HEALTH CARE - User fees

[SirJosephPorter]

So the only difference in a totalitarian system is that it's faster in making decisions. The US would take longer to scrap user fees as we'd take longer to introduce them because we're democratic. Whereas a dictatorship can bake both ideas more quickly. As for the one-child policy, it would only be a matter of the majority supporting an idea to make it legal. Just consider the attempted cultural genocide of many First Nations in Canada over decades in our history, supported by a democratic majority. A democracy can be just as savage as a dictatorship can be benign. In the end, it merely depends on the government in power.

Democracy can be as savage, but things move much more slowly in a democracy. In a dictatorship, once the dictator is convinced the idea is good, it is implemented very quickly.

If in Singapore they want to implement the health care reform that Democrats are trying to implement in USA, I assume it could be done in less than a week.

Dictatorship has a few (very few) advantages over democracy and quick decision making is one of them.

Indeed, suppose as a result of use fees, cancer incidence rises in Singapore (I don’t know that it has, but assume). The dictatorship can pass a law mandating that every citizen must visit the doctor once a year (or once every two years, whatever) to get colorectal checkup, or to get a mammogram, Pap smear etc. If patients have to pay user fee to do that, that is their problem, not the dictatorship’s problems.

Suppose we implement user fees here in Canada and as a result there is an increase in cancer. No way we could pass a law like that, forcing people to visit their doctor. It will be against the Charter.

As I said before, there are things a dictatorship can do, that a democracy may not do.

 

[SirJosephPorter]

And our system, while certainly better than the US' in many respects, is certainly no model for the world either it seems.

Just to ask a question here. Let's say some country in the middle of the Pacific decided to conduct research on various national health care systems, do you honestly think they'd adopt the Canadian system at least without major modifications? My guess is they'd look at other systems instead, and of course would look even less at the US one than ours, but they'd likely still be looking more at the Singaporean or Swedish models in the end. Or if they're really committed, maybe a French-style system (bearing in mind that while it's possibly the best in the world, it's also more expensive too.) But if they're looking for something of quality and efficient but not necessarily the best system, they'd likely be looking at Sweden or Singapore most likely, or some other similar country. But certainly not as public a system as ours.

That makes sense. They won’t necessarily copy any one system. And there is no such thing as the best system any way. By one criteria, even US system may be considered the best in the world (it is best for those who can afford to pay top dollar for it, who have the Cadillac insurance plan, which I understand costs more than 20,000 $ per year per person).

So it makes sense that they will combine features from different systems in the world to best suit their needs, their requirements.

 

[SirJosephPorter]

And Hitler was elected too and very much supported by many at least in the beginning, let's not forget.

I think he got less that 1/3rd votes.

 

[JLM]

No, it is not, it gives the individual a chance to get their life back together. The biggest problem a individual may have is buying more stuff on credit for awhile. Definatly not the end of the world.

I just don't like the idea of vultures making money off a guy when he's down and out.

 

[Colpy]

I think he got less that 1/3rd votes.

44.1%.....a clear majority in any Canadian election.

 

[SirJosephPorter]

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

I just did and what I found blows my mind, sure you wouldn't use these to support anything. You have about 50 within about a 3 year spread. For all intents and purposes they are all tied in a dead heat. When you were yammering about the huge difference between Canada and the U.S. I thought you talking 20 or 30 years. That trivial of a difference could be due to the way the data is collected - anyway it's negligalbe as far as any real comparisons are concerned.

3 years is a big difference, JLM. Canada stands no. 11 in the world; USA stands no. 38 (below countries such as Cuba, Chile and Costa Rica). That is even a bigger difference. That, when taken with other factors such as higher infant mortality, bankruptcies due to health care costs etc., tells me that that is not the system that we should emulate (like with user fees).

25 or 30 years will be the difference between a developed country and a third world country (like Canada and Ethiopia).

But when it comes to developed countries, 3 years is a big difference. If it had been the other way round, if USA had a life expectancy higher than Canada by 3 years, you would be shouting it from the roof top, as the proof positive that US health care system is much better than ours (not that you need much proof anyway).

 

[JLM]

3 years is a big difference, JLM. Canada stands no. 11 in the world; USA stands no. 38 (below countries such as Cuba, Chile and Costa Rica). That is even a bigger difference. That, when taken with other factors such as higher infant mortality, bankruptcies due to health care costs etc., tells me that that is not the system that we should emulate (like with user fees).

25 or 30 years will be the difference between a developed country and a third world country (like Canada and Ethiopia).

But when it comes to developed countries, 3 years is a huge difference. If it had been the other way round, if USA had a life expectancy higher than Canada by 3 years, you would be shouting it from the roof top, as the proof positive that US health care system is much better than ours (not that you need much proof anyway).

