Talk:Canadian and American health care systems compared

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Good article Canadian and American health care systems compared was a nominee for Social sciences and society good article, but did not meet the good article criteria at the time. There are suggestions below for improving the article. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
February 14, 2008 Good article nominee Not listed
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[edit] Doctor Shortage

I don't really think the uncited claim of a Canadian doctor shortage is really justified, as OECD statistics put it very close to the US. True, relative to other countries, both the US and Canada are low. The Office of Technology Assessment published a comparative study 10 years ago and found that Canada had a surplus of doctors and was working to restrict supply. If true, it sounds like any decline in physicians was intentional and not a long-term product of the system. [1]

[edit] Waiting times

The article currently states "Waiting times for major non-emergency surgery have been longer in Canada". Does anyone know the source for this, and is it on a like-for-like basis? I suspect for the US they are counting the average wait time for people needing a procedure WHO HAVE the means to pay for it AND are willing to pay for it. The Canadian system is counting the average wait time for all patients recommended to have the procedure regardless. To make meaningful comparison we should also be told the wait time of those people in the US whose doctors have recommended the procedure but do not have the resource to pay for it or who have the resource but have decided that the price is so high they are not even prepared to pay for it. I am not sure anyone collects statistics about these people. --Tom (talk) 19:34, 7 December 2007 (UTC)

I want a big screen. I'll never be able to afford one, and therefore I won't get one. But oh do I want one. This does not imply, however, that I am "waiting" for one. You're an idiot. —Preceding unsigned comment added by 198.248.69.48 (talk) 02:14, 3 April 2008 (UTC)

Methinks you are confusing the words "need" and "want". In health care clinical "needs" are assessed independently by doctors to deliver a cure or alleviate specific physical or mental suffering. Not quite the same thing as "wanting" a big screen. I don't think Jesus will go around delivering big screens willy-nilly during His second coming. I suppose it is to much to ask you to sign in before throwing insults. --Tom (talk) 16:25, 3 April 2008 (UTC)

[edit] Government regulation of the profession

One difference not mentioned is that in America, government regulates all health professions, including nursing and medical doctors, while in Canada the professions are self-regulated. Also, in America, many hospitals are government owned, while in Canada hospitals are private institutions. --The Four Deuces (talk) 11:04, 7 January 2008 (UTC)

I think a subtopic on regulation would be a good addition to this article. However, I think you are in error about ownership of hospitals. According to this Wikipedia article, two-thirds of U.S. hospitals are private non-profit, the remainder are split between public and private for-profit. In Canada, the vast majority of hospitals are public. --Sfmammamia (talk) 20:57, 7 January 2008 (UTC)

The cause of the confusion is the meaning of "public hospital". In Canada, a public hospital is actually private not-for-profit (unlike public hospitals in the UK, which indeed are government owned and run). So Canadian"public hospitals" are indeed private. See [Marchildon GP. Health Systems in Transition: Canada. Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies. Downloaded from http://www.euro.who.int/Document/E87954.pd; cited on the Health Care in Canada Wikipedia page. To make things even more confusing, some provinces have wiped out individual hospital boards and consolidated them into regional authorities - also private, but often only nominally so. Hope this helps.R2SBD (talk) 04:33, 8 January 2008 (UTC)

[edit] Monopsony

It would be helpful if this section briefly explained what "monopsony" means.

Also, it is not correct that "The Canadian government has outlawed private medical care for services covered by the public health plan". Note that the cited Supreme Court ruling was on a law of the Province of Quebec. The ruling incidentally is not that the law was unconstitutional, but that it violated the Quebec Charter of Human Rights and Freedoms, which is not constitutional law, but a law of Quebec that takes precedence over other provincial laws. Furthermore, the Supreme Court also decided that the Quebec ban on private medical facilities did not violate the Canadian Charter of Rights and Freedoms, which is constitutional law, although it can be overridden by provincial legislatures.

