yet another fine example

[Hypancistrus]

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.

Johns Hopkins is already running clinics. They call it non-urgent care. When you go to the ER, the triage nurse, just as you said, decides where you should go... ER or non-urgent. In addition, Baltimore now has a plethora of the private urgent care centers called Patient First... they are walk ins for people who are sick or in need of care that is urgent but not an emergency... i.e. flu symptoms, minor cuts, burns, aches, pains, etc. This has cut down a lot on emergency room use in Baltimore. These clinics are open from 8 AM until 10 PM.

 

[tsst]

Ohio started running what they call 'Stat-care clinics' that are a step down from an ER.

 

[Ricky87]

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.

I agree with this totally!!. So few people in the ER are emergency cases, but that's the only place people know where to go, and instead of waiting out their injury/illness they choose the ER. Last time I went their with Pneumonia and I had to wait 4 to 5 hours before I could get checked in. By the time I left and got my prescription I was basically done, yet 95% of the other people in ER were fine enough to watch TV or hit up the candy machine. It was just very inefficient to say the least, and that was in Concord NH on a weekday. I can only imagine what it's like for big city hospitals!.

 

[Nova_C]

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?

It's a separate program. As in, the Equalization formula is based on equalizing services, not funding them entirely. Also, it's taken from the Alberta government, so it's money already taxed. As an Albertan I am actually taken aback that you accuse Canada's poorer provinces of 'not making money'. I guess in Alberta we should hoard all our wealth, right?

Honestly, I don't get what's so bad about governmental co-operation. So what if it's a socialist ideal? The end result is better quality of life for everyone. I am NOT restricted in what I can do. I don't live under an oppressive system. If my tax money can go to fire departments and police and public works and transportation for everyone to use, why can't it go to hospitals and ambulances and doctors, too?

Or do you believe everything should be private and you should be billed for every 911 call you make, every road should have a toll, you should be charged a fee when the fire department comes when your house burns down? Do you have any idea at all how many public dollars are spent every day on you?

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?

Well, that's nothing like the Canadian system, I can tell you that. Choosing who gets care is based purely on a need basis. The more severe your medical emergency, the faster your medical care becomes. The person's 'value to society', whatever that means, is irrelevant.

 

[Nova_C]

Oh, also, since tsst is the one who criticized wait times in Canada, then defended the rising wait times in the US as 'non-emergency wait times', why do you give the US a pass on that, but not Canada, when it's the very same issue?

 

[kathylove]

I am happy to hear that some states are already experimenting with some clinics attached to ERs. Maybe they could be studied to find out the pros and cons of funding them, and plan to do so in every state, after improving whatever needs improving from the first experiments?

We also have urgent care centers here. But I don't see that as a big help (at least the way they are run here) because they are not attached to the ER, and they are not required to treat indigent people as are the ERs. What Eric described sounds exactly like what I had in mind. I have always heard that "necessity is the mother of invention" - maybe it is true in this case! Sure would like to know more about how it is working out, and if it would be a good model for the rest of the country.

I just saw a "20-20" program on TV about health care, and they interviewed a number of people in Canada. Although most Canadians seemed RELATIVELY happy with their health care, they did complain about wait times for expensive procedures, such as non life threatening surgery, and MRIs, etc. They did talk about those who could afford it going to the US for those things. And they also said that there was only one place in Canada that you could immediately schedule an MRI with virtually no wait. They then showed a state of the art, for profit, animal hospital, with the finest equipment. Of course, you have to pay for your pet's MRI there.

 

[tsst]

Oh, also, since tsst is the one who criticized wait times in Canada, then defended the rising wait times in the US as 'non-emergency wait times', why do you give the US a pass on that, but not Canada, when it's the very same issue?

Point taken but my criticism was more directed at the weeks and months of wait time for surgery and cancer treatments and the like not so much ER times. And I don't give the US a 'pass' on it either.

 

[Nova_C]

Point taken but my criticism was more directed at the weeks and months of wait time for surgery and cancer treatments and the like not so much ER times. And I don't give the US a 'pass' on it either.

You're right - the wait times are way too long. It's something that's being addressed because, as Kathy said, most Canadians are very upset about it.

However, it is very much for elective surgery. Yeah, we can't let it be that someone with a crippled knee is on crutches for over a year waiting for surgery, but it's not all like that. The wait for heart surgery, particularly bypass surgery, is down to less than 2 weeks for severe cases and less than 6 for moderate cases. Again, that can improve, needs to improve, but people aren't dying in line. It's not a 'disaster' as Cornsnake124 put it.

