I wonder what Chris thinks about Belinda?

If you're Canadian and Jewish, you get a movie contract as soon as you step off the airplane.

But then you end up doing commercials for Priceline, right?

I went to Canada on business shortly after 9/11 (once the planes started flying again), and was really moved by the support we were given. As one of my Canadian colleagues said simply, "we're family". And like any family, you can argue around the dinner table and yell at each other, but when the chips are down , you're there.

Some of you are old enough to remember when the Canadian Embassy in Tehran helped some of the Americans escape during the embassy hostage crisis. these were people who'd gotten away or been out when the "youths" took over the US embassy. The Canadians just neatly and efficiently gave 'em Canadian passports and got them the hell out.

Yup. family.

Not so fast, Dean...

About statehood(s) for oil and timber. I'm not sure that big interests in the USA wouldn't move in and make the Canadians offers they couldn't refuse in regard to these matters. But.

We're fairly evenly divided politically in this country in terms of Republican (conservative) vs Democrat (liberal) power balances. Neither party -- which means no US Senate -- would simply start adding new US states without careful political balancing. Republicans could probably count on conservatives from provinces such as Saskatchewan and Alberta. Democrats from provinces such as Ontario and British Columbia. Quebec? Who in hell would want problems with successionist francophones? Even if the culture and they put to shame the bland culture and even blander food of the Anglophone folk.

In sort, we'd find ourselves back in a 21st century version of the Missouri Compromise, the Kansas-Nebraska Act, and all the pre-civil war crap that resulted from these.

Besides. Who ever said the Canadians -- Anglo or French -- want us moving in on them?

But as a tradionalist of sorts, I just wish they'd get rid of that bland maple leaf flag design and put back that great old-time Union Jack with the fruit salad down on one corner. Sort of went along with the Mounties in their red ceremonial uniforms.

(I remember one time I was in Stratford, Ontario for the Shakespeare theatre festival. Before one of the performances, the played "God Save the Queen", and row upon row of us all stood up, including the Yanks, and among them, numerous well-dressed gentlemen in formal wear with their wartime campaign ribbons displayed. All of us stood at attention, as if Elizabeth II were our queen as well as theirs. My heart almost burst with pride at the often-forgotten tought that America has great neighbors of such caliber as these. So may your independence live forever, Canada.)

Arnold Harris
Mount Horeb WI

When I was living in Russia, the Canadian Embassy had us all in for burgers and Molson on Fridays, often until the wee hours. I have a long-standing fondness for them because of that.

You'd be lucky to get into the US Embassy if you had passport and birth certificate in hand and were being chased by armed assassins.

I wonder what Chris thinks about Belinda?

The Conservative Party has two options: un"merge" or die. Belinda isn't Jesus.

Wait 'til the Great White North gets defrosted (end of the century last I heard). You're gonna see a wave of development and immigration in Canada that'll turn it into a major power.

It'll also make it easier for the U.S. to secure and colonize a badly depopulated Siberia.

“You should adopt a system of private insurers and let your citizens choose among them, so you can fire a carrier you don't like and switch to another. But if you guys did that, I might just move there.”

Oh yes, then you can have profit-driven bureaucrats getting in between you and your doctors telling you both how best to manage your healthcare and siphoning off $billions from the system that could actually go to providing, well, healthcare. Then even more of your citizens could move to the border so they could afford they’re prescription drugs (oh sorry, that won’t work for you but we'll still have Mexico) Excellent idea, eh.

Get real! The USA wouldn't stand a chance against Canada.

If the mounties didn't kick yer asses the killer beavers would (they are kept secret from the common man but the Pentagon is completely aware of Canada's Beavers of Mass Destruction).

Failing all that they have their ultimate weapon to fall back on, they can kill you with politeness.

Yeah, shep. Profit seeking "bureaucrats" are so much worse than government bureaucrats. In fact, they're so bad you describe them with a derisive term for government employees.

History has consistently shown that the private sector is a better system than government for delivering services. You can make all the noise you want about why this shouldn't be true and it doesn't change the facts.

Canada: America's Special Ed class...

Shep: Feh! I've talked to enough Canadians who run over the border to get better and more reliable health care in the US, and Canadians who've been screwed over by the government-run bureaucracy--including one who had a brother die as a result of it--that I'm not impressed with your bloviating about "profits."

Competition at least gives people a choice to say "you're fired" when the bureaucracy screws up, rather than waiting for the next elections and hoping enough other people agree with them.

The problem with you lefties here in America is that you haven't figured out one salient fact:

You are today's reactionary right-wingers, with an endless faith in the power of the state, rather than the power of individuals making free choices.

BMDs, Beavers of Mass Destruction. ROFLMAO. Quick, America needs to build a better beaver, possible with dial-a-yield. I think I actually went out with a BMD once.

A while back I had a more-or-less serious discussion about a possible future where chunks of Canada were absorbed into the United States. The key factor was the secession of Quebec, followed by a collective reassessment by the provinces east and/or west of Quebec, and one group or the other (or both) petitioned for admittance to the United States. This all rested on the prediction that the eastern bloc and the western bloc might split once they were no longer geographically contiguous.

A somewhat analogous situation happened with India, Pakistan, and Bangladesh. The British colony of India was partitioned into two countries, India and Pakistan. Pakistan existed as two distinct regions--East Pakistan and West Pakistan--which were not geographically contiguous. To summarize substantially, there were issues, and following a civil war between East and West Pakistan, East Pakistan became its own country, Bangladesh.

I'm not saying that the secession of Quebec would lead to a civil war between East and West Canada, but I think it might lead to the formation of three separate blocs, rather than two. Given the presence of a culturally-similar and powerful neighbor to the south, it's not unreasonable to predict that one or more of those blocs would be drawn into its orbit. However, given that talk of secession in Quebec seems to have subsided for now, this possible future goes back on the shelf.

