Entries Tagged as 'History'

Comparison of Canadian and American health care systems

There are a number of comparisons between the Canadian and US health care systems; and like with any complex issue you can make the comparison show almost anything you want depending on the metrics chosen for the comparison and the facts included (or omitted).

Often the Canadian and American systems are compared since until the 1960s they were extremely similar, and Canadian and Americans share a large common history and to some extent culture.

This comparison on Wikipedia appears to be an honest attempt to compare and contrast the two systems, it includes a number of citations.  I recommend reading it, and considering what it has to say in light of the the current state health care in the US.

Comparison of Canadian and American health care systems

Originally posted 2010-03-16 13:03:11.

Sean Byler

That’s the name of the groundhog all this folklore is based on about Groundhog Day…

I’m not sure what happens if some groundhogs see their shadows and others don’t — average the results?

Anyway, I’m hoping Winter is as short as possible and that we’ll all have a nice, long, comfortable Spring.

All eyes are on Punxsutawney today.

Groundhog Day @ Wikipedia

Originally posted 2010-02-02 01:00:31.

Does Canada’s Health Care System Need Fixing?

This is from an article on by Sarah Varney (KQED – San Francisco, CA, US – Public Media for Northern California) re-published on NPR.

Amid the debate about reforming heath care in the United States, it’s tough to turn on your television these days without hearing a political ad condemning the Canadian health care system.

One such ad from Americans for Prosperity features a woman talking of her experience with getting treatment for cancer.

“I survived a brain tumor, but if I’d relied on my government for health care, I’d be dead. I am a Canadian citizen. As my brain tumor got worse, my government health care system told me I had to wait six month to see a specialist,” the woman says.

The ads are provocative, but just how accurately do they portray Canada’s system?

At a small doctor’s office in the gritty working-class neighborhood of East Vancouver, Dr. Larry Barzelai meets with John and Bessie Riley, who have been his patients for more than 20 years.

John Riley was recently diagnosed with colon cancer. Contrary to the woman in the TV ad, he says his experience getting in to see specialists has been “nothing but good” so far. “Everything’s gone bang, bang. I’ve had no waiting times for anything,” he says, adding that his only out-of-pocket expense has been the cost of getting to the doctor’s office.

Socialized Insurance, Not Socialized Medicine

Canada has a universal health care system that’s paid for through income taxes and sales tax. All Canadians are covered, and they can see any doctor they want anywhere in the country with no copays or deductibles. Some things aren’t covered: optometry, dentistry and outpatient prescription drugs. Many Canadians have private insurance to cover those services, though some struggle to pay for them out of pocket.

U.S. critics of Canadian health care like to call it socialized medicine, but it’s more like socialized insurance — meaning the risk is pooled together. And while the individual provinces and territories set their overall health budgets and administer the health plans, the delivery of medical care is private. Doctors run their own businesses and then bill the government.

Barzelai says physicians in Canada earn a good living and aren’t faced with the same administrative hassles that American doctors gripe about. “Medical costs here are half of what medical costs in the States are,” he says. “At the same time, our infant mortality is lower, our life expectancy is longer, our rates of obesity are a lot less. So there’s got to be some positive aspects of living in Canada and with the Canadian medical system.”

The Commonwealth Fund, a respected and nonpartisan U.S. health research organization, looked at deaths that could have been prevented with access to quality medical care in the leading 19 industrialized countries. In the latest survey, the United States ranked last and Canada came in sixth.

Professor Bob Evans, one of the grandfathers of the health economics field, has been studying the Canadian and U.S. systems since they were founded around the same time in the mid-1960s. He says that what many Americans hear about Canada — rationed care, long wait lists and a government bureaucrat who gets in between a patient and doctor — is “absolute nonsense.”

“Are there cases of people who wind up not getting the care they need at appropriate times? Yes, of course there are,” says Evans, who is with the Centre for Health Policy Research at the University of British Columbia in Vancouver. “This is a huge system and it’s a very complicated one and things do go wrong. But as a general rule, what happens here is that when you need the care, you get it.” But that wasn’t always the case.

‘The Most Frustrating Moments In Our System’

When federal spending on Canadian health care declined during a recession in the 1990s, lines for non-urgent procedures — and some urgent ones — grew. A few years later, Canada’s Supreme Court found that some patients had in fact died as a result of waiting for medical services. Stories of the deaths and of residents traveling to the U.S. for medical care dominated Canadian news coverage.

In response, Canada’s government poured billions of dollars into reducing wait times in the five medical areas deemed most troublesome, including cancer care, cardiac care and joint replacement surgery. And wait times for these services has dropped: Most provinces now report those times on publicly available Web sites. Such data — and public accountability — don’t exist in the U.S.

