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Thread: Further discussion about Health Care as a "Right"

  1. #21
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    [QUOTE=CanadaSteve]Here's another question for GreenWave:

    We have a few doctors in the family, and I am amazed at how they do not agree that our "health-care" system is really a "sick-care" system. What I mean is this.

    They are trained as doctors to heal the sick. When someone comes in with an ailment, or have injured themselves, their job is to "fix" them.

    However, when it comes to preventative measures (such as diet, exercise, alternative/homeopathic medicine, chiropractic) it appears they all have little training in this.

    Would it not make more sense to focus our efforts on ways for people to live healthier lives, which would cut down on health care costs to begin with? [/quote]

    Well, of course that would be great...but to my knowledge, there are no definitive studies to suggest that any preventative measures are particularly likely to lead to an increased life span that would need to be initiated by physicians. Stuff like this can be taught by lesser credentialed healthcare providers (nutritionists, RNs, exercise science majors) which would make a heck of a lot more sense economically.

    What I mean is, we all know that smoking is bad, overeating is bad, lack of exercise is bad, a poor diet is bad....but as much as physicians should preach this stuff at every opportunity, it doesn't require a MD to tell you that the above things are bad (and patients don't listen to advice on these topics much anyway, which is why I left Internal Medicine for Anesthesia..it's frustrating). You cannot force people to lead 'clean lives' as much as any nanny-state government would like too.

    People aren't coming to see me for 'preventative' care as much as they are with an acute problem, but then again, I'm not a primary care physician....I'm just a dumbass anesthesiologist.

    [QUOTE=CanadaSteve]Also, do you feel, as a physician, that drug companies, not consciously anyway, try and defer this kind of thinking since the money they make comes more for treating patients after the fact then before the fact?[/QUOTE]

    No I do not believe that at all....in either sense that you might mean the question.

    Drug companies make money by making products that can be beneficial, whether you are acutely sick or not. Hence the search for anti-obesity drugs, cervical cancer preventative vaccines, chicken pox vaccines, alzheimer's disease preventatives and others.

    Regarding Pharma Companies, there is a terrible lack of comprehension about drugs and medications amongst the populace.

    The human body is an exceedingly complex system, but people fail to realize that even though the body as a whole is complex, there are multiple examples of overlap between organ systems with regard to the biochemical processes/reactions that govern bodily function. A biochemical reaction that might slow the heart rate and lower blood pressure in the cardiovascular system might cause a far different reaction in the brain of some individuals because similar biochemical processes are active in each organ system.

    One needs to look no further than the example of Vioxx from Merck...I can elaborate the specifics if you want, but suffice it to say that the same inhibition of an enzyme that mediated pain responses, also mediated platelet aggregation which [b]may[/b] lead to a slight increase in heart attack. The effect was small enough that in clinical studies it was not readily apparent. Greater than 99.999% of patients taking Vioxx benefitted, less than 0.001% [b]may[/b] have been harmed...and for that, they almost get sued out of existence. Oh, and BTW, there are multiple companies out there that are now selling silicon implants again...after the legal system destroyed Dow Corning over some lawyers ability to convnce some juries that they were harmful based on exceedingly 'bad' science.

    I'm getting off track here, but wanted to emphasize other sticking points regarding health care in the US (and probably throughout the world)...it is over regulated, over criticized, over utilized, over sued and under funded/paid relative to it's importance in everyone's life.

    The reason I know how important health care is in people's lives is the zeal that some are using to usurp it and control it and the machinations being invented to construct arguments about the 'moral obligation to provide health care to everyone'....no one waste's their time over things that are not valuable or vital in their lives.

    But this is the exact reason that we should expound on the immoral acts of those that would take control of a system for their own good, but in the end destroying it for everyone; no one is going to go into a field that requires a great deal of self and financial sacrifice only to lose control over their livelihood and autonomy to a bunch of politicians. People in the US need to know that they are playing with fire here...there is no other place on the planet that leads the US in innovative health care discoveries. They say the road to hell is paved with good intentions.....well, it's applicable here.