"Competition at least gives people a choice to say "you're fired" when the bureaucracy screws up, rather than waiting for the next elections and hoping enough other people agree with them."

Dean, I'll choose to fire my doctor if I don't like that service (a choice I probably won't have under your ridiculous free-market system). That's all the competition I (and a successful system) need. That's probably why the Congress voted itself a federally run healthcare system that's often called the best healthcare plan in the world because it allows them real choice of healthcare service. If you weren't so blinded by free-market ideology you'd realize that private insurance LIMITS CHOICE.

Wake up. Not everything that’s good for Aetna is good for America.

And, if you market ideologues had actually spent any time in big business, you’d know that bureaucratic inefficiency is by no means limited to government (don’t you people ever have to deal with corporate "customer service"). The only necessary difference between healthcare delivered by government and a big HMO is that the HMO will typically see conflict of interest where providing optimal healthcare is concerned.

Healthcare schmealthcare. They grow reefer in Canada, thus they are my friend.

I fondly remember the times spent with the Canadian Navy while I was a young Naval Officer. Since the US Navy is dry, we spend many an evening over on the Canadian ships quafting some great beer during our joint training in Esquimalt, BC

Dean, Dean, Dean. Our health care insurance system does not suck.

First of all, of every dollar you pay for healthcare, over 11 cents are spent on overhead to the carrier. For things like, administration and for things like, oh, advertising. In Canada, that figure is 1.3 cents of the dollar. The rest goes for healthcare.

Secondly, because of the vast overhead in dealing with a plethora of regulations for different insurers, your healthcare systems pays three times what ours does on administration.

Thirdly, you guys have what, 40 million or so without ANY coverage? Nice.

And lastly, everyone I know is covered. Everyone. Rich, poor, in-between. All the time. And rates never change, and policies are never dropped.

How many Candians did you say you've talked to who went south for treatment? There are probably some, because that allows for treatment that we may not have yet (you do, after all, have ten times our population), or to jump the lineup for treatment. Which we don't generally allow, as we have a policy of universality. You generally don't get faster treatment if you're richer.

And I hope you guys know--I mean, I hope you really know it in your souls, because it's totally true--if 9/11 had happened in Toronto, Vancouver, Edmonton, or Winnepeg--you have no idea how bad we would have tried to help you hurt those people.

Of course. That's why we immediately helped you guys in every way possible. Stranded travellers were billetted in Canadian homes, we sent rescue teams to the States, Canadian firefighters were out on streetcorners collecting money for the families of your fallen. We sent our navy to the Persian Gulf (it's small but wirey), and we sent troops to kick Taliban butt. Including our super-secret anti-terrorist force, and our deadly sniper guys. You may remember their presence, some of your guys accidentally bombed some of them(sad, but no hard feelings, these things happen in wars).

Reasons why I like Canada: hockey, Toronto, the "Windsor Ballet"(if you're a Detroiter you know what this means, ha ha ha), Labatts, Molson, SCTV, the CBC, Don Cherry, Barenaked Ladies, and Sarah McLachlan. Canada, you're an excellent neighbor! Thanks for putting up with us.

Hey Stu? You're in denial about the flaws in the Canadian health care system.

First off, you're able to spend more of your GDP on it--after all, someone else (ahem) is paying for most of your national defense needs.

Second, the great myth of America is that there are people who are going without health care. This is simply a lie. There is no one in America going without basic health care who wants it. A plethora of city, municipal, county, and state-run health care clinics provide immunizations and emergency health care to anyone who needs it, regardless of income.

Thus the great lie of the "uninsured" American--yes, many are without "insurance." But any American can walk into any Emergency Room in America and receive emergency treatment no-questions-asked, and free health clinics exist all over the place for anyone who needs more than emergency care.

In the meantime, your "single payer" system routinely has people waiting 6-9 months for treatments that you can get on-demand here in the states. Which is why numerous health-care clinics here in the states cater almost entirely to Canadians who want to run across the border to pay for health care they might wait months to get up there in Canadia.

Oh, and by the way? I've met Canadians with relatives who died waiting for your all-benevolent single-payer system to pay for tests that any decent private insurance carrier here in the states would have paid for no-questions-asked.

Let's not even talk about which nation, on a per-capita basis, has the least waiting lines for care, or produces more of the world's lifesaving drugs.

Your single-payer system is a cheap, shoddy compromise: everyone gets the same level of mediocre service. Thanks but no thanks. You can brag all you want about your cheap prescription drugs. In the meantime, I know more than one doctor here in the states who left Canada because he couldn't make a decent living up there, and have met more than one Canadian who fled south to the states to pay for care he would have been on a waiting list to get up there.

You guys need competition in your health care system if you're going to really modernize. Meanwhile, we have other byzantine stupidities of our own down here. But I'll still take my HMO over your single-payer system any day of the week.

Hey Shep?

I've met Canadians with relatives who died waiting on the Canadian Single Payer system. Call me a "market ideologue" if you want--I call you merely a Big Brother ideologue in response.

Under Single Payer, the government decides what it will cover and what it won't. Under a competitive system, you decide what carrier you want, based on what you want to see covered and what you don't care about.

What the hell's your beef anyway? Guys like Bill Bradley and Howard Dean and Hillary Clinton have proposed systems more or less exactly as I describe. Are they "market ideologues?"

At least with what I'm proposing, the individual has the power to say, "You people are screwing me over, you're fired, I'm going to someone else!"

In true Single Payer, you have no such option except to vote next time and hope the politicians make the right choices for you. No, thanks, I'd rather have the choice, the individual power to say, "You people are not meeting my needs, I'm going elsewhere."

What's so ideological about that?

The trouble with having Canadian relatives is that sometimes when they come to your house to visit, they forget that you are an american. They sometimes continue to speak in the traditional instinctive anti-US manner, never suspecting for a moment that you might be offended.

