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In reality the AEI is not infamous but largely unknown except to a small group of people, most of whom who either agree with its views or are strongly oppsed.
Frum is in a similar position in Canada. It is possible to not agree with muchbof what the AEI and Frum have to say and not consider them infamous or unwelcome. That is the essence of freedom of expression.
Fair enough. But I did say “I don’t think his ideas are very welcome”, so I think I’m giving away there that it is subjective. But I would stand by the statement that David Frum’s ideas will not poll well in Canada. I think he’d be about as popular as the Bush administration, which he worked for. He was the one who came up with the “axis of evil” expression. He’s also very opposed to universal health insurance, and says that he thinks the American system functions better than the Canadian one. I don’t know how much agreement he’d really find for his ideas. I think the fact that he’s more or less been jettisoned by the conservative movement in the States shows how far things have gone.
“Infamous” was maybe not the best word to use for the AEI. I used it because of members like Charles Murray (although I actually agree with him about basic income) and his book the Bell Curve and some of the race-related comments I’ve seen in some of his essays. You’re right that the word “infamous” though gives away my opinion of them, and I probably shouldn’t have used it. I think “ultra-conservative” is fair though.
Just saw your second post. I would in no way try to stop them saying what they’re saying, so it’s not a freedom of expression issue. I don’t think you have to be “famous” to be “infamous”, although I could be wrong about that 
I think I see now the confusion. I meant “welcome” in the sense of “popular”. I did not mean that he would be prevented from sharing his ideas. I do not think his ideas will be well-received in Canada, but he is of course welcome to share them.
But that is still just your own prejudice Bortrun…“Canadians all think like me or should”.
Re health systems, the US spends more public money on health care than most countries, and as much again privately. The poor, the old, and the wealthy receive better care than in Canada. However a large group of middle class self employed or people between jobs are not covered and face possible bankruptcy from catastrophic illness.
Obviously this is a problem.I would not recommend them copying the Canadian model which is less efficient and privides poorer care than most health systems in Europe yet costs the tax payer more.
I faviur universal insurance coverage for all, but with the freedom to set up private clinics and hospitals, buy additional insurance for enhanced health care, and user fees. This will bring money and efficiency into the system. It is highly unfair that a person can work and contribute for oner thirty years and when he or she needs a procedure or specialist appointment there is a lengthy wait period. People end up having to go to the US for treatment or just suffer or in some cases die unnecessarily.
I don’t think it’s just my own prejudice. It’s my speculation based on personal experience and polling data. Believe me, all Canadians most definitely do not think like me (it’s extremely rare for me to meet someone who thinks like me), nor do I think they should. But I still feel comfortable in saying that Frum’s vision of society would not poll well in Canada. That’s not because I dislike him - on the contrary, I think he’s a fairly reasonable guy, just of a different opinion than me.
I have trouble believing that poor people in the US receive better care than in Canada. The statistic I saw was that 45,000 people die every year due to lack of access to medical care. Presumably a fair number of these people are poor.
I agree that the Canadian model is not the best in the world, but I think you’d find few Canadians who wanted to trade their system for the American one, which is more or less what Frum advocates.
I believe that private clinics are currently allowed. When a doctor sets themselves in private practice, that’s essentially a private clinic, is it not? Doctors in Canada don’t work for the government, they just bill the government. Yes, I know that private hospitals are not allowed. They have to be non-profit and publicly administered as well, I believe. I’m not entirely sure what the technical difference is between a clinic and a hospital.
I don’t have a lot of personal experience with the medial system beyond going for a physical once a year. I’ve never had a serious illness or spent time in hospital. From my family’s experience though, I have see some of the problems with wait times. I agree that this is a problem. However, if it’s a choice between a system where people face long waits, and a system where some people get prompt service while many people die from lack of care, then I choose the former. Luckily, we have more than just the Canadian and American models to choose from.
Private clinics are technically not allowed, I believe, but they are tolerated as an escape valve for a poorly functioning system. Certainly they are discouraged by the official health system, and certainly they cannot be paid for out of the public insurance scheme. In Europe this is not the case, as far as I know. Public insurance and mixed public private delivery is the norm. This is is practical. The Canadian approach is just misguided ideology or protection for the unionized public hospital workers.