  2. #22
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    Okay, I'm going to keep going, if its okay with you Greenwave:

    So how then, for Canada's sake, would you suggest a "tiered" system. Canada will not relinquish its universal health care....not anytime soon.

    However, with the ability to start from scratch and move in a different direction, what would you suggest as a starting point? Is my suggestion about GP's a good one, in the sense that they be the first to go "private."

    Also, innovative wise, what about Canada in this regard? I live in London, Ontario, and even before I ever did, (especially when I was in Banff working during medical conferences), University Hospital at Western University was always touted as a leader world-wide in medical research and break-throughs. Would you agree that Canada has contributed significantly in this regard? I know this has nothing to do with universal health care, but just curious.

  3. #23
    [QUOTE=CanadaSteve]Okay, I'm going to keep going, if its okay with you Greenwave:

    So how then, for Canada's sake, would you suggest a "tiered" system. Canada will not relinquish its universal health care....not anytime soon.

    However, with the ability to start from scratch and move in a different direction, what would you suggest as a starting point? Is my suggestion about GP's a good one, in the sense that they be the first to go "private."

    Also, innovative wise, what about Canada in this regard? I live in London, Ontario, and even before I ever did, (especially when I was in Banff working during medical conferences), University Hospital at Western University was always touted as a leader world-wide in medical research and break-throughs. Would you agree that Canada has contributed significantly in this regard? I know this has nothing to do with universal health care, but just curious.[/QUOTE]

    CS, I really don't know how Canada's health system works. But is it true that it is paid for with very high taxes and there are waiting lists for CT scans and the like. The problem I see with a government run Health care system especially in the US that it is doomed to failure just like anything the govt gets their hands on. Call me a pessimist.

  4. #24
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    [QUOTE=CanadaSteve]Okay, I'm going to keep going, if its okay with you Greenwave:[/quote]

    Fine by me.

    [QUOTE=CanadaSteve]So how then, for Canada's sake, would you suggest a "tiered" system. Canada will not relinquish its universal health care....not anytime soon.[/quote]

    I don't have an opinion....you guys can do what you want. I don't think you are being particularly smart about it, but thats JMO.

    I see the Canadian patients coming here for care...I see the Canadian physicians leaving your system and coming here to work. It's a death by a thousand knives, but it still death (for the system that is).

    And, I would caution Canadians that the dynamics might change...I know that you do not agree that we subsidize anything up there, but IF the US ratchets down pharmaceutical prices here, expect an increase up there. Drug companies will either make a profit, or they will restrict selling their wares to those markets that cover their costs.

    [QUOTE=CanadaSteve]However, with the ability to start from scratch and move in a different direction, what would you suggest as a starting point? Is my suggestion about GP's a good one, in the sense that they be the first to go "private." [/quote]

    I'm not sure what you mean by that, but in any case I believe it to be well-founded but still wrong.

    I understand your point about the GP's going 'private' to get more people covered, but if the market for GP's is better than the market for specialists, if don't allow the specialists to go 'private' too, you are going to have a glut of GP's and no surgeons/anesthesiologists/radiologists/gastroenterologists etc.

    IMO the free market always determines fees, income and directs people to where the NEED to go, so that supply can meet demand....no artificial stimulus or government intervention can do the same.

    [QUOTE=CanadaSteve]Also, innovative wise, what about Canada in this regard? I live in London, Ontario, and even before I ever did, (especially when I was in Banff working during medical conferences), University Hospital at Western University was always touted as a leader world-wide in medical research and break-throughs. Would you agree that Canada has contributed significantly in this regard? I know this has nothing to do with universal health care, but just curious.[/QUOTE]

    Well, actually is does have a great deal to do with Universal Health Care.

    If you want innovation, then you need to attract the best and brightest to the field....restricting autonomy, income and career potential will do nothing to attract talent.

    I am not a medical historian, and can only speak in generalities when it comes to medical innovation and discoveries.

    I suppose that as long as your government has enough funds to prime the research pump, they can stave off the decline...but inevitably it can not keep up and will fail because the funding is 'artificial' in nature and not sustainable as it would be if it were financed by private enterprise and capitalists.