Ultimately, the decisions of the federal and provincial parliaments will determine the future of monopsony. --The Four Deuces (talk) 02:37, 16 January 2008 (UTC)

It's my understanding that the Canada Health Act is the law that prohibits private health insurance for services covered by the public health plans. I've changed "care" to "insurance" in the sentence in question. If my understanding is incorrect, please clarify further. --Sfmammamia (talk) 06:45, 16 January 2008 (UTC)

The first paragraph of Canada Health Act article makes clear that the law provides criteria the provinces must meet in order to receive federal funding (which is only about 20%) for costs they incur. The provinces themselves enact laws that regulate the provision of medical services. The provincial laws prohibit the delivery of medical services outside provincial plans, except for services not covered by the plans. The federal government does not prosecute people who violate provincial health legislation. The Four Deuces (talk) 23:47, 16 January 2008 (UTC)

Okay, is it accurate then to say that "Canadian provincial governments outlaw private insurance for services covered by their public health plans."? --Sfmammamia (talk) 23:54, 16 January 2008 (UTC)

What about "Canadian provincial governments outlaw privately paid health care for services covered by their public health plans."? --The Four Deuces (talk) 21:34, 18 January 2008 (UTC)

Sounds good to me, I've incorporated the wording change. --Sfmammamia (talk) 22:17, 18 January 2008 (UTC)

I have added a direct quote from the New England Journal of Medicine which explains the role of private plans. The NEJM is better-researched and more reliable than most other sources. You can check the original article on-line and see if I've correctly summarized it. If not, we can include a longer quote.

But I too would like a simple explanation of what that "monopsony" sentence means. Nbauman (talk) 15:47, 27 January 2008 (UTC)

Don't know where that sentence comes from, but a monopsony is the opposite of a monopoly: since the single-purchaser in a single payer health care system can (to some degree) dictate prices, it can keep the cost of certain purchases down. This is a standard economic analysis where, for example, the seller is a monopolist - for example, of patented pharmaceuticals. (Put simply, one solution to deal with a monopoly is to compel the monopolist to deal with a monopsonist. Krugman has written quite a bit on this - in particular, that prices are lower in Canada for drugs due to use of this monopsony power, and that - in contrast - the expansion of medicare to pharmaceuticals was specifically designed to protect the drugs companies from Medicare administration using its purchasing power to drive down prices.
That said, the para in the article at present is gibberish, and has almost nothing to do with monopsony as is usually discussed in context of Canadian healthcare system (where it's generally a good thing). The key takeaway is that for certain goods/markets, a monopsonist can result in increased supply to consumers at lower prices - and in certain very specific circumstances, this might actually be beneficial to the producer, too. (Monopsony can also be bad, but also under fairly specific circumstances).--Gregalton (talk) 16:06, 27 January 2008 (UTC)
If the sentence is gibberish, it doesn't belong in the article. I'd like to give anyone who wants to include it a few days to make his point in simple English. I don't think it's necessary to use the word "monopsony," since I'm sure you could stop 10 people on the street and they couldn't give you a definition. A Wikilink to the monopsony article is OK. Nbauman (talk) 16:59, 27 January 2008 (UTC)
I agree. It would be useful to include something about it with respect to pharmaceuticals, but what's there now doesn't make much sense.--Gregalton (talk) 17:15, 27 January 2008 (UTC)

Is the current version helpful enough or should I try again? --Doopdoop (talk) 22:16, 27 January 2008 (UTC)

Are you trying to say, "Because the provincial governments are the sole purchasers in their jurisdiction, they have a strong negotiating position in setting prices."? I think it would be a lot easier to make a statement like that, without trying to work an unfamiliar word like "monopsony" into it.
I don't think we should even discuss monopsony unless we have a WP:RS making that point about the Canadian health care system. Somebody deleted my quote from Paul Krugman on the Manhattan Institute page because it was original research. If those are the rules on WP:OR, then we should apply them consistently.
The section isn't even about monopsony any more, it's about private care in Canada. We should change the heading. Nbauman (talk) 01:04, 28 January 2008 (UTC)

