Canada health care sucks too.

[Isaac Brock]

Originally posted by Said1
Issac: How is Ontario doing post-Mike? How does one hundred million in cut backs sound? Makes good ol' Mike sound pretty good EH? Harris had his short comings, but his changes to welfare, and social spending were needed - the rest is not suited for this thread :. And it's the French who do everything backwards...everyone blames America for Canada's problems, I say blame it on the French :

Yeah, well Ontario has been brewing for something like that for a long time! Shame nonetheless, but I'm sure better times are ahead. Though with the Canadian election turning as it is, I have no clue what's going to happen (or who to vote for, for that matter).

Hey! And easy on the French! I'm part Metis! :

 

[Said1]

Originally posted by Isaac Brock
Yeah, well Ontario has been brewing for something like that for a long time! Shame nonetheless, but I'm sure better times are ahead. Though with the Canadian election turning as it is, I have no clue what's going to happen (or who to vote for, for that matter).

Hey! And easy on the French! I'm part Metis! :

Just curious, have you lived in Ontario before? Better times?? Do a quick google search of the recent provincial tax increases

I ave un petit peu du Francais blood myself, so : . When I don't have to, I'll learn the language someday. For now I'm content with tunning it out.

Who to vote for?? I agree with you there. If one more NDP groupie knocks on my door, I'm going to lodge a complaint That's the popular vote in my area of town, but as usual, I'm off topic again

 

[Said1]

Originally posted by Merlin1047
Isaac, it was never my intention to suggest that Canadian health care was on par with third world countries.

There are two points I'm trying to make in all this. One is that socialism, like communism, is ultimately self-defeating. When people start looking to government to meet all their needs and government starts taxing to the degree that investment and hard work are no longer rewarding, then collapse is inevitable.
I see socialized medicine as just another step in that direction. The second is that privatized medical care is superior in many ways to that supervised or sponsored by government. Privatized medical care responds more quickly to a need, if that need produces profit. That is also it's drawback. If you have an extremely rare condition, you may as well plan on dying. Because where there is no profit, private medicine will produce no treatments. Government mandate for development of treatments for rare ailments is one of the very few roles for government in medicine to which I am willing to agree (besides basic licensing and other fundamental regulatory oversight functions).

I agree with you, but a privatized system seems like it would make things worse in a system where doctors appear to be getting overly selective to being with. Coverage and availability differs from province to province, I can only speak for Ontario.

note to self: proof read before posting!!

 

[Merlin1047]

Originally posted by Said1
I agree with you, but a privatized system seems like it would make things worse in a system where doctors appear to be getting overly selective to being with. Coverage and availability differs from province to province, I can only speak for Ontario.

Said, I believe your concerns are unfounded. In socialized medicine where doctors are paid the same for seeing a patient with the sniffles as opposed to a patient with complex, chronic problems, the natural tendency is to gravitate toward the patient with the easily treatable malady.

I believe that American doctors would love to find a disease which is incurable, but which is 100% treatable with prescription medication. That would boost their profit margins right through the roof.

The bloodthirsty truth is that doctors want to maximize their income. In a private system, a patient with a complex and chronic disease is far more profitable than one with a nose bleed. Therefore the patient with the serious illness gets more attention because he provides the doctor/hospital with more income.

Sometimes greed works.

 

[Said1]

Originally posted by Merlin1047
Said, I believe your concerns are unfounded. In socialized medicine where doctors are paid the same for seeing a patient with the sniffles as opposed to a patient with complex, chronic problems, the natural tendency is to gravitate toward the patient with the easily treatable malady.

I believe that American doctors would love to find a disease which is incurable, but which is 100% treatable with prescription medication. That would boost their profit margins right through the roof.

The bloodthirsty truth is that doctors want to maximize their income. In a private system, a patient with a complex and chronic disease is far more profitable than one with a nose bleed. Therefore the patient with the serious illness gets more attention because he provides the doctor/hospital with more income.

Sometimes greed works.

Not concerns really, more like questions. I would have to double check, but I don't think there is a flat fee for every patient seen by a doctor here. I'm pretty sure billing is based on what is done, meaning there is a different fee for pink eye, than there is for someone like me, with a chronic uncurable condition, easily treated with a perscription.

 

[MrMarbles]

Originally posted by Merlin1047
Said, I believe your concerns are unfounded. In socialized medicine where doctors are paid the same for seeing a patient with the sniffles as opposed to a patient with complex, chronic problems, the natural tendency is to gravitate toward the patient with the easily treatable malady.

I believe that American doctors would love to find a disease which is incurable, but which is 100% treatable with prescription medication. That would boost their profit margins right through the roof.

The bloodthirsty truth is that doctors want to maximize their income. In a private system, a patient with a complex and chronic disease is far more profitable than one with a nose bleed. Therefore the patient with the serious illness gets more attention because he provides the doctor/hospital with more income.

