HEALTH CARE - User fees

Quote: Originally Posted by TenPenny

I gather your doc doesn't pay rent, doesn't have any employees, has no examining tables, no office equipment, nothing.

That's pretty cool.

Quote: Originally Posted by SirJosephPorter

Quite so, 500 dollars a day may barely cover the expenses.

Quote: Originally Posted by JLM

Some measure life expectancy in terms of time others in terms of quality.

Quote: Originally Posted by taxslave

They already do. Since only some services are covered the rest you must pay for with cash.

Quote: Originally Posted by JLM

I don't ever remember stating that U.S. had lowest life expectancy.

Quote: Originally Posted by JLM

You also jump to the conclusion that the lower life expectancy (if in fact that isn't bullsh*t too) is attributable to the health care system.

Quote: Originally Posted by JLM

That is also bull****. That might be 5% of the reason, but there are literally dozens of other possible reasons for it, such as different safety standards in industry, (and the one you are fond of expounding, their rampant death penalty procedures which probably on it's own shortens the average by at least a month or two), warmer climate, which means susceptability to more disease, more interracial violence. etc.,etc.

Quote: Originally Posted by JLM

With our healthcare system being in a bad state of disarray to the point where people are waiting months for certain procedures and people in some areas are even finding it next to impossible to have their own family doctor, I think something fairly unorhtodox has to be done. I suggest that for each initial visit for an illness (people on social assistance being exempt) that the patient pays a $20 fee up front. What this might do is discourage people with trivial complaints like runny noses and hangnails from running to the doctor and running up costs the rest of us can't afford and adding to line ups in the system delaying sick people getting treatment. It might also stimulate some people to get off their rear end and take care of their own health, like maybe getting a little exercise. What do you think?

Quote: Originally Posted by eh1eh

JLM.

Yankee Go Home!

Quote: Originally Posted by SirJosephPorter

Quoting TenPenny
What a pain that would be for the doctor involved, to be charging and keeping track, they'd probably have to start taking debit and credit cards...



No they don’t. Only a few services such as sick note are not covered by OHIP. Typically my wife may charge one or two patients a day for such services. And there it is simple. Either you pay cash up front (no credit cards) or you don’t get the sick not or whatever.

There is no problem in recovering the money. it is no different than buying a bag of apples or a loaf of bread.

But user fee for each and every service will be totally different thing. I think doctors would have a big problem refusing service to patients if they cannot pay. It is one thing to deny somebody sick note, something different altogether to withhold treatment from somebody.

Quote: Originally Posted by Machjo

Another option would be to go towards a more two-tier system. Granted we have a two-tier system already, but leaning much more towards a public one. Sweden has moved closer towards a more balanced two-tier system, as has Singapore, and a few other nations. Why could we not study their various systems and adopt a more balanced two-tier system of our own.

Quote: Originally Posted by L Gilbert

So who said anything about a user fee for each service a doc performs?
A simple user fee for each visit should be enough.

Quote: Originally Posted by SirJosephPorter

You didn’t state it JLM, I did. And it is a fact it is not hard to find, Google for it.

There may be other reasons for it, I think but health care is the primary reason why life expectancy in USA is so low and why infant mortality is so high.

Quote: Originally Posted by Machjo

So if you're looking for more moderate reform, I could go with that too as a step in the right direction, but again, instead of exempting those on social assistance from user fees,why not just give them more money but still not exempt them from user fees? That way they won't unduly burden the system either.

Quote: Originally Posted by SirJosephPorter

User fee is not happening Machjo, get over it. Not even Conservatives are advocating a user fee, and rightly too. It is only the rabid right (like Fraser Institute) which are pushing for user fees, and their ultimate aim is clear, to convert Canadian system into a carbon copy of American system. To them, it is indeed a step in the right direction, a step towards Americanization.

But user fees are not coming, because of all the problems I outlined associated with it. The cure here is worse than the disease.

Quote: Originally Posted by SirJosephPorter

I have no problem with a two tier system in theory; many countries do have that and are doing quite well. It depends upon what kind of system, what kind of involvement there will be by private sector etc. But principally I am not opposed to it.

User fees however, are nonsense. The cure here is much worse than the disease. Institute the user fees for a few years and our statistics will begin to resemble American statistics, low life expectancy (on account of people not going for preventive treatment), high infant mortality (on account of women not going for post natal care, saving the 20$), etc.