Well, on this we have to agree to disagree, 3 years is not a HUGE diffenence in a life span of 80 years. But let's analyze this sensibly. How much of the three years is attributable to health care? Let's compare two cases where one man dies at age 81, drops dead suddenly while digging the garden after a full life without any medical major intervention and another man dies in hospital hooked up to wires and tubes, at age 84 after being in poor health and continuous care for 10 years. This is clearly a case where health care was a huge factor. The other case was a case where health care wasn't a factor, but the patient's own care over a lifetime &possibly his genes was a factor. Now if you had the choice which man would you choose to be?

 

[SirJosephPorter]

Your 70% figure is to high. Here is a definition of what Bankruptcy actually means in the U.S...

That is not my figure, that is CNN's figure. Apparently Obama claimed that last year 80% of the bankruptcies were due to health care costs. CNN carried our fact check and conculdeed that the number was 70%.

I believe CNN.

As for a shortage of doctors and Nurses, it is not because they get low pay or cannot find jobs, you can blame the AMA as well as your CMA for that. Universities are only to willing to increase student medical enrollment. You have to get out more, the real world is not in books or tabloids. I am not saying that to be mean.

I agree, AMA and CMA are partly responsible for doctor shortage. But you seemed to imply in one of your posts that it was Canadian health care system that was responsible for the shortage of doctors and nusres here. So I returned the favor.

 

[JLM]

Ironsides - As much as some people may want to tell you different there are two reasons for doctor (general practicianer) shortage in Canada. The main one is that too many Canadians don't do enough to look after their own health, don't eat properly, don't exercise and don't listen to their own bodies. The second reason is that people with trivial complaints have a habit of running to the doctor for the slightest reason. My own doctor told me several years ago that if every able Canadian spent one hour a day walking, the health care costs across the country would eventually fall to half the current cost. It's as simple as that Ironside.

 

[SirJosephPorter]

And if your aunt had balls she'd be your uncle. User pay is quite a common and acceptable practice. Would you rather have the service paid for by those who don't use it?

User fees are common accepted practice? Where? In USA?

As to service being paid by those who don’t use it, it is called insurance in technical jargon. What we have in Canada is health insurance. By definition, insurance works because most people who contribute to it don’t use it.

And we want to keep it that way. That is why it is necessary for people to visit doctor’s offices for preventive care, pre and post natal care etc. They are not going to do that if you slap them with a fat user fee.

I think that people who eat properly, exercise property have good genes and a good health record shouldn't be paying more than a token amount until such time as they are making regular use of the service.

Again, you seem to have a total misconception of how insurances works. If everybody started to use it, the insurance service will go broke. I, for one have no problem contributing to the health care service, even though both of us use it rarely.

And you may be grumbling about paying for health care right now, but if you get into a serious accident, or get a terminal cancer requiring treatment running into tens of thousands of dollars, you will be the first one to scream at the top of your voice that is it government’s responsibility to give you medical treatment.

Any health care system works because many healthy people contribute to it. Even insurance companies in that paradise of health care, USA work that way. US insurance companies are in business because most of the subscribers don’t use the system.

 

[SirJosephPorter]

Well, on this we have to agree to disagree, 3 years is not a HUGE diffenence in a life span of 80 years. But let's analyze this sensibly. How much of the three years is attributable to health care? Let's compare two cases where one man dies at age 81, drops dead suddenly while digging the garden after a full life without any medical major intervention and another man dies in hospital hooked up to wires and tubes, at age 84 after being in poor health and continuous care for 10 years. This is clearly a case where health care was a huge factor. The other case was a case where health care wasn't a factor, but the patient's own care over a lifetime &possibly his genes was a factor. Now if you had the choice which man would you choose to be?

Health care may not be the only factor, but it certainly is one of the factors. And if it was only the life expectancy in isolation, you may be right, it may not have much to do with health care. However, combine that with other factors, high infant mortality, more than 40 million without insurance, a large number of bankruptcies etc., then it is the health care system that has the problems.

 

[SirJosephPorter]

Ironsides - As much as some people may want to tell you different there are two reasons for doctor (general practicianer) shortage in Canada. The main one is that too many Canadians don't do enough to look after their own health, don't eat properly, don't exercise and don't listen to their own bodies. The second reason is that people with trivial complaints have a habit of running to the doctor for the slightest reason. My own doctor told me several years ago that if every able Canadian spent one hour a day walking, the health care costs across the country would eventually fall to half the current cost. It's as simple as that Ironside.