Set the ground rules. When I visit your house in Canada, I will understand when you criticize the US that it is nothing personal. But when you visit my house in the US, I might not understand so well. Getting along with relatives from other cultures is so demanding.
:^)

First off, you're able to spend more of your GDP on it--after all, someone else (ahem) is paying for most of your national defense needs.

Are you? How much? And defense against who?

"...any American can walk into any Emergency Room in America and receive emergency treatment no-questions-asked, and free health clinics exist all over the place for anyone who needs more than emergency care."

Then why does anyone buy health insurance?

"In the meantime, your "single payer" system routinely has people waiting 6-9 months for treatments that you can get on-demand here in the states."

Everyone can get this treatment on-demand? Or just some?

"I've met Canadians with relatives who died waiting for your all-benevolent single-payer system to pay for tests that any decent private insurance carrier here in the states would have paid for no-questions-asked."

And if they had no insurance? Would your non-covered individual have the tests paid for?

I've worked on healthcare-managed software designed to work in both the US system and the Canadian system. We had to have an expert system created just to inform doctors what treatments would be available to treat different illnesses, based on their insurance carrier. That. Sucks.

But hey, stay with that system if you're happy with it.

Set the ground rules. When I visit your house in Canada, I will understand when you criticize the US that it is nothing personal.

Thoughful, and very polite. When we have American friends or relatives visit, we murmer over and over "Don't mention the war. Don't mention the California gubernatorial. Don't call Bush a moron."

Gets tiring, but we are generally considered to be polite, and we try to live up to it.

Are you? How much? And defense against who?

Funny how a Canadian would even ask such a question, given that on an everyday basis, you guys don't even have to ask it because someone else is worrying about it for you.

You're welcome.

Then why does anyone buy health insurance?

Because health insurance is for needs beyond the basics, that's why, sport.

Come on down here to these primitive 50-nifty state,s and I'll show you where you get free care for all the basics.

Everyone can get this treatment on-demand? Or just some?

Everyone gets the same basic treatment here. Those who can pay for better, get better.

We have that option. You don't.

Oh, except you do. You just run south if you can afford it.

And if they had no insurance? Would your non-covered individual have the tests paid for?

Whatever he could afford. Or pay the insurance fees for.

Waiting lists for basic "equal" care, or the ability to pay for extra if you need it.

I can live with that. So do you guys, though you don't want to admit it. Those of you with more come on down here--too bad you can't just admit it.

But hey, stay with that system if you're happy with it.

Our system is, in my mind, considerably better than yours on the whole, but its most fundamental problem is its byzantine and elaborate nature. It's more complicated than it needs to be---mostly due to government regulation, I might add.

I mean, it's still better. Most of North America's best clinics are in the states. Most of the most lifesaving drugs are produced in the states. Doctors make more money and are treated with more respect here.

But our system is too elaborate, too byzantine. Which I've already said about 8,000 times in this thread.

My view of the best compromise system is one in which all Americans can choose from a list of insurance carriers. If you can afford it, you pay for it, if you can't, then the government subsidizes it. Thus you have the ability to say, "you guys suck, I'm switching to another provider."

Which is a nice compromise between the Canadian system (in which people sick of inferior care can flee to America for better), and the American system (wherein you have to deal with an obscene amount of paperwork in a ridiculously multi-tiered system).

Funny how a Canadian would even ask such a question, given that on an everyday basis, you guys don't even have to ask it because someone else is worrying about it for you.

If I were ungenerous, I'd say you gave this reply because you're not sure if you are or not. But I'm serious. How much are you spending on our defense, and why? And against who? Please don't say terrorists, we've already been nailed by them, and you haven't done anything about it yet.

Come on down here to these primitive 50-nifty state,s and I'll show you where you get free care for all the basics.

I haven't said anything to imply that I think your healthcare system is primitive, or that the US is.

Point is, I don't want to live in a multi-tier healthcare system. That leads to abandonment of the lower end, while the upper end who can pay for it receive great care, and think that everyone is.

If someone implements the system you suggest, we'll see how it works. I'm pretty familiar with the level of care here, and it's excellent.

Shep: who do you think pays the R&D on your "cheap" drugs and medical technology? We do.

I posted a piece from today's SF Chronicle that explains why US cities and states bulk-buying drugs in Canada will produce price increases for both consumers and shortages for Canadians.

I can go to any doctor, specalist or hospital I choose with my plan...no reviews or approvals required...my carrier is not a HMO.

I choose to bear part of the costs for the best plan. It's called choice.

Point is, I don't want to live in a multi-tier healthcare system. That leads to abandonment of the lower end, while the upper end who can pay for it receive great care, and think that everyone is.

...which is, of course, a lie, because nowhere in the American system is there any "abandonment" of the lower end, as I've already explained to you.

Nor is there any mythical Canadian system in which all people get equal treatment, because of course you folks who want and can afford better flee to the freedom-based American system.

So do an awful lot of your doctors. Wonder why that is? Think it's because they find the grass greener over here? Hmm.....

How much are you spending on our defense, and why? And against who?

Last I read, several tens of billions of American dollars annually to protect you against the Communist menace until it was defeated, and since then, against nuclear strikes from potentially belligerent strikes from the likes of North Korea, and from potentially nuclear powers that, through our action, have wound up not possessing nuclear weapons.

Sure, we pacified the Soviets for you. And before that, we pacified the Japanese Empire, and the Third Reich. Sure, we entered defense treaties with you--more than one--in which NORAD would protect you from any other possible threats.

But there you sit in the comfort of your home, snottily snearing at the protection you've been afforded your entire life, and demand that I provide a list of threats to you--most of which you should know, and most of which no one will know simply because we are here.

Christ. I won't bother to say "you're welcome," since I suppose you would consider that "arrogant."

You know, it rather disgusts me that I started this thread as an effort to pay tribute to our Canadian brothers, and pay my respects to a country I've always respect and admired, only to have a Canadian bigot spit on America and its ideas and ideals simply because it's not the same as Canada.

