HEALTH CARE - User fees

[Socrates the Greek]

Health care should be like car insurance, you pay your premium if you are working and you are covered.

If you don’t work it should be automatic, the UI benefits should also cove Medicare. Anything else is bad for the people.

Americans should not be allowed to come and get priority treatment and live Canadians who can not afford user fees get sicker and die.

Or people who do not live here and have relatives here who come here to steal the service go back to their home land, while depriving Canadian Citizens from proper care. That is pour horse sh!t.
Any politician here in Canada who is in favour of user fees is on the bus of cash grab, and should be punished come election time.:angryfire:

 

[Machjo]

I am not sure something like price controls would work thru regulation, but it is better than running up the bills like we are doing.

No, I'm totally opposed to price controls, as they don't allow the hospital to adjust to market conditions when necessary. The only exception I'd make to this is if it could be possible to opt out of the price controls. To take an example:

You could have what we might call voucher hospitals and non-voucher hospitals. To opt into the voucher programme and become a voucher hospital, a hospital would be required to refuse all funding except through vouchers. A person who wishes to pay for an essential medical service through the voucher programme could get a prescription from his physician, show it to the Ministry of Health, and the give him a voucher for that service. He could then go to a voucher hospital to cash it in for the service. Since the hospital would be prohibited from receiving any funding except through vouchers, and would be prohibited from refusing to accept a voucher for services it does offer, it would essentially have to provide the service with the funds available, which of course would mean only essential services with no frills or gimmicks, and likely in a very spartan environment.

Non-voucher hospitals would be prohibited from accepting vouchers, but would otherwise be free to to charge what they want. Essentially, they'd be totally private.

So essentially, you'd have a two-tier system and you'd be free to choose. You could go to a voucher hospital if you wanted to, but if you have the money, you'd probably prefer going to a private one.

Now I also see a major flaw in what I just presented above. While such a system might work well for schools where parents can alway make an informed decision, it might not always work for hospitals, where in some cases at least the person is treated in the absence of consent, owing to his being unconscious. So, do we allow some unscrupulous private hospital to exploit this weakness?

One possibility I could see would be to say that non-consensual health-care (such as when the paramedics or physician etc. must make an immediate decision to save his life in the absence of his consent since he may be unconscious) would be a government-responsibility. That health-care would be free of charge to the patient and totally covered by taxes (bearing in mind that taxes themselves should be levied rationally, such as on junk food, cigarettes, alcohol, etc., and not so randomly).

So this would mean that we'd have the following kinds of hospitals:

a) 100% publicly owned and funded hospitals that would specialize in emergency non-consensual services,

b) private hospitals:

b1) that participate in the voucher programme in the provision of consensual services, and

b2) that are totally privately funded in the provision of consensual services.

 

[JLM]

The best person I've ever read about for determining what gov't should run, what it should regulate, and what it should stay out of was WAC Bennett. BC ran like a clock when he was premiere from what I've read. I haven't seen anyone since then that's even come close to his savvy.

I think you make a good point there, Anna. I worked as a "civil servant" under old W.A.C. for nine years. We didn't like him much in those days of course, but the province was in much better shape then than it is today. My biggest complaint at the time was the Gov't wage was far behind the private sector, but most years we got a 5% wage increase (I guess it was that old bugger who started fuelling inflation) Of course the other benefit was we were guaranteed employment and never missed a days pay and had a generous sick leave plan (that the Union later sold down the river) Of course he wouldn't stand for Unions in the public sector. He was probably what you would call a benevolent dictator. What he really had going for him was he was an astute business man.

 

[JLM]

Yah and not even his son had the smarts to follow in his footsteps!

I think this was the exception to the rule about "the acorn not falling far from the tree", The old man was a Tee totaller and I think perhaps young Bill would have done better had he remained the same. Just a guess on my part,

 

[Machjo]

Health care should be like car insurance, you pay your premium if you are working and you are covered.

Maybe. Certainly private insurance should be allowed for those who want it, and maybe it should be compulsory. And maybe it should all be privatized (with the exception of non-consensual services).

If you don’t work it should be automatic, the UI benefits should also cover Medicare.

