The incentive is in helping people not die.

Yeah, but being misanthropic for a minute, I imagine helping some not-insignifcant percentage of the people you meet in your average ER (or emergent care practice) to "not die" is what might be called a disincentive.

And I'd guess that representatives of that percentage come back again and again and again....

yes, the incentive is helping people not die. in a socialized medical system, the government takes care of that problem as the most egregious cases die before they get the treatment they need. voila! saving the doctors time and effort!

Massachusetts doesn't have significant numbers of poor people without insurance, at least not compared to states like California or Texas. If it doesn't work there it's not gonna work in the Southwest.

Karol's right: if these people are going to die, they might as well get on with it and decrease the surplus population.

Anyway, less money spent on helping poor US citizens get medical care equals more money to spend doing ANYTHING POSSIBLE to help those poor souls in Iraq.

Twenty-four years after the Canada Health Act, mandating universal health care, was passed by parliament the Canada's health care is in shambles.

Nurses have been reduced to the status of government employees and behave as such by routinely withholding their services in order to extract more money from their employer. They are now paid so much that many only need to work part time. This has created a virtual shortage of nurses even though there are plenty of licensed RN's available.

Canadian-educated Doctors are leaving for the US and many talented and aspiring students are rejecting medicine as a discipline because of income limitations and their desire to be something other than government employees.

Doctors are now so scarce that many people can't find a reliable family doctor and are forced to go to public clinics. Consequently Canada imports doctors from the third world, where they are badly needed, and signs them to contracts where they must work in smaller cities and towns for a period before they can practice in the city of their choice. You can imagine what kind of care they are providing.

And it only gets worse. Now there is call to lower standards in order to speed up the certification of foreign doctors entering the country and wanting to practice here.

At the same time health care costs are going through the roof, hospitals cannot afford to upgrade their equipment. For example, the waiting line for an MRI in most Canadian cities is measured in months.

So there it is, a government program that we never had thirty years ago now consumes more money than the next 5 government departments combined and it's slice of the pie gets bigger every year.

Compare this to Dental and Eye care, which are not covered by the Canada Health Act. There is no shortage of highly competent dentists, orthodontists or optometrist and our universities are turning them out in sufficient quantities all the time. Cutting edge technology and innovation are constantly being implemented in these fields and cost to the government is next to nil.

Most people pushing for universal health care are not interested in a humane system to provide efficient medical care to people. They are interested in destroying one.

So what kind of reimbursement rates do the new Mass health plans offer? Do thety pay at the state Medicaid rate? If so, are those rates enough for doctors to get by on? If not, you're going to have fewer doctors accepting said plans...

And you can solve the rest....

Arty,

Now, as someone who knows a Canadian fairly well, I gotta say you're making blanket statements that sound suspiciously like the usual propaganda.
My wife is from a smallish British Columbia city. There is a severe disparity in the treatment between where she lives (i.e., the hinterlands where you claim there are no doctors) and Vancouver. Generally, the hospital where my m-i-l works seems to have pretty good service and, yes, when I used to talk about the horrors of the Canadian health care system I'd get looks like I just suggested we cook up the nearest infant for appetizers. Finally, when bro-in-law needed an emergency MRI, he didn't have to wait, nor did my wife's late grandmother when they were trying to diagnose the cancer that killed her. (And no, it wasn't because they got the cancer late that she died. When your cancer is so freaky you end up being the basis for not one but two articles in medical journals as well as a presentation at a medical conference, all the medical help in the world isn't going to help you. As she said, "Well, obviously the Lord wants me pretty bad.")

On the other hand in Vancouver health care is like a sucking chest wound. Now, there are several reasons for that, to include those you named. However, the biggest reason, at least from what I've heard from the f-i-l who works in provincial government, is that there's the usual mismanagement problematic with all governmental agencies but no mechanism for really changing said government leadership thanks to the contractual laws employees work under (usually plague of the bureaucrats and all that). Also, as you mentioned, the Canadians do have the brain drain problem with their doctors--however, a significant number of them end up returning in about 10 years after they've had their first experience with American malpractice. I've never heard of a Canadian doctor having to show up in court because a woman was upset she had pain during childbirth.

As to the nurses--let's not start winding up to throw stones so quick. I seem to recall their being a class action lawsuit brought by licensed nurses against several major medical providers down here. Why? Oh, that little thing called collusion which is what has kept nurses' salaries relatively low given the demand. When the Department of Labor said in 2005 that the United States has only 85% of the nurses it needs _now_ and real nurses wages have only grown about 10% over inflation, I gotta think that the fix is in. Don't b*tch because Canadian nurses were smart enough to get ahead of the power curve.

