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Old 06-15-2003, 05:57 PM   #1 (permalink)
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Location: The Kitchen
Canadians : Two-tier health care?

I was wondering what other Canadian TFPers thought about a two tier health care system. I've been thinking about this recently as I've been unable to work due to a hernia. From what I understand, the surgery is quite simple and I could be in and out of a private clinic in a day. As opposed to a ten week wait under our current system. I've also been reading about a sharp increase in Canadians going across the border to have medical procedures done far more quickly and competently than they could be done here, along with countless stories about how all of our best doctors are moving south.

I did a bit of research and found I could get hernia surgery in the states for about $3500-$4000. Over the course of the ten weeks I'll be waiting for and recovering from the surgery here, I'll have lost about the same amount of money in lost wages, and I'm by no means a rich man.

So my questions are, what do people here think about our health care system as it is? What sort of suggestions have been made regarding a two-tier system? Would a two tier system help keep doctors in Canada?
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Old 06-16-2003, 06:42 AM   #2 (permalink)
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I'm all for private health clinics offering such services as MRI's, X-Rays, treatments, and hell, even some surgeries as long as they are of the same quality (or better) than our health care system is able to provide.

For each person that pays to go to a private clinic, they are opening up a slot for a 'free user' at a public clinic.
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Old 06-16-2003, 11:02 PM   #3 (permalink)
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Location: Yesterday i woke up stuck in hollywood
I agree with Daval for the small stuff, the things that we have huge waiting lists for, but i think the option should always be there for free health care, so sort of a one and a half tier health care system
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Old 06-18-2003, 09:27 AM   #4 (permalink)
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Here a intresting example about your health care
<a target=new href="http://www.jewishworldreview.com/michelle/malkin060500.asp">Tom Green's hidden health-care lesson -Michelle Malkin - Linky</a>

"Green's mom scoured the Internet for the best American specialists money could buy when her son developed painful symptoms in January. Her search led to the USC Medical Center. Green was diagnosed there with testicular cancer in early March. Four days after receiving the diagnosis, top-notch surgeons removed his tumorous right testicle. One week later, after a CAT scan of his lymph nodes showed no signs of cancerous cells, Green's doctors went ahead and dissected his lymph nodes -- just to make sure the disease hadn't spread."

"In Tom Green's home province of Ontario, the Canadian Medical Association Journal recently reported, 121 residents were permanently removed from the list for coronary artery bypass grafts because their condition had deteriorated irreversibly while waiting for treatment. Koreans and Czechs have better access to computerized tomography than Canadians do."

"Under the Canadian regime, bureaucrats -- not doctors, patients or hospitals -- set fees, make purchases, and allocate resources. Politics inevitably infect these decisions, overriding the best interests of the sick and needy.

The deadly effect of government-controlled health care is no joke. Tom Green is living proof that the free market offers the best medicine."




Personal note: A friend of mine, in Winnipeg, was on a waiting 2 week list to see a doctor about cold symptoms. What if she had SARS, she could have spread it to many more before she could have been treated.

I don't really know much about your <i>"free"</i>health care system, but I don't want a version of the DMV making health choices for me. Government can fuck up anything.
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Old 06-18-2003, 10:33 AM   #5 (permalink)
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Location: Right here
That's interesting, Mr. Mojo since we rely on government for all of our critical needs.

Mail a letter recently? Attend a university? Participate/endorse a military action? Government itself? Mass transit, anyone?

The list is pretty extensive of the things government doesn't fuck up--and actually does quite well.

Of course, I hope we all are aware of the equally long list of corporate misconduct perpetrated by the private industries.

Any family that was "saved" by our medical system should only rightly be constrasted against the family that was "saved" by Canada's system--in short, no money no treatment, regardless.
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Old 06-18-2003, 03:21 PM   #6 (permalink)
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Location: Where hockey pucks run rampant
Just an interesting aside story. My Dad has hearing problems and has had surgery done on both ear drums (they remove the drum, replace the majority of the bone with a metal wire, and the bone grows back over it--a new ear drum of sorts). He goes to a specialists, Dr. Yee, in London, Ontario. Dr. Yee told him this encounter.

A woman came to him who needed ear surgery. He told her when it would be done, where, etc. She had heard about a specialist out of New York state who was quite famous for his ear surgery. She asked Dr. Yee what his opinion was. He said the service here was comparable and on par at least. She had her doubts and decided to head State side. It was gonna cost her $8000 U.S. (the Canadians will appreciate the dollar conversion ). She goes down, gets to the hospital, and waits to meet the specialist.

