Freedom, Health Care, Glasnost & Perestroika

[ToadBrother]

I wouldn't worry too much about it, if theirs more of a profit to be made from doing medicine I'm sure we'll get more doctors.

However I'm certain triage would still be the name of the game on the public side.

That you're belief that any form of competition or private insurance will result in massive deathtolls because we allowed some doctors to work for profit. You can't really make any arguments against allowing private healthcare, or for that matter show how any nation with both universal healthcare and private healthcare have resulted in more deaths so I can safely assume that allowing some competition in our system will not result in the anarchy you're describing.

Okay, I'm not clear on something here. Are doctors going to be working in both systems, or just in one or the other? Will heart surgeons, for instance, be able to ignore urgency of the patient if the payout is big enough from another patient? You didn't actually answer the question. It's almost as if you're talking about two completely separate parallel systems.

[Canadian Blue]

Okay, I'm not clear on something here. Are doctors going to be working in both systems, or just in one or the other?

It's their choice. I think we can allow adults to make decisions over what they want in their careers. As well the administrators of public hospitals will need to learn how to become more efficient, which isn't a bad thing. Competition breeds innovation.

Will heart surgeons, for instance, be able to ignore urgency of the patient if the payout is big enough from another patient?

Depends on which system he's working in. Right now you're just grasping at straws giving us a bunch of situational questions. People don't die by the thousands in any of the countries I cited, and allowing private insurance in Canada likely won't mean we'll need mass graves.

You didn't actually answer the question. It's almost as if you're talking about two completely separate parallel systems.

Yes, I was. I've already cited which system I prefer, now you're just going on with BS situational questions since you can't defend your own position.

Edited December 17, 2008 by Canadian Blue

[ToadBrother]

It's their choice. I think we can allow adults to make decisions over what they want in their careers. As well the administrators of public hospitals will need to learn how to become more efficient, which isn't a bad thing. Competition breeds innovation.

Depends on which system he's working in. Right now you're just grasping at straws giving us a bunch of situational questions. People don't die by the thousands in any of the countries I cited, and allowing private insurance in Canada likely won't mean we'll need mass graves.

Yes, I was. I've already cited which system I prefer, now you're just going on with BS situational questions since you can't defend your own position.

My position is simple, all Canadians deserve a universal system that does not discriminate based upon income levels, that an individual will get the necessary treatments he or she needs without consideration of how much he or she can pay. Having been someone who was in a serious financial situation when my spouse was diagnosed with cancer, and seeing how people in similar straits in the States were basically bankrupted, I want no system like that. The health care system has, all in all, been pretty good to me, and if some guy with seven digit bank accounts can't jump the queue out of some sense of Libertarian "screw the rest of you" attitude, well, I ain't shedding any tears.

Edited December 17, 2008 by ToadBrother

[Michael Hardner]

My position is simple, all Canadians deserve a universal system that does not discriminate based upon income levels, that an individual will get the necessary treatments he or she needs without consideration of how much he or she can pay.

TB,

Yes this is more or less what we have now. The system doesn't seem to be performing well, so something new is needed

[ToadBrother]

TB,

Yes this is more or less what we have now. The system doesn't seem to be performing well, so something new is needed

So what we have now, where the medical system can't punt people out the door if they can't pay, needs to be dispensed with?

If I'm serious financial straights again and my wife's cancer reoccurs, will I be faced with bankruptcy under your changes? Will my wife get lesser treatments if I can't open my wallet? Will she be priorized downwards?

These problems are very near and dear to me, and damned straights, I'd rather have our senile, stuttering system than one that bases everything on how much money a patient can foot.

[Oleg Bach]

TB,

Yes this is more or less what we have now. The system doesn't seem to be performing well, so something new is needed

The system is semi-privatized...half of this and half of the other. It should decide on which way it wants to go. At the sametime there is something wrong with medicine for profit (private)...They have derived a new term. We all know what the definition of sickenss is - they attempt to double their profits by treating us even if we are not sick - so they have engineered that insidiously stupid term WELLNESS...what the hell is that? That means with privatization they want you to pay out money when you are not sick - very clever.

[blueblood]

So what we have now, where the medical system can't punt people out the door if they can't pay, needs to be dispensed with?

If I'm serious financial straights again and my wife's cancer reoccurs, will I be faced with bankruptcy under your changes? Will my wife get lesser treatments if I can't open my wallet? Will she be priorized downwards?

These problems are very near and dear to me, and damned straights, I'd rather have our senile, stuttering system than one that bases everything on how much money a patient can foot.