    I'm sure that it is clear to you now that IMO, there is [b]nothing a government can do better, or more economically, than the private sector, which consists of individuals acting in their own best interests[/b]. You'd rather trust the government to dictate that the lesser among us get care rather than trust in individual physicians to see that the care is available, and that IMO is plain wrong. I am a caring, compassionate, identifiable local healthcare provider, just looking for an even shake; the government is an unidentifiable entity that cares for no one in particular while stating that they care for all. Charitable health care was rampant in America in years gone by, until the government decided that for individuals to accept charity was demeaning....what is amazing is that most cannot understand that the decrease in charity among Americans (although we are still the most charitable nation on earth) began when the government began taking increasing amounts of individuals income, believing they knew better than us how our money was best spent.

    Charity is freely given, and heart-felt...it is understood by both parties involved and furthers humanity. Government induced theft and redistribution of money and services, for whatever stated crisis, is much different. It creates hatred, distrust and insolvency. We used to understand the difference here, but the climate is changing.

    Everyone needs to understand that when governments make decisions (and not just in health care), they are not made in a vacuum....people react, and act, on those decisions. If the government takes more and demands more, people have less to give of themselves freely. If government taxes more, people will earn less...why work for eveyone else but yourself? If the Canadian government makes their healthcare system not physician friendly, the Doctors move here. Government in Canada restricts services? Well, it's just short ride to Buffalo or Detroit.

    So, I guess to answer your question (I have rambled), I would leave important sectors of my economy in the hands of the people who know best how to manage it....and as fellow human beings, know who requires assistance at times of need.

  5. #25
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    Green....

    How do you feel about medicinal marijuana?

    Do you think it to be extremely ignorant of our society to totally dismiss any benefits from it solely based on its illegality?

    I have a few tenants that prefer it to standard Big Pharm drugs as a way to treat anxiety associated with PTSD. Are they legit or just plain hippies?

    Also...solely based on a medical and health perspective, rate these three drugs in order of which one causes the most health problems to the one that causes the least...Alcohol, tobacco and marijuana.

  6. #26
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    [QUOTE=PlumberKhan]Green....

    How do you feel about medicinal marijuana?

    Do you think it to be extremely ignorant of our society to totally dismiss any benefits from it solely based on its illegality?

    I have a few tenants that prefer it to standard Big Pharm drugs as a way to treat anxiety associated with PTSD. Are they legit or just plain hippies?

    Also...solely based on a medical and health perspective, rate these three drugs in order of which one causes the most health problems to the one that causes the least...Alcohol, tobacco and marijuana.[/QUOTE]
    I would say 1. tobacco, 2. Alcohol 3. marijuana.
    Alot of this is probably due to numbers using and amount used, though. Don't know too many people who smoke 2 packs of joints a day!

  7. #27
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    [QUOTE=PlumberKhan]Green....

    How do you feel about medicinal marijuana?[/quote]

    I'm not willing to discredit it...hell, some drug company synthesizes Marinol and sells it. Bad delivery vehicle in the smoke, but if it helps someone and they understand the risks, what do I care?

    [QUOTE=PlumberKhan]Do you think it to be extremely ignorant of our society to totally dismiss any benefits from it solely based on its illegality?[/quote]

    If the criticism of it as a medicinal is based on illegality, then yes, that would be ignorant.

    To be honest, I really haven't followed the medicinal marijuana debate all that much other than to note that the fight is being waged by the 'all drugs should be legalized' vs. the 'all drugs need to be criminalized' sects of society...most reasonable people probably fall somewhere in between.

    Hell, ALL narcotics are addicting and they are illegal without a Rx...what's the big deal with marijuana?

    [QUOTE=PlumberKhan]I have a few tenants that prefer it to standard Big Pharm drugs as a way to treat anxiety associated with PTSD. Are they legit or just plain hippies?[/quote]

    Personally, I would believe they're all hippies looking for an excuse to use...but as I'm not a psychiatrist I can't comment on whether or not it would be useful in that scenario. But I wouldn't rule it out.

    [QUOTE=PlumberKhan]Also...solely based on a medical and health perspective, rate these three drugs in order of which one causes the most health problems to the one that causes the least...Alcohol, tobacco and marijuana.[/QUOTE]

    The worst would have to be tobacco...even used in moderation, it can be harmful.

