Cuba, North Korea, Canada
I can’t agree more with Michael Dettman’s opinion ; the fact that the financial/payer/payee structure of our health care system is similar to that of another country (North Korea) in no way means that our governments are at all at par in terms of being “brutal” or otherwise.
In addition, I would suggest to Dr Tyers (BCMJ 2006;48(4):163) that he do his research regarding Cuba. While that country currently has a two-tiered (private/public) system, they did not previously. I wonder whether those inside the country would think the change has meant an improvement in care.
Anyone familiar with the work of Dr Paul Farmer (Partners in Health, Pathologies of Power author, Harvard Infectious Disease specialist/anthropologist) will recall his descriptions of the Cuban “government monopoly” health care system. No system is perfect, but Cuba’s sounded rather effective in many respects—particularly when pitted against other systems of health care management—including that of the USA.
Hillary Lawson, MD
Revelstoke