In walks Dr. Yee.


So not only was she paying her taxes, she payed New York State for their medical services.


Personally, I've never had a problem with our medicare. The nurses for the ederly would always drive out to my grandparents place to treat them, I've always got into the ER for any of my escapades, and surgery has always been in a decent enough time for our family.

I think there should be the possiblity of a private system to keep competition up and the public version from getting too cocky. Right now, however, I'm satisfied with our universal health care. I'd hate it to be a situation where the insurance building beside the hospital is just as big a building. When I need medical help, I don't want to have to haggle with my insurance broker about whether I deserve the treatment or not. Just stitch me up and I'll be on my way, thanks
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Last edited by duckduck; 06-18-2003 at 03:24 PM..
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Old 06-18-2003, 04:36 PM   #7 (permalink)
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That's interesting duckduck.

Our Congress is debating over privatization of our medicaid (actually, I can't remember if it's medicaid or medicare or both) program. The resolution claims that premiums would only be $35.

Right now an amendment just failed to guarantee medicaid as an option for seniors. Democrats had argued that if the market can do better for less money, then fine. But there should be a government baseline--something people could help to compare as well as something to fall back on, at a minimum.

It seems like your country could become poised to be in reverse of our situation. You already agree to the importance and humanity of providing for the health of a society's infirmed. The problem we have is that we don't yet agree that a society has a responsibility to those who can't help themselves.

Now, it doesn't seem such a huge prospect to allow private industry to compete against the the government system in place. But for us, changing our worldview on individual responsibility is a major paradigm shift--we already had one in the opposite direction during the 50s, and others before that.

I think competition and growth can be stimulated and maintained in an environment that consists of a guaranteed minimum of needs to all citizens as well as private industry competing to give those services better, less expensively, or both.

What do you think? Do you think that system would work (and political viable in your country)?
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Old 06-18-2003, 05:32 PM   #8 (permalink)
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I would never trade in a Canadian style health care system for one run by the private sector. I truly believe the gov't does a far better job of running health care than any private insurer.

I think you would be hard pressed to find too many Canadians who would choose to abandon OHIP in favour of an American style system (we had it a long time ago and we got rid of it. In fact every other industrialized country in the world has a health care system in place, except the US.)

No system is perfect, but for the most part, i am happy with the system that we have. It could always use a tune up, but it is a long way from broke.

I am sure that if i was feeling really ambitious right now, i could dig up a dozen websites that talk about the benefits of our system. I just think that it's pretty good.
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Old 06-18-2003, 06:11 PM   #9 (permalink)
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I like our system of health care for everyone, but we already have private business dealing with many medical procedures. It always irks me when people jump up and down and say we don't want an American style system as soon as someone mentions change.
I agree we don't want an American style system, but there are many different styles of medical systems in the world. Maybe we should look at the British, French or the Swedish systems instead. Let's look outside the box.
It's funny that the only countries in the world that ban private heath care are North Korea, Cuba and Canada and there isn't a country interested in adopting our system.

Here's an article
http://report.ca/archive/report/2002...0i020415f.html
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Old 06-18-2003, 06:25 PM   #10 (permalink)
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Location: The Kitchen
I'm not talking about completely abandoning our health care, I'm talking about keeping our free (slow) system, but adding the option to pay a private business (a lot of money) to care for you immedietely, hence the term "two-tier".
This might sound a bit plutocratic, but if I can afford to pay someone to cut me open and fix me up, why do I have to wait in line with everybody else when I could be in and out of a private clinic in less than a day?
I would never trade our current health care system for a U.S. style one, but with more and more doctors leaving our country because there's no money in public health care, things won't get better anytime soon.


btw... excellent article splck.

Last edited by rockzilla; 06-18-2003 at 06:36 PM..
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Old 06-18-2003, 06:41 PM   #11 (permalink)
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Location: Lowerainland BC
Quote:
Originally posted by rockzilla

This might sound a bit plutocratic, but if I can afford to pay someone to cut me open and fix me up, why do I have to wait in line with everybody else when I could be in and out of a private clinic in less than a day?
You could always drive down to the states and get the procedure done down there.
Seems weird that you can buy almost anything you desire, but if you want to pay to get a bone chip out of your knee, you're not allowed and you'll have to wait upwards of a year.
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Old 06-18-2003, 06:42 PM   #12 (permalink)
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Quote:
Originally posted by james t kirk
I It could always use a tune up, but it is a long way from broke.

