December 5, 2006

"Two-tier" Food Distribution

Because no one should ever be without food simply because they lack the ability to pay; (link fixed)

The B.C. government won a showdown with a new, private "food rations super-market", reaching an agreement with the facility that will bar the foodstuffs depot from charging citizens.

But for the first time in Canada, the private rationing centre will also allow community members to get rations for which they would normally have to go to a public food ration distribution node.

The high-tech, American-style "super-market", which opened Friday, will now operate like any other food rations centre. It will charge the government for the rations rather than billing shoppers potentially hundreds of dollars, Food Minister George Abbott said Saturday.

Posted by Kate at December 5, 2006 9:17 AM

Kate, the link doesn't seem to be working. If you take out the word 'small' at the end of the link, which currently reads:

It should work fine.

Thinking of Stephan Dion, were you?

Posted by: Dante at December 5, 2006 9:35 AM

Brilliant! I'm not going to spill the "beans" but this is a great analysis of Lieberal/Dipper social engineering.

Posted by: Texas Canuck at December 5, 2006 9:47 AM

I fully support private health care. But the food analogy doesn't really work.

For a free market in goods to function consumers must be able to easily differentiate between good and bad products. If it's the freshness of lettuce or taste of Chitos, that's easy to do.

But how many people can judge whether they had a good MRI, or separate the good orthopedic surgeon from the merely mediocre?

Until we have better information about such things, the free market won't do for health care what it's done for so many other products. It's one of the main reasons for the lack of downward pricing pressure in the US system.

Of course, the socialized system is even worse, giving you even less information. And the lower costs mostly come from limiting people's access to care.

Posted by: chip at December 5, 2006 10:20 AM

Nice save at the end there, Chip. Although, it completely nullifies the point you were trying to make!

Posted by: Kate at December 5, 2006 10:23 AM

What a stupid analogy. Food is something everyone needs every day; emergency health care is something most people only need occasionally, sometimes with catastrophic costs.

Posted by: lberia at December 5, 2006 10:42 AM

The food/health care analogy works up to a point. Every human being requires "X" amount of food daily to survive. Whether some people eat more than they need to or go on a diet, eat pricey foods or buy at the bulk bin, eat out at restaurants or cook at home, the "X" doesn't really change.

Health care's different. If you're healthy, the amount of health care you need can be quite low, easily managed out-of-pocket or with modest insurance plans, and the food analogy can hold. If you contract a serious illness, however, the amount of health care you need can skyrocket, and fast. Meeting those kinds of needs out-of-pocket becomes impossible for all but the wealthiest in society. And you don't have the choice of cutting back - if you don't "consume" that health care when you need it, you die. There's also the problem that chip explained - the ability to tell good health care from bad, which can often require expertise in the field that average consumers simply don't have, as opposed to simply biting into a steak and knowing whether it's undercooked.

Health care is an odd fit for a free market. I'm not saying it can't work, just that it's got some unique properties that give rise to problems the free market may not handle in the same way that it handles other fields.

All that said, I don't believe Medicare in its present form is working any more, if it ever did, and we need to open the system up to private investment & infrastructure. If much of Europe can make a mixed public/private system work, there's no reason we can't.

Posted by: Ian in NS at December 5, 2006 10:52 AM

"But how many people can judge whether they had a good MRI"

I'll bite
Those that had one !?

Posted by: richfisher at December 5, 2006 11:20 AM

Excellent food for thought. heh heh heh

I recall the Canadian Taxpayers Federation distributing a column a couple of years ago talking about a "FoodCare" analogy to display some of the moronic beauracracy that exists in the medicare system. It's worth a read:

Posted by: Derek at December 5, 2006 11:23 AM

Chip somehow manages to firmly straddle the fence and almost hurts himself in the process.

"But how many people can judge whether they had a good MRI, or separate the good orthopedic surgeon from the merely mediocre?"

