National Healthcare in Canada Problems
 

I saw this in today's Investors Business Daily. It appears that the private sector is responding to a few problems with Canada's national healthcare plan

Link: http://www.investors.com/editorial/I...issue=20060228

besides the obvious view the author holds against the canadian system according to the adjectives used in the article, it simply doesn't make much sense to me to criticize a system based on the number of people who didn't receive treatment without analyzing whether those people woudn't have even had a line to stand in if they were seeking treatment in a wholly private system.

that is, while it certainly sounds horrendous that 71 people died and over 120 were removed from a list while waiting for treatment, that doesn't mean as much as the author would like us to take it to mean if those nearly 200 people would have been absolutely unable to obtain treatment in the US. and this does nothing to understand the vast amount of people who are able to obtain treatment despite wait lists who otherwise would not have had the funds to obtain treatment in a wholly privatized system. I don't know the numbers, but I suspect far more than 200 people die each year in the US for want of surgery.

that said, I've never seen canadians claim their system was a panacea. Even they agree that changes could and should be made. and quite often I see them suggest a two-tiered system might address many of the concerns others raise about their system. but then to take that into a leap of logic and declare the entire system should be scrapped doesn't serve the patients' interests--for certain.

publicly available health care, ideally, should guarantee a baseline of treatment. not much more, and certainly no less.
elective surgeries shouldn't even be the purvue of such a system, in my view.

the wealthy have always been welcome and able to spend their money elsewhere when they want particular treatments their nations don't or can't provide. eliminating the public guarantee of health care in canada would obviously only benefit a select few at great expense to many who do benefit from such care.

Yeah, I was thinking about this earlier today. You'd be hard pressed to find a Canadan outside of the ghost of Tommy Douglas who thinks the current system is perfect, yet most Canadians agree that universal healthcare is the basis from which any tweaks should emerge. It would be the foundation and some private clinics would be supplemental or specialist to same.

Yet within the US I hear so many people espouse their system as wonderful while slamming the Canadian system, even as 10s of millions go without primary healthcare, millions more lose insurance coverage, and the costs to the consumer mount every year. Surely, these are signs of an imperfect system also?

I'm ever surprised by this disparity.

When you see what Canadan's really PAY in taxes for this 'universal' coverage, you have to wonder if math scores are as bad in Canadian schools are they are US schools these days.

Good luck saving that system, but I've done this one too many times on the board to get into it another time.

That's good to hear!

:lol:

I'd like to see the comparsion in numbers to the US private health care system. There's alot of arguement about it in Alberta especially. Probably more than half of the people in the province are unsure because it's a relatively new idea and concept being introduced as a alternative to a system filled with lots of problem.

Personally, I'm for the private care but I just read an article in the Calgary Sun about the private care being in the works and somebody just made an excellent point of it

Again, I'm still kind of unsure

As a percentage of GDP, Canada spends the same amount of government money on health care that the USA does. Or at least this was the case for the last year I managed to scrape numbers up for.

Canada's health care system isn't perfect. Is yours?

Did you post for the purpose of engaging in a discussion?

Yes because our system is sooo affordable. With my former employer, the monthly premiums for myself, my wife, and our daughter were $660/mo (PPO). That was with them paying 75% of mine and 50% of hers.

aceventura3, I thought that SOP for an OP requires your "take" on the issues that influence you to start a new thread in the first place. I'm going to assume that you want us to respond by offering opinions as to whether the trend in Canada is "good or bad", and how it compares to the healthcare cost and availability to the general U.S. population.

From the <a href="http://www.cbc.ca/news/background/healthcare/public_vs_private.html">CBC News site</a>, 2004 data, in Canadian dollars:
Government annual spending on healthcare: $90 billion
(For comparison, I reduced this figure to $80 billion U.S., to deal with a rough but low allowance for currency exchange rates, i.e., the actual figure would be as low as $70 billion U.S.)
That works out, based on a population of 30 million....to $2666 U.S. dollars per capita.
Add in the $40 billion in "private care" spending..... (the government apparently doesn't pay this tab), and, after cutting it to $32 billion U.S., $1066 U.S. is added to the total expenditure, or a total of $3732 per Canadian, in U.S. dollars.

<a href="http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1314">From the HHS.gov site</a> , the U.S. 2003 Healthcare spending figure is $1.7 trillion, or $5670 per capita (according to HHS....)

The total healthcare annual spending, per capita, in Canada in 2004 was no more than 65 percent of the equivalent per capita cost, in the U.S. and, from the link above:
So....folks.....<h4>Voila !!!</h4> With ten times the population of Canada, U.S. public funding of healthcare expenditure in 2003 was $766 billion U.S., or..... <b>almost exactly ten times the expenditure on primary healthcare funded by Canadian tax dollars to insure that every Canadian received primary care, at a cost that was managed by their government !</b>

The U.S. expenditure of public funds covered only senior citizens and the 40 million uninsured Americans at the time. Another $913 billion was spent to cover everyone else, compared to $32 billion U.S., spent in Canada for private services. This amounts to 30 times what was spent in Canada, or three times the cost, on a per capita, total population comparison basis.

An older <a href="http://64.233.179.104/search?q=cache:PD0wFqvdO1EJ:www.chass.utoronto.ca/clea/confpapers/DWagner.pdf+doctors+emmigration+from+canada&hl=en&gl=us&ct=clnk&cd=7">study</a> that uses 1999 data indicates that Canada suffered a "brain drain" to the U.S. because of higher Canadian taxes on high income individuals, that began at a much lower income threshold in Canada, than in the U.S.

I imagine that, after five years of "Bush tax cuts", the shortfall of medical professionals available to provide healthcare services in Canada has accelerated. Canada enjoys a balance of trade surplus with the reat of the world, with the U.S. trade deficit pushing up nealry to $800 billion annually.
Canada takes in more than $60 million U.S. per day from it's oil exports, while the U.S. borrows $840 million per day (based on $60 per bbl oil price) to purchase foreign oil ($306 billion of the total $800 billion trade deficit.)

