I live in Canada. We believe that a modern society has as one of its
basic human rights the medical care of its citizens. I know I am
going to be inundated by rebuttals because the wealthy pharmaceutical
companies as well as the wealthy hospital companies as well as --
especially -- the insurance companies have carried on a ceaseless
campaign to convince people that looking after the underprivileged in
the state is evil and it is "socialism" and it is ba-a-ad.

As was outlined about ten years ago, a single-payer medical system is
better able to control costs than an out-of-control private
profit-based system. Staistically, Canada pays out a lower percentage
of its GNP for medical care than most if not all industrialized
nations. Why?

Because insurance companies promote extravagance because their
profits are predicated on their paid-out claims. Any controls at all
are easily corrupted and the song goes on.

Every once in a while a TV investigative team highlights the abuses
and the resultant grief suffered by those least able to bear it.
Ho-hum.

Of course the underlying reasons for the ever-higher costs of medical
care and pharmaceuticals is due to the ever-emergent new and
expensive treatments, calling for higher and higher costs. And only a
single-pay system can control those costs, IMHO.

Cost of pharmaceuticals in Canada is 25% of the regular price (which
apparently is already lower than USA) with a monthly maximum, after
which there is absolutely no charge. Being 62, I pay a maximum of
$62.99 per month and after age 65, it will drop by a third or a half.
And that is in Cdn$, which are only worth 63¢ at the moment.

Yes indeed, it may be an evil system and can lead to a healthier
population but we like it...

(...running and ducking!)

,\\urray


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>Linda & Michael and everybody else:
>
>Pricing of drugs can be presented in moral terms, i.e. one can advocate
>there should be social justice and everybody has a right to the proper and
>most efficacious drugs. Unfortunately the real world does work like this.
>There will always be shades of gray. Can everybody have a Rolls Royce and a
>10,000 square foot house? In looking at the price of drugs one can argue
>they are too high for many people. As was pointed out here and in the media
>the cost of developing drugs is very high. So, a more realistic question is
>to ask where is the money from the sale of drugs going? Are the profits of
>the drug companies excessive (especially when compared to those of other
>businesses)? If they are then the governments can do something about it (
>by creating rules like those in Europe). But if they are not other
>mechanisms must be found to pay for them. These mechanisms would be
>insurance plans or government actions. There is a hidden uncertainty in
>this: What is the proper allocation of resources for medical activities.
>The society as a whole needs to decide how much for various activities
>needs to be spent. Defence, Infrastructure (roads), medical, etc.
>
>It is unfortunately true that for new drugs the relevant companies have a
>monopoly which allows them to charge essentially anything, without bounds.
>But why have established drugs for which the development cost has long been
>paid off have risen as well, above the rate of inflation?
>A simple answer again is to ask: are the drug company profits excessive? I
>think if they are we would all be buying Drug Company stocks.
>
>So what is  the answer? The first is to streamline and make more efficient
>the development process. The second is to find a way to distribute the
>load. This is what insurance companies do now in collaboration with
>employers (in a rather ineffective and inefficient way). Unfortunately the
>cost of medical activities has risen steeply recently and shows very little
>sign of slowing down. In fact Carline (the PWP) recently has gotten kicked
>out of an Aetna HMO because their costs have risen too steeply, so oops,
>here goes her plan.
>
>Should medical care be free enterprise based or should there be a
>government based system. The latter tend to be inefficient and cumbersome
>and the former have unaffordable prices. We need somebody to design a
>system. Maybe something like a constitutional convention (similar in
>concept of the framers of the constitution) is needed.
>
>For those who favor "free enterprise" and who argue that it works in the
>US, I would point out that in all such systems there are (government and
>Legal) controls, so that in some sense there is no such thing as "free
>enterprise" it is always only more or less free. The other observable fact
>in the US is that the system as it is practiced now has increased the gap
>between rich and poor and the gap is larger than in many other
>industrialized countries. So maybe the thing we need to go after is
>equalization.
>
>K-F  cg Carline
>
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