Misplaced Priorities and Misguided Decisions

"Maybe someone from Canada could chime in here.  "
I’m from Alberta (Canada West).  From what I can tell, the general opinion of Canadian Health Care from the US point of view is so wrong as to serve as a new definition of wrongness.

I can walk into a clinic (I have 6 in a 10 minute drive from home, more from the office) and see an actual GP with about a 2 hour wait.  If I call my doctor I can see her by appointment in as little as 2 days (the maximum I have been put off is 4 days but that was a scheduling thing between me and her).

I might expect to wait a month (or even several) to see a specialist (like a neurosurgeon).  I can get X-rays done in about 10 minutes and that includes the drive there.

Now its not all milk and honey for sure.  Triage at emergency wards is bizarre to say the least but (personally) I think people go there for mostly non-emergency reasons and so wait around too much.

Health Care is not a business, its a cost; and a cost that is predictable based on the population demographics.  Large number smooth out the variations.

Watching from the sidelines in morbid fascination



"Instead of helping them and punishing the improvident, the exact opposite is happening and we are left to wonder why."

well some of wonder why chris some of us hang out at the ct thread and get the answers. its really pretty simple

for someone who does a great deal of research i would have thought by now the dots would all be numbered. well i am left to wonder why?

In comparison to New Zealand and as a citizen of the UK, I have no qualms with the system in place being there for me when, for one reason or other I’d be out of work and sick. By paying into the state system while working, I can happily forget about the worry of being uninsured against sickness. No system is entirely faultless and many holes can be found no matter what can be done. The advancements in drug therapy and a doubling population has far exceeded the ideals set into the beginings of the National Health Service that were put into place back in 1948, but it is there to support you in most every circumstance for about $35 (American) per week.

Micheal Moore has his followers and detractors with his movie-making style, but the compelling issue from the film ‘Sicko’ that approximations to the sum of 50 million Americans eek out their existence without proper medical cover sends a level of fear in me that the idea of living in the States in this financial crisis would be perilous if at this time I found my medical expenses far exceeded what I could afford to pay.

This is but a matter of my own opinion that a state system should be created, stopping the monopolization of drug industries, even though their argument has always been that high profits advance study. I can see the issue on this thread quite readily, yet the system still in place has no better place to go long-term, unless others can chime in with their opinion…

Much that I find in this film is compelling from my standpoint :-

Sicko - Micheal Moore





Having attended the Lowesville Seminar and gaining some insight into the values and ethics of the Martenson family I can say that IMHO the self assessment is not intended to provide "recommended" actions for you to take but rather to ask you what actions you might recommend that you take for yourself and for your family and your community. Chris is really extending a plea to you and the rest of us to DO SOMETHING. He (and his family) are working flat out to provide us with leadership in the form of data (Chris’ job) and by example of how we can all make a difference with community involvement. Remember…he is the guy who quit his Fortune 300 job to devote his time to be our "faithful information scout".

Like they say on the airlines safety data, "put on your own oxygen mask first and then help others".  Rather than asking "Chris to do it" we need to be saying … "OK…Got it. Now what am I going to do to. This means to do the Self Assmt and solve your immediate scene in a way that works best for you and then get on board any of the myriad of other activities you outlined and get busy.

And I think delving into politics and or religion would be a fatal diversion given the current state of affairs. But that is only my opinion.


Here in England, the National Health Service does get many critisisms but I know quite a few people who would have certainly died an early death without it. Treatments for cancer and other serious diseases are very expensive, and most of the people I know who went through this could not have afforded the treatment, even if they sold all of their assets. At least they will now still be able to raise their families with some quality of life.
Private medical insurance here has so many caveats that you are very limited in what treatments are fully covered. The most serious cases are usually refered back to the NHS. Only the very wealthy can afford the best of care.Standards of care also vary: sometimes they are better, sometimes worse.

I know your side of the argument and appreciate it, but, when disaster strikes a ‘free at the point of delivery’ system (you get help regardless of financial concerns) is of great comfort. Without this, what is a nation state for? If your country is willing to let you suffer and die without any mercy, then why the hell pay any taxes to it?

I don’t think that was the earful that you were expecting. By the way, I do not work for, or have any other financial interest (apart from being a potential patient) in the NHS.

