Gregory Oppedisano's page

Starfinder Roleplaying Game
Starfinder Adventure Path

Thanks,

Well done BONZAI Demons!

Tons of great advice for the GM in this one - really enjoyable hearing Bullmahn talk about what makes a great game.

I agree that there is a lot going on in this adventure- I really enjoyed the tie ins to other Great City elements ( the poem for example...I am going to make up those broadsides mentioned in the begining regarding the bounty..hehehe). I also give you guys big props for keeping all the adventures human/oid centric, which I think a lot of adventures fail to do, especially at higher levels (easier to challenge parties with demons and such rather than statted out NPCs I would persume). I hope that continues for the rest of the adventures. I loved the art inside too; it reminded me of some of the Iron Kingdoms art for the Monsternomicon.

Wow - double thanks!

Just downloaded this; this is the favorite so far...

Thanks!

Gregory Oppedisano wrote:

Here you go what hospital do you want to go to... oh and the numbers are days (not years :))

St. Joseph's Health Centre (Toronto) Toronto Central 51

I know St. Jospeh's; I stayed not far from there last time I was in town, I think.

In contrast, though, I needed an MRI here in Houston this spring. Wait time (for the machine nearest my home) -- 2 days.

There is no doubt that there are a lot more MRIs, CAT scans etc in the USA... more than anywhere in the world i would imagine (though I am not sure).

Canada definitely scores poorly in this area in OECD studies.

This is one of the reasos we are ranked 30th.

Not a great ranking either I will add again...

I think we should look to Italy and France to improve our systems - they dramatically out perform both of our systems.

I've always had a perverse desire to live in Yellowknife. I can't convince the wife and kids to move there though.

Where are you from?

Yellowknife is a pretty big culture shock if you have never lived in a remote community before.

The Canadian north is a literal gold mine of resource industry jobs, consulting and service companies, and major mining operators.

Wages are high, taxes low, housing scarce, and its cold as a m%~#~! f~**~&...

Gregory Oppedisano wrote:

The OECD is not a think tank. Its goals are as follows

But what it isn't, and a bunch of vague goal statements, in no way tell me what weight they attach to which factors when they make their rankings. Does wait time for emergencies count 5 times as much as number of doctors per capita? Half as much? Does the number of specialists compared to the number of GPs get factored in? What about percent rate of luekemia survivors? There are a bewilderingly vast number of factors that can all be considered, and without knowing what relative weight these factors receive, if any, a cumulative ranking is meaningless.

You said you didn't trust think tanks... and wanted to know the rational behind the organization...

And this is not just you but...

I agree with Lou. How do you argue with someone who uses anecdotes. Is so rigidly locked into an ideology that they deny the *existance* of facts that do not support their position and rejects the OECD data without even knowing what the OECD is.

Thinking that you have some better understanding of the comparative analysis of national systems of governance than the OECD is really sad - who do you think you are?

Why do you suppose the governments of the 30 developed nations, that employ the international expert panels of the OECD to make determinations and give recommendations on how their systems work, have not thought to just give you a call and ask you what you think...

Your position would be laughed out of any serious discussion of policy in any major corporation, government body, academic setting...

I am really trying to be polite and understanding.

It is that what you said is twisted that causes the problems.

You are the one who has proclaimed a moral imperative in the providing of health care.
You are the one who has proclaimed a government imperative to do the providing.
You are the one who has proclaimed, and confirmed here, the failure of a system that does not apportion providers according to need.

It is no big jump to unite the moral imperative with the government imperative with the failure (assigned by you) and come up with a "solution" of government mandated assignments.

I understand why you would not want to have to acknowledge the inevitability of such, but that is precisely where the system you have described will end up, particularly with the moral imperative added to it.
That is the problem with moralistic dialectics. Once you add that factor, any excess becomes not merely tolerated, but mandated.

Yay! libertarian talking points!

I imagine that if you polled people you would find that most people think prenatal care is more important than boob jobs.

Some people because they are pregnant
Some people because they care about their neighbors
Some people because jesus told them too
some people because they can think clearly because they do not read libertarian websites
Some people because they have morals
Some people because the answer is obvious
Some people because they are pinko communists

The point is market fundamentalism is amoral and profit without perceived consequence twists values.

I think you have made the point better than I ever could and so I thank you.

Gregory Oppedisano wrote:

Alberta students show strong results on international tests

Are you in Edmonton? I have relatives that live up that way. Not the uncle I mentioned earlier, a different branch of the family. Of course my family is scattered all over Canada. We had to relocate there after my family picked the losing side of the American Revolution.

