Will Dr Day Americanize Canada's Health Care?

[tay]

On Sept. 6, the B.C. Supreme Court will hear a lawsuit led by Dr. Brian Day against the provincial government. Dr. Day, who owns a for-profit surgery centre, seeks to strike down legislation that puts limits on how doctors can profit from medically necessary services

Fundamentally the potential implications of the lawsuit are that many people in Canada won’t be able to afford health care and many people will end up waiting longer for treatment. This lawsuit strikes at the bedrock of Canadian public health care, which is the agreement that we will all be able to access care when we need it, based on our need and not our ability to pay for it.

He is the co-owner of the Cambie Surgery Centre. That is a private for-profit clinic in Vancouver. He has been a vocal proponent of for-profit care for quite a long time.

His clinics were the subject of a bunch of complaints by patients who were trying to access care there. As a result of their complaints, he got notice that his clinics were going to be audited. Instead of opening his doors and allowing the audit to take place and then reimbursing patients that he may have illegally billed, he joined with a bunch of other for-profit clinics and launched this constitutional challenge.

Dr. Day fought the audit for years in court before the Province finally got entry into his clinics and were able to do a limited audit, only over a period of 30 days. But what they found was nearly half a million dollars in illegal billing. In some cases, the physicians in the clinic were charging up to seven times the legal amount.

There’s a second audit underway looking at specific physicians working in Dr. Day’s clinic, because what was also found was evidence of double billing, which is essentially double dipping. Let’s say you’re a doctor and I come to you for a procedure, and you bill me the MSP amount and then you turn around and also bill MSP the same amount. (MSP is B.C.’s Medical Services Plan).

The case gives insight into the kind of practice that Dr. Day runs and would like to expand in Canada, and it also gives us a sense of the really problematic things that can go on in private health care facilities when profit is the motive.

What is Dr. Day's argument? ....... https://ricochet.media/en/1366/heal...se-in-bc-could-open-the-door-to-privatization

 

[Walter]

Liberty is a terrible thing.

 

[pgs]

Well all the public sector unions are positively against two tier . If that means anything .

 

[Machjo]

He won't Américaine it. He'll Europeanize it.

Canada's and the US' share one thing in common. They're both mostly one&tiered systems: the US mostly private, Canada mostly public. They're mostly extreme opposites of one another and neither one ranks as among the best in the world overall.

Those that do rank among the best are French, Swedish, Swiss, British, Singaporean, and many European ones.

They are all very different but what they all share in common is that they are mostly two-tiered with a developed private and a developed public system.

We should free ourselves from blind ideology and learn from the best.

Well all the public sector unions are positively against two tier . If that means anything .

But the WTO works against them by ranking two&tiered systems as among the best in the world. Canada cranks further down the list along with the US. Moderation in all things eh. Notice how the US and Canadian extremes hurt our systems. But anything to be different from the US I guess.

 

[TenPenny]

If there was double billing going on, the people responsible should be charged with fraud.


Other than that, if he wants to run a private clinic, I say go for it.

 

[taxslave]

Well all the public sector unions are positively against two tier . If that means anything .

Means it is a good thing.

If there was double billing going on, the people responsible should be charged with fraud.


Other than that, if he wants to run a private clinic, I say go for it.

Their version of double billing is charging MSP for the prescribed amount and then billing the customer the rest of the cost of the procedures. Same as chiropractors do.
The big problem is government unions are focused on making everyone believe that anything other than a government pay, government operated medical system is bad. May very well be for government employees but not for the consumer. SO this background noise interferes with the obvious fact that there are many two tiered systems in Europe that function much better than ours.

 

[Machjo]

And not just in Europe.

 

[tay]

Recently, Health Minister Jane Philpott informed the province of Quebec that she intended to enforce the Canada Health Act. Tom Walkom writes (link is external):

The Canada Health Act is the federal statute governing medicare. It lists the standards provinces must meet if they are to receive money from Ottawa for health care. And it gives the federal government the right to cut transfers to any province that doesn’t meet these standards.

In particular, it imposes a duty on the federal health minister to financially penalize any province that allows physicians operating within medicare to bill patients for extra, out-of-pocket fees.