Doctors are not private, they are closely regulated and receive a fixed amount per visit, which is ridiculous since it encourages many useless and short doctor visits. If Doctors were able to run their own practices as they saw fit it might solve the present dramatic shortage of family doctors. Who knows?
The alternative to the Canadian system is not the present US system, but rather systems in Europe or Japan or elsewhere where universal coverage is the norm.
I agree that the alternative is not the American system. That’s what I meant by saying our choices are not limited to the Canadian or American models.
Doctors are essentially small business people. They may maintain an office and have to pay their staff and whatnot. Yes, the government has price controls, but I don’t see how you can have the government pay for medical services without saying what those services will cost. Yes, it does give doctors an incentive to see lots of patients, but that then gives patients an incentive to look for another doctor. The government also monitors doctors’ claims, and if someone is submitting a ridiculously large number of claims per day, that will be noticed. I don’t know what, if anything, would be done about it.
Also, I’m far more familiar with the system in Ontario because, even though I lived in Van for a long time, I never switched my insurance over, so I never really used the BC system. Plus, I know some doctors in Ontario so I’ve heard a bit about what the system is like. As far as I know, doctors are able to run their practices as they see fit, they just can’t set their own prices.
One of my main complaints about Canada is that we tend to only compare ourselves to the US and then stop there. So, rather than saying how can we improve our system, we just notice that our system seems to be better than the system in the US and then we stop. I wish people would take a broader, more international view.
Personally, I favor whatever system provides the best care to the greatest number of people at the lowest overall cost to society. I don’t care if hospitals and clinics are public or private, profit or non-profit. I don’t know why there seems to be such resistance to the private delivery of health care services. I’m far from an expert on this, so I don’t know what combination of variables provides the best results. Supposedly, the best system is the one they have in France.
Anyway, we’ve drifted kind of far afield from the original topic
Thank you for your information about the Canadian system, Steve and Bortrun. Your exchange of opinions was very intriguing because I didn’t know anything about that.
Mark, you are right it is a little off topic, except in the sense that ideology, “isms” usually get in the way of solving important issues that confront society. Socialism, conservatism, capitalism, racism, anti-racism, liberalism, and many more “isms” are just terms that hide reality, or ideologies that take us away from the basic question of what we want to do, or sometimes, just terms of abuse.
In other words, the question is how can society best organize itself to provide efficient timely medical care, on the basis of wide spread or universal insurance coverage, so that all members of society are protected from the costs of catastrophic illness, and can afford and get access to modern health services on a sustainable basis.
What are the problems and most practical solutions? What are examples of good practice elsewhere. Forget the ideology, whether such and such a solution is liberal, or free enterprise, or conservative, two tier, in line with “the spirit of the Canada health act” a “defining Canadian value” and other such nonsense.
It’s a great suggestion Steve, to try discuss things beyond the “isms” labels.
Back to the Krugman’s (Liberal Manifesto) book, I liked it like Yutaka. Its main content ( nearly all chapters but the last) are easily separable from the Krugman’s ideological partisan views ( the last chapter).
I read the book about two years ago, don’t have it now and may confuse the things. However, as to my memory, its main content is the statistical tracking, by a professional economist, of the income distribution between the (poor + middle) class of America and her one percent of the most rich, starting from a century ago.
The main conclusions are: (1) up to the Great Depression, the lion share of the income fell on the one-per cent rich, so much so that even the existence of the American middle class back then is questioned; (2) the government intervention known as the New Deal, which controlled and even suppressed the free market, was the main factor of creating the America’s middle class and among the main factors of the end of the depression. Diring the New Deal, the income distribution had become much more even and tend to stay that even up to the 1960 -1970. Then and up to the year when the book was published (2007), though the overall wealth of the average American had been continually rising, it was solely due to the income rise experienced by the one percent of the most rich Americans. The actual wealth of the middle class American, after taking inflation into account, had been declining.
Note that the book was published in 2007, during Bush, and before the health care reform.
I remember one of Krugman’s example, though already too arguable one, of how the rising income of the one percent affects the educational options for the USA middle class.