According to Aristotle, "Politics is a practical science […] concerned with the noble action or happiness of the citizens."  Therefore, once you concern yourself with the well being of fellow citizens you are engaging in politics.  It can’t be avoided.  A local movement dedicated to serving communities first, which is being advocated here (correct?), is a political movement in as much as it must engage the local community power structure.  From the inside out that would be:  the home association (I have one), the PTA, school principal, teachers, the local police, the mayor, the county commissioner, and so on.
It’s true that I have to fix my own financial situation first.  With the information I found here and other places I am trusting that things won’t get better and probably get worse so I am following through on difficult decisions I otherwise could not make.  But after that, when at the next stage of engaging my community, I find that the more people already know about these issues the easier it is for me to talk to people about getting started and organizing.  So when I bring up ideas on how to get the word out and generate awareness I am also asking for help with my community.

BTW as a student of history I find that governments generally have operated with a deliberate and obstinate incompetancy.  These times don’t seem to be any different.

For the gentleman who was saying you would get an earful from the Brits and Canadians,all I can say is"Mate, you re totally wrong!".
Nobody ever said that The NHS was perfect,but it works and it works well.Do You not find it a national disgrace that the richest and most advanced state that the world has ever known cant look after its citizens health needs? If you dont, you should.Watch Sicko,Ive never been so proud to be British and so glad I dont live in the States.

I’ve worked for the federal government for the past 3 years and believe me, you don’t want the federal government as your health care provider. Government has caused the problems we’re having now because our politicians are for sale to the highest bidder. Do you really think they’ll do any better on health care? I’ve heard the old saw about politicians for fifty years, "He may be a crook but he’s our crook". Well, that gives us mostly a bunch of crooks running the country and the majority of the voters in this country are getting exactly what they deserve.

I almost can’t believe what I am reading here.  Chris does a brilliant job of outlining what a foolish and dangerous idea it is to hand over too much control to a central power like the federal government and the general consensus after reading that is to discuss what a great idea it would be to hand over TOTAL control of our healthcare system to the federal government?  Are you serious!!! 
Our government is in WAY over it’s head.  The last thing we want is for a crucial system like healthcare to collapse along with the government when it finally reaches its inevitable gruesome demise.  The best thing we could have to weather that storm is a system of private clinics and non-profit community hospitals like we have now.  Businesses in private ownership will still be there.  I am a dentist by profession and when the time comes I will probably be pulling teeth and draining infections in exchange for chickens.  Nobody is going to keep going to work at the government clinics when there is no money left to pay them.

And it’s pretty hard to compare Canada to the US.  Canada is 1/10 the population of the US and each province regulates its own healthcare.  The people are close enough to the government that they actually have a chance of having their voice heard.  An equivalent system in the US would be for each state / major metro area to have its own system.  I could actually be convinced to go along with something like that. But nobody is proposing that.  I am absolutely certain that a federal system is a BAD idea.

                 "… the moment Chris took a political stance, half the people on the site would leave."
Since my first visit to this site and the Crash Course, I have been struck by the lack of politics displayed by CM and his co-writers. Besides the clarity of the insights found here, the lack of any political tone to the information is a large part of the value of these messages. It’s easy and even tempting to inject politics into all of this, but it would immediately taint the universal value of what’s being expressed here. Politics is of course very present in many of the causes of the problems discussed here, but politics are not necessarily important to the solutions.

There have occasionally been comment threads that have sunk into political back-and-forths, and they quickly become useless and unreadable. I can’t say enough for Chris’ skill at keeping his message as apolitical as possible. 

Jamie A

Regardless of how we choose to participate to effect a change, particularly distressing to me is the recent branding of veterans, Ron Paul supporters, gun owners, etc. (CM enthusiasts?) as potential terrorists!!!
Just where are we heading?  I am very concerned for the direction this country is taking. The politicians and bureaucrats are out of control and anyone with a brain is now going to be called a potential terrorist.  There isn’t one elected official who seems to have a basic understanding of the problems and is willing to step up to the plate.  Except, or course, for Ron Paul (and he’s probably a terrorist).

I’m not saying you should subscribe to Ron Paul’s positions only to point out that someone who does speak out is branded as a nut.

It ain’t lookin’ good folks!

history is branded in the moment with your post now relegated to history. What I’m trying to offer you is the guarantee that change is coming. Some will not be for the good of politicians and, some will not be for the good of us. Time is going to change what we think is the outcome of today, with more variables than even the greatest minds can conjure.

Ron Paul has awoken many, with his voice and reasoning loud and clear. It is fear from the rank and file that set your mind to assume others see him as a terrorist.

As I’m trying to communicate to you, don’t believe that the future is already lost to the stupidity of this government. There are, already, greater movements surfacing and, July 4th is going to be a pleasure to watch what unfolds from it.

People are waking up. Look about you, in this forum, and see how many have a first post?