Sometimes greed works.

The gov't of Canada does not run hospitals or hire doctors (except for some special circumstances) and pay them a base rate. Doctors for instance provide care to patients, then bill the gov't for the costs. Therefore, someone treating pink-eye, gets paid for treating pink-eye, and a broken foot for a broken foot.

 

[crazy canadian]

I haven't gotten to vote in years. That's what happens when you're a Canadian living in the States.

 

[crazy canadian]

I know Prince Edward Island, one of the smaller, more isolated provinces, is in bad need of docs. They seem to be heading to the larger cities, or maybe to the States. Or perhaps it's the baby-boomer docs retiring, and the young docs don't want to be in such a small place. They like the bright city lights, not the quiet, country life.

 

[crazy canadian]

... and another thing, after living here and dealing with headache after headache that I never had to deal with before, insurance companies, not ever getting to see a doc unless it's OK with your insurance co., paying copays and stuff like that, I sure as heck can't wait to get back to Canada in that regard. I really hope healthcare stays the way it is in Canada.

 

[Isaac Brock]

Originally posted by crazy canadian
... and another thing, after living here and dealing with headache after headache that I never had to deal with before, insurance companies, not ever getting to see a doc unless it's OK with your insurance co., paying copays and stuff like that, I sure as heck can't wait to get back to Canada in that regard. I really hope healthcare stays the way it is in Canada.

You're welcome back anytime. Plus, the beer is way better.

 

[crazy canadian]

No kidding. I'm on my second Mike's right now, so I kinda am getting messed up by which conversation I'm on.

I think I should shut off teh computer...

 

[tim_duncan2000]

Here is a good article about Canadian health care:

While many Americans look to Canada for solutions to our health care mess, Canadians, in increasing numbers, look southward, to us.

Canada's National Post recently reported on a nationwide poll. "More than half of Canadians support a parallel private health care system that would let patients pay for speedier service," Tom Blackwell's June 1 article summarized. "The poll found 51 percent favour a two-tier system, with support highest in Quebec, at 68 percent, and Manitoba and Saskatchewan, the birthplace of medicare, at 57 percent."

Canada's political insiders hardly know how to react. No major party espouses private medicine, even in the watered-down form considered in the poll. How could so many Canadians want something very much like what America has? It's unpatriotic!

Patients Must Be Patient

America endures a mixed private-public system. Health care is still "privately provided," though our Medicare programs are nearly as large as our private insurance companies combined, and regulations on health care providers and insurance companies abound.

In Canada, on the other hand, it's pretty much government through and through. Though "free medicine" sounds great, its implementation has led to more than a few problems. For something "free," it comes with a high price tag: Canadians pay for the service in extremely high taxes. Worse yet, Canadian patients are often forced to be extraordinarily patient, even at the cost of their health.

If you need a test, getting it in Canada is not the speedy thing it is in America. There's usually a lag. This applies to treatments, too, especially the older you get.

In his book Code Blue, medical student David Gratzer reported that Canadians wait for radiation therapy three to four times longer than Americans do. The average wait for an MRI scan stretches almost to half a year, while Americans wait three days. Only a fifth of Canadians diagnosed with cancer can see a specialist within four weeks.

These problems aren't secret. Government commissions have listened to hours of horrifying testimony, and there have been numerous public studies. More strikingly, a current case before Canada's Supreme Court has made the problems front-page news. A Quebec doctor and his patient have sued the government for the right to contract privately for medical services. If the Court agrees, Canada's monolithic approach to medical care may be at an end, and with it Canadian waiting. (The court isn't expected to rule on the case until 2005, however, so they'll have to wait for an end to waiting. They're used to it.)

The Private Solution

Wealthier Canadians are lucky, though: they've had America to fall back upon. While Americans traveling to Canada for cheaper prescription drugs is a current news item, for years thousands of Canadians have traveled south of the border for testing, diagnosis, treatment — and even drugs, some of which are just not available up north.

It's no wonder that some Canadians dream of adding another "tier." This would allow more Canadians to do what many do already. A number of polls before the recent one have demonstrated Canadian tolerance for this form of liberalization — this smidgeon of freedom.

So why won't Canada's major parties talk about it?

Well, to jaded Americans, a taboo on talking about private solutions is no shock. Where powerful interests, fear, and fantasy combine — that is, in politics — rational discussion tends not to blossom.

But this sounds cynical, and Canadians try to be earnest. No wonder, then, that the National Post found a shill for the Canadian status quo, one who would tell pious whoppers without flinching.

The Post consulted James Smythe, a health economist at the University of Alberta. "f it really was close to a 50-50 split on such a contentious change to health care, then you would think that that's where the Conservative party would be basing their platform," he told the paper. "I think they are smart enough that they would recognize it if it did exist."

