Nothing is 'free'. Originally our healthcare was mostly funded by the provincial governments, and that was largely done through a sales tax. Here in Nova Scotia it used to be 10%. I think it then went to 11% or so before our provincial and federal sales taxes were integrated about 10-15 years ago. The present provincial portion of the 13% sales tax is 8%. In later years the feds have kicked in a lot more money, but it's still largely a provincial responsibility... and varies by province.
The only additional coverage anyone needs here is for dental and drug plans as those are both private. Medicare will keep you alive in a hospital but it won't cover a lot of drugs if you're not admitted to hospital. Private insurance also covers all the extras while you're in a hospital like private rooms, TV, etc. Medicare is basic coverage and strictly related to what you need medically... Medicare is also universal here in that anyone who is a resident is entitled to services if they have a healthcard.
There are certainly problems with the system here in regards to wait times, and I think it's fair to say that when it comes to treatment... if there is a less expensive procedure and a more expensive procedure, a doctor is likely to think about the likely outcomes before sending you for the expensive procedure. I guess you might say that people are sometimes steered towards accepting their fate rather than pulling all the stops... although medically they might be just as well off. I know of people who had to fight to have things done wheras in the US system, if you've got the money, you get what you want. It may not help, but it was tried... The wait time issues here are mostly a recruitment problem with staff. You can't get people who aren't out there. As I understand it, there's poaching of personelle going on from one end of this continent to the other.
As far as the bureaucracy aspect of medicare is concerned, there are management issues there, without doubt. However, I don't think those issues are any less in a private setting with the same level of bureaucracy. I don't beleive it to be a public/private issue but simply a size issue. With a certain size operation, a management structure must be developed... and management structures become bureaucratic. Hello, GM....
Personally I beleive that if there was a recommitment to medicare in this country at the political levelm then the management structure could be changed in the necessary ways to get the staff and other resources needed to provide better care. I'm not sure it really requires more money, but perhaps sometimes a different point of view on some subjects. There's so much dogma involved here that practical solutions tend to be nixed out of fear... With all that said, I still would not want a private, for profit health system. If one wanted to look at the overall efficiency of our system, you could say that it provides one of the best levels of care anywhere in the world, with little concern of cost to the individual, and provides it to every resident of the country. The US has the very best care for those with the most money, none for those with no money, and probably a balance somewhere in between for the average citizen... for which they pay high insurance premiums, high sales taxes and high income taxes. I think one needs to look at this in perspective...
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