Monday, March 06, 2006

I forget the name of the show, but if you watched the Oscars, y'know that show they're pushing where a team of brilliant doctors fixes the medical problems of some seriously messed up people.

Um, what kind of society is it where people have serious, fixable medical problems and the only way they can get treatment is to win a place on a TV show???

11:37 AM

8 Comments:

It's called Miracle Workers. And, glass houses here, Alex: IIRC, aren't the Canuck health care systems in somewhat serious jeopardy of being declared unconstitutionally incompetent?

By  Kane, at 8:40 PM  

What does that even mean?

Seriously, get rid of the rhetoric, and what the fuck are you actually talking about?

The richest country in the world has 45 million people who can't even afford to go see a doctor, and the highest health care costs in the industrialized world.

Whatever the problems with the Canadian system, the moral abrogation that is the American system is unparalleled. Comparing the problems between the two is like equating jaywalking with first degree murder.

By  DMc, at 9:12 PM  

I'm talking about Chaoulli v. Quebec, which held that Quebec's system of exclusively public healthcare did not provide adequate care, with unconscionably long delays in receiving treatment, and thus the prohibition on private healthcare violated the Quebec Charter of Rights, and possibly the Canadian Charter of Rights and Freedoms. Similar cases are expected to follow in other provinces through the next decade.

Quality healthcare for all may be a noble goal, but Chaoulli v. Quebec didn't reject that goal, but rather held that the system was not providing quality healthcare. And that is what the glass houses comment was about.

But, this is a writing blog, and not the right place to get into a debate over public policy. It gives me enough of a hook on which to hang a paragraph or two about the framing and phrasing of arguments though, particularly the way in which many supporters of the Canadian system seem to defend it on its ideals, rather than on its performance. This very tendency contributed to the manner in which America, which looked on its way to building a comprehensive welfare state in the '60s and early '70s, stalled out in the subsequent decades.

The liberal governments (in our case, the "New Deal Coalition" Democratic party, which dominated Washington from the 1940s through the 1980s) implemented a lot of programs that proposed to do A to accomplish X. And while the conservative opposition may have opposed X in the first place, they got the most traction by pointing out all the cases where A wasn't really accomplishing X. Which the liberals responded to by fiercely defending the nobility and morality of X, while not really doing anything substantial about A. Eventually, this disconnect contributed to an impression among voters of the liberals as out of touch and impractical, and of the Xes as unachievable, even where the government might have achieved them, or at least come closer, by trying, say, B.

Now, I'm not calling on Canadians to reject their Xes, but my point really is that they could stand to be a lot more realistic about their As.

By  Kane, at 10:04 PM  

Canada, America...point is, we should all have coverage.

By  Cassandra, at 12:35 AM  

And in Canada, we do.

Catastrophic mistakes that fall through the cracks are not how you judge a system.

How it does for the most people under its care, for what costs is how you judge it.

The average Canadian pays less, gets more. A few cases where the system is broke does not, in my mind, compare to the American Alternative where you either have no coverage at all, or if you get sick, you go broke.

By  DMc, at 6:19 AM  

My overall impression is that the failures of Canadian health care are largely in long-term care of terminal patients. Which from a point of view of society (and not your dying grandmother) makes sense. Canada -- Quebec anyway -- is really good at preventive care, trauma and anything to do with kids. So I think the people in Miracle Workers would have had a better chance getting treatment up North.

It's nice not to live in fear of your kids getting sick.

By  Alex Epstein, at 7:05 AM  

Like Alex and Denis, I've lived significant portions of my life under both the Canadian and American systems, as patient and parent.

The American facilities are nicer and have better technology - more MRI machines, for example - but there are three key problems in the American approach to medicine.

American medicine lives in fear of the lawsuit. Canadian damages are limited to reasonable amounts, but American courts can award vast sums as damages. As a result, American physicians must cover their asses.

I get migraines. In Canada, my neurologist tested whether or not I might have a brain tumour with some simple physical exercises. When I went down to the US, my neurologist had me get an MRI to test the same thing. That's a waste of resources, and necessary only to make money for the hospital and to cover the diagnosis in case of failure.

The next disturbing factor is the rise of the HMO. We found a fantastic pediatrician in the US, and my sister-in-law wanted to take her new kids to him as well, but her insurance would not pay him because he was not part of their plan.

That's ridiculous. It seems funny, but you actualy have more choice of physician in Canada than you do in the US.

Finally, as Denis points out, there is a huge crowd of underclass Americans who don't get the care they need. Sure, Medicare will pay for their medical needs in theory, but it's not doing the job. Despite similar lifestyles, Canadians have lower infant mortality and longer life spans than Americans.

If you graph the US standard of care, it's an exponential curve that rises with income. The equivalent Canadian graph is very close to a straight line. The peak of US care n question exceeds Canadian care, but the mean level of care in Canada exceeds the mean level of care in the US.

By  Webs, at 12:27 PM  

My son was born with craniofacial deformities. His head was reconstructed by the same doctors who separated the Egyptian twins. We had insurance, but these same doctors do freebies in the lower Rio Grande Valley and even go overseas and perform craniofacial surgeries in underpriveleged countries so, like you, I'm bewildered.

By  MaryAn Batchellor, at 1:31 PM  

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