The Canadian dollar was worth .77 U.S. dollars, on Jan. 1, 2004. Today it buys .88 of a U.S. dollar. The combined pressure on the U.S. dollar of a massive and continuing trade deficit, and $500 billion plus, annual federal budget deficits should facilitate Canadian dollar exchange parity with the U.S. dollar, before you know it !
Exchange calculator: http://www.bankofcanada.ca/en/rates/exchform.html

Here is a link to the http://www.nytimes.com/2006/02/26/in.../26canada.html that the IBD misrepresents as a story of "crisis" in Canadian healthcare.

Given current economic realities, which I would enjoy reading footnoted rebuttals to that offer more favorable scenarios for the future of the buying power of the U.S. dollar, if such an argument can even be credibly advanced,
doesn't it seem reasonable to assume that the emmigration of Canadian healthcare professionals could stop and then reverse?

Which economy has a better chance of sustaining the burden of providing better and more timely healthcare to all of it's residents....say....oh....ten years from now....given what we see as far as cost controls, management of care, availability of care givers going forward, and in terms of the buying power of a given currency and the governments ability to pay or to fund a deficit at a manageable interest rate....Canada's, or the United State's.

I have my doubts if the U.S. will even be able to afford or guarantee relaible availability in 2016 of fuel for it's ambulances or for diesel oil to fuel "back up" generators at it's hospitals.

If Investors Business Daily provided reliable analysis of the true looming problems of importance, I don't think that the state and future trends of Canadian healthcare would be top ten on it's list. Our grandchildren are going to be asking, "what were they thinking"? How could they just stand by, consuming 30 percent of the worlds oil every day, while the price quadrupled, borrowing money until the world refused to lend more, with no conservation plan, no plan to curb imports of foreign made goods or the loss of the national industrial base, and no plan to raise taxes to match increased government spending?

Can anyone argue that there is no chance that a Canadian dollar will fetch five U.S. dollars in 2016? Can anyone argue the opposite?

I guess that I wasn't quite done. I am reacting to <b>the MESSAGE</b> from aceventura3, the IBD, and Ustwo, et al.

They want to convince us that government cannot provide anything to the public that the "private sector' cannot do cheaper and better. I just read that medicare's administrative overhead costs are six percent, and private medical insurance administration, and I assume, profit, takes a 25 to 30 percent bite out of insurance premium charges on private insurance plans.

For the majority of Americans, (The U.S. is one of only two major industrialized nations that does not provide government funded healthcare.) the "system" is a private payer system. Looking at the info provided below, and in my last post, I have to wonder: <h4>U.S. population is ten greater than that of Canada. Why is there no cost or performance benefit result from an expected economy of scale, here in the U.S., given the sheer size and purchasing influence, as well as more money to purchase better technology and to make better use of it to manage costs, and to provide lowered expense per patient due to better treatment outcome and theoretically.... less misdiagnoses and shorter, less expensive treatment regimens, due to earlier and more accurate diagnosis and treatment, aggravated in Canada by it's "long lines" of those waiting to be examined and then waiting extended periods to be treated by specialists? </h4>

How will Americans pay for these cost increase projections ?

Sorry.

My take is that the private sector will do a better job of responding to healthcare needs than government. Government healthcare systems over time will fail.

Why do no major medical or drug developments come out of Canada from Canadian companies or the Candian healthcare system? when you think about it, it seems that the US actually subsidizes Canadian healthcare doesn't it?

Ever hear of diabetes? I suppose not.

Oh, more recent....

http://www.lhsc.on.ca/about/medical.htm

Ever hear of Pacemakers?

Not chemical enough or recent enough?

MBP8298? Or is a treatment for multiple sclerosis not good enough?

C'mon, Yakk. Recognize that some of us 'Muricans" aren't Canada 'bashers". I think that you will agree that I posted a set of arguments that are accurate and favorable enough, comparing Canada and the U.S., and their respective abilities to provide adequate medical care to their populaces currently, and in the future, to more than offset other opinions posted here.

Your faith in private sector - it seems you take this on faith... Am I right in this assumption?

The healthcare system is not the same thing as pharmaceutical companies - having doctor visits paid for by taxes shouldn't affect whether some other company makes Viagra II or not... In fact, keeping healthcare and pharamceutical concerns separate strikes me as a good idea. I always feel uncomfortable when I go to the doctor and he's writing on my chart with a lipitor pen or using an allegra clipboard.

lol, host, of course he agrees. his reply was to aceventura
:icare:

Yup

It's like suggesting cops and the guys who make Berettas are the same thing.

"Well, they make a fine 9mm, they should probably be in charge of the streets as well. Why spend tax dollars on flatfoots?"

Look up what the average middle class canadian pays in taxes for health care, you might surprise yourself.

I can insure my family (with better care) for many times less.

Wrong. Views based on my study of history and economics. I don't pretend to be an expert, and my views do change occasionally. There is a positive role for government, but our current federal government is too big, growing to fast and too big a portion of our overall economy.

Medical innovation is more than pharmaceutical companies. R&D is the cornerstone of the quality of healthcare. Most RD in healthcare is financed in the good old USA by private companies. The world benefits from our R&D, but who pays the price? People in the US who have private insurance, those who pay full "retail" prices for medical care, and US tax payers. It is not fair is it?

You have to admit given every inovation in the medical field, that list is pretty pathetic isn't it?

Getting back to the issue at hand - If you take out the profit motive, inovation comes to a complete stop. Well not a complete stop, but its moving so slow...

If you have the 'truth' then go ahead and enlighten us. I already posted that I was paying 20% of my pre-tax income towards health care expenses.

Here's the basis for my confusion. What I snipped above seems more like soundbite than reasons. You don't need to produce a massive document ala host, but I really think it would be helpful for you to summarize what you base this belief on. I'm trying to find a way to jump aboard with your ideas, but just repeating privatization over nationalisation doesn't help me get any closer to you.

