HEALTH CARE - User fees

JLM

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Here is what I've already said as to why it will improve the service (I never pretended to try to make it the "best in the world" so at least TRY to stick to the truth
" 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."

"User pays" applies to virtually everything else we do (with the possible exception of somethings the Gov't. sticks its nose into) It's just plain common sense.
 
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SirJosephPorter

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Canada has an excellent health care system, too. We just like to complain about it, because we want to make it better.

Only about health care system? We like to complain about everything. We live in one of the best countries in the world, still we probably grumble more than almost any country in the world.

I think many Canadians are like spoiled brats, who don’t know how good they have it in Canada. I always say, those who can afford should go abroad and live in another country (in Europe for instance) for a few months. It is a sobering experience.
 

JLM

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Nov 27, 2008
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It is not patriotism, we just have a excellent health system. I have no idea where these negative figures about our health care system comes from, but having been almost everywhere in the world, there are only 2-3 countries I world trust my life too and only one the U.S. for cancer treatment. No, I have not tried most of them, but I know many people who have. I never said we did not need a health care system, but so far I have not heard anyone talk about regulating the price of treatment. (includes: medicines, equipment, doctors, technicians, nurses fees as well as the 25-40 administrators some say we need to treat each patient.

I am aware of what the Fraser Institute is and does.

As you are most likely already aware, Ironside, Fraser Institute is a NON PARTISAN think tank.
 

SirJosephPorter

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Here is what I've already said as to why it will improve the service (I never pretended to try to make it the "best in the world" so at least TRY to stick to the truth
" 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."

Yes, I saw that argument and I came back with the query as to why people won’t stop going for pre and post natal care, for preventive treatment like Pap smear, cancer testing (colorectal cancer breast cancer etc.). Why would it only stop them from visiting the doctor when they have runny nose (which is a symptom) but won’t stop them when they have no symptoms (pre, post natal care etc.).

What evidence do you have to show that people will still continue visiting doctors for preventive care? You have none.

"User pays" applies to virtually everything else we do (with the possible exception of somethings the Gov't. sticks its nose into) It's just plain common sense.

Sure user pay applies to everything else, but medicine is not like everything else. Let us take the example of provincial parks, we have user fee there. If you don’t pay user fee, you don’t visit provincial park, end of story.

What happens if you don’t pay user fee for medicine? If you get even sicker as a result, government will treat you for free, hospitalization, food, drugs the whole deal. How is that going to save any money?

That will be like provincial parks charging use fee, but also telling citizens that if somebody really needs to visit the provincial park, the park will pay for their flight, accommodation, food etc., in addition to the fee for provincial park.

How is that going to save any money?
 
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JLM

Hall of Fame Member
Nov 27, 2008
75,301
548
113
Vernon, B.C.
Only about health care system? We like to complain about everything. We live in one of the best countries in the world, still we probably grumble more than almost any country in the world.

I think many Canadians are like spoiled brats, who don’t know how good they have it in Canada. I always say, those who can afford should go abroad and live in another country (in Europe for instance) for a few months. It is a sobering experience.

Canada is definitely one of the best countries in the world- maybe THE best. I think many PEOPLE are like spoilt brats- that is not a trait peculiar to Nationality. I have cousins who live in England and I haven't heard that they've been particularly "sobered" and last I checked England is part of Europe.
 

SirJosephPorter

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As you are most likely already aware, Ironside, Fraser Institute is a NON PARTISAN think tank.

Your opinion only JLM, you have no evidence for it. That is like Republicans in USA claiming that FOX is not a Republican mouthpiece. Visit their website and you will see conservative position on a whole variety of issues (except health care of course, there they have a far right position, outside the mainstream of even the conservative party).
 

JLM

Hall of Fame Member
Nov 27, 2008
75,301
548
113
Vernon, B.C.
Yes, I saw that argument and I came back with the query as to why people won’t stop going for pre and post natal care, for preventive treatment like Pap smear, cancer testing (colorectal cancer breast cancer etc.). Why would it only stop them from visiting the doctor when they have runny nose (which is a symptom) but won’t stop them when they have no symptoms (pre, post natal care etc.).