From this I hazard that Smythe's work is narrowly directed to the field of medicine, not Public Choice. As an analyst of politics he seems a tad naive. But then, economics itself gives him trouble:

Prof. Smythe said there may be some argument to be made in favour of private medicine from a libertarian point of view, but he said there is no economic case to be made for it.
Two-tier health care does not create any efficiencies, he said.
Well then. If waiting for weeks and months for testing, diagnosis, and treatment is not an inefficiency, what is it?

The Dark Side of Socialized Medicine

Calling something "free" and paying for it with taxes doesn't take away the need to make hard choices. Demand for medical services is almost limitless, especially when you make the "demand" little more than a request. So some means of rationing has to be put in place. And in Canada, doctors and administrators naturally choose the easiest method: delay.

Like socialist systems elsewhere, Canada's health care system rations by procrastination.

Crude, yes, but it can be horrifyingly effective. If the system is lucky, enough people die while waiting — or have their life spans reduced — thereby diminishing resource drain. This is how socialist systems have generally distributed goods: by making the queue, the waiting line, integral.

Perhaps Prof. Smythe knows this. The historical record makes it quite clear that this is what happens when you establish a socialist system for a widely consumed good. The cognoscenti "figure in" the waiting as part of the equation, and call the resulting monstrosity "efficient." Or as they say in the computer biz, "that's not a bug, that's a feature!"

It's only the patients/citizens/rubes who are fooled. (They must not be reading my free Common Sense e-letter.)

Jump Ahead

But how can you fool so many people for so much of the time? In Canada, it's part national pride ("we're not Americans!") and part egalitarianism.

Funny thing is, just like in the late Soviet Union, Canada's system falls short of the egalitarian ideal. Even there, the richer you are, the better your recovery rate. And this is not simply because rich people treat themselves better than the poor can. It's also because queue-jumping — "pushing ahead in line" — is rampant. David Gratzer summarizes the importance of "celebrity and connections":

Last year, researchers from the Institute for Clinical Evaluative Sciences in Toronto surveyed cardiologists about preferential treatment. In a nutshell, the study's authors wanted to know whether the heart specialists were willing to help certain patients queue jump. Eighty per cent responded that they did. (On a whim, I brought this study up one afternoon with a group of medical students. The consensus was that 20 per cent of the cardiologists had blatantly lied.)
The rich and the famous just expect to go ahead. And do. "Bypass surgeries," Gratzer notes, "are performed 20 per cent more frequently in wealthier neighborhoods." Bypass indeed.

As Your Mother Put It . . .

"Would you jump off a cliff just because all your friends are doing it?"

For too many American policy wonks, the answer is Yes. Though jumping off a cliff can be hazardous to your health, many commentators on health care prescribe a similar leap into the abyss of socialized medicine. You know the litany: "Every major industrialized nation has national health care, except for America."

Americans should take caution. We certainly don't want to emulate a system whose patients now contemplate an about-face, emulating our system. Though our mixed public-private health care system is a notorious disaster, it's less of a disaster in some important ways than the costly, regimented government-run system that Canada established decades ago. As Canadians have discovered.

Mom was right: let's not jump.

Link

 

[Isaac Brock]

Sorry to bump this up, but I read a good article in paper today:
From the Winnipeg Free Press

Editorial -The jury is in: We can't afford health-care profit

Sun Jun 13 2004

By Dale Swirsky



THERE is only one taxpayer. Whether a tax is federal, provincial or municipal, on income, sales or a user fee, the same taxpayer pays them all.
So it is with health care. Whether costs are covered by public tax dollars, personal payments to private providers, or insurance premiums, at the bottom of health care's financial food-chain are individual Canadians footing the bill.

Stephen Harper says Canadians don't care whether their health-care provider is public or private for-profit -- we just want quality service. True enough, but which delivery model provides the quality we seek at a cost that we can afford?

In trying to figure that one out, voters should digest "information" from the nation's propaganda machines as one would junk food. Anybody familiar with so-called "think-tanks" can predict their bromidic prescriptions. Instead, go to respected medical journals -- something Mr. Harper apparently hasn't done.

The New England Journal of Medicine (NEJM) in 1999 compared 3,421 different health-care jurisdictions and found the highest costs were in places where all health care was delivered by for-profit suppliers. For-profit jurisdictions had higher costs in every category -- hospitals, physicians' services, home care, and other facilities.

Jurisdictions with a mix of for-profit and non-profit providers, as Mr. Harper is advocating, had intermediate costs. The lowest-cost areas were served exclusively by non-profits. As well, jurisdictions in which all hospitals converted to a profit basis saw costs grow more rapidly than in all those which remained non-profit. Even though for-profit health-care providers spent less on personnel and had shorter hospital stays, their increased spending on shareholder returns, marketing, executive remuneration, administration and ancillary services made them more expensive than non-profits. Last year, the Journal noted that America's health-care administration costs were $1,059 (US) per capita, compared to $307 (US) in Canada. If Canada paid such costs, we would be spending $33.4 billion (Cdn) more each year on administration. In a 1997 report, the Journal found administration costs were highest in for-profit suppliers, intermediate for private non-profits, and lowest for public facilities.

