Americanization of health care in Canada

[the caracal kid]

then it is called tough shit. sounds cruel, but it is the reality under the current system as well when you hear stories like one i remember of a man being in severe pain and unable to move, laying on his back in his living room for weeks, with some kind of back injury, because there was not room for him.

we have seen time and again how government monoliths end up collapsing under their own weight.

yes, if an expanded system could be done, it would be better for "all", but to do so would require that such a system moved beyond the current scope of "healthcare" and into "lifestyle management" (not just to encourage proper diet and exercise, but to properly encourage proper use of the system. BC sent out a "treat yourself" booklet to every house a few years ago to help alleviate people going to emergency rooms for splinters (for ex). I have never seen any reports on if it was effective. I hope it was.)

 

[Summer]

RE: Americanization of he

But you and I both know that "tough shit" isn't going to cut it. Sooner or later those people will have to be treated. What happens when it is the parent of young children? What if it is a child? No reasonable society is going to be comfortable with the idea of just letting people die or suffer permanent disability without even an attempt at treating them, and so sooner or later they will in fact be treated, and the general public will have to assume the cost through one avenue or another anyway.

That is an everyday reality right now in the U.S. One reason our medical costs are as high as they are is because of all the uninsured people who wait until a problem becomes major and then seek care at an emergency room because they know that is the one place they cannot be turned away (by law). Rather than having had inexpensive preventive care or early care for a problem, they often present at the emergency room when the problem is so severe that it requires major intervention, and this intervention costs far more than the initial care would have earlier on. Yet because these patients did not have the money to pay for that earlier care, they receive the more major care in the ER or are hospitalized, and they then receive a bill that they usually cannot afford to pay. So in the end the hospital absorbs the cost, and in turn jacks up the cost of all services it provides, thus spreading the cost of treating the uninsured out over EVERYONE who uses that hospital. Some of that cost even translates into higher charges from the hospital to insurance companies, who in turn pass them on to their customers in the form of higher premiums. In the end, the general public still, winds up paying for the care provided to those who cannot afford to pay for their own, and yet the outcome of that care is often far worse for those patients than it would be under an outrightly public system, because they wait so long to seek treatment. So basically it's less for the dollar, rather than something reasonable, in terms of quality of outcome.

The other side of the coin, of course, is that sometimes people who do not have health insurance will go to the emergency room for a minor health issue (especially if it involves a child) that really ought to be seen in an office visit by a regular physician. Again, they cannot afford the office visit, and would turned away for lack of insurance were they to attempt to see a doctor in the office, but they will go to the emergency room because they know that they cannot be turned away there, even though the problem they are going there for does not belong in the ER.

 

[the caracal kid]

the same stuff happens under a fully public system but for different reasons. that is why an expanded health public system would have to move more into "lifestyle care".

I do think the public system (either fully or private-public) requires everybody has a family physician. It also requires people use that physician appropriately! The same need for user awareness is necessary for emergency rooms.

just to play devils advocate, since i have filled up on IAC's rhetoric in the other thread: what is so wrong with letting people die? they are just doing their part to decrease the surplus population! (i am just joking, and remembering the old scroogie movie!)

 

[Summer]

Re: RE: Americanization of health care in Canada

the same stuff happens under a fully public system but for different reasons. that is why an expanded health public system would have to move more into "lifestyle care".

I for one have no problem with it doing that to some degree. Better lifestyle education could save a lot of people a lot of health problems. Even HMO's in the U.S. try to do a bit toward that, including the one I worked for.

I do think the public system (either fully or private-public) requires everybody has a family physician. It also requires people use that physician appropriately! The same need for user awareness is necessary for emergency rooms.

But when people do not have coverage to see a physician for a particular illness and the ER is their only avenue for obtaining care, that is when the problems develop. That's what happens here in the U.S. on a daily basis.

just to play devils advocate, since i have filled up on IAC's rhetoric in the other thread: what is so wrong with letting people die? they are just doing their part to decrease the surplus population! (i am just joking, and remembering the old scroogie movie!)

Hmmm.... where'd this handy cream pie come from? :idea: :angel1:

 

[tracy]

Summer, I swear you are reading my mind. I have to laugh a little when Canadians talk about private health insurers as providing more choice (they don't!) or being more efficient (they aren't!).

On the matter of choice, I was not allowed to see just any doctor with my HMO. He had to be on the HMO's list. I couldn't go to any hospital. It had to be on the HMO's list. I couldn't get any test or treatment because it had to be approved by the HMO. With the PPO, I can at least choose any doc or hospital, but I still have to get their approval for tests and treatment.

On the matter of efficiency, time after time public has shown to be cheaper than private simply because they don't waste nearly as much money on administration (paying people like Summer's friends to refuse your claims) or paying their shareholders (the profit they make does not go back into providing good medical care).

I work neonatal intensive care and see first hand the amount of money wasted on treating emergencies that could have been prevented or minimized with a little early care. Unfortunately only the er has to treat patients, so that's where the uninsured go. No health care workers would ever deny emergency treatment based on the patient's finances, so those emergency room bills are not going to stop any times soon. And those who say they are ok with being refused emergency care are just lying.

 

[Summer]

RE: Americanization of he

Tracy, you and I have both seen it from the inside, as both patient and provider. It's amazing how much there is that really isn't visible from the outside, isn't it? I honestly never had a clue until a few short years ago.

I've got coverage under a PPO now, through my fiance. Costs a bundle, too, but beats being without. I've gone without insurance before, and was hospitalized for three days during that time with something that could have killed me if left untreated (a DVT). So I also know firsthand about how the uninsured use the system in the only way they can.

