Friday, January 27, 2006

Crocodile tiers

"First, do no harm. Second, prohibit competition."

O, the colossal con that is Canada's health care system. Ian Gillespie of LFP:

In the last few days, about 1,000 Londoners have lost their family doctor. Many of them are angry...

But yesterday, I spoke to the doctor who cut those patients loose. That doctor, who asked to have her name withheld, gave me her side of the story...

She said private clinics aren't the solution because they'll simply create a two-tier system.
The "two-tier" slogan jumps right out in this context, considering the situation of my 1,000 new brothers and sisters in health care exile. Two tiers? What doublethink is embodied in that phrase. If more than one tier is wicked, then the dreaded "two tiers" is surely less wicked than the thousands of tiers we have now in Ontario.

I can irrefutably demonstrate that there are already at least two tiers. Take my tier as a basis. Tell me, on which tier am I?
  • No family doctor
  • Not a doctor myself
  • No friends who are medical doctors to help me work the system
  • Native English speaker, can communicate with harried, overworked staff
  • Not famous in any degree; only a few other nobodies will know or care when it is my turn to die from "strategic malpractice"
  • No political pull in any degree; same
  • Live in a city
  • Not in prison
  • The price of US health care would be ruinous for me at this stage
  • Family connections on staff at distant hospital; if I already knew I were dangerously ill I could get bumped to or near the front.
Changing any one of these variables changes the quality and speed of care actually made available to a person. Everybody knows this. For example, be it ever so humble, my tier has an OK chance of pushing someone else down a queue, so that he is the one who has to suffer and die. That would be someone on a tier also lacking pull, fame, and money, but also, fatally, without family connections. Better luck next Ponzi scheme.

And we would both have to be sacrificed to the Spirit of Wan-Teer if that was what it took to cure the singer from, say, the Tragically Hip. Yes, it's the Twilight Zone, and there are few among us with enough scruples not to implicitly subject strangers and their families to pain at the price of one's own illness being lifted. Who even considers it? If you think this is harsh then tell me you wouldn't counsel the love of your life to bend the rules and jump the damn queue.

And on which tier is the doctor in the story?

So there are at least two or three tiers already, just by varying this one minor factor.

With the ten factors I've listed, quantizing each to two levels to simplify, there are at least 2^10 = 1024 different tiers. A few minutes' reflection should suggest many more aspects of life that affect health care quality and quantity from person to person. When you have thought of twenty, you have found out that Ontario has over one million tiers.

These are real tiers of privilege, that aren't necessarily surpassed by the ordinary prudent individual planning that helps us get us everything else in life via the free(r) market. These are unjust, artificial tiers imposed by a monopoly. As ever, the socialist approach, suggested by the very concept of a "tier" itself, brings about the exact phenomenon it was purportedly intended to prevent. Forget your heart of hearts. Look deep into your brain of brains. Now ask yourself, can a person really believe ">1 tier bad" and ">2 tiers good"? If not then please shed the tiers.

Wouldn't we all be better off if our own health care didn't have to come from the deprivation of another? Monopolies inevitably cause simultaneous shortages and rising prices because there is no price system to help a monopoly do a good job allocating resources and weighing conflicting priorities. That is, to do a good job planning for the future -- the future which is now upon us as an overworked skeleton crew of doctors "fire" patients. Real businesses, which should be providing health care, must plan intelligently and provide good service, or lose money and go out of business. This threat compels real businesses in a way that a cushy monopoly never is compelled, to find the most efficient way they can with the budget they have to make their customers walk away happy.

Instead of you stepping over the sick people whose doctor your city lured away with your tax money, real companies could be stepping over each other to give you what you want at the lowest price.
"I don't know what the answer is," she said.
On Medved today, he thought to shock his American radio audience with the outlandish fact that here in Canada our winning candidate actually ran on a platform of reducing wait times. Monopolies invariably create expensive shortages. This monopoly approach will continue to leave ever more and more ordinary people without health care, and forbidden by law from getting it. It doesn't have to be like this. End health care prohibition.

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