You need any further proof that democrats are without honor...

[shagdrum]

We Are No Longer a Nation of Laws. Senate Sets Up Requirement for Super-Majority to Ever Repeal Obamacare
The Senate Democrats declare a super-majority of senators will be needed to overrule any regulation imposed by the Death Panels
Posted by Erick Erickson

If ever the people of the United States rise up and fight over passage of Obamacare, Harry Reid must be remembered as the man who sacrificed the dignity of his office for a few pieces of silver. The rules of fair play that have kept the basic integrity of the Republic alive have died with Harry Reid. Reid has slipped in a provision into the health care legislation prohibiting future Congresses from changing any regulations imposed on Americans by the Independent Medical Advisory Boards, which are commonly called the “Death Panels.”

It was Reid leading the Democrats who ignored 200 years of Senate precedents to rule that Senator Sanders could withdraw his amendment while it was being read.

It was Reid leading the Democrats who has determined again and again over the past few days that hundreds of years of accumulated Senate parliamentary rulings have no bearing on the health care vote.

On December 21, 2009, however, Harry Reid sold out the Republic in toto.

Upon examination of Senator Harry Reid’s amendment to the health care legislation, Senators discovered section 3403. That section changes the rules of the United States Senate.

To change the rules of the United States Senate, there must be sixty-seven votes.

Section 3403 of Senator Harry Reid’s amendment requires that “it shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.” The good news is that this only applies to one section of the Obamacare legislation. The bad news is that it applies to regulations imposed on doctors and patients by the Independent Medical Advisory Boards a/k/a the Death Panels.

Section 3403 of Senator Reid’s legislation also states, “Notwithstanding rule XV of the Standing Rules of the Senate, a committee amendment described in subparagraph (A) may include matter not within the jurisdiction of the Committee on Finance if that matter is relevant to a proposal contained in the bill submitted under subsection (c)(3).” In short, it sets up a rule to ignore another Senate rule.

Senator Jim DeMint confronted the Democrats over Reid’s language. In the past, the Senate Parliamentarian has repeatedly determined that any legislation that also changes the internal standing rules of the Senate must have a two-thirds vote to pass because to change Senate rules, a two-thirds vote is required. Today, the Senate President, acting on the advice of the Senate Parliamentarian, ruled that these rules changes are actually just procedural changes and, despite what the actual words of the legislation say, are not rules changes. Therefore, a two-thirds vote is not needed in contravention to longstanding Senate precedent.

How is that constitutional? It is just like the filibuster. Only 51 votes are needed to pass the amendments, but internally, the Senate is deciding that it will not consider certain business. The Supreme Court is quite clear that it won’t meddle with the internal operations of the House and Senate. To get around the prohibition on considering amendments to that particular subsection of the health care legislation, the Senate must get two-thirds of the Senate to agree to waive the rule. In other words, it will take a super-majority of the people the citizens of our Republican elected to overrule a regulation imposed by a group of faceless bureaucrats and bean counters.

Here is the transcript of the exchange between Jim DeMint and the Senate President:

DEMINT: But, Mr. President, as the chair has confirmed, Rule 22, paragraph 2, of the standing rules of the Senate, states that on a measure or motion to amend the Senate rules, the necessary affirmative vote shall be two-thirds of the senators present and voting. Let me go to the bill before us, because buried deep within the over 2,000 pages of this bill, we find a rather substantial change to the standing rules of the Senate. It is section 3403 and it begins on page 1,000 of the Reid substitute. . . . These provisions not only amend certain rules, they waive certain rules and create entirely new rules out of whole cloth.” ​

The Senate President disagreed and said it was a change in procedure, not a change in rules, therefore the Senate precedent that a two-thirds vote is required to change the rules of the Senate does not apply.

Senator DeMint responded:

DEMINT: and so the language you see in this bill that specifically refers to a change in a rule is not a rule change, it’s a procedure change?

THE PRESIDING OFFICER: that is correct.

DEMINT: then i guess our rules mean nothing, do they, if they can re define them. thank you. and i do yield back.

THE PRESIDING OFFICER: the senate stands adjourned until 7:00 a.m. tomorrow.​

That’s right. When confronted with the facts, the Senate Democrats ran for cover. The Senate Democrats are ignoring the constitution, the law, and their own rules to pass Obamacare.

To quote the Declaration of Indepedence:

When in the Course of human events it becomes necessary for one people to dissolve the political bands which have connected them with another and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.​

This, Ladies and Gentlemen, is one of those causes. When the men and women who run this nation, which is supposedly a nation of laws not men, choose to ignore the laws and bribe the men, the people cannot be blamed for wanting to dissolve political bands connecting them to that government.

For your edification, the full transcript of the exchange between Jim DeMint and the Senate President is presented, unedited, below the fold.

7:30 PM
PRESIDENT, I YIELD THE FLOOR. DEMINT
not. mr. president, i yield the floor. mr. demint: mr. president?

THE PRESIDING OFFICER
the senator from south carolina.

DEMINT
mr. president, i ask unanimous consent that i be allowed to speak for ten minutes.

THE PRESIDING OFFICER
without objection.

DEMINT
parliamentary inquiry, mr. president. does rule 22 of the standing rules of the senate provide that on a measure or motion to amend the senate rules, the necessary affirmative vote shall be two-thirds of the senators present and voting?

7:31 PM
THE PRESIDING OFFICER
it does.

DEMINT
further parliamentary inquiry. is it also the case that on numerous occasions, the senate has required a two-thirds cloture vote on bills that combine amendments to senate rules with other legislative provisions that do not amend the rules?

THE PRESIDING OFFICER
that would require a two-thirds vote.

DEMINT
i have numerous examples here. we did it twice this year on senate bill 2349 and i could read those but i’ll spare the chair all of these. i’m just trying to get at a concern we have here. am i correct that with respect to these bills, there was a combination of legislative provision and rules changes and the chair ruled that because they were — and i’m referring, mr. chairman, to the — earlier this year, those he

referred to where we required the two-thirds cloture. am i correct on these previous bills that with respect to the bills, there was a combination of legislative provisions and rules changes and the chair ruled that because there were rules changes, a two-thirds vote was required?

7:32 PM
THE PRESIDING OFFICER
if there were changes to the standing rules of the senate, a two-thirds vote would have been required to invoke cloture.