[edit] The American flag should be on top

Someone keeps vandalizing this page by putting the Canadian flag on top of the American flag. This comes despite the fact that the American flag is to be respected and be placed above all other flags regardless of any other circumstances. Even if this is an international website, it is run in the United States and therefore we are obligated to show the due respect to our flag. —Preceding unsigned comment added by 192.77.143.167 (talk) 17:25, 17 January 2008 (UTC)

I have reverted the flag order to reflect the wording order in the title. This is the only neutral way to present the flags, in my opinion. Otherwise, I suggest we delete the images or replace them with another image. Did it ever occur to you that American editors are not the only editors who work on this article? --Sfmammamia (talk) 17:37, 17 January 2008 (UTC)
192.77.143.167 has made a bold edit and placed the flags left and right. I understand that this layout is frowned upon per WP:LAYOUT#Images. Would an alternative compromise be to place both flags side by side and float both on the right side of the lead section? --Sfmammamia (talk) 02:31, 18 January 2008 (UTC)
In the real world (e.g., physical flags at a press conference or summit meeting) protocol would call for both flags to be of equal size and to be flown at the same height [[2]]. That rule would seem to be a good place to look for POV-neutral guidance in this situation. The critical issues would seem to be a) the images should be the same size, and b) they should be the same distance from the top of the page. The current arrangement would seem to meet those requirements, as would placing them next to each other on the right side of the page. —Preceding unsigned comment added by 146.145.79.247 (talk) 14:45, 18 January 2008 (UTC)
Done. Both flags floated right.--Sfmammamia (talk) 16:45, 18 January 2008 (UTC)

If this ridiculous pissing contest continues to be an issue, then get rid of both flags and put a generic hospital photo at the top. --David Shankbone 16:48, 18 January 2008 (UTC)

[edit] Private Care

May I suggest the following sentence be changed because it is inaccurate and biased:

"The ruling, which found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists, has been called a turning point for the country's health system and is expected to lead to greater privatization."

First, the ban is not "unconstitutional" as I explained above. Second, the source for the "turning point" statement is owners of private clinics, including an article by one of the litigants published by the Cato Institute! It would be more helpful if someone wanted to describe how specific governments have reacted.

Suggest the sentence be re-worded as:

"The ruling found that a Quebec provincial ban on private health insurance was unlawful, because it was contrary to Quebec's own 1975 legislative act, the Charter of Human Rights and Freedoms." --The Four Deuces (talk) 20:43, 1 February 2008 (UTC)

The judgment was indeed very hard to deciipher because the judges split so many ways on different issues. But I agree it was not unconstitional in the sense that the Charter of Human Rights is not framed as constitutional law. If I remember rightly the judges overall decided it was constitutional for legislators to discriminate against the private sector in order to protect the public service. So I think you should make that change. --Tom (talk) 09:26, 2 February 2008 (UTC)

I have made the changes. The judgment is difficult to read, but the original writing left the impression that it was something like Roe v Wade. In fact, it only applies to Quebec, and the Quebec government has a number of options, including a legislative override of the Charter. --The Four Deuces (talk) 22:37, 3 February 2008 (UTC)

[edit] GA Review

The article is very comprehensive, well-written, and informative. I believe it mostly meets the Good Article criteria, with the biggest exception being the 'citation needed' tags in the article (mostly near the end, but some earlier ('medical professionals'). The only other minor issue is that the 'impact on economy' section is very short, and really only cites on case, so it's not exactly complete. It would be good if more studies on the economic impacts could be provided. Other than these issues, I think the article meets the criteria, and can be promoted once they are addressed. I will put this article on hold at WP:GAN until February 10, 2008, so that these issues can be solved. Cheers! Dr. Cash (talk) 17:23, 3 February 2008 (UTC)

In my view, it still needs a lot of clean-up. There are a number of errors and confusions, many pointed out on the talk page, but not yet dealt with. Can you extend the hold a bit, and I'll try to do some work on it. Note that as stands there are inconsistencies between the same topic as covered in this article and related ones, including Canada Health Act, Medicare Canada, and Health care in Canada.R2SBD (talk) 19:17, 11 February 2008 (UTC)

