yet another fine example

[Nova_C]

My second link didn't take, so here it is: http://www.factcheck.org/askfactcheck/is_health_care_better_in_canada.html

 

[tsst]

...Canadians, by average, are healthier with longer life expectancies, lower infant mortality and lower maternal mortality....

This is a factor of lifestyle more than healthcare. We in the USA have some of the worst lifestyle habits for sure. Or are you inferring a correlation to folks living or dying as a direct result of treatment or denial of treatment?

...The thing is, Canada doesn't score much better than the US on the WHO's reports. Canada's implementation of UHC isn't very good. The Swiss have a system of mandatory insurance - that is, health care is privately insured, but the industry is regulated and everyone is required to buy insurance. People on low incomes are subsidized to ensure that premiums don't hurt the poor. It seems like a good compromise between the US and Canadian systems and the Swiss system is pretty widely regarded as one of the best in the world...

Nobody here wants folks to lack access to healthcare. Most of the issues are based on who pays for the subsidizing and the doubt that the gov can run it and do a good job. As you readily admit Canada doesn't and they are socialist what makes anyone think a capatalistic based society and its gov would do it better or even do it good?

Anyway, to respond to tsst's post directly:



The government does not mandate prices. They negotiate them with the pharmaceutical company. If you really think a company is going to agree to a contract with the Canadian government that has them selling at a loss to Canada you're out of your mind. They simply don't have as large a profit margin in Canada as they do in the US. So yeah, Americans are making up some of the difference by paying more, but it's a difference in profit margin only...

That's semantics. Mandate/negotiate, they control the prices. No they probably wouldn't sell at a loss but for sure they can run margins much closer and make up for it here because the price is what the market will tolerate. What ends up happening is that markets that will pay more end up absorbing more costs for R&D, manufacturing, etc.

Also, I don't believe for a second that a business would do what's right for the betterment of a country. Of course they wouldn't. Businesses are driven by the profit motive and that's the way things should be. However, people don't always have a choice when it comes to health care and government oversight prevents profiteering from desperate people, something that is absolutely going on in the US right now....

Gov oversight is a very real concern on the deployment of a UHC. I for one don't believe our gov can do it and do it well.

If you want to compare the single best clinic in the US with the whole of the Canadian system, you go right ahead, but it's ridiculous. A single clinic rated as the #1 in a nation is of course going to be better than the average. That's what above-average means. ...

I am not comparing it to the average I was comparing it to ALL in Canada. There is not a hospital in Canada better, none. The others they compete with are here Johns Hopkins, Mayo Clinic and UCLA Medical Center. I was making a point that our care is top notch. It is the cost and availability of insurance that is the downfall. The WHO reports don't simply look at care quality.

Although, I'm curious. How many people can afford to go to that clinic? Is the Cleveland Clinic something that most cardiology patients go to? I'm sorry your father had to go through something so scary and it's reassuring that he was able to see the best and brightest to improve his quality of life, but does that clinic see anyone regardless of ability to pay?...

Yes. They also have seen patients from every state in the US and over 80 other countries.

This analogy is pretty flawed since health care performance can't really be compared to cars, but okay, let's run with it. Since Canadians are healthier, live longer, and have broader access to health care, it's more like a BMW being cheaper than a Yugo since the Canadian system costs less. (I don't even know what a Yugo is. )

For reference: http://www.time.com/time/specials/2007/article/0,28804,1658545_1658533_1658529,00.html

lol Actually I was comparing the Yugo to Canada and BMW to USA healthcare. Just because it is affordable and more available does not equate to better care.

In fairness the Yugo comparison may have been a little harsh.

 

[tsst]

An interesting stat I saw while looking for info.

Cleveland Clinic has performed about 500 robotic heart surgeries - more than any facility in the country - with 0 percent hospital mortality and 99 percent success. Robotic valve repair results in shorter hospital stays and costs less when compared with non-robotic valve repair.

 

[Nova_C]

lol Actually I was comparing the Yugo to Canada and BMW to USA healthcare. Just because it is affordable and more available does not equate to better care.

In fairness the Yugo comparison may have been a little harsh.

Perhaps, considering Canada is rated as overall better health care than the US.

As far as the Cleveland Clinic goes, that place is remarkable. However, you weren't straight with me. According to the Clinic's website, the only people who aren't billed for services directly are Ohio residents who fall below a certain line, in which case, they are covered by the state government. A little socialist for my tastes.....