I am a little farther north than that... in Grande Prairie. I live in the middle of the Canadian oil and natural gas patch... home of the $18 an hour subway sandwich artist job... land of CO2 emmissions... the one place on earth where global warming looks like a good idea!

Gregory Oppedisano wrote:

David Fryer wrote:

Gregory Oppedisano wrote:

I teach in the number one jurisdiction in Reading, the number one jurisdiction in Writing, the number three jurisdiction in Mathematics and number three jurisdiction in Science ON THE PLANET (according to the OECD) and guess what - its all public education...

Except that, according to the OECD itself, they do not track the whole planet, only their member countries. I understand that hyperbole is felt needed at times. Could you please direct me to the statistics, as I am unable to locate them in the OECD report.

I am not sure what report you mean...

I was reading their 2007 overview of Education, but I could not find ranking for individual subject areas such as math, writing, and reading. All I could find were statistics about graduation rates, performance as it relates to socio-economic factors, etc. I could not locate any place where there was a comparitive ranking bases on individual fields of study. That is why I asked where you found those specific statistics.

I am not sure about the PISA documents from 2007... I think PISA is tested every three years 2000, 2003, 2006.

I participated in the study in 2000 - published in 2003 - that is the one I was quoting because I am very familiar with the results... here is a summary:

Alberta students show strong results on international tests

Edmonton... Alberta students continue to achieve excellent results on international tests, sharing the highest scores in reading, improving from third to second in mathematics and ranking fourth in science. The results are from the 2003 Programme for International Student Assessment (PISA), administered by the Organization for Economic Co-operation and Development (OECD).

"These test results confirm that Alberta students are among the best in the world," said Minister of Education, Gene Zwozdesky. "I am very proud of their achievements which demonstrate that students benefit from our province's excellent teachers, high-quality centralized curriculum, outstanding learning and teaching resources, and standardized assessment program."

PISA is administered every three years and assesses the international achievement of 15-year-old students in reading, mathematics and science. In Alberta, over 2,400 students from
120 schools participated in the test. Alberta is the only province whose average scores are significantly higher than the Canadian average in every area tested.

"Participating in international testing is an important component of our learning system," said Zwozdesky. "It gives Albertans the chance to see how well our students are doing in relation to other students around the world."

In 2000, Alberta students scored the highest of all participants on the reading component of the PISA tests. Alberta students had the third highest rankings in science (behind Korea and Japan) and mathematics (behind Japan and Quebec). In 2000, the tests focused on reading and literacy. PISA 2003 focused on mathematics and a new content area called problem-solving skills. Problem-solving questions test a student's ability to solve real-life situations requiring more than one subject area, such as using a map to calculate the shortest distance between two routes.

A copy of the Canadian results published in Measuring up: Canadian Results of the OECD
PISA 2003 Study is available from the Council of Ministers of Education, Canada at www.cmec.ca. For more information on PISA, visit www.pisa.oecd.org.

I will look for data on the 2007 study and get back to you!

It is not what I am suggesting, it is what Gregory Oppedisano has said is a problem with a capitalist system, and thus something that would inevitably be changed with a single source system, be it government or private.

Wow you have really twisted what I said more than once now.

I think it is a waste of health resources to have a system which has surplus of resources devoted to providing boob jobs and cannot provide prenatal care to every woman who is pregnant.

That does not mean that the government decides which job a doctor can do.

Gregory Oppedisano wrote:

Alberta is a province - there are several major centers there other than Calgary...

Yes, I know, but if Calgary is too cold for the Mrs., then Edmonton certainly is! Toronto has a higher population density, and the number of MRO machines is greater in absolute terms, but not proportionately.

Here you go what hospital do you want to go to... oh and the numbers are days (not years :))

St. Joseph's Health Centre (Toronto) Toronto Central 51

Scarborough Hospital ** Special note (Toronto) Central East 62

Rouge Valley Health System ** Special note (Toronto)Central East 65

University Health Network ** Special note (Toronto) Toronto Central 73

Toronto East General Hospital (Toronto) Toronto Central 78

Sunnybrook Health Sciences Centre ** Special note (Toronto) Toronto Central 79

Mount Sinai Hospital (Toronto) Toronto Central 93

I don't care if every think tank in the world says something, if I don't know what their purpose in saying it is. What's the rubric? How does this scale work? Send me a link, and I'll be more than happy to take a look at it. But as they say, the burden of proof is on the believer: could you at least post a link to the methodology for me? If there is none posted anywhere, then I'm for sure not going to give it much credence.