That's rather remarkable, ain't it?

Dean,

I lived in Canada (New Brunswick) for 19 months and I would disagree that Canada is 95% the same as our culture. There is in fact no single Canadian culture. Just like Southerners differ greatly from New Englanders.

Canadian culture overall is a blending of American, British, and French cultures, heavily spiced with accomodations to the natural climate.

Across Canada, you have the culture of the western provinces, the culture of Ontario, the culture of Quebec, the maritime culture, and the culture of Newfoundland. Up north, you have the culture of the indigenous peoples.

Maritime culture is hostile to America in many ways. The French/Quebec culture is more ideologically close to France proper. Also, Canadians are more genetically homogeneous than Americans. They prefer more centralized control overall. The western provinces are most like America, but really most like the Western Mountain States culture than other American cultures.

Many, but by no means all, Canadians are also resentful that they are effectively ignored by the USA. When I lived there, American TV and American news was pervasive. They resented that there was so little news about Canada in our American broadcasts, while fully 1/3 to 1/2 of news in Canadian papers and on Canadian broadcasts is about America.

Also, the English speaking Canadians resent the French Canadians. This is because the way their government is set up, the French Canadians have undue influence. The English speaking Canadians feel as though they are held hostage to French Canadians demands. (Example: All Canadians are required to learn French, but French Canadians are not required to learn English - at least this was the case in 1979, '80, and '81.)

By in large, having lived there, I would accept the western provinces as part of the USA if they wanted to be Americans - including Ontarians. You couldn't pay me to have Quebec or Northern New Brunswick as part of America. And the Maritime (and Newfoundland) provinces would be more comfortable reverting back to British rule.

But this will not happen, because Canadians enjoy having a distinct identity from Americans. They get to enjoy the benefits of our culture without incurring the "world leader" responsibilities we have. They would rather pass on those.

They snuggle under the protective blanket of American security without incurring the cost. In this way, they are like the Europeans. But in other very important ways, they are truly North American, not European. They are much more independent minded, having decended from the same type of immigrant stock that Americans have. Also, unlike continental Europeans, their legal system is based on English Common Law, just like ours.

So, Canadian culture is not 95% like American culture, even if it appears so at first glance. Living among Canadians for 19 months disabused me of my misconceptions about the cultural similarity. They like Americans generally, but also do not want to be confused with Americans. They are proudly and distinctly Canadian, as they should be.

Oh, by the way. When I lived in Canada, I needed an operation on a ganglian cyst in my wrist. It caused excruciating pain. I had to wait three months for the outpatient surgery to be performed.

The problem with our healthcare system can be summed up by looking at how Construction contracts are administered vs. the health care industry.

In healthcare, if I go to the emergency room, I get a bill from the hospital, a bill from the doctor, another bill from any specialist that is consulted, a seperate bill from the radiologist, a seperate bill from the lab, and then I go to the pharmacy to get my prescriptions filled. So one visit to the Emergency Room nets me 5-6 different bills. I have to fight with my insurance company because even though the hospital is on the preferred provider list, the doctors, the labs, and the pharmacist might not be. Then the insurance company slow-pays the bills, and I am forced to intercede to make sure bills ultimately get paid.

Contrast that with the Construction Industry. I hire a General Contractor to build my house. He in turn hires earth movers, foundation specialists, framers, plumbers, air conditioning contractors, electricians, alarm installers, sheet rockers, cabinet makers, floor tile layers, carpet layers, painters, masons, roofers, carpenters, wallpaper hangers, etc. to get the house built. I pay one person. He pays everyone else, has the incentive to hold down prices in order to ensure his own profitablity, and still be able to offer his services at a competitive rate.

Right now, in the health care business, every entity is independent and the patient is stuck with trying to become an expert in a field which is foreign to his experience while simultaneously in pain or trama. This is ridiculous.

The solution is to force a situation where doctors, or hospitals in effect become "general contractors" of medicine. There is nothing in the law that precludes me from hiring subcontractors directly, but most people, not being experts, will pay an expert premium to the general contractor to handle the details.

HMO's and PPO's was the insurance companies' efforts to become that general contractor. But the public rejected this because they were not experts in health, only experts in money. It is past time to demand that hospitals and/or general care physicians become "full service" suppliers of medicine. Then the market forces can act correctly to hold down rising costs.

Shep,

You said "And, if you market ideologues had actually spent any time in big business, you’d know that bureaucratic inefficiency is by no means limited to government (don’t you people ever have to deal with corporate "customer service")."

First you claim we're ideologues, implying our position is spurious despite an entire body of historical economic data to the contrary. Then you imply we have no knowledge of business despite the fact that socialists tend to work for government or related institutions and free market supporters tend to work for private firms. Then you create a strawman by claiming we believe inefficiency is limited to government.

That's a quick 0-3 in one paragraph.

And lastly, I can't believe anyone would claim we have a free market system. We have a system riddled with government interference from start to finish. The lack of choice in our system is a direct result of involving employers in an attempt by the economic illiterates in congeress to get something for nothing. Thanks to them, we don't have the optimal two parties in our system, we have five.

Canada? Whats that?

...Canadian bigot spit on America and its ideas and ideals simply because it's not the same as Canada.

Dean! Whoa man! "Bigot"? Where? Where did I do any of this? "Spit on America?" C'mon, read the stuff again. You said we had a crappy healthcare system, and I said we didn't. That's it. That isn't spitting on America.

Y'know, it's tough discussing issues like this with you guys sometimes. I don't know if it's because of national pride, or what, but hint at critisism of America, and you get this kind of reaction. I'm not even critising, fercrissake, I'm trying to figgin' defend a component of our country that I think you slagged without knowing all the facts. Did I call you an anti-Canadian bigot because of that? Sheesh.

