In Canada, waiting lists for medical services, whether MRI diagnostics or heart surgery, have become the norm. It has developed and grown worse over many years, so much so that most citizens do not even think of questioning the existence of such waiting lists.
All controversy concerns, not their existence, but merely how long those lists are and whether anyone is "unfairly" jumping the queue. As mentioned in Fear of Private Medicine, a simple MRI disagnostic can require a waiting time of 13 months in Ontario at present.
Jumping the queue is immediately associated in the minds of many Canadians with private medicine - the free market, and the reaction of most is horror that anyone would suggest allowing any part of that evil "American-style" health care system into Canada. What they are really concerned about, of course, is that someone would be allowed to use their hard-earned money to buy better health care.
Such "concern" is nothing more than envy and the desire to cut down anyone who would do better than themselves. This envy is becoming pervasive in every aspect of life, for example the hatred of Bill Gates, Martha Stewart, and many others purely as a result of their success (what Ayn Rand referred to as hatred of the good for being the good), but it seems to draw special focus on the medical system here (and is increasingly evident now in the U.S.).
The very existence of waiting lists is what needs to be re-established as the issue. They need not and should not exist. The only reason there is still any choice at all is because the U.S.A. is our neighbour - if I were to need an MRI, instead of waiting many months to get one here, I would very happily drive across the border where that evil "American-style" system will happly provide me that MRI and anything else I need on demand and at a price I'm more than happy to pay.
But I shouldn't have to drive to the States, I should be able to drive into my local town, or at worst, the closest city, pay my money and get my test with nothing more than perhaps first making an appointment over the phone with whichever private testing facility is able to fit me in the earliest or at a time most convenient to me.
Monday, May 24, 2004
Fear of Private Medicine
The belief that private medicine is somehow evil and dangerous has become so ingrained in Canada that merely including the words "private" and "medicine" in the same sentence will cause people to react with horror as though one had just advocated genocide or worse.
The mere thought that any citizen, if allowed to do so, could acquire better medical services than any other by using (horrors) money sends them into a panic. Thus we are not allowed to pay for any medical service covered by government. The result, as is typical with any government monopolized service, is scarcity and rationing.
Presently in Ontario, getting a simple MRI requires getting on a waiting list that can be as long as 13 months! Waiting weeks or months for a diagnostic test can result in unncessary pain, disability, and even death. Waiting lists essentially defeat the entire benefit of such tests, and medicine as a whole!
But, the reasoning goes, it is not "fair" that some ("the rich" of course) would be able to get better medicine than others, that such "two-tier" (shudder) medicine is immoral.
So let's see how such egalitarianism works in practice:
In a free-market system, it is true that there will be some that cannnot afford the best diagnostics or the best doctors, or the insurance to acquire same, while others enjoy good treatment whenever it is needed. Everyone, of course, would fall on various points in a scale rather than all being at one extreme or the other.
Under our "fair" egalitarian system, everyone is entitled to equal services and, of course, everyone believes those equal services will be good - if only government would spend enough. The actual result, since every expenditure in a government system is a cost and to be avoided, is that everyone gets equally poor service - and waiting lists for most things.
Or to drive the point home a little more clearly, picture two kids suffering from some condtion causing them much pain and which might evetually kill them if not treated soon enough. One is in a poor family, the other isn't...
In the free market, one child will get immediate diagnostics, treatment will begin, the kid will most likely be relieved of pain and of the possibility of premature death. The poor child may not be able to get needed treatment as quickly and may have to accept less than the best. In rare cases this may even result in death.
But the actual chance of dying as a result of having a free market is extremely remote for several reasons: 1) It is a very small minority that would be in such a circumstance to start with; 2) Faced with such a desperate case, few doctors if any would turn their backs, they would give needed aid first and worry about payment later, if at all; 3. Most importantly, in a free market, supply rises to meet demand - with the result of wiping out waiting lists and making aid available sooner for everyone; 4. Finally, charity still works in a free market at least as well as it does now.
In our "fair" system, both children suffer in pain for many months or even years, and both have an equal chance of dying prematurely since neither of them is permitted to get timely diagnostic tests or medical treatments. With no profit motive, there is no incentive for supply to meet demand because everything is a cost. The motivation is exactly opposite - and the result is what we have - currently over 28,000 people in great pain and disability waiting up to a year to get hip replacement surgery.
Somehow, in this country and many others, it has been decided that the latter is somehow better, that it is more desirable that two children suffer needless pain and possibly even die - in the name of egalitarianism.
Somehow it has become accepted that, if not everyone can get the best then none is to be allowed to have it; that rather than allowing the majority get the best medicine their money can buy, all are to be held down to a mediocre but equal level of care.
To my American neighbours, this is where your system is currently headed if you do not seriously begin to fight it now.
The mere thought that any citizen, if allowed to do so, could acquire better medical services than any other by using (horrors) money sends them into a panic. Thus we are not allowed to pay for any medical service covered by government. The result, as is typical with any government monopolized service, is scarcity and rationing.
Presently in Ontario, getting a simple MRI requires getting on a waiting list that can be as long as 13 months! Waiting weeks or months for a diagnostic test can result in unncessary pain, disability, and even death. Waiting lists essentially defeat the entire benefit of such tests, and medicine as a whole!