Is this assuming that you now know if you are getting a good surgeon in the Canadian system? Here in the evil US of A we can pick and chose who we want to cut us up and also find out everything about him and his/her track record. I also don't have to wait a half year for a MRI or a year or two to get a hip/knee/whatever fixed.

I've said it before and I'll say it again: Universal health care only brings everyone DOWN to the lowest common denominator. Canada doesn't have to use the evil system here. There are a lot of other countries that have workable systems in place. Check out Australia for example. The answer is out there, you just have to get your head out of your asses. Tommy is still dead. Deal with it.

Posted by: Texas Canuck at December 5, 2006 11:24 AM

Q: "But how many people can judge whether they had a good MRI, or separate the good orthopedic surgeon from the merely mediocre?"

A: Dr. Nick Riviera, do you remember me?

Posted by: Ace at December 5, 2006 11:28 AM

Forget the lobster, however we do have stewed jackfish for one and all.

Posted by: ud513 at December 5, 2006 11:30 AM

Reminds me of the young Quebecois I was talking with back in the late 70s, he'd been to Cuba and was expressing great admiration, for the Cuban government... "an' dey DELIVER de groceries to ever' familee, ever' two weeks"...

Posted by: anon at December 5, 2006 11:40 AM

I weep for this country.

Posted by: Gerry Atric at December 5, 2006 11:56 AM

It's truly amazing, isn't it? The degree to which people have been brainwashed that health care isn't a commodity like any other - that it is somehow immune to the same laws of economics that had created the rationing our governments argue doesn't even exist.

They stand in the bread line as dutifully as housewives used to in the Soviet Union, and they're thankful for it.

Not a one of these people who uses the bogeyman of "US style health care" to frighten Canadians seems aware that the Canadian system is used just as often by Americans as an example of what they might get if they go down the road of socialized medicine.

It's like the Cuban example - people vote with their feet. Just as no American has ever drowned in a leak boat 30 miles from Castro's shores, no American has ever travelled from Rochester to Regina to seek care they cannot receive at home.

That, my friends, is the bottom line. It doesn't matter if you're broke, if you're dead.

Posted by: Kate at December 5, 2006 12:19 PM

"Ah, well if it isn't my old friend Mr. McGreg - with a leg for an arm and an arm for a leg!"

Posted by: Dr. Nick Riviera at December 5, 2006 12:31 PM

Missed it by that much...

Posted by: Texas Canuck at December 5, 2006 12:51 PM

“What a stupid analogy. Food is something everyone needs every day; emergency health care is something most people only need occasionally, sometimes with catastrophic costs.”

Your razor sharp analytical skills are shining brighter than ever.

Emergency health care is something most people only need occasionally just like fire insurance, CPR and front end alignments.
Oh I could go on and on about all the things that should be taken out of private hands.

“sometimes with catastrophic costs.”

You’ve got that right. Have you checked the price of tickets to the Ice Capades lately?

Posted by: Wayne in Wetaskiwin at December 5, 2006 1:01 PM

Ian in NS: Have you ever thought about how much information there is to buying a car? There are hundreds of variables to consider, technical details that most people understand. That's why in the market place things such as "brands" have evolved. Brands carry a lot of information that solves many of the problems.

Posted by: david maclean at December 5, 2006 1:13 PM

Kate, the point stands and is clear enough. While privatized health care is preferable to socialized care, the free market will not work the wonders it has for food, cars and other products.

Not until consumers of health care have much better information about the care they are getting.