I'm not so sure about that.When my mother was ill with cancer I would have to say the system failed her.She waited several months and three cancellations for an operation for pancreatic cancer until they told her it almost was to late.Anyone who knows anything about pancreatic cancer knows what I mean.It tends to spread very quickly.

Finally and literally at the 11th hour she got her surgery.Her surgeon,one of the best in the city told us he got all the cancer.Her radiologist said he would schedule her for radiation and that her prognosis was excellant.He told her that she had a 4-6 week window of opportunity to begin radiation for the best chance to beat the cancer.She began her radiation 6 months to the day after he said that.He said the window of opportunity had closed by 4 months but would still go ahead with it.My mother lived 4 more months.

This isn't a once in a while thing that happens.It happens everyday to someone else and everybody throws up their arms and say, our hands are tied.Funny how a former mayor of the city I live in as well as a member of parliament get diagnosed with cancer and get fast tracked but normal people who have paid into the system their whole lives tend to get screwed.

There already is a two tier system in place.One for people of influence,the other for everyone else.Why do you think politicians are against a two tier system? Because the only difference would be that when they get fast tracked,they would have to pay for it.Why would they pay for something when they can jump to the front of the line when it is already available for free?
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Old 06-18-2003, 10:02 PM   #13 (permalink)
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Location: Right here
Quote:
Originally posted by splck
You could always drive down to the states and get the procedure done down there.
Seems weird that you can buy almost anything you desire, but if you want to pay to get a bone chip out of your knee, you're not allowed and you'll have to wait upwards of a year.
Unless we adopt a system similar to yours.

So your system doesn't even allow private competition? That's very interesting--I don't have very much experience with different country's health care systems.

Do you feel as though your health care research is stagnant? Or are your medical techniques as advanced as ours--that is, do we only have more specialists because of the money or also due to technological sophistication?
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Old 06-23-2003, 12:08 AM   #14 (permalink)
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Location: Vancouver, Canada
Smooth - Canada does have two tier system now. In Vancouver you can get an MRI scan done quick if you have the cash, or you can wait. While some R and D is slow, some is blindingly fast because the money is there and we don't have to hunt for private corps to back us. (Take SARS - we were first to map the genetic code of the virus here in BC.)

There are good points and bad to both sides of the border; one thing though about Canada - they can't kick you out of emergency if you can't pay.
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Old 06-23-2003, 06:00 AM   #15 (permalink)
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Location: Lowerainland BC
Quote:
Originally posted by The Bolshevist
Smooth - Canada does have two tier system now. In Vancouver you can get an MRI scan done quick if you have the cash, or you can wait.
My understanding is that this is true if you just want to have an MRI (your own decision), but not if your Dr orders it. If you're Dr tells you that you must have an MRI, you have to wait just like everyone else, private clinic or not (sounds crazy to me). I agree that Canada has a two-tier system already. If you have a workers comp claim you can get one very fast because it's not part of the Med system.
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Old 06-23-2003, 09:26 AM   #16 (permalink)
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Splck - perhaps in other parts of Canada you have to wait, but at least in Vancouver, two tier is so entrenched that private services are considered nearly normal and the gov't turns a blind eye.
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Old 06-23-2003, 11:01 AM   #17 (permalink)
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Location: Lowerainland BC
Quote:
Originally posted by The Bolshevist
Splck - perhaps in other parts of Canada you have to wait, but at least in Vancouver, two tier is so entrenched that private services are considered nearly normal and the gov't turns a blind eye.
I'm in Vancouver too, just so you know. As for the MRI's, I was going on just what I read in the papers a few months ago, so I may be mistaken.

Have a good one neighbor.
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Old 06-23-2003, 05:50 PM   #18 (permalink)
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The Bolshevist, splck,

Mt brother andsister both live in B.C. For years they have been trying to get me to move out. Love the province! But I was confused as to the particulars as to how the B.C health care system works. In Ontario, the employer pays for OHIP. In B.C, you guys get a bill for your health care. How does this figure into the thread discussion? Can you pay a higher premium and receive better service? If you can, would this not be a two-tier system?
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Old 06-25-2003, 09:20 AM   #19 (permalink)
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Location: Toronto
Quote:
Originally posted by gibber71
I'm not so sure about that.When my mother was ill with cancer I would have to say the system failed her.She waited several months and three cancellations for an operation for pancreatic cancer until they told her it almost was to late.Anyone who knows anything about pancreatic cancer knows what I mean.It tends to spread very quickly.

