universal health care for U.S.

RolandTD20Kdrummer

DOSW wrote:

Not personally. But I've spoken and heard from many people who have and have heard nothing but good experiences.

It's not as bad as people make it out, but the more complicated and $$$ the operation (doctor/surgeon expertise) is, the more you have to present (with symptoms) to get a timely procedure undertaken. It all depends on how you present (and with what).

In essence, you do get taken care of quite reasonably, and you're free to pick and choose, and make decisions (unpteenth opinions) throughout the entire system until satisfied.

Whatever drawbacks may be, I would never be comfortable to let an insurance company handle my health. I've heard too many horror stories where you;re left owing tens of thousands of dollars on a technicality. Insurance companies are famous for that.

nobody should be put in the position to be potentially financially ruined for getting sick. Pretty ruthless to steal from sick people.

jlew24asu

Kann wrote:

I live in France and there are no standing lines (It's not because you have universal health care that people spend all day at the doctors, you only go there when you need too) and you get to choose whichever doctor/hospital you want - anywhere in the country - as long as he has a university diploma.
Higher taxes is right though.

I guess it matters where you live. what is the population like in your area? I live in a city of 4 million and long lines are just a way of life no matter where I go. I have been to france several times but never to a government run place. regardless, I might have more confidence that your government can run something like UHC better then mine. and I certainly do not want to pay 40% + in taxes for this.

jlew24asu

Kel Varnsen wrote:

Of course. I personally don't have one at the moment and just use the walk-ins, since I am too lazy to make the effort to find a family doctor. Plus I maybe need a doctor once a year. But I know lots of people who do have them and no one was forced to choose someone they didn't want.

well thats good. but I wasnt suggesting anyone would be forced to see anyone. just that when something like this is free, its first come first serve. thats not something I want when I need a doctor.

Kel Varnsen

jlew24asu wrote:

well thats good. but I wasnt suggesting anyone would be forced to see anyone. just that when something like this is free, its first come first serve. thats not something I want when I need a doctor.

It's not 100% first come first serve, they do triage. So if you go to a clinic or an ER and you have a sore finger obviously someone with a major injuries is going to be treated for you. And if you have a regular doctor and you need to see him or her, all you have to do is make an appointment.

Kann

jlew24asu wrote:

I guess it matters where you live. what is the population like in your area? I live in a city of 4 million and long lines are just a way of life no matter where I go. I have been to france several times but never to a government run place. regardless, I might have more confidence that your government can run something like UHC better then mine. and I certainly do not want to pay 40% + in taxes for this.

I used to live in a small town (like 250k) and it never was a problem at all. I moved to paris a few months ago and it's still not a problem for physicians. I went to an ER in a hospital once here and did have to wait 1-2 hours (it wasn't really serious so I had to wait for several "serious cases" to be taken care of). I really think it's more of a matter of a voluntary policy more than a matter of a competent government. And would the insurance companies that rule the market today accept the idea of uhc?

jlew24asu

Kann wrote:

I used to live in a small town (like 250k) and it never was a problem at all. I moved to paris a few months ago and it's still not a problem for physicians. I went to an ER in a hospital once here and did have to wait 1-2 hours (it wasn't really serious so I had to wait for several "serious cases" to be taken care of). I really think it's more of a matter of a voluntary policy more than a matter of a competent government. And would the insurance companies that rule the market today accept the idea of uhc?

I just see too many negatives for this to work here. the cost is much too high and in the end, I believe actual patient care will suffer.

Kel Varnsen

jlew24asu wrote:

I just see too many negatives for this to work here. the cost is much too high and in the end, I believe actual patient care will suffer.

Just curious how much would a health insurance plan comparable to what I get for "free" cost in the United States?

I remember a couple of years ago one of the news shows up here was examining health care around the world and they talked to their Washington correspondent (a Canadian Citizen). She had recently had a baby in the US and even with her health insurance the whole thing ended up costing her $15,000-$20,000 because of all the stuff her plan didn’t cover. Stories like that make me wonder if universal health care really would cost more.

Royals32

There are more than enough Canadian doctors graduating every year that there is no reason we should be dealing with the long waits in our emergency rooms and specialist clinics. The problem is that once they graduate, they have to make a decision as to where they want to practise. Option A - relatively "fixed" income in Canada, working in a UHC system. Option B - go to the U.S. and become a medical business man and take offers from the highest bidder (I know it's TV but I was floored when I was watching an episode of Grey's Anatomy and the "Chief" was giving the TV doctors a hard time about shrinking PROFITS!!!) Now, I don't blame them at all for pursuing the most lucritive opportunity available to them - hell, I've left tons of jobs for better paying ones and I'd be a hypocrite if I judged them for doing the same.