DEMINT
i thank the chair. mr. president, am i also correct that the senate has required a two-thirds cloture on amendments to bills where the amendments combine legislative provisions

and rules changes?

i have a number of references on bills that this was done if there’s any question, and i have given them to the parliamentarian for consideration. is there an answer? i mean, i know that there have been amendments to bills that we required two-thirds because they include rule changes. i just wanted to get a confirmation from our parliamentarian. is that, in fact, the case, where two-thirds cloture on amendments to bills have been required to have a two-thirds vote because

there were rules changes included in them?

7:34 PM
THE PRESIDING OFFICER
the chair would like to check that for a future answer.

DEMINT
okay. i believe the parliamentarian does have some of the references of times this has been done. we’re quite certain it has. but, mr. president, as the chair has confirmed, rule 22, paragraph 2, of the standing rules of the senate, states that on a measure or motion to amend the senate rules, the necessary affirmative vote shall be two-thirds of the senators present and voting. let me go to the bill before us, because buried deep within the over 2,000 pages of this bill, we find a rather substantial change to the standing rules of

the senate. it is section 3403 and it begins on page 1,000 of the reid substitute. these provisions not only amend certain rules, they waive certain rules and create entirely new rules out of whole cloth. again, i’ll skip over some examples but let me read a few of these provisions that amend the senate rules which are contained in section 3403 of the reid substitute. it’s section d, titled referral. the legislation introduced

under this paragraph shall be referred to the presiding officers of the prospective houses, to the committee on finance in the senate, and to the committee on energy and commerce, and the committee on ways and means in the house of representatives. the bill creates out of whole cloth a new rule that this specific bill must be referred to the senate finance committee. another example under section c, titled “committee jurisdiction.” and it references rule here. “notwithstanding

rule 15 of the standing rules of the senate, a committee amendment described in subparagraph a may include matter not within the jurisdiction of the committee on finance if that matter is relevant to a proposal contained in the bill submitted under subsection c-3. clearly a rule change. so there’s no pretense that this bill is being referred under the rules of the committee of jurisdiction. and now it is allowing the finance committee to add whatever matter it wants to the

bill, regardless of any rules regarding committee jurisdiction. and of good measure, the bill even specifically states that it is amending rule 15. let me just skip over a number of other examples referring to rules just to try to get to the — the point here. because it goes on and on, and i’ve got pages here. but there’s one provision that i found particularly troubling and it’s under section c, titled “limitations on changes to

this subsection.” and i quote — “it shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.” this is not legislation. it’s not law. this is a rule change. it’s a pretty big deal. we will be passing a new law and at the same time creating a senate rule that makes it out of order to amend or even repeal the law. i’m not even sure that it’s constitutional, but if it is, it most certainly is a senate

rule. i don’t see why the majority party wouldn’t put this in every bill. if you like your law, you most certainly would want it to have force for future senates. i mean, we want to bind future congresses. this goes to the fundamental purpose of senate rules: to prevent a tyrannical majority from trampling the rights of the minority or of future co congresses. mr. president, therefore, i would like to propound a parliamentary inquiry to the chair. does section 3403 of this

bill propose amendments to the standing rules of the standing rules of the senate? and further parliamentary inquiry. does the inclusion of these proposed amendments to the senate rules mean that the bill requires two-thirds present and voting to invoke cloture?

7:38 PM
THE PRESIDING OFFICER
the section of the proposed legislation addressed by the senator is not — does not amend the standing rules. the standing rules of the senate.

DEMINT
okay. mr. president –

THE PRESIDING OFFICER
and, therefore, its inclusion does not affect the number of votes required to invoke cloture.

DEMINT
mr. president, is the chair aware of any precedent where the senate created a new law and in doing so created a new rule — and i’m quoting from our bill — “it shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment or conference report that would repeal or otherwise change the law.” is the chair aware that we have ever put this type of binding legislation on future congresses in a bill?

7:39 PM
THE PRESIDING OFFICER
it is quite common to do that.

DEMINT
i would ask the chair to get those references, if the parliamentarian would, to us. mr. president, another parliamentary inquiry. if this new law will operate as a senate rule, making it out of order for senators to propose amendments to repeal or amend it it — i’ve been in congress 11 years. i have not ever heard of an amendment being called out of order because it changes something that was done before. you know, how is that different from the types of senate rule making for which our predecessors in their wisdom provided a two-thirds cloture vote?

this seems to be a redefinition of words in my mind. mr. president, it’s clear that the parliamentarian is — is going to redefine words, as i’m afraid he has done as part of this process before, but this is truly historic, that we have included rules changes in legislation. we have included rules changes in this legislation yet we’re ignoring a rule that requires a two-thirds cloture vote to pass it. i believe that

it’s unconstitutional. it subverts the principles that — i believe it subverts the principles that we’ve operated under and it’s very obvious to everyone that it does change a rule. mr. president, it’s clear that our rules mean nothing if we can redefine the words that we use in them. and i yield the floor.

7:40 PM
THE PRESIDING OFFICER
the chair will note that it is quite common to include provisions affecting senate procedure in legislation.

7:41 PM
DEMINT
is there a difference between senate procedures and rules?

THE PRESIDING OFFICER
yes.

DEMINT
and so the language you see in this bill that specifically refers to a change in a rule is not a rule change, it’s a procedure change?

THE PRESIDING OFFICER
that is correct.

DEMINT
then i guess our rules mean nothing, do they, if they can re define them. thank you. and i do yield back.

THE PRESIDING OFFICER
the senate stands adjourned until 7:00 a.m. tomorrow.​

 

[shagdrum]

There can be no question that these people are nothing short of tyrants. It is also abundantly clear that the "death panels" are in fact real.

 

[04SCTLS]

It is also abundantly clear that the "death panels" are in fact real.

So in that case who would you add to the "wish" list

 

[shagdrum]

So in that case who would you add to the "wish" list

do you simply not understand the implications of this, or do you not care?

 

[shagdrum]

YouTube- DeMint Challenges Democrats on Rules Changes in Reid Health Bill

 

[fossten]

He's rich so he doesn't care. He just stops in to tweak people and then run for cover.

 

[04SCTLS]

Aren't you jumping to conclusions.
I haven't heard of death panels in countries that have socialized medicine.
Where are the examples of manditory institutionalized euthenasia you seem to fear.

 

[04SCTLS]

He's rich so he doesn't care. He just stops in to tweak people and then run for cover.

Yes,
If I was ever denied some care or procedure I could pay for it out of pocket no matter the cost even into 7 figures.

So I post stuff I find interesting that's not on Hot Air or the Huffington Post.
I take these posts with a grain of salt.

 

[shagdrum]

Aren't you jumping to conclusions.
I haven't heard of death panels in countries that have socialized medicine.
Where are the examples of mandatory institutionalized euthanasia you seem to fear.

