HEALTH CARE - User fees

TenPenny

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I am open to sensible suggestions (e.g. putting doctors on a salary would be a sensible suggestion), but user fees will do more harm than good.

Based on those that I know, every female GP would be in favour of this idea (they don't want to work 60 hour weeks), but younger male GPs wouldn't (they'd rather work long hours and make money than have family time).
 

AnnaG

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Jul 5, 2009
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I never said that, Wulfie. But my point is that user fees will lead to American type health case system, since it will punish unnecessary visit to doctor's office (for cold, sniffles etc.) as well as the necessary ones (for real illnesses, for preventive care etc.).
Not necessarily.



Exactly, and how do you do that without also penalizing the genuine visits to the doctor's office? User fee is a blunt instrument, which will discourage the unnecessary as well as the necessary visits.
Possibly; unless the gov't fine tunes the conditions involving user fees. You shouldn't look at things as if they could never be amended, modified, etc.

I am open to sensible suggestions (e.g. putting doctors on a salary would be a sensible suggestion), but user fees will do more harm than good.
... in your opinion.
 

JLM

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Hey Anna- When a person repeats something more than two or three times it's often because they don't quite believe it themselves but they know if they do they will. LOL
 

AnnaG

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In the short time I worked in a hospital and the 5 years I worked at Health Canada, I can truly say I believe a lot more is wasted in poor management and corporate misuse of funds then by abusers of the system..

Those who abuse the system can easily be discouraged from seeing doctors by savvy nurses and receptionist but corporate mismanagement and waste is rarely never seen and or reported..

When you think about it, the people you will hurt the most are the working poor.. Those who are always at the doctors and are on social assistance will get waivers due to financial aid requirements..

So again, people with barely enough to get by, seniors on tight pensions and the working class that don't qualify, will get hit by repeated fees.. And these fees might start at $20.00 but will soon get boosted as medical costs rise and government look at new places to find funding..
I agree; there aren't that many abusers. Not every doctor has a "savvy" nurse, though.
The gov'ts get funding whichever way they can swindle them, big deal. The only other thing they can do is do like Campbull did to pay for the Olys, chop the hell out of the healthcare budget (and the education budget).
 

AnnaG

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Hey Anna- When a person repeats something more than two or three times it's often because they don't quite believe it themselves but they know if they do they will. LOL
Ah, you mean like that old adage, "repeat a lie often enough and you begin to see its truth"? lol
Sometimes it's just the Redundancies Minister for the Ministry of Redundancies Ministry hearing itself talk. lol
 

ironsides

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Feb 13, 2009
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I never said that, Wulfie. But my point is that user fees will lead to American type health case system, since it will punish unnecessary visit to doctor's office (for cold, sniffles etc.) as well as the necessary ones (for real illnesses, for preventive care etc.).



Exactly, and how do you do that without also penalizing the genuine visits to the doctor's office? User fee is a blunt instrument, which will discourage the unnecessary as well as the necessary visits.

I am open to sensible suggestions (e.g. putting doctors on a salary would be a sensible suggestion), but user fees will do more harm than good.

How is that penalizing a genuine visit. those on welfare or public assistance will do exactly what they do now, and that is get treated, state pays for it and they leave. Those who can afford the co-payment will do the same thing. It is only $20 or less and as I said before yearly checkups are no cost. Doctors working for U.S. government health agencies as well as private health insurance companies collect salaries and those who don't will charge the patient the co-payment and are required by contract to accept what ever their health plan pays for the balance. Parients are always allowed to see a doctor that accepts their insurance.
 

AnnaG

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How is that penalizing a genuine visit. those on welfare or public assistance will do exactly what they do now, and that is get treated, state pays for it and they leave. Those who can afford the co-payment will do the same thing. It is only $20 or less and as I said before yearly checkups are no cost. Doctors working for U.S. government health agencies as well as private health insurance companies collect salaries and those who don't will charge the patient the co-payment and are required by contract to accept what ever their health plan pays for the balance. Parients are always allowed to see a doctor that accepts their insurance.
That's just awful, Ironsides. How you guys can cope over there is a mystery? lol
 

SirJosephPorter

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Nov 7, 2008
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Based on those that I know, every female GP would be in favour of this idea (they don't want to work 60 hour weeks), but younger male GPs wouldn't (they'd rather work long hours and make money than have family time).