What evidence do you have to show that people will still continue visiting doctors for preventive care? You have none.





Sure user pay applies to everything else, but medicine is not like everything else. Let us take the example of provincial parks, we have user fee there. If you don’t pay user fee, you don’t visit provincial park, end of story.

What happens if you don’t pay user fee for medicine? If you get even sicker as a result, government will treat you for free, hospitalization, food, drugs the whole deal. How is that going to save any money?

That will be like provincial parks charging use fee, but also telling citizens that if somebody really needs to visit the provincial park, the park will pay for their flight, accommodation, food etc., in addition to the fee for provincial park.

How is that going to save any money?

People are intelligent beings, they do not have to be treated like little babies. Most people who are seriously sick will go to the doctor. With a "user pay" system no one would be denied access due to indigence. There are possibly a very few people who are too stupid to go to the doctor when necessary, but your sending them on their way isn't going to help them- they'd more than likely get run over by a truck en route.
 
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SirJosephPorter

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People are intelligent beings, they do not have to be treated like little babies. Most people who are seriously sick will go to the doctor. With a "user pay" system no one would be denied access due to indigence. There are possibly a very few people who are too stupid to go to the doctor when necessary, but your sending them on their way isn't going to help them- they'd more than likely get run over by a truck en route.

We are talking of preventive are here, JLM. Sure most people will go to the doctor if they are seriously ill. But will most people go the doctor for pre and post natal care, for routine cancer testing etc., if they have to pay 20 $ for it? Some will, others won’t. Do you have any evidence to suggest that most people will visit the doctor for preventive care even if they have to shell out 20 $ for it? Human nature tells us that many of them won’t.

As to your claim that nobody will be denied access due to indigence, how are you going to achieve that? You want to put in one more layer of bureaucracy to decide who gets the exemptions and who doesn’t? Of course there will have to be machinery set up to handle appeals, any disputes etc. You are going to set up a substantial bureaucracy for that. How often is everybody’s status checked? Every six month? Every year? Who is going to pay for it?

There are many unanswered question, with huge implications for health of the population.
 

ironsides

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Feb 13, 2009
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" 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."

"User pays" applies to virtually everything else we do (with the possible exception of somethings the Gov't. sticks its nose into) It's just plain common sense.

The $20 fee is not a bad idea, it would make people think first before seeing a doctor for a frivolous reason. Some insurance plans have what they call a co-pay which is waived for initial visits which would take care of annual checkups.
 
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JLM

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Nov 27, 2008
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We are talking of preventive are here, JLM. Sure most people will go to the doctor if they are seriously ill. But will most people go the doctor for pre and post natal care, for routine cancer testing etc., if they have to pay 20 $ for it? Some will, others won’t. Do you have any evidence to suggest that most people will visit the doctor for preventive care even if they have to shell out 20 $ for it? Human nature tells us that many of them won’t.

As to your claim that nobody will be denied access due to indigence, how are you going to achieve that? You want to put in one more layer of bureaucracy to decide who gets the exemptions and who doesn’t? Of course there will have to be machinery set up to handle appeals, any disputes etc. You are going to set up a substantial bureaucracy for that. How often is everybody’s status checked? Every six month? Every year? Who is going to pay for it?


There are many unanswered question, with huge implications for health of the population.

I can't speak for women but for men there is only one type of cancer (prostate) where testing has been effective in extending life. There was an interesting piece on CBC radio the other night on the subject. More important than any tests is to listen to your body and get lots of exercise. Why would a person who doesn't eat right and doesn't exercise be interested in tests? They would just be counter productive.
 

SirJosephPorter

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The $20 fee is not a bad idea, it would make people think first before seeing a doctor for a frivolous reason. Some insurance plans have what they call a co-pay.

Quite. It will also keep people away from the doctor when it come to pre and post natal care, preventive care etc., resulting in higher infant mortality and increase in cancer incidence.

As to copay, that works differently from user fee. My understanding is that copay applies to hospital stay. So if hospital expenses come to 100,000 $, the patient will be on the hook for 10% or 20% of it, or 10,000 $ or 20,000 $.