The "death panel" claim, in the original context, was metaphorical and referred to government rationing of healthcare. When you use a blatant liberal straw man to characterize a conservative argument, you only make yourself look like a fool...

Also, when it comes to things like this, legislation grows and changes through the bureaucracy that implement's it. For instance, Section 1801 of the 1965 Medicare Act reads:

Nothing in this title shall be construed to authorize any federal officer or employee to exercise any supervision or control over the practice of medicine, or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer, or employee, or any institution, agency or person providing health care services​

Due to bureaucracies changing the legislation, that entire passage has been rendered irrelevant.

YouTube- ObamaCare and Mission Creep: Why health care reform will end up covering much more than you think.

As to "death panels" in countries with socialized medicine, what do you call Britian's National Health Service:

In the British National Health Service, which has been in place for 60 years, not only are rationing and 'death panels' happening, they are policy. 'Death panel' is a euphemism for government bureaucrats deciding that somebody is too old or too sick to continue to receive costly treatment, the treatment is discontinued, and the patient is left to die.​

EVERY country with socialized medcine and rationing has a death panel of some sort!

Do you really think that the recommendations of the Independent Medicare Advisory Boards will remain simply "recommendations"? Especially given all the systematic coercion in the bill?

These people are circumventing rules, laws and the Constitution outright in order to enshrine these death panels in place. They are :q:q:q:qting on the Rule of Law!!!

Why? Are they simply doing it to enshrine mere recommendations in place?

 

[fossten]

Yes,
If I was ever denied some care or procedure I could pay for it out of pocket no matter the cost even into 7 figures.

So I post stuff I find interesting that's not on Hot Air or the Huffington Post.
I take these posts with a grain of salt.

Guess what. Under Obamacare, if you're denied care you can't pay for it. You have to suffer.

 

[04SCTLS]

Guess what. Under Obamacare, if you're denied care you can't pay for it. You have to suffer.

Money talks in America.
I cannot forsee that changing regardless of the legislation.
Human nature finds a way to satisfy a demand.
Let's see how this plays out past the next congressional and then national elections.

 

[Calabrio]

Money talks in America.
I cannot forsee that changing regardless of the legislation.
Human nature finds a way to satisfy a demand.
Let's see how this plays out past the next congressional and then national elections.

That's a cop out.

"Money talks"- yeah, just like the powerful in Europe and Canada do, they will have the ability to fly to parts of the world that have quality medicine that is constantly improved through free markets and competition.

Human nature has a way of satisfying demands, it's called captialism and free markets. Government has a way of stifling liberty and crush independence.

You say "let's see how this plays out"- did you just miss the point that Shag posted showing how this bill has amendments built into it that are designed to make it virtually impossible to alter after it's passage?

It's nearly impossible to "undo" a juggernaut like this anyway, but this fascist progressives are making sure that it's impossible to do through the Congress.

You clearly don't understand the scope of what's going on here.
This isn't just some kind of policy. It can't just be "rolled back" if it doesn't work. This is the massive, broad, far reaching, all encompassing frame work that will turn over our personal freedoms to the government.

It's unconstitutional.
It's unnecessary.

And since it doesn't do what it was originally promised to do, there's overwhelming opposition to it, and the programs don't "kick in" for about 4 years, why the rush? Why are did they fight so hard to get the bill passed before the fall recess? And why are they staying up, doing 1am votes, and planning on a Christmas Eve vote this week?

 

[04SCTLS]

In the British National Health Service, which has been in place for 60 years, not only are rationing and 'death panels' happening, they are policy. 'Death panel' is a euphemism for government bureaucrats deciding that somebody is too old or too sick to continue to receive costly treatment, the treatment is discontinued, and the patient is left to die.

Britain is no longer a plundering Empire, so they do what they can afford.
I'm sure the rich resource countries are more generous.

In this country for people with no health insurance the point is kind of moot.
Even people with private insurance are denied care based on cost and other variables.
This death panel claim is a red herring not because it won't happen but because the practice already exists.

You could maybe say the government would do a worse job dealing with the death panel issue than the private sector.

And your argument is disingenuine because unlimited funds are not available to be spent on patients.

 

[fossten]

In this country for people with no health insurance the point is kind of moot.
Even people with private insurance are denied care based on cost and other variables.
This death panel claim is a red herring not because it won't happen but because the practice already exists.

You cannot prove either statement.

If you need care you can get it. Emergency rooms are required to treat you. What Obama wants is to put government in charge of decision making instead of doctors. Anybody with money can go get treatment and pay cash for it. Under Obamacare, that won't be the case.

Let me ask you this - if Obamacare is so good, why did Harry Reid have to bribe several senators to get their votes?

Why did Reid have to grant several states EXEMPTION from the bill if it's such a wonderful plan? Why wouldn't EVERY STATE be jumping over each other to join in the ballgame if it's such a super bill?

 

[shagdrum]

Britain is no longer a plundering Empire, so they do what they can afford.
I'm sure the rich resource countries are more generous.

In this country for people with no health insurance the point is kind of moot.
Even people with private insurance are denied care based on cost and other variables.
This death panel claim is a red herring not because it won't happen but because the practice already exists.

You could maybe say the government would do a worse job dealing with the death panel issue than the private sector.

And your argument is disingenuine because unlimited funds are not available to be spent on patients.

The "rationing" in the private sector is metaphorical; arising from the natural scarcity of resources. The rationing of a socialist/facist bureaucracy is deliberate and literal. To equate the two is to mislead.

People are NOT denied care in this country. That is a blatant LIE. Their particular insurance may deny them coverage for a particular procedure, but they are still free to find another means to get pay for care if need be. It may be difficult to do, but they are not denied care.

I never made any argument based on a premise of unlimited funds available to be spent on patients. In fact, the arguments I have made and perpetuated have acknowledged, if not depended on the fact that healthcare is a scarce resource as are any funds to pay for it. I have even pointed out the Marxist delusion of being free from economic concerns as a flaw in other arguments. Stop mischaracterizing me.

The fact is, the free market is infinitely better then bureaucracy at dealing with the fundamental economic problem of scarcity.

To claim that death panels "practically already exists" in this country is to, again, misrepresent what a death panel is.

I have already pointed out that ANY and EVERY country with socialized medicine that rations that care has a death panel. Weather they are resource rich or not is only a factor in how long they can avoid rationing, but it is inevitable. What is being set up is economically unsustainable in even the best economies; it is a ponizi scheme, nothing more...