You've confused me here - I'm really not sure how topical this is. I've taken "public healthcare" to mean that health insurance is nationalized. There should still be pharmaceutical companies, there would still be doctors, and there would still be companies doing R&D on things like artificial joints, etc... There's still a profit motive for those guys because they want their artificial knee to be used more often than the other company's artificial knee - sort of like defense companies still compete for profit from government contracts. Do you also oppose public defense?

In fact, if your mantra of private over public is really the sum total of your feelings on these issues, I'd like to know if you have any reason (other than safety) that law enforcement and military matters shouldn't be handled by private companies... Prepare the way for the Acme Naval Force! I'm only bringing this absurd question up to prompt you to give me more basis for your (obviously strong) opinion that private management is synonymous with efficient operation.

Can you handle the truth?

1A)You pay more, because others pay nothing.

1B)When people pay nothing they could careless about costs, costs go up.

1C)When costs go up, those who are paying nothing don't care. You pay more.

2A) You pay more, because others get subsidized care.

2B) When people get subized care they careless about costs, costs go up.

2C) When costs go up, those getting subsized fight for and usually get higher subsidies. You pay more.

Solution: Have a competetive system were able people (I think we should support children, the old and mentally il) pay for what they use.

When people are active in a economic system, the system works well. when people are passive they get exploited. Our current system is failing because people are passive. Why do we let our employers control our health insurance? An employer is more concerned about profits than they are about anyone's health, hence our system has problems for employees.

There are other options: for example, a government-mandated system of private insurors. One big pool -- no exclusions -- with varying rates based on socioeconomic status. Insurers make money by maximizing efficiencies within the gov't-mandated set of outcomes and coverages (with certain subsidies available as necessary).

Apparently the Swiss -- hardly wild-eyed free-spenders -- run their system that way, and provide excellent healthcare to the entire population for ~11 percent of GNP. The population has choice between insurors, there is competition -- and even some public control of policy. I hear it's an expensive system; but it's in good shape and gives good service. And as a percentage of GNP, it's less than what the US spends on health care (15 percnet). Here's a report:

http://www.civitas.org.uk/pdf/Switzerland.pdf

My point: there's a point between private healthcare and public healthcare -- and that's private healthcare that does business under a set of national standards, regulations, and policies.

Here is another article from IBD. I concur with the views. I do not believe there is a healthcare crisis. I believe that most people who choose not to have healthcare insurance do it by choice. There is another thread covering this in more detail.

It is ironic that our auto insurance market, withvirtually every car covered through private insurance, works better than our health insurance market. The reason: Everyone has to have it and participate in the market, and the conumer in much more active in the auto insurance market than they are in health insurance. A person will shop for auto insurance, but won't shop for health insurance. Isn't that screwy?

Can you handle posting facts instead of hypothesis? USTWO is talking shit about how the Canadians pay up the ass for health care, I call him on it that I was paying 20% of my gross income on it and Host posts a comparison of how much they spend vs what we spend and all you two can do is repeat a tired mantra.

I agree. Some states have workers' compensation insurance systems that fit this mold. And those systems work. I still think "national healthcare" is a system that will fail in time.

Here is a fact: I pay 5% of my gross income on health insurance.

Here is a question: Why are you paying 20% of your gross income?

Irepeat myself because there seems to be a need to. If you don't agree with the logic in the points above, what kind of facts do you want to make you a believer. You seem to take a passive approach to your coverage, I don't, you pay more. You see, I just repeated myself again. I can't help it, so please ignore me if it bothers you.

I apologize. I am getting a bit carried away.

You need to post hard facts, as others have done, not opinions.

Posting that you spend 5% of your income (which is false, part of your tax dollars already go towards health coverage in the form of Medic-aid and money you might otherwise receive in terms of a salary are instead diverted by your employer towards medical coverage) means zero. If you make, for example, 1 million a year, and you spend 5% that's 50 grand. If you make $100,000, then you are spending 5K. It doesn't mean anything to the overall debate.

The numbers that matter are things like percentage of tax dollars plus money paid by individuals for private coverage plus dollars paid by employers towards health coverage. Or, numbers such as percentage of GDP.

The paucity of such figures from "your side" of the debate is astonishing, and perhaps, revealing.

What have Canadians produced? Two words:

Medicinal Marijuana.

Seriously though, I am with Ustwo on this one (a little shiver just went down my spine... I love you, Ustwo!).

I am walking away from this thread, as I have done all that I can to talk about this.

If you don't like our system, then vote against it when some nutjob tries to implement it in your region.

And to educate yourself further, I would recommend the collective works of "Barrer and Stoddart", two healthcare economists that objectively looked at the system.

Roy Romanow chaired a Royal Commission on canadian healthcare just a few years ago, and the report is free to download in .pdf format from the Government of Canada website.

If I was so inclined, I could cut-and-paste the whole damned thing here, but at over 200 pages long, it would get a little tiresome.

Kirby and Fyke had some good thoughts on their commissions, but it is a little bit dated. Oh well, if you are a fan of history, you could check those old guys out too.

Finally, talking shit about our healthcare system is a social faux pas. When asked "What makes you Canadian?" in a recent poll, National Healthcare ranked number 1.

Taking time to let that soak in; It is like I am burning the ol' Stars and Stripes while taking a shit in the Liberty Bell.

Here is a link to a summary of a recorded symposium, the participants all doctors think there are problems with waiting times and shortages of resources. In my opinion other than spending more money no solutions were presented. They can shuffle the folks on the list but waiting times will continue to get worse.

http://www.wcwl.org/media/pdf/librar..._papers.13.pdf

Let's be fair. I was not the first to bring up % of gross income being spent on health insurance, why didn't you make your points when it first came up? However, what is meaningful to my response to that point was not the % I pay but the implied challenge.

If a person paying 20% of their gross income on healthcare insurance actively researched and evaluated their options, they could easily lower that percent or their total out of pocket costs. To me, a real person, experiencing a real result is the best kind of "fact", don't you agree?

Just like I will ask you, since you are in Canada. How long have your wait time been? How long were they 5 years ago, 10 years ago?

Do you actually dispute that wait time are getting worse?

