Systems Thinking

Update Below

I have not forgotten that I am going to write on systems-thinking and its problems in Christian theology.  I am thinking about it a lot, actually.  But in the interim, I have noticed something about how people think of good things versus bad things in their respective cultures.  PenGun  mentioned either here or at Assistant Village Idiot about a serious medical condition he had, and how grateful he was to the Canadian Health System that everything went well.  I have noticed the same thing from the Brits*, that when they recover from something it is because of the NHS. Scandinavians say such things about almost everything, actually. They perceive their system of everything to be better: policing, military, diplomacy, education, healthcare, traffic. When I went to Romania to pick up my boys for adoption, I went to the schools they had been attending to discuss how they were and what material was being covered to help integrate them to the private Christian school they would be attending in America.  None of the teachers were able to discuss what they were covering this year, and none knew anything about my two children individually.  They all wanted to talk about how the Romanian system was so superior to what we were doing in America. 

You might think that just by law of averages alone that the Americans could have gotten something right, seeing as by objective measures…

My cousin-in-law from Belgium would speak in similar fashion, that the system of schooling she was used to from childhood was so far superior to the schools she was sending her children to now (Concord, NH, very good.  Their boys went on to do well at MIT and UChicago).  Relatives of my sons who moved to Norway for better jobs took their girls out of Tromso abruptly and moved back to Transylvania, with part of the reason being that they felt the school system was much better. Similarly, when I speak to people from Quebec (and thus maybe all of Canada, or maybe not) it’s the same thing.  They believe that Quebecois everything is better in general. Stores, food, politeness – oh let me guarantee you that this is not so.  They have old-world gestures and customs but are solidly insulting – This attitude is so strong among Swedes that even other Scandinavians notice it, and resent it.  It is considered arrogant to put yourself forward as better at anything in any way, but there is this universal idea that their systems, their way of doing foreign policy, or religion, or serving food, or crossing the street is simply better. It is fascinating that all of these cultures consider Americans arrogant because individuals are boastful, or because we notice that we clearly have aspects of our culture that show considerable success – such as a longer life expectancy than any other country  after receiving a cancer diagnosis, regardless of what your income level is – and say so.  To most other places, you can brag about your culture in extreme fashion, but you should not give the merest hint of excelling in yourself. It’s an interesting value.  Once adopted, people outside of that will seem unconscionably rude, sure. We offend them in this way, and that we do not change even after they have pointed this out repeatedly just infuriates them more.

I think I get it.  I see the point, and see why that would be annoying to others.  We regard New Yorkers the same way ourselves, as braggarts who can list for you why their bagels, their coffee, their hospitals, their museums, and a hundred specific items are better; while our Californians, Texans, and probably a few other groups are more like the Europeans and Anglospheric cultures, lauding their entire culture as superior.  But mostly, this way of looking at things strikes Americans as insane.  We are more granular.  This particular hospital is outstanding, because it saved my son’s life, or because it is a great teaching/research facility.  This particular school/college is world class, though another college might suck. No one says “Whew! The American health care system saved my wife’s life!”  We attribute such things to the specific expression of a doctor, a program, a hospital, not the system. We do have the somewhat contrary, somewhat ironic belief that the American system is better precisely because there is independence and variation. The system is a non-system, and we like that. There are no better hospitals than here. There are no better militaries, though we have an amazing array of stupidities in all of our branches. The highways are better, though we have some terrible roads. Yet we do not even think in terms of saying “All American hospitals are better than those you find in other countries.”  Though we do note that people from everywhere come here, but also know that they don’t come to any random American hospitals because the average is better, but come to specific hospitals.

Critics would say that this is precisely because our results are so uneven.  The excellences  may be real, but look at all your citizens who don’t have good things because of the inequality.  That would be a fair criticism in theory, if it could be backed up.  Yet because a black family in Mississippi has a higher real income than an average family in Sweden, I have to call that criticism a bit weak. There actually are poor people in those other countries, you know.  They just don’t talk about them, and pretend that this is an American phenomenon.

You could call either arrogant with some justice. I think Americans are more used to dealing with the accusation and acknowledging it.  I don’t think Brits or Scandinavians or Canadians think they even have to consider the question, so certain are they that they must be right. Pay no attention to that man behind the curtain.