 

[04SCTLS]

You cannot prove either statement.

You like to deny things you don't agree with.
_______________________________________________________________
Why Insurance Companies Deny Health Care

September 11, 2009 Aaron Glantz, New America Media

SAN FRANCISCO, Sep 10 (New America Media) - As President Barack Obama addressed the nation on health care, the California Nurses Association revealed that health insurers have rejected about one-fifth of all medical claims in the state over the past seven years.
Using data culled from California's Department of Managed Care's Web site, the CNA said it found that the state's five largest insurers rejected 31.2 million claims for care from 2002 through June of this year. According to the nurses' union, PacificCare denied the largest percentage of claims (40 percent), followed by Cigna (33 percent), HealthNet (30 percent) and Kaiser (29 percent).

To find out why so many insurance claims are being rejected, NAM editor Aaron Glantz interviewed Wendell Potter, the former chief of corporate communications for insurance giant Cigna, where he worked for 15 years. Since May 2009, Potter has worked as a senior fellow on health care at the Center for Media and Democracy.
What is your reaction to hearing those figures?

I'm somewhat surprised because I had always been told when I was in the industry that the vast majority of claims were paid routinely. But on the other hand, I also know that insurance companies that are publicly owned –- as most of the big ones are these days -– are under pressure from investors to reduce expenses. This is coming on the heels of other things that we've heard about that insurers do, like giving bonuses to employees for rescinding or canceling coverage of people when they get sick. So knowing the things that they do to avoid paying claims, including dumping the sick, it doesn't shock me.
The nurses' union says this represents care that was denied, whereas the insurance companies are saying that it's just a bookkeeping matter. What is your belief based on your own experience at Cigna?
Well, I know the insurance industry will always say that they don't deny care, they deny coverage and that is their distinction. The distinction from the insurance company's perspective is if they deny coverage, then the person has the possibility of paying for the medical treatment out of their own pocket, or finding someone to pay for it. The reality, of course, is that when people are denied coverage, that is the equivalent of denying care because most people just don't have the financial resources to pay for care, particularly, if it's a big medical claim.
What is the discussion around these kinds of issues in these companies? Do these sets of data get reported to people at the executive level?
Yes. The executives always need to know how much is being paid out in claims because it affects what's called the 'medical loss ratio,' which is reported when the companies report their quarterly earnings. Investors are always looking to the insurers to keep that medical loss ratio down. That is the measure of how much of the premium dollars are being paid out in claims. If it's 80 percent, for example, it means that 80 cents out of every dollar is paid out in claims. As recently as 1993, 95 percent of every premium
dollar was paid out in claims. Now it's down to about 80, so insurance companies are doing a lot of things to avoid paying those claims.
Did you have a target amount you wanted to pay out over a particular period of time?
Well, it depends. Several years ago, the medical loss ratio at Aetna was something like 77.9 percent, and then the next year, the medical loss ratio had gone up to 79.5 percent. Investors were very upset with that kind of increased medical loss ratio and the stock for that company declined sharply. I've seen the stock values for companies that disappoint Wall Street in the medical loss ratio declining 20 percent in a single day. So you look at the benchmarks of what the medical loss ratio was for the same period a year ago, and for the previous three months.
Did you feel that Wall Street pressure on a daily basis?
Absolutely. In corporate communications, I didn't feel it as much as some of the line employees who have a direct ability to influence the medical loss ratio like the medical directors and the people who handle the claims. And the pressure is on all employees. It's always in the back of your mind: 'I need to make sure that I don't do something that causes the company to miss Wall Street's expectations.'
Were you involved at all in the public relations debacle around the 2008 death of 17-year-old Nataline Sarkisyan of Northridge, Calif. who passed away after being denied a liver transplant by Cigna?

Yes, I was. At that time, I was the chief spokesperson for the company. I was the person who was responsible for putting out the company's statements and answering questions from reporters when they called about it.
Her request for a liver transplant was denied, and then Cigna reversed itself under pressure, but she ended up dying because the transplant came too late.
Yes, that's right. The transplant had been requested by her doctors weeks before her death. Her doctors felt that it was her last resort and had recommended it. Cigna felt that the transplant in her case would have been experimental and on those grounds chose to deny coverage for it. The family sought the assistance of the California Nurses Association and reached out to the media and it became a very, very highly publicized case. And I can't tell you how many calls I got from all over the world regarding that. Then, in the midst of all that publicity, Cigna decided to reverse itself and decided to cover the procedure. But you're right. She died just about two hours after the family was told that Cigna changed its mind.
At the time, some people argued that it was just an isolated incident. But now there is data showing that Cigna denied 33 percent of claims and PacificCare denied up to 40 percent. Does this data cause you to speak about that experience in a new way?
Well it does. One of the talking points that I used when reporters called was that 90 percent of requests for a transplant are approved by Cigna. I haven't seen data to know whether that is still accurate.
At the time that you were fielding all these media calls for Nataline, did you feel like you were standing up for a reasonable argument?
I was troubled. My main responsibility was to communicate the company's point of view but, you know, I have a daughter myself. When you start thinking about the actual family involved, even if you are convinced one hundred percent that your company is in the right, you can't completely disassociate yourself from what's going on and that this is a life or death situation.
Looking back, do you think Cigna was in the right?
I can't comment on that. I was not among the group that reviewed the claim when it first came in. What I do know is that I think the California Nurses Association was right in pointing out that this is not an isolated case. People need to realize that there is a corporate executive who often stands between a patient and his or her doctor. That's the reality. And I think the insurance industry is now fear-mongering during this debate on health care reform, saying that a government bureaucrat could stand between someone and his or her doctor. But the current situation is just as bad, if not worse, because you have people doing that now who are denying care to meet Wall Street's expectations.

Wendell Potter is former head of corporate communications for Cigna Corporation, where he worked for 15 years. He is now a fellow at the Center for Media and Democracy.___________________________________________________________

Let me ask you this - if Obamacare is so good, why did Harry Reid have to bribe several senators to get their votes?

Why did Reid have to grant several states EXEMPTION from the bill if it's such a wonderful plan? Why wouldn't EVERY STATE be jumping over each other to join in the ballgame if it's such a super bill?

I never said it was wonderful.
I can afford denied coverage so the current system is better for me were I to need expensive service.

 

[fossten]

Again, Mr. Obtuse, an insurance company CANNOT DENY CARE. It can only deny COVERAGE.

Got it?

By the way, here's what we're headed for if Obamacare is passed.