Perhaps I made a poor assumption, I initially did not think we needed facts to prove that the wait times in Canada were getting worse, and that being the reason for the increase of illegal private clinics in Canada.

...sigh...

Like calling Healthcare "Free" instead of "Universal", I must object to the use of the term "Illegal" when discussing private medical clinics.

You are allowed to open a private clinic in Canada. You must be a member of good standing in your area of specialty, and you must also provide competent care.

The confusion comes when it is time to pay the bills. The Canada Health Act forbids the use of Federal funds to pay for private clinics. What we have here is federal government matched funds, or in layman's terms, "50 cent dollars". When the bill comes to the public clinic, they only see half of the costs.

When the bill arrives for a private clinic, they see the true, unsubsidized cost. Private clinics cry foul, and say they are being penalized. In reality, they are not being compensated for following our rules.

If you are a public clinic, and you see 10,000 patients every year, and you charge a fee to one patient that contravenes the Canda Health Act, then you are at risk of losing half of the compensation for the 10,000 visits. Is this illegal? Technically, no. It is the old philosophy of "Carrot and the Stick". Play by the rules, and you have access to federal funds. Fuck around, and we cut you off, and you soon find out how expensive healthcare really is.

Please stop calling the private clinics "illegal".

Thank you Ben...

As for the wait times... I can give all the anecdotes you would like. I have never had a problem with wait times. Then again, I live in Toronto and have an adundance Hospitals and clinics to visit. Go to the north. This is not the case, especially where things like MRI machines are concerned. Then again, given the population, private clinics are less inclined to set up their either as they would see little return on their investment.

Most of the complaints on wait times that I hear about have to do with elective surgeries rather than emergency surgeries (i.e. life and death). Wealthy people like to go and spend the money in clinics in the US rather than wait a couple of months. I don't think monetarily challenged US citizens could afford to do this sort of thing either so I see it as a wash.

I can tell you that my father-in-law waited no more than a few weeks to have his heart valve replaced from diagnosis to replacement. I can tell you that when I showed up in emergency with my daughter, fresh from getting her head kicked by a horse, was seen in triage within five minutes of arrival (maybe less).

I have seen people showing up with flu symptoms wait for hours in the same emergency (my advice to them is suck it up or go to a clinic... what the fuck are you doing in Emerg with flu symptoms anyway?).

I've said it before. Our system, though flawed, provides service to 100% of our population for less than the US system that doesn't even provide the same level of service (i.e. millions go without coverage).

I have never bought into the belief that private can always do something better than public. All I have to do is look at the rolling blackouts of California (I'm talking about Enron and their ilk here). There are other examples.

The rolling blackouts were in large part caused by the government regulations. Utilities are VERY heavily regulated from the EPA to costs and are a very poor example to use as 'government' doing a better job than private.

But you are correct, Canadians spend less of their GDP on health care and it is 100% coverage. So its cheaper (perhaps you get what you pay for comes to mind here) and you spend less of a % of your national production on it, but you spend more per household via taxes to do it. Thats not win-win, thats lose lose.

It's really just a matter of how you look at it.

I don't have a problem with paying more in taxes to ensure that there is Universal Healthcare (amongst the other things we get for our taxes).

Some would rather see a system where everyone fends for themselves.

It's a good thing that I live in this country and you live in yours... this way we both get the system we like. No?

I don't think you gave a direct response to the concerns raised in the link, fact based stuff from experts, not my opinion.

Are wait times a problem?

Is that the reason for the increase in illegal clinics?

Are wait time getting worse or better?

I would assume better due to fed up people going to the illegal clinics :p

Are you guys saying this just to piss BigBen off? Seems to me he gave good reason to not use the term "illegal clinics" - namely that they're not illegal.

Thanks Uber... they aren't illegal. Get your head around the concept.

Are wait times getting worse? At this moment, reports say they are. One of the problems with wait times though is that there is no agreed upon way of keeping track of this data.

Different provinces track it differently.

That said, it seems to be a hot item with politicians of late so I would say that either a) the wait times are bad or b) the wait times are slow but people want them to be faster and policians smell a way to get votes

It's probably a bit of both. Again, from what I have read, the wait times are typically around elective surgeries (i.e. not life threatening).

One of the ways that has been suggested to solve the issue is to allow private clinics to open and dip into the public stream. There are examples where this has been done and works well.

Our system has it's flaws (what system doesn't?). It's just a matter of looking at what you are trying to accomplish and how you are going to acheive it. We want to offer Universal Healthcare.

You have pointed to some stats that show a number of people have died because of wait times. It's not the greatest news. I can reverse this, how many people die every year in the US because they cant' afford a proceedure? How many people let an illness slide because they can't afford to get it treated at the treatable stage?

I don't have those stats but I would like to see them.

I think that HSA's are one of the best ideas to come along in quite a while to help people deal with their medical costs and I signed up for one as soon as they became available. However I wonder if costs will really fall when trips to the doctors and hospitals decrease or if the cost per visit and hospital stay will just rise in order to maintain current income levels.
That is a good question. Many people from my father's generation worked for the same company for most of their lives (in his case Procter & Gamble) and were taken care of in exchange for their loyalty and dedication with great benefits. The trend today seems to be for most employers to pick up less and less of these costs and to layoff far more frequently. As people pick up more of the costs for medical benefits, the more there will be the perception that something has to be done to subsidize them.

I was the first to reply to this thread. In that post, I asked the same questions as you just did, Charlatan. That data request had been ignored this entire time indicating to me this is a "discussion" only in the sense that the thread starter and a number of people responding are interested in espousing their ideals regarding private vs. public sector services. and only that.

It was not my intent to compare Canada's healthcare to the US. The point in the original article posted is that "illegal", according to the NY times, clinics are being established to address wait times. In my opinion that is an indicator that the system will eventually fail. Experts further cite ethical and legal problems with wait times and a need to improve how limited resources are best allocated. In my opinion this is another indicator he system will eventually fail.