But that’s not to say there still aren’t frustrations with waiting for medical care in Canada.

Jocelyn Thompkinson is a peppy 29-year-old who was born with a neural tube defect similar to spina bifida. “I haven’t been able to walk since I was 8, and I’ve had lots of surgeries, lots of medical interventions of various types,” she says at BC Children’s Hospital, in a leafy Vancouver neighborhood. “But beyond that, I hold a job, I have a pretty much normal life.”

She credits an army of Canadian doctors and physical therapists for giving her that normal life, though there have been roadblocks. “Of course there were some times when I had to wait for care, and those are always the most frustrating moments in our system,” Thompkinson says. Several years ago, when she was on a long waiting list for a pain clinic in Vancouver, she traveled to Seattle and then Texas to get care. The visits and tests cost her $1,800.

Few Canadians actually go south for medical care, though. Canadian researchers say it’s a bit like getting struck by lighting — it’s extremely rare, but when it happens, everyone talks about it.

Provincial governments do pay for Canadians to receive specialty care in the U.S. in some cases. For example, a shortage of neonatal beds means a small number of women with high-risk pregnancies are sent to U.S. hospitals to deliver their babies.

It doesn’t happen often, though, and public opinion polls continue to show strong support for publicly financed, universal health care in Canada.

NPR.com

Originally posted 2010-03-11 02:00:20.

ROWE

No, not Rowe vs Wade (but I’m sure I’ll have a rant on that if the current court hears a case that could reverse that land mark decision)… but Result Only Work Environment; essentially a version of “Flex Time” that is focused on increasing productivity by avoiding “presenteeism” (where someone is physically in the office, but mentally somewhere else).

You can read about an article on NPR about the Human Services and Public Health Department of Hennepin County (Minneapolis, MN).

The End Of 9-To-5: When Work Time Is Anytime

Originally posted 2010-03-29 02:00:45.

Ethernet

Today in 1980 the Ethernet specifications were published by Xerox working with Intel and Digital Equipment Corporation (DIX) and the foundation of affordable networking was born.

That work is based on a wireless networking project at the University of Hawaii (ALOHAnet) lead by a brilliant visionary, Norman Abramson, who I also call a friend.

Norman Abramson

Norman Abramson on Wikipedia

Originally posted 2010-09-30 03:00:40.

The Incredible Shrinking State

Rising Temperatures, Disappearing Coastlines
December 8, 2009

Greenland and Antarctica hold the world’s largest reservoirs of fresh water, locked in their giant ice sheets. Global warming may cause large parts of these ices sheets to melt within centuries — changing the shape of coastlines around the world.

See the entire article on NPR.

Originally posted 2010-04-14 02:00:12.

The Rules of Engagement

Secretary of Defense Robert Gates is blasting Julian Assange for the release last week of some 76,000 documents his WikiLeaks site obtained from an informant relating to the “killing of thousands of children and adults” in Afghanistan and Iraq.

Mr Gates said in a Pentagon news conference:

Mr. Assange can say whatever he likes about the greater good he thinks he and his source are doing, but the truth is, they might already have on their hands the blood of some young soldier or that of an Afghan family,

Mr Assange stated:

Secretary Gates could have used his time, as other nations have done, to announce a broad inquiry into these killings. He could have announced specific criminal investigations into the deaths we have exposed. He could have announced a panel to hear the heartfelt dissent of U.S. soldiers, who know this war from the ground. He could have apologized to the Afghani people.

But he did none of these things. He decided to treat these issues and the countries affected by them with contempt. Instead of explaining how he would address these issues, he decided to announce how he would suppress them.

This behavior is unacceptable. We will not be suppressed. We will continue to expose abuses by this administration and others.

If in fact the US military is responsible for the types of conduct alleged by Mr Assange, and the Joint Chiefs and Department of Defense have knowledge of this conduct (or actually condoned or ordered it) I can certainly understand why Mr Gates would have made such remarks — and the fact that no investigation into this matter has been launched by the US would seem to indicate (once again) that the US military plays a much different game than they publicize or propagandize.

It’s clear to see why our government keeps secrets from it’s citizens — the question really is how much more have they not disclosed?

Originally posted 2010-08-06 02:00:47.

Puncak Jaya

Puncak Jaya is the name of a glacier in Indonesia that you can literally see melting — not as some would say at a glacial pace, but at a rate of six inches per week.

Puncak Jaya is one of very few tropical glaciers left.  As you might expect, glaciers in a tropical region exist in a delicate balance, and can be devastated by even slight changes to their climate.