I don't totally agree with this. If you can't work, it should be automatic. But if you can work, then the government has an obligation to ensure you have an opportunity to work. I could see two options here:

1. If you're unemployed and sent to school to learn some trade or profession, then the school could be required to pay this insurance to cover you while you're studying. But if you get kicked out of that school, obviously they won't cover your insurance anymore.

2. If you're unemployed and do some volunteer work to gain work experience, the government could cover you since you're still making a contribution to the community and trying to better yourself.

This is where the concept of some kind of Canadian improved version of the US Peace Corps could be of value. But, alas, it's too American for some.

 

[Machjo]

Americans should not be allowed to come and get priority treatment and live Canadians who can not afford user fees get sicker and die.

Why not? If they're paying the market rate for it, then that's more money coming into the system allowing hospitals to hire more physicians, which thus gives us more access to health care in the long run.

[quoteOr people who do not live here and have relatives here who come here to steal the service go back to their home land, while depriving Canadian Citizens from proper care. That is pour horse sh!t.

whether they come from the US or overseas, they are providing extra funding to our health care. I see nothing wrong with private sector health care. The question is whether we ought to have public sector health care and if so, what kind.

Any politician here in Canada who is in favour of user fees is on the bus of cash grab, and should be punished come election time.:angryfire:

I won't tell you how to vote.

 

[JLM]

Maybe. Certainly private insurance should be allowed for those who want it, and maybe it should be compulsory. And maybe it should all be privatized (with the exception of non-consensual services).



I don't totally agree with this. If you can't work, it should be automatic. But if you can work, then the government has an obligation to ensure you have an opportunity to work. I could see two options here:

1. If you're unemployed and sent to school to learn some trade or profession, then the school could be required to pay this insurance to cover you while you're studying. But if you get kicked out of that school, obviously they won't cover your insurance anymore.

2. If you're unemployed and do some volunteer work to gain work experience, the government could cover you since you're still making a contribution to the community and trying to better yourself.

This is where the concept of some kind of Canadian improved version of the US Peace Corps could be of value. But, alas, it's too American for some.

YOu make a lot of good points- there's just one problem, too many people these days who are eligible to work - "on paper"- run like a 23 jewel Waltham while in neutral, but in gear and in the real world ain't worth sh*t.

 

[Liberalman]

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?

The doctors would love that it is called extra billing and it would kill the government healthcare

 

[Machjo]

YOu make a lot of good points- there's just one problem, too many people these days who are eligible to work - "on paper"- run like a 23 jewel Waltham while in neutral, but in gear and in the real world ain't worth sh*t.

I'm not sure i follow you here. Do you mean that some who are not able to work might appear to be able to work, and that under such a system would find themselves without coverage?

I can only guess that if a person appears to be able to work, that his physical body would certainly need to be fine, and for us to not notice any phychological issue, it would need to be more of an emotional than some ind of genetic or other problem with the physical brain itself.

I'd imagine that if a person seems to fail all his classes and keeps getting fired from every job he gets, he'd always have the option of joining the government volunteer programme. If even they won't hire him because he seems unstable somehow, then perhaps they could have it as a protocol to recommend such a person for other psychological testing and possible therapy if necessary. If it's something that's curable, then the hospital could cover his medical insurance (hmmm... well, I guess it won't need to. After all, it is the hospital). I agree that in the end, there will be grey areas where it's hard to say if he's really unable to work or if he's just lazy, and I suppose until we're sure, then we can classify them as unable to work and give them free insurance. But I would advise we keep a close watch on him and as soon as we find he can work, we then start treating him like the rest of those who can. I'm all for helping people, but we do need to be cautious.

 

[SirJosephPorter]

I wasn't talking about privatizing. BC Medical wants to allow Americans to join our health care system, creating room for more operating rooms and more doctors because, out of the country people (Americans in this case) would pay 4 times the amount any BC person pays. It is what the BC gov't is proposing at this time and it sounds good to me. The example they are using is that we allow foreign students into our universities at 4 times the cost of BC students and many are very happy to come here because it costs them less than at "home" and because we have a high standard of education here. The feeling is that if it works for the schools, it can work for medical as well.

Now that is an interesting idea. So what you are saying is that Americans will be entitled to the same health care as Canadians, provided they pay 4 times what a BC person pays.

But do you have a health care premium in BC, like we do in Ontario? If so, will four times that cover the total health care costs for Americans? Canadians pay a lot more for health care in the form of income tax. Is four times what Canadians pay a reasonable amount to charge for Americans, does the BC government hope to make a profit from that?

