Amid the debate about reforming heath care in the United States, it’s tough to turn on your television these days without hearing a political ad condemning the Canadian health care system.

One such ad from Americans for Prosperity features a woman talking of her experience with getting treatment for cancer.

“I survived a brain tumor, but if I’d relied on my government for health care, I’d be dead. I am a Canadian citizen. As my brain tumor got worse, my government health care system told me I had to wait six month to see a specialist,” the woman says.

The ads are provocative, but just how accurately do they portray Canada’s system?

At a small doctor’s office in the gritty working-class neighborhood of East Vancouver, Dr. Larry Barzelai meets with John and Bessie Riley, who have been his patients for more than 20 years.

John Riley was recently diagnosed with colon cancer. Contrary to the woman in the TV ad, he says his experience getting in to see specialists has been “nothing but good” so far. “Everything’s gone bang, bang. I’ve had no waiting times for anything,” he says, adding that his only out-of-pocket expense has been the cost of getting to the doctor’s office.

Socialized Insurance, Not Socialized Medicine

Canada has a universal health care system that’s paid for through income taxes and sales tax. All Canadians are covered, and they can see any doctor they want anywhere in the country with no copays or deductibles. Some things aren’t covered: optometry, dentistry and outpatient prescription drugs. Many Canadians have private insurance to cover those services, though some struggle to pay for them out of pocket.

U.S. critics of Canadian health care like to call it socialized medicine, but it’s more like socialized insurance — meaning the risk is pooled together. And while the individual provinces and territories set their overall health budgets and administer the health plans, the delivery of medical care is private. Doctors run their own businesses and then bill the government.

Barzelai says physicians in Canada earn a good living and aren’t faced with the same administrative hassles that American doctors gripe about. “Medical costs here are half of what medical costs in the States are,” he says. “At the same time, our infant mortality is lower, our life expectancy is longer, our rates of obesity are a lot less. So there’s got to be some positive aspects of living in Canada and with the Canadian medical system.”

The Commonwealth Fund, a respected and nonpartisan U.S. health research organization, looked at deaths that could have been prevented with access to quality medical care in the leading 19 industrialized countries. In the latest survey, the United States ranked last and Canada came in sixth.

Professor Bob Evans, one of the grandfathers of the health economics field, has been studying the Canadian and U.S. systems since they were founded around the same time in the mid-1960s. He says that what many Americans hear about Canada — rationed care, long wait lists and a government bureaucrat who gets in between a patient and doctor — is “absolute nonsense.”

“Are there cases of people who wind up not getting the care they need at appropriate times? Yes, of course there are,” says Evans, who is with the Centre for Health Policy Research at the University of British Columbia in Vancouver. “This is a huge system and it’s a very complicated one and things do go wrong. But as a general rule, what happens here is that when you need the care, you get it.” But that wasn’t always the case.

‘The Most Frustrating Moments In Our System’

When federal spending on Canadian health care declined during a recession in the 1990s, lines for non-urgent procedures — and some urgent ones — grew. A few years later, Canada’s Supreme Court found that some patients had in fact died as a result of waiting for medical services. Stories of the deaths and of residents traveling to the U.S. for medical care dominated Canadian news coverage.

In response, Canada’s government poured billions of dollars into reducing wait times in the five medical areas deemed most troublesome, including cancer care, cardiac care and joint replacement surgery. And wait times for these services has dropped: Most provinces now report those times on publicly available Web sites. Such data — and public accountability — don’t exist in the U.S.

But that’s not to say there still aren’t frustrations with waiting for medical care in Canada.

Jocelyn Thompkinson is a peppy 29-year-old who was born with a neural tube defect similar to spina bifida. “I haven’t been able to walk since I was 8, and I’ve had lots of surgeries, lots of medical interventions of various types,” she says at BC Children’s Hospital, in a leafy Vancouver neighborhood. “But beyond that, I hold a job, I have a pretty much normal life.”

She credits an army of Canadian doctors and physical therapists for giving her that normal life, though there have been roadblocks. “Of course there were some times when I had to wait for care, and those are always the most frustrating moments in our system,” Thompkinson says. Several years ago, when she was on a long waiting list for a pain clinic in Vancouver, she traveled to Seattle and then Texas to get care. The visits and tests cost her $1,800.

Few Canadians actually go south for medical care, though. Canadian researchers say it’s a bit like getting struck by lighting — it’s extremely rare, but when it happens, everyone talks about it.

Provincial governments do pay for Canadians to receive specialty care in the U.S. in some cases. For example, a shortage of neonatal beds means a small number of women with high-risk pregnancies are sent to U.S. hospitals to deliver their babies.

It doesn’t happen often, though, and public opinion polls continue to show strong support for publicly financed, universal health care in Canada.

NPR.com

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“What I don’t understand about you is this,” she said. “You hold to your old belief in goodness with a tenacity that is virtually unshakable. Yet you are so good at being what you are! You hunt your victims like a dark angel. You kill ruthlessly. You feast all the night long on victims when you choose.” “So?” I looked at her coldly. “I don’t know how to be bad at being bad.” She laughed. “I was a good marksman when I was a young man,” I said, “a good actor on the stage. And now I am a good vampire. So much for our understanding of the word ‘good.’”

· Anne Rice, The Vampire Lestat

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Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada’s health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn’t when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada’s GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada’s. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada’s government decides who gets health care and when they get it.While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don’t get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists’ care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.Princeton University health economist Uwe Reinhardt says single-payer systems are not “socialized medicine” but “social insurance” systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren’t enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

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No barber shaves so close but another finds his work.