Like you, I am not a big fan of "fundamental attribution" thinking, although I don't totally discount it in all cases -- certainly I know people whose "personal success" can be attributed to Daddy's contacts and money, but I know some others whose personal success is exactly that. At least one other who started with all the advantages and ended up a bum. And others who tried like hell to make it -- much harder and much smarter than many "successful" folks, by a wide margin -- but just got dealt bad breaks across the line, through no fault of their own. Any permutation of the above can happen. But the typical American viewpoint is "All of my money is mine. Everyone else has to go get their own."

The OECD is not a think tank.

Its goals are as follows:

OECD brings together the governments of
countries committed to democracy and the
market economy from around the world to:

• Support sustainable economic growth
• Boost employment
• Raise living standards
• Maintain financial stability
• Assist other countries' economic development
• Contribute to growth in world trade

OECD also shares expertise and exchanges
views with more than 100 other countries
and economies, from Brazil, China, and Russia
to the least developed countries in Africa.

Monitoring, analysing and forecasting
For more than 40 years, OECD has been one of the world's largest and most reliable sources of comparable statistics, and economic and social data. As well as collecting data, OECD monitors trends, analyses and forecasts economic developments and researches social changes or evolving patterns in trade, environment, agriculture, technology, taxation and more.

The Organisation provides a setting where governments compare policy experiences, seek answers to common problems, identify good practice and coordinate domestic and international policies.

http://www.oecd.org/pages/0,3417,en_36734052_36734103_1_1_1_1_1,00.html

But he's not quoting raw statistics. He's quoting an internationally recognized study jointly conducted by scientists, economists, politicians, etc. -- including American representatives of same -- precisely for the purpose of interpreting statistics and creating a ranking system.

A study of this sort is precisely the act that validly transforms statistics into facts, as I understand you to mean that term.

Greg is citing excerpts from this study -- this interpretation of statistics into facts -- as opposed to pointing us to the whole study (good question -- is it available online?). Since, I assume, its probably rather voluminous.

The OECD generally provides rankings online - as well as some portions of their reports on line.

Generally the government (of member countries) provide sections of the reports to the media and through various departments related to the reports.

From my experience while taking a course in comparative systems analysis during my masters - using OECD analysis texts to compare education systems - the whole report is produced as an academic text - 300-500 pages of methodology, statistics and other gathered data as well as recommendations to the country that asked for the analysis.

I do not believe these texts are available online - you can find them in any university library however.

Gregory Oppedisano wrote:

In alberta wait times for MRI are between 5-20 weeks depending on severity/need.

Sorry, I was looking at the GTA. No way my wife would ever consent to move to Calgary, despite the work opportunities I could find there.

Alberta is a province - there are several major centers there other than Calgary... I just want to be clear that if you live in Hobema - you have the same wait time as if you live in Calgary...

Well GTA is the highest concentration of services and facilities in Canada - so I would expect the wait times to be better there than in the sparsely populated west!

Hal Maclean wrote:

Don't you guys have HMOs that require you or your doctor to get permission before you can get treated? Does that involve calling some person in a cubical somewhere who must approve or disapprove the treatment?

For those Americans lucky enough to be insured, we typically have a choice: the HMO model you describe, or the more expensive PPO model, in which we don't have to ask "mother-may-I," but have an almost equally hard time getting insurance to cover anything. The HMO is cheaper, but allows them to refuse to reimburse for anything unless your "primary care physician" (not a cubicle person) okays it first and it's also "in network."

In either case, the person in the cubicle comes in afterwards and typically tells you that your insurance won't be covering your procedure, and that you have to pay $15,000 out of your own pocket for your 2 stitches or whatever. Then you get a doctor's note saying the stitches were a medical necessity, and you file an appeal. They come back and say they'll pay $5,000 and the remaining $10,000 is your problem. You appeal the appeal and threaten the CEO with public castration; they come back with "on later review, we find that the procedure maybe was necessary after all. We will cover $14,500, and the remaining $500 is your responsibility."

My wife files the same appeals several times a year, every 2 years, for the same required MRI scans. That keeps us down to around $750 a pop, instead of $5,000 each. In Canada, though, we're told there's an average 5 year wait for an MRI scan, which is no good for a person who needs them every 2 years.

That's funny in a sad way.

In alberta wait times for MRI are between 5-20 weeks depending on severity/need.
The government tracks wait times here:
http://www.ahw.gov.ab.ca/waitlist/AccessGoalCharts.jsp

http://www.ahw.gov.ab.ca/waitlist/AccessGoalCharts.jsp

David Fryer wrote:

Here are some other facts from the OECD report. Canada has a high suicide rate than the United States. Canada is the third worst country in terms of death after having been admited to the hospital after a stroke or critical illness, which means only two other countries have more people die in the hospital after a critical illness, and one of them is Mexico. America has more long term care beds in hospitals and nursing homes, per capita. The United States government spends more per capita on health care than Canada does, even without a single payer system.