Update: There may be a midpoint in that granularity that I did not originally credit, though I intuitively came close. Americans are more likely to think of themselves in terms of regional, state, or even urban units and describe things that way. I might say “In New Hampshire we are likely to…” while Southerners, Westerners, or Midwesterners might give credit to their entire region for getting things right. LA, NYC, and DC think of themselves as cultures in their own right. This is not the same as a Canadian, who would never say “In New Brunswick we have designed things so that…” or a Dane breaking things down by region. Yet even there, in Newfoundland they do think that way a bit, and the Scots or Welsh certainly do in the Isles. I think the contrast between America and other places does hold and is worth noting, but I think I drew the lines too sharply.

*The UK, especially the English, still has more of this “American” attitude than other places. We got it from them, after all. Hence Oxford and Cambridge, perhaps overrated but still exceptionally good.

39 thoughts on “Systems Thinking”

  1. I was a bit this way about California but I have been cured by the increasing evidence of decay. I moved to Los Angeles in 1956 and cannot think of a nicer place to live. I liked Chicago but for the weather.

    When I was a Surgery resident, friends from Australia moved in two doors down. He was a transplant fellow at LA County and my wife assisted them in finding s rental. His wife spent the next year explaining to us that everything in Australia was so much better than in America. Then it was time to go home. She left virtual heel marks all across the Pacific. We subsequently visited them in Australia although their marriage did not survive the return. At the time, Australia was not the most feminine friendly place on earth. I have not been there in 25 years so do not know if it has changed.

    Anyway, I am typical of the old in that nothing seems as nice as it was when I was young. Unfortunately, this may actually be true and not an old man’s sentiment.

  2. The girls were prettier then, I remember; hamburgers tasted better, students worked harder, Christmas was more special, and comedians were funnier, goshdarnit.

    Or maybe my libido, taste and digestion, focus, piety, and sense of humor were better then.

    Nah. Unreasonable as it is, Mike, I’m with you. Everyone with any sense would want to move to NH in 1965. Bring your bootlace tighteners for both skating and skiing, though.

  3. I said no such thing. I expressed my gratitude to the doctor who performed the operation to clean up my perforated ulcer. I would have died otherwise. I have no especial gratitude to any system, although I like ones that perform well. Yours works for people with money quite well. The Canadian system built on the premise that money should not affect medical outcomes, is one I far prefer to the American one.

    What impressed me was how well the whole thing worked. I was in there for my condition, and really am not anxious about dying, I have no god to please, sorry cheap shot. Anyway I was there and got to see what they had to put up with on a regular basis, and how they dealt with it. Its not something I recommend, but I would not trade the experience, as I learned so much.

    The nurses run the place. I had a guy with serious diabetic issues in the next bed, a big seeping hole in his leg and he went though a lot of pain. The nurses would gather round the computer and try to figure out ways to give him more pain killers without hurting him. It was a nightly thing, as it was worse then. They were real angels of mercy. They had trainees in the daytime and I volunteered to be the training dummy. I had a stack of stents sticking out of me. ;) Every one from the cleaning staff to the doctors was impressive.

    The entire place was just extremely high grade.

    They sent me off to private school when I was eight years old. I am not a Christian because they made me go to chapel a lot, and bored I read the Book Of Common Prayer, well the back, where the cool stuff is. Like how the Jews are damned and other neat stuff. A system exposed in that case.

    “Critics would say that this is precisely because our results are so uneven.” They are not uneven, they are really bad. To the point one must ask, what is wrong with you?

  4. A few years ago a PETA representative published a letter in the local paper telling us all about how vilely cows were treated. This is in Wisconsin. Any drive in the country takes you by dairy farms. Even quick views from the road demonstrate that much of the letter is false, and a visit to a farm disproves the rest.

    Making wild claims about a place where some of us actually live isn’t a good way to boost your credibility.

  5. Everyone with any sense would want to move to NH in 1965.

    I actually did move there for a year in 1994-95. I spent a year in Hanover getting a degree in health policy from Dartmouth. I liked it a lot and might have stayed. They offered me a job but I had to fund a salary out of grants that did not appear. Had I not been alone, I would have been more interested in staying. Long story about being alone.

  6. “Critics would say that this is precisely because our results are so uneven.” They are not uneven, they are really bad. To the point one must ask, what is wrong with you?

    Nothing that communisms would not fix, eh? You persist in contaminating these comments. We are not interested in NDP opinions.

  7. It’s only arrogance if the facts don’t back up the evaluation. Set a standard besides envy, and test it.

    Cancer survival rates by quintile, how about?

    Disposable income of the bottom 10% of households?

    Size and/or characteristics of living areas?

    Stuff owned by the poorest 10% of households?