Does a millionaire have the right to go and eat at a soup kitchen thus screwing a poor person out of a meal? That's what leftist zealots are advocating with our healthcare system. Why should I be punished with plugging up the medical system for everybody when I can pay and jump the line and free it up for everybody? Including a private element will not jeopardize the public system as long as a salary cap is put in place, and those doctors training at Canadian Universities only to go to the US should have to pay a tax equivalent to their tuition.

[Canadian Blue]

Having been someone who was in a serious financial situation when my spouse was diagnosed with cancer, and seeing how people in similar straits in the States were basically bankrupted, I want no system like that. The health care system has, all in all, been pretty good to me, and if some guy with seven digit bank accounts can't jump the queue out of some sense of Libertarian "screw the rest of you" attitude, well, I ain't shedding any tears.

We're not talking about the UNITED STATES OF AMERICA!!!

We're talking about making reforms to the Canadian healthcare system. Like I stated before just once I'd like to see an argument against any reform that didn't include a reference to the United States, even though myself and every other proponent of some reforms have stated that's the last system we want.

So what we have now, where the medical system can't punt people out the door if they can't pay, needs to be dispensed with?

Jesus Christ. That's what our current system basically does if you're on a waiting list, the only difference is that their are no alternatives for you in Canada.

If I'm serious financial straights again and my wife's cancer reoccurs, will I be faced with bankruptcy under your changes? Will my wife get lesser treatments if I can't open my wallet? Will she be priorized downwards?

Once again, that depends on which system she's with. If theirs more competition then she could very well get better care due to the fact some physicians would like to see your dollars spent in the private sector instead of the public system.

These problems are very near and dear to me, and damned straights, I'd rather have our senile, stuttering system than one that bases everything on how much money a patient can foot.

Problem is that you haven't even bothered to read anything posted, nor can you show how people are dying in droves in countries with some private healthcare involvement. So your argument is based on pure emotion and nothing else, no?

[Michael Hardner]

Oleg, that's a conspiracy theory there. "Wellness" is just a term.

TB,

So what we have now, where the medical system can't punt people out the door if they can't pay, needs to be dispensed with?

If I'm serious financial straights again and my wife's cancer reoccurs, will I be faced with bankruptcy under your changes? Will my wife get lesser treatments if I can't open my wallet? Will she be priorized downwards?

These problems are very near and dear to me, and damned straights, I'd rather have our senile, stuttering system than one that bases everything on how much money a patient can foot.

That's a false dilemma and really at the root of the problem. Your attitude mirrors those of people who have a stake in not changing.

Unfortunately, without improvement to the system it will slowly deteriorate until a right-wing zealot finally comes in and succeeds in destroying the whole thing. This is what happened in Ontario with Harris and I'd rather change things continuously than with a disastrous overhaul.

[Michael Hardner]

Blue,

Does a millionaire have the right to go and eat at a soup kitchen thus screwing a poor person out of a meal? That's what leftist zealots are advocating with our healthcare system. Why should I be punished with plugging up the medical system for everybody when I can pay and jump the line and free it up for everybody? Including a private element will not jeopardize the public system as long as a salary cap is put in place, and those doctors training at Canadian Universities only to go to the US should have to pay a tax equivalent to their tuition.

I want to point out that the system is too sick currently to support such a change.

There are no controls and not enough information currently. We wouldn't be able to tell if the public system was jeopardized or not. Your proposal is therefore too risky.

[Michael Hardner]

double post

Edited December 17, 2008 by Michael Hardner

[blueblood]

Blue,

I want to point out that the system is too sick currently to support such a change.

There are no controls and not enough information currently. We wouldn't be able to tell if the public system was jeopardized or not. Your proposal is therefore too risky.

how so it spurns the economy, reduces wait times, and generates tax dollars.

[White Doors]

Nevermind the fact that if your family is friends with a Dr under our current system they can and do call in 'favours' for you to get you to the head of the line. I don't see why a 'who you know' system is more pluralistic and fair and it certainly doesn't spur innovation, other than to become friendly with your neighbour who is a MD.

[Michael Hardner]

Blue,

how so it spurns the economy, reduces wait times, and generates tax dollars.

I'm going to frame this as though I 100% agree with your approach to make it clear why I think you need to wait.

If you implemented a new system such as yours, there would be inevitably be at least one problem along the way. That problem, no matter now small, would be blown out of proportion by those who have a vested interest in keeping the system the same. The issues as they are today are not dealt with rationally, but instead are cloaked in issues of national identity. So nothing improves.

As such, before we move forward with any kind of solution we need to establish performance metrics that are:

1) Clearly and easily understood.

2) Measured by objective parties engaged specifically to do the job.