The table of comparative statistics on cancer outcomes is a howling error, almost as bad as David Gratzer/Rudolph Giuliani's comparison of U.S. to U.K. prostate cancer survival statistics. There are good comparative statistics, which Guyer cited, and we should use them in the article. If JoeCarson insists on keeping these in, this will never be a GA. Nbauman (talk) 01:27, 12 February 2008 (UTC)

Many POV issues are still remaining. --Doopdoop (talk) 22:15, 12 February 2008 (UTC)

Doopdoop, greater specificity to your comment would be very helpful to those of us interested in improving the article. --Sfmammamia (talk) 22:53, 12 February 2008 (UTC)
For example some parts of this article violate WP:SYN --Doopdoop (talk) 23:00, 12 February 2008 (UTC)
...And they are? What specifically? --Sfmammamia (talk) 23:08, 12 February 2008 (UTC)
Sentences that cite studies which compare American and Canacian healthcare systems are OK. To cite one general source about USA and another about Canada is original research. --Doopdoop (talk) 23:27, 12 February 2008 (UTC)

More than a week has elapsed since I put this one hold, and the issues I brought up still have not been addressed. Furthermore, based on the other comments that others have made above, I don't think it's time to pass this as a GA quite yet, so I have failed the article. It can be renominated at WP:GAN once these issues are resolved.

On a more technical note, I recategorized this in the {{ArticleHistory}} to topic=socsci instead of topic=natsci, since it deals more with the politics of healthcare than an actual scientifically-related medicine topic. Cheers! Dr. Cash (talk) 18:03, 14 February 2008 (UTC)

[edit] POV, WP:SYN and WP:NOR problems in the article

Wikipedia does not publish original research, and that includes any unpublished analysis or synthesis of published material that serves to advance a position. So if you want to compare costs of healthcare in USA and Canada, please use sources that directly compare healthcare in these two countries. To do otherwise is original research, and it is not allowed in Wikipedia. For this reason I think that NPOV dispute tag should be placed on top of this article.

It would be an original research if I had created an article called "Toyota Prius and Honda Accord compared" with the following fully cited text: "Prius may pose a safety risk to blind pedestrians who rely on engine noise to sense the presence or location of moving vehicles.[1] Accord features better fuel efficiency due to Honda's Variable Cylinder Management (VCM) system, which shuts off 2 or 3 of the cylinders depending on the type of driving.[2]" --Doopdoop (talk) 19:53, 13 February 2008 (UTC)