Heavy rains throughout the region are responsible for the rapid melting of the glacier, but it’s the slight warming that’s causing the shift.

For those deep in denial who just can’t seem to admit that there’s a global climate change occurring, just open your eyes.

Originally posted 2010-09-06 02:00:16.

Bye-bye, tax breaks?

By Jeanne Sahadi, senior writer CNN
October 26, 2010: 2:05 PM ET

NEW YORK (CNNMoney.com) — Who says there’s no bipartisanship? Democrats and Republicans running for Congress are finding every way possible to assure voters they will keep Americans’ taxes low forever.

But those will be hard promises to keep after the economy recovers. Tax experts almost uniformly say the next Congress should rethink the more than 200 tax breaks in the federal code that cost more than $1 trillion a year. And, yes, that includes even the really, really popular ones.

Lawmakers may be presented with the idea as early as December, when President Obama’s fiscal commission issues its report. There is a possibility the commission may recommend curtailing or eliminating some tax breaks.

Commission co-chairman Erskine Bowles has publicly expressed support for the idea. So has commission member Alice Rivlin, former White House budget director. Another member, Republican Sen. Judd Gregg, who coauthored a bipartisan plan for tax reform, supports curtailing some breaks but only to lower marginal tax rates in the context of broader reform.

The $1 trillion-plus in forgone revenue is close to the amount allocated for defense and discretionary spending in 2010, or the equivalent of nearly a third of the latest federal budget.

Cutting back on tax breaks can be a more efficient way to bring in revenue than raising income tax rates because it would subject more work and business income to taxation. If done right, it also promises to make the tax code fairer and simpler.

For years, leading tax experts and economists from the left and the right have contended that tax breaks are, in reality, a form of spending. The cost of tax breaks is mostly invisible, since there’s no formal accounting of them on Uncle Sam’s books. And once passed into law, they are rarely scrutinized.

“[Tax breaks] are styled as tax savings, but really function as replacements for explicit government spending. Some make sense, but a great many are poorly targeted and would never pass Congress if presented as an outright spending proposal,” tax expert Edward Kleinbard wrote in an article this summer called, “Sacred Cows: It’s Them or Us.”
Popular tax breaks: Dogfight ahead

A disproportionate amount of the lost revenue from tax breaks comes from just five of them.

Not surprisingly, those five are also among the most popular:

  • mortgage interest deduction;
  • tax-free income workers get from employers to pay for health insurance;
  • deduction for state and local taxes;
  • deduction for charitable contributions;
  • and myriad tax breaks for retirement savings.

Many of those breaks are only available to the roughly one-third of taxpayers who itemize deductions on their returns.

There have been a number of proposals over the years for how the biggest breaks might be modified.

Most recently, the bipartisan Committee for a Responsible Federal Budget put out a paper highlighting many possibilities that combined could raise $1.7 trillion in additional revenue over a decade.
Think you’re smart about deficits? Try this

For instance, consider the money that workers receive when their employers contribute to their health insurance costs. That subsidy is currently treated as tax-free income to the worker and is unlimited.

The subsidy could instead be converted to a credit, which is a dollar-for-dollar reduction of one’s tax bill. The credit would be phased out for higher income taxpayers and it would be refundable for low-income workers who don’t make enough income to owe any federal income tax.

“This strategy would reduce the incentive for employers to offer ‘gold-plated’ insurance plans,” the budget watchdog group wrote.

The mortgage interest deduction — currently available on up to $1.1 million of borrowing — could be gradually reduced so that it only applies to loans on up to $500,000. And the option tax filers get to deduct interest on their second homes could be eliminated.

“[Today’s] policy is regressive (providing larger tax breaks to those well off enough to purchase more expensive homes), promotes homeownership over other productive investments and costs the government roughly $100 billion a year in lost revenues,” the committee noted in its paper.

Since everyone in Congress can identify and vilify what they see as “tax breaks for special interests,” curbing tax breaks has a lot of bipartisan support. The problem, of course, is that there’s less agreement on just which tax breaks deserve the ax or at least a haircut.

And, of course, since politicians much prefer to hand out tax breaks to voters and financial backers, it may be hard for them to muster the mettle required to reverse gears.

How hard? Bowles put it plainly at the fiscal commission’s public meeting in September.

“It’s not going to be easy,” he said. “It’s not going to be fun, and in many cases, it’s also not going to be popular. It is going to require sacrifice on the part of all Americans to get there.”

Original Article on CNN.com

Originally posted 2010-11-06 02:00:55.

April Fool’s Day

Pull a prank — and find out more about the history and origin of April Fool’s day.

April Fool’s Day on Wikipedia

Originally posted 2010-04-01 01:00:33.