Overall, if the U.S. created any kind of UHC system, the biggest beneficiary would be the Canadian public. Once the Canadian doctors practising in the States are faced with a similar situation down there, the incentive to stay is gone and they all come home - no more line ups and no more waiting lists. As long as our doctors keep leaving to pursue virtually unlimited incomes in a profit driven health care system, not much will change - out of reach medicine for a huge number of Americans and a middle of the road health care system in Canada.

Kel Varnsen

Royals32 wrote:

There are more than enough Canadian doctors graduating every year that there is no reason we should be dealing with the long waits in our emergency rooms and specialist clinics. The problem is that once they graduate, they have to make a decision as to where they want to practise. Option A - relatively "fixed" income in Canada, working in a UHC system. Option B - go to the U.S. and become a medical business man and take offers from the highest bidder (I know it's TV but I was floored when I was watching an episode of Grey's Anatomy and the "Chief" was giving the TV doctors a hard time about shrinking PROFITS!!!) Now, I don't blame them at all for pursuing the most lucritive opportunity available to them - hell, I've left tons of jobs for better paying ones and I'd be a hypocrite if I judged them for doing the same.

Overall, if the U.S. created any kind of UHC system, the biggest beneficiary would be the Canadian public. Once the Canadian doctors practising in the States are faced with a similar situation down there, the incentive to stay is gone and they all come home - no more line ups and no more waiting lists. As long as our doctors keep leaving to pursue virtually unlimited incomes in a profit driven health care system, not much will change - out of reach medicine for a huge number of Americans and a middle of the road health care system in Canada.

Actually the number of doctors leaving Canada each year is fairly small and the number who return to Canada is actually higher. Check out this link:

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20071025/doctors_canada_071025/20071025?hub=TopStories

I really think the biggest problem is that we have a fairly small population and a huge area. So places like Manitoba only have one medical school for the whole province (or Alberta which only has 2. When you consider that more and more doctors are retiring if the new doctors can't fill the need there will be a problem. Plus I hear all the time about people who are super smart but can't get into medical school because there are not enough spaces. I think trying to create more doctors at home is a way more efficient solution than to try and compete with American salary rates.

blackredyellow

I think that we definitely need something in place. I have a recent story that makes me hate the healthcare system that we currently have:

My aunt an uncle had insurance through his work (a machinist)... My aunt works fulltime for a small office that doesn't offer health insurance. About 9 months ago, my uncles company got bought out, and the new owners cut back on EVERYTHING (vacation time, overtime, etc.). About 6 months ago, my uncle had a heart attack and had to have bypass surgery. About a month ago, the employer sent a memo saying as of Jan 1st they are discontinuing health insurance. They don't make much money, but are above the max for any state/federal help, and with my uncle's recent history, not one insurance company with take them on.

So as of Jan 1st, they will not have health insurance until one of them finds a job that offers it... even then, I'm sure his pre-existing condition of his recent bypass surgery will allow the new insurer to basically not cover any heart related needs he may need in the future.



Also, my wife is pregnant with our first child due in January... we are insured through her work policy (cheaper than mine) with Blue Shield of Northeastern NY... With her doctor's blessing, we are considering traveling out of the area for christmas, so I called Blue Shield to see how the coverage would work if she went into labor while we were out of town... it is a $1000 deductable, and they only cover 70%... I don't get that... Blue Cross and Blue Shield are national companies, why can't your normal coverage extend anywhere they cover? I can see a small regional insurer, but a national company like Blue Shield? That doesn't make sense to me.

blackredyellow

Kel Varnsen wrote:

Just curious how much would a health insurance plan comparable to what I get for "free" cost in the United States?

My work for example, if we went through my company instead of my wife's for a family the monthly premium is a little over $1,100.00! The company pays $800 or so, and my share would be about $300.

