<blockquote><i>And why can't Alberta have private-run health clinics as long as there is access for all?</i></blockquote>

Because there's a doctor shortage. There would be access to all, AFTER there was access for the rich. I'd rather not die while waiting.

That would only occur if there was a two-tiered system. Are you saying there is no possibility of a one-tiered system with private participation?

Nope!

Short of a law requiring doctors to work at least x hours in the public system at public pay? Why would any doctor - a limited resource, which is they key strength in a capitalist system, that scarcity/demand drives up prices - work for the public system? Young ones, maybe, or those with less experience. Either way, there would be fewer doctors available to the public system. Even if demand saturated at a level - say 500 doctors accepting only high-paying clients - that's 500 fewer skilled doctors available to the public system. No, I don't see how it would work short of the public system paying private rates. Wait, we already do that. So... ?

Private participation need not be about patients directly pay general practitioners. It can be more at the wholesale level. Clinic for only certain functions being funded by drug companies or pharmacies, say, or the public purchase of testing services from private suppliers. Or private insurance for non-covered drugs. Moving from private practice to public service, I received a drug plan benefit. This is essentially private health care of a sort. Those things all happen now. Could not a one-tiered system where the supply of the privately run service is available to all without discrimination be used to lower costs while improving access?

I'm suffering from poling fatigue/media debate about health care fatigue. Doesn't it seem to everyone else that we've been asked about our health care preferences enough? Sheesh. Do you want private health care now? Do you want private health care now? How about now? How about private health care with fries?

oops polling

You're pretty much describing what we have now, Alan. I'm not sure I get the subtle differentiation - do you mean P3s? Because look at the costs of the Royal Ottawa or the bed reduction/cost increase in the Brampton P3. I have yet to see something that tells me unequivocally that the private sector really introduces 'efficiencies' into the process, unless by efficiencies you mean hiring underqualified people for shitty pay, of course. How would the pirate sector improve access, exactly? Access is still mostly about staffing, and there still aren't enough trained practitioners out there, unless they conjure them up some way the univerities and colleges haven't tried yet...

Also, the private sector wouldn't improve access in all places (like, say, unprofitable small towns) only in places where it would profit them. The government will still end up subsidizing, which will allow private companies even more room for rapatious business practices - they have a safety net, after all.

Marian: yes. It's like they think if they ask enough they'll catch us on a bad day, "FINE, enough already!" If you repeat something enough in the media, it becomes true, doesn't it?

I think my point would be that if Alberta wants to try something - let them and if the Quebec Court says that the folk there can have delay insurance they should be allowed to do that. Why are we so certain that we have achieved perfection?

How can we be so sure that what we have is perfection? We can't. But I live without what we had and it sucks.

Also, it is possible to fix a good thing until it really isn't good anymore. Take the 1965 Mustang. That was a beautiful car. But the company thought it could improve on a good thing... The result: the 1971 Mustang.

We haven't achieved perfection, but I think private sector involvement is a step in the wrong direction. It costs more (look at the US) and it produces worse service (look at Thatcher's Britain). We need to improve our current system, but it's already one of the better ones out there. The problems with it aren't necessarily structural (overmanaged as usual, but what isn't?) they're of the supply type. Private systems don't solve supply problems - in fact, economies of scale are lost with more private systems, unless there's a monopolistic something in place which would probably be bad: look at Monsanto vs small farms. I don't see how introducing another player - more profit to be distributed to yet another layer of people - will introduce better anything.

'nee <- flaming socialist

Woohoo!

Or should that have been: Power to the people?