Americanization of health care in Canada

[Summer]

Re: RE: Americanization of health care in Canada

mostly diagnostic options until this much yapped about "pharmacare" comes to be.

one thing we need to change when it comes to the "americanized" healthcare we do have (not to pick on you guys) but our doctors are salesmen for the pharacuetical companies and the diagnostic labs. The only things the nit-wits do well is cast broken bones and prescribe antibiotics (the former can also go sour and the latter they do far too much of). The problem with end-user freedom is idiot patients that want an antibiotic and will go from clinic to clinic until they get a doctor that prescribes what they are looking for. One thing good about your system is people know the cost of medical services. It has been suggested that people actually see what the cost is up here.

Wait - you're saying they opt out of diagnostics, yet somehow a doc is supposed to know how to treat what hasn't been diagnosed? *scratches head* That would be a nice trick if it were possible, but I don't think it is.

And don't kid yourself on the antibiotic thing or the "salesmen for pharmaceuticals" thing, as both are the same down here. Our docs also push various drugs (which in turn have been pushed to them by the actual salesmen employed by the drug companies) and we also have our share of idiot patients who will go from doc to doc looking to get an antibiotic or other drug that they don't really need. The insurance company can still deny payment FOR that drug and maybe even for the appointment if there have already been too many, but it doesn't stop the patient from wasting the doc's time.

 

[the caracal kid]

opt out of funded diagnostic options, purchase insurance for other diagnositc options, or pay for diagnostics themselves.

right now the doc can say "lets do test A", even though test "b" would be more conclusive. The patient should have the option of deciding if they want a different diagnostic service than the doctor wants to run (for a variety of reasons).

I want people to have more control over their healthcare. I don't want to suggest a monolithic intrusive socialist system that would border on social engineering so i am looking at a hybrid system. Perhaps we should just let the sick die and alleviate the surplus population issues if it is going to be so much trouble.

 

[Summer]

Re: RE: Americanization of health care in Canada

opt out of funded diagnostic options, purchase insurance for other diagnositc options, or pay for diagnostics themselves.

right now the doc can say "lets do test A", even though test "b" would be more conclusive. The patient should have the option of deciding if they want a different diagnostic service than the doctor wants to run (for a variety of reasons).

Diagnostics are expensive enough that only the wealthy are likely to pay for it themselves. And setting up an insurance plan to cover only certain diagnostics would A) be so difficult as to not be cost-effective and B) not be something that the average person would purchase, as the average person knows nothing about diagnostics in the first place. Besides, diagnostic testing is an integral part of essential care and treatment. You can't realistically separate it out.

Likewise, the average patient isn't going to know enough about diagnostics to be able to second-guess his doctor in terms of what test would be better. That's why docs go to medical school and study up on the latest advances even during their professional careers, after all - so that they can do a proper job of figuring out what is wrong with their patients and how best to treat them.

A better option would be to make sure that all doctors are up on what is best at the moment, and allow them to be the ones practicing medicine - NOT insurance people, and NOT leaving it for the patients themselves to have to flounder over. If what you're concerned about is doctors ordering not the best test but the most expensive one, keep in mind that it isn't the doctor who is paid for these tests but the testing facility/lab/etc. itself. Keep the cost of tests from lining a doc's pocket and you'll have effectively removed any financial incentive for them to order the "wrong" tests.

I want people to have more control over their healthcare.

Agreed that people should have control over their healthcare, but not that they should have to go to medical school themselves in order to be able to do it.

I don't want to suggest a monolithic intrusive socialist system that would border on social engineering so i am looking at a hybrid system.

I guess I don't see how your idea of a "hybrid" system addresses that issue.

Perhaps we should just let the sick die and alleviate the surplus population issues if it is going to be so much trouble.

Will you please STOP channeling IAC???? :roll:

 

[the caracal kid]

i am still working out the hybrid myself.

i am really trying to work from personal choices to a possible national model, but you are correct that i most likely do not reflec the average user because i see paying for choice as good, understanding medicine and not trusting blindly in doctors as good, etc.

I really do NOT have trust in western doctors given the lack of training they get in areas such as nutrition. I have seen blatently stupid mistakes by doctors. I could have been a victim of such an oversight if i did not already have a private doctor not covered by public services.

Now that said, i will say that doctors are overworked quite a bit and they should not be faulted for everything. The system itself with its billing methods and a lack of complete body healthcare contributes quite a bit. Doctors are overworked, the nurses are increasingly loaded with more demands yet not able to question doctors (last time i heard anything), and a failure of the public to take responsibility for themselves and how they use the system all need to be addressed.

