Monday, July 16, 2007

Sicko and health care systems.

I was putzing around Facebook and it led me, eventually, to this very insightful suggestion:
In order to think about institutional choices related to health care, I’ve learned to ask two questions. First, who pays? And secondly, who makes decisions about the care provided? The first question is important because medical providers pay the most attention to the person or institution that pays them. If I pay my grocer myself, she will make sure she stocks food that I like. If she is paid by someone else (for example, the corporation that owns her store), then she’ll be sure to put what that person wants on the shelf, and pay less attention to my requests. The second question is important because different decision-makers may have different objectives to fulfill in their determination of the care you receive

and on Canadian health care vs. American HMOs:
The commonality between HMOs and single-payer national health care systems should have made Michael Moore more skeptical about the European, Cuban and Canadian systems. You see, each of these countries has a health care system that is, in effect, a single, national HMO.

Because I know Canada the best, I’ll use it as an example, but the point applies to all the rest. The questions are: who pays? And who decides? Moore makes the same mistake that most of us make regarding national health care systems when he says that “everyone” pays in such a system (remember the golfer scene?). The better answer to the first question is that the provincial health ministry pays, because it controls the revenue that doctors, diagnosticians, and medical service providers receive. The answer to the second question is the same: each provincial health ministry in Canada decides what medical goods and services will be available in any given year. A budget is set for the year, and the health care system has to stay within that budget. A bureaucracy is rewarded with more funds when it stays within its budget, hence the goal in any given year is to minimize costs: exactly the charge Moore brings against the “greedy” for-profit HMOs . A national health care system is simply a single HMO for everyone.
The quotes are from The Skeptical Liberal, and you can read his extremely well-thought out and defended opinion on Michael Moore's Sicko and the effects ofHMOs on American health care in their entierty here.


zolton said...

I think you skirt over the real issue although this post was an ok one.
The American HMO work within the capitalistic economic structure. Automatically profit is put above people.Sorry to say but this is one place privatization should not occur. (think about it principally) In Canada the system is government controlled In hopes to give access to health care across the country proportionately. You have a centralized body giving money to the provinces to do what they want with providing health care.
Provincial governments however do have to follow a schema dictated by the federal government. This system is radially different then the HMO who caters towards profit and not the services and people that they are supposed to be functioning for.

BTW have you seen the movie Sicko?
Or do you just judge the image of something, being to ignorant/innocent? to understand the substance?

zolton said...

Oh honey, you should also read the artical:
The Plan to disappear Canada
'deep integration comes out of the shadows'
by Murray dobbin
You can find it in the Tyee
And remember thats the guys your attempting to legitimize!
Thanks to the SPP we will be singing the America the beautiful in a couple of years.

Get it yet? the Right does not have Reason on its side.