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Update on health care systems

Apparently Canada is beginning to consider privitization of health care - the article linked to below gives some info about facets of their public system that do not work well by American standards (or by Canadian standards). It surprised me to read that long-term care, a big worry for many, is not covered in Canada. Between the PR in favor of Canada's marvelous free medical care, and the article below, I'm not sure whom to believe.
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There are several live links on the page above for further reading.
Reply to
dapperdobbs
Not to nit pick but Canada's single payer government run health care system is no more free than Medicare or the VA healthcare system here.
--
 .Bill.
Reply to
Bill
Health insurance is publicly run in Canada, but the hospitals and clinics aren't owned by the government. Most of the hospitals are non- profit, but that is a vague term. Doctors are given a fee for service rather than being employed directly by the government.
It's less expensive to treat people at the start of an illness than to wait until they need to go to the emergency room. It's especially important that people with chronic conditions such as hypertension and diabetes get proper care. I don't see how those problems are solved when health insurance isn't available to all.
In the USA, major medical is supposed to be covered by the government with the private insurers taking on the less risky aspects of health insurance.
Look at KND if you think that long term care is a promising business.
-- Ron
Reply to
Ron Peterson
I had the privilege of flying to Vegas from Detroit next to a Canadian business executive, and her and I were comparing notes. She did not understand some of the US health care problems... for example she had no idea how American payroll deductions worked (for health care) and was curious if wages here were higher because of that.
She did not understand pre-existing conditions either- the idea someone which owned a small business could be refused to buy health insurance because they had a condition.
She liked the fact she could get access to health care easily, and the hassles of payments were low (she had a few teenage boys which had broken a few bones, and she said it was never a problem getting them health care).
We talked about rationing and how much money was spent on end of life care too. She liked her system more than ours when the conversations was done with and she had to weigh taxes vs benefits. IMO from that one conversation alone, I think the delta is too much money (for the additional cost of health care above the Canadian system, it really does not appear to be much value to have the benefits of private insurance).
Meaning I think a lower priced Canadian system is better than the higher priced American system as the additional benefits of the higher cost do not look like needed (required?) benefits.
Reply to
jIM
One big advantage of the Canadian system that should not be forgotten is that it provides for everybody. There are not millions of people lacking insurance coverage and easy access to medical care like in the USA. In Canada there is no such thing as a person going bankrupt because they have to pay the high costs of medical treatment. In other words, like many European systems, the Canadian system is humane.
People who don't like "socialism" and economic planning in general often raise various objections and point to things like higher Canadian taxes, the delay in getting some kinds of treatment, the fact that wealthy Canadians go to the USA to get high-tech medical procedures that are not readily available at home, etc. Those arguments are all what might be called "Red Herrings." They collapse when closely examined. Americans should quit going into denial and admit that their system lags behind the rest of the industrialized world. Then maybe they could get on with the difficult task of improving it.
Reply to
Don

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I'm a Canadian and it irks me that somehow Americans think we have free health care here. It's not free. We have a government funded insurance plan that covers many but not all aspects of health care. It doesn't cover dental, eyecare, physiotherapy, chiropractor visits, prescription drugs, cosmetic surgery (unless the cosmetic surgery is to recover from say cancer or such). newspapers suggest that in Ontario that 63% of all health care related visits are covered by government funding. Much of the government funding is taken directly from government revenues ( I.E income taxes, sales taxes, bond sales, profits from government run agencies)
I have a private insurance plan just like all those Americans that covers me for a broad range of health care items like drugs (max 4000 a year, dental, $2000 per family member per year, taxi cab rides during cancer treatments) My wife and I pay $150 a month for this plan to our insurance company. It is deducted at the time of her paycheque by her employer.
We also pay $300 a year each in our province of Ontario to be allowed onto the taxpayer funded insurance plan. Low income people do not pay this fee.
Canada has a Universal health care system that means although not everything health care related is covered by THE single payer system, every Canadian citizen is covered by THE single payer system regardless of economic or social means. Health care laws are/can made by the federal government however health care policies are done at the provincial level. Funding is provided by the provinces with SOME federal government funding for items like vaccines or hospital construction. My province of Ontario spends 46% of it's $114 Billion dollar on Health care as a whole. Everything from reimbursing doctors to funding construction to paying nurses.
Let it be on record that I do not support Universal Health in Canada. Let it be on record that I support a for-profit competitive health system. Dentists in Canada are for-profit for example.
Canada has Universal health care. Canada does not have free health care
Reply to
The Henchman
My personal belief is that U.S. healthcare (I refuse to call it a system) needs major changes to make it more humane and accessible to all. However, the Canadian system is not all milk and honey either.