Finally and literally at the 11th hour she got her surgery.Her surgeon,one of the best in the city told us he got all the cancer.Her radiologist said he would schedule her for radiation and that her prognosis was excellant.He told her that she had a 4-6 week window of opportunity to begin radiation for the best chance to beat the cancer.She began her radiation 6 months to the day after he said that.He said the window of opportunity had closed by 4 months but would still go ahead with it.My mother lived 4 more months.

Friend,

first, i am very sorry for the loss of your mother because my mother also died of Pancreatic cancer. It was fucking unreal and not a day goes by that I don't think about her.

But,

From what i learned about Pancreatic cancer, and I learned alot believe me, it's fatal 99.9% of the time regardless of treatment. By the time any symptoms are discovered, it's over.

My mom was given 3 months to live by the doctors, i remember thinking that they were on glue, that cancer took years sometimes, or that there was something that could be done, something that could be tried.

The honest truth was that there was nothing that could be done. She spent her last few weeks at home with us.
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Old 06-25-2003, 10:11 AM   #20 (permalink)
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Location: The True North Strong and Free!
don't get me wrong. The health care in Canada is very good. Its just that the waiting times for some tests/scans/treatments can be a little excessive, hence private companies can compliment the basic healthcare.

I would never, ever, want to revert to a US based system. *shudder*
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Old 06-29-2003, 10:07 PM   #21 (permalink)
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Location: with the dust bunnies
speaking for the east coast:
basically, our biggest problem with the medical system is that there are too few doctors.
apparently, in my province, roughly 75% of the population does not have a family doctor. waiting lists for family doctors are years long. now that is an unsubstantiated quote. i have no statistics to support that, but personal knowledge. i personally have not seen a doctor in seven years.
what this adds up to is overburdgeoned clinics and emergency rooms and overworked, underpaid nurses.
would a two-teir system help this situation?
most likely not. could it hurt? again, i don't see how.

lets try tackling this from a different angle:
how would you propose to FIX our broken system, and make it work again?
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Old 06-30-2003, 04:16 AM   #22 (permalink)
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Location: Toronto
Quote:
Originally posted by monody
speaking for the east coast:
basically, our biggest problem with the medical system is that there are too few doctors.
apparently, in my province, roughly 75% of the population does not have a family doctor. waiting lists for family doctors are years long. now that is an unsubstantiated quote. i have no statistics to support that, but personal knowledge. i personally have not seen a doctor in seven years.
what this adds up to is overburdgeoned clinics and emergency rooms and overworked, underpaid nurses.
would a two-teir system help this situation?
most likely not. could it hurt? again, i don't see how.

lets try tackling this from a different angle:
how would you propose to FIX our broken system, and make it work again?
This problem you can lay squarely at the feet of the doctors.

It is not uncommon in all provinces that the small towns are without family doctors cause basically medical grads don't want to work there. (no offense to small town folks)

Ontario has recently offered some incentives in this area to foreign doctors stating that they can get their licenses in half the time if they agree to work in small communities. There are also incentive programs to medical students.

The other part of the problem is simply that we are not graduating enough doctors. They should DOUBLE the number of students taken into medical school with the proviso that they must work 5 years in a small community.

But the OMA (Ontario Medical Association) will not permit them to increase the number of graduating medical students because this will increase the number of doctors on the market. Doctors like to think of themselves as gods and if it is demonstrated that more people can easily pass medical school, you errode their (the doctor's) position in god-dom.

The requirements to get into medical school are rediculous. There are lots of qualified people who get rejected because they don't have a 95% average out of a science background. The truth of the matter is that you do need brains to be a GP, but you don't have to be Einstein.

It's politics when it comes to this issue.

Last edited by james t kirk; 06-30-2003 at 04:19 AM..
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Old 06-30-2003, 05:38 AM   #23 (permalink)
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Location: with the dust bunnies
might i just add:

i live in the provincial capital.
population of about 81 000.
there are 62 family physicians/general practioners listed in the phone book within an hours drive from here.

that means each doctor would have 1300 patients each, if we don't count people outside the city limits.

