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Lynn in Omaha wrote:

" If the Canadian system is so wonderful, why do we read of all the
people coming accross the border to upstate NY for medical treatment?
        WE have friends in Australia who have private insurance because
they don't feel the national insurance is adequate."

The above posting was very interesting to me as it is a perfect example of
the dangers of two tiered health care systems. About a year ago there was
an extremely interesting program on CBC radio that discussed the Australian
health care system. Their system consists of both a government administered
health care program and private "pay as you go" clinics. The Australian
system was designed so that everyone would be able to afford to get quality
health care, but that those with greater financial resources would have to
pay for their own health care and those with less money would be provided
with health care by the government. The program researcher gave several
examples of people who had literally sold all of their possessions in order
to have operations or pay for medical procedures for their children rather
than waiting for the procedure to be done in the government run system. As
Lynn has commented on from first hand experience, there is a perception in
Australia that the government run system is somehow not as good as the
private system.

However, the researcher pointed to several studies showing that BOTH
systems were equally successful in treating serious illness, and that there
weren't any more deaths due to the waiting list for treatment under the
government program than there were under the private system. The problem is
that many people feel that that will get better health care simply by
paying for it themselves ("you get what you pay for"). The researcher
pointed out that there is a great deal of guilt involved for parents with
sick children which contributes to them turning to private clinics so that
they can have their children treated sooner, even if it means impoverishing
themselves. It was not the doctors who thought these operation needed to be
done sooner, it was the parents.

The same problem exists in Canada, some people who are on long waiting
lists for certain procedures are travelling to the United States because it
is possible to get immediate treatment if you have enough money. This is
not to say that there are more people dying because of long waiting lists
for medical procedures in Canada than in the US, because this simply isn't
true. The perception that "you get what you pay for" in terms of health
care does exist in Canada, but since there are no private clinics in Canada
(except Quebec), it is not possible to jump the queue unless you leave the
country.

These are important considerations when designing health care systems, and
from the experiences of the Australians and the Americans it seems like
there are two choices. One, we have no government intervention in health
care and everyone pays their own way. This would lead to doctors charging
huge fees (no regulation) and poor people would die from treatable
illnesses and go into debt trying to get diagnosed for celiac disease. Two,
we have a managed health care system to which everyone has equal access,
and people could go to the doctor for a blood test, not a credit check.

To me the choice is simple.

Elise Gorseth
Assistant Scientist
SCRIPTGEN Pharmaceuticals Inc.
200 Boston Avenue, Suite 3000
Medford, MA 02155

Tel: (617) 393-8041
Fax: (617) 396-1028
E-mail: [log in to unmask]