So let me get this straight. The doctor shortage in Canada is the fault of the Canadians. But the doctor shortage in USA is a good thing (according to you)? Is it any wonder that you are so enamored with US health care system? You clearly have a childlike faith in anything American.

 

[JLM]

User fees are common accepted practice? Where? In USA?

As to service being paid by those who don’t use it, it is called insurance in technical jargon. What we have in Canada is health insurance. By definition, insurance works because most people who contribute to it don’t use it.

And we want to keep it that way. That is why it is necessary for people to visit doctor’s offices for preventive care, pre and post natal care etc. They are not going to do that if you slap them with a fat user fee.



Again, you seem to have a total misconception of how insurances works. If everybody started to use it, the insurance service will go broke. I, for one have no problem contributing to the health care service, even though both of us use it rarely.

And you may be grumbling about paying for health care right now, but if you get into a serious accident, or get a terminal cancer requiring treatment running into tens of thousands of dollars, you will be the first one to scream at the top of your voice that is it government’s responsibility to give you medical treatment.

Any health care system works because many healthy people contribute to it. Even insurance companies in that paradise of health care, USA work that way. US insurance company are in business because most of the subscribers don’t use the system.

You're wrong, I understand fully how insurance works. I have absolutely no problem with paying for insurance issued by a private company, where the premiums are based on risk as they are in most types of insurance. I do have a problem with Gov't. involvement.

 

[JLM]

So let me get this straight. The doctor shortage in Canada is the fault of the Canadians. But the doctor shortage in USA is a good thing (according to you)? Is it any wonder that you are so enamored with US health care system? You clearly have a childlike faith in anything American.

Wrong again. I have no idea of what is the cause of doctor shortage in the U.S. if indeed there is a shortage. Just the fact that Canadians can go to the U.S. for timely treatment would indicate to me there isn't a shortage there. But the bottom line is I'm not concerned with the demographics in the U.S.

 

[SirJosephPorter]

You're wrong, I understand fully how insurance works. I have absolutely no problem with paying for insurance issued by a private company, where the premiums are based on risk as they are in most types of insurance. I do have a problem with Gov't. involvement.

So you want American type of health care system here, big deal. Get over it, it ain't happening. I don't even see user fees being implemented in the near future. Even Conservatives are not advocating it.

 

[SirJosephPorter]

Wrong again. I have no idea of what is the cause of doctor shortage in the U.S. if indeed there is a shortage. Just the fact that Canadians can go to the U.S. for timely treatment would indicate to me there isn't a shortage there. But the bottom line is I'm not concerned with the demographics in the U.S.

When I wrote that in USA there will be a shortage of between 40,000 and 100,000 Family doctors in the next few years (this according to CNN), you wrote back saying that it may be a good thing (I assume you remember the post, you don't need me to dig it up).

 

[JLM]

So you want American type of health care system here, big deal. Get over it, it ain't happening. I don't even see user fees being implemented in the near future. Even Conservatives are not advocating it.

I don't recall saying anywhere that i wanted U.S. healthcare system, but if a sensible solution works for us and it happens to coincide with their system so be it. As far as commenting on the U.S. shortage (based only on that supposition) that it may be a good thing, Yes I did say it may be a good thing, but in the context that it might get people off their asses more and contribute more to their own health care.

 

[Machjo]

Singapore - Wikipedia, the free encyclopedia

According to this, Singapore is a parliamentary democracy like Canada's.

 

[AnnaG]

The only reason given so far for user fees is that the doctor may have to collect and record them.

Nooooo ... the reasons I've seen so far is to dissuade some people from costing dozens of dollars by going to see their doc or to the emergency room because of a sniffle, it'd help offset some costs of overhead for docs, etc.
The only rational reasons against user fees are that it MAY prevent a few people from seeing their doc when they have something serious wrong with them, and the other reason (not so rational) is that it might add a little bookwork.

 

[AnnaG]

3 years is a big difference, JLM. Canada stands no. 11 in the world; USA stands no. 38 (below countries such as Cuba, Chile and Costa Rica). That is even a bigger difference. That, when taken with other factors such as higher infant mortality, bankruptcies due to health care costs etc., tells me that that is not the system that we should emulate (like with user fees).

Wrong. Canada is 30th, USA is 39th according to the WHO.

25 or 30 years will be the difference between a developed country and a third world country (like Canada and Ethiopia).

But when it comes to developed countries, 3 years is a big difference. If it had been the other way round, if USA had a life expectancy higher than Canada by 3 years, you would be shouting it from the roof top, as the proof positive that US health care system is much better than ours (not that you need much proof anyway).

Not necessarily. 3 years would only be a big difference if the quality of life in the later years would be the same.
But, I'm not surprised that didn't occur to you, a lot doesn't.