Wait for it now...

I am going to agree with you that those are all facts. Those are facts that the OECD used to determine national rankings.

Canada is ranked 30th after all... but still 7 places higher than the USA and at half the cost...

I would like Canada to look to Italy and France to reform our system. They clearly deliver health care more effectively than we do...

Here are some other facts from the OECD report. Canada has a high suicide rate than the United States. Canada is the third worst country in terms of death after having been admited to the hospital after a stroke or critical illness, which means only two other countries have more people die in the hospital after a critical illness, and one of them is Mexico. America has more long term care beds in hospitals and nursing homes, per capita. The United States government spends more per capita on health care than Canada does, even without a single payer system.

Wait for it now...

I am going to agree with you that those are all facts. Those are facts that the OECD used to determine national rankings.

Canada is ranked 30th after all... but still 7 places higher than the USA and at half the cost...

I would like Canada to look to Italy and France to reform our system.

Gregory Oppedisano wrote:

I teach in the number one jurisdiction in Reading, the number one jurisdiction in Writing, the number three jurisdiction in Mathematics and number three jurisdiction in Science ON THE PLANET (according to the OECD) and guess what - its all public education...

Except that, according to the OECD itself, they do not track the whole planet, only their member countries. I understand that hyperbole is felt needed at times. Could you please direct me to the statistics, as I am unable to locate them in the OECD report.

I am not sure what report you mean...

OECD is comprised of the 30 most developed countries - but they do administer systems of governance analysis for non member countries.

This is their website:

http://www.oecd.org/home/0,2987,en_2649_201185_1_1_1_1_1,00.html

Their publications of comparative analysis are available at any university library - they are not article length - they are entire texts.

Their data is referenced on every major study of economic, health, education and infrastructure performance.

Statistics are not facts.

That is the error you are making there.
Statistics are just statistics. Whether they are properly interpreted in relationship to the facts that they categorize is something completely different.

I agree that *some* stats are not facts.

I trust the OECD.

If you want to go by raw statistics, I can just point to the fact that more people immigrate to the US every year than immigrate to Canada. That proves more significantly than anything else which country is better overall.

How will you explain that away?

I think the American Dream is a very powerful symbol of freedom and the search for a better life for all of the people of the world. America is a beacon of democracy and opportunity and I am very fond of all my American friends and would live in American in a heart beat!

Canada has about 260,000 immigrants per year.

USA has about 7-800,000 immigrants per year.

per capital more people are coming to Canada... but the USA is still the number one destinatin for people seeking a better life.

Or should we compare how many people come to the US for healthcare? What about for education? For all of the statistical "advantages" you throw about as if they were scientific laws, how do you explain those simple statistics?

I would love to do you have any data?

Gee, Canada doesn't get Fox? Don't diminish yourself/your arguments by going down these roads. Too many counter-arguments, and none that matter.

I joke Fox is very nice news...

I have actually been quoted on fox... told off actually by O'Reilly...

you can google it.

I have a very strong position on health care.

In the 1990's conservatives in Canada tried to create a crisis in health care, by under funding it, to change the system to a for profit model.

I have heard most of these arguments for 20 years - we have had a national debate going on in Canada for most of my life.

That is why I trust the data.

I know, and you know too, that there will be no health care reform in the USA... there are hundreds of billions of dollars at stake in the for profit model.

I am sorry if I came on to strong.

The difference is, Greg; she knew what she was talking about, and you're just quoting supportive statistics.

That is silly. The ranking of health system performance is a fact. Italy is number one. Canada is number 30 (not that great in my estimation). USA is number 37.

The cost of the systems are facts.

Opinion is opinion. I heard stories are I heard stories.

Oh an I should point out - my Grand mother was a nurse for 35 years, my mother is a health care aid, and two of my best friends are doctors... and my sister is a stewardess (they have first aid).

Plus I have 3 kids and have been to the doctor and hospital lots.

The crux of your argument is somebody told me... OECD facts don't count, I have real life experience and I am no longer talking about it...

Ouch!

Sorry.

I worked with an RN who was going back home to Canada.

She was going to work for 1 year there or whatever, then avail herself of the 1 year's paid maternity.
She said she'd like to stay working in the U.S., though, because it's really nice to be able to actually help people.

Here's one:

I work with a doctor from the USA and he said that one in three babies are eaten by nurses in private hospitals...

