Posted: Mon Oct 18, 2004 9:57 pm
Your posts have raised some valid points, civiltech.
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<br />A democratic nation should function on the basis of delivering the best value for citizens, both current and future.
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<br />The determination of 'best value' must be devoid of political ideology. Determining 'best value' may at times times on the various toes of those who perceive themselves to be on the 'right' or 'left' but, so be it.
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<br />The problem is that those who identify themselves by an 'ism' generally develop tunnel vision, and tend to trip a lot along their paths ( and generally blame others for these falls).
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<br />I read the U.K. document with interest, realizing in the process the rather embarassing fact that I haven't previously had any real knowledge of national medical systems outside of our own and that of the U.S.
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<br />I'll admit, I don't care how a service is delivered, so long as it delivers the best value to citizens and leaves none out in the cold who haven't chosen to be there.
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<br />So whether any service is delivered by the public sector, a public/private mix or the private sector is in my view irrelevant, so long as it meets the goals I indicated.
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<br />A couple of things caught my eye in the document:
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<br />[QUOTE] The number of practising GPs in each county is subject to collective agreements negotiated between the counties and the GP section of the Danish Medical Association. The result is an even distribution across the population.[/QUOTE]
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<br />Canada may not have this type of agreement with medical associations. However, I suspect, perhaps wrongly, that some similar situation exists for a number of self-styled 'professions' in Canada, whether legislatively or in unspoken agreement between government, the university interests and the 'profession', which effectively limits the number of association members available on the free market at any given time. Assuming this is true, this effectively renders the 'professional association' a trade union.
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<br />Now the reason given for this state of affairs may be some 'protection of the public interest'. However, in reality the agreement serves to limit the number of 'professionals' in a given category available on the free market, and thus artificially inflate the income of the overall group.
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<br />I believe in the free market. If the Canadian market requires 5000 physicians, accountants, lawyers, engineers, whatever, be graduated each year and individuals with the ability, as measured by by real rather than self-serving artificial university standards, to acquire the necessary skills are ready and willing, then facilities should be in place to encourage the same. The consumer, or government with the consumer's money and on their behalf, should not be required to support a standard of living that 'professionals' believe is their due solely on the basis of an artificial structure that encourages the same.
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<br />As with any other product in the free market, the high quality practitioners would be in demand, and have an income appropriate to that demand. A glut on the market might encourage some to seek employment elsewhere, e.g., rural communities. Essentially, these 'professionals' would like most need to work for the going rate and in locations where a demand exists.
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<br />The problem with artificially inflating the income of certain professions is that this tends to attract individuals that while able to pony up the club entry fees, e.g., ability to memorize, are not desirable club members, rather than solely those who are suited to the profession and confident in their ability to make a good living in a competitive environment.
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<br />So, I think that if we're talking privatization, we also need to be talking about applying free market principles to all of those who wish to participate in the game.
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<br />The other point I noted was:
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<br />[QUOTE]However, DRG payment is to be the same, and as a result, so far, no private providers have signed contracts all complaining that payments would not cover costs.[/QUOTE]
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<br />The implication is that the private sector can not provide the services of the public sector at the same cost. This doesn't strike me as promising.
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<br />Anyway, I am grateful for your post and the reference.
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<br />In an earlier post, you said:
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<br />[QUOTE]Unfortunately public sector, though it rules out profit, also rules out the competitive spirit. I just left the public sector and returned to the private dejected with the way things are run.[/QUOTE]
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<br />I disagree that the public sector 'rules out the competitive spirit'. What it does (like many unionized environments) rule out the concept of receiving recognition, e.g., promotion, that one might receive in the private sector based on contribution, proven ability and potential.
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<br />I'll agree that the public sector probably spends greater resources than the private to produce an acceptable product. However, this must be balanced out against the consequences of increasing profit by cutting corners, as is a risk in private sector endeavours.
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<br />Regardless, the bottom line is leadership (the mantra in both the private and public sectors, though forgotten quickly when convenient in the public). People tend to 'follow the the leader'.
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<br />I'm not sure what point you've been attempting to make to Kory. I'd hazard a guess you're in your late twenties or early to mid thirties, with a long way to go yourself. I'm guessing this because you seem to be in the 'now I understand how things are in the real world' phase.
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<br />Realistically speaking, one's view of 'how things are in the real world' are based on the 'real world' we've individually experienced. I'm sure your's, mine, etc, 'real world' differs substantially, based on the lives we've lived and the experiences we've had to date.
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<br />Fact is, the only 'real world' any of us have to live in is the one in which we starve if there's no food, freeze if there's no heat, etc. The rest is an artificial construct created over the centuries which we now inhabit, and choose to accept to the extent we're comfortable with. When most cease to be comfortable, the construct changes, as the Romanovs, Bourbons, etc. learned the hard way. We co-exist with the construct at hand based on our own wants and needs, e.g., actions and choices of those who like lots of money may differ from those who don't.
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<br />Kory's points are well taken. How things are is not necessarily how he believes they should be.
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<br />Your points are also well taken. How the things might be desired to be is not necessarily as you (and I) have experienced.
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<br />There's no right or wrong, or any 'listen grasshopper' to it. Just two points of view.
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<br />The lessons you've learned are not necessarily what Kory should learn, or perhaps what you yourself should have learned.
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<br />Word to the wise though, I've noticed patronization generally doesn't play well to the audience.
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<br />As I mentioned, I've found your posts quite valuable. Being 'civil' is to my mind a good thing.
"When we are in the middle of the paradigm, it is hard to imagine any other paradigm" (Adam Smith).