    Ability to go to college just because you want to?
    (Sure, you have to pay for it. But you’re allowed to, and people do, all the time, for fun.)

  8. Yours works for people with money quite well. The Canadian system built on the premise that money should not affect medical outcomes, is one I far prefer to the American one.

    *shrug* Your people with a little money– or just a problem that is more cheaply treated by letting them die– prefer our system. Easier to go into debt and pay if off to live, than to die for no added charge.

    I still remember the poor lady who had to come give birth in America because one of our hospitals– and not even a big, fancy one; just a pretty normal regional hospital– had more incubators for new babies than the entire province she called home.

  9. You are too generous to the foreign devils.

    That isn’t sincerity you are observing, it is mix of preference falsification and stockholm syndrome.

    The bureaucrats have had a lot of chances to kill off PenGun through sheer incompetence and indifference to human life. They haven’t managed it yet, so he sucks up in futile optimism of delaying the happy day.

    Anyone with half a brain can work out that for national bureaucracies of any real size, caring is erased by the scaling effects. Their denial of the obvious is pathetic and disgusting. Compare the kids of Stalin’s buddies “if the Czar only knew” while the man himself was laughing about the murders.

    Foreigners live in foreign countries under foreign governments because they lack enough pride in human dignity to keep the bureaucrats appropriately in check.

    If you talk much with them about their political opinions, you violate the rule against hanging around with stupid people.

  10. There are more options, there is more variability among options, and there is more variability of results in the USA than in other places. You can’t have more options without having more variability of results. Critics of the American system tend to focus on the variability of results, without acknowledging that people tend to prefer to have more rather than fewer options.

  11. I looked up the PenGun’s comment and he does state he thanked the doctor specifically, and it doesn’t directly attribute a good outcome to the Canadian Health care system as such.

    I think the overall tone of discussion illustrates a point that AVI made indirectly. When confronted with evidence that some individual outcomes are bad (long waits for diagnostic procedures, use of American hospitals for critical or time-sensitive care), there is a redirection to the claim that the ‘system’ is overall better despite those bad outcomes. On the other hand, when statistics show that the Canadian system is not overall better, individual good outcomes are cited as evidence that it is.

    This seems to be true of any discussion of specific outcomes that devolves in the comparison of ‘systems’ as I’m sure the Romanian teachers were aware of areas where their instruction lagged behind what would have been provided at the same age level in America.

  12. I’ve noticed this mostly here in Connecticut (but also in Massachusetts etc) on how terrible Texas is. I’ve heard this on trains, from some neighbors etc. When I politely ask “Have you ever been to Texas?” or less politely “Do you know how big Texas is and how many big cities there are?” they can’t understand how I can think that. I say I’ve gone pretty much everywhere in Texas on business (and for that matter the other 49 states as well), and there is a lot that’s unique and interesting in Texas. To me this indicates insecurity on a high order. When asked what’s good about CT, I get invariably that it’s halfway between NYC and Boston. My followup is to ask “when is the last time you went to either city?” I usually get some fumble about it’s so far, you have to take a train… (From my house to Midtown manhattan is 90 miles, a 2-3 hour drive in good traffic). I never get anything detailed about CT. Whereas I a replanted Midwesterner could tell them 100 interesting things.

    One has to be proud of something, but if you are insecure it tends to be systems, areas but also with a sneer at others.

  13. The system is a non-system, and we like that.

    That’s key, I think. When a national government monopolizes an entire major sector of the economy then it’s no longer judged by the performance of its components but instead its referred to as a system.

    That’s why there’s no transportation system or housing system or food system in the United States, but those systems no doubt existed in the Union of Soviet Socialist Republics. Socialists are afraid of complexity and independence and can’t understand how such a massive delivery of goods and services could operate as individual components. But it does.

    Socialists just don’t get it, and they rail against it. Roger Kimball:

    Socialism is also unselfishness embraced as an axiom: the gratifying emotion of unselfishness, experienced alternately as resentment against others and titillating satisfaction with oneself.

  14. I’ve noticed this mostly here in Connecticut (but also in Massachusetts etc) on how terrible Texas is.

    The summer heat and winter cold are both terrible. The coastal mosquitoes rival those of Alaska (Texas’ isn’t bigger at everything). Even the native food, Tex-Mex, is too hot. A great Texas journalist once wrote, “Texas is Mississippi with better roads,” and you know how much you hate Mississippi.

    Terrible politicians are from Texas: Johnson, Bush, Graham, Cruz…. Texas is so close to Mexico that when The Plan de San Diego succeeds, cartels will be murdering people in the streets. You can’t really get along in Texas anymore unless you speak American Spanish (We’re that close to another rebellion and succession—Azteca, this time).