These days younger doctors don't want to work 60 hours a week either. This is not the old generation, where doctors were mostly male and worked very long hours. These days, young doctors, both male and female want to hae a life outside medicine, and the salary model is proving to be very popular (and the province is also encouraging it).
 

SirJosephPorter

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How is that penalizing a genuine visit. those on welfare or public assistance will do exactly what they do now, and that is get treated, state pays for it and they leave. Those who can afford the co-payment will do the same thing. It is only $20 or less and as I said before yearly checkups are no cost. Doctors working for U.S. government health agencies as well as private health insurance companies collect salaries and those who don't will charge the patient the co-payment and are required by contract to accept what ever their health plan pays for the balance. Parients are always allowed to see a doctor that accepts their insurance.

Have there been any studies as to whether this discourages patients to visit the doctor for preventive care, pre and post natal care etc.? Infant morality in USA is high; it is higher than in Canada and higher than many developed countries. One of the reasons for this may well be the user fee. User fee may well discourage some mothers to go for well baby care (baby is healthy, is not showing any symptoms of illness, then why spend 20$ on a doctor’s visit?)

So there is a reason to think that this bears out my argument that preventive medicine will suffer as a result of user fees. Anyway, have there been any studies in USA?
 

TenPenny

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These days younger doctors don't want to work 60 hours a week either. This is not the old generation, where doctors were mostly male and worked very long hours. These days, young doctors, both male and female want to hae a life outside medicine, and the salary model is proving to be very popular (and the province is also encouraging it).

What they will find is that doctors don't want to work 24 hrs/day, so it will be interesting to see how it develops.

Let's face it, many docs would be happy to work 37 hrs/week with paid vacation, maternity leave, pension benefits, no office expenses, etc etc...
 

AnnaG

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I don't see user fees specifically mentioned here.
Harvard did a study on user fees and found that they tend to decrease the chances of the poor getting adequate healthcare. But then that can always be mitigated by the gov't covering the user fees. If the gov't does this it can also graduate its coverage to include those people who wouldn't find it impossible to pay a user fee, but could pay a part of it.
See what happens when you quit thinking along linear lines? You find answers to problems.
 

SirJosephPorter

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What they will find is that doctors don't want to work 24 hrs/day, so it will be interesting to see how it develops.

Let's face it, many docs would be happy to work 37 hrs/week with paid vacation, maternity leave, pension benefits, no office expenses, etc etc...

That is not what is meant by salary.

Perhaps salary is a misleading word, though it is called the salary model. It is more like capitation; doctor is paid a certain amount per patient, and nothing else. Doctor is still responsible for all the expenses, office rent, staff salaries etc. As to paid vacation, there is no vacation given as such. But if the doctor keep his office shut for two weeks, he won't lose any money (or will lose only a little, he still gets a small amount for each service he provides). There is no pension.

Also, if a doctor wants to work long hours, it is still possible in the salary model. He can look after nursing homes (that will be extra payment, not covered by the model), assist in operations (again extra), work in Family Planning Clinics (my wife does a clinic 3 hours a week, she is paid by the city, not OHIP) etc. It is just that most of the younger doctors don’t want to work as hard as the older doctors, they are happy with less money for less work.
 

SirJosephPorter

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What they will find is that doctors don't want to work 24 hrs/day, so it will be interesting to see how it develops.

Let's face it, many docs would be happy to work 37 hrs/week with paid vacation, maternity leave, pension benefits, no office expenses, etc etc...

Under the salary model, they don’t have to work 24 hours a day, but they have to provide evenings and weekend coverage. But if there are say 7 doctors in a group, that means that each doctor has to do one evening session a week, and one weekend in every seven.
 

ironsides

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Feb 13, 2009
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I never said that, Wulfie. But my point is that user fees will lead to American type health case system, since it will punish unnecessary visit to doctor's office (for cold, sniffles etc.) as well as the necessary ones (for real illnesses, for preventive care etc.).