Posted by: chip at December 5, 2006 1:23 PM

How sick is a country, that it concocts a national identity on it’s belief in socialised medicine?
Over the last forty years, self-important individuals and organizations have taken it upon themselves to stitch together a Canadian identity. Blind to our subtle differences to the other Americans, these lazy dolts embarked upon an agenda of taking a contrary position to whatever the USA does. Trying to define yourself by asserting what you are against, rather than what you are for, is foolish and useless. But if you are set on taking that course, what kind of morons would choose the USA as the country, to be contrary to?
Unfortunately their most successful contrarian cause has been health care. After years of denigration of the US health care system, by the CBC and others, the majority of Canadians have been convinced that universal government provided health care is superior and a defining Canadian value.
Canadians may be pro-choice when it comes to a woman’s “right to choose” but we have become perversely no-choice in the grander picture, of a patient’s right to choose.
Experiencing a two-tier, private and public, system was just the medicine I needed to inoculate myself against this socialised medicine, mantra.
I lived in the United Arab Emirates, where I experienced the benefits of a two-tier system. The government system is free for all residents and has waiting lists (but much shorter than in Canada). There are a multitude of private hospitals and clinics. Private health care insurance premiums there are comparable in cost to Alberta or BC health care premiums.
I needed a dermatologist to check some abnormal spots on my skin. Unlike in Canada, no referral was needed from a GP. I made an appointment and was examined 2 days latter. After the examination he booked an operating theatre. Five days later I was on my way, without the nasty bits.
A few months later, residing back in Vancouver, I visited a walk in clinic with the same concern. The doctor determined that the spots should be checked by a specialist. I stood by, as the clinics receptionist telephoned the specialists office.
“ Nothing open for two months? Hmmm, this gentleman is quite concerned that they should be examined sooner. Mole? No .... It doesn’t appear to be a mole.
Scaly? Sir, are your spots scaly ? “
“Ok then, waiting two months for an appointment, should be no problem.”
I finally received the treatment that I needed 2 ½ months later. I suppose that this delay should have caused me some anxiety and frustration but I was relieved to know that Canadian medical receptionists are much better at determining what is benign and what is malignant, than the citizenry at large.

Posted by: Cal at December 5, 2006 1:24 PM

I am totally on board with privatizing health care. It is indeed a commodity and all of the rules of economics apply to it as they do to anything else. Canadians do indeed have to be de-programmed.

The only part of the US system that bothers me (and what I would hope we would try to avoid) is that the oligopoly that they have there does make it so that the prices are higher than they need be (because it is not pure competition) and the insurance companies and HMO have practically become government bureaucracies (with much less government, of course) all by themselves.

I have not taken the plunge and crossed the border myself - although I will if the Liberals get into power again - but I do have about a half-dozen old school/work-mates down there and I do often go to visit. All of them, their friends and families much prefer the US health system. It is super-fast and much more efficient and all of my old colleagues report that they have more money in their pockets than they did while in Canada - despite having to pay for medical care out-of-pocket.

But I have heard some whacky stories.

The wife of one of my buddies was telling me about how, when her mother suffered a heart-attack, they called the ambulance to get her to the hospital (natural thing to do). Well, the lady didn't make it. About a month or so later, they got a letter from the family's health insurance company saying that they weren't going to pay for the ambulance because, since the woman was pronounced DOA at the hospital, the ambulance wasn't really "medically necessary." The insurance company reversed its decision on (some sort of) appeal...but the fight took a few months.

Another friend has a son with severe asthma. He makes monthly claims on his insurance for the cost of the medication. He says that every third month, like clockwork, his insurance company routinely refuses to pay the cost of the medication. They also routinely reverse themselves after a fight is made.

It is clear what is going on companies have all done studies...and their adjusters all have "denial quotas". They have worked it out so that they know if they deny a certain number of claims then a certain number of people will accept the denial right away, a certain number will back down after a week, a month...some will fight all the way to the end.

And because the insurance companies collectively form an oligopoly - it is the same situation as we have with the banks - they all follow the practices of the lowest common denominator. That is, the company that does the most bonehead things and gets away with it while maximizing profits.

I wouldn't like to see us take on that part of the American system.

Posted by: bryceman at December 5, 2006 1:31 PM

Before he was Premier of the Province, Campbell could be counted on to support free market / minimal government principles. Its tragic what happens to those principles when political power trumps all else. The BC Government has become an administration mired in leftist status quo policy and even advancing in areas like FN treaties and public sector pampering.