Crashious Clay

Under a universal health care system the only true cost to us all will be the forfeiture of our basic rights and freedoms to choose ie...shots to take, medication to take, etc... With the government in every other area of our daily lives today, do you really want to invite them into your doctors office too? The current system is by no means any better ,but at least the money that I do pay every month allows me the privilege to make up my own mind in determinining what I think is best. In my opinion, debating over which system is better is so pointless and shallow because regardless of whatever side your on what is really being weighed here are two enormous piles of shit. What everyone should be discussing and demanding is a health care system that is focused on cureing people and not just treating them with overpriced drugs prescriptions that were never intended to completely fix what has been ailing ya from the jump.

FYI-all comments were in no way directed towards the person who posted this thread.

Kel Varnsen

Crashious Clay wrote:

Under a universal health care system the only true cost to us all will be the forfeiture of our basic rights and freedoms to choose ie...shots to take, medication to take, etc...

Who says you forfit your rights? I don't have to get a flu shot if I don't want to, nor do I have to get treatment if I don't want to.

blackredyellow wrote:

My work for example, if we went through my company instead of my wife's for a family the monthly premium is a little over $1,100.00! The company pays $800 or so, and my share would be about $300.

$1,100 a month? That is crazy. Plus I am sure there is all kinds of other fees on top of that. My entire montly income tax deduction is less than that.

prism

National Health Insurance
Liberal Benefits, Conservative Spending
by Steffie Woolhandler, MD, MPH and David U. Himmelstein, MD

FEW WOULD dispute that our health care system is deeply troubled. Thirty-nine million Americans are completely uninsured and millions more have inadequate coverage. After a brief lull, health care costs have resumed their exuberant growth; health maintenance organizations (HMOs) have fallen to the basement of public esteem and have failed to contain costs; commercial pressures threaten medicine's best traditions; and healing has become a spectator sport, with physicians and patients performing before a growing audience of bureaucrats and reviewers. Opinion on solutions is more divided.

Debate over health care reform has been muted since the defeat of the Clinton Administration Rube Goldberg scheme for universal coverage. But the fast developing health care crisis--business leaders grappling with rapidly rising premiums, workers and unions facing cutbacks in coverage, governments confronting deficits, and a sharp upturn in the number unemployed and uninsured--promises to spur new interest in reform.

We advocate a fundamental change in health care financing, national health insurance (NHI), because we are convinced that lesser measures will fail.

In the 35 years since the implementation of Medicare and Medicaid, a welter of patchwork reforms has been tried. Health maintenance organizations and diagnosis related groups promised to contain costs and free up funds to expand coverage. Billions of dollars have been allocated to expanding Medicaid and similar programs for children. Both Medicare and Medicaid have tried managed care. Oregon essayed rationing in its Medicaid program, Massachusetts and Hawaii passed laws requiring all employers to cover their workers, Tennessee promised nearly universal coverage, and several states have implemented high-risk pools to insure high-cost individuals. For-profit firms pledged to bring business-like efficiency to running HMOs, hospitals, dialysis clinics, and nursing homes. And market competition has roiled health care's waters.

None of these initiatives has made a dent in the number of uninsured, durably controlled costs, or lessened the inexorable bureaucratization of medicine.

All such patchwork reforms founder on a simple problem: expanding coverage must increase costs unless resources are diverted from elsewhere in the system. With US health care costs nearly double those of any other nation and rising more rapidly,1 and the economy gone sour, large infusions of new money are unlikely.

Absent new money, patchwork reforms can only expand coverage by siphoning resources from existing clinical care. Advocates of managed care and market competition once argued that their strategy could accomplish this by trimming clinical fat. Unfortunately, new layers of bureaucrats have invariably overseen the managed care "diet" prescribed for clinicians and patients. Such cost management bureaucracies are not only intrusive but expensive, devouring virtually all of the clinical savings.

Resources seep inexorably from the bedside to the executive suite. The shortage of bedside nurses coexists with a proliferation of RN utilization reviewers. Productivity pressures mount for clinicians, while colleagues who have withdrawn from the bedside to the executive suite rule our profession.

Bureaucracy now consumes nearly 30% of our health care budget.2-4

The latest policy nostrums--medical savings accounts and voucher schemes like President Bush's "premium support" proposal for Medicare--would further amplify bureaucracy and limit care. Medical savings accounts discourage preventive and primary care, while failing to curb the high cost of care for severe illnesses (which account for most health spending). Such plans would also require insurers to start keeping track of all out-of-pocket spending, while retaining their existing bureaucracy, and would slash the cross-subsidy from healthy enrollees to the sick.

