# Vermont uses ACA to launch single-payer health care **URL:** \ **Category:** Great Debates\ **Created:** [November 25, 2013, 4:46pm UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762 "2013-11-25T16:46:00Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 2:56am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/101 "2013-11-26T02:56:38Z")
> [@Wesley\_Clark](#): > > [2 million americans a year.](http://www.law.harvard.edu/news/bulletin/2013/summer/feature_1.php) What is it with people not caring enough to read the cites they post? There is not one mention of Canada in that article. > [@](#): > > [1-10 americans buys drugs from Canada.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936287/) Yes. They buy American drugs from Canada. Because Canada forces pharma companies to sell drugs at low prices. Try that in the US and you will kill pharma companies. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [November 26, 2013, 3:25am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/102 "2013-11-26T03:25:20Z")
> [@Terr](#): > > What is it with people not caring enough to read the cites they post? There is not one mention of Canada in that article. What does that matter what the destination is? The fact is the US system is so poorly run and expensive that people are going all over the world to escape this system. Why does it matter how many go individually to Canada or Mexico or Belgium or the UK? Americans travel to a wide range of wealthy and middle income countries for health care. > [@Terr](#): > > Yes. They buy American drugs from Canada. Because Canada forces pharma companies to sell drugs at low prices. Try that in the US and you will kill pharma companies. How will it kill the pharma companies? If it killed them, they wouldn’t sell in Canada at all. They would pull out of that market if it was costing them money. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 3:30am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/103 "2013-11-26T03:30:59Z")
> [@Wesley\_Clark](#): > > What does that matter what the destination is? The guy I was responding to talked about the patient flow from US to Canada. I asked for a cite. You jump in with a cite that has no mention of Canada whatsoever. Why did you respond to me with that cite? Was that relevant to my question? > [@](#): > > How will it kill the pharma companies? If it killed them, they wouldn’t sell in Canada at all. They would pull out of that market if it was costing them money. It probably makes them money but on the thinnest of margins. They make it up by jacking up prices in the US. If there was no US to jack up prices in, those prices in Canada would not be supportable. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 3:34am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/104 "2013-11-26T03:34:31Z")
BTW. About Canada… > **[National Post](https://nationalpost.com/category/news/)** > > Read the latest breaking news in Canada and the rest of the world. We bring all of today's top headlines and stories to your fingertips. The national median wait time was 18.2 weeks, about three days longer than last year, according to Waiting Your Turn, the 2013 edition of the Fraser Institute’s annual report. In 1993, the median wait time was 9.3 weeks. … Manitoba’s wait time was 25.9 weeks, Nova Scotia’s was 25.8, Saskatchewan’s was 25.7, Newfoundland and Labrador’s was 23.7, Alberta’s was 23.1, and British Columbia’s was 19.9. That’s wait time from the time you visit your GP to the time you get specialist’s treatment. How would you like, in the US, to wait 20 weeks for treatment from a specialist? I needed something done recently here in the US. The “wait” time was about 10 days - and that’s because I had to psych myself up for it. Otherwise it could have been done in 5 days. In Canada, looking at that article and taking that specialty’s wait times, it would have taken 5 months until I could have that procedure done. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 3:52am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/105 "2013-11-26T03:52:21Z")
> [@Terr](#): > > So it is not patient flow. It is medical fraud. Not sure why calling it that does not make it a flow anyhow. The point IMHO stands, there is a lot of movement in the Canadian border with Americans abusing the Canadian system. Numbers are hard to come by, but they are large enough to not ignore them and it shows that many Americans close to Canada choose to vote with their feet. [http://cfevancouver.com/file/download/38.pdf](http://cfevancouver.com/file/download/38.pdf) > [@](#): > > In October 2004, Auditor General Fred Dunn examined the occurrence of > medical identity theft. > > The following are some of the results: > > •In some regions near the U.S. border there were twice as many health > numbers than residents; > > •One Albertan was issued 60 duplicate or replacement health cards, while > 32,440 people had received five or more > ; > •123 municipalities had at least 2 health numbers for every person counted in the Dec. 2003 census And that was Alberta alone. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 3:58am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/106 "2013-11-26T03:58:33Z")