· English Proverb

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Why do I hate Device Center?  Well, I couldn’t really care whether I use the-man-in-the-moon or what ever to sync my phone, all I care is that I not have to use Outlook!  And you guessed it, Device Center will only synchronize with Outlook, Windows Sync Center allows synchronization with a number of sources (including Outlook if you use that POS).

The options I had were use third party synchronization software (which I was forced to use back when I had a Motorola KRZR — and I really didn’t want software to limit what I could sync), use Google (I really don’t want Google to have more of my personal information than they already have, or try MyPhone (not that I’m wild about Microsoft having my personal information; but I know that they’re a clueless company who wouldn’t know what to do with the information even if they realized they had it).

There are many things that MyPhone won’t do, and we might as well get those listed first:

• It will not download ring tones
• It will not synchronize to live contact, calendar, etc
• It will not allow you to backup on your desktop

Things it will do:

• It will limit you to 200 MB of storage
• It will synchronize contacts (including pictures, but it does have some limitation with field sizes; so Garmin GPS points are a little problematic)
• It will synchronize calendar (but it doesn’t allow notes or reminder, you have to enter those on the phone)
• It will synchronize task lists (again see the above limitations)
• It will synchronize text messages
• It will synchronize browser favorites
• It will synchronize photos
• It will synchronize videos
• It will synchronize music
• It will synchronize documents
• It will allow for deleting and archiving.
• It will support multiple phone
• It will support social networks (well, Live)
• It will provide your phone’s last known location (last sync)

If you’re willing to pay for enhanced services:

• It will ring your phone
• It will provide your phone’s current location
• It will lock your phone
• It will erase your phone

Presumably these last services are targeted at lost phone (so you might wait until you’ve lost your phone to pay for the service, and I guess if it can’t do it you might be able to get a refund).

Currently MyPhone only supports Windows Mobile devices (so you can consider it’s something you get when you purchase a Windows Mobile phone), and most current Mobile 6.1 and 6.5 phones already have it pre-installed (but you can easily download it and install it on any Windows Mobile 6, 6.1, or 6.5).

To effectively use MyPhone you should have an unlimited data plan (or it might end up costing you quite a bit of money to do the synchronizations).

I don’t want to give anyone the impression that I think MyPhone is the best thing since sliced white bread (who came up with that expression — white bread is horrible), but it works, and it works well — and it provides a service for owners of Windows Mobile 6.x that Windows 7 doesn’t (so much for Microsoft’s flagship products, makes you wonder why you have to pay the big bucks for things that don’t work well, and don’t work together).

One of the nice features of MyPhone is that you can use it to sync information to you phone regardless of what desktop operating system you run (I believe synchronizing to Windows Mobile devices still requires a third party [extra cost] product on OS-X; Sync Mate or Missing Sync).

NOTE:  I believe Microsoft considers MyPhone to be part of the Windows Live offerings, but since it doesn’t inter-operate with Windows Live (at least in the current version) I don’t see how anyone can make that claim with a straight face (where do they get these programmers and program managers).

Microsoft MyPhone

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… to wish to make a thing look pretty or look smart is to think poorly of it in itself and to want it more conventional, and to try to improve it is to weaken and perhaps destroy it.

· John Crowe Ransom

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GIMP is an acronym for GNU Image Manipulation Program. It is a freely distributed program for such tasks as photo retouching, image composition and image authoring.

It has many capabilities. It can be used as a simple paint program, an expert quality photo retouching program, an online batch processing system, a mass production image renderer, an image format converter, etc.

GIMP is expandable and extensible. It is designed to be augmented with plug-ins and extensions to do just about anything. The advanced scripting interface allows everything from the simplest task to the most complex image manipulation procedures to be easily scripted.

That’s what the GIMP site says; but what GIMP is is a free Open Source alternative to programs like Adobe Photoshop and Corel Paint Shop Pro that runs on Linux, OS-X, and Windows.

GIMP is reasonably easy to use, powerful, and rock solid.

If you understand the principles of image/photo editing you’ll be a pro at using GIMP in no time — far easier to use than Photoshop, far more functional than Paint Shop Pro.  And it’s free — totally free — just download it an install it.  There’s lots of plug-ins for it as well (so make sure you take a look at some of those add ins).  Be sure and review the online documentation, tutorials, and FAQ; plus there are a number of well written books on GIMP available for purchase.

GIMP.org

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And yet, I have found that nothing in this world is incapable of explanation if only one is smart enough or lucky enough to think of it.

· ”Ellery Queen”, The Chinese Orange Mystery

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On 4 March 2010 Apple filed suite against HTC for infringing on some twenty patents for iPhone technology they allegedly used in their Android handsets (but not their Windows Mobile handsets).

It’s pretty obvious to me that HTC manufactured Windows Mobile handsets long before the iPhone, and those handsets used many of the basics of the technology described in the twenty iPhone patents — so who’s stealing from whom?

It’s totally ironic that Steve Jobs is quoted as saying:

We can sit by and watch competitors steal our patented inventions, or we can do something about it. We’ve decided to do something about it. We think competition is healthy, but competitors should create their own original technology, not steal ours.

When in 1996 in the PBS Documentary “Triumph of the Nerds” he said:

Picasso had a saying. He said that ‘Good artists copy; great artists steal.’ And we have always been shameless about stealing great ideas.

I think Eric Von Hipple of MIT’s Sloan School of Management may have hit the nail on the head:

The social value of patents was supposed to be to encourage innovation — that’s what society gets out of it. The net effect is that they decrease innovation, and in the end, the public loses out.

Those who can’t innovate, litigate.

Steve Jobs, 1996 “Triumph of the Nerds”

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Thus choosing to die resisting, rather than to live submitting, they fled only from dishonour, but met danger face to face, and after one brief moment, while at the summit of their fortune, escaped, not from their fear, but from their glory.

· Pericles, funeral oration

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