And I wouldn't call the US system a disaster, either, but I don't believe it's sustainable as is. There is a lot of money being spent considering how many people end up simply not going to get treatment because of the cost. I'm convinced your money could be better spent and some kind of government option is, according to the rest of the first world, the way to go. America isn't that different from other nations, at least not so different that some of the public options in place in other countries couldn't be adapted. Your government already spends a ridiculous amount of money on health care. Is that money well spent?

 

[tsst]

...And I wouldn't call the US system a disaster, either, but I don't believe it's sustainable as is. There is a lot of money being spent considering how many people end up simply not going to get treatment because of the cost. I'm convinced your money could be better spent and some kind of government option is, according to the rest of the first world, the way to go. America isn't that different from other nations, at least not so different that some of the public options in place in other countries couldn't be adapted. Your government already spends a ridiculous amount of money on health care. Is that money well spent?

The only gov money spent is medicare/medicaid. The large amount is citizens via insurance or personal expense. I am not convinced the gov can do it. They have proven over and over they can't run massive programs and do it well. Our SS system is a great example it is near bankrupt after having been pillaged by our political leaders for decades. I started this thread to show 'yet another fine example' of political mismanagement. And I absolutely don't want the gov having anything to do with medical decisions. (ie who gets care and who doesn't, etc)

 

[Hypancistrus]

It's a separate program. As in, the Equalization formula is based on equalizing services, not funding them entirely. .... Honestly, I don't get what's so bad about governmental co-operation. So what if it's a socialist ideal?

Thank you for the explanation.

Simply put, I am not a fan of the redistribution of wealth. It does not encourage innovation, nor the seeking of advanced degrees and certification. So taking money from me, even health care money, and redistributing it to others, is not something I support. I have worked my butt off to get through two degrees in order to get the best opportunities in my field... why should others who have not worked as hard benefit from that?

Does that means I do not feel badly for people who ARE working hard and have circumstances working against them with regards to insurance, like what Kathy was saying about small businesses? No... and I liked Kathy's suggestions for dealing with that, keeping it in the private sector.

I am not convinced the gov can do it. They have proven over and over they can't run massive programs and do it well. Our SS system is a great example it is near bankrupt after having been pillaged by our political leaders for decades.

'Zactly.

 

[Nova_C]

Thank you for the explanation.

Simply put, I am not a fan of the redistribution of wealth. It does not encourage innovation, nor the seeking of advanced degrees and certification. So taking money from me, even health care money, and redistributing it to others, is not something I support. I have worked my butt off to get through two degrees in order to get the best opportunities in my field... why should others who have not worked as hard benefit from that?

The thing is, society would fall apart if that was not happening. Whenever someone drives on a public road, or calls the police, goes to court, they are benefiting from tax dollars that you have paid. Maybe they've paid more than you, maybe they've paid less than you, maybe they've paid the same as you. The thing is, have you every driven to another state for a holiday or business? Did you pay to have that highway paved all by yourself? Did you pay a toll when you used that highway? People take for granted all the things that the government provides with tax dollars. You don't even think about it, but modern society could not operate without the government running those things.

 

[tsst]

The thing is, society would fall apart if that was not happening. Whenever someone drives on a public road, or calls the police, goes to court, they are benefiting from tax dollars that you have paid. Maybe they've paid more than you, maybe they've paid less than you, maybe they've paid the same as you. The thing is, have you every driven to another state for a holiday or business? Did you pay to have that highway paved all by yourself? Did you pay a toll when you used that highway? People take for granted all the things that the government provides with tax dollars. You don't even think about it, but modern society could not operate without the government running those things.

Nova_C, We are not arguing for the total abolition of gov. We are arguing for minimal gov. I am happy for you that you are happy living in socialism, it's just not for me. This country did not rise, in a few hundred years, to be where it is under socialist, marxist, or communist rule. No offense but I don't want to live in Canada. I don't want America turning into South Canada. I want to live in the USA. And I want as much freedom as humanly possible in a civil society. I love this country and fear its demise the more we swing to socialism and beyond. As we say 'give me liberty or give me death'.

Sorry I didn't intend to get all soapboxish.

 

[Cornsnake124]

Nova_C, We are not arguing for the total abolition of gov. We are arguing for minimal gov. I am happy for you that you are happy living in socialism, it's just not for me. This country did not rise, in a few hundred years, to be where it is under socialist, marxist, or communist rule. No offense but I don't want to live in Canada. I don't want America turning into South Canada. I want to live in the USA. And I want as much freedom as humanly possible in a civil society. I love this country and fear its demise the more we swing to socialism and beyond. As we say 'give me liberty or give me death'.