Exactly, and how do you do that without also penalizing the genuine visits to the doctor's office? User fee is a blunt instrument, which will discourage the unnecessary as well as the necessary visits.

I am open to sensible suggestions (e.g. putting doctors on a salary would be a sensible suggestion), but user fees will do more harm than good.

It will not lead to anything different SJP, clinics now hand out medicines for people who just walk in with a flu, cold, sniffles etc. The fee has nothing to do with a American form of health system.
You are just spreading misinformation.

I will put you on the escalator today. :smile:


http://www.youtube.com/watch?v=XivNwQ76mCs


 

Francis2004

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Nov 18, 2008
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I found Harvard's take on user fees.

User fees have unintended effect of decreasing health care access for poor | HarvardScience

Anyway, one can always vary the conditions concerning user fees, so I can't see them being such a big deal.
If you can't pay them, gov't pays them. If you can't pay all of it, gov't can pay the amount you can't afford.
Does anyone have any more "insurmountable" problems with user fees?

Simply put User Fees under the Canadian Health Act are illegal.. :smile:

All the reasons I posted prior are damn good reasons why.. One way or another all the rich and poor will get around the system and middle and poor working class will pay this tax again..

We are already over taxed and this is another tax grab.. Start at $20.00 and it will only increase.. Simple..
 

JLM

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Nov 27, 2008
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Simply put User Fees under the Canadian Health Act are illegal.. :smile:

All the reasons I posted prior are damn good reasons why.. One way or another all the rich and poor will get around the system and middle and poor working class will pay this tax again..

..

"We are already over taxed and this is another tax grab.. Start at $20.00 and it will only increase.. Simple"

Maybe I'm just plain bloody stupid, but I'm having a hard time figuring out how money I pay for a service I receive is "another tax grab".
 

Francis2004

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Nov 18, 2008
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"We are already over taxed and this is another tax grab.. Start at $20.00 and it will only increase.. Simple"

Maybe I'm just plain bloody stupid, but I'm having a hard time figuring out how money I pay for a service I receive is "another tax grab".

We have already discussed how low income people will be exempt more then likely by their medical card.. We always know rich people get around the system and might pay but will get it back..

Seniors, middle and low working families will be the biggest losers in this deal.. They aren't the ones who abuse the system and will have to fork out the fees when ever they need the system the most.. How difficult is that to understand..

User Fees cannot be imposed on a "if he has a cold he pays and if not he does" basis.. It doesn't work that way..

When a doctor requires you to go in to see him / others 5 times in a month how will you justify to those people who barely make ends meet but usually don't go see doctors have to fork out the money..

The problem is the small amount of abusers that fill the system.. Why give the Government a chance to Tax you more with an open option of User Fees when you don't have too ?

I would imagine User Fees in Canada and would be dictated by the same fee structure this Treasure Board web link shows if the Canada Health Act was to be amended..

User Fees
 

AnnaG

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Simply put User Fees under the Canadian Health Act are illegal.. :smile:
I mentioned that a while back, yes. So? That doesn't mean we cannot discuss it.

All the reasons I posted prior are damn good reasons why.. One way or another all the rich and poor will get around the system and middle and poor working class will pay this tax again..
Like I said, it can be modified. IOW, there's more than one way to skin a cat.

We are already over taxed and this is another tax grab.. Start at $20.00 and it will only increase.. Simple..
Like everything else. So? People seem willing enough to keep forking money over for ridiculous things, and sometimes for no good reason at all.
 

SirJosephPorter

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Nov 7, 2008
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It will not lead to anything different SJP, clinics now hand out medicines for people who just walk in with a flu, cold, sniffles etc. The fee has nothing to do with a American form of health system.
You are just spreading misinformation.

I will put you on the escalator today. :smile:


Really? And how many clinics are there like that, ironsides? How many people do they cover? Do they cover everybody? Are they guaranteed funding at least for a few years? Or are they purely charitable clinics which may close any day if the charity runs out of money?

Volunteer clinics will never replace universal health care.