At the risk of pissing you off some more, I checked, and we spend considerably less of our GDP on health care than the US does, around 10% to your 14%. Our infant mortality rate is significantly lower than years, and our life expectancy is considerably higher, and increasing at a faster rate than the US's. I know that other factors can contribute to this than a better healthcare system, but take it for what you will.

We spend less of our GDP on the military than you do, but we don't have nukes. By choice. As do many other nations that haven't been invaded yet. If you feel that your nation is owed thanks for our defense, then let me say, sincerly, thank you. For the record, we were involved in both WWII, the cold war, and the Korean war. We suffered a much higher casualty rate than US troops did, but yeah, without you guys and your sacrifices, the allies would have lost, plain and simple. So again, thanks.

And I thought Dean had a hair-trigger temper...

Canada can't be that all bad. They do have some really good hockey teams. And

There's a lot of people in the USA, including
real States of this Union looking for better priced prescription drugs. Apparently,some prescription drugs in USA have prices approved by or/and condoned by congressional and senatorial persons (unnamed) who have private interest group supporters that have f'd over the american buyer.

God bless Canada.....

Did you know that Canada has a warship?

Really.

What I like about Canada:

1) The French language. The most beautiful language in the world. France was once a great country. May she be so again someday.

2) Women's rights: Several years ago, they passed a Politically Incorrect law banning the hideous, loathsome, despicable practice known as female genital mutilation. And that's _all_ I want to say or think about _that_.

3) Homosexual rights: Homosexual marriage is becoming a reality there, and at the very least, civil unions. No "sodomy" laws. Up there, their Borks, Scalias, and Santorums are justly slapped down by their Conservative party instead of canonized as they are here.

What I don't like about Canada:

1) It's too cold up there for me.

2) Socialized medicine: What Dean said. And... "The forgotten man of socialized medicine: the doctor" -Ayn Rand

2) Censorship vs. free speech: I despise Ernst Zundel and he can goose-step off a cliff, but I will still defend his right to vomit his excrement -- and my right to call it that.

3) Gun control vs. the right to keep and bear arms: You are not truly free unless you have the freedom to defend your freedom, the freedom to speak the only language tyrants understand. Better to have a gun and not need it than to need it and not have it.

But I thought there was widespread gun ownership in Canada?

(I'm serious this time)

1) It's too cold up there for me.

Is not. Had to take off my fleece today, I worked up a sweat. No snow, and I bike cummute to work each day. We had a day or two of snow a few weeks ago...

2) Socialized medicine: What Dean said. And... "The forgotten man of socialized medicine: the doctor" -Ayn Rand

Um, afraid to even read this point.

2) Censorship vs. free speech: I despise Ernst Zundel and he can goose-step off a cliff, but I will still defend his right to vomit his excrement -- and my right to call it that.

Completely agree with you. Let him wallow in his own crupulance, no need for the state or the judiciary to step in. BTW, did you know you had two number 2 points?

3) Gun control vs. the right to keep and bear arms: You are not truly free unless you have the freedom to defend your freedom, the freedom to speak the only language tyrants understand. Better to have a gun and not need it than to need it and not have it.

Another touchy point with Americans, so let me tread carefully here - you will have to pry the gun control legislation from our cold, dead hands.

Re: the warship. Hey, no fair, we have a bunch of 'em. Not big ones like yours, but then again, we're completely landlocked, so where would they dock?

Casey - guns, yes, especially in the north where you need to shoot things to eat. Few handguns, because they're basically for shooting people, which is against the law. And a way-too-expensive gun registry system that needs to be fixed (not eliminated).

I think we're mostly happy about the gun-control thing. My kids go to school in the roughest part of Vancouver, and I never have to worry about firearms. Some of the gangs may have some, but there are really very few available. Our homicide rate is way below yours, as are any kind of gun-related crimes (not dissing the US, just saying so).

Sorry about the 2 number 2's. Never was good at math.

Casey Tompkins:
Is there widespread gun ownership in Canada? Wasn't sure. But -- good! I hope so.

Actually, I should have entitled my last points "What I like about the U.S.A.". The True North Strong and Free. And: The Land of the Free and the Home of the Brave. Let's keep it that way!

Are there a lot of gay people in Canada? I like gay people, they always smell good.

Stu,

"...you will have to pry the gun control legislation from our cold, dead hands."

I really hope the irony in that statement was intended, because it was beautiful. By the way, in many situations, shooting people is against the law down here, too. Not in all cases, thank goodness.

Wow, I go to work and 8 hours later I come back and this thread has exploded! There's problems with both healthcare systems. Some people prefer the centralized system, even if they have to wait 1+ years for an MRI. Thank God we have "Michigan MRI". They play those commercials all over the Canadian stations. If USA wasn't there, probably the Canadian healthcare system would seem alot worse (without Michigan MRI). As it stands today though, I can't imagine anyone abolishing it for any reason. Until something dramatic happens in the USA, Canadians generally don't have much to worry about.

Sure, there's the odd sibling rivalry going on, but who's counting?

Also, I wasn't a reader here back in November 2002 but I read your article just now and thought it was great!

I should also mention that the only time I've ever heard the term "Hoser" is in stereotype-Canada satire things.

"Canada rules. It really does. I don't want you guys' health system though. You should adopt a system of private insurers and let your citizens choose among them, so you can fire a carrier you don't like and switch to another."

And they should get rid of their politically correct censorship laws, and they should legalize self-defense, and maybe get over their silly anti-death penalty kick, and, and...

Stu, you ever hear of a little place called Vancouver? How about the Maritime provinces? Or do you just have a really odd definition of "landlocked?"

Are there a lot of gay people in Canada?

Vancouver.

But then you end up doing commercials for Priceline, right?

Hey, at least he's working. :)

I needed an operation on a ganglian cyst in my wrist. It caused excruciating pain. I had to wait three months for the outpatient surgery to be performed.