US heathcare has problems, in my opinion, for different reasons. One being the passive approch consumers take with healthcare and healthcare insurance. Another, as pointed out an in article linked above, are the large numbers of people who by choice opt out of purchasing healthcare insurance. In addition there are far too many capable of paying people who get virtually free healthcare.

The problem with health insurance.

Why is company-wide health insurance popular?

Because it is cheaper. For fundamental reasons.

Let's suppose we have health insurance that costs 1000$/year.

Bob, Alice and Charles are offered it.

Each has an expected amount/year they will spend on health.

Alice: 1000$/year
Bob: 500$/year
Charles: 1500$/year

So, Bob looks at the coverage, and says "this is a bad deal".

Alice and Charles say "sure, that sounds like a good deal".

Then the insurance company goes "gasp! Everyone who signed up is costing us more than 1000$/year. Our average costs are 1250$/year! Let's raise prices."

Alice hears about the price raise. "Naw, I only spend 1000$/year on health insurance", and drops the coverage.

Now only Charles is signed up for 1500$/year.

The insurance company goes "gasp! Our average costs are 1500$/year! We better raise prices."

This is known as the Lemon Effect -- only the people who the insurance company doesn't want to cover want the coverage.

Then again, the Insurance Company could magically learn what the expected price for each person is, and offer them coverage at the correct price.

This requires the Insurance company know everything about it's clients that the clients know about themselves. How much you smoke. Your family history. Your day-to-day habits. Eventually, your genetic markers and health predispositions.

They also need to be able to change their premiums at will -- or be able to cancel it whenever you have the option to cancel it.

Any asymetry between the information or options the insurance company has and what you have causes "lemon effects", the larger the gap the larger the effect.

By offering insurance to every employee of a company, insurance companies get a population that can be understood statistically. They only need to know as much about the entire company's workforce's health as the company knows about it's workforce's health. (well, not quite -- people can change jobs based off health benefits)

If you can push the insurance up to a national level, the lemon effect goes away entirely, other than people choosing to immigrate based off health concerns.

And that is why group health insurance can be cheaper than individual health insurance, why individual health insurance will never cover everyone, and why government health insurance can be useful.

In a previous thread there was a comparison of health insurance to auto insurance, fire insurance or workers' compensation insurance. Virtually every vehicle in this country has some form of insurance. Some would argue if it is affordable, but there is no question that the market is heathy and competetive.

In workers' compensation insurance virtually every worker has medical coverage for injuries on the job. Market conditions vary state to state, but generally most agree that the market is healthy and competetive. In some states fraud is a problem, but fraud has not hurt availability in most markets.

Virtually every building in this country is covered for fire insurance. The market is healthy and competetive.

The same could be true of health insurance. I don't know why we don't make health coverage a higher priority than auto insurance.

Seems like doctor shortage in Canada is reaching "crisis level".

http://www.angelfire.com/pa/sergeman...shortage2.html

Just to be fair here is a link the article is titled "What doctor Shortage", it appears there are lots of foriegn trained doctors working low wage jobs who can not get licensed, but the article still acknowledges a shortage.

http://www.caribbeanmedicine.com/article26.htm

O.k. defenders of the Canadian run system how about some facts to support the system has long-term viability. If Canadian trained doctors on a net basis are leaving the country, how are they going to fix that?

I have neither the time or patience to "debate" (read argue to a brick wall) about this any further.

This defender of Canadian Healthcare has officially left the building.

I have a plethora of information to disseminate, and the employability of IMG's is a hot issue, that is correct. Not here, not in this forum.

Go read the Romanow Report. Go on... I dare you. Cover to cover. Every line.

Ask yourself why these docs aren't working in the US. Then ask yourself if you want to be seen by Dr. Nick Riviera (Simpson's reference). That is why IMG's are driving fucking taxi cabs. They don't know how to read test results, let alone communicate effectively with patients.

...sigh...

Now call it free and illegal again, and I will be spending some of that healthcare money tonight. Checking myself into a fucking insane asylum.

Someone didn't read the article closely enough. Your article is not a reprint of the original article in the NYTimes, but rather a paraphrasing. The words "illegal" belong to Investors Business Daily. As host already pointed out, IBD paraphrased the article wrongly.

It would really help to foster debate if everyone read the posts they're replying to instead of making assumptions or operating off of falsehoods.

You've said this several times, but you haven't mentioned what your annual deductible is.

I would disagree with this. Workmen's comp in California tripled for some businesses within the last few years, causing some businesses to go under. The premiums for a roofer can equal 2/3 of the roofer's pay, not that I'm going to Google that to provide a link.

There is a great deal of fraud on both ends of it.

Good call, marv.
Of course, all the other examples in his post were inaccurate characterizations, as well.

I think most people reading those claims recognized them as bs supposition, however.
fact is, lots of people go uninsured, whether they be drivers or homeowners. I'm not sure where ace gets the notion that virtually every car and house is insured--that's simply not true.

I live in a state that requires liability insurance, yet when I worked for a minimum-wage employer with other minimum-wage employees, I knew plenty of folks who went without insurance. I would say about half of my crew (15 people) were without liability insurance yet still driving cars.

I see the article posted as propaganda - not good journalism. Shows more the degredation of the New York Times than it does the degredation of the Canadian health care system.

In any case, there are a lot of people against providing universal healthcare in the United States (not necessarily on this board or participating in this discussion) and I don't understand why. There are plenty of organizations that have opened free clinics, and people aren't protesting those... is it just because they want people to go without proper medical attention, or is it because they don't want tax payers footing the bill - or are they worried that their tax money will go towards the health care of illegal immigrants? Sounds like the latter from what I have heard around Southern California lately. Dunno... I would think something like that would be easily solved by stating that no illegals get care at government-run clinics, then require proof of citizenship at the door.

I wonder how long it will take for independent free clinics to provide universal health care.

I could only offer anecdotal information on wait times, beyond reading a report recently that had wait times in Ontario decreasing last year.

Personally, I've never had a problem - when my wife gave birth the only waiting was for labour to begin, y'know?