Something about that statement seems less valid than internationally recognized data...

Greg, honestly,....do you actually know anything about what you're talking about besides some statistics?

While arguing from anecdote is a pleasurable pursuit - I think critical thinking requires argument from data...

I am hoping that that is not just me...

Public education is a fine example of why I don't want universal healthcare. Have you noticed how children in private schools and those that are schooled at home out perform children in a public school? Would you rather go to Harvard or go to a local public supported community college?

See this is what happens when you can't argue with facts. You compare apples to oranges.

By the way the US education system is also a shambles... privatizing it won't fix it either - but have I got a great solution for another thread!

I teach in the number one jurisdiction in Reading, the number one jurisdiction in Writing, the number three jurisdiction in Mathematics and number three jurisdiction in Science ON THE PLANET (according to the OECD) and guess what - its all public education...

Gregory Oppedisano wrote:

Here are some health care stats:

"There are three kinds of lies; lies, damned lies, and statistics."

- Benjamin Disraeli by way of Mark Twain (or one of several other possible sources)

You keep parroting those same statistics as if they proved everything.
They do not. Especially when they deliberately ignore numerous additional factors.

Look I know you think that you may have thought of something that the OECD did not... i understand that a nation that has Fox news should not trust anyone...

The OECD employs teams of systems analysts, mathematics professors, statisticians etc. to gather and compile data in a way that the USA and other participants in the studies) agree are valid before doing their comparative analysis.

Government, universities, political parties, think tanks - they all get their data from the OECD. When a government makes a decision on a health care, or education or infrastructure issue the first place they look for data is the OECD.

The OECD is a non partisan, organization for democratic MARKET based reforms...

Anyway. There is a serious problem when a person's full treatment costs (x+y) and the government only agrees to pay (x) and the person can pay (y), but the government forbids them to pay it unless they are willing to pay all of (x+y) even though they could only afford to pay (z) where (y) < (z) < (x+y). That is a horribly screwed up system. Anyone that is willing to accept a system that does not encourage a system where the individual and the state can work in concert with one another obtaining a better result than either could do alone, is a person I don't want making decisions for me.

This is essentially present in some form in all western democratic systems. For example if I need surgery for cancer, a pharmaceutical regime and want to go to a miracle spa and pray for healing in Mexico.

The Canadian government pays for my surgery, my extended health coverage at work pays for my drugs, and I pay for the spa in Mexico.

You know what is never annoying? Someone cut and pasting the same crap over and over again. That is never annoying at all.[/snark]

Not nearly as annoying as a field of strawmen yelling "the facts don't matter" and repeating libertarian talking points in a never ending cycle...

Well you have to be aware that the term socialized has a pejorative connotation since the cold war. Its a connotation that makes some listeners shut off and not listen to an argument on its merits the second they hear the word. Why use it then, if you want the most possible people to actually listen to what you have to say?

Also, people have a tendency to talk about "socialized" as if we don't already have tons of socialized things all over this country. Like public education. Yet I don't hear many people call public education a damned socialist institution that should be reviled because its socialist.

It's just one of those words that, in the American context, tends to shutdown converstation more than it furthers conversation.

Essentially, though, I agree. There's no valid reason for the word to have a perjorative connotation. Yet it does.

You are absolutely correct Lou - you internationalist you - the rest of the developed world did not suffer under McCarthyism and the RED TERROR!

So we can differentiate between the words socialism (democratic application of Keynesian economic theory) and Communism (dictatorial regimes in Russia and China).

Also, somethig in your $2100 vs. $2700 stat number is off as Canada spends 50% per capita as the U.S. I'm not sure what's off, but something is, maybe beacause at the reduced cost of treatment and the currency difference, $2100 buys 2x as much care as in the US? Not sure.

That said "it costs a bunch" is not, in my book, an argument not to provide universal coverage. It just raises the questions of how do we make it cost less, and what on earth is more important to spend money on? We spend on roads, education, clean water, etc. Why not...

Spending per capita should include all sources of health spending both public and private - for example Canadians can pay for private supplemental insurance(for things like dental and pharma) and the American government pays for some public health care 9elderly, some chilren, military etc).

Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003

Canada $2,998

United States 5,711

Lots of interesting diversions...

...but critical thinking requires the ability to accept facts and utilize data.

And remember - I have no stake in american health care - I feel badly for americans... but I am not invested in the system.

When something is ranked - the higher the ranking the better something is.

