A Usenet persona calling itself BCITORGB wrote:

Scott insists:
===============
Everyone should be able to seek out a hospital and/or a surgeon
that can provide service immediately. In Canada, while people sit on
waiting
lists, beds in hospitals are empty or occupied by chronically-ill
patients.
Even if your local hospital is idle, if you're not at the top of the
list,
they won't help you.
===============

If beds are empty and the hospital is idle, why wouldn't they help you?

Because they don't have any money or staff, and evidently because government
bureaucrats don't give a damn about sick people and don't want to fill
hospital beds because it makes them look bad to be at capacity all the time.



It seems to me, you get waiting lists (waits of any kind) when
enterprises (including hospitals) are operating at or near capacity.

That would be true. But in the free market model, when such shortages occur,
the market responds with more beds and services.

You'll wait when there are no more beds, no more doctors, or no more
nurses. What other reason would there be to wait?

The question is *why* are there no beds, nurses or hospital rooms available.


One of the most discussed waits in Canada appears to be MRI's. It seems
we've not bought enough. On the other hand, it appears they're as
commonplace as slurpy machines at a 7-11 in the USA. Quite likely,
we've been a bit miserly when it comes to MRI's. On the other hand, all
the private clinics in the USA which sport these spiffy macines are
going to have to recoup their investments. This they do by taking it
out of the pockets of those who require the MRI.

Well, not quite. They can't simply charge whatever they want because their
customers will go to a competitor, so they have to keep the prices down.
Other than that, what's wrong with their providing a service for a fee?

The Canadian government sees no need to spend more money on MRI machines
because there's no economic reason to do so. They, like most government run
enterprises, don't respond to marketplace pressures, they respond only to
political pressures.

So, wait for a couple
of days in Canada, or wait a few minutes in the USA (and pay dearly for
the convenience).

Try "wait a year or more" in Canada.

"Although computer scanning (in place of conventional x-ray) is routine
diagnostic procedure in the United States, a patient in Ontario can wait as
long as a year and four months for an MRI scan."


If hospitals are "idle", there's absolutely no waiting. They quickly
spring into action.

You would think, but evidently not:

"Despite many recent claims, there is little evidence of efficiency in
countries with national health insurance. While people wait for months and
even years for hospital admission, hospital managers appear uninterested in
admitting more patients.

€ While more than 50,000 people wait for surgery in New Zealand, at
any point in time one in five hospital beds is empty and one in four is
occupied by a chronically ill patient using the hospital as an expensive
nursing home.

€ While more than one million people wait for surgery in Britain,
at any point in time about one-fourth of all beds are empty and another
one-fourth are being used by nursing home patients.

€ While more than 250,000 people wait for surgery in Canada, at any
point in time almost one in five hospital beds is empty and a fourth of all
beds is being used by nursing home patients."



Where do you get your data?!

National Center for Policy Analysis, Report 166



frtzw906


--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

Scott simplistically states:
==================
But in the free market model, when such shortages occur,
the market responds with more beds and services.
====================

But... http://www.usaweekend.com/03_issues/...831nurses.html ...

"More than 126,000 nursing positions in hospitals around the country
are unfilled, according to the Joint Commission on Accreditation of
Healthcare Organizations. In addition, the workforce is shrinking,
because it's aging (and retiring) at twice the rate of other
occupations."

Hmmmm.... as far as I can tell, there are shortages of medical
personnel EVERYWHERE; whether in the Canadian system or the American.

There are likely a myriad of reasons, but allow me to ride one of my
hobby horses: as far as docs are concerned, it's the doctors' unions (I
know they don't call them unions, but they're the toughest one of them
all). They very successfully play the supply management game. The
enrollment in universities is influenced by the "union". And, let's
face it, the entrance requirements to get into med school in both
Canada and the USA are nuts. If med schools pumped out more docs and
nurses, neither Canada nor the USA would have shortages.

This is not a free market vs any other kind of system issue, because
there is no free market in the supply of labor in this industry.