Quote: Originally Posted by Machjo

What does the US have to do with this. Whether the US system is totally private, totally public, two-tier or whatever should have no bearing on what kind of system Canada has. Let's say one day the US adopts the Canadian system, will we then demand that we go to the current US system just to be different?......

Quote: Originally Posted by L Gilbert

A lot of people cannot break out of the rut they are in concerning comparing Canada with the US. Sir Portly is only one of them. Not his fault.
Maybe he's right, though, and Canada doesn't have any merits of its own unless compared to the US, but I doubt it.

Quote: Originally Posted by YukonJack

User fees should be paid by EVERYONE. Even by people on social assistance. (Is that euphamism for welfare??). Smaller amount, of course, but no visit to a doctor should be totally free.

$5.00 for people working and $2.00 for those on welfare and pension would be about right.

Quote: Originally Posted by SirJosephPorter

User fee is not happening Machjo, get over it. Not even Conservatives are advocating a user fee, and rightly too. It is only the rabid right (like Fraser Institute) which are pushing for user fees, and their ultimate aim is clear, to convert Canadian system into a carbon copy of American system. To them, it is indeed a step in the right direction, a step towards Americanization.

But user fees are not coming, because of all the problems I outlined associated with it. The cure here is worse than the disease.

Quote: Originally Posted by Machjo

If you want to argue against user fees (and you did present an argument worth considering earlier about people then choosing not to get the help they need), then come up with rational arguments instead of just 'we have to be different at all costs'. Our policies should be based on rational decision making and not just on trying to be different or to conform to or avoid a right wing, left wing, or whatever other label there might be. Labels are just labels. And as for trying to be different as a goal in its own right is just ludicrous.

Quote: Originally Posted by SirJosephPorter

I have presented plenty of arguments against user fees, Machjo. But in addition, an important argument is to look at the countries where they already have a user fee and see how they are functioning.

Since in USA they have user fee (and copay) in many places, it is not at all out of place to see how American system is functioning. Since we would be going the American way if we adopt user fee, I think it is very important to see what user fee has done to that country (lower life expectancy, higher infant morality etc.). It would be absurd to do what they are doing and then to expect a different result form them.

I think it is a very legitimate argument.

Quote: Originally Posted by Machjo

Also, this comparison is extremely harmful to Canada, simply because if the US comes up with a good idea, we then feel we must reject it on no other grounds than that it's a US idea, and we will never touch it until either we have no more choice in the matter or many other nations adopt it so that it's not viewed as too American anymore.

Quote: Originally Posted by Machjo

Whether we come in first or last, we should simply aim at having a good and efficient system. If we're last but still have a good system, who cares. After all, would you rather be last among all good candidates, or first among trash? It's all relative, and certainly we should not set our goals in comparison with any other nation, but simply be satisfied with having a good and efficient system in place.

Quote: Originally Posted by L Gilbert

And it's only the syphilitic left that deplore the idea because the nanny state should do it all. But the nanny state is failing to keep everyone fit and well, isn't it?

Quote: Originally Posted by Machjo

Also, this comparison is extremely harmful to Canada, simply because if the US comes up with a good idea, we then feel we must reject it on no other grounds than that it's a US idea, and we will never touch it until either we have no more choice in the matter or many other nations adopt it so that it's not viewed as too American anymore.

Quote: Originally Posted by Machjo

I think it's a matter of balance in the end. If we have no public sector, there is always the risk of the private sector exploiting the system unfairly. But to do what the Canadian left has done an shift so far towards a nearly completely public system is showing its cracks. That's probably why the Swedish and Singaporean systems, both of which used to be ore like Canada's, have rejected that system, though granted they've rejected the US one too (though the Singaporean model had freely borrowed from the US system nonetheless while still having a system all its own, and superior, essentially combing the best of both worlds. This is perhaps what Canada could do, learn from the US system and incorporate its good points into ours.

Quote: Originally Posted by SirJosephPorter

And how is user fee going to improve our system? Nobody here has presented any argument as to how it will benefit us, except perhaps that it looks attractive because Americans are doing it. There is no way it can help our system, and plenty of ways in which it can hurt our system.