    No interurban rail exists to speak of. You must drive in Los Angeles-level traffic jams in every big Texas City. Land is cheap, because it’s poor caliche, barely watered. Your house’s foundation will break in year. Then your AC will be invaded and ruined by ants. And if by chance you live near a stream, your pets will be killed by wild pigs or eat by alligators. Yes, gators—they live in the gully washes between four-lane roads.

    Never visit. Slander Texas frequently. And never, never move from the NE or NW or California to Texas. Please.

  15. Connecticut is great- A lovely verdant mix of small farms and woodlots, little villages with beautiful churches nestled in the valleys, rolling hills and granite outcroppings for kids to explore, thriving cities filled with world famous manufacturing concerns like Bridgeport and Colt, seaports and a great river and quiet New England living all filled with a sense of history from before the Revolution.
    All, of course, in 1960.
    BCI (before communist infestation)

  16. ReisGuy: “And never, never move from the NE or NW or California to Texas. Please.”

    Love your comment! Here’s hoping all those Californicators take your advice.

    Trying to think of other good reasons for those people to move to Canada instead of Texas — in some of the smaller towns, it can be really tough to find top class Thai food. That’s the kind of problem people in Portland don’t have.

  17. I wish more of those yankees and left coasters would read ErisGuy’s comments and stay home. Like Mike I watched California deteriorate as the lefties moved in the brought in their socialist expectations. Stay away morons, we are not being pushed out again so keep your systems and stay in the mess you created. We’ll deal with the heat, fire ants and pigs. You deal with the riots, crime, and unfunded liabilities.

    Death6

  18. “Like Mike I watched California deteriorate…”
    The root of decline for most states directly goes to the “one person one vote” abomination decreed by the Supreme Court. That gave all political power to the cities, and destroyed the previous social compact. California I think held out a bit longer than places like NY, IL, etc., because there were plenty of people how had moved there who knew what they had left behind. But if you meet new neighbors from NY, say, ask them where they’re from before writing them off. If they’re from say Syracuse, Utica, etc., then NY’s condition really isn’t their fault (though you can casually drop Cuomo’s name in conversation if you want to be sure–if they don’t recoil in horror, they’re to be avoided at all costs).

  19. Dirtyjobsguy
    I’ve noticed this mostly here in Connecticut (but also in Massachusetts etc) on how terrible Texas is.

    I am reminded of my last visit to my home area in Connecticut. A high school friend and I were discussing where other classmates had ended up. He mentioned a classmate living in the mountain states who had turned into a Tea Party type. I replied that my political views were not far from the Tea Party. “That’s because you’re from Texas,” my friend replied. I replied that my political changes were rooted in my hometown. My friend quickly terminated our meeting, saying that he needed to review the agenda for his board meeting that evening. (My decade’s experience of being on my HOA board was that board agendas were passed out 3-5 days before the meeting.)

    Then there is the childhood friend who took a business trip to Texas. She had just returned from vacation in Italy. She spent her junior year abroad and ended up getting a Master’s in Italian, so she knows Italy quite well. In her return to CT, she compared and contrasted how women got treated. In Italy, incessant harassment/flirting. “Whereas in Texas, when at a bar I indicated I didn’t want to pursue a conversation, my decision was respected.” Texas- it’s another country, like they say.

  20. ErisGuy
    Never visit. Slander Texas frequently. And never, never move from the NE or NW or California to Texas. Please.

    I voted Democrat in my home state of Connecticut. In my decades of living in Texas, I have morphed from voting third party to voting Republican.

  21. I think I understand some of where Pengun is coming from. It’s based on my experience, 25 years ago, navigating the VA “system” on behalf of my dad when he suffered a massive heart attack. This was after he had been using them for his primary care for about 10 years.

    I will be forever in the debt of many people there for the care that they gave. My deepest debt is to two different doctors. The first was a student at the time and coached me in how to browbeat the medical and surgical services into working together to treat my dad instead of just passing him from side to side. The other pointed out that he had become eligible for Medicare while under treatment and that we could exit the VA and get him the rehabilitation that actually got him out of the hospital and home, instead of spending his last years in a nursing warehouse.

    The VA system was then, and remains, horrendous. They will gladly transport a critical patient halfway across the country before they will let him go across the street. I wonder if the Dallas VA Hospital is even in the top 20 hospitals in the DFW area? That’s the problem with “systems”. They don’t allow anything to exist outside.