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Scott simplistically states:
==================
But in the free market model, when such shortages occur,
the market responds with more beds and services.
====================

But... http://www.usaweekend.com/03_issues/...831nurses.html ...

"More than 126,000 nursing positions in hospitals around the country
are unfilled, according to the Joint Commission on Accreditation of
Healthcare Organizations. In addition, the workforce is shrinking,
because it's aging (and retiring) at twice the rate of other
occupations."

Hmmmm.... as far as I can tell, there are shortages of medical
personnel EVERYWHERE; whether in the Canadian system or the American.

There are likely a myriad of reasons, but allow me to ride one of my
hobby horses: as far as docs are concerned, it's the doctors' unions (I
know they don't call them unions, but they're the toughest one of them
all). They very successfully play the supply management game. The
enrollment in universities is influenced by the "union". And, let's
face it, the entrance requirements to get into med school in both
Canada and the USA are nuts. If med schools pumped out more docs and
nurses, neither Canada nor the USA would have shortages.

Med schools respond to market conditions in the US. As the doctor population
shrinks, scarcity increases value and wages go up. As wages go up, more
people choose to become doctors and nurses. It's pure free market economics.
In Canada, however, compensation for nurses and doctors outside of private
practices, particularly surgeons, is government controlled, so there is
little motivation to become a surgeon or a nurse. This leads to more
shortages, which leads to inadequate staffing, which leads to empty beds
because there's no one to care for patients.


This is not a free market vs any other kind of system issue, because
there is no free market in the supply of labor in this industry.

Don't be silly, of course there is...in the US. But you're absolutely right
about the lack of a free market in Canada. Therein lies the problem.


--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

Scott thinks:
================
In Canada, however, compensation for nurses and doctors outside of
private
practices, particularly surgeons, is government controlled, so there is
little motivation to become a surgeon or a nurse. This leads to more
shortages, which leads to inadequate staffing, which leads to empty
beds
because there's no one to care for patients.
==============

Sorry Scotty, in Canada the compensation for doctors and nurses is
governed by a bargaining process between, for example, the nurses union
and various local/regional health boards. Here, in the Vancouver area,
for example, the doctor's union/association will bargain with, among
others, the board representing the Catholic hospitals in the region.

The doctor's association bargains for the pay schedule amounts which
determines doctors' pay.

Hmmmm.... bargaining.... what a unique concept....

As to med schools responding to market conditions.... well, I'm from
Missouri... are you telling me there's no collusion between the AMA
(that is the doc's association, right) and the med schools?

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Scott thinks:
================
In Canada, however, compensation for nurses and doctors outside of
private
practices, particularly surgeons, is government controlled, so there is
little motivation to become a surgeon or a nurse. This leads to more
shortages, which leads to inadequate staffing, which leads to empty
beds
because there's no one to care for patients.
==============

Sorry Scotty, in Canada the compensation for doctors and nurses is
governed by a bargaining process between, for example, the nurses union
and various local/regional health boards. Here, in the Vancouver area,
for example, the doctor's union/association will bargain with, among
others, the board representing the Catholic hospitals in the region.

The doctor's association bargains for the pay schedule amounts which
determines doctors' pay.

Hmmmm.... bargaining.... what a unique concept....

And the ultimate upshot is that the government (through the health boards)
controls how much doctors and nurses get paid, and the boards get their
funding through the government, which controls the aggregate amount
available for health care in any locale. Thus, if there is X amount
available, and the demands of doctors and nurses equals X+1, something gets
cut. Either they cut the number of personnel, or they take the money from
some other part of the budget to compensate. That's why hospital
administrators are constantly facing cuts and shortages of basic equipment
and supplies I would imagine. It doesn't do any good to have a full staff if
there are no supplies or equipment to serve patients.

That's the nature of socialized medicine. The total amount available for
everybody's free medical services is set by the legislature, and however
it's parceled out, whether as compensation for staff or for facilities,
equipment and supplies, there's only X available, and once it's gone,
everybody has to put up with the shortages.

Down here, a hospital can have exactly as much equipment and as many
supplies, doctors and nurses as it can afford, based on its competitive
advantage in the free market.