Anyway, everyone else is charged for services rendered. Your father's stay of three weeks would have cost $80,000 for the room alone. If your insurance covers that, awesome. If not, though, and a very large portion of the US populace is uncovered, that is prohibitive.

Here's the thing. My belief in the Canadian system comes down to one simple ideal: No one should be refused necessary medical care. Regardless of how good the US system is for those who can pay, those who can't are left in the cold. The number of people who declare bankruptcy would decline by more than half if there was a government run insurance option.

In Canada, lots of people have to wait a while for treatment. But they get treatment. And trends in both countries are moving towards each other. US ER wait times are up to an hour according to the CDC. Every single province in Canada is attacking the issue of wait times. Is the US worried about the increase in your nation? If so, is anything being done about it?

Ultimately, the largest provider of health insurance in the US claimed profits in excess of $4 billion dollars, a profit of 4%. Health insurance companies spend an average of 47% of revenue on claims. That means that in one single health insurance provider in the US, over $53 billion dollars is going to overhead. Over half! And the government is supposed to do worse?

 

[Nova_C]

Let me add that I think that what the Cleveland Clinic does is pretty amazing. In fact, if what the Cleveland Clinic does would be adapted all across the US you'd have a two tier medical system that ensures that the poor are not refused necessary medical treatment. That Clinic is pretty close to what the federal government is trying to do with the rest of the US.

 

[Ricky87]

Anyway, everyone else is charged for services rendered. Your father's stay of three weeks would have cost $80,000 for the room alone. If your insurance covers that, awesome. If not, though, and a very large portion of the US populace is uncovered, that is prohibitive.

Here's the thing. My belief in the Canadian system comes down to one simple ideal: No one should be refused necessary medical care. Regardless of how good the US system is for those who can pay, those who can't are left in the cold. The number of people who declare bankruptcy would decline by more than half if there was a government run insurance option.

In Canada, lots of people have to wait a while for treatment. But they get treatment. And trends in both countries are moving towards each other. US ER wait times are up to an hour according to the CDC. Every single province in Canada is attacking the issue of wait times. Is the US worried about the increase in your nation? If so, is anything being done about it?

Ultimately, the largest provider of health insurance in the US claimed profits in excess of $4 billion dollars, a profit of 4%. Health insurance companies spend an average of 47% of revenue on claims. That means that in one single health insurance provider in the US, over $53 billion dollars is going to overhead. Over half! And the government is supposed to do worse?

I like your post; especially the bolded section. I am with the simplification of health-care by the US government, and that figure you posted on "Health insurance companies spend an average of 47% of revenue on claims" is a big reason why. If we just focused on treating, healing, and preventing and could ignore private insurer profit margins than we would be in much better shape. Their should be no substantial profit when it comes to national health, and excess money that's made is being taken by sick people who just want a good quality of life!.

 

[danielle]

4% profit is actually a low margin and while 53% of monies received by insurnce companies are not spent on claims they are spent on R&D, salaries, operating expenses, and of course monies not recouped go into that 53% as well when patients do not pay...in our country patients often do not pay The US offers free health care as it is to those unable to pay for coverage falling below a very fair income line IMO. Pregnant women, children under the age of 18, and those who are disabled receive automatic coverage, free prescriptions, and access to any specialist they need. In our country the government doesn't tell us what prescriptions we can't take, what procedures are not allowed, or how long we have to wait. Nova we discussed this in another thread you live in the richest province in Canada, but health care on the whole in Canada is not equal. Provinces with more money have more facilities, doctors, specialists, and services, but still these richer Canadians come here for treatment. In your country patients with suspected lung cancer can't get a PET scan in most provinces because the machines are costly and unavailable so they come here, in your country patients may wait years unable to work disabled by a condition as minor as a torn ACL because they are "waiting" for surgery, and while they wait your government turns their back and doesn't provide the monies they need to live. In your country illegal immigration, fraudulent disability claims, and life-styles are too different to compare your system with ours it just not an even playing field at all. We use more health care than any other nation because of the way we live- we're lazy, fat, smoke, drink, abuse drugs, just hopped the border with swine flu, and driving a benz to the grocery store to use our foodstamps. Two different cultures
A government system here would cost twice what yours does and as your system struggles financially how is it you think we can endure these expenses? We have a military in our country- wheres yours? Oh thats right we're your neighbors I'm not being rude btw, but serious. We are too different as a country or culture for a system like Canada's to work and it doesn't work all that well there anyway. It may be cheaper I won't argue that, but in the end you pay for it being taxed 20+% and still we have a higher degree of available medical technologies, more doctors per patient for each region, more available medication options, more nurses per patient, more hospitals and emergency facilities, outpatient centers, and specilists than Canada-I for one sleep well at night knowing that

 

[Nova_C]

Danielle, 4% is not a high margin, that's for sure, but these are insurance companies. What R&D do they do? They are not medical companies. I think over half going to bureaucratic overhead is ridiculous. Also, why would an insurance company be liable if a patient doesn't pay? If the insurance company denies a claim, they'd have to be taken to court to make them do so. The only other reason a patient wouldn't pay is if they don't have coverage, so no insurance company is involved anyway.