For example: the Montreal Canadians are a better hockey team than the Toronto Maple leafs... Now as a Leafs fan this hurts me to say... I might point out that the Leafs beat the Canadians 3 times last year, that Mats Sundin is a hall of fame player, that the leafs play in the most intense media market in the world and that effects performance... but a look at the facts - in this case the standings - will tell you the Canadians finished 1st and the leafs finished last in their division... so even if i don't like the data, even if I don't want to believe it, even if i will argue with you that the Leafs are better till i am blue in the face... the facts are that the habs are better.

When you compare costs - the lower the cost the more affordable it is.

For example: Sadly the tickets to the leafs games are more expensive than the tickets to the Canadians games... essentially leafs fans pay more to watch their team lose than habs fans pay to watch their team win

Here are some health care stats:

Canadians live longer than Americans

Canadians have low infant mortality than Americans

Canadians lose less years due to preventable disease than Americans

Canadian health system is ranked 30th in the world

American health system is ranked 37th in the world

Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003

Canadian Health system costs $2998/person

American Health system costs $5711/person

Even if the systems performance was EQUAL - the Canadian system costs 50 cents on the dollar and includes EVERYONE.

WHY PAY MORE FOR LESS?

Because your system isn't as good as you make it out to be.

I am not inventing the data.

None of these statistics address what I said.

Why do Canadians live longer than Americans? It could be because they sleep longer than Americans, or because they go to bed earlier.

By having better health care(sleep) you avoid getting sick, and thereby make sickness care less important in determining your lifespan.

Why do Canadians lose less years due to preventable disease than Americans? It could be because they eat more nutritious food in moderation than Americans do or supplement better vitamins and minerals, it could have nothing to do with their sickness care.

Why does Canada's sickness care system cost less? Because of rationing, or because of better health(not sickness) care.

Why does Canada have lower infant mortality rates than the US? It could be because of better nutrition of the mothers, it could be because vaccine policies are different, it...

Really... that is your argument... *sigh*

The data is relevant because it is impossible to think critically without data.

The data is collected and evaluated by the OECD - an organization of democratic states that is tasked with gathering data by those states, to provide governments support for making DEMOCRATIC MARKET BASED REFORMS to various systems (health, medical, infastructure etc).

The OECD is for free markets. In the case of health care their data supports single payer universal systems.

True story. I literally have to be dragged to the doctor to be seen. If I need stitches, I just grab super glue. The United States has a pretty unhealthy culture over all, esspecially when it comes to our weight. Of course it could be that we think too much.

That is awesome - I can't wait to tell my wife that I my weight is a function of my genius!

Somehow I don't think she will find it comforting!

Let me ask you something. Have you looked into some of the reasons why the U.S. is lacking in these areas? It's more of a culture thing than...

There are many variables. The OECD considers these when doing it's comparative analysis and rankings.

For example:
Canada has a very low population density - so medical resources are more difficult to deploy.
Canada has long cold winters (snow shoveling causes heart attacks).
Canadians are sedentary (hockey night in Canada anyone?).
Canada has poor medical services in isolated norther communities
Canada has difficulty attracting doctors to poor isolated northern communities.
Canada has illegal immigration.
Canada has a diverse racial and ethnic population.
Canada is fat and eats terribly (but still handsome)

The one thing that boggles my mind - if you are in favor of free markets why on earth would you pay twice as much for worse results?

Gregory Oppedisano wrote:

Somebody found Wikipedia...

Actually I have access to Lexus/Nexus and a few other academic journal search engines.

Yes but that was cut from wikipedia.

It is ok I like wikipedia...

I haven't read in detail all the posts on this discussion of sickness care, so I apologize if this hasn't already been pointed out.

The US does not have single payer sickness care, but it does not have a free market sickness care system either. Sickness care in the United States is close to pure socialism/single payer, but not quite there yet.

It is single payer if you are age 65 or over, you can't get sickness care coverage except through Medicare by law at that age. HMOs exist because of the HMO acts of the 1970s, I believe the last one was in 1976. Medical licensing restricts the supply of doctors, which forces high salaries. And advertising is heavily restricted and regulated by the FDA, which makes it illegal to claim that your substance can treat or cure affliction or disease X unless the FDA gives you permission to state that, permission only granted to large pharmaceuticals that can afford to lobby(aka bribe) the FDA.

The problem of Canada and European nations with the single payer/"universal" sickness care is one of rationing. By making sickness care "free" you have the problem of too much demand, and not enough supply. This problem is "solved" by rationing, which causes the long wait times as mentioned by some posters. Rationing also leads to people being denied sickness care, or getting substandard care.

Note I have been saying sickness care throughout this, not health care. That is because when people talk about health care, they are really talking about sickness care.