3) Bought into *beforehand* by all sides.

4) Gathered and published for public consumption on a continuous basis.

It sounds basic, and in fact it is. These are the minimum requirements to make a decision on whether any system is successful.

But we don't have this now.

A pilot public/private project could help establish this new vehicle for information and prepare us to evaluate the system that you would like to eventually install.

[Oleg Bach]

Nevermind the fact that if your family is friends with a Dr under our current system they can and do call in 'favours' for you to get you to the head of the line. I don't see why a 'who you know' system is more pluralistic and fair and it certainly doesn't spur innovation, other than to become friendly with your neighbour who is a MD.

My nose is running - should I go to emerg doc? I need some loving....it's amazing how many lonely people come to the emergency department just for human contact - maybe we should just have a section at hospitals for the lonely...a kiss and a kind word might save millions.

[stevoh]

Whenever I look at the privatization of our health care system, I look at how I am treated in the currently private dentistry system.

My insurance is provided through my workplace, my health care is provided through my taxes, no difference financially to me there (as in paying method hassles).

However, 15% of the total bill is my responsibility. I would rather pay higher premiums but I am not given that choice. I wouldn't want that in my regular health care.

And, I am sometimes told that something "took longer than expected" (which means it took longer than the insurance company will pay for) so I have to cover that as well, wouldn't want that in my regular health care.

And sometimes I am told something is not even covered. Like if I have two wizdom teeth go bad in a year. I would definitely not want that in my health care system.

And, the key to me is, if ever I am in a tough financial situation, and my payments lapse, I would no longer have dental coverage. That is not acceptable for basic health care, even if it is somewhat acceptable to live with bad teeth.

So, based on my experience with privatized dentisty, I wouldn't want the same system for health care. Its too easy to end up with extra charges or items not covered. Even worse, those expenses are sudden, unpredictable, and my put me in a situation where i have to choose health or bankrupcy, simply not an acceptable choice to me. And even worse if one of my children is denied care due to unforseen financial situations.

Why should I be punished with plugging up the medical system for everybody when I can pay and jump the line and free it up for everybody?

Because a two tier pay for better health care system means that the people who can afford to pay more get better technology, more highly paid health care professionals, and better institutions for their health care. These advantages have an effect on the lower tier of health care as health care professionals are naturally attracted to higher paying cutting edge clinics, the lower tiers health care quality starts to lower. Worse equipment, worse institutions, less highly paid health care professionals.

Unless there was some way to provide the higher tier without any compromise the quality of the lower tier, I am totally against it. I don't see how you can offer better quality private health care without having a negative effect on public health care.

[Canadian Blue]

So we should simply become content with having a mediocre system because the private sector is more open to innovation and efficiency than the public system?

[blueblood]

Whenever I look at the privatization of our health care system, I look at how I am treated in the currently private dentistry system.

My insurance is provided through my workplace, my health care is provided through my taxes, no difference financially to me there (as in paying method hassles).

However, 15% of the total bill is my responsibility. I would rather pay higher premiums but I am not given that choice. I wouldn't want that in my regular health care.

And, I am sometimes told that something "took longer than expected" (which means it took longer than the insurance company will pay for) so I have to cover that as well, wouldn't want that in my regular health care.

And sometimes I am told something is not even covered. Like if I have two wizdom teeth go bad in a year. I would definitely not want that in my health care system.

And, the key to me is, if ever I am in a tough financial situation, and my payments lapse, I would no longer have dental coverage. That is not acceptable for basic health care, even if it is somewhat acceptable to live with bad teeth.

So, based on my experience with privatized dentisty, I wouldn't want the same system for health care. Its too easy to end up with extra charges or items not covered. Even worse, those expenses are sudden, unpredictable, and my put me in a situation where i have to choose health or bankrupcy, simply not an acceptable choice to me. And even worse if one of my children is denied care due to unforseen financial situations.

Because a two tier pay for better health care system means that the people who can afford to pay more get better technology, more highly paid health care professionals, and better institutions for their health care. These advantages have an effect on the lower tier of health care as health care professionals are naturally attracted to higher paying cutting edge clinics, the lower tiers health care quality starts to lower. Worse equipment, worse institutions, less highly paid health care professionals.

Unless there was some way to provide the higher tier without any compromise the quality of the lower tier, I am totally against it. I don't see how you can offer better quality private health care without having a negative effect on public health care.

refer to my salary cap. Taxes generated from these new businesses can be used to better fund public systems. You have to remember that there are also standards that everyone adheres to. Saying that a two tier system is going to result in an incompetant public system is proposterous because the standards in place won't allow it. Just because the private sector can buy better equipment doesn't mean that the public system will become third world. All must meet health and safety standards. Look at professional sports, baseball is dominated by a relatively few teams and as a result is very uncompetitive which causes some problems, football is different due to the fact they have a salary cap, which results in it being competitive, and solves a lot of problems.

