[ExI] Single Payer Healthcare

[Stathis Papaioannou]

On Mon, 3 Apr 2017 at 1:19 am, spike <spike66 at att.net> wrote:

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> *From:* extropy-chat [mailto:extropy-chat-bounces at lists.extropy.org] *On
> Behalf Of *John Clark
> *Sent:* Sunday, April 02, 2017 7:19 AM
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> *To:* ExI chat list <extropy-chat at lists.extropy.org>
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> *Subject:* Re: [ExI] Single Payer Healthcare
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> On Sun, Apr 2, 2017 at 1:15 AM, spike <spike66 at att.net> wrote:
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> ​> ​>…Most USians know of Canadians who have done hail Mary plays down
> here.  That means we get a lot of really sick people who spend a buttload
> of money on something that may or may not work.  How does it figure in?
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> ​>…I'm a ​USian and I don't know anybody like that, but I do know of some
> who go to Canada to buy drugs because they are much cheaper. And I know how
> that figures in.
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> John K Clark
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> Clarification: when I lived in Washington state, we had Canadians who came
> to the US for cancer treatment in particular.  When one gets cancer, the
> speed and competence of treatment is everything.  In the Canadian system if
> a patent gets cancer and needs aggressive treatment, they are treated in a
> particular order with that order decided somehow (how?)
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> Canadian triage takes into account age, chances of recovery, general state
> of health and so forth.  The US system does not.  The Canadian comes to the
> US, where the order and extent of treatment is determined by what the
> patient can afford.  When one is going to die, one can afford a lot of
> things once thought too expensive.
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> John how did you think they distribute medical care in countries where the
> government pays?  You should get to know some Canadians, particularly ones
> who have come to the USA for medical treatments.
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> Regarding going to Canada to buy drugs: they are much cheaper there.
> Canada doesn’t really need a system like we have to determine the safety
> and efficacy of a drug.  That process of FDA approval costs over a billion
> dollars, a billion **real** US dollars.  Since Canada (and everywhere
> else) can just use US FDA approved drugs without that enormous expense,
> they can sell the drugs much cheaper, with the cost of production a tiny
> fraction the cost of FDA approval.  USians pick up the tab for the FDA.
> When I lived in Washington I knew plenty of USians who did exactly that:
> took a day trip to Canada to load up on medications.
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> Well, that doesn’t seem quite right, so let’s do this: US-ians can use
> drugs that are approved by another country’s version of the FDA, some place
> with a very high tax rate.  How about… Burundi.  If Burundi’s FDA approves
> a medical treatment program, we just use theirs, free.  We can disband our
> FDA, don’t need them.  If Burundi’s standard treatment for cancer is a
> feathered bone-thru-the-nose guy dancing around casting out evil spirits,
> well that shouldn’t cost much, doesn’t require any particular medical
> equipment (depending on how you count the nose bone (those aren’t cheap you
> know.))
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> This approach leaves still a number of imponderables, such as: do the
> witch doctors employ witch nurses?  And after the procedure is there a
> recovery facility, and if so, is it called a witch nursing home?  What are
> their medical review boards like?  Bet that’s a hoot.  Do the medical
> students need an undergrad degree in Burundi?  And what if the witch doctor
> is incompetent, the surgery goes wrong and she accidentally casts out a
> good spirit, causing the patient to get worse?  Are witch doctors required
> to carry malpractice insurance?  And what if we discover a witch doctor
> isn’t really a doctor but is an actual literal witch, who falsified medical
> or spiritual credentials?  What if she is in practice with someone who is a
> doctor but isn’t a witch?  If the two work together can they qualify?
> Which witch is guilty of malpractice?
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> We know US style medicine is expensive the way we do it.  The US is
> subsidizing drug development for the whole world.
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I'm not sure about Canada but in Australia there is a parallel private
health system which anyone can access if they have private insurance or pay
cash. The main advantage to this is that some elective procedures such as
joint replacements are faster in the private system; you may only have to
wait two weeks rather than two months. But complex and life-threatening
conditions are often treated in public hospitals by choice even for the
privately insured, because public hospitals have the best facilities and
expertise.

> --
Stathis Papaioannou
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