The second sentence of the article compares the costs quite clearly, using a reliable source. I will look for a more up-to-date version of that comparison. Otherwise, I don't know what you are talking about. The sentence you deleted (and that both I and Gregalton restored) was not a comparative statement. --Sfmammamia (talk) 20:00, 13 February 2008 (UTC)
Please look at the Toyota/Honda example above. There are no comparative statements there. Original research prohibition covers both comparative and non-comparative statements. --Doopdoop (talk) 20:11, 13 February 2008 (UTC)
Let's see WP:SYN states no "synthesis of published material serving to advance a position". Please be specific about what statement attempts to advance a position that is not supported by a source. The statement that health insurance is expensive in the U.S. is well-supported by cost data throughout the article (per-capita, GDP, and private out-of-pocket cost comparisons are well supported by reliable sources in the article). Again, it's my understanding that, according to WP:LEAD, it is unnecessary to footnote statements in the lead section that act as highlights for material covered later in the article. The fact that costs are rising rapidly, I think, is not likely to be challenged by anyone's POV, but if you need a cite for that, I'm happy to add one. The last part of the sentence in question, about personal bankruptcies, is already supported by cite. --Sfmammamia (talk) 20:29, 13 February 2008 (UTC)
One of the many issues - source does not compare personal bankruptcies in the US and Canada. --Doopdoop (talk) 20:37, 13 February 2008 (UTC)
Perhaps because the structure of health care in Canada guarantees that Canadians do not go bankrupt because of health problems or hospital bills???? That's fundamental to the system's design. --Sfmammamia (talk) 20:45, 13 February 2008 (UTC)
Maybe. We will never know for sure unless we get a source that compares relative impact of healthcare systems on personal bankruptcies in US and Canada. --Doopdoop (talk) 20:57, 13 February 2008 (UTC)
I agree that it would be nice to find a source that compares causes of bankruptcy in the U.S. and Canada. But it is not necessary to do so, because the statement as written says nothing about Canada and does not attempt to synthesize two sources to make a comparison or advance a position about contrast between the two countries. It only states the situation in the U.S. So it does not violate WP:SYN or WP:OR. If you are saying that including the bankruptcy information only for the U.S. is POV, then fine, let's take out that clause until we can find a source that makes the comparison. Hopefully that will satisfy your concerns. If not, I hope you will continue to cite specifics here rather than making general complaints that do little to help us reach consensus on how to improve the article. --Sfmammamia (talk) 22:27, 13 February 2008 (UTC)
We did find a source who contests the conclusions in Health Affairs, and that is Zywicki, who we cited in the article. That satisfies the WP requirements of WP:NPOV, and bends over backwards to satisfy WP:WEIGHT.
It's an established fact, documented in Health Affairs, the Wall Street Journal, and many other reliable sources that in the U.S., health care costs are a major cause of bankruptcy. To claim that we must find a source to say that health care costs are not a major cause of bankruptcy in Canada is patently ridiculous. If anything, it's OR to raise such a bizarre counter-argument. I think it's enough for NPOV to say we've seriously examined every objection, no matter how desperate, and they don't hold up. Nbauman (talk) 00:41, 14 February 2008 (UTC)
Let's assume it is an established fact (Todd Zywicki source disputes this). But we don't know if health care funding costs (taxes or insurance contributions) are important for Canadian bankruptcies. If there were no healthcare tax payments and insurance , some Canadians would be saved from bankruptcy. I cannot quantify this effect and compare it to the US situation. But this comparison should not be performed here at Wikipedia, we should leave this role to the sources. --Doopdoop (talk) 00:59, 14 February 2008 (UTC)
According to this article between 7.1 percent and 14.3 percent of Canadian bankruptcies are attributable to “health/misfortune.” (Quoting J.S. Ziegel, “A Canadian Perspective,” Texas Law Review 79, no. 5 (2001): 241–256.) This compared to a rate of about 50% for the U.S. I will remove the POV tag which was always nonsense. It would have been better to have placed a citation request at the appropriate point.--Tom (talk) 18:13, 25 February 2008 (UTC)
Your comment is interesting but it is your original research. It is not clear that you can compare these bankruptcy rates directly (maybe research methodology is different in these two studies, maybe Canadian study does not take into account higher taxes paid by Canadians for health care funding. Article tags still apply. --Doopdoop (talk) 20:54, 25 February 2008 (UTC)

(undenting) Doopdoop, as the editor who added the POV template, would removing the statement regarding U.S. bankruptcies resolve your POV concern with the article? If not, could you please specify what other POV concerns in specific you have with the article? You have not posted anything in this discussion for more than 10 days, so I think Tom's removal of the POV template was justified, because you have made little effort at working toward consensus on your concern(s). The POV concerns of one editor do not make consensus. Thoughts of other editors on this suggestion?--Sfmammamia (talk) 21:27, 25 February 2008 (UTC)

I would strongly oppose removing the reference to the Health Affairs article on bankrutcy. That's a major characteristic of the American health care system.
I don't think the Zywicki article actually disputes the Health Affairs article, but I've been willing to leave it in just to make sure we're getting all points of view. But if Doopdoop wants to make an issue of it, I'd like him to quote the exact text from the Zwyicki article that disputes the Health Affairs article. Nbauman (talk) 21:57, 25 February 2008 (UTC)

Sorry for taking so long to reply. At this moment I think that removing bankruptcy sentence from the lead or moving it down to some other section would resolve POV issues in the lead. I think that POV, WP:SYN and WP:NOR problems not in the lead should be resolved by making edits or tagging the relevant sections. Until somebody removes bankruptcy sentence or moves it to some section below I am restoring the POV tag. --Doopdoop (talk) 19:26, 29 February 2008 (UTC)