As of this year, 694,161 Canadians are on a waiting list for medical procedures. Assuming one person per procedure, that means 2.08 percent of the population is queued up for “free” care, according to the Fraser Institute’s annual survey on wait times.

These Canadians pay for their health care in both taxes and the hard currency of pain, anguish, and lost wages…

Worse, an incredible 16 percent of the population — five million people — is waiting to get a primary care doctor.

By the way, your source is a lefty site. The founder wrote a book called "Weapons of Mass Deception: The Uses of Propaganda in Bush's War on Iraq. " He also was a Vietnam War protester and organizer of the first Earth Day. In other words, he's a lefty wacko 60s hippie.

 

[shagdrum]

You like to deny things you don't agree with.

Actually, you are asserting things that you cannot prove. You keep missing the basic point that health CARE is not the same as health COVERAGE.

 

[hrmwrm]

Waiting Lists in Canada: Reality or Hype?
American Medical Student Association
Prepared by Kao-Ping Chua, AMSA Jack Rutledge Fellow 2005-2006
Introduction
Waiting lists in Canada have been a highly symbolic issue to people on both sides of the
U.S.-Canada border. For those who support privatization of the Canadian healthcare system, the
waiting lists speak to a vast lack of healthcare delivery capacity in the public system. Such lists,
they argue, would be minimized by moving towards a two-tiered system of care in which the
public system existed alongside a parallel private system that would allow privately insured
patients to "jump the queues" - i.e. get faster access to care. On the other hand, for those who
believe in the fundamental principles of equity that the Canadian system is built on, the waiting
lists point not to a fundamental flaw in the structure of the Canadian healthcare system but rather
to a gross underfunding of the system, which has been triggered largely by reductions in federal
funding to provinces for healthcare. The answer, these advocates argue, is to increase funding
levels for the current system without moving towards a two-tiered system.
All of this, of course, makes the important assumption that significant waiting lists in
Canada exist in the first place. Those who oppose the Canadian single-payer system, including
the American health insurance industry, have long used long waiting lists as an argument against
single-payer health insurance, citing anecdotal evidence, various surveys, and media reports.
Despite this, an objective look at the issue reveals that the evidence for waiting lists is
inconclusive. Indeed, while waiting lists certainly do exist for certain non-emergent
procedures, it is not at all clear that the "waiting list crisis" that is so often talked about by
the media and opponents of single payer actually exists.
This primer will attempt to present a balanced view of the evidence for waiting lists in
Canada. It is not the objective of this paper to argue for or against Canadian single-payer; such
arguments can be found elsewhere. Rather, the objective of this paper is to ensure that the debate
around waiting lists in Canada occurs in an informed, rational, and intellectually honest fashion.
Definitions
A "waiting list" is a list that patients are enrolled in once they opt to pursue an elective
procedure, assuming that they cannot get this procedure performed immediately. In Canada,
waiting lists do NOT exist for emergency procedures. It is a myth that Canadians with serious,
life-threatening illnesses are enrolled on a waiting list before they can receive life-saving
therapies.
"Waiting time" or “wait time” is more difficult to define. A common definition is the
length of time between when a patient is enrolled on a waiting list and when the service is
received [1]. However, different provinces and organizations define waiting times differently
(e.g. time from seeing GP to treatment, time from seeing specialist to treatment, time from being
enrolled on hospital waiting list to treatment, etc.). These differences can result in dramatically
different measurements of waiting times. Waiting times are a part of every healthcare system;
indeed, there are often significant waiting times for elective procedures in American hospitals as
well. The difference between countries, of course, is the magnitude of the waiting time.
The lack of good Canadian data on waiting lists
Recently, waiting list data has been monitored and published online by some of the
Canadian provincial governments [2].
British Columbia Ministry of Health
www.hlth.gov.bc.ca/waitlist
Alberta Ministry of Health and Wellness
www.health.gov.ab.ca/waitlist/WaitListPublicHome.jsp
Saskatchewan Surgical Care Network
www.sasksurgery.ca
Manitoba Ministry of Health
www.gov.mb.ca/health/waitlist
Cardiac Care Network of Ontario
www.cn.on.ca/access.html
Cancer Care Ontario
www.cancercare.on.ca/access_waitTimes.htm
In an important paper, McDonald et al. issued a scathing analysis of the current datakeeping
system for waiting lists by the Canadian provincial governments [1]. The authors write:
"With rare exceptions, waiting lists in Canada, as in most countries, are non-standardized,
capriciously organized, poorly monitored, and (according to most informed observers) in grave
need of retooling. As such most of those currently in use are at best misleading sources of data on
access to care, and at worst instruments of misinformation, propaganda, and general
mischief…There may be serious problems of excessive waiting times for some procedures in
some jurisdictions, at some times; or there may not. We simply have no reliable systems in place
with which to assess what are, at the moment, still largely self-reported claims…With few
exceptions, our current understanding of the 'wait list situation' in Canada is so totally dependent
on data of suspect quality, drawn from a variety of ad hoc sources, based on inconsistent
definitions, used for a variety of purposes, and overseen by no one, that it is little wonder that we
find so much confusion…"
They further make the following conclusions regarding waiting lists in Canada:
• "In Canada at the present time it is impossible either to understand the true
magnitude of wait lists or genuinely and rationally manage the patients on those
lists. Few current wait lists in Canada, or elsewhere, are sufficiently defined and
standardized to provide inter-temporally consistent and geographically comparable
databases…”
• It is virtually impossible to know how to interpret any particular claims about the
length of time patients are currently waiting for any particular procedure. Reports
based (ostensibly) on the same patient populations can produce substantially different
estimates of median wait times (as was the case recently in British Columbia). With rare
exceptions such as cardiac and cancer care in some jurisdictions, there is an almost total
absence of consistently applied criteria (within procedures, let alone across) for
determining when patients should be added to wait lists, and how they should be
prioritized.
• Commonly 20-30% of those on wait lists are found in the international literature to
be inappropriately placed, because they have already received the procedure, have died,
never knew they were on a list, were placed on the list in the first place for reasons
unrelated to medical necessity, or were no longer awaiting the procedure for some other
reason." [1]
This paper underscores a few important points. First, the data on waiting times in Canada
is incomplete and poorly standardized, despite some recent attempts to standardize the data (e.g.
