Soaring costs force Canada to reassess health model

Machjo

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Oct 19, 2004
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Seeing that part of the strain stems from low birth rates in the country, I think we cannot ignore the importance of immigration. It's either that or people retire later or they pay more taxes. But one of these three will have to give if we're to keep a single-payer system. Heck, even if we go to a two-tiered or even private system.

Right now we just don't have enough taxpayers to support the elderly. Simple as that.
 

JLM

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Nov 27, 2008
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Seeing that part of the strain stems from low birth rates in the country, I think we cannot ignore the importance of immigration. It's either that or people retire later or they pay more taxes. But one of these three will have to give if we're to keep a single-payer system. Heck, even if we go to a two-tiered or even private system.

Right now we just don't have enough taxpayers to support the elderly. Simple as that.

I think you are absolutely right- if it's going to be accomplished through the tax system (and seeing how health care is a service that should be delivered equally to all, regardless of ability to pay), then the higher earners are going to have to bear the brunt. Since Gov't is undoubtedly going to be playing a role to some degree, I think they should lay out two or three scenarios to deal with it & mail them out to the electorate, hold a referendum to make the popular decision, instate it forthwith and put an end to the problem.
 

Machjo

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Oct 19, 2004
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I remember France having a big debate on this a few years ago. Essentially it came down to three options:

1. Increase immigration. Many opposed this since it would mean a transformation of French culture.

2. Raise taxes. Many of the young opposed this for obvious reasons.

3. Raise the retirement age. Many elderly opposed this ofr obvious reasons.

In the end, it appears France is trying a balancing act by raising taxes a little, raising the retirement age a little, and raising immigration a little. The grand compromise.

But let's not kid ourselves that this debate will hit Canada sooner or later unless we start haivng more babies.
 

SirJosephPorter

Time Out
Nov 7, 2008
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Seeing that part of the strain stems from low birth rates in the country, I think we cannot ignore the importance of immigration. It's either that or people retire later or they pay more taxes. But one of these three will have to give if we're to keep a single-payer system. Heck, even if we go to a two-tiered or even private system.

Right now we just don't have enough taxpayers to support the elderly. Simple as that.

I don’t see how higher birthrate will help. There is expense associated with babies being born. Once having been born, it will be at least 20 or 25 years before they start contributing to government coffers. Until then money has to be spent on them (it costs several hundred thousand dollars to raise a baby). And after they have contributed to health care system for 30 or 35 years, they will start drawing heavily upon it and strain the resources again.

Immigration seems to be a more attractive alternative. We don’t have to spend several hundred thousand dollars on each immigrant, and they start contributing right away.

But at the end of the day, there will also have to be service cuts and tax increases. Private insurance companies can step in where government gets out of any particular service.
 

ironsides

Executive Branch Member
Feb 13, 2009
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if any system is going to collapse because of costs, I would expect it to be the American system, since health care costs in USA are much higher than in any other country (and rising at a very fast rate).
Yes, but we can afford to support it longer than most other countries.
 

The Old Medic

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May 16, 2010
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Tonington, are you crazy, or merely stupid?

The fact that there are privately held companies that provide some aspect, or even all, medical care does NOT mean Canada has a mixed government and private health care system. Canada essentially has a single payer system, 100% controlled by the government. It is illegal in Canada for a Canadian citizen to walk into a physicians office, plop down their own money and get an elective surgery done ahead of those that have their provincial health care. The can not pay the physician any more than exactly the same fee that the government would pay that surgeon, that hospital, etc. As a result, very few physicians will even consider bumping a patient up a waiting list, because there is absolutely no financial incentive to do so.

A private health care system would not have its fees controlled by the government. They would offer medical care to anyone that walked through their doors and could pay the fee that this entity charges. The government would NOT control their fees, would not control who gets what service, but also would not pay that entity one red cent.

As to the concept that physicians should be forced to provide services for a flat government salary, that was tried in the old Soviet Union. It didn't work well there, and it will not work well anywhere. Physicians are like anyone else, they want to earn as much as they can for their services. There is absolutely nothing wrong with that.

Competition is a good thing. When you have competition, you keep prices down, quality goes up and everyone benefits.

Private medical means that either you, or an entity other than a governmental body, pays for the medical care you receive. This happens is EVERY European country, it happens in the USA, it does NOT happen in Canada.

This is exactly why many, many Canadians go to the US or other countries for elective procedures. The government of the provinces do not have the funding to allow everyone to receive all medical treatment, so people get on waiting lists. If they have the money, often rather than wait 10-15-20 months or more, they will go to the US and get their surgery done NOW.

Government has a responsibility to see that everyone has access to essential health care. I do not disagree with that premise at all.

But, I also believe that those that can afford something better than the governmental system should have the right to access a higher level of medical care in their own country. Unfortunately, this is NOT allowed in Canada.