In 1971, Canada and the U.S. had similar health-care systems and spent a similar portion of their GDP (seven per cent) on it. That year, the provinces signed onto medicare. Today, Canada spends 9.8 per cent of its GDP on health care while the U.S. spends 14.7 per cent, the highest rate in the world. If Canada spent, per capita, what the Americans spend on health care, it would be costing us $49 billion (Cdn) more per year. How many Mayo Clinics could Canadians have if we spent $49 billion more on health care?

Some argue that while for-profit health-care delivery might cost more, the expense could be justified if it resulted in superior service to Canadians. However, increased spending on shareholder returns, marketing, executive remuneration, administration, and ancillary services doesn't improve outcomes.

The Canadian Medical Association Journal in 2002 collated 15 studies involving more than 26,000 hospitals and 38 million patients. The conclusion was that adult mortality at for-profit health-care facilities was two-per-cent higher than at non-profit ones. In Canada, 2,200 more people would die every year if the mortality rate of our health-care system rose by two per cent. More alarming was the finding that perinatal mortality at for-profit suppliers was 9.5-per-cent higher than at non-profits.

The Journal of the American Medical Association (JAMA) in 1999 compared for-profit and non-profit Health Maintenance Organizations (HMOs) and found that for-profit HMOs rated lower than non-profits in all 14 quality indicators. The study projected that if the non-profit agencies adopted for-profit practices, an additional 5,925 U.S. breast cancer patients would die each year.

Even if there's a single government purchaser of health-care services, as Mr. Harper insists he would maintain, for-profit suppliers produce less desirable outcomes. In 2002, JAMA examined 10,736 hemodialysis centers treating end-stage kidney disease, all paid by the American medicare system. Patients at the for-profit centres had a mortality rate eight per cent higher than those treated at non-profit ones. This result is consistent with a similar study 20 years earlier. In short, an immense number of scientifically peer-reviewed studies have found "that private businesses delivering health care for profit have greatly increased the total cost of health care and damaged -- not helped -- their public and non-profit competitors," according to the New England Journal of Medicine's former chief editor.

While the for-profit lobby in Canada routinely hails free-market health-care reforms in Britain and Sweden, the medical journals all say that more data is required to assess them properly. However, the journals do note that British Prime Minister Tony Blair dramatically increased government funding after inheriting a health-care system in disarray from competition injected by the previous Conservative administration. The British Medical Journal in 2002 found that private-public health projects cost twice as much as publicly-funded ones. And the American Journal of Public Health last year recommended nine things we can learn from Blair's successful health-care reforms -- none of them involving for-profit delivery.

So, when it comes to prescriptions for Canada's health-care system, whom are you going to believe? The New England Journal of Medicine or the National Post? The Canadian Medical Association Journal or the Fraser Institute?

The answer is as obvious as the party you should vote for if health care is a key issue for you. If your riding is a tight Liberal-Conservative battle, vote Liberal. That doesn't mean you have to trust Liberal promises. It means you can trust that the Martinites are not bent on waving the magic for-profit wand over medicare, as the Conservatives are.

And if you're in a Liberal-NDP battleground, vote NDP. There are many reasons to avoid an NDP government but, in a minority-government scenario, trust a New Democrat more than a Liberal to hold Paul Martin in check on for-profit health-care delivery.

Yes, Canada's health-care system needs reform. But as health-policy expert Michael Rachlis has noted in his new book, Prescription for Excellence, the innovations required to reduce costs and improve outcomes are already taking place -- in the non-profit sector.

Free-market advocates must acknowledge that the "laws" of supply and demand become skewed in health care. How much would you pay for shoes, or a car, or a stereo? Now, how much would you pay for medical treatment for yourself or a loved one whose life was in danger? Is it any wonder that a free market in health care leads to costs spiraling beyond what many can afford?

The free market permits optimum outcomes in most sectors of our society. But, as George Bernard Shaw observed, no sane society, seeing that giving bakers a pecuniary interest in baking provides for a supply of bread, would go on to give surgeons a pecuniary interest in cutting off legs.

Dale Swirsky is a Winnipeg high school teacher and former Progressive Conservative party member.

Maybe Canada isn't so far in outfield afterall. Apparently according to American doctors, you pay more than we do (Almost 50%!).

 

[MrMarbles]

Some much for our system being 'flimsy', 'backwards' , and in the 'gutter' as i've heard it described as.

Universal health care has it's flaws, but how could you deny people the basic right to medical treatment?

Greed is not a good insentive to provide proper treatment.