Example 1: A Canadian friend's son had a condition that could not be diagnosed. He needed an MRI. At that time, due to budget constraints, the number of MRI units in the Toronto area was so limited that he could not get the test for five months. Fortunately my friend had the resources to take his son to Buffalo and pay for the MRI. The boy had an aortic aneurysm. Once the MRI was available he received the immediate surgery he needed after which the surgeon confirmed that it was unlikely the boy would have survived until he could get the MRI in Canada.
Another Canadian friend's wife suffered a herniated disc that caused a foraminal stenosis (pinched nerve where it exits the spinal column) which caused constant severe pain. The time to get on the surgery schedule at their local hospital was 18 months because the condition was not life threatening. Fortunately they live in western Canada and by shopping around to hospitals in smaller towns they got that down to two months. I had the same problem in the U.S. and was on the operating table 10 days after I first saw the surgeon.
Healthcare is always rationed regardless of whether the system is public or private because there is always more demand than financial resources can support. Whether you ration based on someone's assessment of need, ability to pay, by limiting available facilities or by some other method the one thing you can be sure of is that care will be rationed.
Of course you can make things infinitely worse by doing things that are obviously stupid. One example in the U.S. is that any hospital that operates an emergency room must treat anyone who walks in the door, whether they can pay or not. The result is that everyone who has no insurance goes to the ER everytime they have a runny nose. The result is that treatment is often delayed for those with real emergencies and hospitals are closing their emergeny rooms.
Another example that is not confined to the U.S. is a healthcare system without copays for all services. Even if the amount the patient must remove from his/her wallet is small it provides some deterrent to abuse of the system. I have traditional Medicare and a type F medigap policy. It costs me nothing out of pocket to go to the doctor, urgent care, the ER. It did not cost a penny out of pocket for my back surgery. If there is no out of pocket cost there is abuse.
--
 .Bill.
Reply to
Bill
More perspectives, and then consequences:
-The high dysfunction and expense of the US health system is not because it is "too privatized", rather it has weird historical distortions that often stem from gov't such as letting care be driven from a lawsuit avoidance perspective.
-The socialized/Canadian model isn't the only way of progress, rather a corrected private system is the logical direction if the US were to continue as prime example of 18th century Enlightenment (the philosophical direction where US led the world in throwing out ruling classes and freeing up economies).
-The current US digression into socialized health entitlements is not a few baby steps towards the world trend, but a grab bag of dysfunctional junk with perverse incentives.
Already private buyers of health insurance are facing needless price blowups that may force them to drop or cut back coverage, such as due to the already activated mandated dropping of lifetime caps. Believe it or not, some individuals don't want to buy expensive coverage that allows any loony to take $9000 daily doses of (probably ineffective) drugs for life for example.
By far, most health expense is wasted for self inflicted lifestyle diseases, such as smoking, hypertension, or diabetes2 "epidemic" (easily cured by resuming diet and exercise lifestyles common a few decades ago), but under gov't programs there is no way to avoid paying for your neighbors irresponsiblity in those regards.
The ultimate silliness comes in 2014 IIRC where a tax credit is given that covers health insurance for those who report little income. So there is every incentive to remain parasited off "other peoples money" rather than lose your free ride for a gold plated health plan that is breaking the back of folks earning (or reporting) just a bit more. That year, whatever taxpayers are left will pay for the "charity" health plan and for needless overcoverage of their own plan.
Reply to
dumbstruck
On Thu, 21 Oct 2010 19:01:26 CST, dumbstruck wrote:
Absolute nonsense.
The ultimate silliness is your post. Thumper
Reply to
Thumper
How ling would someone with no insurance wait in the USA.
How ling would someone with no insurance wait in the USA.
Reply to
Thumper
I didn't mean to imply *I* think the Canadian system is "free." Many years ago a 'northern' friend of mine complained to me about high taxes there, and in the same (run-on) sentence, applauded "free" health care. Yours are some of the first numbers I've seen.
I really hadn't expected such interest, and since it's "my" thread I''m proud to seize this rare opportunity to praise and thank everyone for their civic interest and sense of moral responsibility in constructing a world we can all be proud of!
That we can construct a world to be proud of is not an issue. We have such a world today. In the Middle Ages, prior to the Renaissance and the subsequent Industrial Revolution, statistics for infant mortality, literacy, and quality of life were "absolutely intolerable" by today's standards. With the Industrial Revolution came Capitalism and Democracy (even if it was a re-birth of an Ancient Greek notion that was far ahead of its time). A major problem in the world today is simply that we have such enormous surplus in developed nations we do not know what to do with them. In historical perspective, 300 years from 1700 to 2000 is a very short period of time. Developed nations qualify as Nouveaux Riches.