However, the federal government has only rarely penalized provinces which allowed extra billing:

Compared to the billions the federal government spent on health transfers over the period, these penalties were pittances. But they did make the point that medicare is indeed a national program.

And in every province except B.C., where the issue has morphed into a constitutional court case, the extra-billing problem was apparently resolved.

There, Dr. Brian Day has launched a court case (link is external), claiming that extra billing is a practice that is protected under the Charter of Rights and Freedoms. If the case succeeds, medicare -- as a defining Canadian institution -- will be finished. Someone has to meet the challenge head on. That task has fallen to Philpott.

But it imperative that Justin Trudeau stands behind her by providing the money to defend medicare. Originally, medicare was a 50/50 proposition. Half of the costs were to be born by the provinces and half by the federal government. In 2013, CUPE released a report (link is external) on Healthcare spending. The fifty-fifty split was ancient history.


According to the report,the federal government covers only one fifth of provincial health spending, where it used to cover half – and it wants to scale back further. The 2004–2014 Health Accord provided stable funding after deep cuts in the 1990s. It has brought the federal government’s cash share of provincial health spending up to 20 per cent1 (link is external) from a low of 10 per cent in 19982 (link is external) and part way to its original 50 per cent share. The current federal government wants to reverse this progress.

The "current federal government," of course, was the Harper government. When Stephen Harper headed the National Citizens Coalition he advocated dismantling medicare. These days, Dr. Day has taken Harper's place.

Minister Philpott has signalled that the line has been drawn. But, if she is to succeed, the prime minister is going to have to put money where her mouth is.

 

[tay]

He won't Américaine it. He'll Europeanize it.

Canada's and the US' share one thing in common. They're both mostly one&tiered systems: the US mostly private, Canada mostly public. They're mostly extreme opposites of one another and neither one ranks as among the best in the world overall.

But the WTO works against them by ranking two&tiered systems as among the best in the world. Canada cranks further down the list along with the US. Moderation in all things eh. Notice how the US and Canadian extremes hurt our systems. But anything to be different from the US I guess.

The American insurance and Pharma companies have been schmoozing Canadian Politicians and think tanks for decades to convince Canada to go private. I want no part of a partial private system..

Shela Bryan, 63, has been comparing prices for individual health insurance plans since May, and she can't believe what she has been seeing.

"They cost a thousand, $1,200 [a month], and they have a deductible of $6,000," she said. "I don't know how they think anyone can afford that."

Bryan, who lives in Hull, Ga., a hamlet of about 200, was on her husband's insurance plan for decades. When he died in 2013, she continued his workplace coverage through COBRA, but she had to pay almost the full price of the insurance, or about $800 a month. But it was "the Cadillac of insurance," Bryan said, with low copays, prescription drug coverage and a $500 deductible.

That option will run out in a few months, so she is turning to the individual insurance market in what is shaping up to be the most expensive year for the 400,000 or so consumers in Georgia who buy their own policies but don't purchase them on the health law's marketplaces.

About 10 million Americans buy individual insurance coverage without cost-reducing federal subsidies on the marketplaces on the open market, according to the Congressional Budget Office.

In Georgia, consumers who don't get insurance through their employers or don't qualify for tax credits to help pay for policies they purchase are facing double-digit premium increases. Blue Cross Blue Shield of Georgia, the only insurer offering plans throughout the state, received an increase of more than 21 percent from the state insurance commissioner. Humana was awarded a 67.5 percent hike.

Prices are going up in other states, too. BlueCross BlueShield of Tennessee was granted a 62 percent rate hike, while state officials approved a 46 percent increase for Cigna. Florida authorities gave plans there an average 19 percent bump. And last week, Minnesota officials announced that premiums for the seven insurers on the individual

Bryan, who makes just over the $47,520 limit for a subsidy, finds herself on her own in the individual market now. "I've worked ... all my life," said Bryan, a maintenance supervisor.. "We're the ones entitled to something, because we've worked. They tear me up in taxes and then they say my income is too high for a subsidy?"

