with assumptions made about school funding and organization which are out of date.

[ShortcutToMoncton]

Originally Posted by driven 

Oddly ... at the university level the government leaves quality to private industry (accreditation) ... there are 5 private accreditation bodies in the USA. Only distance education is government accredited at the college level. We are the ONLY country in the world that does that. (But I digress).

Originally Posted by Don Pickett 

I wouldn't. There's a big myth in this country that private schools, or privately run schools are better, but it's quite often not true. I went to public schools up until college, and the private schools in the areas were never the better school. In Atlanta, where I went to elementary and middle school, there were some private school which were as good as the public schools, and some which were worse. And, in Connecticut, where I went to high school, kids were sent to private school when they couldn't hack the public schools. Even where I live now, in NYC, private schools vary widely in quality. Some are better than the public schools, some are worse, and some are just as good. But sending your kid to one is not a guarantee that s/he will get a better education.

See, this is how I understand the matter in the US, as relating to "private" colleges. I'm not an expert but have done some varying levels of personal research on colleges in the States (for my own purposes). Compared to Canada, there's a shocking variety of quality; degrees are handed out to people from the best of the best/rich (Ivy League) to pretty much anyone who can afford to pay (some local university colleges). In Canada, while we do not have the super-elite schools that the US does, we also do not have the shitty little local college/universities either; we've got some great schools, and lots of good schools, but I don't think any of them are considered "mediocre." There is something to be said about that consistent level of post-secondary education. I don't know a lot about the subject but I know we don't have a strict "public accreditation" system; but at the same time, there's a very strong focus on equality through the post-secondary education system in Canada.

(When I was researching law schools that was one thing that really stood out for me in the States. In Canada no matter which law school you attend, you won't be significantly disadvantaged in the overall job market. In the States, there's an enormous diversity of school quality and it really seems to make a difference which school you get into. There were some schools only requiring 3.0 GPAs to make it in, hahaha.)

On that note, there has been some talk on directing more funding to certain schools; because of the "equality focus," it means we do have some great schools but not really any "best of the best, Ivy League schools." We don't have the population base or the monetary base (from alumni or industry) to make those large contributions seen in the States, and as a result with equal public funding it's almost impossible for great schools like the University of Toronto or McGill to make that step into "elite schools." I really think it would be a good idea as long as existing universities are not denied additional funding measures. A program structured towards really promoting and raising the quality level of certain universities (say, 1 on West Coast, on Prairies, 2 in Ontario, 1 in Quebec and 1 on East Coast), and create our own little mini-very of the "Ivy League schools." Unfortunately, I imagine every other university and their alumni would protest mightily, and this is one case where our focus on equality will probably drag a good idea down.

Additionally, citing the private college system isn't a very good thing right now, as tuition cost increases at most colleges have been running at double the rate of inflation, annually, since the 1980s, and I don't think you can argue that the quality of the education has increased with the cost. At present you have a generation of just graduated kids who have enormous amounts of debt, which it will take them years to pay off. If you really wanted schools to be privately run you'd still need some sort of government oversight in order to ensure accountability, and then you're right back where you are.

This is the other issue. For private education up to the secondary level, you're gonna need some serious regulation detailing how things are to be laid out. Right now, a person making $15 000 a year can afford to have her kids in school; can that be guaranteed with a private system? Can people be guaranteed that a school within their "price range" is available in their area? What about tuition regulation? As Don points out, even in Canada with out "cheap tuition" at the university level there's a lot of people starting to be "priced out" of the university experience.

On that note, does anyone know how much people currently pay towards the education system in taxes? I assume everyone's calling for that to be cut out correct?

greg

[ghporter]

Originally Posted by driven 

Oddly ... at the university level the government leaves quality to private industry (accreditation) ... there are 5 private accreditation bodies in the USA. Only distance education is government accredited at the college level. We are the ONLY country in the world that does that.

In many ways the fact that these accreditation bodies are non-governmental is misleading. The Department of Education approves these bodies, and often federal funds are not available to a school if it is not properly accredited. Further, the country's professional certification bodies (at least in health care) will not themselves accredit a school that is not already accredited by the appropriate general accreditation body. For example, my university must maintain accreditation by the Southern Association of Colleges and Schools in order to even be considered for accreditation by The Accreditation Council for Occupational Therapy Education. This is true of our nursing program, our PA program, our dental hygiene program, our clinical lab program, our respiratory therapy program, etc. I believe the dental and medical schools have more stringent requirements on their curricula, but must also follow the same sort of process. In order to sit for my board exam, I not only have to have a degree in OT, I have to have it from a school that's accredited by ACOTE, and in order to get a license to practice, BY LAW I have to pass the board. That pretty much means that BY LAW in order to practice I have to have a degree from an accredited institution.

The "old boy network" stuff that happens in Ivy League schools, where students that come from very rich families and get through their college career by benefit of lot$ of $eriou$ $tudy $essions are not so much a matter of them getting the benefit of a "big name" degree as in the academic dishonesty of the schools in question and a total lack of academic integrity all round. I'm in a University of Texas System school, and while UT really only has students so they can keep a steady flow of grad students handy for TA duties and as a source of research fellows to do the hands-on dirty work of the research the Regents actually value (no problem really, but ask me if I have any strong feelings about the matter) the system provides some of the finest schools around, with some of the most well regarded programs in a variety of disciplines. I could have gone to any other OT school I wanted, but I wanted this school for its reputation and rigor. You don't really find "rigor" in those Ivy League schools' non-professional programs. Is there actually a real accreditation body for business schools? I mean other than comparing programs to those at the Wharton School (part of the University of Pennsylvania system now, but originally an independent, non-degree granting business school that never went wanting for students).