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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>From:</span></b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> extropy-chat [mailto:extropy-chat-bounces@lists.extropy.org] <b>On Behalf Of </b>John Clark<br><b>Sent:</b> Sunday, April 02, 2017 7:19 AM<br><b>To:</b> ExI chat list <extropy-chat@lists.extropy.org><br><b>Subject:</b> Re: [ExI] Single Payer Healthcare<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><div><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>On Sun, Apr 2, 2017 at 1:15 AM, spike <<a href="mailto:spike66@att.net" target="_blank">spike66@att.net</a>> wrote:<o:p></o:p></span></p></div><div><div><p class=MsoNormal><o:p> </o:p></p></div><blockquote style='border:none;border-left:solid #CCCCCC 1.0pt;padding:0in 0in 0in 6.0pt;margin-left:4.8pt;margin-right:0in'><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> <o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Arial",sans-serif'>> >…</span><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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?</span><span style='font-size:11.0pt;font-family:"Arial",sans-serif'><o:p></o:p></span></p></div></blockquote><div><p class=MsoNormal><o:p> </o:p></p></div><div><div><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>>…</span><span style='font-size:13.5pt;font-family:"Arial",sans-serif'>I'm a </span><span style='font-size:13.5pt;font-family:"Calibri",sans-serif'>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.</span><span style='font-family:"Arial",sans-serif'><o:p></o:p></span></p></div></div><div><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Calibri",sans-serif'>John K Clark<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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?) <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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 *<b>real</b>* 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.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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.)) <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>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?<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>We know US style medicine is expensive the way we do it. The US is subsidizing drug development for the whole world.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>spike<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></p></div><div><p class=MsoNormal><span style='font-size:13.5pt'> </span><o:p></o:p></p></div><div><blockquote style='border:none;border-left:solid #CCCCCC 1.0pt;padding:0in 0in 0in 6.0pt;margin-left:4.8pt;margin-right:0in'><p class=MsoNormal style='margin-bottom:12.0pt'><o:p> </o:p></p></blockquote></div><p class=MsoNormal><o:p> </o:p></p></div></div></div></body></html>