Category Archives: Health

The 51st State

A conservakin implied I’m not cosnervative because I said single-payer health care is not the worst thing in the world.

So, I’m going to take a round about way to explain Canada and why single-payer is not good but not horrible, but why this might not necesasrily work for the US.

Contrary to what most believe English Canada is conservative, it always has been. The US has always been the liberal. When the US revolted against the British in order to install Puritan liberalism Canada was mostly French Catholic at the time and was wary of Puritan anti-Catholicism, so it refused to join the revolt and remained a British possession. The loyalists, Americans who opposed the revolution, moved to Canada because and formed the core of English Canada. At the very beginning, Canada was founded by conservatives who were opposed to the revoutionary liberalism of the Americans.

Almost a hundred years after the American Revolution, Canada became indpendent in 1867. The process was slow because of the inherent distrust fo the loyalists for republicanism and mob rule. Until 1931, the UK still had the power to legislate for Canada. It wasn’t until 1982 that Canada was allowed to modify its own constitution and introduced a Bill of Rights. The Queen is still the Head of State and technically legally owns Canada.

Until the late-70’s Canada was a liberal-conservative country, in the Burkean sense. It conserved its institutions, had a free-market, and reformed slowly. The Liberals were pro-free market, anti-government interventionism, and pro-responsible government. The Conservatives were aristocratic, in favour of noblesse oblige and organic community.

That changed in 60-70’s. During that time, Quebec had the quiet revolution, and its moved from traditional Catholic social doctrine to French socialism and an independence movement began. The Liberal Party under Pearson and Trudeau moved from classical liberalism to social liberalism and the New Democratic Party formed as a social-democratic party from an older farmer’s party.  In the Progressive Conservative Party the Blue Tory (neo-liberal) faction began to arise in the traditionally Red Tory (aristocratic). The Blue Tories continued to grow stronger and eventaully eliminated the Red Tories in 2003 with the creation of the Conservative Party.

Around this time, English Canada, or at least the populous and powerful southern Ontario region, adopted US puritan liberalism and combined it with Quebec’s French socialism to outholy the American puritans.

Also up until this time, Canada was an imperial dependency of Great Britain. The Suez Crisis in 1956 and the development of NORAD in 1958 marked when Canada began to move from Britain’s Sphere to the US’ Sphere. This process was completed in 1982, when Canada officially became its own country and informally became an imperial dependency of the US.

Since WW2, Canada has joined pretty much every American war except for Vietnam and Iraq. In Afghanistan, Canadian troops were literally airlifted over by the US. Our military has been consistently and severly underfunded, as we rely on the US to protect us. NORAD made us an integral part of the US continental defence system, while the NATO partnership basically made Canada’s military a semi-independent arm of the US military. The Canadian and Americans markets are integrated through NAFTA and over two-thirds of out exports are to the US, much of which are just raw materials. OUr cultural products are almost entirely American in origin (despite fairly useless Canadian content regulations).

Despite the nationalist left’s posturing (and yes that exists, and essentially it is ‘we hate America and love socialist health care’), or any practical purposes, Canada is essentially a somewhat indpendent 51st of the US, and the left are the one’s forcing American liberal culture on the US.

Despite having adopted the American revolutionary puritan spirit and trying to outrun the US in the holiness competition, this is not natural to English Canadians. Canadians are pragmatic converts to the faith, not natural zealots, like our American breathern.

This manifests in different ways.

First, Trudeau is the only real radical who has ever led Canada. He combined adopted English puritanism and French socialism to enlarge the state. Under him came a huge bloat in government. But beyond that, all our leaders have generally been moderate, non-radical liberals or conservatives. Change, while always moving left, has generally been small, sane, incremental increases rather than radical, half-baked changes.

Example in point, health care. Canada has single-payer, public health insurance, which is technically more socialist that Obamacare’s mandatory private insurance. But even in it’s Trudeaupian radicalness, the Public Health Act is a short, sane 14-page document that basically says provinces need to offer universal comprehensive public health insurance to receive federal health funding. It mostly followed the lead of what provinces were already establishing on their own and the actual implementation was left up to the provinces. On the other hand, Obamacare is a 900-page monstrosity detailing every last specific of dozens upon dozens of provisions and forces them upon the states, willing or not, and has had to be rewritten by the Supreme Court twice, just to be feasible.

This is generally the case. Canada creates short, sensible, incremental laws that leave the details and implementation up to professional bureaucrats or the provinces, while the US creates insane, bloated, radical laws that address everything related or unrelated in detail.