Now, don't get me wrong--I'm not in favor of any existant universal health care. Having been in Europe for a couple of years where the docs can pull the plug on you just because you're taking up a bed cured me of that. Well, that and seeing what government run health care looks like for 27 years of my life. However, I think A. we need to stop recycling the same tired propaganda and B. figure out something that covers people whose employers either can't afford or won't provide medical care. Why? Because universal health care is a vote getter and it's rapidly becoming one of those issues where conservatives better come up with an alternative plan or they won't be in a position to control what plan gets adopted at all.

I think there are ways to get there from here. Pointing and laughing at the Canadians isn't going to get us any further down the road--but rational discussion about the pros and cons of their system as well as doing what we Americans do best (making things better) might.

Oh, and Dawn...really? That's the incentive, helping people not to die? That's like saying lawyers should defend all death penalty cases for free--after all, it's keeping people from dying. Sure, doesn't pay the murderous student loan fees, but altruism is supreme, right?

We're (allegedly) a capitalist society. Doctors (heck, any professional) have a right to expect fair compensation for a skill that they've learned. If the government disincentivizes being a doctor, no one will want to do it. Unless you're planning on having random bystanders perform surgery when you need it, that's not good.

Are we blind...can we not see that the Emperor has no clothes.

Our health care system is not about health but about money.
Our medical model of industrialized birth sets us up for the 'Domino Doctrine'. The unnecessary medical intervention that costs a fortune and steals from the those who really need it. It is the first toppling domino that triggers the cascading effect on short and longterm health. It puts us on the path to the pharmacy and on a slippery slope of poor health. When we trust nature and the holistic health which we are innately designed to produce, birth outcomes are statistically improved. We need to stop treating pregnancy as a disease but as the miracle that it is. We need to trust and respect our health and survival handbook that is embedded in the amber of our mind (amygdala)...when we do...we don't just survive we thrive. But there is no money in nature...or natural birth. Parturition in the west is about a guaranteed pension plan for medical professionals, their suppliers and the pharmaceutical industry. Pharmaceuticals are th NUMBER TWO PROFIT CENTRE OF THE GLOBE only next to war, in ability to make a small handful VERY VERY RICH on the backs of the ill-informed, and media manipulated individuals who live under the despair of the merchants of fear.

Lets start eliminating the root causes rather than duping politicians, policy makers and people then prescribing drugs for iatrogenic symptoms. We must eliminate the pervasive parasitic pharmacentric medical system and start putting prudence before profit and peoples welfare before big pharma?

Natural birth, natural feeding and hands on nurturing is what we need in order to eliminate most of the problems we endure and are duped to believe are natural. Our headlines are black with the detritus of manipulated health. Much of the physiological and psychological harm created at birth taints lives and creates poverty and hurts people who can not adapt to society and strike out against it.

Some of the obvious hard costs are easy to see but most are hidden and extensive. Obvious ones like malaligned teeth and the obscene cost of ortho treatments to correct what nature does for free along with the 25% of children who undergo treatment of AOM (severe ear ache) and end up with rubber grommets surgically implanted in their ear drums (at what cost? and then compounded by hearing loss, impacted learning and further costs of tutoring and remedial treatments...the costs just compound?) This is just the tip of the iceberg as a result of not breast feeding (which is made horrific in a hospital setting often causing defeat). Another quantifiable is the 8% of all visits to a doctor for children under 14 due to AOM- a direct result of bottle feeding!....PARASITIC or what? We know the harm we do, the science is available, the empiracl evidence is everywhere but NOT on our continent, yet we continue to drug and treat the symptoms at a huge profit.

With Mit Romney and political cohort pandering to the billion dollar infant formula industry is it any wonder we are in HARMS way? Thank God he shot himself in the foot and won't be president.

The peaceful nations around the world have one thing in common...no... NOT nuclear arms....natural birth, breastfeeding and physical bonding....Those are the hallmarks of Peaceful nations.....these are the countries who can afford universal health care because they are born healthy and stay that way generally....
can you guess why we are bottling our intelligence and storing at the headquarters of the the Central Intelligence Agency?...cause someday we might need it...THE TIME IS NOW!

Cheers,
Global Harmony and Health to all when we start raising our kids from hour one... and stop razing the planet.