Of course, this makes everyone who is paying pay more, but anyway.

As far as Alberta being rich, yeah, it is, but as I explained in the thread you're talking about Canada has the Equalization program. Transfer payments are paid to the government by every province based on the economy of those provinces. That means Alberta pays way, way more than anyone else, except maybe Ontario. Then those funds are fed back to the provinces based on need. Alberta and Ontario are the only two provinces who don't receive any funds back at all. A lot of people complain about this, especially in Alberta, but it ensures all provinces have the funds to provide equal levels of health care and education.

The little dig about our military is irrelevant, and I think our military deserves way more funding than it gets as it is, but we have 1/10th the population you do with several times the landmass. Canada is always going to be vulnerable. The thing is, the military can't defend against terrorism (That's the realm of internal security such as CSIS and the RCMP) and who's going to mount an invasion into Canada?

I sleep well at night, too, knowing that if I get injured, can't work, and I'm let go, my medical costs are covered so that one day I will get better and return to the workforce.

 

[tsst]

Perhaps, considering Canada is rated as overall better health care than the US....

This statement is deceiving. When you think better you are counting costs, deployment, etc. When I think better I am thinking medically only.

As far as the Cleveland Clinic goes, that place is remarkable. However, you weren't straight with me. According to the Clinic's website, the only people who aren't billed for services directly are Ohio residents who fall below a certain line, in which case, they are covered by the state government ....

I never said they didn't bill I said yes to the question you asked. (below)

but does that clinic see anyone regardless of ability to pay?

Anyway, everyone else is charged for services rendered. Your father's stay of three weeks would have cost $80,000 for the room alone. If your insurance covers that, awesome. If not, though, and a very large portion of the US populace is uncovered, that is prohibitive....

And it was absolutely wonderful to have that choice for him to live 8 more years instead of a gov saying his life wasn't worth it or saying he had to wait months or years.

Here's the thing. My belief in the Canadian system comes down to one simple ideal: No one should be refused necessary medical care. Regardless of how good the US system is for those who can pay, those who can't are left in the cold. The number of people who declare bankruptcy would decline by more than half if there was a government run insurance option.

Refusal is a fallacy. If you go into a hospital and need urgent care like in your case with chest pains they will treat you regardless. (just ask the 11 million illegals that get care) What they won't do is elective treatments without insurance.

In Canada, lots of people have to wait a while for treatment. But they get treatment. And trends in both countries are moving towards each other. US ER wait times are up to an hour according to the CDC. Every single province in Canada is attacking the issue of wait times. Is the US worried about the increase in your nation? If so, is anything being done about it?

ER times are on the rise due to non-emergency issues being treated. True emergency issues are treated fast.

Ultimately, the largest provider of health insurance in the US claimed profits in excess of $4 billion dollars, a profit of 4%. Health insurance companies spend an average of 47% of revenue on claims. That means that in one single health insurance provider in the US, over $53 billion dollars is going to overhead. Over half! And the government is supposed to do worse?

danielle handled this one better than I could.

 

[tsst]

L... That Clinic is pretty close to what the federal government is trying to do with the rest of the US.

Not even close. The gov wants to control it all. Not just funding but approvals, eligibility, life expectancy vs value, etc, etc, etc.

 

[tsst]

...What R&D do they do? They are not medical companies.

Most if not all invest in medical research. It's a win for them too. If their investment results in shorter stays etc.

I think over half going to bureaucratic overhead is ridiculous. Also, why would an insurance company be liable if a patient doesn't pay? If the insurance company denies a claim, they'd have to be taken to court to make them do so. The only other reason a patient wouldn't pay is if they don't have coverage, so no insurance company is involved anyway.

When someone doesn't pay the costs for everyone else go up. The insurance company pays indirectly for someone not paying.