She could end up paying as much as $14,000 in premiums for a pared-back policy, she said, which is $4,400 more than she is paying for the COBRA plan. The deductible would also rise by $5,800, and she wouldn't have drug coverage. The cheapest policies would amount to more than a quarter of her yearly income, or double her mortgage.

Bryan said she feels like she is paying for other people's subsidies with her high premium.

more

Without Subsidies, Health Coverage Is Pricey For Many : Shots - Health News : NPR

 

[Curious Cdn]

Liberty is a terrible thing.

Yeah. We should all have the freedom to lose our houses because we get sick. Aetna needs that liberty to squeeze a 35% margin out of human misery.

You will never meet Jesus, Walter.

 

[Remington1]

45,000+ (approx) people die in the US due to having no coverage or lack of health care every year. Some illness like cancer cost thousands of dollars just for the screening, then the cost of radiation and chemo is astronomical. Then comes the other type of illness that fall under "only for the insured or rich", like kidney, liver, lungs, etc, decease! Poor uninsured men are the highest on the death scale. Preventive and screening is not part of an uninsured family and 1 in 5 adults and 1 in 10 kids are uninsured (socioeconomic, diet play a role); so basically it's the poor that are affected the most again. IF Canada did not have the full health care, I would be dead myself. Studies can be done, but with care that the poor are not left behind.

 

[Walter]

45,000+ (approx) people die in the US due to having no coverage or lack of health care every year. Some illness like cancer cost thousands of dollars just for the screening, then the cost of radiation and chemo is astronomical. Then comes the other type of illness that fall under "only for the insured or rich", like kidney, liver, lungs, etc, decease! Poor uninsured men are the highest on the death scale. Preventive and screening is not part of an uninsured family and 1 in 5 adults and 1 in 10 kids are uninsured (socioeconomic, diet play a role); so basically it's the poor that are affected the most again. IF Canada did not have the full health care, I would be dead myself. Studies can be done, but with care that the poor are not left behind.

What utter crap.

 

[Remington1]

What utter crap.

Check the data for yourself.

 

[Curious Cdn]

What utter crap.

You will never meet Jesus, you mean-spirited miser. You will come up wanting.

 

[darkbeaver]

I'll die before this is enacted, So I don't care much, you younger people might want to pay attention though. FlastLine villa don't care.

T he golden years. Never doubt. Forward into you must venture, or feed plants, the big picture don't change muchs.Nary a blip.

HealthCare is not a commodity it is duty, the law, if you slither arroud that you will be cursed, fer sure. You got together with those gaureentees, if you can't do it, we'll find a fix, fer sure. The old and infirm are cared for above all else except the babes. Make sure youy do that and you will be a longrun Empire. Those old repositorties can instruct you like no other. They been there, that's hgow you goit here, stupid.

 

[tay]

Brian Day’s legal battle against universal public health care in Canada is now before the BC Supreme Court. Day—along with other would-be profit-makers—are hawking unprecedented privatization as the solution to challenges in Canada’s health care system.

But two crucial facts are often missed in debates about public vs. private health care. First, Canada already leaves more of our health care to the private sector than most industrialized countries. And second, the private, for-profit sector is the single biggest source of waste and inefficiency in Canadian health care.

The private health sector in Canada has grown to nearly a third (29%) of total health expenditures, largely in the form of out-of-pocket payments and private extended health insurance (for those who have it). That’s because important health services like prescription drugs, mental health supports, dental care, optometry, physiotherapy, and home and community care largely fall outside the scope of public coverage – much more so than in Europe.

In turn, the other 71% of Canada’s health expenditures are financed under the public system – a proportion that trails the vast majority of countries in Europe according to OECD data. In countries such as Germany, France, Denmark, Sweden, and the United Kingdom, privately financed health care represents a significantly smaller share than in Canada – between about 15% to 21% of health expenditures. In other words, the scope of public health care coverage in Canada is too small, not too large.

The result of our high levels of private health expenditure is billions of wasted dollars annually.

One of the most glaring examples is our lack of a national prescription drug plan. Health policy experts estimate that a national pharmacare program would actually reduce the total cost of prescription drugs in Canada by $7.3 billion each year.1 That’s even after an assumed increase in total pharmaceutical usage, as a result of medicines being made available to those who need them, regardless of ability to pay.