    Next would be MJ...less impurities than tobacco and much less tar per weight.

    Last would be Alcohol...unless used in excess, and then it might jump up a spot. Hell, there is even some evidence that alcohol in moderation may be beneficial to your health.

    But then again, isn't moderation always an issue? ;)

  8. #28
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    [QUOTE=MnJetFan]CS, I really don't know how Canada's health system works. But is it true that it is paid for with very high taxes and there are waiting lists for CT scans and the like. The problem I see with a government run Health care system especially in the US that it is doomed to failure just like anything the govt gets their hands on. Call me a pessimist.[/QUOTE]


    Yes to all the above. Almost ten percent of our taxes go towards our health care system. It is a system that worked for awhile, but in the end, needs major reforms. Wait times have risen astronomically, shortage of beds, emergency wait times. I needed stitches a few years ago and went to the emergency, signed in and left for four hours. I then returned and still had to wait another hour before I got seen. This is quite common, yes. People are waiting, years in some cases, for stuff like knee replacement surgery. We just don't have enough doctors, and hospitals are facing larger and larger cut-backs.

  9. #29
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    [QUOTE=CanadaSteve]Yes to all the above. Almost ten percent of our taxes go towards our health care system. It is a system that worked for awhile, but in the end, needs major reforms. Wait times have risen astronomically, shortage of beds, emergency wait times. I needed stitches a few years ago and went to the emergency, signed in and left for four hours. I then returned and still had to wait another hour before I got seen. This is quite common, yes. People are waiting, years in some cases, for stuff like knee replacement surgery. We just don't have enough doctors, and hospitals are facing larger and larger cut-backs.[/QUOTE]

    Aren't you the same guy that has asked us not to poo-poo socialized medicine in other threads?

    Everything you just mentioned in that quote is what I said would happen with a socialized medicine program...why would we want that? Are your 'reforms' going to magically correct those deficiencies without increasing the costs?

    Or do you just believe in shared misery, which is what a federal health care program in the US would evolve to if it was enacted (more than it is now).....

    It would be available to all, at least Mon-Fri from 0800-1700, but with equal suckitude for all the patients across the financial spectrum.

    Americans want better.

  10. #30
    [QUOTE=CanadaSteve]Yes to all the above. Almost ten percent of our taxes go towards our health care system. It is a system that worked for awhile, but in the end, needs major reforms. Wait times have risen astronomically, shortage of beds, emergency wait times. [B] I needed stitches a few years ago and went to the emergency, signed in and left for four hours. I then returned and still had to wait another hour before I got seen.[/B] This is quite common, yes. People are waiting, years in some cases, for stuff like knee replacement surgery. We just don't have enough doctors, and hospitals are facing larger and larger cut-backs.[/QUOTE]

    Waiting 4 hours to get stiches is [B]not[/B] unusual in America's inner city hospital ERs.

  11. #31
    [QUOTE=Greenwave81]Aren't you the same guy that has asked us not to poo-poo socialized medicine in other threads?

    Everything you just mentioned in that quote is what I said would happen with a socialized medicine program...why would we want that? Are your 'reforms' going to magically correct those deficiencies without increasing the costs?

    Or do you just believe in shared misery, which is what a federal health care program in the US would evolve to if it was enacted (more than it is now).....

    It would be available to all, at least Mon-Fri from 0800-1700, but with equal suckitude for all the patients across the financial spectrum.

    [B]Americans want better[/B].[/QUOTE]

    This is part of the problem.
    What American's [B]WANT[/B] is not always medically necessary or emergent.
    In socialized medicine people have to wait for non-emerganty procedures and uneccesary CT Scans/MRIs are deemed wasteful and not done. The average lay person does not understand that. Thats part of the problem.