Voucher programs are thinly veiled mechanisms to cut care. The vouchers offered are invariably too skimpy to purchase fully adequate coverage, forcing lower-income individuals into substandard plans. Voucher schemes also posit that frail elders and other vulnerable patients will make wise purchasing decisions from a welter of confusing insurance options. Finally, vouchers would boost insurance overhead by shifting people from group plans (ie, Medicare or employer groups) into the individual insurance market where overhead averages more than 35% of premiums.5

WHY NHI?

The fiscal case for NHI arises from the observation that health care's enormous bureacratic burden is a peculiarly American phenomenon. No nation with NHI spends even half as much administering care, nor tolerates the bureaucratic intrusions in clinical care that have become routine in the United States.

Our biggest HMOs keep 20%, even 25%, of premiums for their overhead and profit6; Canada's NHI has 1% overhead2 and even Medicare takes less than 4%.7 And HMOs inflict mountains of paperwork on physicians and hospitals. The average US hospital spends one quarter of its budget on billing and administration,4 nearly twice the average in Canada. American physicians spend nearly 8 hours per week on paperwork, and employ 1.66 clerical workers per physician,8 far more than in Canada.

Reducing our bureaucratic apparatus to Canadian levels would save 10% to 15% of current health care spending, at least $120 billion annually, enough to fully cover the uninsured and upgrade coverage for those now underinsured. Proponents of NHI,9 disinterested civil servants,10, 11 and even skeptics12 all agree on this point.

HOW NHI? Unfortunately, piecemeal tinkering cannot achieve significant bureaucratic savings. The key to administrative simplicity in Canada (and other nations) is single-source payment. Canadian hospitals (mostly private, nonprofit institutions) do not bill for individual patients. They are paid a global annual budget to cover all costs, much as a fire department is funded in the United States. Physicians (most of whom are in private practice) bill by checking a box on a simple insurance form. Fee schedules are negotiated annually between provincial medical associations and governments. All patients have the same coverage.

Unfortunately, during the 1990s Canada's program was starved of funds by governments responsive to pressure from the healthy and wealthy who sought to avoid cross-subsidizing care for the sick and poor. Where once Canadian and US health care spending were comparable, today, Canada spends barely half (per capita) what we do.1 Shortages of expensive, high-technology care have resulted. Yet, Canada's health outcomes remain better than ours (eg, life expectancy is 2 years longer1), and most quality comparisons indicate that Canadians enjoy care equivalent to that for insured Americans. A system structured like Canada's, but with double the funding, could provide high-quality care without the waits or shortages that Canadians have experienced.

The NHI that we propose would create a single tax-funded comprehensive insurer in each state, federally mandated but locally controlled. Everyone would be fully insured for all medically necessary services, and private insurance duplicating the NHI coverage would be proscribed (as is currently the case with Medicare). The current byzantine insurance bureaucracy with its tangle of regulations and wasteful duplication would be dismantled. Instead, the NHI trust fund would dispense all payments, and central administrative costs would be limited by law to less than 3% of total health care spending.

Each hospital and nursing home would negotiate an annual global budget with the NHI, based on past expenditures, projected changes in costs and use, and proposed new and innovative programs. Many hospital administrative tasks would disappear. There would be no hospital bills to keep track of, no eligibility determination, and no need to attribute costs and charges to individual patients. Cost shifting would be pointless as there would be nowhere to shift costs to.

Clinics and group practices could elect to be paid fee-for-service, or receive global budgets similar to hospitals. While HMOs that merely contract with providers for care would be eliminated, those that actually employ physicians and own clinical facilities could receive global budgets, fee-for-service, or capitation payments (with the proviso that capitation payments could not be diverted to profits or exorbitant executive compensation).

As in Canada, physicians could elect to be paid on a fee-for-service basis, or receive salaries from hospitals, clinics, or HMOs.

Properly structured, NHI would not raise costs; administrative savings would pay for the expanded coverage. While NHI would require new taxes, these would be fully offset by a decrease in insurance premiums and out-of-pocket costs. Moreover, the additional tax burden would be smaller than is usually appreciated, since nearly 60% of health care spending is already tax supported (vs roughly 70% in Canada). Besides Medicare, Medicaid, and other explicit public programs, our governments fund tax subsidies for private insurance that exceed $100 billion annually.13 In addition, local, state, and federal agencies that purchase private coverage for government workers account for 22.5% of total employer health care spending (D.U.H. and S.W., unpublished analysis of Current Population Survey data from the US Census Bureau, 2001).

