HEALTH CARE - User fees

[AnnaG]

That would likely lead to the gov't getting into the wheelchair manufacturing business. Pure socialism. Except that pure socialsim isn't attainable so it'd be distorted socialism and somewhere along the line, a few would exploit many.

No, I wouldn't be in favour of government getting into the wheelchair industry. I don't know how much it would cost to mass-produce a wheelchair that meets the most basic functional criteria. If it's more than $1,000 then the value of the voucher might have to be raised. I'm sure though that if the value of the voucher is high enough, and there are enough people who cannot afford luxury wheelchairs, that the vouchers would create a market. I'm sure one company or another would see the opportunity here. The same company might even split into two branches. One would opt into the voucher programme for those on government assistance, etc., and the other would sell the same wheelchair at the same price to those who are not poor enough to receive the voucher but not so rich as to afford the luxury wheelchairs. The higher-end market would still stick around thought I'm sure.

You do know that the companies make different models, don't you?
Like cars, You could buy a Chevy Aveo or Cobalt, or you could buy a Caddy.

I wish you'd figure out the quote function.

 

[SirJosephPorter]

SirJosephPorter, if the Canadian Health Care System is willing and able to pay, let's say $1,000.00 for whatever operation - elective or otherwise - what does it matter where that operation takes place?

If hypocrisy wasn't an issue, that $1,000.00 would be paid to ANYONE in whole or in part of an operation, anywhere in the world.

And it would reduce the witing list for the same operation in Canada.

Better let someone die than pay those damn yanks, right SirJosephPorter?!

Where did you read that Canadian system is willing to pay 1000 $ for any operation, YJ? OHIP has a set schedule for each procedure. They will pay this much for appendix, this much for hip replacement, this much for bowel resection etc.

If somebody gets any medical care abroad, OHIP will pay him according to OHIP rates. If it costs him any more than that, it is up to him to make up the difference (or plead with the hospital not to charge him any more).

 

[Machjo]

That would likely lead to the gov't getting into the wheelchair manufacturing business. Pure socialism. Except that pure socialsim isn't attainable so it'd be distorted socialism and somewhere along the line, a few would exploit many.You do know that the companies make different models, don't you?
Like cars, You could buy a Chevy Aveo or Cobalt, or you could buy a Caddy.

Of course. But I though you were saying that all wheelchairs were way overpriced.Now you're saying that cheaper models exist already? Which is it?

 

[AnnaG]

Of course. But I though you were saying that all wheelchairs were way overpriced.Now you're saying that cheaper models exist already? Which is it?

Both.

I still wish you'd figure out the quote function.

 

[JLM]

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

Better things have been killed...............LOL

 

[Machjo]

Both.

So, do reasonably cheap models exist already? If so, then problem solved. if not, then how do you propose the government intervene specifically in the profits of those companies without becoming nanny-statist?

 

[SirJosephPorter]

I can agree with you in principle here. However, there are other possibilities. For example, I could see some kind of what we might call Universal Medicare. It would be a kind of blend between private and public health care in that while the individual would have to pay for his own insurance (with the government possibly picking up the tab for the more destitute), this insurance would provide medical vouchers for essential medical services which could be cashed in at any voucher hospital, anywhere in the world, that opts into the voucher programme. this would mean of course those hospitals would be required to accept the vouchers for the services the vouchers are earmarked for, and would be prohibited from accepting any money. In this way for example, a hospital in Florida in a particular community with many Canadians living there could choose to opt into the voucher programme. First it would need to seek approval from the Canadian embassy in its country. Once th embansy is satisfied that the hospital meets the necessary requirements, then any Canadian given a voucher for a particular operation and who would like to go to that hospital for the operation would be free to do so. this would have the advantage of making our insurance more mobile.

Of course many kinks would need to be worked out before this could work, but in Europe I believe their national coverage covers them across the EU if I'm not mistaken. So clearly something of the wort could be established.

That certainly sounds feasible, Machjo. The problem is that there is a huge difference between the health care costs in USA and in Canada. So if the Florida hospital accepts the voucher for hip replacement, carries out the operation and sends the voucher back to Canada. Will the hospital get paid according to US rates or according to Canadian rates? That could be the sticking point.

