HEALTH CARE - User fees

[SirJosephPorter]

The Canadian Health Care System is funded by PUBLIC, TAXPAYERS' MONEY.

As such it should strive to deliver the best service to ALL.

So, if one should find a service in the States that can deliver relief in two weeks, rather than eight months in Canada, the Canadian Health Care System should cover the expenses. After all, it would enable another Canadian to get one step ahead in the cue.

Of course, the Canadian Health Care System is NOT about helping patients. I is about padding the coffers of the Government.

Why should Canada cover elective health care in US? If anybody wants to go to USA for elective health care, let them buy insurance for it in USA and use it same as any American would do.

And it is nonsense to say that Canada should deliver the best health care for all. Canada should deliver the best possible health care for all, possible with the resources available to Canada.

Paying four times as much in USA for the same elective procedure here (hip replacement, cataract etc.), is just not cost effective, it is a waste of money.

I have cataracts in both my eyes and at some stage I will need to get cataract operation. When the time comes and if I find that the waiting list here is too long, I may go to USA to get it done. But I wouldn’t expect government to pick up the tab; I will pay for it out of my own pocket.

 

[Machjo]

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

If one wheelchair compay sells it for $4,000, and another sells it for 4$,500, the first company is out of business unless it's some kind of superior quality wheelchair.

Also, in the event of some kind of voucher system as given as an example above, let's say the government gives wheelchair vouchers of 1000, and a company that wants the right to take the vouchers must forfeit all rights to taking any income other than the vouchers, then I'm sure one company or other will get into the business of making $1,000 wheelchairs. the more expensive wheelchairs might continue to exist, but only for those who can afford them and who'd rather forfeit the vouchers so that they can buy a more expensive wheelchair on their own.

 

[Machjo]

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

The rest is just one vast ocean.

 

[SirJosephPorter]

Yep, I think there are a few things wrong with the system contrary to the opinion of some. For one thing I don't really thing all Canadians are willing to fund the system to cover the true costs. Our health is our most important asset and we have to decide what it's worth to use. Surely equal to the amount some spend on booze and cigarettes. Of course abuse to the system is at fault for a lot of the problem (which user fees up front would solve (much to the chagrin of the resident expert). I'd just as soon they drop me from the system refund my money and I'll take my chances with a private insurance policy (which I bet would be quite reasonable with $1000 deductable)

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).

As to you wanting to opt out of the system, fat chance of that happening. I can just see if government gives people the option to opt out. The healthy ones, who don’t use health care at all, will opt out, leaving only the sick ones, for the government to pick up the tab. And of course the healthy ones, if they get into a serious accident or have cancer, will expect the government to pick up the tab for them as well.

Well, that is not how insurance works. We need plenty of healthy people for insurance to work.

 

[YukonJack]

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?!

 

[AnnaG]

If one wheelchair compay sells it for $4,000, and another sells it for 4$,500, the first company is out of business unless it's some kind of superior quality wheelchair.

?? I don't follow. If our friend goes to buy a wheelchair, he looks at several of about the same quality and whichever one is the least expensive is what he buys. I can assure you that because Brand A's chair is cheaper, they are still making profits. And what's more, Brand A would most likely do a lot more business. What have you been smokin today? lol

Also, in the event of some kind of voucher system as given as an example above, let's say the government gives wheelchair vouchers of 1000, and a company that wants the right to take the vouchers must forfeit all rights to taking any income other than the vouchers, then I'm sure one company or other will get into the business of making $1,000 wheelchairs. the more expensive wheelchairs might continue to exist, but only for those who can afford them and who'd rather forfeit the vouchers so that they can buy a more expensive wheelchair on their own.

So much for market value and YAY gov't nanny!

 

[SirJosephPorter]

User fees will not happen because of so-called "SOCIAL JUSTICE".

There are those who made something of their lives can afford them and there are the slugs who never did anything, but waiting for and receiving hand-outs, who can't.

In our politically correct system the slugs are favoured, in the name of social justice.

