Blame Canada

peapod

Hall of Fame Member
Jun 26, 2004
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Well I kinda wondered about the "milk and honey land" nascar and pepper have been telling us all about. It gots me to start lookin into their fairy tales...from the gang at epiphanies, great job guys 8)

Last week a little post of mine on frustration with US health care made some noise http://ezraklein.typepad.com/blog/2005/10/canamerica.html

and also here http://www.washingtonmonthly.com/archives/individual/2005_10/007317.php
I have to admit I was taken by suprise that my bitching got so much attention.

Much of that attention demanded that I give proof for my accusations! Well, if you read the post closely you'd see I wasn't making any claims except the simple fact that our health system has its problems, waiting being one of them. But today I'm going to give all those naysayers some satisfaction by debunking another huge myth about the perils of Canadian medicine: that many thousands of desperate Canadians cross the border every year seeking medical care because of unsatisfactory care at home, be it long waits, lack of new technology, or [insert appropriate false claim about Canadian care here.]

Three years ago, long before this blog came into existence, Health Affairs ran an article on Canadians seeking care in the US.

http://www.healthaffairs.org/

The authors used some nifty methodology, including surveying numerous US hospitals along the border, as well as institutions generally regarded as "America's Best Hospitals". On the Canadian side, they used the National Population Health Survey (which literally asks, "In the past twelve months did you receive any health care services in the United States?" and "Did you go there primarily to get these services?"), as well as querying insurance companies on the Canadian side about the popularity of policies that cover US institutions.

Before I pull back the curtain to reveal their astounding findings, let's make a couple things clear. Many Canadians travel in the US every year. It is expected that this fact will show up in statistics. Further, I assume there are some very wealthy Canadians who will always say "No thanks" to waiting lists, and hop over to the US. I believe that is a reasonable assumption, and a fact of life that I'm comfortable with.

So what did the authors find?

In terms of hospitals along the border offering advanced treatments or special diagnostic technology (i.e. CT scans and MRIs), about 640 Canadians were seen, along with 270 for procedures like cataract surgery. They compare this to about 375,000 and 44,000 similar procedures in the region of Quebec

alone during the same period. If you divide the total number of Canadians seeking those treatments in the US, divided by the number in Quebec alone that's about 0.09%. Not even a tenth of a percent.

But the most striking stats come from the Canadian National Population Health Survey (NPHS). From the article:
Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received care in the United States during the previous twelve months, and only twenty had indicated that they had gone to the United States expressly for the purpose of getting that care.

Only 20 of 18,000 sought care in the United States. I can't believe how many people are coming over here! Their system but be truly awful.

But let's give this number some context. We've all heard about seniors getting their prescriptions from Canada. (Hell, even driving to visit my sister at college in rural Kansas, I saw a billboard for "Canada Drug of Topeka!") But how many seniors really do that? Is it exaggerated, like the claims of Canadians coming stateside?

Polling data from 2003 (approximately a year after the Health Affairs article) indicates that 8% answered YES to the following question:

"Have you ever bought prescription drugs from Canada or other countries outside the United States in order to pay a lower price?"

If 8% of the 18,000 Canadians polled in NPHS had expressly sought care in the United States, that would be 1,440. Not 20, as the survey showed.

In other words, we have 72 times the number of Canadians seeking care in the US going to Canada (or at least calling there) to get prescriptions.

Honestly, what's really wrong with this picture?

[Source: Katz, Steven J et al. "Phantoms in the Snow: Canadians' Use Of Health Care Services In The United States." Health Affairs May/June 2002
 

Nascar_James

Council Member
Jun 6, 2005
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Yep. Unfortunately, many Americans do head north of the border to purchase their drugs, Peapod. It would be foolish not to. The key reason is lower cost. So Canada does indeed provide more affordable drugs. I've even met a few who head south to Mexico to purchase their drugs.

However, many Canadians head south and pay out of their own pockets to avoid a long wait list in order to have critical surgery. This applies to those who can afford it. Many can't and wind up waiting on long lists for their surgery.