The same problems remain in the "Government involvement" section - facts are compiled from different sources to advance a position, but WP:SYN prohibits that. This sentence is especially unfair in the context of this article: "The U.S. government spends more on health care than on Social Security and national defense combined". --Doopdoop (talk) 20:16, 1 April 2008 (UTC)

Please explain what you mean by "especially unfair". What POV do you ascribe to the statement? --Sfmammamia (talk) 20:34, 1 April 2008 (UTC)
It well might be that the same argument applies to Canada. Actually it is not easy to determine whether Canada spends more on health care than on Social Security and national defense combined, as the spending might be categorize differently in Canada. The line between the social security and health care spending might also be not very clear and consistent. --Doopdoop (talk) 20:59, 1 April 2008 (UTC)
Very good point. I'm impressed with this article. As an American living in Norway I know how difficult/impossible it can be to compare costs of living, tax rates, wages and pensions. And on and on. (Yes, I do pay over US$8 for each gallon of gas...) And the assumptions people make! -- "Health care" does or does not include dental care, glasses and all or some or no prescription drugs. Though contributors to this article have disagreements, I know it's difficult. I've learned a lot from this article, thanks. --Hordaland (talk) 22:28, 1 April 2008 (UTC)
In my opinion, it is entirely likely that the Canadian government also spends more on health care than on national defense and social security combined. But saying the same is true about Canada, if it could be sourced, is not notable. What is notable are the implied contrasts. Canadian government spending constitutes 70% of health care dollars but covers everybody, while in the US, the government's 45% of spending covers only 27% of the population. The Canadian military budget is $16 billion, or a mere 1.4% of GDP, compared to the 3.7% of GDP the US spends on its massive military budget, so that contrast is quite remarkable in and of itself. Social Security spending may be difficult to compare, but I imagine someone has done it. I will keep looking for sources. --Sfmammamia (talk) 23:13, 1 April 2008 (UTC)

I am removing the OR tag, as there has been nothing new stated here in talk about what statements in the government section involve original research. Please cite specific concerns here. --Sfmammamia (talk) 23:22, 1 April 2008 (UTC)

WP:SYN is just one kind of WP:OR. I thought that there is no separate tag for WP:SYN, but I've found one. --Doopdoop (talk) 20:18, 2 April 2008 (UTC)
So far, you still have not specifically stated what position is being advanced by the assemblage of facts in the government involvement section. To my eye, there's no conclusion reached about the differences between Canada's government involvement and that in the US. The sentences are assembled merely to summarize the differences. Hence, no WP:SYN is involved. I'm reverting the tag. --Sfmammamia (talk) 20:33, 2 April 2008 (UTC)
E.g. position "USA bad, Canada good" is advanced by the inclusion of the sentence "The U.S. government spends more on health care than on Social Security and national defense combined". --Doopdoop (talk) 21:27, 2 April 2008 (UTC)
In my opinion, there's nothing in that sentence that says or implies that the USA is bad. --Sfmammamia (talk) 21:53, 2 April 2008 (UTC)
This sentence is from a source that has criticised American system. --Doopdoop (talk) 21:57, 2 April 2008 (UTC)
So? The sentence, by itself, could just as easily be used by the right/libertarian point of view as support for getting the US government out of healthcare as it could be used by advocates for greater government involvement and spending. As such, the sentence itself does not advance a position. --Sfmammamia (talk) 23:00, 2 April 2008 (UTC)
The sentence advances critical POV (both leftwing and extreme rightwing). Just because you have split this POV in two means nothing, WP:SYN still applies. --Doopdoop (talk) 21:39, 3 April 2008 (UTC)

(undenting)Doopdoop, I suggest you reread WP:SYN. If the assemblage of facts does not serve to advance a specific position, it is not synthesis, by definition. Otherwise, everything in Wikipedia that derives from an assemblage of facts from a variety of sources would have to be labeled synthesis. Clearly this is not the case. I'm going to let other editors ring in on this one. --Sfmammamia (talk) 01:32, 4 April 2008 (UTC)