The second is race. Canada is divided by region: southern Ontario thinks it rules the rest of Canada, if it even deigns to notice we exist, the West resents the East, and Quebec hates everybody. These regional divides define Canadian politics, but because they are regional they mostly don’t matter in everyday life. Our conflict is a distant thing with those folks over there. While we have some minor racial troubles, particularly concerning Aboriginals, race is not that big a deal in Canada.

In the US race is everything. All conflict is essentially racial conflict and evevrything must address race. There are two large minority groups each making up about 12% or so of the population. It’s white republicans vs everybody else. So, there’s constant pressure to keep pushing the racial divides and keep the holiness competition moving. In Canada, our largest racial minorities are well-behaved East Asians and South Asians (each at about 5%) and some struggling aboriginals (~4%), who live largely on reserves anyways. So, while there’s some racial nonsense in universities, in the real world Canada, race doesn’t really matter. A few neighbourhoods might be bad, but nothing compared to US ghettos.

The third is bureaucracy. Canada’s bureaucracy, while having all the problems a normal bureaucracy has, is a professional bureaucracy made up of competent people. Most civil servants have to undergo some form of testing when entering the civil service and it is seen as a public service to enter the bureaucracy. The politicians mostly leave the bureaucrats alone. This ensures that the Canadian bureaucracy is generally functional if inefficient.

On the other hand, the US bureaucracy operates on a spoils system and is essentially seen as an opportunity to plunder. The politicians appoint the bureaucrats for political reasons rather than professionalism and race issues eliminated testing for competency. So, the bureaucracy is dysfunctional looting rather than simple inefficiency.

Fourth immigration. Immigration in Canada is generally done on a merit basis. Other than a small number of refugees, the people allowed in are either competent job seekers or the families of said job seekers and immigration is generally spread out among varying countries. Illegal immigration is a relatively minor problem. In the US immigration is based on a lottery, Mexicans are the thoroughly dominant immigrants, and illegal immigration is a major problem. Canada does not share America’s fling the borders open attitude.

Finally, Canadian politicians rationally attempt to fix problems, even the liberals are sane in this regard. For example, in the 90’s Canada experienced a debt crisis. The ruling Liberal Party made large cuts to public and introduced some new taxes and eliminated the deficit and tamed the debt in a few years. Since then, the federal budgets have been more or less balanced and the debt growing but stabilized. Meanwhile, US politicians continue to ignore their debt and deficit and continue to ramp up spending without being able to pay for it.

So, while Canada has adopted socialism, it is not the wild-eyed fanatical puritanism of the US, but rather a pragmatic socialism. Even there though the US and Canada’s level of socialism is not that much different. While Canada’s tax levels are 10 percentage points higher, the US actually now has slightly higher government spending levels than Canada because the US funds its spending with debt rather than taxation.

So, now back to the original point. In Canada, single-payer health care is not the worst thing in the world. It’s probably less efficient than a fully free market one would be and tax levels are somewhat higher because of it, but in terms of health care, it not really that bad for most people. A few people have longer wait times for ‘elective’ surgeries, family doctors can be difficult to find in some place, and there’s the rare person who gets overlooked in the emergency room, but mostly it works fine. While the comparative effectiveness of the US and Canadian systems has been debated endlessly, essentially health outcomes are not really all that different once you account for race and obesity, and the Canadian system is cheaper overall.

The question is, though, if this could actually be applied to the US. The Canadian single-payer system more-or-less works because the government is basically functional. The US bureaucracy is basically dysfunctional. Look at Obamacare, regardless of the merits (or lack thereof) of a theoretical mandatory subsidized health insurance system, the actual applied system is one giant unworkable clusterfuck. I find it highly unlikely that the US would adopt a sane approach to a single-payer system.

Would the US federal government ever be able to create a simple 14-page law that says the states only get federal health funding if they provide comprehensive public insurance? Doubtful. Even if by some miracle they did, there is no way it would be competently and professionally run.

Abortion Regulation and Hypocrisy

I came across this Slate article defending and promoting the dismemberment of unborn children. Abortion is a travesty, but the support of abortion not what was particularly interesting about this piece. Rather this part is:

And partly because the bill was written by nonphysicians using nonmedical terminology, there is a good deal of uncertainty among doctors about precisely which procedures will be illegal come July.

In some ways, these new second-trimester bans are of a piece with the national movement to intimidate and harass physicians, with strategies that range from forcing them to perform unwanted ultrasounds and read from factually flawed “informed consent” scripts, to forcing them to obtain admitting privileges at local hospitals (which may refuse to provide them)—or new efforts to simply refuse to let doctors learn about abortion in the first place.

This has echoes of earlier pro-baby-killing insanity in Texas. You might remember that last year the baby-killers got in a fit because Texas instituted laws where abortion clinics had to “meet the same architectural, plumbing, staffing, training and other requirements that apply to surgical centers”.