    As I said, I owe many debts to individuals, the “system” was more of a deadly adversary.

  22. “Nothing that communisms would not fix, eh? You persist in contaminating these comments. We are not interested in NDP opinions.” What is communisms?

    I’m in the OPs post, I get to talk here.

    You mean the New Democratic Party? LOL, I did not vote in the last election, for the first time in my life. I understand the lesser evil, but could not endorse any candidate, so I did not vote.

  23. On the VA, I gave some thought to working at the VA after I retired from practice. I could not so surgery anymore but I thought I could use my 30 years experience in the clinic or ICU care. The application is about 40 pages and I quickly gave up. At the recruit center, I met a guy who is a retired medical officer from the Army. A very sharp guy whop was also interested in the VA. He tried to apply for part time. This was in Phoenix, one of the hospitals involved in major scandal. Nope. No part time.

    I suspect these guys have things sewn up. just like the other fed bureaucracies.

  24. Yours works for people with money quite well. The Canadian system built on the premise that money should not affect medical outcomes, is one I far prefer to the American one.

    Great. Stay in Canada. Then everybody’s happy.

  25. The VA system was then, and remains, horrendous.

    And that’s what government-provided healthcare would like here.

    (As an aside, may I respectfully suggest perhaps truncating the list of links on the right? At least those for the archives, and perhaps some abbreviation of the others as well? As it is, the comments box is near the middle of the page, and I doubt that many people access the archives regularly anyway. Thanks.)

  26. The Canadian system built on the premise that money should not affect medical outcomes, is one I far prefer to the American one.

    Says the person with zero experience. The suggestion to stay there is best, I think.

    I used to go an annual laparoscopy meeting in Saskatoon. It was excellent, then one year it was cancelled. All the faculty had emigrated. I attended a meeting on quality improvement in healthcare about 25 years ago,. The guy sitting next to me was an architect who was designing the first new hospital to be built in Canada since 1980. They closed the nursing schools to save money and cut back on medical school places to rely on foreign graduates from Bangladesh. The NHS did much of the same. We stayed with my friends in Chichester in 2015. He is a retired army doc. The city is very English, unlike London. He said, “If you see a brown face it is an NHS doctor.”

  27. Rome had a “system”. Which worked really, really well for a lot of people for a short period of time, then worked really well for a smaller number of people, and then failed utterly, leading to what is arguably termed “The Dark Ages”.

    That’s the thing about “system”. System has a life cycle, and a lifespan. You build a system, and you sow the seeds of its own destruction with the founding. Eventually those seeds sprout, grow to life, and begin to eat away at the structure. Give it long enough, and the ivy will insinuate itself in between the blocks of the structure, and pry the whole damn thing into ruin.

    System is in and of itself a flaw. You see a problem, and you implement an instance of “system” to deal with it, and then it grows like a cancerous lesion until it actually supplants the problem, making more and better problems. Eventually, the “system” instances become so great that they take up all the resources, and choke the life out of the entire ecology, as if they were some great mat of algae on the pond of life.

    The trick that needs to be learned is the mastery of these things, and to kill the beast once the crisis or the problem is solved. Nobody does this, or thinks through at the beginning of things, “At what point is this done…? When are we finished with this, and how do we determine if it’s working?”.

    Had someone had the wit and wisdom to do this back in the 1960s, when we were starting out on this great big “racial harmony” project, we’d be at the point right about now where the questions about diminishing returns and whether to keep doubling down on insanity would be starting to be asked. Unfortunately, not a single idiot in government or policy thought to limit it all, and here we are.

    The thing I’d like to go back and ask all those geniuses who set this BS in motion is this: At what point is affirmative action done? What’s the limit? Are we to keep these set-asides in place forever, enshrining them into law forever? How long are we going to keep punishing people for things that they had nothing to do with, themselves? How long are we to provide unfair advantage to people who did not suffer one whit of the evils of slavery or Jim Crow? When is this over, and when can we all be simply citizens of this country, with no institutional advantage or disadvantage?

    The racial demagogues want to keep the animosity going, because without it, they’re powerless. At this point, they’re the only ones keeping this going, but they’re fanning the flames for a rebirth of actual racism as we speak, and it won’t end well for their catspaws. At all. 13% does not order around the other 87% in a country like ours, and the backlash will be severe.

  28. “The Canadian system built on the premise that money should not affect medical outcomes, is one I far prefer to the American one.

    Says the person with zero experience. The suggestion to stay there is best, I think.”