You forgot that this is a comparison article. Unless a fact advances a position that is cited from a source that compares US and Canadian health care, it is a POV and WP:SYN. --Doopdoop (talk) 21:11, 4 April 2008 (UTC)
From a quick look at other such comparison articles, I don't think your assertion is correct. See Canadian and American politics compared and Canadian and American economies compared for examples. Not every statement in these articles requires a point-for-point comparison sourced from an article conducting such a comparison. As this dispute about WP:SYN seems to be unresolved for now going on six or seven weeks, I've asked other editors to comment. --Sfmammamia (talk) 17:00, 5 April 2008 (UTC)
It is very likely that Canadian and American politics compared article has the same problems. --Doopdoop (talk) 19:18, 27 April 2008 (UTC)

[edit] Article name change

I think we should change the name of the article to "Studies comparing Canadian and American health care systems". This change would reduce rampant original research that is now present in the article. --Doopdoop (talk) 00:44, 14 February 2008 (UTC)

Oppose Inconsistent with other, similar comparison articles, listed and linked higher up in the discussion (see topic 19). Once again, you are making a general complaint -- "rampant original research", I believe, is unfounded and, I find, unhelpful. If it were true, changing the article title would be a completely inadequate method of resolving it. --Sfmammamia (talk) 01:36, 14 February 2008 (UTC)

[edit] Auto-archiving

I'm going to be bold and establish auto-archiving for this talk page, very long indeed. Objections welcome.--Gregalton (talk) 10:13, 26 February 2008 (UTC)

[edit] Source ...

This blog has some good links and ppt slides with comparative data that may be of interest: http://matthewholt.typepad.com/the_health_care_blog/2003/11/policy_oh_canad_1.html . I'll try to integrate later, but for others that may be interested...--Gregalton (talk) 15:09, 26 April 2008 (UTC)

Interesting. It could be useful for finding links to reliable sources -- and I would prefer peer-reviewed sources -- but remember that WP doesn't usually accept blogs as reliable sources.
I've looked at The Health Care Blog before, after it was recommended in the WSJ and elsewhere, and frankly, I was disappointed. I'd rather spend the time on the NEJM, and JAMA, and BMJ, and Health Affairs, and ....
There is one glaring error in that link, BTW, which is to imply that kidney dialysis isn't used in the UK when appropriate, which may have been true in the 1980s, but isn't true today, contrary to what the entry might lead you to believe.
As for Robert Blendon's surveys, I once met Blendon, and heard his presentation, BTW. The big caveat to everything he says is that, as he acknowledges, he's asking people for their opinions, and he doesn't try to find out whether their opinions are true. There was another study, which I linked to in this WP entry, which found that patient perceptions aren't an accurate predictor of the quality of medical care. It's relatively easy to survey doctors or patients for their perceptions, but it's harder to do a chart review to see what the quality actually was. It would be very easy to fill this WP entry up with surveys about Canadian and U.S. health care, but they don't reflect on the quality of care, unless they were at least published in a peer-reviewed journal like Health Affairs. Nbauman (talk) 18:02, 26 April 2008 (UTC)
All good points. I wasn't primarily suggesting the blog itself as primary source, but the various links (which some blogs are definitely good for).
One point on opinion comparisons, however: they are perfectly valid in at least two contexts, i) where the question actually is perceptions/"contentedness" (like doctors' opinion of system), which are frequently raised in punditocracy/blogosphere ("Canadians unhappy with system!"); and ii) if one accepts that health system is political choice of trade-offs, and there are some outcomes that are valued in political market but not so much in "market" outcomes, perceptions do matter. For example, some say Canadian society places high value on equality (at least some minimal level) or equity; if Canadians are of the opinion that the system is relatively equal and rate this aspect positively, then arguably political system has provided something of value. Which should not really be controversial - societies everywhere value things like police and fire services that are provided through taxation, and in most societies some degree of "equity" (expressed in a variety of ways in each society), but for some reason this is highly controversial in health care.--Gregalton (talk) 19:41, 26 April 2008 (UTC)