    There is no reason why we can not have a universal health care system AND allow for private insurance for those who can afford to buy it. This is done in many European Nations

  12. #32
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    [QUOTE=CanadaSteve]Yes to all the above. Almost ten percent of our taxes go towards our health care system. It is a system that worked for awhile, but in the end, needs major reforms. Wait times have risen astronomically, shortage of beds, emergency wait times. I needed stitches a few years ago and went to the emergency, signed in and left for four hours. I then returned and still had to wait another hour before I got seen. This is quite common, yes. People are waiting, years in some cases, for stuff like knee replacement surgery. We just don't have enough doctors, and hospitals are facing larger and larger cut-backs.[/QUOTE]
    Why don't you think you have enough doctors?

  13. #33
    [QUOTE=jets5ever]Why don't you think you have enough doctors?[/QUOTE]

    The # of MDs Canada graduates each year is relatively small and it is nearly impossible for foreign trained MDs to get licensed and work in Canada.

    If the USA had the same restrictions for foreign trained MDs to get licensed in the USA we also would have a terrible nationwide shortage of docs.

  14. #34
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    [QUOTE=Greenwave81]Aren't you the same guy that has asked us not to poo-poo socialized medicine in other threads?

    Everything you just mentioned in that quote is what I said would happen with a socialized medicine program...why would we want that? Are your 'reforms' going to magically correct those deficiencies without increasing the costs?

    Or do you just believe in shared misery, which is what a federal health care program in the US would evolve to if it was enacted (more than it is now).....

    It would be available to all, at least Mon-Fri from 0800-1700, but with equal suckitude for all the patients across the financial spectrum.

    Americans want better.[/QUOTE]

    Green, I have said all along that I don't think socialized medicine could work in a country with over three hundred million people, and I have never said there isn't anything wrong with our system.

    And I would think that I have been pretty open to listening to your suggestions, since you are a doctor and I am a seminary student. I think I have given you the respect in your knowledge, and have asked for that knowledge.

    Canada will not give up its universal health care. Not anytime soon, because it is part of being Canadian, just like Capitalism is apart of the United States. However, I am not naive in my thinking that there are not flaws in how we execute it. I have been raised in this system to believe that everyone gets the health care (eventually) they should get. But I also see that with almost one in every ten tax dollars going toward a "sick-care" system, this is going to either end in no system at all, or one that is going to get too expensive for us to afford.

    That is why I want to listen to people like yourself who are outside the system and can give suggestions as to how to improve it. But this is where we run into problems, for when you live outside of the U.S. (in many cases), we don't believe that unrestricted capitalism is the way to go. That privatization of everything is not the way to go. While it has its positives, it also has its negatives, and is not the way for everyone to have to live. If it works for the U.S., great...but there are societies, cultures, countries that do not want to embrace this philosophy.

    So, back to your comment. I am all ears for listening and learning about how the U.S. runs their medical system, and I firmly believe there is a way to ensure that people can get the health care they need without having to mortgage their homes to get it, while doctors can earn their fees for the important work they provide for society...

  15. #35
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    [QUOTE=jets5ever]Why don't you think you have enough doctors?[/QUOTE]

    What he said:

    [QUOTE=kennyo7]The # of MDs Canada graduates each year is relatively small and it is nearly impossible for foreign trained MDs to get licensed and work in Canada.

    If the USA had the same restrictions for foreign trained MDs to get licensed in the USA we also would have a terrible nationwide shortage of docs.[/QUOTE]

    Also, they go south of the border to make more money...period.

    I do not begrudge a person moving so they can earn a greater living, but I do think they should have to put in some time on their native soil. If they received their education (which contrary to the bit**ing and moaning of students here in Canada about tuition fees is REMARKABLY subsidized by federal tax dollars) they should have to offer their services to the Canadian medical profession for at least a few years...my opinion of course.

    Again, private health care worked for this country for MANY, MANY years. However, we are coming into an era where we just have too many people (even at around a population of 35 million), a good percentage of which are hitting retirement age and above (thanks to the baby boomers).

    We are also starting to see the drastic results of the affects of smoking from the 1930's-1950's. The care for cigarette-related sicknesses have skyrocketed here, and it is taxing the system. As is the constant need for updated medical equipment, and insurance for doctors.