Though Americans used to move comparatively long distances to school and work, such a distance has a limit. Schools in the US, both public and private, always turned out to be better in the areas where both relatively rich and the middle class families used lived. But lately, with the enormously increased cost of the houses, many of the young midlle class parents were forced to leave for a cheaper housing areas, and therefore less decent schools for their kids. Note that they left not because the school became more expensive, but because 99% of the young parents could no longer bye houses in the good school areas.
One argument that I’ve heard against the private medical services and hospitals in Canada, is that the private service will attract the best doctors, and they will become expensive, and this will inevitably decrease the quality of the service affordable by the middle class.
Steve,
I agree that “isms” can get in the way, but they’re also very useful and interesting. They represent a body of thought, maybe based around a few major people’s ideas, or around particular problems or whatever. They provide a framework for approaching problems.
However, when it comes to solving actual problems in the real world, I’m in favor of whatever achieves the objectives. I don’t care if it matches a particular ideology or not. Maybe my impression is different than yours, but I never thought of Canada as a particularly ideological country.
But it does kind of matter what a person’s ideology is because that will strongly inform the sort of system they propose. You could have a very socialist system where all hospitals are government agencies and all medical professionals are civil servants. Or you could have a very capitalist system where the government doesn’t get involved with health care at all, and if you can’t pay, then you can’t pay.
Luckily, I think most people just want something that works.
Ilya,
I’ve heard the argument as well, but I think it refers to allowing wealthy people to pay extra money for faster or better services, thereby creating a two-tier system.
I was talking more about allowing private for-profit hospitals to deliver publicly insured medical services. Or even non-profit private hospitals. As it stands now, I believe all hospitals must be publicly administered, so charities and other organizations can’t set up their own hospitals.
My own opinion, for whatever it is worth, is that things tend to work best when you have public and private services competing with each other. They keep each other honest.
Also, I don’t really have a problem with wealthy people being able to buy faster or better services - I suspect they already do that. Even regular people do that. I knew a guy who flew to China to get an operation on his knee because he was going to have to wait like a year to get the operation in Canada. We might as well keep that money in the country.
But on the other hand, I favor policies that would prevent the creation of a very wealthy elite, like what Krugman is talking about in his book (as you describe it). I think that the attempt to completely eliminate inequality in communist countries was misguided, but the recent decades in the US where a majority of the wealth was allowed to concentrate in the hands of a tiny minority of the population was equally misguided. Canada has been heading down a similar road, albeit at a slower pace.
Inequality is necessary to reward people for doing more difficult or more dangerous jobs, or simply for working hard or for having better ideas or abilities than other people. But it has to be within reason, or I don’t think society can function well.
So, I guess in my ideal world, the wealthy don’t have so much money that they can fund an entire health care system only for themselves that nobody else can access.
“The first lesson of economics is scarcity: There is never enough of anything to satisfy all those who want it. The first lesson of politics is to disregard the first lesson of economics.” --Thomas Sowell
@KnowSome
It might be true that in economics scarcity of economic resources is the starting point of the discipline, but I don’t equate economics with the philosophy of frugality. In my opinion, politics as a discipline is not to disregard scarcity of economic resources but to analyze scarcity or asymmetry of power. I found the excerpt from Thomas Sowell’s writing interesting. Could you show us the context of the phrase?
Here is an article about Sowell, which mentions the quote.
QUOTE: Sowell is one of my intellectual mentors. I have followed his career for many years. In 1988, I changed my worldview from liberalism to conservatism during my first year at Harvard’s graduate school and law school and began reading Sowell religiously…"
I read through your link on Sowell. It concisely and finally proves that Krugman, together with the progressive taxation, are absolutely irresposible
“Responsible academics now realize that progressive policies that promoted legalized thievery through “progressive taxation” 100 years ago and the advent of the welfare state of the 1930s with FDR’s “New Deal” and LBJ’s “Great Society” of the 1960s have done such diabolical mischief to my people that sociologists have made the observation that the black family during the horrors of slavery was a stronger more cohesive unit than the contemporary black family, particularly since the 1960s.”