Demonstration projects in 1 or more states might precede national implementation of NHI. Initially, funding might mimic existing patterns to minimize economic disruption, but all payments would be funneled through the NHI trust fund. Thus, Medicare and Medicaid moneys, as well as current government expenditures for employee health benefits, would go to the trust fund. Employers would pay a tax equivalent to the average now spent for health benefits. In the long run, a shift to a more progressive, income tax funding base would provide a fairer and more efficient revenue stream.

The NHI we propose faces important political obstacles. The virtual elimination of private health insurance will evoke stiff opposition from insurance firms. Similarly, investor-owned hospitals and drug firms fear that NHI would curtail their profits.

Practical problems in implementing NHI also loom. The financial viability of the system we propose is critically dependent on achieving and maintaining administrative simplicity. Canada's macromanagement approach to cost control -- enforcing overall budgetary limits is inherently less administratively complex than our current micromanagement approach, with its case-by-case scrutiny of billions of individual expenditures and encounters. However, even under NHI, vigilance (and statutory limits) would be needed to curb the tendency of bureaucracy to reproduce and amplify itself.

National health insurance could solve the cost-vs-access conflict by slashing bureaucratic waste. It would reorient the way we pay for care, and eliminate financial barriers to access. National health insurance could restore the physician-patient relationship, offer patients a free choice of physicians and hospitals, and free physicians from the bonds of managed care.

How many more failed patchwork reforms, how many more patients turned away from care they cannot afford, how many trillions of dollars squandered on malignant bureaucracy, before we adopt the only viable solution: NHI?

Steffie Woolhandler, MD, MPH
Cambridge

David U. Himmelstein, MD
1493 Cambridge St
Cambridge, MA 02139

REFERENCES

1. Organization for Economic Cooperation and Development. OECD Health Data 2001 [computer database]. Paris, France: Organization for Economic Cooperation and Development; 2001.

2. Woolhandler S, Himmelstein DU. The deteriorating administrative efficiency of US health care. N Engl J Med. 1991;324:1253-1258.

MEDLINE

3. Himmelstein DU, Lewontin JP, Woolhandler S. Who administers? who cares? medical administrative and clinical employment in the United States and Canada. Am J Public Health. 1996;86:172-178. MEDLINE

4. Woolhandler S, Himmelstein DU. Costs of care and administration at for-profit and other hospitals in the United States. N Engl J Med. 1997;336:769-774. MEDLINE

5. Pauly MV, Percy AM. Cost and performance: a comparison of the individual and group health insurance markets. J Health Polit Policy Law. 2000;25:9-26. MEDLINE

6. Special report. BestWeek Life/Health. April 12, 1999.

7. Heffler S, Levit K, Smith S, et al. Health spending growth up in 1999: faster growth expected in the future. Health Aff (Millwood). 2001;20:193-203. MEDLINE

8. Remler DK, Gray BM, Newhouse JP. Does managed care mean more hassles for physicians? Inquiry. 2000;37:304-316. MEDLINE

9. Grumbach K, Bodenheimer T, Woolhandler S, Himmelstein DU. Liberal benefits, conservative spending: the Physicians for a National Health Program proposal. JAMA. 1991;265:2549-2554. MEDLINE

10. US General Accounting Office. Canadian Health Insurance: Lessons for the United States. Washington, DC: US Government Printing Office; 1991. Publication GAO/HRD-91-90.

11. Congress of the United States Congressional Budget Office. Universal Health Insurance Coverage Using Medicare's Payment Rates. Washington, DC: US Government Printing Office; 1991.

12. Sheils JF, Haught RA. Analysis of the Costs and Impact of Universal Health Care Coverage Under a Single Payer Model for the State of Vermont. Falls Church, Va: Lewin Group Inc; August 2001.

13. Sheils J, Hogan P. Cost of tax-exempt health benefits in 1998. Health Aff (Millwood). 1999;18:176-181. MEDLINE

Thecure

Crashious Clay wrote:

Under a universal health care system the only true cost to us all will be the forfeiture of our basic rights and freedoms to choose ie...shots to take, medication to take, etc... With the government in every other area of our daily lives today, do you really want to invite them into your doctors office too? The current system is by no means any better ,but at least the money that I do pay every month allows me the privilege to make up my own mind in determinining what I think is best. In my opinion, debating over which system is better is so pointless and shallow because regardless of whatever side your on what is really being weighed here are two enormous piles of shit. What everyone should be discussing and demanding is a health care system that is focused on cureing people and not just treating them with overpriced drugs prescriptions that were never intended to completely fix what has been ailing ya from the jump.