Health care includes the following-
Avoid accidents, don't take unnecessary risks.
Eat good nutritious food in moderation.
Supplement with vitamins/minerals those nutrients you can't get through food.
Exercise.
Get 7-8 hours of sleep each night, most important, get some sleep before midnight.

Health care is a responsibility of individuals, not governments.

Canadians live longer than Americans

Canadians have low infant mortality than Americans

Canadians lose less years due to preventable disease than Americans

Canadian health system is ranked 30th in the world

American health system is ranked 37th in the world

Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003

Canadian Health system costs $2998/person

American Health system costs $5711/person

Even if the systems performance was EQUAL - the Canadian system costs 50 cents on the dollar and includes EVERYONE.

out of curiosity how long has canada had free health care now?

Saskatchewan introduced universal health coverage in 1946.

Hmm that statement is so silly it kinda made it hard to listen to anything else you have to say.

If you know of another way to increase profits I am curious to hear it...

I saw the original post - I am sorry if you are offended.

You cannot use Walter Reed as an example of the failure of a public system and then upon learning that it was privatized use it as a failure of a public system.

The people that privatized Walter Reed did so for ideological reasons - not because they saw themselves a stewards of the public good... that is why elections are important.

I agree that it is hard to take a new position on something you feel strongly about - I often continue to argue my original position after I have been convinced that I am wrong about something so that I can learn the full extent of the other position.

I have no agenda here. I do not profit from the system you have in the USA.

I am merely attempting to educate you (and others) on a different way of doing things - because there are soooo many misconceptions about single payer public health care in the USA.

Then how do you explain these figures? According to the American Heart Association, Canadians are 17% more likely that U.S. citizens to die from a heart attack. 30% of U.S. heart attack patients have had angioplast as opposed to 11% of Canadian patients. 13% of U.S. heart attack patients have had bypass surgery, as opposed to a mear 4% of patients in Canada.

The North American Association of Central Cancer Registries found that cancer patients treated in the U.S. are more likely to survive that cancer patients treated in Canada.Canadians have a higher rate of colorectal and stomach cancer. Colon cancer patients are more likely to die in Canada than in the U.S.

In Canada 24% of emergancy room patients had to wait more than 4 hours. In the United States the number was half that. In Canada 57% of patients had to wait more than 4 weeks to see a specialist. In the United States on 23% of patients did. In Canada 21% of patients had to wait more than three weeks for a biopsy. In the U.S. less than 1% did. In Canada 50% of hip replacement surgery candidates have to wait more than 6 months for their surgery. No recorded patient in the United States has ever had to wait that long.

Canada has 4.6 MRI machines per 1...

Somebody found Wikipedia...

Simple:
Canadians live longer than Americans

Canadians have low infant mortality than Americans

Canadians lose less years due to preventable disease than Americans

Canadian health system is ranked 30th in the world

American health system is ranked 37th in the world

Total Health Expenditures Per Capita, U.S. and Selected Countries, 2003

Canadian Health system costs $2998/person

American Health system costs $5711/person

Even if the systems performance was EQUAL - the Canadian system costs 50 cents on the dollar and includes EVERYONE.

The propaganda out there tells you that the minute you don't have health insurance and you get sick, you're kicked to the curve. Not true. I have health problems and I have no insurance and I'm getting very good treatment.

Who is paying for your treatment?

Can we change the perception of CEO incomes at the same time? If we're looking to trim some fat out of the economy, many of them make a whole lot more than my doctor. ;-)

No kidding!

In the case of health care - corporations (management/shareholders) profit from your illness and your doctor/nurse etc work.

I can guarantee that after thanking your doctors and nurses for saving you life you have never felt the urge to go up stairs and thank the CEO and investors who drove the cost of the whole procedure up so they could make dividends at your expense...

EDIT: Also the comments about private healthcare providers not being beholden to customers is a bit wrong. If me and my family are looking to purchase health insurance and we ask our family and friends about theirs and learn that company A has a reputation of dumping people, even though they are cheaper. Guess what. We wouldn't purchase insurance from them. With a government, if you recieve poor service then you can switch to ... what?

First off - the government cannot refuse to take me as a patient if I am sick - which you are well aware is a MASSIVE failure of the system you are defending. So lets not pretend the consumer is in control in the American system - we know you are at the mercy of the system.

Second - if I receive poor treatment from my doctor - i can go and see another doctor - any doctor I like - for free. I can continue to shop for doctors until I am happy with the service I am receiving - for FREE!

I prefer to talk about systems, rather than one experience, but I will give you an example.

