From: Duncan Frissell <frissell@panix.com>
Date: Thu, 19 Sep 1996 11:23:18 +0800
To: unicorn@schloss.li>
Subject: RE: Risk v. Charity (was: RE: Workers Paradise. /Political.
Message-ID: <3.0b19.32.19960918165617.00a19168@panix.com>
MIME-Version: 1.0
Content-Type: text/plain


At 03:44 PM 9/18/96 EST, jbugden@smtplink.alis.ca wrote:

>I did not respond to the other poster because it seemed clear that he was not
>informed on the subject. While people debate the precise reasons for it, the
>Canadian health system spends about two thirds as much as the U.S. system
as a
>percent of GNP while covering more people as a percent of population. This
is a
>fact.

Canada has the world's second most expensive system (after ours) and I
think is a bit closer to 80% of our per cap expenditures.  Canada's costs
and ours used to track pretty well.  When Canada adopted the Provincial
Health Systems model in the mid '60s they fell 20% (relative to us -- while
our costs were exploding because of Medicare-Medicaid).  Since then,
Canadian costs have risen at approx the same rate as ours.  

Per cap expenditures on the uninsured in America are approximately the same
as on the insured.  As are average number of days in hospital, etc.  Most
of the uninsured just go to hospitals and don't pay.  States have various
methods of sharing this cost out.  Interestingly, even though government
expenditures here are 60% of the total, per cap government expenditures on
health care are higher here than in the UK under the Nattie Health.  

Our system is much more expensive than it has to be because the
unrestricted insurance model encourages over consumption.  Americans are
very assertive about getting what's coming to them.  They don't like to
wait.  They can only be restrained by market pricing. 

>This is another way to create risk pool seperation as well as reduce health
>costs. Some people will not be able to afford tobacco, reducing the potential
>candidates for tobacco related illness. The additonal revenue can be used
as a
>"risk premium" to fund the related long term medical expenses.

Course Canada lost it when smuggling defeated the high tax levels on
cigarettes.  This will be more of a problem in the future as more efficient
markets enable more smuggling.
 
>If all you do is replace Big Brother with Big Business, then all that has
>changed is the name.

GM shoots fewer people than the US Gov.  And if they started shooting more
people, their cash flow would suffer.  People are willing to accept less
violence from private institutions, however large, than from governments.

In addition, average institutional size is down.  Big business is smaller.

DCF