One of my co-workers just developed one of those. She had the surgery 4 days after she got the diagnosis. She could have had it the next day, but she wanted to make arrangements to take time off work first. Her total out of pocket cost was the $20 "co-pay" for the initial office visit.

In healthcare, if I go to the emergency room, I get a bill from the hospital, a bill from the doctor, another bill from any specialist that is consulted, a seperate bill from the radiologist, a seperate bill from the lab, and then I go to the pharmacy to get my prescriptions filled. So one visit to the Emergency Room nets me 5-6 different bills. I have to fight with my insurance company because even though the hospital is on the preferred provider list, the doctors, the labs, and the pharmacist might not be. Then the insurance company slow-pays the bills, and I am forced to intercede to make sure bills ultimately get paid.

You need a better insurance company. If I go to the emergency room, I get a bill for $50, which I pay. All other bills go directly to my insurance carrier, and how soon those bills get paid is a matter between the provider and the insurance company, not my concern.

And I only pay the $50 if I go to the ER without talking to my doctor on the phone first. If he instructs me to go to the ER, I pay nothing.

HMO's and PPO's was the insurance companies' efforts to become that general contractor. But the public rejected this because they were not experts in health, only experts in money.

That turns out not to be the case. There are bad HMOs, and good ones. I've been in the same HMO since 1981 and I am very happy with it.

I like gay people, they always smell good.

You probably don't know so many gay people as I do then. :)

"1) It's too cold up there for me.

Is not. Had to take off my fleece today, I worked up a sweat. No snow, and I bike cummute to work each day. We had a day or two of snow a few weeks ago..."

Actually, it's too cold up _here_ for me! I used to live in (usually) sunny California, where we didn't have any snow, ever. Due to various circumstances, I moved up here to Washington (the state, not the Death Star). At least I'm not living on the Hayward Fault anymore.

Gary,

It's not fair if they are gay hippies. Are the ones you know hippies? That would account for it.

"You know, it rather disgusts me that I started this thread as an effort to pay tribute to our Canadian brothers, and pay my respects to a country I've always respect and admired, only to have a Canadian bigot spit on America and its ideas and ideals simply because it's not the same as Canada."

I'm glad you spoke up, Stu, because I didn't read any of this in your writing at all either. I thought there was an intelligent discussion going on here and then it suddenly exploded into name calling. I'm Canadian and don't actually know much about healthcare (ours or America's) and was reading this discussion with great interest until that comment above. Dean, I hope you try to re-read Stu's words and calm the anger down a bit.

(You did kind of mess up a bit with the issue of "landlocked" though, Stu, but I got a chuckle out of it. Now, a Saskatoon-based warship would be another issue entirely.)

Oh, and Cheekysquirrel, Beavers of Mass Destruction was priceless.

Sorry about the landlocked thing, I do live in Vancouver and splash about in the saltchuck - I was making an obscure reference to a bit on Mercer's "Talking to Americans", where he was asking people if they minded Canada's navy using American ports, as Canada was, you know, landlocked. Almost everyone he talked to smiled and said "Sure, that would be fine."

You gotta love Americans - generous and friendly folk. Even if you talk to the most rabid anti-American, they'll admit Americans are the nicest people in the world, once you get it clear that you aren't talking about the government.

I worked in an emergency room at an American hospital for a while a few years back, and I can verify that, indeed, by law, they are not able to turn down ANYONE that comes walking in the door. Frequently someone would walk in who was obvious homeless and high on drugs and had not a penny on him, and we had to treat him anyway. The doctors had a kind of love-hate relationship with this law, because it cost the hospital insane amounts of money every year, but on the other hand they couldn't in good conscience turn those people away, either...

Anytime you're in America and you have any kind of illness whatsoever, even a simple cold, just walk into the emergency room of a nearby hospital and they'll help you out, no questions asked. Actually, that's not entirely "no" questions asked, because if you're wearing, say, an evening gown and a diamond necklace, they're probably going to suspect you're lying to them about the completely-broke-and-cannot-pay-my-bill thing.

And as to the comment that, for every dollar we spend on a doctor's visit, 11% of that goes to the insurance carrier? Well, for every dollar that we spend on taxes, 38% goes to paying government bureaucrats. So private ownership STILL beats out government control anyway. And if government regulation of the medical field were to decrease, that 11% would probably drop with the amount of paperwork that had to be processed.

I wonder why people still believe that the South of the US is somehow significantly culturally different from, say, New York? I've visited 47/50 states and have seen no significant differences. I don't live on a ranch or own horses or wear cowboy boots. Dallas is just like any other city: big and dirty and covered in cement and smog and old bubblegum. The only tumbleweeds I've ever seen have been on Looney Tunes. People from the North always seem surprised to hear this, too.

I think as intranational communication is increasing, little regional differences like that are disappearing. I mean, my grandparents live out on a farm in East Texas and speak a pronounced country dialect, but no one else I know under the age of, say, 40 does... Is the same true of Canada?

I live in BC, the westernmost province. I don't notice much difference in accents until you hit Quebec. The Quebecois have quite an accent, speaking French and all, and Maritimers have a distinct accent. Especially Newfoundlanders. And there's a distinctly aboriginal accent in the north, even among non-aboriginals.

By the way, while I understand that even the uninsured can receive some treatment, I was responding to Dean's statement that he's heard of people dying while waiting for treatment in Canada. I was trying to point out that probably a lot more die in the US because they can't get treatment that isn't provided because they're uninsured. His statement was:

I've met Canadians with relatives who died waiting for your all-benevolent single-payer system to pay for tests that any decent private insurance carrier here in the states would have paid for no-questions-asked.

... the key phrase being "any decent private insurance carrier". If you don't have one, the implication is that the patient waiting for the test dies. So I don't get why this argument can be used as a condemnation of the Canadian system.

