Germany has a two-tiered system: If you are wealthy enough, you can go for private health insurance, and even if not you can gamble with one of the hundreds of insurance companies at the table. It also has a metric shitload of laws and regulations to keep the market forces that work on such a system like gravity on buttered toast from ripping the whole thing apart. The bureaucracy necessary to keep the regulations a) enforced and b) halfway watertight creates another drag at the system, which might be the second least effective in the world.

According to http://www.lexas.net/laenderdaten/bevoelkerung/aerztedichte-ranking.asp, the US has more doctors per inhabitant than Sweden or Switzerland, if less than Denmark or France. Of course, they might all be in R&D, or busy filling out forms…

I’m from the part of the country with some of the longest waiting lists in Canada, and not the rural part. I’m from the largest city in the province. I had to wait 18 months for jaw surgery. My uncle waited six months to see a specialist about the slipped discs in his back. My teacher waited 3 years for an elective knee replacement. It took months to get in to see any specialist, and it wasn’t uncommon for there to be less than five specialists in some fields… in the whole province.

I didn’t pay a dime for my jaw surgery, and it turned out great. My oral surgeon has a great reputation across the country, and I haven’t been to a dentist that hasn’t commented on what a fantastic job my orthodontist did. My psychiatrist was really understanding, and my family doctor was always helpful and never judgmental. It never even occurred to me that a doctor could refuse to prescribe birth control and make me feel like a slut for asking.

But let’s not pretend that there are no waiting lists. The people of provinces like Saskatchewan will laugh in your face.

some of this isn’t just because of evil profiteers, tho’ they are a prominent issue, if not *the* prominent issue, but because the overall health infrastructure has deteriorated, and the same hugeass repair bills exist for the health care infrastructure (new hospitals, rural clinics, doctor training, etc, etc) that also exists for roads, rails, and power infrastructure.

That’s definitely a point that needs to be raised and discussed, though we shouldn’t let it be a barrier to getting changes in the system. When we have frickin’ bridges falling into the Mississippi because people are so crazy for tax cuts that they don’t realize (or don’t care) that people will literally die if we cut back too far, it’s going to be a hard sell to point out that we need start-up funds to get our health care system up to snuff.

Obviously, I think it’s worth the cost, but there are people out there who whine that they have to pay taxes for useless things like fire departments and libraries, so convincing them to spend money on things that might be controversial like health care is going to be a long slog.

sophonisba: You’ve never had a doctor who point-blank ignored what you were telling them, or insulted you, or left you in tears, or didn’t believe you were in pain so wouldn’t prescribe you the drugs you need, or didn’t believe you’d understand what your problem was so wouldn’t explain it to you, or–? I’ll stop, but I could go on. … There’s nothing that’ll make you feel as demoralized or as absolutely helpless and powerless as a bad doctor.

Actually, I haven’t, but that’s probably because I’ve been to the doctor fewer than 10 times since adulthood. I’m persuaded by the idea that “allowing you to keep your doctor” strikes a chord with people because of worry about getting stuck with a bad one like those you’ve had before. I will count myself even more fortunate in that after hearing about your frustrations. Thanks…

BTW, have I ever mentioned how much I love that you call yourself “sophonisba”?

The earlier commentators are right. While we will save huge money when it’s all said and done, we will almost certainly have huge huge upfront costs and a changover period. Beyond the usual costs of changeovers in something as intricate as a country’s heath care system, is that in the US, the issue is that health care is over rationed, and some of this isn’t just because of evil profiteers, tho’ they are a prominent issue, if not *the* prominent issue, but because the overall health infrastructure has deteriorated, and the same hugeass repair bills exist for the health care infrastructure (new hospitals, rural clinics, doctor training, etc, etc) that also exists for roads, rails, and power infrastructure. I am convinced, as I told the Agonist guys a year or so ago, that a significant barrier to initiation of a national health care system even though many actors desire it is that TPTB is trying to focus the public’s attention on health insurance, and not the declining availability of *health care*. A new national heath care initiative would reveal holes as soon as a rush of people who urgently needed care but couldn’t get it arrive to recieve it then.

I am all for national heath care. However, I want *health care* and not health insurance. We should have our eyes open as to the larger costs and struggles, so we can force this thing through despite initial dissappointment and prevent bad compromises.

As a last note, think about this…A national health care system depends on cheap doctors, who are paid distinctly middleclass wages. It’s one of the bases for why doctors resist a full-fledged attact on insurance companies–as indicated by that excellent little pair of links provided by Matt at comment 67

Hear, hear, BlackBloc Universal health care should be - indeed, must be, if it’s to be truly universal - the same quality for every person, rich or poor, capitalist or labor; that same quality should be as high as our resources allow, which means ‘gold-plated’ if we can gold-plate it for everyone, a decently basic level if that’s all we can manage.

Mmm - at some stage in a socialised system, you have to start evaluating people and proposed spending based on cold hard criteria such as years of good health restored. This can and does lead to real controversy and heartbreak - how do you weigh timely eye operations versus clearing heart operation waiting lists, to use one NZ example?