And please, stop the bull manure about US insurance companies routinely denying coverage to everyone. They do not do this, unless something is prohibited by the contract that you agreed to when you signed up. I have had private medical insurance (as has my wife and my children) for many years, and we have never once been denied any medical care. My wife is a quadraplegic, and she went on Medicare in the 1980's. Medicare has denied her many medical procedures and treatments, so we almost never utilize it.

Isn't that odd, that Medicare denies treatment that her private insurance covers? That's the difference between government control and private medical insurance. With one, you get whatever the government says you can have, with the other you get what you really need.
 

SirJosephPorter

Time Out
Nov 7, 2008
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Don't forget, we now have a health care system similar to most others in the world. Thanks for the good luck wish.

Not yet, it will be years before the health care system of your country starts to resemble that of some other countries. The full legislation does not come into force for ten years or so.
 

AnnaG

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Jul 5, 2009
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You have come at this from a point of view I did not expect. What I was referring to was privatization of health care services in Canada, not sending Canadians to Costa Rica or India. I was well aware of that health care gambit, but it does nothing to explain the continual expansion of the privater sector in Canadian health care in spite of the fact there does not seem to be any evidence that this saves any money. Can you find any private health care services in Canada that outperform the public sector?
I don't know and I'm not going to look. Private health care in Canada is young. After it smoothes out and runs for a while, then I can assess it. I know the combination of private/public health care works like a charm in other countries and I think Canadians are competent enough to make it work here, so that is all I need to know. I'd be happy if the private sector matched the public sector for cost per capita and alleviated the wait times somewhat by having the ones that can afford private to actually use private if it means less downtime for them. I know if I needed a knee replacement or something, I don't want to wait months in pain for it. I'll spend a few hundred and fly to Europe or Mexico and spend $5 or $6000 getting it done the same week I make an appointment. At least that way I get a holiday in a nice place, see new scenery, and don't have to wait.

Seeing that part of the strain stems from low birth rates in the country, I think we cannot ignore the importance of immigration. It's either that or people retire later or they pay more taxes. But one of these three will have to give if we're to keep a single-payer system. Heck, even if we go to a two-tiered or even private system.

Right now we just don't have enough taxpayers to support the elderly. Simple as that.
Besides that, if we are going to compensate for low birth rates by letting more people in, we should freakin well let the medical practioners that immigrate to actually practise their professions. It's blatantly idiotic to increase a population without increasing the appropriate services that the population needs at around the same rate.

I think it's got a lot to do with superior healthcare just costing more money. :smile:
I don't think that is a big deal. Like I mentioned a couple months ago, the paraplegic friend of ours pointed out that at a medical supply store, his tires cost about twice what a bicycle shop charges for the exact same tire. IOW, if it has a medical application, it costs more by whole number factors. I can imagine what an X-ray machine costs for an airport in comparison to one for a hospital: probably a third the price. And why? The excuse is probably something that the X-ray machine for a hospital has to be more finicky and produce more resolution. 'Scuse me but X-rays are X-rays. They make denser things show up brighter in the plates.

That is true, I cannot see myself heading off to some other country for discounted health care, cheap is not necessarily better. :)
That is why it is prudent to shop around. There are lists of places in countries that provide better services for whichever procedure one needs.

Face it: our public system is not that great. The insurance only covers A, B, and C and leaves out covering D, E, and F so private insurance takes up the slack anyway. If you have something threatening your life, fine, Z00M - into the hospital you go. If it is something that only makes your life miserable like bad knees, hips, torn rotator cuffs, etc., It's called elective and you can wait.
So we might as well bite the bullet and allow private in to do the things that the public system doesn't want to or can't.
 

JLM

Hall of Fame Member
Nov 27, 2008
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Don't forget, we now have a health care system similar to most others in the world. Thanks for the good luck wish.

I wouldn't be too hasty to start jumping up and down with joy over this piece of "good fortune". Things aren't always what they seem. :smile::smile:

I don't know and I'm not going to look. Private health care in Canada is young. After it smoothes out and runs for a while, then I can assess it. I know the combination of private/public health care works like a charm in other countries and I think Canadians are competent enough to make it work here, so that is all I need to know. I'd be happy if the private sector matched the public sector for cost per capita and alleviated the wait times somewhat by having the ones that can afford private to actually use private if it means less downtime for them. I know if I needed a knee replacement or something, I don't want to wait months in pain for it. I'll spend a few hundred and fly to Europe or Mexico and spend $5 or $6000 getting it done the same week I make an appointment. At least that way I get a holiday in a nice place, see new scenery, and don't have to wait.
.

If the plane makes it that far without blowing up.....................:lol::lol::lol::lol::lol::lol:
 

ironsides

Executive Branch Member
Feb 13, 2009
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Saw this about great places to retire, it listed some brief info about their health systems.
Calitri, Italy
Tip: As a retiree with a residency visa, you may be able to gain access to the country's national health-care system. But many expatriates prefer to buy their own health insurance because private hospitals tend to be more upscale than their state-run counterparts.