I live in a rural town about 2 hours north of Toronto, and I can tell you that there is a difference in accents between the two places (Toronto and my town, I mean). It's not a huge difference, but it's there.

When I went to Hull, Quebec (right on the Ontario/Quebec border) for a week, I found that everyone could speak English absolutely perfectly to the point that there wasn't even a noticeable accent change. But when I went to Montreal for a week, barely anyone could speak English very well. In fact, I met someone from France while I was there, and she said that Montreal was "more French than France", noting that France stop-signs say "STOP" on them and Montreal signs say "ARRET". (This is just what she claimed, I actually don't know whether France really has "STOP" on their signs.)

Actually, yeah, in France the stop signs say "STOP" in English. Go figure, that.

When I lived in Quebec, I had a francophone girlfriend who didn't speak much English. She was from a family of PQuists (Quebec seperatists), but even she shuddered when I tried to order "un chien chaud" one time.

"Don't say that, it makes you look like a tourist," she said.
"How do I ask for it then?" I asked.
"Un 'ot dog."

Ah, okay then.

“I've met Canadians with relatives who died waiting on the Canadian Single Payer system. Call me a "market ideologue" if you want--I call you merely a Big Brother ideologue in response.”

Lots of people die here too, Dean. Sometimes it’s because of a medication, test or procedure denied by an insurance company or HMO and sometimes just because they got bad care from a “free-market” provider. People also wait a long time for non-elective procedures – and you (as usual) started the personal aspersion (“bloviating”?).

“Under Single Payer, the government decides what it will cover and what it won't. Under a competitive system, you decide what carrier you want, based on what you want to see covered and what you don't care about.

At least with what I'm proposing, the individual has the power to say, "You people are screwing me over, you're fired, I'm going to someone else!"

In true Single Payer, you have no such option except to vote next time and hope the politicians make the right choices for you. No, thanks, I'd rather have the choice, the individual power to say, "You people are not meeting my needs, I'm going elsewhere."

In the present system a corporation decides what it will cover. Like I said, they have what in healthcare delivery is often a competing interest: to keep the customer while profiting from the transaction. They negotiate fees to keep profits up, government will do it to keep costs down. I happen to think that with something as big as national healthcare, four years is a pretty good time frame to judge whether the balance is right and, If not, make adjustments at the ballot box.

And you’re competition paradigm claim is bullshit. Most people who have insurance have no choice but to go with their employer’s plan or choose between two of them, at best. Those that don’t have increasingly limited choice of who they can go to when they need help, often public hospitals which are the last places you would want to deliver the sort of care they need (unless of course, they now need an expensive emergency procedure that could have been avoided if they only had access to decent primary care). Regardless, why would you want to fill up ERs with people with the flu or sinus infections – that’s just stupid and we all pay for it!

“What the hell's your beef anyway? Guys like Bill Bradley and Howard Dean and Hillary Clinton have proposed systems more or less exactly as I describe. Are they "market ideologues?"”

No they’re politicians who don’t want to take on the insurance industry, the pharmaceutical industry and the AMA, all at once. Otherwise, they’d tell you that it’s crazy having a profit motive involved in delivering your healthcare (other than a direct provider’s profit), that the only way to get true market competition, long-view heath care that emphasizes (and pays for) preventative and early-intervention health maintenance, and the lowest cost system for ratepayers and taxpayers is a single-payer, government managed system.

“What's so ideological about that?”

Your belief that private insurance industry is necessary to a competitive national healthcare system is obviously premised on the belief that a private-sector solution is necessarily better than a government one. That’s an ideology.

I have the choice of going to any doctor I wish. There's plenty of choice. If I don't like my current doctor, I just won't go to him again. I'll go to a different doctor of my choosing. If I show my health card, the gov't pays the bill. If I don't show my health card, I pay the bill.

Shep: the "ideology" that private-sector solutions are better than government ones (for any given problem set; even Libertarian Commandos rarely suggest that national defense be privatised) in the health field can be... tested against the various actual systems used all over the world.

Dean appears to be using both experiential evidence and deduction from premises about the nature of government enterprise vs. private enterprise to make his case. Only the latter could even approach ideology... and the case against non-competitive non-accountable centrally controlled systems being less efficient has been so strong as to be ironclad since at least the 40s. Hayek was right.

(On another note, not specifically directed at you, since I don't remember who said it and I'm too lazy to search the comments for it, it appears that some people are upset about private healthcare systems because rich people get better care. The reason I find this amusing is the tacit assumption on their part that if only the rich didn't get better care, the poor would (ie, that the amount of healthcare is zero-sum). This is patently false; not only do the rich not make care scarce for the poor, but rich people paying for new drugs and treatments make them cheaper in the long run. What starts out as an expensive luxury only becomes a cheap commonplace if the rich exist to buy it and increase production because of their demand. But we're back to Hayek here, again.)

Sigivald,

Excellent point. You can tell a socialist because he's more concerned that someone has too much rather than that someone makes too little.

Sigivald: if private-sector healthcare solutions were better than public ones, wouldn't they be (a) cheaper and (b) keeping you alive longer? That would be the most definitive subjective test that I can think of. Everything else is opinion.

Just a quick comment on the defense umbrella of America. Who do you think assures the relative safety of the seas? All of them. Although piracy does still exist, it does not interfere with global commerce in any significant way. Last I heard, we weren't receiving a check from any country to assist in this endeavor. It is really a shame, as Canada once had one of the finest navies in the world.

Tacitus has something on the whole healthcare thing today...

“the "ideology" that private-sector solutions are better than government ones (for any given problem set; even Libertarian Commandos rarely suggest that national defense be privatised) in the health field can be... tested against the various actual systems used all over the world.”

Sigivald, the fact that our system is unique among developed nations (as well as the many confounding variables) makes a comparison difficult but it should also give you a clue. And I would say the empirical data cements the case in favor of government-run. Why should national defense not be privately managed and national health care should?