the Western Canada Waiting List Project). For example, waiting times are defined differently
from province to province, and they can be estimated through a variety of methods (retrospective,
cohort, cross-sectional, etc.), each of which yield differing results. Second, the number of people
on waiting lists may not be an appropriate indicator of access as actual waiting time, since
international studies have shown that many people are inappropriately placed on waiting lists or
no longer belong there.
Provincial government data on waiting lists
Despite the flaws mentioned above, provincial government data on waiting lists is still
the most objective source of information on the topic. The following discussion will highlight a
few pertinent examples in order to illustrate some general points about waiting lists:
1. British Columbia [3]
As can be seen by the data from British Columbia, waiting time varies by
specialty. For example, the median wait time for orthopedic surgery was 9.3 weeks, whereas the
median wait time for vascular surgery was 2.7 weeks. Similarly, the waiting time varies by
procedure as well, as evidenced by the waiting times for endarterectomy (3.0 weeks), cataract
surgery (9.4 weeks), gall bladder surgery (5.1 weeks), hip replacement (21.8 weeks), and knee
replacement (28.3 weeks).
Waiting lists will naturally be influenced by demand for a particular procedure,
supply of physicians doing the procedure, availability of appropriate healthcare facilities to do the
procedure, density of healthcare facilities in a given geographic region, etc.
2. Manitoba [4]
Manitoba's waiting time information for CT scans illustrates another important point:
within provinces, there is great variability for waiting times between hospitals. While the median
wait time for CT scans for all Manitoba was 10 weeks, the range was as low as 3 weeks to as high
as 18 weeks, depending on the facility.
Non-government data on waiting lists
In the absence of complete, reliable, standardized governmental data, some organizations
and researchers have turned to self-report in surveys to paint a picture of waiting lists in Canada.
1. Patient self-report [5-10]
Statistics Canada, a non-partisan organization, has compiled an extensive set of statistics
on waiting times based on the Health Services Access Survey of 2003. Important findings
include:
• The median wait time for non-emergency (elective) surgeries was 4.3 weeks [95% CI,
3.9- 4.7]. 40.5%, 42.1%, and 17.4% of Canadians in the survey reported waiting less
than 1 month, 1-3 months, and more than 3 months for the surgery, respectively. The
proportions varied between provinces.
• The median wait time to see a specialist for a new illness or condition was 4.0 weeks
[95% CI, 3.4-4.6]. 47.9%, 40.7%, and 11.4% of Canadians in the survey reported
waiting less than 1 month, 1-3 months, and more than 3 months to see a specialist,
respectively. The proportions varied between provinces.
• The median wait time for selected non-emergency diagnostic tests (CT, MRI, or
angiography) was 3.0 weeks [95% CI , 2.1-3.9]. 57.5%, 31.5%, and 11.5% of Canadians
in the survey reported waiting less than 1 month, 1-3 months, and more than 3 months to
receive these diagnostic tests, respectively. The proportions varied between provinces.
2. Physician estimate [2]
Every year, the Fraser Institute, a prominent free-market think tank, publishes a survey
based on physician estimates of waiting times for their patients. In 2004, the survey found the
following:
• Median wait time between visiting a general practitioner and consultation with specialist:
8.4 weeks
• Median wait time between visiting a specialist and receiving treatment: 9.5 weeks
• Median wait time for CT: 5.2 weeks
• Median wait time for MRI: 12.6 weeks
Clearly, there are significant differences between the Statistics Canada estimates
and the Fraser Institute estimates. These differences may be explained by different definitions of
waiting times, differences in perceptions between patients and physicians, and source bias.
The most important point here is that differences in methodology and sources can result
in dramatically different results. The lack of standardized government data on waiting lists
makes it difficult to conclude with any certainty the magnitude of waiting lists in Canada.
What about waiting lists in the U.S.?
On average, U.S. citizens experience some of the shortest wait times for non-emergency
surgeries among industrialized countries, although the waiting times vary considerably by
procedure [11]. Furthermore, the short waiting times apply mainly to those who have insurance;
for those who do not, the waiting line is arguably infinite. Finally, the short waiting lists in the
U.S. should be tempered with the realization that the lack of universal healthcare in the U.S.
means less demand for the system. If there were universal healthcare without an expansion of
capacity, one might see how waiting lines in the U.S. could increase [12].
In a cross-national survey of sick adults in five countries, 40% of people in the U.S. said
it was either very difficult or somewhat difficult to see a specialist, compared with 53% in
Canada. Of the U.S. respondents indicating it was difficult to see a specialist, 40% cited long
waiting times (vs. 86% in Canada), 31% cited being denied a referral or having to wait for a
referral (vs. 10% in Canada), and 17% cited not being able to afford private insurance (vs. 3% in
Canada). 14% of U.S. respondents indicated they had a "big problem" with long waits to get an
appointment with their regular doctor, compared with 24% in Canada. Based on this data, more
Canadians than Americans report that waiting lines are a problem when trying to see their
physicians, although some Americans experience this problem as well. Also, more Americans
report problems with obtaining referrals and cost of care as obstacles to seeing specialists [13].
Canadians coming to the U.S. for care: a "health care zombie"
Opponents of the Canadian healthcare system commonly conjure up the image of hordes
of Canadians crossing the border to receive healthcare in the U.S. due to long waiting lists. Yet,
the studies that have been done on this issue do not support the legitimacy of this idea.
Katz et al [14] developed a multi-faceted strategy to study this issue, drawing upon 1)
Surveys of ambulatory clinics in three large U.S. cities near the Canada border (Detroit, Buffalo,
Seattle); 2) State hospital discharge data from Michigan, New York, and Washington State; and
3) Surveys of the U.S. News and World Report "America's Best Hospitals", where Canadians
might be thought to go to for care.
• 136 ambulatory healthcare facilities in Detroit, Buffalo, and Seattle responded to the
survey. In 1997-1998, 52 of these facilities reported seeing no Canadians, 56 reported
seeing fewer than 10, 21 reported seeing 21-25, and 7 reported seeing more than 25.
• From 1994 to 1998, 2,031 Canadians were admitted to hospitals in Michigan, 1,689 to
hospitals in New York, and 825 to hospitals in Washington. During this period, these
hospitalizations represented only 0.23% of all the hospitalizations that occurred in the
three provinces bordering these states.
• Finally, responses from eleven of America's Best Hospitals generally indicated that the
number of Canadian patients seen at the hospitals was low.
Katz also drew upon several Canadian sources of data for the study:
• Federal and provincial government surveys of the citizenry. Only 90 of 18,000
respondents to the 1996 Canadian National Population Health Survey indicated they had
received health care in America in the past year, and only 20 of these had gone to the