The facts as I know them are:

A) Canadians spend less on healthcare than Americans overall.
B) Canadian children are less likely to die than American children, at birth and during childhood..
C) Canadians live longer than Americans.
D) The US is the only "first world" country to not have universal healthcare.

Like I said, the Canadian system is not perfect, but if had to choose between the two systems, I'd choose the Canadian/European option every day.

:lol: Perhaps literacy in the US is in decline, eh, my hoser comrade?

At any rate, I hear you about foreign docs. I have two anecdotal examples to share. My wife is friends with a lady doc from the US, an Ob-Gyn - unlike a doc from say, Egypt, she only has to pass an exam to practice solo (she can practice supervised in a hospital setting until then, is my understanding).

She failed her first shot at the exam. I'm glad we have that safeguard in place. She'll probably pass next time, but until then she is unqualified.

In another instance, we took our daughter to a clinic (after hours) and there was an Israeli doctor there. English was obviously not his first language - he wrote down some information incorrectly and I had a hard time understanding him. Israel is a well educated country, I don't doubt their docs are well qualified - but language is a problem. I'd like to see all the non-English/French docs spend about a year doing nothing but learning the language.

Train more doctors?

Reduce 'free' money given to Doctor training, increase student loans for Doctors, and excuse large amounts of such loans for Doctors who stick around?

Import more Doctors from elsewhere?

Note that Canada is currently producing 88% of the increase in demand for Doctors. If this is accurate, then Canada's 15% lack-of-coverage will be going down over time to 12%.


In Canada, your annual deductable is 0$. If you want to compare US vs Canadian health insurace, you should compare them at the apple-to-apple level.

There are some uncovered things that you need to get private insurance for, or pay for out-of-pocket. Like ambulance rides (50$), parking (2$), and drugs (in my case, my company's drug plan is "fill out a form, and get your money back". Plus dental, glasses every 2 years, short term and long term disability... Sort of neat what happens when companies have to look for things to insure. =) )

I'm familiar with Oregon. The problem of uninsured became so bad that there are now laws that the police will confiscate your vehicle until proof of insurance is presented. Some people just flat out lose their cars and go buy another cheap used car after they consider insurance, the ticket, and impound fees.

california also requires liability. they weren't ever able to pass something as strict as oregon's laws on how to enforce it, but many carriers won't insure you if you refuse uninsured motorist. these are two examples of how both the governmen and the private sector responded to the reality that many people refuse or are unable to secure insurance.

I live in California also. Work Comp. (W/C) premiums at one point were artificially high, then after some deregulation became artificailly low although losses and fraud did not decrease. During the time of initial deregulation, many W/C insurance companies priced policies artificially low to gain market share in hopes of high investment returns and the ability to raise rates befor losses caught up. It did not work. Many W/C insurance companies left the market, a few went under, and there was consolidation. Premiums went up dramatically. The biggest premium increases occured in those industries with the worst results, like roofing. The way the market responded was with increased loss control activity under the high premium enviroment. True, some companies with high frequency and severity of injuries to their workers went out of business, but those companies that operated safer grew. It is kind of like natural selection. It was a net good thing.

My point is that free markets will respond to problems if given a chance. Centralized controlled market don't seem to have this same ability.

It seems no one agrees that wait times in Canada are poor and are getting worse, that there is a doctor shortage that is getting worse, and that the increase in "private clinics" (legal or not) are attempting to address problems. On the otherhand I have admitted we have problems in the US with healthcare. But according to Big Ben I am a "brickwall", been called worse, but my mom still loves me. :icare:

http://select.nytimes.com/gst/abstra...AB0894DE404482

http://www.nytimes.com/2006/02/28/in...=1&oref=slogin

Just for the record I went to the NY Times website and did a search, for anyone interested.

How did you enjoy reading the Romanow Report?

Are there certain parts you would like me to clarify?

What was your favorite part?

What part do you think the US could easily adopt?

What surprised you the most?

What surprised you the least?


HERE IS THE LINK. I INIVTE EVERYONE TO READ IT.

The dog ate my homework professor Ben... I promise to read it this week.

I have not finished reading but so far my favorite part is in the Exec Summary:
It seem an acknowledgement that something dramatic needs to be done to fix the system. Do you agree?

AceV... it simply acknowledges what we have been hearing. It says nothing to the veracity of the statements.

The report is an attempt to understand what the truth of the matter is...

I could not disagree more. Keep reading. It is his way of starting the discussion by saying that people who "Fear Monger" have no idea what they are talking about. Romanow has some dramatic ideas, but he does not say that dramatic changes need to take place.

I read the preamble to the report and skimmed here and there.

It seems to be more of a pep talk and what can be done to make a national system work, not a 'should we have a national system'.

The outcome was predetermined.

Quite frankly I don't care what system you guys have up there, I just want to make sure it stays up there.

You are probably right Ustwo. The outcome of "we will continue to have Universal Healthcare" is predetermined.

We will never go back to an "everyone for themselves" system. The point of the report is to adress the issues within the existing system and look at how we might solve them. Trashing the system entirely would not be an option.

I predict that we will ultimately swing more towards a European model.

When the underlying theme is 'it will work if we all work hard enough to make it work' its nothing more than propaganda :)

Good luck with that eruopean model.

Hey, I know we will prevail, now that we have Ustwo's luck on our side.

Perhaps... time will tell.

I wish America all the best with Lassier-fair medicine. :thumbsup:

I suppose it is one way to thin the herd, so to speak.

I don't think we are thinning the herd from lack of medical care so much but quite a few are probably financially wiped out from hospital bills.

flstf... it's either they can't afford it so they don't go until it's too late or they do go and then are bankrupt due to the expense.

So, yes, I agree.

You know more about it than I do. I did, however, read an article in the newspaper about the owner of a janitorial service with gross receipts of $30 million, who was trying to sell the business because the WC increases had caused him to be operating at a loss.

And I agree with your last paragraph.

And I love your mom! :icare: :lol:

You would be very hard pressed to convince too many Canadians we would be better off with a US styled health care system.