Copay does not keep people fro seeking medical treatment, if sickness is serious enough, people will seek the treatment. However, copay is probably responsible for many bankruptcies. If somebody is stuck with a sudden, unexpected bill for 20,000 $, that may well cause him to declare bankruptcy (especially if he is already heavily in debt).
 

JLM

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Nov 27, 2008
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Vernon, B.C.
Canada is definitely one of the best countries in the world- maybe THE best.
 
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ironsides

Executive Branch Member
Feb 13, 2009
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Quite. It will also keep people away from the doctor when it come to pre and post natal care, preventive care etc., resulting in higher infant mortality and increase in cancer incidence.

As to copay, that works differently from user fee. My understanding is that copay applies to hospital stay. So if hospital expenses come to 100,000 $, the patient will be on the hook for 10% or 20% of it, or 10,000 $ or 20,000 $.

Copay does not keep people fro seeking medical treatment, if sickness is serious enough, people will seek the treatment. However, copay is probably responsible for many bankruptcies. If somebody is stuck with a sudden, unexpected bill for 20,000 $, that may well cause him to declare bankruptcy (especially if he is already heavily in debt).


No, co-pay has nothing to do with hospital visits (although it can, just means that for Ex, a patient pays $500 and policy covers everything else) mostly it is used for partial payment of medicines and doctor visits.
 

SirJosephPorter

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I can't speak for women but for men there is only one type of cancer (prostate) where testing has been effective in extending life. There was an interesting piece on CBC radio the other night on the subject. More important than any tests is to listen to your body and get lots of exercise. Why would a person who doesn't eat right and doesn't exercise be interested in tests? They would just be counter productive.

It is not only prostate, colorectal cancer testing is also very important. If your doctor has not told you about it, he is seriously falling down on his job. Recently Ontario has started pushing colorectal testing in a big way. If they can prevent a few cancers that way, it will result in big savings.

In Ontario, doctors give patients colorectal testing kit. Patients collect stool samples and mail it to the laboratory, it is all free. Doctor gets a bonus for getting so many patients a year to get tested.

More and more jurisdictions these days are emphasizing preventive screening and rightly so. For women, of course there is the checking for breast cancer.

All the preventive care will be in jeopardy if people have to pay 20$ each time to do it.

And let me get this strgaight, did CBC say that testing for prostate cancer is useless? If the didn't that means testing still prevents some prostate cancer. Now in your Utopia, no doubt everybody eats right and exercises, but in Canada, many people don't do that.

If prostate screening detects even a few cancers, that means preventive care is important.

Anyway, so in your Utopia, if somebody does not exercise and eat right, will he be denied treatment for prostate cancer? How else are you going to get everybody to exercise and eat right?

If your alternative to preventive testing is that everybody must exercise and eat right, you may as well give up, it ain’t happening.
 

SirJosephPorter

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No, co-pay has nothing to do with hospital visits (although it can, just means that for Ex, a patient pays $500 and policy covers everything else) mostly it is used for partial payment of medicines and doctor visits.

We may be arguing semantics here, I thought payment for doctor's visit was user fee, while payment for hospitalization was copay.
 

JLM

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Nov 27, 2008
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"It is not only prostate, colorectal cancer testing is also very important. If your doctor has not told you about it, he is seriously falling down on his job."- He told me about it. A very impractical test untess a person has symptoms. I never denied the importance of prostate testing. Get it myself every December.
 

SirJosephPorter

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"It is not only prostate, colorectal cancer testing is also very important. If your doctor has not told you about it, he is seriously falling down on his job."- He told me about it. A very impractical test untess a person has symptoms. I never denied the importance of prostate testing. Get it myself every December.

In most cancers, once you develop symptoms, it is usually too late. Either it has metastasized (spread all over body) when it is untreatable, or it may be treatable by extensive chemotherapy, medication etc. That is very expensive to the health care system, very annoying and painful to the patient.

Colorectal testing detects cancer when it is in very initial stages. In very initial stages, the treatment is painless and doesn’t cost very much. If you don’t want to get testing done that is your affair of course. But governments rightly are emphasizing preventive medicine these days and rightly so.