The little dig about our military is irrelevant, and I think our military deserves way more funding than it gets as it is, but we have 1/10th the population you do with several times the landmass. Canada is always going to be vulnerable. The thing is, the military can't defend against terrorism (That's the realm of internal security such as CSIS and the RCMP) and who's going to mount an invasion into Canada?

Nobody because we're here! That's not a dig that's a fact. If someone invaded Canada they would have to deal with the USA, Britain and other allies. The whole world knows that. This allows Canada to take a more socialist pacifist approach to national defense. :fullauto::twoguns::flames::madeuce:

 

[Hypancistrus]

Then those funds are fed back to the provinces based on need. Alberta and Ontario are the only two provinces who don't receive any funds back at all. A lot of people complain about this, especially in Alberta, but it ensures all provinces have the funds to provide equal levels of health care and education.

They have every right to complain!

That is Marxism or communism... taking what everyone earns, putting it in a big pot, and then divying it up evenly... only in this case it's not even at all! Y'all are paying for other folks who aren't making money with the money you work hard to make!

Regardless, I do have a question... if Alberta and Ontario don't get any money back, then what money pays for the health care in your province? Do you all pay additionally for that? Is the "equalization" program a seperate program?

I never said they didn't bill I said yes to the question you asked. And it was absolutely wonderful to have that choice for him to live 8 more years instead of a gov saying his life wasn't worth it or saying he had to wait months or years.

This I think is the scary part of this particular proposal... the whole end of life counseling thing... choosing who gets care based on their value to society...

Are we livestock, people?

Not even close. The gov wants to control it all. Not just funding but approvals, eligibility, life expectancy vs value, etc, etc, etc.

Yeah... and they (both Repubs and Dems) have proven themselves more than capable of handling other large programs in the past, right? No Child Left Behind and school systems anyone?

 

[kathylove]

I would just LOVE to have a health system run with the efficiency and results of our public school system - NOT!

 

[Hypancistrus]

I would just LOVE to have a health system run with the efficiency and results of our public school system - NOT!

Is it wrong that as a public school teacher I am not offended by this statement and actually agree with it?? *scratches head*

 

[tsst]

...This I think is the scary part of this particular proposal... the whole end of life counseling thing... choosing who gets care based on their value to society...

Are we livestock, people?

They want to treat us like livestock.

Yeah... and they (both Repubs and Dems) have proven themselves more than capable of handling other large programs in the past, right? No Child Left Behind and school systems anyone?

lmao. They couldn't even handle their own checking accounts a few years back. Or paying taxes correctly.




Nova_C, Also a side note they, as in the gov forcing this on us, will not be required to participate. They will stay on their cushy fully funded plan and not have end of life counseling. I am sure Ted would not vote for it if he were required to use it. (late 70s with ailing health)

 

[wade]

I would just LOVE to have a health system run with the efficiency and results of our public school system - NOT!

Great point Kathy, maybe we could model the health care after the post office.

 

[kathylove]

"Is it wrong that as a public school teacher I am not offended by this statement and actually agree with it?? *scratches head* "

Haha! It is mostly BECAUSE of discussions with teachers that I feel this way! Most teachers I know would far rather teach in private schools, but can't afford to because the pay is too low. And most parents I know would prefer their kids to be in private schools, but can't afford to because it costs too much. However, many private schools do not charge more than what we (taxpayers) are paying per child in public schools. Seems like that ought to point towards SOME sort of solution!


One of the things I dislike most about the government take over is that it isn't good enough for them, just for "us". Congress should be required to live with the laws they pass - good enough for us, good enough for them!.

Stay tuned for MY health care solutions!

 

[kathylove]

OK - here is my own partial solution for the heath care problems in the U.S. There is no "full solution" unfortunately. Even giving the whole thing to the government will not be a full solution, because that will cause long waits and rationing, as has been discussed.

Kathy's Partial Health Care Fixes (long, but probably not nearly as long as the President's solution!)

First, require that health insurance companies offer the same policies to any group that they offer to a similar sized business, with the same prices and limitations. For example, AARP could offer the same exact policy that is offered by a giant corporation that employs millions of people. And the important part is not only the price, but the fact that employees of large corporations will pay more based on gender or age, but not according to pre-existing conditions. They may even have a 1 year waiting period before covering those conditions, but then they will be covered. As it stands now, a small business with a few employees usually can't afford insurance if anyone in the group is too old, or has a preexisting condition. If everyone could get the best price on insurance just by joining a large organization (you could even have a "citizens of the State of Florida" organization"), then a lot of people without coverage would join, and the rates would come down for those WITH insurance already, because their rates are artificially high because they have to pay for the uninsured who are treated by the hospitals now. And every year the prices go up, more employers drop coverage, causing more uninsured, causing prices to go up to cover THEM...it is a spiral downward that will leave MOST uninsured sooner or later...not sustainable!