I read the article, the guy obviously has an agenda, most of it is tripe, but I will comment on this.

Cancer victims fare no better. The average patient has to wait 5 1/2 weeks from the time he's referred by his family doctor to the time he's treated by an oncologist. Enough time, in other words, to die from the fright of having a serious disease go untreated.

My father had lung cancer.

Long story short, he went to the hospital when the pain became too much for him to handle.

It was a Sunday in October I remember.

They admitted him that day. (Juravinski Cancer Centre / Henderson Hospital in Hamilton)

He was under the care of an oncologist the next day and started radiation treatments the following week once they had put him through every battery of test imaginable to mankind.

Once that was over, they started Chemo on him.

They got about half way through that when they gave up because it was clear that he wasn't strong enough to continue and they were only doing him a disservice.

All in all, he received every possible treatment in a timely fashion that I or anyone else would think of.

He had a battery of doctors, professionals, nurses helping him the best they could.

I could not find fault.

He died 6 months later. The fact that he died had nothing to do with the health care that he received.

The bottom line with those BS American articles that you dig up is that the idea of Universal Health Care has a lot of Americans who profit from the industry scared. They will do or say anything to protect the goose that laid the golden egg.

Is the Canadian Health Care system perfect?

No, it is not.

Is the American Health Care System perfect - Ask the 40 some odd million people who have no health care, or those who have so many holes in their coverage, they might as well have none.

Would I want American styled Health Care?

Never.

I would prefer just to improve our system thanks.

But, I would never presume to tell you what to do with your life.

Actualy, Americans pay more in taxes towards their inept government run medicare and medicaid per Capita than Canadians pay for full coverage.

If you look at my T4 from last year, in combined Federal, Provincial Income taxes, plus CPP (Canada Pension Plan) and EI (Unemployment Insurance) the total deductions from my gross pay as a percentage is 30%.

I can live with that.

I work for a corporation of 1,000 professionals in Canada (Engineering Firm). We are part of an international firm of 20,000 professionals.

Obviously, primary health care is covered by the gov't. with the Canadian office.

However, dental and prescription medication is covered by our "benefits" package.

I have one word to describe our private sector benefits package (from Sun Life, previously Green Shield)

TERRIBLE.

It is bare bones. Skeletal in fact.

There are more things not covered than are covered.

Example, about 1.5 years ago, my tooth cracked (long sad story). The dentist initially prescribed some antibiotics.

The cost was around 50 bucks.

Our "plan" covered 8 dollars worth. I had to pay the rest.

The tooth ended up having to be pulled.

The cost of the implant was $1,800.00.

Our "plan" paid zero. That's right, goose egg. Why? (I asked believe me.) Well, I was told that a molar implant was considered "cosmetic"

"You have to be fucking kidding me" was my response. I was then told that Sun Life / Green Shield has many different benefits packages available, some of which cover dental implants, just my employer chose "this package" and well, it doesn't cover dental implants.

The crown for the implant (getting done right now) is about $2,000.00 (I get it next Friday) Can't wait to see how much of that is covered. My guess will be another doughnut.

Bottom line, my company is a large Engineering firm in Toronto. They are as cheap as they come. They make good profits, we have a solid business going, but they'd sooner eat glass than give me any kind of real coverage. (But they tell me all the time that I should be happy because "It's your plan your way")

Anyhoo, I hardly trust the characters that I work for to implement ANY kind of Primary medical insurance coverage. If I ended up needing brain surgery, they would tell me it was "cosmetic" because after all, it was on my head.

One final thought.

There has not been an American president to date with the balls to implement any kind of Universal Health Care plan for its citizens.

Clinton made some weak noise about it for about a day or two and never really saw it through (other than putting Hillary in charge).

Change takes courage, and Americans and American politicians seem to abhor change.

When I see this kind of behavior, I can't help but marvel at what kind of courage Tommy Douglas (Keifer Sutherland's Grandfather by the way) had way back when.

We know the healthcare system in the US is screwed up.

Questions about Canada's healthcare:

Is everyone treated equal in your system? Is a convicted felon on the same footing as 12 year old child? If they both need a kidney who gets it first? Who decides those kinds of questions? Who decides when the cost of keeping a person alive on life support is greater than the benefit?

Is preventative healthcare important? What kind of treatment could a drug addict get to break the habit? Alcoholic? Over-eater? How do you decide that somthing is "necessary" vs "elective"? Can I get state of the art contacts, laser eye surgery, or do I have to get lod fashion glasses?

Do you like "big brother" making these decisions?

And what % of that goes to medical coverage?

Why not post your answers to all of the questions in your post. Tell us what your insurance coverage provisions and payment limits are, and the total annual cost of your medical/eye care insurance coverage....and who decides the order of priority if you should be put on a list of patients who are awaiting a kidney transplant.

We'll use your answers about your own situation to compare with the answers from a Canadian. Maybe comparing the terms and coverage of an insured American with those of every Canadian, will help us sort out what 40 million uninsured Americans and all Canadians are missing out on,
in the world of private medical insurance coverage of the Americans who are fortunate enough to "enjoy" it.

I have no idea.

But, the whole enchalada comes out of there, and we have been running budget surpluses for about 10 years straight now and paying down the debt.

Once the debt is gone, they will have a lot more money for Health Care.

I await the well considered "only socialist nations pay down the national debt" response.

:lol:

Count down... 10, 9, 8, 7...

Followed quickly by the old, "we pay for your national defense" response.

I don't understand what you want. The general consensus is that the Canadian Healthcare system is better than what we have in the US. Many people here would like to adopt the Canadian plan. I want to understand it. I am not very interested in comparing it to a broken system in the US, that seems pointless.

My gut tells me that we would be better to move in the direction of requiring every able American to "purchase" healthcare. I think it is a joke that we make sure that virtually every automobile and every building is insured but not every human life. Think about it some more and you find that in most states a guy who rides a motorcyle is force to wear a helmet, because of 'costs to society if he gets hurt', but he doesn't have to have health insurance using the same logic. :confused:

I would agree if I thought that putting our medical care in the hands of insurance executives instead of our government would result in better, less expensive care. Maybe it would, but I have some doubts that they would have our best interests in mind or be able to control hospital costs.