With the high taxes they pay, Canadians surely deserve a health care system that will actually take care of them and not let them die waiting for surgery. If the government cannot manage the health care system in Canada, it is time to scrap it and drastically lower taxes to offset for the money that is saved. It's better to go with a network style private insurance where one pays a monthy premium similar to our home or auto insurance. Efficiency would greatly increase.
 

Reverend Blair

Council Member
Apr 3, 2004
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Actually the article you posted already proves that, Pea. It shows that less than 1/10 of 1% of Canadians actually go south to seek treatment. Nascar didn't bother reading that though. Facts scare the hell out of him.
 

Ten Packs

Council Member
Nov 21, 2004
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Kamloops BC
It's better to go with a network style private insurance where one pays a monthy premium similar to our home or auto insurance. Efficiency would greatly increase.

Bullshyte. I knew a guy in Detroit (knew him very well at one time) that positively raved that his Medical plan (that covered him, his grown son and adolescent daughter) only cost him about 800 bucks a month!



800 BUCKS A MONTH ?

.
.



Never mind that the Prime Directive for clinics and hospitals up here is not for the Board of Directors and Partners to get bigger and bigger Yachts, every few years....
 

Nascar_James

Council Member
Jun 6, 2005
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Re: RE: Blame Canada

Reverend Blair said:
Actually the article you posted already proves that, Pea. It shows that less than 1/10 of 1% of Canadians actually go south to seek treatment. Nascar didn't bother reading that though. Facts scare the hell out of him.

The reason why that is Rev, as I've stated above is that not all can afford it.
 

Nascar_James

Council Member
Jun 6, 2005
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Ten Packs said:
It's better to go with a network style private insurance where one pays a monthy premium similar to our home or auto insurance. Efficiency would greatly increase.

Bullshyte. I knew a guy in Detroit (knew him very well at one time) that positively raved that his Medical plan (that covered him, his grown son and adolescent daughter) only cost him about 800 bucks a month!



800 BUCKS A MONTH ?

.
.



Never mind that the Prime Directive for clinics and hospitals up here is not for the Board of Directors and Partners to get bigger and bigger Yachts, every few years....

He's been taken for a ride. My insurance (through a corporation)covers several members of my family for less than one quarter of the price he's paying. Surgeries and maternity costs are included.
 

Reverend Blair

Council Member
Apr 3, 2004
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The reason why that is Rev, as I've stated above is that not all can afford it.


Nonsense. If affordability were the issue, we could expect to see at least 5% of people going down there. We are seeing less than 1/10 of 1%.

He's been taken for a ride. My insurance (through a corporation)covers several members of my family for less than one quarter of the price he's paying. Surgeries and maternity costs are included.

So you're paying almost $200 a month and are bragging because surgery and maternity care are included? Not only do we know that many people do not have those things included because you took the time to mention it, but we have evidence of somebody paying 4 times as much.
 

Dexter Sinister

Unspecified Specialist
Oct 1, 2004
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Regina, SK
I think the real difference lies in the answer to this question: is medical care a business or a public service? In the United States it's a business, in Canada and most European nations I know anything about, it's a public service. And when it's a business, it's about the bottom line, not health care.
 

zenfisher

House Member
Sep 12, 2004
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Seattle
A guy I work with was telling me his brother in law has three health plans . He recently had a stroke. He is in limbo with the family scraping cash to pay for hospital bills...while the HMO's are fighting over who pays what. One of those plans is from the US Navy.
 

Nascar_James

Council Member
Jun 6, 2005
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Re: RE: Blame Canada

no1important said:
Less than 1/4so what that about 180-200 a month then?

200x12=$2400 per year for family health insurance. This amount is far far less than my tax savings between Canada and the US. So I come out way ahead. In addition, I save taxes and get a reliable healthcare system. No waiting lists for critial surgeries.
 

Nascar_James

Council Member
Jun 6, 2005
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Reverend Blair said:
The reason why that is Rev, as I've stated above is that not all can afford it.