FYI-all comments were in no way directed towards the person who posted this thread.

i currently live in Canada that has universal health care and i am not forced to take any shots or what meds to take. i talk to my doctor and we make a decision about what is good for me. i don't like any medication but i have to take one for a rare condition that i have. i talked with my doctor abotu this med and agree to take it for a trial run. this medication has saved my life.

now i agree with you that we should be demanding a health care system that cures people but i will go one step further and say that we need a health care system that prevents people from getting sick. PREVENTION IS THE KEY.
Demand that pop is not served to our children, have healthy food in schools. bring gym classes back to schools. clean the enviroment so that our food and ourselves don't have all the toxins. the best way to cure something i sto not having affect us any more.

Royals32

Kel Varnsen wrote:

Actually the number of doctors leaving Canada each year is fairly small and the number who return to Canada is actually higher. Check out this link:

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20071025/doctors_canada_071025/20071025?hub=TopStories

I really think the biggest problem is that we have a fairly small population and a huge area. So places like Manitoba only have one medical school for the whole province (or Alberta which only has 2. When you consider that more and more doctors are retiring if the new doctors can't fill the need there will be a problem. Plus I hear all the time about people who are super smart but can't get into medical school because there are not enough spaces. I think trying to create more doctors at home is a way more efficient solution than to try and compete with American salary rates.

My point was that as long as the opportunities are there for them, they'll take them. Why wouldn't they? Once that incentive is gone, it's a much less attractive option. If the U.S. institutes a similar system to ours, the majority of the doctors who leave for the money won't have a reason to anymore.

That report is definitely good news but it only refers to the last few years. What about the previous 30? According to that report, 207 doctors left last year, so if 207 doctors leave every year (some years have been as high as 550), that's well over 6,000 doctors and that's a very conservative estimate. I'm sure they all didn't leave for the same reason, but the majority left for financial opportunities/gain. Wouldn't you agree that if we had 6,000 more doctors in Canada right now, we'd be in a lot better shape?

I never said we need to try and compete with American salaries. That's impossible in a non-profit driven medical system and I agree 100% that we need to train more doctors, but keeping them is the trick.

blackredyellow

Crashious Clay wrote:

Under a universal health care system the only true cost to us all will be the forfeiture of our basic rights and freedoms to choose ie...shots to take, medication to take, etc... With the government in every other area of our daily lives today, do you really want to invite them into your doctors office too?

Who would be taking away any freedoms??? The doctor experience wouldn't be much different, but instead of the doctor being reimbursed by the insurance company, they will get reimbursed from the gov't. I think you are confused and paranoid by what universal health care is.

Right not you don't really have total freedom anyway... if your insurance company won't pay for a procedure, chances are you're not getting it.

onelongsong

pickupyourwill wrote:

right now I'm all for it, but would like to be better informed on the details. what does everyone think of this issue? yay or nay?

it'll never happen in the us. those with money control the government and we'll never stand for the high taxes. let the poor work like we had to.

Kel Varnsen

onelongsong wrote:

it'll never happen in the us. those with money control the government and we'll never stand for the high taxes. let the poor work like we had to.

I don't really buy that argument. Based on the premium cost that blackredyellow gave he pays more for health insurance than I do for income tax (and my income taxes cover more than just health care).

onelongsong

Royals32 wrote:

My point was that as long as the opportunities are there for them, they'll take them. Why wouldn't they? Once that incentive is gone, it's a much less attractive option. If the U.S. institutes a similar system to ours, the majority of the doctors who leave for the money won't have a reason to anymore.

That report is definitely good news but it only refers to the last few years. What about the previous 30? According to that report, 207 doctors left last year, so if 207 doctors leave every year (some years have been as high as 550), that's well over 6,000 doctors and that's a very conservative estimate. I'm sure they all didn't leave for the same reason, but the majority left for financial opportunities/gain. Wouldn't you agree that if we had 6,000 more doctors in Canada right now, we'd be in a lot better shape?

I never said we need to try and compete with American salaries. That's impossible in a non-profit driven medical system and I agree 100% that we need to train more doctors, but keeping them is the trick.

the us cannot limit a persons earnings. that's our basic freedom. why do you think it's hard to find an american doctor in america? people come here for the money. and that's the bottom line.