This does lead to problems. The greed and avarice, haves and have- nots, global pollution and depletion of resources, over-crowding in cities the size of which man never rationally contemplated as humanly possible let alone probable; we also have technological dependence, traffic jams, the movie industry, cell phones, and other horrors. Lots of problems! But for all the problems we have in the present, and for all their seeming urgency, I personally think we should not forget how we got here with all these warehouses full of stuff not even DaVinci wrote about. We got here through Capitalism and Democracy, each and both of which are a summation of free individual choices.
As free individuals, we are not forced to like each other, but we do. Smile at a complete stranger, and they'll likely smile back at you. Go to a foreign country and smile at a starnger there, and chances are, they'll smile back at you. Whether we admit it or not, most of what we do, we do with the benefit of another in mind. From brushing our hair to crafting very expensive Ferarri's to creating real works of purely aesthetic art, we have someone else in mind, their pleasure, their satisfaction. There are many great gifts one man can give another: amongst these is the right to be free and make his own choices as an individual.
As we move from developed nations to enlightened civilizations, I think individual freedom of choice is something worth considering. Enlightenment is an individual, ongoing, never-ending process.
Reply to
dapperdobbs
You disagree with his post. OK. Why?
It is far more useful for someone to present their views and reasons instead of just bad mouthing someone else's. -- Doug
Reply to
Douglas Johnson
Sorry, dumbstruck presents compelling arguments. Any "free ride" provides an incentive to catch that ride. Any tax is a disincentive to do what is taxed. That observation is hardly silly or inaccurate. You can debate the impact of such policy, but it's not to be dismissed outright.
Reply to
JoeTaxpayer
?
I didn't mean to imply *I* think the Canadian system is "free." Many years ago a 'northern' friend of mine complained to me about high taxes there, and in the same (run-on) sentence, applauded "free" health care. Yours are some of the first numbers I've seen.
--
My wife goes to a migraine specialist once a month  The cost of the visit, 
about 45 minutes is $175.  The doctors performs 9 separate billable tasks 
 Click to see the full signature
Reply to
The Henchman
Reports of one's personal experiences as to what is covered by health plans in the two countries and what is not, as well as reports of waiting times for various services, etc., are interesting and suggestive, but they do not tell us a lot about the overall quality of health services in the two countries. In order to get a good picture as to how the systems function, we need to know the figures about HOW MANY people are treated for all the various medical conditions, hOW MANY people have to wait HOW LONG for what illness, including emergencies, in the entire population, HOW MANY people do not receive adequate treatment, whether untreated conditions are life-threatening or trivial, how people pay for the services and how their quality of life is affected by the cost of treatment, and various statistics of that sort. I firmly believe that if the two systems were thoroughly compared taking all those statistics into consideration, the Canadian system would come out way ahead. One thing to bear in mind is that it is unusual to find a Canadian resident who would want to have the American system replace the Canadian one.
Reply to
Don
The only time I have done this was for an emergency room visit in 2004. They filled out the charge slip with a line item charge of $100, which was their minimum ER visit charge. Any subsequent additional costs were to be added as an additional line item.
BTW, many hospitals give discounts if you pay in advance.
Reply to
bo peep
United States medical providers generally do not like working with people without insurance, because the providers think they will not be paid. Plus for many ailments, specialists are so booked that one will indeed wait weeks, months, etc.
In 2007, I wanted a second opinion on a broken arm. I had cash, ready to pay hundreds of dollars for a few minutes with an orthopedic physician. I wanted a little peace of mind. I must have called ten orthopod's office, saying I would pay cash, greenbacks. No one would see me, because I did not have insurance or because they were too booked or because they only worked with patients insured through a given company. I do not appreciate your remark. It is not reality. For heaven's sake, it is common for people having even good, non- catastropic insurance struggling just to get access to routine medical care.
Reply to
Elle
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I may be forced to research this further, but the above link states that:
"...all US-issued money, both paper and coin, is legal tender and therefore must be accepted for debts in the country, while foreign money is not."
Reply to
dapperdobbs
That is interesting and must vary widely by location. I have never had to wait as much as two weeks to see a specialist for an acute problem here in Arizona. Primary care physicians are another story. I do believe that specialists give priority to patients referred by another physician and that may have had some influence on your experience seeking a second opinion.
--
 .Bill.
Reply to
Bill

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