    Its in the documentation that defines the system.

  29. Hell is a combox argument about health care systems covering the same ground that was covered ad infinitum in spring of 2009 forever and ever and ever and….

  30. Its in the documentation that defines the system.

    You should do standup Pen. The man who read the instructions and knows they must be correct.Few NDP members have ever built anything.

  31. Kirk – The thing I’d like to go back and ask all those geniuses who set this BS in motion is this: At what point is affirmative action done? What’s the limit? Are we to keep these set-asides in place forever, enshrining them into law forever?

    I think people did ask those questions back then, which is why after providing wide support for Civil Rights bills for almost 100 years significant numbers of Republicans started to ask those questions in about 1964. They got lied to by the Democrats, especially LBJ, who woke up the realization that they could create a perpetual motion machine for bribing people to vote for them to keep the set-asides in place.

    Its in the documentation that defines the system.

    If you believe that it explains a lot.

  32. Again, if you think the ‘documentation’ describes the way a system, any system, actually works, you’re hopeless.

  33. I don’t think he means “documentation” in quite that way. I think PenGun means that the Canadian health care system says that it wants to be fair to everyone regardless of money, and so therefore it is, because it says so. It is in the documentation. The legislation defining American health care is focused on providing both insurance and care for children, pregnant women, the disabled and impoverished, plus protection for the recently unemployed and access to care even for those who are not insured. But because we don’t beat our chests and say “Everybody! Everybody! Do you hear me?” he subscribes to the very common belief among Canadians and Europeans that there are millions of the wretched wailing in the streets without care. My son in Norway has a girlfriend who believes this about America, because that is just common knowledge among Scandinavians in particular. When i visit there they all tell me about the American system. I have learned repeatedly that facts simply don’t matter in the face of this. The same bogus statistics get set out and refuted, then trotted out again next Tuesday.

    American liberals had similar good feelings ten years ago, enraptured that “Finally! Now everyone is covered!” Megan McArdle was prescient then and worth reading now. https://www.theatlantic.com/business/archive/2010/03/8-predictions-for-health-care/37826/

  34. Anecdotes, so take them as you will.

    A friend of my wife and myself was [she is retired now] a local pharmacist. Her favorite vacation involved flying down to the Caribbean and scuba diving. The first mate of the boat she usually ended up on was a Canadian national whose family was from Port Hardy at the north end of Vancouver Island. He had Crohn’s Disease that sometimes incapacitated him and required he return to Canada for treatment. Except, the treatment ended up being the same thing over and over; prescribing painkillers and anti-diarrheals. That is all their system was allowed to prescribe for it, even if it doesn’t work. They never actually diagnosed Crohn’s, just tried to treat symptoms.

    Our friend got tired of this [they were becoming closer, and about a year later got married], grabbed him by the scruff of the neck and took him to a gastroenterologist in Colorado Springs, and within a few days when test results came back had a Crohn’s diagnosis. There is no “cure” for Crohn’s, what you are after is drugs that put it in remission. There was a cheap drug here that put it into remission, but it was not available under the Canadian healthcare system.

    He stayed here, and incidentally went back to school and became a Nurse-Practitioner [and a US citizen] and had a full and better paid career until he retired when she did.

    Another story from that family. His mother needed an MRI to confirm a cancer diagnosis. After much arguing, it was ordered. At the time there were only 4 medical MRI machines in the whole Canadian medical system. She had to fly to the nearest one in Winnipeg, Manitoba from Vancouver Island. It was more than a bit ironic that MRI’s were common in Veterinary medicine in Canada and if she could have gone to a vet, she could have gotten the image in Victoria on the island. Veterinary medicine is not nationalized up there.

    In passing, I have had to have an MRI due to an injury while fighting felons, here in Colorado before MRI’s became common with most hospitals having one. Our solution in this country was to allow medical contractors mount MRI’s in trucks and have them and their technicians ride circuit to hospitals hitting them once a week. I called the doctor Monday, had the order for the MRI Tuesday, Wednesday the truck came and it was taken. Consulted with the surgeon Thursday, and had the very successful surgery Friday.

    Anecdotal, but I’ll take our system.

    Subotai Bahadur

  35. I seem to remember an old joke that goes something like: “I take exception to your criticizing my wife, but what is unforgivable is that you are right.”

  36. AVI – yes, I know what he means and as Subotai’s anecdote shows the documentation is wrong. All people do not get ‘fair’ treatment *regardless of money* in Canada any more than all people without personal funding are denied treatment in the United States.

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