U.S. specifically for that purpose.
• Canadian contracts with U.S. healthcare facilities. Some Canadian provinces have
contracted with nearby U.S. hospitals for radiation therapy for cancer, although this is a
relatively small proportion of patients. For example, Ontario contracted with Michigan,
New York, and Ohio healthcare facilities in 1999 for breast and prostate cancer
treatment. During the period lasting from March 1999 to October 2000, the number of
Ontario citizens treated in America with radiation therapy for breast and prostate cancer
was only 8.5% of the total number of Ontario citizens that were treated with radiation
therapy for prostate and breast cancer during the same time interval.
• Pre-approval of experimental therapies. Finally, there are some Canadians who apply
for approval to come to the U.S. for treatments not yet available in Canada, such as
gamma knife therapy for intracranial pathology and brachytherapy for prostate cancer.
Again, however, the numbers are small; for example, Quebec approves about 100
requests per year from Canadians wishing to go the U.S. for such treatments.
In sum, the number of Canadians receiving care in the U.S. appears to be
extremely low compared to the amount of care that Canadians receive in Canada. There does
exist a group of Canadians who come to America 1) To receive therapies not approved in Canada;
2) To avoid long waiting lines; and 3) Because of limited capacity in Canada in certain
technologies. However, these Canadians are by far the exception, not the rule.
The idea that Canadians flock to the U.S. specifically for healthcare loses even further
legitimacy when one considers that the number of Canadians treated in the U.S. does not just
include people who specifically go to the U.S. for healthcare; it also includes care given to
Canadians traveling in the U.S., Canadians working in the U.S. on business travel, and Canadians
who move to the U.S. during the winter to avoid the cold ("snowbirds"). Finally, in some rural
areas of Canada, it is more convenient to go to the U.S. than to travel long distances to healthcare
facilities due to simple proximity [14].
Unfortunately, the image of Canadians crossing the border will continue to be conjured
up despite the fact that such images are based purely on anecdotal evidence. As Katz writes:
"Despite the evidence presented in our study, the Canadian border-crossing claims will probably
persist. The tension between payers and providers is real, inevitable, and permanent, and claims
that serve the interests of either party will continue to be independent of the evidentiary base.
Debates over health policy furnish a number of examples of these "zombies" - ideas that, on logic
or evidence, are intellectually dead - that can never be laid to rest because they are useful to some
powerful interests. The phantom hordes of Canadian medical refugees are likely to remain
among them" [14]. In the end, the image of Americans crossing the border to obtain Canadian
drugs may be more realistic than the image of Canadians crossing the border to obtain American
healthcare.
Summary
What is clear from this analysis is that Canadian waiting lists are undoubtedly a problem
for many Canadians on certain elective procedures. What is not clear, however, is the magnitude
of the problem, and it is certainly not necessarily true that there is a Canadian "waiting list crisis."
• The lack of quality data on waiting lists from the Canadian government, coupled with the
limitations of surveys (e.g. differing methodologies), makes it very difficult to conclude
with any certainty the size of the true waiting list problem.
• The Canadian experience with waiting times will necessarily be uneven, as waiting times
vary by specialty, procedure, province, and region. That is, any given individual
Canadian will have different experiences with waiting times. This may partly explain the
existence of anecdotal reports of intolerable waits from certain individual Canadians
(such stories often are dramatized in the media), juxtaposed with the denial of the
problem from other Canadians.
• The U.S. does not experience problems with waiting lists as much as Canada does,
although the problem does exist for some Americans.
• There is a small minority of Canadians who receive care in the U.S., and even a smaller
minority who specifically come to the U.S. to receive care. The idea that hordes of
Canadians cross the border to avoid waiting lists is a myth.
[Note: For an exhaustive review of how certain countries have dealt with the problem of waiting
lists, please see:
Hurst J and Siciliani J. Tackling Excessive Waiting Times for Elective Surgery: A Comparison
of Policies in Twelve OECD Countries. Online at www.oecd.org/dataoecd/24/32/5162353.pdf]
References [Note: All references are available online, including the Health Affairs articles].
1. McDonald P et al. "Waiting Lists and Waiting Times for Health Care in Canada: More
Management!! More Money??" Health Canada, July 1998. Online at http://www.hcsc.
gc.ca/english/media/releases/waiting_list.html
2. Esmail N and Walker M. Waiting Your Turn, Hospital Waiting Lists in Canada (14th
Edition). Fraser Institute, October 2004. Online at
http://www.fraserinstitute.ca/admin/books/chapterfiles/wyt2004.pdf
3. Government of British Columbia Health Media site. Online at
http://www.healthservices.gov.bc.ca/cpa/mediasite/waittime/median.html
4. Government of Manitoba Health Wait T ime Information Site. Online at
http://www.gov.mb.ca/health/waitlist/
5. Statistics Canada. "Median waiting times for non-emergency surgeries, household population
aged 15 and over, Canada and provinces, 2003." Online at
http://www.statcan.ca/english/freepub/82-401-XIE/2002000/tables/html/at007_en.htm
6. Statistics Canada. "Non-emergency surgeries, distribution of waiting times, household
population aged 15 and over, Canada and provinces, 2003." Online at
http://www.statcan.ca/english/freepub/82-401-XIE/2002000/tables/html/at008_en.htm
7. Statistics Canada. "Median waiting times for specialist visits for a new illness or condition,
household population aged 15 and over, Canada and provinces, 2003." Online at
http://www.statcan.ca/english/freepub/82-401-XIE/2002000/tables/html/at009_en.htm
8. Statistics Canada. "Specialist visits for a new illness or condition, distribution of waiting
times, household population aged 15 and over, Canada and provinces, 2003." Online at
http://www.statcan.ca/english/freepub/82-401-XIE/2002000/tables/html/at010_en.htm
9. Statistics Canada. "Median waiting times for selected diagnostic tests, household population
aged 15 and over, Canada and provinces, 2003." Online at
http://www.statcan.ca/english/freepub/82-401-XIE/2002000/tables/html/at011_en.htm
10. Statistics Canada. "Selected diagnostic tests, distribution of waiting times, household
population aged 15 and over, Canada and provinces, 2003." Online at
http://www.statcan.ca/english/freepub/82-401-XIE/2002000/tables/html/at012_en.htm
11. Anderson G and Hussey P, Commonwealth Fund. “Multinational Comparisons of Health
System Data, 2000.” Online at http://www.cmwf.org/usr_doc/comp_chartbook_431_files.pdf
12. Blendon R et al. "Confronting Competing Demands To Improve Quality: A Five-Country
Hospital Survey." Health Affairs, May/June 2004; 23(3): 119-135.
13. Blendon et al. "Common Concerns Amid Diverse Systems: Health Care Experiences In Five
Countries." Health Affairs, May/June 2003; 22(3): 106-121.
14. Katz S et al. Phantoms in the snow: Canadians' use of health care services in the United
States. Health Affairs, May/June 2002; 21(3): 19-31.