But, the reasoning goes, it is not "fair" that some ("the rich" of course) would be able to get better medicine than others, that such "two-tier" (shudder) medicine is immoral.
So let's see how such egalitarianism works in practice:
In a free-market system, it is true that there will be some that cannnot afford the best diagnostics or the best doctors, or the insurance to acquire same, while others enjoy good treatment whenever it is needed. Everyone, of course, would fall on various points in a scale rather than all being at one extreme or the other.
Under our "fair" egalitarian system, everyone is entitled to equal services and, of course, everyone believes those equal services will be good - if only government would spend enough. The actual result, since every expenditure in a government system is a cost and to be avoided, is that everyone gets equally poor service - and waiting lists for most things.
Or to drive the point home a little more clearly, picture two kids suffering from some condtion causing them much pain and which might evetually kill them if not treated soon enough. One is in a poor family, the other isn't...
In the free market, one child will get immediate diagnostics, treatment will begin, the kid will most likely be relieved of pain and of the possibility of premature death. The poor child may not be able to get needed treatment as quickly and may have to accept less than the best. In rare cases this may even result in death.
But the actual chance of dying as a result of having a free market is extremely remote for several reasons: 1) It is a very small minority that would be in such a circumstance to start with; 2) Faced with such a desperate case, few doctors if any would turn their backs, they would give needed aid first and worry about payment later, if at all; 3. Most importantly, in a free market, supply rises to meet demand - with the result of wiping out waiting lists and making aid available sooner for everyone; 4. Finally, charity still works in a free market at least as well as it does now.
In our "fair" system, both children suffer in pain for many months or even years, and both have an equal chance of dying prematurely since neither of them is permitted to get timely diagnostic tests or medical treatments. With no profit motive, there is no incentive for supply to meet demand because everything is a cost. The motivation is exactly opposite - and the result is what we have - currently over 28,000 people in great pain and disability waiting up to a year to get hip replacement surgery.
Somehow, in this country and many others, it has been decided that the latter is somehow better, that it is more desirable that two children suffer needless pain and possibly even die - in the name of egalitarianism.
Somehow it has become accepted that, if not everyone can get the best then none is to be allowed to have it; that rather than allowing the majority get the best medicine their money can buy, all are to be held down to a mediocre but equal level of care.
To my American neighbours, this is where your system is currently headed if you do not seriously begin to fight it now.
Sunday, May 23, 2004
Perspective on U.S. abuses in Iraq
There is no doubt that some soldiers and officers are guilty of abuse and acted without due authority in these cases - and should be tried and punished appropriately.
However, a package deal is being passed by most of those antagonistic to the U.S. presence there - the notion that many or even most of those prisoners are innocents and, regardless of that, the notion that anything short of treating these prisoners as honoured guests is de facto abuse.
The first is simply wrong; there may be a few exceptions but otherwise all prisoners there are there for a legitimate reason. If they did not directly attack civilians or coalition soldiers, they at least aided and abetted those who did, or are otherwise involved in undermining efforts to bring stability and a better form of government to that nation.
The second is a blurring of the difference between prisoners of war and domestic criminals. Prisoners of war are taken in lieu of killing them, and because it is a war, it is perfectly legitimate to use various tactics on prisoners in an attempt to gain information that can help the war effort.
Does this mean torture is ok? Well, yes it does, however there can still be objective measures on what is acceptable to a civilized nation. A common sense rule here is that any such tactics (including humiliation and demoralization) is legitimate only if it is conducted with the clear and specific purpose of gaining information that might help save lives, either soldier's or civilians, or contribute to defeating the enemy. If any such acts are conducted out of nothing but hatred, sadism, etc, then it most definitely is abuse and must be stopped.
Most of these prisoners, if free, would not hestiate to kill coalition soldiers, and in many cases, civilians too. There is no moral basis for not treating them accordingly.
However, a package deal is being passed by most of those antagonistic to the U.S. presence there - the notion that many or even most of those prisoners are innocents and, regardless of that, the notion that anything short of treating these prisoners as honoured guests is de facto abuse.
The first is simply wrong; there may be a few exceptions but otherwise all prisoners there are there for a legitimate reason. If they did not directly attack civilians or coalition soldiers, they at least aided and abetted those who did, or are otherwise involved in undermining efforts to bring stability and a better form of government to that nation.
The second is a blurring of the difference between prisoners of war and domestic criminals. Prisoners of war are taken in lieu of killing them, and because it is a war, it is perfectly legitimate to use various tactics on prisoners in an attempt to gain information that can help the war effort.
Does this mean torture is ok? Well, yes it does, however there can still be objective measures on what is acceptable to a civilized nation. A common sense rule here is that any such tactics (including humiliation and demoralization) is legitimate only if it is conducted with the clear and specific purpose of gaining information that might help save lives, either soldier's or civilians, or contribute to defeating the enemy. If any such acts are conducted out of nothing but hatred, sadism, etc, then it most definitely is abuse and must be stopped.
Most of these prisoners, if free, would not hestiate to kill coalition soldiers, and in many cases, civilians too. There is no moral basis for not treating them accordingly.
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