As I understand it today they get hospitals, etc.. to agree to an amount for certain procedures for those who carry their insurance and the hospitals sometimes charge the uninsured 2 or 3 times that amount. I don't know how well it would work if insurance executives had everyone covered.

An observation of the future? You say 'will do'. Is that an indication that currently the opposite is the case?

Canada is a very small country vs. the United States. I would expect its contribution to the science to be proportional. Do you have any numbers to back up your claim that they are not 'doing their share' on the research side of things? Or is this just inflammatory material.

Europe, and France in particular, have made major contributions which would mean even if Canada is slouching, the fact they have public health care isn't necessarily to blame.

Well, I disagree with helmet laws, so my proposal would be their elimination. Your automobile doesn't need to have insurance, you only need insurance against the damage your automobile may do to others. I don't know what the insurance laws for buildings are where you live, but my understanding (please correct me if not the case) is that buildings only need to be insured for the same reason, that is to cover damages that may be caused to inhabitants other than the owner. If you buy a house you have to insure it so the mortgage company is protected, but if you own it outright, I don't think such insurance is mandated, at least not that I'm aware of (not in that situation myself, so I could be wrong). Certainly, though, I would argue that such insurance should not be mandatory if the only risk is to your own well-being.

My fault for confusing the issue. My main point with those examples - we have able working men in the US who will insure a $30,000 car before they will insure their children. Yet, we complain about the uninsured in this country.

Currently in the US we have a hybrid system. Large percentages receive healthcare coverage from government, some through corporate employers and others with no insurance who rely on emergency room care. I think a true competetive private market with active consumers will do a better job than a centralized "one-size fits all" system. My bias is always with having a choice.



I admit to not having numbers on the amount of R&D done by Canadian drug companies. My concern, however is with the US. If we pass national healthcare, and that causes taxation at such high levels that it stops R&D - I think that is bad - it has to be factored into the real costs of such a plan.

So my question about Canada and its R&D activity has to do with how has taxation to pay for national healthcare affected investments in R&D. I don't have the answer, but it doesn't seem like you have the answer either.

It doesn't seem like anyone has any answers other than to say healthcare in Canada is better than in the US. O.k. I guess that settles it. Thanks

Research into pharmaceuticals is not directly related to Universal Health Care as I see it.

Maybe I am wrong.

On one hand, you have the big pharmaceutical companies who carry out research in the name of making a buck should they develop a drug that actually works (without causing you to die as a side effect of something completely different).

On the other, you have a government run health insurance plan where everyone is insured, and "making a profit" out of sickness is eliminated from the equation.

Canada has plenty of research going on right now in disease treatment I can assure you.

It used to be that a great deal of research was carried out by government institutions, universities, etc. Now, more and more, if not exclusively, drug research is done by the big pharmaceutical companies. The catch word of the day is "public private partnerships" which basically means that the tax payer pays and the pharma companies do the work and of course, keep all the profit.

Back 50 years ago, the result of government research was vaccinations for polio, scarlette feaver, TB, small pox, etc. Antibiotics were discovered in British government run facilities.

Now, I can't think of too many big discoveries that have been revealed to the world since everything went private.

Being the conspiracy theorist that I am, I figure that the pharma companies don't want to CURE anything. They just want to come up with a "treatement"

They would rather have you swallow a beaker full of pills to alieviate the symptoms of AIDS rather than cure it or vaccinate against it.

I hardly believe in the nobility of the Big Corporations, sorry. Probably due to my exposure to big corporations.

I have no problem with companies making a buck, but I see how they go about doing it on a daily basis and it is hardly noble.

In the best enviroment for healthcare don't you agree that you would have investment in research and development in prevention and in order to bring down longterm costs? I think R&D and good healthcare are closely related.

Also, think about laser eye surgery. In the US this proceedure was pretty much not covered by insurance. However, there was a market for it and the private sector responded. Proceedures improved and costs came down. This would not have happened accept for active participation by consumers. If left up to insurance companies they would not have covered it, if left up to government they would have not provided coverage. However the private market had an opportunity to rspond.

Laser eye surgery is not covered by Universal Healthcare in Canada. It is a private market procedure.

Public spending being around 1/3 of the total roughly based on the last numbers I saw, the other 2/3 being private healthcare spending.

A good universal healthcare system is not a 'one-size fits all' system. There is no reason to limit consumer choice.

A couple of assumptions that aren't necessarily valid. I mean it is true, it could be done that way--I don't think anyone would deny there are many ways to do universal coverage poorly. But it is certainly dependent on how the system is set up, and how the tax code is amended to pay for it. It is very certainly possible to do it in a way that companies in fact see a reduction in cost with the increase in taxes more than compensated for by the elimination of the health care benefit premiums they are paying now.

Right now, as a country, the US pays $5,274 per capita for a system that close to 40% of the people don't have adequate access to, while most other developed nations pay $2,000 to $3,000. The US number is 10.0% of the GNP, and out of 21 other major developed nations, only Germany (10.9%) and Switzerland (11.2%) pay more. Most are closer to 9%. France has a very comparable system, at $2,736 per capita costs (9.7% of GDP) and a quality of care comparable to that most covered Americans recieve, but which covers all French. Each system has its unique situation, but it is clearly a mistake to assume that to transition to a universal care system from our current system would automatically entail a rise in costs and/or a reduction in quality.

No, I don't have the numbers either, and I'm not even saying you're wrong, just that I wouldn't presume Canada (or anyone for that matter) to be slouching in R&D without having some stark data first.

Canada may or may not be better than the US in healthcare provision, but I don't think the right approach is to say Canada is better, let's go with it. Even if Canada's system is doing better for them than our system is for us, it doesn't mean their system will work for us. What we can do however, is to look at their system, at what it does well and where it fails, and take those lessons into our approach as we develop a better system here in the States.