As to med schools responding to market conditions.... well, I'm from
Missouri... are you telling me there's no collusion between the AMA
(that is the doc's association, right) and the med schools?

What sort of collusion are you alluding to? If you mean price-fixing, no,
because that would be a violation of federal law. If you mean a conspiracy
to limit med school admissions to keep the number of doctors artificially
low, I seriously doubt it, because that would probably be illegal, but if
not, it would certainly outrage everyone if it came to light. More
importantly, med schools are in competition with each other for students, so
it's extremely unlikely that they would shoot their own feet just to pander
to the AMA.
--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

Scott thinks:
===============
More importantly, med schools are in competition with each other for
students, so
it's extremely unlikely that they would shoot their own feet just to
pander
to the AMA.
===================

Hmmm... are you sure they're in competition with each other? If I were
a university president, the last faculty I'd want to increase enrolment
in would be medicine. Just a quick google got me tuition figures for
med school in Arizona (albeit two conflicting figures: just under
$10,000 and just under $13,000 per year). I'll assume the figures are
comparable around the USA. Surely you're not going to claim that $9,000
covers the entire cost of a med student's education. There's going to
be a huge government subsidy that accompanies this $9,000.

Med Schools have to be a royal pain in the ass to university
administrators as they are incredibly capital intensive with constant
demands for upgrading. It's so much simpler/cheaper to pump up
admission into business schools where your major expenditures are
chalk-and-talk seminars.

So, Scott, I doubt very much that there's competition between
universities to get med school students.

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Scott thinks:
===============
More importantly, med schools are in competition with each other for
students, so
it's extremely unlikely that they would shoot their own feet just to
pander
to the AMA.
===================

Hmmm... are you sure they're in competition with each other?

Yup. Positive.

If I were
a university president, the last faculty I'd want to increase enrolment
in would be medicine. Just a quick google got me tuition figures for
med school in Arizona (albeit two conflicting figures: just under
$10,000 and just under $13,000 per year). I'll assume the figures are
comparable around the USA. Surely you're not going to claim that $9,000
covers the entire cost of a med student's education. There's going to
be a huge government subsidy that accompanies this $9,000.

Med Schools have to be a royal pain in the ass to university
administrators as they are incredibly capital intensive with constant
demands for upgrading. It's so much simpler/cheaper to pump up
admission into business schools where your major expenditures are
chalk-and-talk seminars.

So, Scott, I doubt very much that there's competition between
universities to get med school students.

They're just like any other business. How ever much of a pain med students
are, the university has a lot invested in the med school program, as you
yourself admit, and the only way to pay for all that infrastructure is to
have students in the programs. Any med school administrator who went to the
Regents with the argument "Med students are a pain in the butt, let's not
only not recruit them, let's deny them admission so we don't have to spend
any money educating them" would be fired.

--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

On 28-Mar-2005, Scott Weiser wrote:

In Canada, however, compensation for nurses and doctors outside of private
practices, particularly surgeons, is government controlled,

Exactly what percentage of doctors in Canada are not in private practice?

Mike

A Usenet persona calling itself Michael Daly wrote:


On 28-Mar-2005, Scott Weiser wrote:

In Canada, however, compensation for nurses and doctors outside of private
practices, particularly surgeons, is government controlled,

Exactly what percentage of doctors in Canada are not in private practice?

Doesn't matter. What's government controlled is the compensation provided by
the national health service for in-hospital care and surgery, irrespective
of whether the doctor is a government employee or a private contractor.

--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

On 29-Mar-2005, Scott Weiser wrote:

What's government controlled is the compensation provided by
the national health service for in-hospital care and surgery, irrespective
of whether the doctor is a government employee or a private contractor.

First of all, there are no doctors that are government employees. It
has already been pointed out that doctors in Canada are all self
employed. Furthermore, doctors work on a fee-for-service basis. If
they do the work, they submit the paperwork and get paid. The
health insurance ministries cannot avoid paying for work that has
been done.

You are, as usual, full of ****.

Mike