so lets not limit this to small towns.
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Old 06-30-2003, 12:05 PM   #24 (permalink)
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monody,

do you think that is a high ratio? I don't know what our ratio is down here but 1300 patients per doctor is only about 4 persons per day.
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Old 06-30-2003, 04:30 PM   #25 (permalink)
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One of the big reasons that Canadian and other socialist health care systems work as well as they do is that they benefit from the R&D done by capitalist health care systems. Basically, if the entire world converted to socialized medicine, medical progress would slow down dramatically, and people in need of major surgery would be in major trouble. Right now, Canada gets all of the benefits of a socialist program while, at the same time, knowing that they can cross the border if they need immediate, high quality, or unusual procedures.
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Old 06-30-2003, 04:42 PM   #26 (permalink)
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I don't care for our healthcare system myself. Nothing like paying some evil bastards x amount a month for them to decline payment when you need them most. Same with car insurance, THOSE FUCKERS PISS ME OFF.
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Old 06-30-2003, 06:46 PM   #27 (permalink)
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Location: Just SW of Nowhere!!! In the good old US of A
First let me say that I am opposed to anything socialized. There is a reason why the starter of this thread is considering coming south for surgery. He may be coming south to find a good Canadian doctor. I live in basically a rural area - we are at least an hour and a half from a semi-major medical center (by plane!) We have in the past had a difficult time getting doctors to come to our hospital - we now have seven. Of the seven doctors two are from Pakistan and the other five ... are Canadian. They come here for basically two reasons. Money. Work load. They are making a lot more money and seeing less that a third if the patients they were having to see in Canada. You may look at socialized medicine as an asset - perhaps the wait, lack of choice as to time or care is worth it to you. Me! I'll continue trying to pay for what I have.
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Old 07-01-2003, 09:42 AM   #28 (permalink)
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Location: Toronto
Quote:
Originally posted by db8r7
One of the big reasons that Canadian and other socialist health care systems work as well as they do is that they benefit from the R&D done by capitalist health care systems. Basically, if the entire world converted to socialized medicine, medical progress would slow down dramatically, and people in need of major surgery would be in major trouble. Right now, Canada gets all of the benefits of a socialist program while, at the same time, knowing that they can cross the border if they need immediate, high quality, or unusual procedures.

Mmm, not quite.

That's a tired old arguement put out by the health care lobby.

The bottom line is that of all the G-7 nations, only the US has no health care system in place.

Do you honestly think that medical research is not done in Canada, or Britain, or France, or Germany, or Italy, or Japan merely because we have a government run health insurance plan?

Be serious.

Americans tend to cite examples of a few Canadians who seek treatment in the US, or some doctors who practice medicine in the states as examples of how government run health care does not work.

Well, 99% of Canadians seek medical care in Canada, and we live longer than you, have a lower infant mortality rate, and are never without medical service.

Also, keep in mind there are many American doctors who practice medicine in Canada. It doesn't prove a thing.

I think the proof would be in talking to the average citizen in the street, and this one would not want a US styled health care system under any circumstances and probably 85% of Canadians out there would agree.

As to your last sentence, "high quality" health care. I think there are some very "high quality" medical facilities here. Typical american attitude that everywhere else in the world is second rate.

As far as "unusual procedures" go, most americans seem to fear the "unusual disease" will get them. In most cases it's going to be heart disease from eating like pigs, or lung cancer from smoking like a chimney that gets you. Very seldomly will the exotic disease get you. Most people only ever need basic health care

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Old 07-06-2003, 09:16 AM   #29 (permalink)
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Location: Montreal
The problem with our health care system is that money must be distributed as fairly as possible, which means that some institutions get the short end of the stick and have to close down ER wards or cut the amount of available beds. All this puts an unnecessary strain on staff, which results in medical professionals "defecting" elsewhere for a lower workload and an equal or (often) higher amount of money, as Liquor Dealer said.

While it pains me to see Canadian professionals leave the country for the promise of the almighty buck, it is a reality: people want the most money for the least amount of work.

However, having a two-tier medical system would create new problems. Sure, you could choose to go to private clinics for what ails you if you have the money, but medical staff would still flock to those institutions for the same reasons they would go to the States. Poorer people would still end up shafted by the system, even if private clinics would free up public hospitals, since the government would most likely cut funding, thinking that the people now have an alternative way to get medical treatment. If you think the government wouldn't cut those funds, you are one disillusioned person.

Basically, I support our current medical system, but then again I've never had to wait 6 months for a major operation. However, specials provisions should be created to keep doctors in Canada, while nurturing the private clinics on a smaller scale to maintain R&D, because (and let's not kid ourselves here) this is where research gets done the fastest; universities don't even come close.

Also, solid benefits and a better work environment for nurses would greatly help the situation, IMO. Nurses do the grunt work and sadly remain heavily underappreciated. I'm not surprised that Quebec has seen so many nurse strikes, since they're the ones who are most in contact with patients and administer the most common care (blood tests, samples, etc.).
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