Sorry I didn't intend to get all soapboxish.

you must spread some more reputation around before giving more to tsst!!

 

[Ricky87]

Honestly, I don't get what's so bad about governmental co-operation. So what if it's a socialist ideal? The end result is better quality of life for everyone. I am NOT restricted in what I can do. I don't live under an oppressive system. If my tax money can go to fire departments and police and public works and transportation for everyone to use, why can't it go to hospitals and ambulances and doctors, too?

Able to rep. Totally weird!. Why am I posting this?!.:bounce:

 

[Nova_C]

Nova_C, We are not arguing for the total abolition of gov. We are arguing for minimal gov. I am happy for you that you are happy living in socialism, it's just not for me. This country did not rise, in a few hundred years, to be where it is under socialist, marxist, or communist rule. No offense but I don't want to live in Canada. I don't want America turning into South Canada. I want to live in the USA. And I want as much freedom as humanly possible in a civil society. I love this country and fear its demise the more we swing to socialism and beyond. As we say 'give me liberty or give me death'.

Sorry I didn't intend to get all soapboxish.

My argument isn't about that - it's about the notion that government involvement is intrinsically bad. This thread started with a link to a government program that isn't working very well. The assumption was that since that one didn't work well, government run health care must not work as well. My argument is that the government runs many, many things well that people take for granted. Why can't health care be one of these things?

America isn't going to turn into south Canada. As much as you may think that Obama is leftist, the Democratic party is still pretty far right compared to our Conservative Party of Canada, our right wing party. The gap is enormous. Any implementation of health care that the Democrats manage to implement will still be heavily privatized. It won't be like Canada's system.

I came into this thread not only because of misconceptions about Canada's health care system, but because many people's objections to UHC are purely ideological. That is, it's socialist, so it's bad. This is a weak argument. We've managed to debate back and forth about the realities of both systems. I don't like ideological debates because they are largely meaningless. However, a debate about the pros and cons of private versus public health care is something I relish.

We're obviously at a point where we have to agree to disagree. I am okay with that. You fear mismanagement, increased wait times, reduced performance because of the government track record. These are things I understand. About the only thing I ask is that people stop bad mouthing the Canadian system as a gimmick to an ideological argument without first understanding why the Canadian system works the way it does.

 

[tsst]

... You fear mismanagement, increased wait times, reduced performance because of the government track record. These are things I understand.

Ding Ding Ding ... you got it. They have a very questionable track record this thread is just one example. Most of your examples are not run by the fed gov. Police, fire, most roads are locally run. My cousin runs a township road dept. My neighbor is a fire chief. Neither are directly controlled from Washington neither have their decisions made by a US senator.

About the only thing I ask is that people stop bad mouthing the Canadian system as a gimmick to an ideological argument without first understanding why the Canadian system works the way it does.

Fair enough. If it works for Canadians and they are happy with it great. I for one don't want it.

 

[kathylove]

Yes - from all of the interviews I have read or have seen on TV, most Canadians are REASONABLY happy with their system. So, if it is a financially viable system that can continue as it is, and the population is happy - then great!

Our own system is NOT viable the way it is - fewer people each year have any insurance at all, which leads to fewer the next year, and increased costs for the remaining insured people each time others are dropped. So I don't think it can continue. But I would rather try to fix the system we have instead of toss it out and give it to our bloated, incompetent, federal government. The LAST thing I want to give them is more money and more power over our lives. If necessary, I would feel more comfortable giving money and power to more local levels of government (although I don't like that either) because I feel that local citizens have more chance to make a difference in local government than in the federal government.

It sounds as though Canadians have a lot more trust in their federal government to do the right thing competently than a lot of Americans have in our own government. If your trust is warranted, and it works well (I am not able to say whether it is or not - that is for you to say), than I am REALLY happy for you! Wish I could say the same down here!

 

[tsst]

Has anyone heard anything about the Whitehouse ... on second thought nevermind!

 

[Ricky87]

Has anyone heard anything about the Whitehouse

I think I've heard of it. Didn't it used to be rented out by some loser from Texas. Good thing his lease ran up, though. Now it's occupied by this wonderful gentleman, and his wife and kids. Their the kind of family where you can just sit down and have a beer with, you know?!.

 

[wade]

There goes the neighborhood.