Welcome to CM.com



I’m late to catch this topic, but I’m also familiar with the military’s socialized health system. It is excellent and I I have personally received top notch care from various providers. But I can’t see it as a workable model on a larger scale. As it is now, any of the payments required for Tricare are basically nominal and I’m sure they can’t cover the entire costs of the program (i.e. it’s subsidized). It seems easy to run socialized medicine when you’ve got the American taxpayer fueling it for a more select group of individiduals (military and their families) but without this support, I don’t see Tricare as a profitable (or even sustainable) business model. Am I missing something?

I have heard that VA care is quite good from the local vets that I know.  I work in health care and truly feel that the idea of profitable healthcare is a fallacy.  There is always someone footing the bill,  it is a game of cost shifting, a shell game.  The new technologies and medicines and other doo dads are just too expensive, especially when the manufactuers need to make a profit and recoup research and development costs in a free market system.  This is just my opinion of course.  What I have seen is that costs get transferred to the taxpayer as hospitals have become more and more reliant on medicare and medicaid entitlements.  This is no judgment again safety net insurance programs, they are a lifesaver in this system. This cost shifting became particularly onerous (in my own experience, an N of one) as managed health care came on the scene.  Hospitals became more and more dependent on patients with state and federal health insurance.  I was told this many times during my work in healthcare and I believe it to be true but cannot give you hard data to back it up.  During the 90’s some of the fanciest hospitals in my area became big medicaid providers whereas in the 80’s they wouldn’t need to do that. 

How the dollars are spent is a whole other issue.  Too many unnecessary people in middle and upper management IMHO. Too much money going to the politicians and the BIG corporations. Maybe we docs make a little too much too but it would help if we got free education like they do in Europe.

I really believe healthcare is a cost and an entitlement. Best we can hope for with that is that we contain costs in a reasonable way, but the free market system has had its downside in that it primarily feeds the large medical corporations at the expense of everyone.  It is way out of balance.

It was great meeting you and everyone else at Lowesville BTW



Hey Mike - (sufficiently recovered from the scotch tasting I presume?)

Tricare could be a good starting model.  One of the biggest issues would be expanding the number participating providers who would accept the lower payments.  Here in Va Beach almost every provider accepts Tricare, no doubt because of the large number of military and retirees.  They take the lower payments and press on knowing they have a huge pool of patients who will always be there.  I had an MRI a few months ago - received a bill for ~$1900, Tricare paid ~$400 (accepted by the provider) and my copay was $14.44.  I think you could make it work - especially if it came down to providing the service at a lower cost, or not having patients recieve the care and the provider not getting any payment.

Another key issue is that the cost of services would have to come way down - as you note, the American taxpayer covers the costs of healthcare for the country’s military members and their families (a fair exchange in my opinion, I’m sure many would disagree, but I’m not going there).  Opening up the service to a national level would require a better defined model of taxpayer-employer-member support to work.  And I would entirely exclude elective procedures such as vanity plastic surgery, medically necessary plastic surgery of course would be fine, but if you want new boobs for the upcoming cruise or high school reunion, pay for them yourself.  Tricare in its current form and function couldn’t support the entire nation, but could certainly be used as a starting point to implement a workable system.

The biggest challenge is that Tricare doesn’t have enough moving parts to satisfy the meddling knuckleheads in DC.

I am reminded of the [possibly apocryphal] assertion that "Pollock jokes" originated from the Nazis’ wholesale murder of the Polish intelligentsia, who loudly decried Hitler’s fascist government.  The "joke" was that the slaughter was so significant that the collective I.Q. of the Polish people was lowered.


[quote=Mike Pilat]
 As it is now, any of the payments required for Tricare are basically nominal and I’m sure they can’t cover the entire costs of the program (i.e. it’s subsidized). It seems easy to run socialized medicine when you’ve got the American taxpayer fueling it for a more select group of individiduals (military and their families) but without this support, I don’t see Tricare as a profitable (or even sustainable) business model. [/quote]

An excellent, and discerning point, Mike.  The two situations are indeed different, both in their sheer size, and the ability to access "outside" funds. 



I have one of the "best" private insurances (except for congress) in my state. I pay extra for supposed "access". I see PA’s and NP’s and not the MD’s. I can get prescriptions as long as they are on the "approved list". Surgeries I can’t comment on because thankfully I haven’t needed any.

The issue is, our entire healthcare system is broken. Kinda like the trains (to get back on track).

In all things, and I mean ALL things, to find who is in charge, "follow the dollar." It will lead you to the real decision makers.

On a side note, ever wonder when we stopped being "citizens" and became "consumers"?



About the same time we started having "clients" instead of "patients", as I recall . . . . .

Isn’t obvious the people telling Obama what to do are the banksters. This government is working for the interest of wallstreet. Obama is just another puppet like Bush.