 

[Summer]

Re: RE: Americanization of health care in Canada

i am still working out the hybrid myself.

i am really trying to work from personal choices to a possible national model, but you are correct that i most likely do not reflec the average user because i see paying for choice as good, understanding medicine and not trusting blindly in doctors as good, etc.

I agree with you on all of the above, except that I don't think anyone should have to pay extra for "choice" as choice should ideally be built right into the system that everyone has equal access to and uses. Choice is an integral part of good medicine, as are patient involvement (to the best of the individual patient's ability, that is - some people simply don't/won't understand medical terms, etc. and you can't force them). The key isn't laying on an additional tier of "choice" for those who can afford it (while those who cannot don't get it), but rather altering and improving the public system so that EVERYONE gets to make choices in their own healthcare - choice of which doctor to see, which hospital to use, when to get a second opinion, which of various recommended therapeutic approaches they wish to use in treating a particular problem, etc.

I really do NOT have trust in western doctors given the lack of training they get in areas such as nutrition. I have seen blatently stupid mistakes by doctors.

Agreed here too. The solution is to improve doctor training and include a through grounding in nutrition and an understanding of alternative medicine, etc. as well as to have better oversight of doctors by their more-experienced peers.

I could have been a victim of such an oversight if i did not already have a private doctor not covered by public services.

Both my mother and I were victims of such oversight by PRIVATE doctors (that being all the U.S. really has). I was the fortunate one in that I only spent a week in the hospital. My mother died. (No, these were unrelated incidents, many years apart, involving two completely different doctors in two different states.) Public vs. private isn't the determining factor in avoiding medical mistakes. Better training and oversight, along with just having better doctors in the first place, is.

Now that said, i will say that doctors are overworked quite a bit and they should not be faulted for everything.

Agreed.

The system itself with its billing methods and a lack of complete body healthcare contributes quite a bit.

BINGO! In fact, I daresay these things account for as much as 80% of the problem, if not more.

Doctors are overworked, the nurses are increasingly loaded with more demands yet not able to question doctors (last time i heard anything), and a failure of the public to take responsibility for themselves and how they use the system all need to be addressed.

Yep. Interestingly enough, at the HMO where I worked, RNs were used as the processors who overruled the opinions of doctors in order to deny patient claims, though, including some of the ones that were wrongly denied as I described. So while I do agree that nurses ought to have the freedom to question doctors, I don't see that as a panacea, either.

 

[tracy]

Re: RE: Americanization of health care in Canada

the nurses are increasingly loaded with more demands yet not able to question doctors (last time i heard anything).

Any nurse who tells you that is a bad nurse. Nurses have every right to question doctors, some just lack the balls to do it. The hierarchy in a teaching hospital like mine is resident, fellow, attending. The resident orders something. If the nurse disagrees, she discusses it with the resident first (residents are the most inexperienced and usually open to discussion). If the resident won't budge and the nurse still believes that the resident is wrong, the nurse takes it up with the fellow (the fellow is nearly a full fledged independent specialist, but not quite). If the fellow won't budge, the nurse next talks to the attending doctor (he's the full fledged specialist). If the attending disagrees with her, she either does what's ordered or refuses. A nurse's license is her own to protect and she can't defend an incompetent or dangerous action by saying "the doctor told me to". She will lose her lisence if that's her defense and not be able to work again. I've had dangerous orders written several times and not once have I carried them out. I have also had doc's refuse to write an order when it was needed, and usually a simple "So, I can chart that I informed you of the situation and received no medical orders?" lights a fire under them.

 

[tracy]

Re: RE: Americanization of he

Exactly. And what are you supposed to do, turn away a newborn infant just because his/her parents can't afford to pay the bill?

Exactly. This is the main reason I have for believing healthcare needs to be available for all. I have never seen a parent say "well, we don't have insurance, so I guess you can let our child die...".

 

[tracy]

Summer, thanks for explaining how the health care industry really operates in the States. I don't think most Canadians know or believe that it is such a heartless, profit-oriented system. We lived in the States for many years and had medical emergencies there and in Canada. All I know is that one hospital stay there sent us spiralling into bankruptcy, even though we had health insurance.

It sounds bad, but you were actually lucky that you were able to claim bankruptcy to deal with your health bills. New legislation has gone into effect making it so that health care bills are no longer wiped out by declaring bankruptcy. Those bills never go away.