“Dean appears to be using both experiential evidence and deduction from premises about the nature of government enterprise vs. private enterprise to make his case. Only the latter could even approach ideology... and the case against non-competitive non-accountable centrally controlled systems being less efficient has been so strong as to be ironclad since at least the 40s.”

I saw it as using anecdotal evidence and a tortured explanation of why a private insurance-based system is more competitive. Dean also telegraphed his ideological bias (no secret, BTW) against government solutions (as you appear to do as well) by missing my point: The competition that matters in a healthcare system is the competition between heath care providers who are actually delivering services to customers. The best way to get there is free access to as universal a pool of providers as possible. That is an anathema to insurers who try to limit choice (and competition) as a way to reduce costs and maximize profits. And how does putting a third party between customers and services please Hayek?

The moral and practical imperative is to get everyone into a system so that 1) no one suffers without reasonable access medical care, 2) competition among health care providers is as wide as possible, 3) costs are pooled as widely as possible and 4) the native incentive in the system is to reduce total long-term costs by providing the most effective healthcare possible.

Shep

"The competition that matters in a healthcare system is the competition between heath care providers who are actually delivering services to customers."

This would be an important facet if it actually ocurred. Since single payer formulas include price caps or unilateral fees, how can you pretend there is competition?

Stu,

That's a great idea. Now all we need it to implement a free market system in America and we can have your test.

Don't hurt yourself pattin' yerself on the back, Karen. The US Navy works for the United States.

Their operations merely have the pleasant (to the rest of the world) side effect of a Pax Americana for oceanic travel. :)

Stu/Shep what are Canadians going to do when American drug companies stop offering their products in Canada? I ask because between your convoluted drug procurement system (where both the federal and provincial government try to fix drug prices), and the upswing in Americans buying drugs in Canada (which Canada is doing nothing to stop), those drug companies are going to stop offering their goods to Canada. In 2002 only 2/3rds of the new drugs released in America appeared in Canada, and the trend is to even fewer new products heading to the Canadian market.

http://www.nationalreview.com/comment/pipes200310240953.asp
(drug shortages and lack on new drugs)

http://www.csmonitor.com/2002/0828/p01s04-wogi.html (Canada's low number of doctors)

http://right-thinking.com/comments.php?id=P740_0_1_0_C (Canadian government determines how long you wait for care)

http://right-thinking.com/comments.php?id=P145_0_1_0_C (more than half of Canada's doctors are imports, and diagnostic equipment is lacking in many hospitals)

This does not sound a like a terribly effective, or safe, health care system to use. Maybe this is why so many Canadians come to America's 'inferior' health care system.

"And you’re competition paradigm claim is bullshit. Most people who have insurance have no choice but to go with their employer’s plan or choose between two of them, at best."

Yeah, that's a problem. We don't need to nationalize the whole shebang to fix it, though; we'd get much better results if we stopped the laws and tax quirks that encourages people to get their health insurance from the company store.

"No they’re politicians who don’t want to take on the insurance industry, the pharmaceutical industry and the AMA, all at once. Otherwise, they’d tell you that it’s crazy having a profit motive involved in delivering your healthcare"

No crazier than having a profit motive involved in delivering your food, your cars, or your computers.

"that the only way to get true market competition, long-view heath care that emphasizes (and pays for) preventative and early-intervention health maintenance, and the lowest cost system for ratepayers and taxpayers is a single-payer, government managed system."

Having an insurance compnay or government bureau aying for preventative and early-intervention health maintenance is not the way to ensure that the most effective prevention is actually done. What we need is for insurance companies to be allowed to charge based on risk; then they'd give discounts for people who got preventative and early-intervention health maintenance that actually produced a cost savings; those discounts in turn would induce the individual to pay for that preventative and early-intervention health maintenance out of his own pocket if, and only if, the cost savings and general health improvement was actually worth the upfront cost.

Mark Wickens has some beautiful pictures of country and city in Canada.
http://wickens.ca/

Eric says:

"This does not sound a like a terribly effective, or safe, health care system to use. Maybe this is why so many Canadians come to America's 'inferior' health care system."

This is a myth. Here's a reprint of an article from Health Affairs called "Phantoms in the Snow". And here are the figures:

Our telephone survey of likely U.S. providers of wait-listed services such as advanced imaging and eye procedures strongly suggested that very few Canadians sought care for these services south of the border. Relative to the large volume of these procedures provided to Canadians within adjacent provinces, the numbers are almost undetectable.
...
These findings from U.S. data are supported by responses to a large population-based health survey, the NPHS, in Canada undertaken during our study period (1996). As noted above, 0.5 percent of respondents indicated that they had received health care in the United States in the prior year, but only 0.11 percent (20 of 18,000 respondents) said that they had gone there for the purpose of obtaining any type of health care, whether or not covered by the public plans.

Hardly a flood of Canadians seeking to benefit from a superior health system.

"'The competition that matters in a healthcare system is the competition between heath care providers who are actually delivering services to customers.'

This would be an important facet if it actually ocurred. Since single payer formulas include price caps or unilateral fees, how can you pretend there is competition?"

mj, there are as many ways to design the single-payer system as there are dumb reasons why private insurance companies are necessary to create market forces. Besides, price caps don't prevent healthcare providers from finding cheaper ways to deliver services that customers want and thereby making a bigger profit. That is the point, isn't it?

Well I happened to live in Canada and I’m glad to see all the positive things you have written about my country, its touching it really is because my views were somewhat harsher on our so called "brothers" because of many things. One point I read was someone said if we were that bad wouldn’t we say “hey we need your wood and oil wouldn’t we say hey you are part of the U.S.A now” and I laughed because the U.S.A actually did say "hey we need your water we have many more people then you do and we think the water belongs to North America as a whole" which is absolutely ridiculous. Anyways this site has changed my mind on how nice some Americans are i'm glad they are such understanding peoples.