Nonsense. If affordability were the issue, we could expect to see at least 5% of people going down there. We are seeing less than 1/10 of 1%.

He's been taken for a ride. My insurance (through a corporation)covers several members of my family for less than one quarter of the price he's paying. Surgeries and maternity costs are included.

So you're paying almost $200 a month and are bragging because surgery and maternity care are included? Not only do we know that many people do not have those things included because you took the time to mention it, but we have evidence of somebody paying 4 times as much.

Rev, one of the corporations that I am "involved" with provides me with benefits that includes partial payment (actually a good amount) for medical coverage. And yes it only costs me about $200/month for the whole family.

So taxwise, I am still way ahead and I have reliable healthcare.
 

Reverend Blair

Council Member
Apr 3, 2004
1,238
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Winnipeg
So your company pays the other $600 or so per month? That's a tax levied by private enterprise instead of the government. Nothing more, nothing less.
 

Tresson

Nominee Member
Apr 22, 2005
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Nascar_James said:
So taxwise, I am still way ahead and I have reliable healthcare.

At least until you get sick. The instead of getting the treatments you need they'll only pay for the least expensive trearment. I have an Uncle that works for HMOs on contract work. Most of those contracts include bonuses for having patients take the least expensive treatment. Not the best treatment for whatever making them sick but the least expensive treatment.
 

Mad_Hatter

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Oct 14, 2005
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If one compares the American and Canadian health care systems it is clear that Canada is way ahead. We have higher life expectancy, lower infant mortality rates and pay far less in terms of total GDP on health care spending.
Like Peapod mentionned, the problems within the Canadian system are greately overstated by the Americans. Waiting lists are certainly a problem, but nowhere near the problem that critics would have us believe. Same goes for patients travelling to the US for faster treatment; of course it happens, but the numbers are much lower than critics make out.

I would also like to point out to Nascar that he may have the greatest health insurance plan in the world, good for him. Perhaps you are right, Nascar. You personally receive better health care than the average Canadian. However, it bears pointing out that 18-20% of the American public have NO coverage what-so-ever. If they get sick and can't afford treatment they are not going to even receive a modest subsidy on drugs or doctor visits.

However, it would be a crime against the Canadian people if we're to deem our healthcare system not in need of serious revamping simply because it is better than the American model.

A quick glance at Europe demonstrates that we have a long way to go. Canada is the only country which boasts a completely public health care system (though, in fairness this is somewhat of a myth as we pay for our own drugs and dental insurance). Countries like Sweden have a modest two tier system with modest user fees and is serving its people better according to aforementionned indicators. Japan is another example of a two tier health system which is faring better than ours. In Japan the patient actually pays between 20-30% of his bills but the government pays more in terms of drugs, dental etc.

I am curious as to what you fine folks think should be done to improve our healthcare system. Simply increasing funding to it may not be a long term solution as costs will continue to spiral upwards. Would anyone consider a modest two-tier system, modest user fees or any other alternative to reduce wait times and deliver better treatment? Or is public health a value to dear to both our hearts and Canadian identity to forgo?
 

Reverend Blair

Council Member
Apr 3, 2004
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The problem with two-tier in Canada is that it leaves us open to a Chapter 11 suit under NAFTA, Mad Hatter. The US insurance companies would be able to force us into an American-style system because health care would suddenly become a commodity.

The Romanow Report still holds the key to fixing Canadian health care. While some try to say that it just says to throw money at the problem, that is wholly untrue. While it does call for increased funding, it also contains cost-saving measures like increased home care and more attention to homeopathic practices and preventative measures.
 

MMMike

Council Member
Mar 21, 2005
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Toronto
The Romanow report is a complete disaster. Maybe he stumbled onto a few good ideas here and there, but for the most part it is a recipe for the status quo with dramatically increased funding. And where is this money supposed to come from? At the expense of other programs (read: education and infrastructure). The only solution is to open the system up to competition and private capital. An obvious first place to start would be private delivery of simple treatments or orthopedic procedures... Another good idea is to start funding hospitals based on patients treated or procedures performed - this will create incentive for efficiency.