My son needed medical care. The first doctor refered us to a specialist. The specialist had no bed side manner for treating a 3 year old and immediately recommended a surgical procedure to help my son. My wife and I rejected his advice and went to see a second specialist. The second specialist was wonderful with children and recommended a considerably less invasive cream.

We chose the cream. My son is fine. At no point did a government bureaucrat interfere with me or my various doctors making treatment decision for my son.

So your claim is that in Canada, if a doctor believed that a treatment costing $1 million/day would be the most effective, the government would pay that with out batting an eye?

The Canadian system controls costs by purchasing in bulk - that is why Americans come here for drugs.

I know that there are cases where new drugs available in the US are not immediately available in Canada because of regulations, availability, efficacy trials etc. (for example viagra) but the drugs do become available. Sometimes drugs are delayed because there are other cheaper equally effective or more effective drugs available all ready - they eventually become available as well. I think some of the new antihistamines fall in this category.

I am not sure there is a medical treatment that costs $1 million dollars a day... nor can I think of an example of Canadians being denied the most scientifically effective treatment available because of cost.

Can you?

If doctors were denying Canadians the most effective course of treatment there would be outrage.

Agreed. The best way to fix the problem is to change the mindset of people, rather than turning the whole system over to the government. Our cultural perception is that doctors should live in big fancy houses, drive big fancy cars, and live extravegant lifestyles. In order to change the way health care works in this country, we should change the way people view the role of healers in our society, rather than just playing musical chairs with who runs the system.

I definitely agree with this.

I honestly think in Canada you could create a two track system - one that operates similarly to the VA hospital system in the states where doctors act as employees and are tasked with improving the health of their patients.

The pay for service model in Canada, and the profit model in the USA creates a lot of stress in the system for doctors. Really who would want to have a doctors work life - many of the younger doctors I know would trade more time off for less pay.

This would require a lot more doctors though...

My uncle was a doctor in Alberta and we have discussed this subject at some length. He told me that the doctors already know what the government will pay for and that is the direction that they steer the patient. It's not a matter of the government deciding a course of treatment, it is a matter of the government deciding if they will pay for a course of treatment. In Oregan, for example, doctors can still recommend chemo for their medicare patients, the government just won't pay for it.

The fact that your "uncle" would admit medical malpractice to you in a "conversation" you had is very surprising to me.

I have many "friends" and "family" who are doctors, nurses, health care workers. In the medical treatment manuals or clinical practice guidelines for the care and treatment manuals (and you can actually look this up) there is always a tiered recommendation for treatment based on probability of success - not cost.

When you visit a doctor in Canada - the doctor is paid for the visit not for the course of treatment - so for example if you have high blood pressure a Canadian doctor get paid the same if he prescribes drugs, as he does if he recommends exercise.

For surgical procedures - doctors are paid by procedure - failing to provide the proper procedure would constitute medical malpractice and open the doctor up to law suits and losing his certification.

The basic problem is that preventative care is unavailable to many Americans. They go untreated and small diseases here and there and lack of doctor to patient education leads to more VERY sick people taxing the system.

By giving everyone access to basic preventative care, you give everyone lower medical costs.

I am a case in point. I have genetically based high-cholesterol. Even with changing my diet, I would not be able to lower it to a point where it is safe. So I have to be on cholesterol medication.

If I didn't have health insurance, this would go untreated and I'd likely have heart disease sooner rather than (hopefully) never. Because I am going to the doctor and am able to get a prescription for cholesterol reducing medication, I am saving the insurance company money. If it were government paid healthcare, I'd be saving the taxpayers money.

You are absolutely correct.

The problem for a corporation is that they are responsible for their shareholders on a quarter by quarter basis - so they do not see it that way - why should the CEO today care if the CEO in 10 years saves money?

Also you are faced with the fear that if you lose your health care or you will be denied health care because of preexisting conditions... this is an insanity of the private system - in Canada if I am sick the medical system *wants* to treat me.

Still a failure of the government they were the decisionmakers and couldn't look past cost, how does that make it the problem of privatization and not a problem of the final decisionmakers. Privatization can work just fine if more than just the cost is looked at.

You can't have it both ways. You can't say that things should be privatized and blame the public sector for the failures of privatization.

Private for profit health care has a LEGAL responsibility to maximize profits for share holders - that is how a corporation works.

There are only two ways to maximize profit. Charge more or decrease services.

When the Walter Reed scandal was an example of public system failure you were outraged. When your information changed and you learned that it is an example of the failure of privatization - you are no longer outraged at Walter Reed - now it is the people in the government who privatized it who are at fault.

Ideology should not get in the way of clear and critical thinking.