Four times sounds too low to me considering that Canadian pay a hefty amount health care premium in the form of income tax.

 

[SirJosephPorter]

A few weeks ago in the local paper Talloola, it was stated that a dentist from Ladysmith is going to open a dental clinic for free or very low cost to people who need dental work done but cannot afford the high fees in place right now. Several other dentists have jumped on board and I understand that should be opening up reasonably soon. I will watch for it just in case it doesn't hit your paper or in case you happen to miss it. I believe the clinic will be here but take in folks Island wide. I hope it happens as there certainly are a lot of people who require dental but simply cannot afford it. We are fortunate enough to be on two plans - mine and my husband's. I had dental work done in December and for work that cost over $3200.00, I paid only $140.00. I feel very very lucky. Since I don't plan to work any longer than a few more months, it was good to get that expense out of the way. My husband's plan will continue and while I won't get as much paid if I have a next time, I'll still have up to $1500.00 paid per year.

Indeed. Now imagine that happening for all of health care, either because it is privatized, or there are user fees. Mind boggles.

 

[SirJosephPorter]

Yeah, well...................We (yup, both of us) didn't have to wait at all for knee and hip replacements. (Ont.)

Both of us got referred to an orthapedic surgeon and the wait was something like two weeks.

Walk into the local ER with your hand on your chest, and you'll be in the Ottawa Heart Institute within an hour. Helicopter if needed.

??????????????????? I hear the horror stories, but can't think of any local.

Thank Whosisname!!:idea:

There are horror stories in any health care system, including in USA. But those who want to privatize our health care along the line of US health care follow the horror stories here with relish, with glee, while ignoring the much more numerous horror stories in USA. Like the recently released study, which said that 40% of the maternal deaths in USA are preventable with proper access to health care.

 

[AnnaG]

No, I'm totally opposed to price controls, as they don't allow the hospital to adjust to market conditions when necessary. The only exception I'd make to this is if it could be possible to opt out of the price controls. To take an example:

Is that why it costs $3 or 4 hundred to build a wheelchair and yet they cost thousands? Why is it that a pair of tires for a wheelchair in a medical supply store is 4 times the cost of those in a bicycle shop for exactly the same pair? Yeah, no price controls needed there alright.

 

[SirJosephPorter]

That's exactly what I said.

And I said I find that hard to believe. At least here in Ontario, travel agents strongly advise anybody traveling to USA to get health care insurance before going there. The costs in USA are much higher than in Ontario and Ontario will only pay at the Ontario rates.

If you fall ill in Florida or indeed in any place in USA you may be stuck with huge health care bill. We always take out medical insurance when we travel to USA.

 

[AnnaG]

Indeed. Mind boggles.

That's obvious.

 

[Machjo]

Is that why it costs $3 or 4 hundred to build a wheelchair and yet they cost thousands? Why is it that a pair of tires for a wheelchair in a medical supply store is 4 times the cost of those in a bicycle shop for exactly the same pair? Yeah, no price controls needed there alright.

So why doesn't some other wheelchair company come in to take that market?

 

[AnnaG]

There are horror stories in any health care system, including in USA. But those who want to privatize our health care along the line of US health care follow the horror stories here with relish, with glee, while ignoring the much more numerous horror stories in USA. Like the recently released study, which said that 40% of the maternal deaths in USA are preventable with proper access to health care.

The Lord of ASSumption speaks.
Who said people want private healthcare "along the line of US health care"? Most people I've seen never specify what brand of private healthcare they'd like to see. But with your fixation on everything American, I can understand your ASSuming things like that.

 

[Machjo]

The Lord of ASSumption speaks.
Who said people want private healthcare "along the line of US health care"? Most people I've seen never specify what brand of private healthcare they'd like to see. But with your fixation on everything American, I can understand your ASSuming things like that.

Yup. If it's not Canadian, it's American:lol:

 

[AnnaG]

So why doesn't some other wheelchair company come in to take that market?

Maybe because of greed? Why accept $1000 for a product when you can get $4000?

 

[AnnaG]

Yup. If it's not Canadian, it's American:lol:

Exactly. I guess in Porker's tiny little mind, ooops, I meant world, there are only 2 countries on the planet.