hmm. the solution is to hire the canadians to run our healthcare system. if we run it, it will not be efficient or well run. not much uncle sam has run has been. "I think it's broken eh."

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That's a nice straw man argument you just wrote there. "A straw man argument is a rhetorical technique based on misrepresentation of an opponent's position. To "set up a straw man" or "set up a straw-man argument" is to create a position that is easy to refute, then attribute that position to the opponent."

The American health care system is inefficient because it has innumerable middle men each taking a piece of the pie, lacks collective bargaining, has nonexistent vertical integration, and spends a lot of money on things that don't improve health care, like marketing and multiple redundant bureaucracies. The Canadian system is a model of synergy that would do a corporate merger specialist proud.

Instead of arguing against this, you misrepresented that I was saying that Americans are innately less efficient, and then knocked down that silly assertion, pretending that you'd actually refuted my argument.

actually, it was a joke (sort of) and not a misrepresentation. I said american government operations are always (or almost always) inefficient. not you. and my statement was not a straw man but a sad joke that we would most likely be better off having the canadians run it than running it under uncle sam's guidance. for a change I can say to someone else, lighten up.
in all seriousness, the argument for eliminating middlement is false. frequenlty you will eliminate the middle man and find he served a purpose. having worked in healthcare, I can say that the government is among the worst offenders in inefficiency. slow to approve, even slower to pay. "I'm calling about a past due invoice"..."Just a mintue I'll check"...(10 minutes later)..."it was coded incorrectly. It needs to be coded correctly." "How do I get it fixed?" "I don;t know, that's not my job. Call billing (click)." so what I'm saying is, it's not stilly at all. while this may not be mexico, eliminating something mythically unnecessary middleman (in reality you're just insourcing them) isn't going to get you any savings when you make everyone a government employee (with government pensions, retirement, and benefits) and subject to the contract padding that would make philadelphia proud. what is killing the american system is many things, not elast being that it isn't fully anything. it's anything but market oriented...there have been estimates that one third of the cost of running a practice is compliance with insurance and government rules. then there's litigation and that fact that the rest of the world, europe in aprticular, don't pay their fair share of research costs and piggy back off american money. we shoudl pay less, they should pay more.

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"You down wit OPM?"
Fumo: "Yeah, you know me!"

I'm not going to pretend I know anything about Canada's healthcare system because my only sources are the US media.

What I find fascinating about US healthcare tho is how many prices there are for the same procedure or service.

If you have Medicare, the hospital gets one price for your room. If you have commercial insurance it's another price (depending on what's been negotiated between your insurance plan and a hospital network in the area). If you have Medicaid it's yet another depending on which state you live in. If you don't have insurance, watch out--you will get charged the manufacturer's suggested retail price because you have no group to negotiate a lower one for you.

And the patients, the ultimate customers, may not even know what the price is and many times don't even want to know.

It sounded like sarcasm to me, not honest (joking) agreement, so I'm sorry for misunderstanding your intent.

I wouldn't be at all surprised by your 1/3 figure. The U.S. system (including its many private insurance companies and HMOs) has far more bureaucracy than the Canadian. Most Americans don't realize that the Canadian system consists entirely of private doctors and privately run hospitals. Doctors are independent practitioners, just like in the U.S., and hospitals are run by private boards of directors, just like in the U.S. The big difference is that they're paid by a single funding source, with streamlined procedures and a single universal standard of coverage. Compare that to the U.S., where any given doctor or hospital has to deal with numerous insurance companies, HMOs, medicare and medicaid, utilization review boards, and various other services and companies, each with its own contractual coverage provisions, individual and group coverage plans full of small print, idiosyncratic billing systems, compliance systems, hospital liasons and negotiators, service plan designers, advertising and marketing departments, and supporting bureaucracies.

In addition, Canada's single system applies across the country, so it can collectively bargain to get very good prices on products and services. The size also allows for great economies of scale.

Canada is effective at giving good care for low cost for the same reason that Walmart is able to have such low prices: streamlined central management and billing, collective bargaining, and economies of scale.

You are wise. I'm originally from Canada, and am currently studying law in the U.S., with an emphasis on elder law and health law, so I know the structue and workings of both. Plus, my sister had a serious emergency in the U.S., and was subsequenly transferred to a Canadian hospital, so I have lots of practical experience with both systems.

The varying prices really are quite incredible. Now imagine how low the prices would be if the group negotating for you covered of every patient in the country.