How Socialized Medicine Works in Canada (Maybe)

James Fallows highlights a reader's email:

First, a primer from a reader in Montreal (I think - or someplace up there):

>>Here is how health care is financed in Canada.

1- The state determines how much money is available for heath care from the budget of the year. Say $1.00 [billion] etc

2- The state then asks the various medical professionals for a price for say 50,000 broken legs to be repaired, 20,000 births, you name it. The statistics of the needs of the country are known from previous experience.

3- The medical professionals discuss between themselves how to divide the available money for the various procedures. They know that it takes 10 minutes to do this and two hours to do that.

4- They return to the state with a price list for each procedure.

5- The state then guarantees that every medical act will be paid according to the price list.

6- The medical professionals know that they will get paid immediately upon completion of services. The only paper to fill is a credit card slip of paper containing the identification number of the physician and the procedure with the agreed price.

7- That is it. No collection agency, no discussion with an insurance about the need to do an MRI etc.. Whatever is ordered by the doctor is executed. If a question arises, then it is the medical association that looks into the matter and decides. The association has the power to remove the license of the offending doctor.

<<In a follow up note, the same reader adds:

>>There is a social impact as well.   Since health care is free, when a doctor screw things up (yes it happens in Canada) fixing the problem is also free. Hence the patient does not develop the anger of paying his bills and losing his home for the mistake of somebody else.

Result: A Montreal friend orthopedic surgeon specializing in spine surgery told me that he pays $5,000 per year for malpractice insurance per year.

Compare that with the $250,000 for insurance of the average surgeon in Dallas, TX. The doctor must recover the insurance fee by charging more, and you end up in a vicious loop.

Fairness and justice makes life easier for everyone.<<

I tihnk that would reasonably apply my concept of cooperation between government and medical providers to handle medical delivery and control costs.  I would like to see doctors, hospitals, insurance companies along with the administrators of Medicare and Medicaid work out a plan to deliver better than current U.S. health care (which is on average less effective than France) at a cost within 5% of France's health care cost.  My guess is that we would discover that doctors, hospitals and insurance companies end up with most of the excess spending the U.S. has in relation to France, while patients do not benefit.  Our "market" system does medicine so inefficiently.