Chiang Mai, Thailand
The Draw: Far from the civil unrest in Bangkok, this city in northern Thailand offers cooler temperatures and a calmer environment. Renowned as a medical-tourism destination, it is home to an ample supply of private hospitals, state-run clinics and full-service pharmacies that provide high-quality health care at bargain prices.

Punta del Este, Uruguay
Low-cost health care is a plus.

Tip: As an expat, you can buy private hospital insurance, which covers you at specific medical facilities, for about $50 a month.

Buenos Aires, Argentina
Tip: Doctors, dentists and other medical-care providers generally expect you to pay cash upfront.
great-places-to-retire-youve-never-heard-of: Personal Finance News from Yahoo! Finance
 

Tonington

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Oct 27, 2006
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Tonington, are you crazy, or merely stupid?

None of the above.

The fact that there are privately held companies that provide some aspect, or even all, medical care does NOT mean Canada has a mixed government and private health care system.

You can pay for those services with cash. Not a government health card. Cash.

Are you crazy, or stupid? How is that not private medicine? A company that offers services outside of the government funded hospitals and health clinics, that I can pay for with cash out of my pocket? And if you go to my link at the very bottom, and follow it to the source, you can see that it's not just diagnostic services.

You should avoid talking about the system in a country that you do not understand. You end up looking crazy, and stupid.

Canada essentially has a single payer system, 100% controlled by the government. It is illegal in Canada for a Canadian citizen to walk into a physicians office, plop down their own money and get an elective surgery done ahead of those that have their provincial health care.

You really should stop your fingers from typing about matters you have no understanding of.

A major Supreme Court decision that is entirely relevant:
CBC News - Canada - Top court strikes down Quebec private health-care ban

And please, stop the bull manure about US insurance companies routinely denying coverage to everyone.

You should address this to whomever said it. It wasn't me.
 

The Old Medic

Council Member
May 16, 2010
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Oh yea, soak the rich to pay for MY care.

Hate to tell you, but that doesn't work either. All it does is drive the rich out of the country, and you lose all of their income and the jobs that their income produces.

The higher your tax rate goes, the less government actually takes in. That has been proven over and over and over again.

I just love those communists out there though. Lets take from the rich and give to the poor. They don't realize that you can only bleed someone for so long, and for so much, and then they die. Or in the case of the rich, they move their capital to another country, where they will be treated fairly.

If you truly want socialized medicine, where everyone gets exactly the same, what you end up with is everyone getting the lowest common denominator. There is simply no way to avoid that.

Canada already has that. The provinces that are smaller in population are going broke, their health systems are breaking down, and either the system itself has to change, or the taxes will become prohibitive to prop up an ailing system.

And i hate to tell our idealists, but in Canada not everyone does get the same level of medical care. It varies quite a bit from one province to another, and it varies a great deal in rural areas vs more urban areas. The waiting time for elective procedures are MUCH longer in rural areas than they are in cities, as just one example.

Then there is access to specialists. Urban areas have the specialists, the rural areas do not.

Hospitals in urban areas tend to have many more services available, have much better access to technology, and even have better medicines available, better medical care, etc.

Affluent areas tend to have a lot more specialists, a lot better clinics and hospitals, etc. than poorer areas do. That reflects in the kinds of health care that are available to the people, its quality, its basic availability.

No, you don't have the same medical care available from one area of Canada to another. Not even remotely close to that "ideal".
 

Tonington

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Oct 27, 2006
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Did someone actually say that Canadians enjoy uniform health care from coast to coast to coast? They obviously haven't traveled much if they think that. Another possibility is that Old Medic is crafting a straw man to whack...
 

AnnaG

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Jul 5, 2009
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If you truly want socialized medicine, where everyone gets exactly the same, what you end up with is everyone getting the lowest common denominator. There is simply no way to avoid that.

Canada already has that. The provinces that are smaller in population are going broke, their health systems are breaking down, and either the system itself has to change, or the taxes will become prohibitive to prop up an ailing system.

And i hate to tell our idealists, but in Canada not everyone does get the same level of medical care. It varies quite a bit from one province to another, and it varies a great deal in rural areas vs more urban areas. The waiting time for elective procedures are MUCH longer in rural areas than they are in cities, as just one example.

Then there is access to specialists. Urban areas have the specialists, the rural areas do not.

Hospitals in urban areas tend to have many more services available, have much better access to technology, and even have better medicines available, better medical care, etc.

Affluent areas tend to have a lot more specialists, a lot better clinics and hospitals, etc. than poorer areas do. That reflects in the kinds of health care that are available to the people, its quality, its basic availability.

No, you don't have the same medical care available from one area of Canada to another. Not even remotely close to that "ideal".
Which refutes your claim that Canada is where "everyone gets exactly the same, what you end up with is everyone getting the lowest common denominator."