 

[Karlin]

Well it happened AGAIN - someone [ caracol] has hijacked the discussion away from the theme [with his wierd assertion that "the private health care option" is the reason he is alive].

Here are quotes from the site again for caracol to reply to:

Lengthy waits for consultations, referrals, appointments, diagnostics and, most critically, approval for all these things from the insurance companies.

The delay in approvals often led to setbacks in treatment.

Courses of treatment that run counter to the insurance company's ability to save money are vetoed.

Quite obviously, this individual [the author] found American health care to be much worse than Canada's public system, with the exception of possible better care if you are really wealthy.

Canadians know that benefits of having a healthy population - it actually does cost LESS overall -to the economy, in terms of family and community strife, and as a population ready to face the future - to have healthy people, including the poor. When the poor are ill or dying, we all pay a price - don't forget "the poor are a great source of wealth".

So it is important for everyone that WE ARE ALL HEALTHY. This is a Canadian priority.

The current system has some conflict-of-interest problems that will only be bigger problems if private care is realised. The Pharmaceutical industry is driving the KIND OF CARE we recieve, and thats as true in Canada'spublic system as it is in USA private care. "Create the Problem, Offer the Solution" is in play here - they create illness and then administer pills to cure it...

We can only get away from this crime by having non-corporate control over health care. The doctors get their training from Pharmaceutical-funded medical schools - all of the doctors and all of the med schools.
ALL "medical publishing" is controlled by the Pharmaceutical industry, and their lobby in Washington is by far the largest of any lobby group. Even licence for a medical practise are given out or not given out according to the desires of BigPharmaCorp. THE FDA itself is staffed by former BigPharmaCorp executives,and ex-FDA sits on BigPharma boards.

The control runs down the line from there, with all treatments having to do with taking a pill, as if there are no other valid ways to treat an illness. This way, we can clearly see that many usefull therapies would be left out when treating illness. The cheapest and sometimes most effective treatments could be non-patentable non-pharmaceutical, and it will not be used.

This must change, and that is what we need to talk about, how to bring these back into play. It won't happen when we let the corporate side have control as they do now.

one more point - "Lengthy waiting lists" are just another basic "supply shortage" situation that was created on purpose. Same as the gasoline shortage [created artificially] drove up prices, these waiting times were "arranged" to happen by creating bottle necks at the "seeing a specialist" phase...

It is the "lengthy waiting period for joint replacement" that is driving much of the talk about private care now, so in that we can see WHY they created the shortage. {it will ultimately make the richer, it will create private health care, and it will force more people into paying when allowed to.}

Can you respond to these issues Caracolkid? Or do you just want to tell us more fantasies about how private care saves lives? To see you throw yourself into their corporate arms is nearly funny, but actually is it just sad to see such loyalty to those vile and disgusting corporate medical animals.

 

[Reverend Blair]

RE: Americanization of he

The need to concentrate on the present faults in our system without examining why those faults exist is part of the deal, Karlin. The shortage of healthcare professionals was created through cuts to education and healthcare over the course of decades. It was predictable and there were plenty of warnings given, but that was all ignored in the push to destroy our social safety net.

The most laughable thing is that the same people who did that are now promising to save us money by bringing in, and making us pay for, more (and more expensive) private care. How anybody can maintain that paying more for the same thing is cheaper is beyond me. It's nothing more than blind adherence to the lie of unfettered capitalism.

 

[the caracal kid]

"Can you respond to these issues Caracolkid? Or do you just want to tell us more fantasies about how private care saves lives? To see you throw yourself into their corporate arms is nearly funny, but actually is it just sad to see such loyalty to those vile and disgusting corporate medical animals."

it is not a fantasy, and i did not throw myself into corporate arms of any kind. Quite the contrary.

Now, as to your questions:
A private altenative that is separate from the public system would allow people choice. I am not for dismantling public health care, but for allowing people to have alternatives to what the public system provides.

You are correct that the economy depends on healthy citizens. However, so long as the government is in the business of not enouraging proactive healthy lifestyles while funding reactive healthcare there is a conflict of interest. Yes, it is horrible how the pharmaceuticals have taken control of healthcare in north america. I for one am opposed to this. You confuse my desire for greater feedoms for citizens with supporting corporate healthcare.

 

[Reverend Blair]

A private altenative that is separate from the public system would allow people choice. I am not for dismantling public health care, but for allowing people to have alternatives to what the public system provides.