 

[the caracal kid]

well, again i must state i am not suggesting an americian system of healthcare, so your HMO issues would not apply.

i am currently in the grey area in our system (unofficial private service and public service). I have 3 doctors, should i need them, the freedom to get whatever care i deem to be the most benefitial to me, the freedom to get tests when i want them (no cues). It is worth it.

 

[tracy]

Re: RE: Americanization of health care in Canada

well, again i must state i am not suggesting an americian system of healthcare, so your HMO issues would not apply.

i am currently in the grey area in our system (unofficial private service and public service). I have 3 doctors, should i need them, the freedom to get whatever care i deem to be the most benefitial to me, the freedom to get tests when i want them (no cues). It is worth it.

Sounds like you're happy within the Canadian system then?

 

[tracy]

Re: RE: Americanization of he

Tracy, you and I have both seen it from the inside, as both patient and provider. It's amazing how much there is that really isn't visible from the outside, isn't it? I honestly never had a clue until a few short years ago.

I've got coverage under a PPO now, through my fiance. Costs a bundle, too, but beats being without. I've gone without insurance before, and was hospitalized for three days during that time with something that could have killed me if left untreated (a DVT). So I also know firsthand about how the uninsured use the system in the only way they can.

One of my coworkers recently got into a car accident. She will never be able to pay the bills. Over 20K for the emergency room care alone (not including her time in intensive care and general medical). And thanks to the new bankruptcy laws, she can't even do that to get rid of her health care bills. It's pretty sad when a nurse can't afford to be hospitalized in the hospital she works in day after day.

 

[Summer]

RE: Americanization of he

Yep. I couldn't pay my hospital bill, either.

 

[the caracal kid]

not really. what i have works because of loopholes.

i would like to see the choices i have become part of the system officially.

 

[Summer]

RE: Americanization of he

So how exactly would YOU set up the system so that everyone was covered for any illness/injury and yet there was no chance of a for-profit entity putting its bottom line ahead of people's health? Oh, and you have to make sure that the same standard of care is available to everyone regardless of whether they can afford private health insurance or not.

Tell us how you'd do it. I'm curious.

 

[tracy]

Re: RE: Americanization of he

Yep. I couldn't pay my hospital bill, either.

And all it does is drive up healthcare costs for everyone else. We have a lot of babies whose care is incredibly expensive, but they will never pay for a dime of it.

 

[Summer]

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?

 

[the caracal kid]

under public-private, all basicemergency care is covered. it is in secodary care that people have the options opened up to them.

for example, a person gets diagnosed with a cancer. the public system offers chemo (and probably some other options), but there are also other effective and experimental treatments that are not offered. under a strict public system, the person has the choice of taking what beurocrats have decided is ok, or paying out of pocket for alternative care. under public-private, a person can plan for their future (yes, i know the old people don't plan beyond what socks to wear tomorrow arguement) as to what type of treatments and coverages they want in case of a need. It gives people individual responsibility for their health and thier lifestyle choices.

Don't think the public system is all that great. It may not have the problems of the US system (which is not the type of system i desire), but it is full of its own problems (some of which do share a common source with the americian and other western systems).

I really want every action taken to see a proactive healthcare system instead of a reactive one, and private-public is one of the methods to that end. Let people choose.

 

[Summer]

RE: Americanization of he

So you're looking at people only taking insurance to pay for unusual things like experimental treatments for diseases they are unlikely to get anyway?

How much do you really think that would cost, and how many people would realistically opt to buy insurance they are unlikely ever to use? Remember too that the premiums are likely to be high if it's going to cover costly experimental stuff, and high premiums are a strong disincentive to buy, especially if one is willing to gamble that they won't get that sort of dire disease (and most people are willing to take that chance).

Basically, it sounds like you're mostly into keeping the public system for the most part. Even now under the public system, people with lots of money can afford to come to places like the Cleveland Clinic or the Mayo Clinic, even if they have to cross the border to do so.

 

[Timetrvlr]

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.

We lost everything including our house. We received bills from surgeons, anesthesologist and assorted specialist, people we had never heard of, demanding a fee. When we enquired as to what they did, they "Consulted". Our insurance paid only a small portion of the bills, the rest was our problem.

Recently, my wife was in a Canadian hospital in BC for an emergency operation. She was in ICU for ten days and four more days in a general ward. They saved her life and it didn't wipe us out financially. That's the real difference between for-profit medical care and Universal health care.

What I am concerned about is updating and improving our Universal Health Care system., that really affects me and everyone I know. I don't want to open the gates to the for-profit medical providers and insurance companies either, I want health care that anyone can afford just as it was originally envisioned. Our current system is a good one but it is badly outdated and needs to be improved. What we do need is a Federal Standard of Universal Healthcare that all Provinces must meet and the ongoing commitment of Federal money to do it. For some reason, the two leading parties are reluctant to discuss it. Jack Layton appears to be the only one that cares about this very important issue.

 

[the caracal kid]

"What we do need is a Federal Standard of Universal Healthcare that all Provinces must meet "

as it is we have a 10 tier system (as has been said by some before).

My gf took advantage of this inequality by flying out to ontario to get a treatment not offered in BC, yet by being in ontario BC medical covers it. So for the cost of a flight you can get different services covered in canada. pretty neat, huh?

yes, summer, i do want to maintian the base public system but i want to see it opened up to cover more as well as become more proactive. As you said, preventative care is cheaper (or earlier treatment). We need a proactive system and i see public-private as the route to it. The primary reason for this approach is because i do not want to suggest too much of a "state health police" system. With parts private, people still have the option of opting out of some services.

I think people really need to see the levels of abuse within the current system. It lays hidden from the public, as a sort of "i know but i don't want to know" disease.

 

[Summer]

RE: Americanization of he

What would you have people opt out of, though?

 

[the caracal kid]

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.