A Candians View of the Health Care Situation

Something no doubt many Americans reading this aren't going to register because it simply will never occur to them to pay attention to this little detail:

They're complaining that the Canadian system under-performs compared to EUROPEAN systems. They are NOT complaining that it under-performs compared to the American system, which would be insane since the Canadian system clearly outperforms the one in the US.

 You might be interested in another little fact that I find shockingly few Americans have any clue about considering the fact that health care is
such a prominent subject of debate:

US public (as in tax) spending on health care: 6.85% of GDP
Canadian public spending on health care: 6.95% of GDP

(As of 2005 at least, latest figures available from the OECD online database)

For one thing, Canadians actually only pay marginally higher taxes than Americans. for another, it isn't because of their health care system, which consumes about the same proportion of government spending as the US already spends on IT'S system, but delivers, obviously, far more value for the money. what higher taxes exist are for other social services. Oh, and the fact that Canadians prefer balanced budgets (they were running budget surpluses and paying down the national debt for 12 years straight before the global recession hit) to constant irresponsible pandering tax cuts.

So, no... it's not safe to say tax increases are necessary if the US were to enact an actual, real, single payer universal coverage model. At least not any tax increases of any significant size. If the US were to do so the negotiating ability of Medicare (let's just cal the new system "medicare" expanded to the entire population) would wield ENORMOUS negotiating leverage and a corresponding ability to get prices for services back under control again. That represents massive cost savings by itself. It would be operating in a far larger risk pool, which always makes insurance operate with greater efficiency as it's ability to mitigate risk due to point failures increases, and it would allow the kinds of large scale administrative savings that a "public option" simply cannot achieve... further extending the ability to reduce cost for services. How the heck does a care provider see any administrative overhead reductions if they go from dealing with 1500 private insurers plus medicare... to dealing with 1500 private insurers plus medicare plus whatever the public option is? They don't. It's worthless to them.

Although to be blunt, tax rates are too low in the US considering the fact that they've been fighting military conflicts in two countries for the last 8 years and have been running massive budget deficits and they should be raised anyway... but screaming whining children who erupt into near riot just from hearing the words "tax increase" in the States make that a political minefield no matter how good for the nation it is. But, different debate.

It is ridiculously self evident that health care most certainly does not behave like any other market. The profit motives are all upside down and backward for one thing.

If I’m selling… let’s say cars… what does my ideal customer look like? First of all, they drive a lot. They NEED my product. And they will use it often, which translates to more service providing replacement parts and maintenance on top of the fact that they recognize that it is worth paying me for the car in the first place. and this is all a GOOD thing for me. I get individually compensated for meeting every single one of those needs. So I am going to gear my efforts towards providing the segment of the population with the greatest need for my product with what they are looking for, because that’s in my own best business interest. I make a good profit, society gets it’s needs met, everyone is relatively happy, nation ticks along relatively well. Hurray, the system works.

If I’m selling health insurance what does my ideal customer look like? Someone who USES health insurance a lot? Someone who is even likely to in the future? *Hell no*. Because they do NOT make me more money. They COST me more money… in direct proportion to how much services they use. So where is my motive to gear my business towards meeting the greatest needs of society in my business sector? It simply does not exist. My profit motive is in the opposite direction. I want to sell my services to the people who need them LEAST while doing everything in my power to avoid having the people who need my services most as my customers.

You will never, EVER, find any company providing any regular old consumer good employing an entire department of lawyers whose job is to try to figure out ways to wriggle out of a contractual obligation to deliver the services they're selling to the people who most need their product. Ever. Because that would be **insane** in the market for any regular commodity. But it makes perfect business sense to a private insurer because that market is NOTHING like the market for most other things.

The private sector, to put it bluntly, sucks at providing insurance. It is very very good at making a profit doing it, but not by utilizing any business model that optimizes the benefit to society gained by their operating within that society. Government is far better geared towards providing insurance than the free market is if the goal of having the insurance exist in the first place is supposed to be to maximize the security of the society it is being provided to.

If on the other hand the only purpose you see for insurance is to create a mind bogglingly profitable insurance industry and the welfare of sick people simply isn't a priority in your decision making... well, then the free market is your way to go.