http://www.amsa.org/AMSA/Libraries/Academy_Docs/WaitingTimes_primer.sflb.ashx

 

[fossten]

Waiting Lists in Canada: Reality or Hype?

***


• The U.S. does not experience problems with waiting lists as much as Canada does

There you go. Thanks for supporting the point.

 

[hrmwrm]

as much as canada. doesn't mean your without them.
and it doesn't mean they will expand.
bad arguing point. you haven't proven it.
and then you miss the point of who the healthcare system actually serves. here, all.
there. those with coverage or who can pay.

 

[Calabrio]

It's amazing how you have a "No God, No Masters" picture in your avatar, yet seem inclined to make government your master through legislation like this health care nightmare.

 

[shagdrum]

as much as canada. doesn't mean your without them.
and it doesn't mean they will expand.
bad arguing point. you haven't proven it.

It's called basic economics. When you actually have a basic understanding of such things (and you have demonstrated countless times that you don't), it is rather self explanatory why Canada has waiting lists; They have to ration healthcare to control "costs"!

Unlike the private sector, government can NOT control true costs. ALL they can do is shift costs around and reduce the quality and/or quantity of healthcare they purchase. Hence rationing.

As to Canada's waiting list, I think the Fraser Institute would have something to say about the disinformation in your article. The evidence of waiting lists due to systemic market distortions in the program is not simply "anecdotal" and lacking an "objective look at the issue", as your article absurdly claims. The Fraser Institute's annual report on Canada's waiting lists called "Waiting Your Turn" debunks that claim. The problem is that many advocates of single payer systems are in denial about the truth and engage in a lot of prevarication.

Specifically:

• the average time a patient waited between referral from a general practitioner to treatment rose from 16.5 weeks in 2001-02 to 17.7 weeks in 2003. Saskatchewan had the longest average waiting time of nearly 30 weeks, while Ontario had the shortest, 14 weeks.
• In 2003, the wait time for diagnostic procedures could range from 2 to 24 weeks, depending on province and the specific procedure

According to this article by Walter E. Williams,

As reported in a December 2003 article by Kerri Houston for the Frontiers of Freedom Institute titled "Access denied: Canada's health-care system turns patients into victims", in some cases, patients die on the waiting list because they become too sick to tolerate a procedure. Miss Houston says hip-replacement patients often end up non-ambulatory while waiting an average of 20 weeks, and that's after waiting 13 weeks just to see the specialist. The wait to get diagnostic scans followed by the wait for the radiologist to read them just might explain why Cleveland, Ohio, became Canada's hip-replacement center.

Adding to Canada's medical problems is the exodus of doctors. According to a March 2003 story in Canada News, about 10,000 doctors left Canada in the 1990s. Compounding that exodus is the drop in medical school graduates. According to Miss Houston, Ontario has turned to nurses to replace its bolting doctors. It is "creating" 369 new nurse practitioner positions to take up the doctor shortage. ​

The most absurd part of your article is this claim:

Clearly, there are significant differences between the Statistics Canada estimates and the Fraser Institute estimates. These differences may be explained by different definitions of waiting times, differences in perceptions between patients and physicians, and source bias. The most important point here is that differences in methodology and sources can result in dramatically different results. The lack of standardized government data on waiting lists makes it difficult to conclude with any certainty the magnitude of waiting lists in Canada.​

There are a few problems with this;

First, the author "explains" the differences in statistics through nothing but speculation.

Second, the author's argument is ultimately fallacious; that the stats are vague so the issue cannot be clearly defined and discussed.

Third, the claim that because the stats are not already standardized across the nation, they cannot be compared is absurd. This ignores the possibility that a statistician can standardize them; make them comparable. This "problem" is confronted often in statistical analysis and there are various ways to make the data comparable.

There is also this little tidbit that I would agree with (except for the line about an "arguably infinite wait line for the uninsured" which misleads and compares apples and oranges);

On average, U.S. citizens experience some of the shortest wait times for non-emergency surgeries among industrialized countries, although the waiting times vary considerably by procedure. Furthermore, the short waiting times apply mainly to those who have insurance; for those who do not, the waiting line is arguably infinite. Finally, the short waiting lists in the U.S. should be tempered with the realization that the lack of universal healthcare in the U.S. means less demand for the system. If there were universal healthcare without an expansion of
capacity, one might see how waiting lines in the U.S. could increase.​

While the author seems to ignore the fact that government is inherently inefficient (which would play a dominant factor in that hypothetical) he is right that going to universal healthcare would lead to waiting lines. In short, your article, dispite it's ultimately specious dismissal of empirical evidence, verifies the point being made by us in citing the waiting lists in Canada...

and then you miss the point of who the healthcare system actually serves. here, all.
there. those with coverage or who can pay.

And yet our system serves us better then your system. Got any more mindless platitudes and cliche's that ignore and distort reality?

A truly free market system is DICTATED by the consumers. A government run system is ruled by bureaucrats and politicians; political interests reign supreme. To claim that a government run system serves people better then a free market system is to demonstrate utter economic and political ignorance. Though I would agree that America's system could be better. There is too much government interference already and it is not a truly "free market" system; around $.40 out of every $1.00 in our healthcare industry comes from the government.

​

 

[hrmwrm]

Though I would agree that America's system could be better.

and so could canadas. it's a different philosphy which has it's shortcomings just as the american system does.
and there are waiting lists in either system.

And yet our system serves us better then your system.

and that's not a fully true statement. it serves SOME better. and if it served you better, it would be cheaper than ours. yet it's not.
what about the underinsured or uninsured? what are the waiting times for them? days, weeks, months, years? we don't have that qualification here.

 

[shagdrum]

and that's not a fully true statement. it serves SOME better. and if it served you better, it would be cheaper than ours. yet it's not.

And why are costs so expensive here in America? The reasons for that are very important. Also, it is not clear that health care in Canada is cheaper then in America. Canada simply doesn't purchase as much health care (hence the waiting lists). More likely, the healthcare they do purchase is on par, if not more expensive then America.

what about the underinsured or uninsured? what are the waiting times for them? days, weeks, months, years? we don't have that qualification here.

They can (and do) get immediate care if they go to the emergency room. Many use that as their health plan. Many of the uninsured are also self insured. The true number of people in dire straits because of a lack of insurance is a LOT lower then you think...