> [@GIGObuster](#): > > Not sure why calling it that does not make it a flow anyhow. The point IMHO stands, there is a lot of movement in the Canadian border with Americans abusing the Canadian system. Numbers are hard to come by, but they are large enough to not ignore them and it shows that many Americans close to Canada choose to vote with their feet. The point certainly doesn’t “stand”. It’s not “patient flow”. It is Americans trying (and in a lot of cases succeeding) to obtain Canadian medical services for free through fraud. Since “free” (even when fraudulent) will always be cheaper than US medical care, it certainly cannot be taken as a legitimate “patient flow” indicating anything about the differences between Canadian and US health care other than the fact that Canadians are laughably lax about preventing fraud in their system. In fact, I don’t think there can be any legal “patient flow” from US to Canada, since AFAIU Canadian doctors are not allowed to accept private patients or perform private services. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 3:59am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/107 "2013-11-26T03:59:59Z")
> [@Terr](#): > > BTW. About Canada… > > [http://news.nationalpost.com/2013/10/28/canada-must-offer-private-options-along-with-universal-health-care-to-combat-long-wait-times-report/](http://news.nationalpost.com/2013/10/28/canada-must-offer-private-options-along-with-universal-health-care-to-combat-long-wait-times-report/) > > The national median wait time was 18.2 weeks, about three days longer than last year, according to Waiting Your Turn, the 2013 edition of the Fraser Institute’s annual report. In 1993, the median wait time was 9.3 weeks. > … > Manitoba’s wait time was 25.9 weeks, Nova Scotia’s was 25.8, Saskatchewan’s was 25.7, Newfoundland and Labrador’s was 23.7, Alberta’s was 23.1, and British Columbia’s was 19.9. > > That’s wait time from the time you visit your GP to the time you get specialist’s treatment. How would you like, in the US, to wait 20 weeks for treatment from a specialist? > > I needed something done recently here in the US. The “wait” time was about 10 days - and that’s because I had to psych myself up for it. Otherwise it could have been done in 5 days. In Canada, looking at that article and taking that specialty’s wait times, it would have taken 5 months until I could have that procedure done. And looking further in the cite: > [@](#): > > But some question the Fraser Institute report and the conclusions of its authors. > > “It is the same old sky-is-falling report,” said Dr. Ryan Meili, a family physician in Saskatoon who is vice-chairman of Canadian Doctors For Medicare. > > “Wait times don’t get shorter when you introduced more delivery of care outside of the public system, they get longer. You don’t just draw patients away from the public system, you also draw away providers,” he said. > > Dr. Michael Rachlis, a health policy analyst associated with the Canadian Health Coalition, a pro-universal-healthcare organization, said the co-payment plans from abroad “which allow some people to jump the queue” is not the answer to Canada’s wait times. > > “We do tend to wait too long but it has nothing to do with us having a public system. It has a lot to do with how we organize services,” Dr. Rachlis said. “We can eliminate virtually every wait time by better management.” ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 4:01am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/108 "2013-11-26T04:01:48Z")
> [@GIGObuster](#): > > And looking further in the cite: What’s your point? Yes, looking further in the cite some people dispute the proposed solution to the long wait times. Note that they are not disputing the long wait times themselves. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 4:02am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/109 "2013-11-26T04:02:07Z")
> [@Terr](#): > > The point certainly doesn’t “stand”. It’s not “patient flow”. It is Americans trying (and in a lot of cases succeeding) to obtain Canadian medical services for free through fraud. Since “free” (even when fraudulent) will always be cheaper than US medical care, it certainly cannot be taken as a legitimate “patient flow” indicating anything about the differences between Canadian and US health care other than the fact that Canadians are laughably lax about preventing fraud in their system. > > In fact, I don’t think there can be any legal “patient flow” from US to Canada, since AFAIU Canadian doctors are not allowed to accept private patients or perform private services. That is not the point, I’m just saying, the American system that does not cover all citizens is not a good one when it allows situations like that one to be possible. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 4:04am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/110 "2013-11-26T04:04:15Z")
> [@GIGObuster](#): > > That is not the point, I’m just saying, the American system that does not cover all citizens is not a good one when it allows situations like that one to be possible. What “situations”? Fraud? Since fraudulent stealing of Canadian health care by Americans is “free”, how do you propose the American system would prevent it, except making it “free” here too? With probably even longer wait times? That’s the ticket. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 4:04am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/111 "2013-11-26T04:04:27Z")