You say it works in Europe. Are the health care costs in different EU countries comparable or do they vary greatly, as they do between Canada and USA?

 

[YukonJack]

"If we had 20$ user fee, I suspect government will take at least 15$ of it. So that if government pays doctors say, 35$ per visit currently, they will reduce that payment to 20$, leaving doctors to recover the rest from the patients. Doctors probably would refuse to do it, and we will have a big revolt on our hands".

That is why I suggested a very nominal $5.00 user fee per doctor visit. Neither the government nor the doctor would want to be seen as greedy vultures, and it would affordable - if disciplinary - for everyone. Let the doctor keep it.

As it is now most doctors insist a visit, paid for - or more correctly chiselled from - the government for refilling a long-standing presciption for a chronic condition. If that is not money-grabbing, undeserved, I don't know what is. Combined with the fact that the visit, totally unneceserily robbed the patient of his/her time, in addition to the 15-20 minute waiting the doctor always subjects everyone, regardless of appointment time.

The same $5.00 should be forfeited by the doctor if he/she ignores the time of the appointment and ambles in 15-20 minutes late.

 

[SirJosephPorter]

In the famous words of Ronald Reagan, SirJosephPorter (Jimmy Carter acolyte): "Here you go again!"

All I said that if EVERYONE had to pay a whatever small amount for a doctor visit, the total health care cost would go down for everyone. On another thread I suggested $5.00, and one of your socialist soul-mates thought that it was too small.

There is none so poor that could not afford a $5.00 user fee. If it may be at the cost of a case of beer or a pack of cigarettes, so be it.

The slugs I referred to are the ones who decline even that small responsibility of their own lives.

5 $ is too small an amount, YJ. It probably will cost more to administer the system that what the 5$ would raise. There will have to be an administrative bureaucracy to manage the user fees. That bureaucracy probably will cost more than what the user fees would raise.

 

[AnnaG]

So, do reasonably cheap models exist already? If so, then problem solved. if not, then how do you propose the government intervene specifically in the profits of those companies without becoming nanny-statist?

Wrong. The problem is not solved. Medical supplies are still grossly overpriced. Gov't should regulate the buggers.
Like I said, why should medical supply stores get away with selling tires that are 4 times the price of bicycle shops? What I am saying is that gov't should cap it. What you are saying is that all stores should accept a gov't fixed price or sell something else. It's the difference between control and regulate.

And I am not going to talk to you anymore until you figure out how to use quote functions properly.

 

[JLM]

"User fees are a bad idea, and nothing is going to convince me otherwise. User fee will in the long run lead to increased health care costs and to poor health in general of the population (since it will discourage preventive care)."

Preventative care isn't something that requires paying for, (other than maybe a pair of hiking boots). it's certainly not done at a doctor's office or clinic, it's done at the kitchen table, on the track, on the mountain side or in the swimming pool. It will be a frosty Friday when I start paying a doctor to do preventative maintenance.

 

[SirJosephPorter]

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

Better things have been killed...............LOL

I see. So you agree that the ultimate objective of user fees is to kill the government operated health care system?

 

[AnnaG]

I see. So you agree that the ultimate objective of user fees is to kill the government operated health care system?

wow Having a problem understanding what you see?

 

[YukonJack]

"5 $ is too small an amount, YJ. It probably will cost more to administer the system that what the 5$ would raise. There will have to be an administrative bureaucracy to manage the user fees. That bureaucracy probably will cost more than what the user fees would raise."

SirJosephPorter, my suggestion of a $5.00 user fee was never meant to be a money-making enterprise, either for the doctors or the government.

But if it was known that a frivolous visit will cost you $5.00, I have a feeling that the number of frivoilous vists to the doctor would greatly reduce.

And that, in turn would reduce health care cost for everyone.

 

[JLM]

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.

Charging the Americans four times is criminal never mind gouging. Give it to them at 25% over our cost and they will be happy and will bring lots of business our way. We want to encourage them, not deter them, so they will rent motel rooms, buy groceries, patronize restaurants, buy souvenirs etc. Americans know a lot about how the hospitality industry works - We don't.