Who needs a strong NDP when the BC Liberals are overlapping their turf so well.

As to Health Care, Ive recently voted with my feet, am living much closer to my US specialists, and now allowed to get private coverage instead of having to pay cash as a Canadian Health Care refugee.

Posted by: John Chittick at December 5, 2006 1:40 PM

The opposition to "two-tier" health care reminds me of the free trade debate.

All of the public health care shibboleths that we think Leftie Canadians have are in fact not true at all:

Soviet Canuckistan is crumbling as we speak.

Posted by: Ace at December 5, 2006 2:10 PM

the free market won't do for health care what it's done for so many other products. It's one of the main reasons for the lack of downward pricing pressure in the US system.

The reason for the lack of downward pricing pressure in the US system is because all three levels of government are jamming their big, fat, socialist feet into the market and kicking it into the ground. Medicare is huge down there, and it's getting bigger. The so-called "private" health market has government regulation up the ying-yang, from drug companies to insurance companies to hospitals. Unfortunately the Americans are blundering into the same, stupid trap of nanny statism that the rest of the world discovered 40 years ago or so.

If much of Europe can make a mixed public/private system work, there's no reason we can't.

It isn't working in Europe. If it was working, then most of the governments there wouldn't be running chronic, severe deficits and looking at bankruptcy and demographic implosion in the next decade or two.

All of the arguments about how medicine is so special that it can't be trusted to free markets are baloney. I am not an expert on automobiles, electrical wiring, electronics, home insurance, or veterinary medicine, yet I am able to find and deal with experts in these fields quite easily by using trusted references, performing a minimal amount of research, and by depending on the essential honesty and fairness that are commonly found in voluntary and mutually beneficial exchanges of goods and services.

Life is complicated and potentially catastrophic from birth til the day you kick off. Unless you think that people are too stupid and mean to live their lives privately and in voluntary associations, and that a mysterious race of anomalously intelligent and compassionate beings inhabit the offices of the government, then medicare must be dismantled - now.

Posted by: Justzumgai at December 5, 2006 9:19 PM

David Maclean: again, the difference between cars and health care is that there's never a situation where a consumer needs a top-of-the-line car. (S)he can get by with the lesser model. If you've got a serious illness to fight, the top-of-the-line drug or treatment might be the only thing standing between you & death. Then it becomes a market where the seller holds all the power, and the buyer effectively has no choice. Once you get there it's not a free market for that buyer any more. If you want to take the dispassionate view and say, hey, shit happens, well - let's see if that view holds when it's a loved one who's facing that situation.

Posted by: Ian in NS at December 6, 2006 8:40 AM

"Then it becomes a market where the seller holds all the power, and the buyer effectively has no choice."

Ian are youi kidding, It's like that now!
Why do you assume that only one vendor will offer your "top-of-the-line drug or treatment cure"?

Posted by: richfisher at December 6, 2006 2:32 PM

If you've got a serious illness to fight, the top-of-the-line drug or treatment might be the only thing standing between you & death.

Private insurance works for your car worth $20-50k, it works for your house worth $200-500k, it'll work for a heart transplant worth $100k. People with chronic conditions will have to pay more for insurance. But then again they know that don't they? They can pay the extra premiums or they can save the dough for the inevitable.

And for everything else, there is charity. Can you find a single example in the pre-medicare history of Canada when a poor, young person died because vital care was withheld from them by rich, greedy doctors and hospitals? I'll bet you can't.

I admit that expensive treatment has seldom been given for free to older people. But that has been the case both before and after medicare was instituted. It's called "triage" and/or "agism", and although it exists, frankly I haven't heard very many complaints about it. I have heard complaints when the opposite happens, and politically connected old people get it for free from the public system.

Posted by: Justzumgai at December 7, 2006 1:18 AM