In our system, everybody is given equal chance, in the name of social justice. If you want to live in Devil take the hindmost kind of society, where people routinely go bankrupt trying to pay the health care costs, I suggest you move to USA.

 

[Machjo]

Why should Canada cover elective health care in US? If anybody wants to go to USA for elective health care, let them buy insurance for it in USA and use it same as any American would do.

And it is nonsense to say that Canada should deliver the best health care for all. Canada should deliver the best possible health care for all, possible with the resources available to Canada.

Paying four times as much in USA for the same elective procedure here (hip replacement, cataract etc.), is just not cost effective, it is a waste of money.

I have cataracts in both my eyes and at some stage I will need to get cataract operation. When the time comes and if I find that the waiting list here is too long, I may go to USA to get it done. But I wouldn’t expect government to pick up the tab; I will pay for it out of my own pocket.

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.

 

[AnnaG]

User fees are a bad idea, and nothing is going to convince me otherwise.

I doubt anyone could convince you of anything anyway, Sir Ostrich. lol

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).

If I don't want to pay user fees over and above my med insurance premiums, I would be more likely to make sure I didn't get sick. How's that for prevention?
You think weird.

As to you wanting to opt out of the system, fat chance of that happening. I can just see if government gives people the option to opt out. The healthy ones, who don’t use health care at all, will opt out, leaving only the sick ones, for the government to pick up the tab.

Maybe. Maybe not.

And of course the healthy ones, if they get into a serious accident or have cancer, will expect the government to pick up the tab for them as well.

Not everyone is like you.

 

[SirJosephPorter]

And that is exactly what would happen here in the U.S. (again) Every goverment organization must have a BIG bureaucracy to run it, no savings there.

Really? Canada spends very little on medical administration, much less that what USA does. Indeed, administrative costs in US health care systme are astronomical, much more than those of any other health care system. One agency administering health care (even if it is the government) is much cheaper than 1500 separate agencies administering it (I think that is how many insurance companies are there in USA).

Not to mention that that one agency (the government) is not trying to make a profit, while the primary goal of the 1500 agencies (the insurance companies) is to make a profit, health care is only a secondary goal. The first loyalty of an insurance company is to the stock holders, the second to the employees and the third to the patients.

 

[AnnaG]

In our system, everybody is given equal chance, in the name of social justice. If you want to live in Devil take the hindmost kind of society, where people routinely go bankrupt trying to pay the health care costs, I suggest you move to USA.

... and you don't consider yourself more important than anyone else? roflmao Devil take the hindmost? rofflfmao

 

[YukonJack]

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.

 

[AnnaG]

Really? Canada spends very little on medical administration, much less that what USA does. Indeed, administrative costs in US health care systme are astronomical, much more than those of any other health care system. One agency administering health care (even if it is the government) is much cheaper than 1500 separate agencies administering it (I think that is how many insurance companies are there in USA).

Not to mention that that one agency (the government) is not trying to make a profit, while the primary goal of the 1500 agencies (the insurance companies) is to make a profit, health care is only a secondary goal. The first loyalty of an insurance company is to the stock holders, the second to the employees and the third to the patients.

And the first consideration of gov't is bureaucracy, The second is for tax dollars to waste and for bureaucrats' pensions and stuff. The third is votes. And the fourth is the voters. So what?

 

[Machjo]

??
So much for market value and YAY gov't nanny!

How is that any more nanny-statist than a price ceiling as you'd proposed above? In the case of a price ceiling, the government would be forcing all wheelchair companies to sell their wheelchairs at $1,000. In a voucher system, only those companies that choose to opt into the voucher programme so as to sell their wheelchairs to government recipients would have to sell their wheelchairs at $1,000. Companies that choose not to into the voucher programme would still be free to sell their wheelchairs at any price they want. So essentially, you'd have a choice.

If you're poor and need a wheelchair, the government gives you a $1,000 wheelchair voucher which you could cash in at a participating company, which would be prohibited from accepting any payment other than the voucher. Or if you choose to forfeit the voucher and pay with your own cash, then you could buy what you want.