Another major source of waste in Canadian health care is the bloated administrative costs of the private sector (such as the duplication of claims processing systems across multiple private insurance companies). The Canadian Institute for Health Information finds that the total share of private health expenditures going to administration is more than triple the share in our public health system. Moreover, private sector administrative costs have rose continuously over the past four decades, even as they fell in the public health system.

Academic studies have found that administrative costs in the United States’ highly privatized health care system are about double those in the Canadian health care system – part of the reason the US spends much more on health care as a share of its total economic pie (GDP) than we do in Canada.

Furthermore, for-profit extended health insurance in Canada is among the most inefficient in the world. Health policy researcher Michael Law found that Canadians pay $6.8 billion more in private health insurance premiums than they receive in payouts from claims in a given year. That means for every dollar paid, Canadians only receive $0.74 in benefits. Private insurers are in the business of making money after all.

- See more at: The biggest source of waste in Canadian health care? The private, for-profit sector : Policy Note

 

[Dixie Cup]

I am so tired of listening to this conversation again and again. Why we refuse to look into the systems that operate better than ours so that we can improve it simply baffles me. When I needed a hip replacement, the wait time was excruciating - so I was willing to cash in my RRSP's to go elsewhere to get it done just so that I could relieve myself of the pain. I figured that if I went down south, that I could at least claim a portion of the medical expense on my taxes. Checked with CRA - nope - no can do. Why? because the procedure was available here. "But", I said, I can't access it and I don't know when I can and I'm in pain". Too bad. You'll simply have to wait your turn. How is this a good system? How is it when people are suffering and there's no relief, how can anyone in good conscience
allow the suffering to continue until there's an "opening?" I called Dr. Day's clinic 'cuz I would have gone there but they don't do hips! Figures.


Anyway, to make a long story short, I did eventually get it done but the wait was incredibly long. I'm told that eventually I'll have to get my other hip done but it doesn't bother me at all and I'm hoping I die before I have to go through that again.


In the European model, I would have been able to get it done right away (or fairly quickly) and it would not have cost me a dime because both the public and private are covered. What's wrong with that? My sister-in-law's mother in Germany had hers done shortly after I did and her wait was a couple of weeks, not months. It didn't cost her anything either.


So we may have "universal health care" but I'm sure there are people dying just waiting for treatment - I have no doubt! How can we be proud about that?


JMHO

 

[pgs]

I am so tired of listening to this conversation again and again. Why we refuse to look into the systems that operate better than ours so that we can improve it simply baffles me. When I needed a hip replacement, the wait time was excruciating - so I was willing to cash in my RRSP's to go elsewhere to get it done just so that I could relieve myself of the pain. I figured that if I went down south, that I could at least claim a portion of the medical expense on my taxes. Checked with CRA - nope - no can do. Why? because the procedure was available here. "But", I said, I can't access it and I don't know when I can and I'm in pain". Too bad. You'll simply have to wait your turn. How is this a good system? How is it when people are suffering and there's no relief, how can anyone in good conscience
allow the suffering to continue until there's an "opening?" I called Dr. Day's clinic 'cuz I would have gone there but they don't do hips! Figures.


Anyway, to make a long story short, I did eventually get it done but the wait was incredibly long. I'm told that eventually I'll have to get my other hip done but it doesn't bother me at all and I'm hoping I die before I have to go through that again.


In the European model, I would have been able to get it done right away (or fairly quickly) and it would not have cost me a dime because both the public and private are covered. What's wrong with that? My sister-in-law's mother in Germany had hers done shortly after I did and her wait was a couple of weeks, not months. It didn't cost her anything either.


So we may have "universal health care" but I'm sure there are people dying just waiting for treatment - I have no doubt! How can we be proud about that?


JMHO

The public sector unions love it , and they hold the power .

 

[TenPenny]

In my experience, if you have a life-threatening condition, you get looked after as fast as possible.

 

[pgs]

In my experience, if you have a life-threatening condition, you get looked after as fast as possible.

Sure our emergency care is fantastic and our doctors are as well trained as any , but the system still has faults and waste . Wasted time is the biggest problem . IMHO