Secondly, make sure that all insurance companies offer at least one (or more) policy that is the same across the board, so that those who don't understand "legalize" will know that POLICY A from one company is the same as POLICY A from another company, and can compare prices.

I feel that one of the most important cost containment policies would be to require that "POLICY A" would be a policy similar to the ones being offered now that are high deductible (maybe even $5K), but with very good coverage after that. The reason is that most of the money spent by insurance companies (so I have read) go out for the myriad "small expenses" for constant trips to the doctors for kid's ear infections and other non-life threatening problems. If consumers had to pay either out of pocket, or from their health savings account (a great idea, and tax advantaged, too!), they would be careful consumers, checking costs, just like they do when buying groceries. There is no incentive to be a careful consumer when the insurance is going to pay, and the consumer's cost will be the same, no matter how much the insurance company spends. And if you get to the $5K deductible, you will either pay it from your health savings account, from pocket, arrange payments with the hospital, or if you are really poor, it will be written off, at far less cost to the hospital than if you had no insurance and your whole $50K stay (or whatever it is) had to be written off. The way it is now, you either have full insurance, or you are a charity case - nothing in between. With relatively inexpensive, high deductible insurance, lots of us could afford insurance when we couldn't before. Just think - if I have a job, but it doesn't offer health insurance, and I could now buy reasonably priced, high deductible insurance, the worst that will happen is that I will be stuck with a $5K bill. A burden, but not something that would bankrupt most people. And doctors and hospitals will not have to overcharge to cover so many uninsured. As a small business owner, I had to give up my health insurance years ago, hoping not to get sick. Because of age / preexisting conditions, it would cost more than my mortgage. But if a cheap, 5K deductible was available regardless of preexisting conditions, I would jump on it. There would still be those who couldn't afford even that, but they would be far fewer than the numbers of uninsured we have today. Maybe we would decide that taxpayers should subsidize those earning too little for even those cheap policies - I don't know. Keep in mind that those without insurance are ALREADY subsidized now - they are written off as charity cases, and everyone with insurance pays for it.

High cost of emergency rooms: Of course, a lot of use is because uninsured people can't afford to go to the doctor. But if we could get more people insured, that would help. My plan would be to open clinics adjacent to the ER that would be similar in nature to the health dept. clinics we already have now. These clinics would charge on a sliding scale according to income (as many health dept. clinics already do). They would have longer waits than the ER, with less fancy equipment, and doctors may be general doctors instead of specialists. So costs are much cheaper than the ER. But a triage nurse in the ER would look at incoming patients and assign them to the ER or clinic as needed, freeing up expensive ER resources for those who really need them. That would really help hospital cost containment, as the ER is one of the biggest financial losers because of uninsured patients who MUST be treated, according to law. But treat them in a cheaper clinic, if their condition warrants it! Many hospitals have shut down their higher level trauma centers because of the expense. This would help.

These two items would not FIX the whole system. But neither would anything else I have heard. But I think they would put a huge dent in the problem, while requiring minimal government intrusion. After we implemented these two fixes, we could find some other ways to encourage people to be savvy consumers, rather than having the government take it over and make it just as good as our school system (or post office) - if we are lucky!

 

[RobbiesCornField]

Kathy Love for President!

 

[vetusvates]

Kathy, thank you for the great post. I knew I was following this thread waiting for something brilliant to pop up.

With respect to Louisiana, I do not know exactly how they work (i.e., are paid for), but because of the dwindling (gov't) funding of the Shreveport, New Orleans, and Baton Rouge charity hospitals and their respective ER's,.....there are indeed satellite clinics associated with said ER's, that have sprung up, that are designed to siphon non-emergency situations off of the ER's. Such that waiting times are shorter at both the ER and it's satellite clinic(s). It is my understanding that paying at these clinics is sliding scale, based on last two paycheck stubs (or absence thereof), or a very similar pro-rated scale.

Whether this has come about pro-actively as a major solution,....or as a logical default manoeuvre to work for the short-term,....seems irrelevant. It is working for people. For all classes of people.
What I know is first hand, because my guys qualify to come to my halfway house by technically being documented at indigent status. So we send them to these clinics for everything from spider bites to tooth aches to colds and flu.