    Canada at one time was a country where it was incredibly hard to sue someone. I was in a car accident when I was sixteen, and I sustained a broken right arm (with severe nerve damage), bruised ribs, sprained ankle, and a concussion. The driver was the sister of a good friend of mine. I spent a week in the hospital, underwent an eight-hour surgery to repair my arm and nerves, and was in physio for six months. The lawsuit netted me three thousand dollars. I was talking to a lawyer one time about that, and he said if that had occurred more recently in Canada, I would have retired a millionaire.

    Our court systems are changing, and we are becoming more "Americanized" with frivolous lawsuits...this has drastically altered the costs for Physicians to do business...

    Anyway, sorry for the long reply.

  16. #36
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    [QUOTE=kennyo7]Waiting 4 hours to get stiches is [B]not[/B] unusual in America's inner city hospital ERs.[/QUOTE]


    Sorry, the point was at one time, you could walk into an emergency in many places in Canada and be treated within an hour for whatever the trouble was...now, there are extremely longer wait times.

  17. #37
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    [QUOTE=kennyo7]T

    There is no reason why we can not have a universal health care system AND allow for private insurance for those who can afford to buy it. This is done in many European Nations[/QUOTE]


    This was one of my points. Many European (and to my knowledge Scandinavian countries leading the way) in which the two appear combined. I think Canada personally needs to let go of their original concept of socialized medicine, and allow for their to be reforms that embrace some private aspects to alleviate the heavy-tax burdens we are facing because of our over-worked system.

  18. #38
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    [QUOTE=kennyo7]This is part of the problem.
    What American's [B]WANT[/B] is not always medically necessary or emergent.[/quote]

    Only a liberal would think that way...why do you know better what everyone wnats or needs than the individual themselves? And, if they can afford it and want to pay for it, why do you begrudge them?

    Who are you to decide what is medically necessary or emergent?


    [QUOTE=kennyo7]In socialized medicine people have to wait for non-emerganty procedures and uneccesary CT Scans/MRIs are deemed wasteful and not done. The average lay person does not understand that. Thats part of the problem.[/quote]

    Excuse me if I don't understand why you (or the government) get to decide what is necessary or uinnecessary in [b]my life[/b].

    If my knee hurts, and it is affecting my job and life, why should I wait until you, or somone that thinks like you, decides that an MRI is necessary...just so that I can get on the 'list' to get my non-emergent knee scope 9-12 months from now?

    [QUOTE=kennyo7]There is no reason why we can not have a universal health care system AND allow for private insurance for those who can afford to buy it. This is done in many European Nations[/QUOTE]

    Except that as soon as you do that, everyone on the federal program will run and scream to get the government to provide what everyone else is working to afford...it's what led to the mess in the US in the first place.

    We have universal health care right now...go ahead, don't shave or shower for 4 days and then pretend you are homeless and broke, make up a name and go to an ER complaining of abdominal pain or the worst headache of your life....tell them you have no insurance, and no means to pay...I bet you get seen.

    Half of the people without medical insurance are that way [b]by choice[/b], taking the extra cash from the employer instead...most (I said most) of the others who are truly poor are too lazy to go to the government office and sign up for Medicaid. Hell, here in MO kids qualify for medicaid even if the parents make up to 3X the poverty level (about $50K/yr)...and for an average young adult, a catastrophic policy would cost less than the cost of cigarettes or booze for a year.

    Because people make bad choices in life shouldn't screw the system for the rest of us.

  19. #39
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    [QUOTE=kennyo7]The # of MDs Canada graduates each year is relatively small and it is nearly impossible for foreign trained MDs to get licensed and work in Canada.

    If the USA had the same restrictions for foreign trained MDs to get licensed in the USA we also would have a terrible nationwide shortage of docs.[/QUOTE]

    Okay, so who created these restrictions? Also, how much do MDs in Canada get paid, relative to MDs in America?

  20. #40
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    [QUOTE=CanadaSteve]This was one of my points. Many European (and to my knowledge Scandinavian countries leading the way) in which the two appear combined. I think Canada personally needs to let go of their original concept of socialized medicine, and allow for their to be reforms that embrace some private aspects to alleviate the heavy-tax burdens we are facing because of our over-worked system.[/QUOTE]

    And what do these Scandanavian countries have, 16 million residents or so?

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