[Oleg Bach]

refer to my salary cap. Taxes generated from these new businesses can be used to better fund public systems. You have to remember that there are also standards that everyone adheres to. Saying that a two tier system is going to result in an incompetant public system is proposterous because the standards in place won't allow it. Just because the private sector can buy better equipment doesn't mean that the public system will become third world. All must meet health and safety standards. Look at professional sports, baseball is dominated by a relatively few teams and as a result is very uncompetitive which causes some problems, football is different due to the fact they have a salary cap, which results in it being competitive, and solves a lot of problems.

Those that need immediate and special urgent care can be pushed upwards into the superiour private care system. Use the public system for basic care and the private for high level care - I am sure that both systems can exist in mutual co-operation - but stringent laws must be in place first to ensure there is no abuse of money that is public - that finds it's way into the private sphere. We all assume that if we establish a two tier system that the system will become a mirror of the American - heal for profit only system - this is Canada - we know better.

[guyser]

I dont think your analogy works.

Look at professional sports, baseball is dominated by a relatively few teams and as a result is very uncompetitive which causes some problems,

Very competitive I think you meant. One would have to go back to 2000 for a repeat winner.

football is different due to the fact they have a salary cap, which results in it being competitive, and solves a lot of problems.

What solves thier problems is not the cap, but the lack of guaranteed salaries. One can be cut at anytime.

FYI

[stevoh]

Saying that a two tier system is going to result in an incompetant public system is proposterous because the standards in place won't allow it.

I fail to see why standards are suddenly going to work in a two tier system, when standards are not adhered to (due to staffing/funding shortfalls in most cases) in our current one tier system.

Standards are great, but when you can't meet minimum standards due to shortfalls, as in our current system, the same thing will happen in the public component of a two tier system.

[ToadBrother]

refer to my salary cap. Taxes generated from these new businesses can be used to better fund public systems. You have to remember that there are also standards that everyone adheres to. Saying that a two tier system is going to result in an incompetant public system is proposterous because the standards in place won't allow it.

What are you going to do, start fining public hospitals? Shut them down?

Just because the private sector can buy better equipment doesn't mean that the public system will become third world. All must meet health and safety standards. Look at professional sports, baseball is dominated by a relatively few teams and as a result is very uncompetitive which causes some problems, football is different due to the fact they have a salary cap, which results in it being competitive, and solves a lot of problems.

Do you actually think you'll get a salary cap to fly with the Libertarians? These people don't think government should have any part in the medical system. They sure the hell don't want bureaucrats saying "Okay, a GP makes this much... a surgeon makes this much... a heart surgeon makes this much..."

[ToadBrother]

I fail to see why standards are suddenly going to work in a two tier system, when standards are not adhered to (due to staffing/funding shortfalls in most cases) in our current one tier system.

Standards are great, but when you can't meet minimum standards due to shortfalls, as in our current system, the same thing will happen in the public component of a two tier system.

But to the Libertarians who despise Medicare, that's really the point. It's destruction of the public system via the back door.

[Smallc]

Also, this wouldn't have been an emergency Cat scan issue as it's hard to diagnose an aneurism without a Cat scan, alhough the aneurism could kill her at any moment.

Maximum wait for a Cat scan here is 5 weeks. And that's the maximum wait. At some facilities, it's a week or less. MRI is too long right now with a maximum wait of 3 months. this is because of changes to rules allowing any doctor to order an MRI. To solve the issue, a new dedicated childrens MRI has been bought for the childrens hospital which will bring it back to the level that the Cat scan is at now. My point is that things are done to improve the system all the time. If you find a problem with the system, point it out. The government isn't always aware of the problems and they can't read people's minds.

[Michael Hardner]

Maximum wait for a Cat scan here is 5 weeks. And that's the maximum wait. At some facilities, it's a week or less. MRI is too long right now with a maximum wait of 3 months. this is because of changes to rules allowing any doctor to order an MRI. To solve the issue, a new dedicated childrens MRI has been bought for the childrens hospital which will bring it back to the level that the Cat scan is at now. My point is that things are done to improve the system all the time. If you find a problem with the system, point it out. The government isn't always aware of the problems and they can't read people's minds.

Smallc,

In fact, they're in charge of monitoring the system and communicating how well it's running and they don't do that.

It shouldn't be our job to die on the front steps to inform them that there's a problem.