Then it should be completely separate...no public money whatsoever...and not open to private insurers. If those choosing to use it under those terms want to pay for healthcare via their taxes and again out of their bank accounts, then they can.

If we allow private insurers, who will dump expensive care onto the public system as a matter of course, and cross-over of public money into private institutions, then the public system will be weakened and eventually destroyed.

 

[the caracal kid]

yes, it should be separate, but it should be (including insurance for those alternates). Unless, of course, public health care wants to cover ALL diagonsitic and treatment options, which to date it does not. Lets call it what it is, public health care is health insurance with only one insurer. The government is still an insurer though, and as such is making choices that give the greatest coverage per dollar. If you are "fortunate" enough to fall ill or injured in a common manner that the best treatments are so commoditized that public health covers them then you are doing alright. If you are unfortunate enough to become ill in a way where the best treatments are still expensive or experimental you are left hung out to dry. So rev, do you think that public health services should fund ALL services?

i suspect we agree on the notion that certian things are best in the hands of government because they can not be run properly for profit.

Now, the other problem is that healthcare is treated as separate issue when it is severley intertwined with many other areas of society. Rev, do you think the government should start putting health first in all realms of society? Should it take the economic hit of eliminating unhealthy industries for the long-term gain of a healthier populace?

 

[jimmoyer]

I wonder if any entitlement benefit can escape
the laws of finance, the troubling problem of
World Trade grabbing jobs and companies that pay
taxes for these entitlements ?

 

[Reverend Blair]

So rev, do you think that public health services should fund ALL services?

Yes, including dental, chiropractic and other alternative treatments, and prescribed drugs.

i suspect we agree on the notion that certian things are best in the hands of government because they can not be run properly for profit.

Yes.

Now, the other problem is that healthcare is treated as separate issue when it is severley intertwined with many other areas of society. Rev, do you think the government should start putting health first in all realms of society? Should it take the economic hit of eliminating unhealthy industries for the long-term gain of a healthier populace?

Considering the costs those industries incur, not just in healthcare but in other areas of our society, yes.

In some cases (tobacco and alcohol for instance) that can be done through education. We've already made great strides in that direction.

In other areas, such as corporate polluters, the costs in heathcare and lost productivity are staggering and the corporations need to be made to clean up their act.

 

[the caracal kid]

i am with you rev. if the gov healthcare program covered everything there would not be the areas for private service.

i also support health services having more power in all areas of government. for far too long the gov has played the "acceptable risk" card with people's lives.

 

[Nascar_James]

Re: RE: Americanization of health care in Canada

i support a national public system for basic and emergency services. Beyond that, i am quite happy to pay for options not offered under a single insurer service because they have deemed not to cover something.

Canadians deserve better than a single serve system.

Perhaps a model like car insurance in BC where basic is required through public but extended systems are available from other insurers.

I like my private healthcare, thank-you. I am not going to give it up so that everybody can recieve LCD service.

Same here. I don't want to wind up on a waiting list like many Canadians do every year to have surgery and then not make it to the surgery.

 

[Reverend Blair]

RE: Americanization of he

You should stay down there in Jesusland then, James. Please.

 

[Karlin]

Re: RE: Americanization of he

You should stay down there in Jesusland then, James. Please.

Thats harsh, but yes - Canadians have "agreed" to do it this way, in the spirit of "I will wait if need be, so that we can ALL have the health care we need".

Its like sharing... a concept erased from the American mindset a few decades ago.

One note about the "joint replacement waiting times" is that these are problems that developoed over 20 years, and waiting another 6 mos isn't a bad idea because sometimes patients find alterntive help - {For instance, taking cayenne pepper three times a day for 3 mos. has reversed some people's hip pains enough that they returned to activity}.{ the way the doc explains it"your cartilidge is gone", it seems there is no hope of reversal, but that scenario isn't allways accurate, and X-rays lie sometimes].

ALSO - Joint replacements rarely result in a pain-free hip.

But I do understand the agony of chronic pain in the hip , and how frustrating it can be to wait for relief. Have a toke.

 

[Reverend Blair]

But I do understand the agony of chronic pain in the hip , and how frustrating it can be to wait for relief. Have a toke.

Well...as long as it's just medicinal. :wink: :lol:

Thats harsh, but yes - Canadians have "agreed" to do it this way, in the spirit of "I will wait if need be, so that we can ALL have the health care we need".

Its like sharing... a concept erased from the American mindset a few decades ago.

It is like that. Unfortunately, some seem convinced that we need to follow the example of the USA. Greed does weird things to people.