Didn’t it seem odd to anyone else that somehow baby-killing “clinics” were not held to the same basic safety standards that applied to other clinics? Didn’t it seem even more odd that leftists, usually in favour of safety regulations, were so opposed to the application of safety regulation in this particular case?

But this article combined with the earlier Texas events point out something even more odd: when it came to their sacred rite of abortion, the leftists seem to recognize that stringent regulations have negative effects on the ability of service providers to provide services.

Now compare this to Obamacare: somehow the leftists realize that heavy, arbitrary, and unclear regulation hurts the ability of baby-killers to kill babies while at the same time calling for even heavier, more arbitrary, and more opaque regulation on the health care industry as a whole? Do they want health care to be worse, do they lack the ability to integrate particular reasoning into wholistic worldviews, or are they just base liars and hypocrites?

When it comes to baby-killing, leftists even go so far as to say that basic regulations are simply forms of harassment and intimidation. Yet these same leftists will happily call for far more stringent and arbitrary regulations on everything not related to baby-killing. So, by the leftists own logic it seems that leftists wholeheartedly support the harassment and intimidation of any productive activity.

It it interesting to note how hypocritical leftists are on regulation. When it comes to things that are unimportant to the leftist, like economic production and good health care, stifling regulation is good, but when it comes to something important to the leftist, like massacring babies, any regulation at all is too much. As I’ve written before, the definition of good regulation to a liberal is anything that increases the power of government and doesn’t personally impact them, while the definition of bad regulation is anything that inconveniences them personally.

Disordered Eating

The Return of Kings has had one of their recent articles, 5 Reasons To Date A Girl With An Eating Disorder,  blow up: so much so, even the Daily Mail has written a piece on it.

I think the arguments in the post is rather stupid. Aurini outlines why you should not date a girl with a dating order. Essentially, she is a disordered, self-destructive person who will destroy everything around her, including your relationship with her.

This is not a defence of the article, rather it is a short analysis of the response to this article and the response to a previous RoK intitiative, #FatShamingWeek.

Both obesity and anorexia are disordered; both are unhealthy, self-destructive lifestyles.

Yet, when RoK shames the former self-destructive lifestyle, RoK is decried as evil, but when RoK preaches acceptance of the latter, RoK is also decried as evil. As usual, Jezebel best exemplifies this lack of logical thinking

How can both acceptance of self-destructive eating habits and shaming of it be evil?

Or, to turn it around on the social justice types, why is it acceptable for people to body-shame anorexics?

This is perplexing to me: how can being unhealthily skinny be worthy of shame, while being unhealthily fat is not?

The best answer I can find comes partially from here:

Easy: change is hard.

It is a lot easier to come to accept (and possibly overcome) your self-loathing mentally than it is to overcome the pain of diet and exercise. Self-loathing is vague and amorphous, pain is immediate and direct.

Self-loathing can be reasoned at, self-justified, denied, and overcome by other emotions. There is no reasoning with, denying, or ignoring pain: pain is.

Instead of facing the pain, it is easier to accept the self-loathing.

Being obese is easy, being anorexic takes willpower and self-control.

The social justice war for fat acceptance and against anorexia has nothing to do with health, nothing to do with proper eating, nothing do do with a balanced life; it has everything to do with self-control and responsibility.

What the modern social justice warriors hate more than anything is personal responsibility. They do not want to be held responsible for their choices, they do not want to have to accept the consequences of their actions, they do not want to have to change, and, above all that, they do not want to feel shame or have anyone to judge them for their failings.

But how can they avoid shame when they are fat, which is shameful?

They can try to make obesity seem good, which they try but fail at because nobody can deny the disgust they feel at seeing a morbidly obese landwhale and the landwhale can’t help but notice the poorly-hidden looks of disgust often directed her way.

The second method is to deny people, themselves, agency; they have to deny that people are capable of controlling themselves and their destinies. How can they be responsible, how can they feel shame, when they have no control over their situation?

But, the anorexics show this for the lie it is: the anorexic takes complete personal responsibility for her weight, to a disgustingly unhealthy degree.

The anorexic shows extreme, unhealthy levels of self-control and self-discipline.

So, for the social justice warriors to maintain the lie that people become fat (or poor, or unsuccessful, or failures in other manners) for reasons beyond their control they have to pathologize the anorexic.

They can’t pathologize normal levels of self-control, because most would see through that, but they can pathologize unhealthy extremes of it.

To the social justice warrior, the fight against anorexia is a fight against the concept of self-control.

The health aspects of it are only secondary.

This is the only reasonable explanation I can think of as to why being morbidly skinny is somehow much worse than being morbidly obese.