 

[SirJosephPorter]

"User fees are a bad idea, and nothing is going to convince me otherwise. User fee will in the long run lead to increased health care costs and to poor health in general of the population (since it will discourage preventive care)."

Preventative care isn't something that requires paying for, (other than maybe a pair of hiking boots). it's certainly not done at a doctor's office or clinic, it's done at the kitchen table, on the track, on the mountain side or in the swimming pool. It will be a frosty Friday when I start paying a doctor to do preventative maintenance.

If there is user fee, preventive care will most certainly have to be paid for. Visit to doctor’s office for pre and post natal care, annual health check up, preventive cancer testing etc. All these will be discouraged by user fees.

It will discourage the poor people big time, but it will also discourage the middle class. Why pay 20$ when nothing is hurting, when there are no problems? That is human nature.

The result will be that we may join USA in having a high rate of maternal deaths, much higher than most other countries. Due to lack of pre and post natal care, number of premature babies may increase (increasing the health care costs), infant mortality may increase. Because cancer was not diagnosed early (due to lack of cancer testing), cancer incidence may increase, thereby increasing health care costs.

I can see many harmful consequences for user fees.

 

[Machjo]

That certainly sounds feasible, Machjo. The problem is that there is a huge difference between the health care costs in USA and in Canada. So if the Florida hospital accepts the voucher for hip replacement, carries out the operation and sends the voucher back to Canada. Will the hospital get paid according to US rates or according to Canadian rates? That could be the sticking point.

Of course it would be not only Canadian rates, but also Canadian dollars. Then it's up to the hospital to convert it and pay whatever currency conversion fees might apply.

Honestly, I can't imagine many US hospitals being interested in participating in something like this except maybe (big maybe) hospitals near the Canadian border or where many Canadians live in the US. But I think the principle itself, once the details are worked out, is sound.

You say it works in Europe. Are the health care costs in different EU countries comparable or do they vary greatly, as they do between Canada and USA?

I didn't say that this particular voucher system worked in Europe. In fact, I'm not even sure if they use such a voucher system between their countries. What I had read though is that for example a Briton's public health insurance covers him anywhere within the EU. I don't know the details of the arrangement though. Though it may every well be something totally different from what I'm proposing, it still proves that it is possible to have a public health care system that still grants you freedom of movement, which is especially important in recession when a person may wish to travel abroad to find work (though granted then he'd be switching public systems too) or when (for a more realistic application in this case) he may have to travel to various countries all the time for business even though he resides and pays taxes in Canada (and let's not assume that all international merchants are necessarily rich in this age of globalization where we have ever more smaller-scale international companies springing up, sometimes even one-man companies).

 

[JLM]

I see. So you agree that the ultimate objective of user fees is to kill the government operated health care system?

You're putting words in my mouth again, S.J. - I don't like it. Gov't system can sink or swim on its own merits- I don't really care.

 

[SirJosephPorter]

Charging the Americans four times is criminal never mind gouging. Give it to them at 25% over our cost and they will be happy and will bring lots of business our way. We want to encourage them, not deter them, so they will rent motel rooms, buy groceries, patronize restaurants, buy souvenirs etc. Americans know a lot about how the hospitality industry works - We don't.

I am not sure you understood what VanIsle was getting at; let me illustrate it with numbers.

Let us say that health premium in BC is 600 $ per year. I think what VanIsle is saying is that BC will offer Canadian health care to Americans for 2400 $ per year (unless I am reading her wrong).

To that my response is, would that be enough to recover the health care costs from Americans? A Canadian may pay only 600 $ per year in health premium, but he may be paying an extra 2000 $ per year in income tax, which may go to health care.

So my question is, would 2400 $ be enough to over the health care costs? Four times sounds too little to me.

 

[YukonJack]

AnnaG laid down the law to poor Machjo by saying:

"And I am not going to talk to you anymore until you figure out how to use quote functions properly."

AnnaG, I DON'T use the quote function, because I think - no, I am sure - I can express my views better, just using my own words.

Have you ever thought what those poor old, mostly dead by now, suckers did attempting to quote someone, before the age of computers, before those who can't or refuse to think for themselves?

The quote function is nothing but a crutch.

SORRY, I GOT OFF THE TOPIC!