How is that any more nanny-statist than your proposal?

 

[SirJosephPorter]

Another option to consider though is to have a private system that is simply regulated by the government.Through granted that might need a bureaucracy too. But then again, if we take this to its extreme, all government organizations need a bureaucracy, so do we go ahead and privatize the military and police, and what about highway construction, etc. They all need administrations, etc. So while your point is valid, we have to be careful not to demonize bureaucracy completely.

His point is NOT valid, Machjo, the bureaucratic, administrative costs are much higher in USA than they are in Canada.

In Canada, doing accounts receivable, sending the billing to the government is a small part of the secretary’s job. She may spend perhaps 1 to 2 hours every day doing it, entering the billing on the computer (which goes to the government at the end of the month, by a diskette or a modem).

In USA, a doctor almost has to hire a full time person to handle the accounts receivable. There are hundreds of insurance companies, each has a different set of forms, different fee codes, different way of submitting the billing, different address where the billing should go etc.

In short, US healthcare system is a bureaucratic nightmare. USA spends much more on medical bureaucracy than does any other developed country.

 

[Machjo]

His point is NOT valid, Machjo, the bureaucratic, administrative costs are much higher in USA than they are in Canada.

In Canada, doing accounts receivable, sending the billing to the government is a small part of the secretary’s job. She may spend perhaps 1 to 2 hours every day doing it, entering the billing on the computer (which goes to the government at the end of the month, by a diskette or a modem).

In USA, a doctor almost has to hire a full time person to handle the accounts receivable. There are hundreds of insurance companies, each has a different set of forms, different fee codes, different way of submitting the billing, different address where the billing should go etc.

In short, US healthcare system is a bureaucratic nightmare. USA spends much more on medical bureaucracy than does any other developed country.

I'd read about that before. I was not disputing the facts, but simply giving him the benefit of the argument. You can't dismiss all administration. It is needed, but needs to be efficient. And indeed there are areas where the government is more efficient than the private sector. Those areas are far and few between, but administrative streamlining can be one of them in some cases.

 

[AnnaG]

How is that any more nanny-statist than a price ceiling as you'd proposed above? In the case of a price ceiling, the government would be forcing all wheelchair companies to sell their wheelchairs at $1,000.

Gov'ts shouldn't dictate market values. That leads to a great deal of problems. Capping profits still allows leeway.

In a voucher system, only those companies that choose to opt into the voucher programme so as to sell their wheelchairs to government recipients would have to sell their wheelchairs at $1,000. Companies that choose not to into the voucher programme would still be free to sell their wheelchairs at any price they want. So essentially, you'd have a choice.

If you're poor and need a wheelchair, the government gives you a $1,000 wheelchair voucher which you could cash in at a participating company, which would be prohibited from accepting any payment other than the voucher. Or if you choose to forfeit the voucher and pay with your own cash, then you could buy what you want.

You'd have a load of companies not accepting vouchers. 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.

How is that any more nanny-statist than your proposal?

Gov'ts shouldn't dictate market values. That leads to a great deal of problems. Capping profits still allows leeway.

 

[SirJosephPorter]

Well then I guess BC people should be heading for Ontario because you wait a very long time for such things both here and Alberta.

In Ontario it varies a lot for place to place, VanIsle. I mentioned cataract a while ago. Waiting list for cataract in my area is three weeks, which is hardly any waiting at all. In some other areas it may be as much as six weeks, or even three months.

 

[SirJosephPorter]

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

Are you kidding? Doctors would love user fees, would welcome it with open arms, provided they get to keep it. But unfortunately it won’t work that way, government would want a piece of the pie too (a fairly large piece of the pie).

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.

As to killing the government health care, you are probably right there.

 

[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.

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.

Gov'ts shouldn't dictate market values. That leads to a great deal of problems. Capping profits still allows leeway.

I'm not sure I understand what you're getting at here.