> [@Terr](#): > > What’s your point? Yes, looking further in the cite some people dispute the proposed solution to the long wait times. Note that they are not disputing the long wait times themselves. Of course I noted that, the point is that it is the Canadians choice in the end. [http://www.marketwatch.com/story/myths-about-canada-us-health-care-debunked-2012-08-09](http://www.marketwatch.com/story/myths-about-canada-us-health-care-debunked-2012-08-09) > [@](#): > > The fourth myth is that Canadians have far longer wait times for medical treatment because of its system. This is one I hear all the time. Carroll says this is true, BUT…there’s a good reason: > > Canadians have shown admirable restraint — something normally in short supply here in the U.S. They’ve actually opted to hold down medicare costs by consciously waiting longer and limiting supply, mostly for elective procedures. Imagine that. > > Canadians, in other words, have made a choice to be fiscally conservative, Carroll says in his well- documented article. They’re more realistic and less demanding than many American patients are. Carroll says that Canadians COULD, if they wanted to, cut down wait times — by spending more on health care. But they’ve actually made a conscious choice not to do this. > > This is no smoke screen: I’ve heard callers on Canadian radio shows state exactly this many times. They’d rather show personal restraint by waiting a bit longer than running up deficits. > > The final myth about Canada rationing health care in its system and the U.S. not doing so governmentally, is trickier, Carroll admits. But he points out that although the U.S. pays quite a bit more of its GDP than Canada does on health care, far more Americans in need of care go unseen by doctors. And U.S. medical outcomes, he adds, are middling at best. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 4:05am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/112 "2013-11-26T04:05:28Z")
> [@Terr](#): > > What “situations”? Fraud? Since fraudulent stealing of Canadian health care by Americans is “free”, how do you propose the American system would prevent it, except making it “free” here too? With probably even longer wait times? That’s the ticket. If the American System was the superior one then that situation would not take place. Neither paying more than double of our GDP and in turn get less care and less people covered. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 4:07am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/113 "2013-11-26T04:07:55Z")
> [@GIGObuster](#): > > Of course I noted that, the point is that it is the Canadians choice in the end. It may be Canadians’ choice to have 5-month average wait times for any specialist procedures, but I bet you if you put the question of whether they wanted something like that here to most US health care consumers, they’d laugh at you. And yes, I know, you don’t have to tell me, you personally would be all for it. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 4:10am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/114 "2013-11-26T04:10:43Z")
> [@GIGObuster](#): > > If the American System was the superior one then that situation would not take place. If the Canadian system was not ridiculously lax about fraud, that situation would not take place. No American system would prevent it. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 4:14am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/115 "2013-11-26T04:14:53Z")
> [@Terr](#): > > It may be Canadians’ choice to have 5-month average wait times for any specialist procedures, but I bet you if you put the question of whether they wanted something like that here to most US health care consumers, they’d laugh at you. And yes, I know, you don’t have to tell me, you personally would be all for it. Meh, I have seen more evidence of Canadians laughing at the FUD the right in the USA tells about their system. [http://www.realclearpolitics.com/articles/2009/10/31/why\_canadians\_are\_laughing\_at\_us\_98957.html#ixzz2linqNeNZ](http://www.realclearpolitics.com/articles/2009/10/31/why_canadians_are_laughing_at_us_98957.html#ixzz2linqNeNZ) Follow us: @RCP\_Articles on Twitter > [@](#): > > Canadians apparently love their system. A columnist for the Calgary Sun, Stephen Lautens, attended a conservative forum in Florida and sent back this report: > > "When hearing the horrors of the Canadian health-care system being described last weekend, all I could do was wince. … ‘Would (you) like to speak to a real, live Canadian about our health care,’ I asked (two ladies in a bar)? > > "‘Can you pick your own doctor?’ was the first question. ‘Because we hear the government assigns you a doctor in Canada.’ > > "You indeed pick your own doctor, I assured them. … **It was also not true, I said, that it takes months to see your doctor. Mine complains she doesn’t see me enough. There are gaps in our system, I confessed, where there are unacceptable wait lists for some kinds of surgery – hips and knees and other things in demand.** > > "‘What’s your health-care premium?’ they wanted to know. They quoted theirs as being a couple thousand dollars a month. \*\*Their jaws dropped when I told them there really isn’t one and everyone is covered from birth. > \*\* > "At this point, a small crowd had gathered around me at the bar to hear the Canadian tell his magical tale of health-care coverage. I told the story of breaking my shoulder in a fall, having one of the best shoulder specialists in Canada put it back together, a few days at the hospital and nine months of physiotherapy. The cost? > > “Thirty-five dollars, because the sling I went home in wasn’t covered.” > > The “disgusting” thing from an American perspective is the low level of the health-care debate. Or is it the gullibility of millions of Americans? The Senate Republican leader, Mitch McConnell, along with Fox News, has used the Shona Holmes story to attack health-care reform. True or not, it is interesting stuff, except for one thing: The American reforms being discussed are not at all like the Canadian single-payer system. > > So, Canadians, with longer, healthier lives, are yelling at Shona Holmes and laughing at us. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 4:17am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/116 "2013-11-26T04:17:28Z")
> [@GIGObuster](#): > > Meh, I have seen more evidence of Canadians laughing at the FUD the right in the USA tells about their system. > > [Why Canadians are Laughing at Us | RealClearPolitics](http://www.realclearpolitics.com/articles/2009/10/31/why_canadians_are_laughing_at_us_98957.html#ixzz2linqNeNZ) > Follow us: @RCP\_Articles on Twitter Cool story, bro. Especially about the ladies’ in a bar having health care insurance premiums of a couple of thousand dollars a month. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2013, 4:25am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/117 "2013-11-26T04:25:54Z")
> [@Terr](#): > > Cool story, bro. Especially about the ladies’ in a bar having health care insurance premiums of a couple of thousand dollars a month. It is even cooler when we looks at the polls of those days: > **[New poll shows Canadians overwhelmingly support public health care |...](http://www.pnhp.org/news/2009/august/new_poll_shows_canad.php)** > > An orgaization of 16,000 American physicians advocating for single-payer national health insurance. > [@](#): > > OTTAWA, Canada — In a last-ditch effort to convince Canadians that their public health care system should be privatized, Canadian Medical Association (CMA) President Robert Ouellet has promised to “pull out all the stops” during the association’s annual meeting next week. Trouble is, Ouellet’s mission to lead the change to privatization is exactly the opposite of what 86 percent of Canadians want. > > A new poll conducted by the Toronto-based Nanos Research points to overwhelming support — 86.2 percent — for strengthening public health care rather than expanding for-profit services. > > “With more than 8 in 10 Canadians supporting public solutions to make public health care stronger, there is compelling evidence that Canadians across all demographics would prefer a public over a for-profit health care system,” said Nik Nanos, president of Nanos Research. BTW, it would not surprise me that Americans traveling abroad are not so poor and if they had a medical condition, it would not be impossible then to have huge premiums. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [November 26, 2013, 5:13am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/118 "2013-11-26T05:13:29Z")
> [@Terr](#): > > If the Canadian system was not ridiculously lax about fraud, that situation would not take place. No American system would prevent it. If fraud were an actual problem, they’d do something about it. Instead, they weathered the recession way better than we did. The fraud is only a problem for the pharmaceutical companies, not the health care system. And seeing how much they clearly overcharge for their medicine here in the U.S., I don’t really care about that. A leaner, more care-focused medical industry is something I very much want. I want to get rid of the people who become doctors only because it is a lucrative profession. You seem to assume a priori that everyone will agree that things you think are bad are bad. It’d be one thing if you were on a board with people who generally think like you do, but you aren’t. Why are you always so surprised that so many of us are, well, liberal? Do you really think it’s because we haven’t thought about these things? ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 26, 2013, 5:23am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/119 "2013-11-26T05:23:23Z")
> [@BigT](#): > > The fraud **is only a problem for the pharmaceutical companies** , not the health care system. > > Why are you always so surprised that so many of us are, well, liberal? Well, I used to be surprised that posters do not read the threads to which they reply (or, if they read them, they display utter lack of reading comprehension). But now I am used to it. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [November 26, 2013, 6:15am UTC](https://boards.straightdope.com/t/vermont-uses-aca-to-launch-single-payer-health-care/674762/120 "2013-11-26T06:15:15Z")
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