Some Things Canada Gets Right

[Smallc]

I think you miss the point, smallc. Any wait time is too long.

So what fictional country are you planning to take up residence in?

[Smallc]

I have fought this one size fits all system for the last 8 years.

So instead of trying to improve upon our system, you've been trying to destroy it then. I wouldn't expect you to get far that way.

[Oleg Bach]

So instead of trying to improve upon our system, you've been trying to destroy it then. I wouldn't expect you to get far that way.

That's a fairly wise statement. It's not about destroying a system - it should be about tweaking it - and fixing the broken parts....but some get lofty and rigid in their thinking - you can be so far right that you forget to do what is right - and that is help - not over throw a system you have no replacement for.

[August1991]

August, the cost of the US wait times was not factored in either. How is it any different?

What are the US wait times - compared to the Canadian wait times?

---

It's common on this forum to argue that the choice is not dichotomic (big word) between the US and Canada but between what we have in Canada and many other possibilities. Argus often talks about European health care systems.

Well, I'm willing to ignore the other systems and compare directly the US system and Canada's. As a first step, I think someone should take into account the cost of waiting in an emergency ward, or waiting in a doctor's office.

Official bureaucratic statistics don't consider these waiting costs. Do private businesses include as a cost the time that you are put on hold?

-----

Ugh, I have fallen into a trap. I wanted to start a thread on how we in Canada get some things right and I see that the thread has fallen into a debate on health systems.

If I could write an equivalent article in a US review, I would speak rather about a more fundamental Canadian success. We in Canada have avoided Civil War. I think that we Canadians have achieved this because we recognize collective rights. Americans choose civil rights.

Anyway.

Edited February 10, 2009 by August1991

[Oleg Bach]

Wait times only cost the waiter - time! There is no connection between long wait times and added expense to the system. When a patient waits - he is absorbing the cost emotionally, personally and financially - the system is static during this period and not part of the WAIT - they are busy providing service. Cluttering of emergency wards is due to a lonely and paniced public that lacks the skill of first aid and situations that are so simple the common lay person can remedy what is not a doctor neccesity. The emotional issue is paramount - I would persume that 50% of patients "waiting" are waiting to be touched and talked to - they are just plain lonely and lost --- it's a sad state of our modernity.

[jdobbin]

What are the US wait times - compared to the Canadian wait times?

It depends on what you are waiting for and where you are waiting.

For example, if you are waiting for a psychiatrist, the wait in Manitoba is 6 to 15 weeks whereas in central Minnesota, it is 5 months.

It's common on this forum to argue that the choice is not dichotomic (big word) between the US and Canada but between what we have in Canada and many other possibilities. Argus often talks about European health care systems.

If we decide to go the U.S. route of privatization that is what we have to compare.

If we are looking at universal systems, we have to look elsewhere.

Well, I'm willing to ignore the other systems and compare directly the US system and Canada's. As a first step, I think someone should take into account the cost of waiting in an emergency ward, or waiting in a doctor's office.

Who should that someone be?

There are some very long waits in U.S. and Canadian E.R.s

http://abcnews.go.com/Health/story?id=5884487&page=1

But for 58-year-old Michael Herrara of Dallas help never came. He died of a heart attack last week an estimated 19 hours after he arrived at Parkland Memorial Hospital's emergency room waiting room complaining of severe stomach pains, according to reports from WFAA News in Dallas.

Winnipeg had someone die after 34 hours in the E.R. when no one noticed that him sitting there.

Many in Canada don't have a family doctor. Many in the U.S. can't afford a family doctor.

Who is better off?

Official bureaucratic statistics don't consider these waiting costs. Do private businesses include as a cost the time that you are put on hold?

You have to wonder when you can't call many businesses direct and are put on hold waiting.

[Oleg Bach]

It depends on what you are waiting for and where you are waiting.

For example, if you are waiting for a psychiatrist, the wait in Manitoba is 6 to 15 weeks whereas in central Minnesota, it is 5 months.

If we decide to go the U.S. route of privatization that is what we have to compare.

If we are looking at universal systems, we have to look elsewhere.

Who should that someone be?

There are some very long waits in U.S. and Canadian E.R.s

http://abcnews.go.com/Health/story?id=5884487&page=1

Winnipeg had someone die after 34 hours in the E.R. when no one noticed that him sitting there.

Many in Canada don't have a family doctor. Many in the U.S. can't afford a family doctor.

Who is better off?

You have to wonder when you can't call many businesses direct and are put on hold waiting.

Corporate greed and the need to be occultish and hide from the public - get a human being and pay them...and the reason most companies like the auto answer electo phone voice is because they are not on the up and up - and they do not want to have a question tossed to a human being that might spill the beans... I like it when I dial the phone and YOU pick up - don't need the insult of a machine.

[msj]

He's right about our banking system (but for the wrong reason). Various bank acts have removed alot of regulation in Canada too. (For example, unlike the US, Canadian banks have no government-regulated reserve requirement.)

Not sure what you are trying to say here. Yes, Canada operates under regulations as set out in the Bank Act and for which the Office of the Superintendent of Financial Institutions sets the Tier 1 Capital ratio and other capital ratio's that are supposed to be maintained.

Sure, it's not the same as what most people think of as a "reserve requirement" but it is still regulation, nevertheless (and good regulation at that).

he fact that our federal government had a "surplus" or that the CPP/QPP is "solvent" (meaningless terms in the context of North American governments) are not defining differences.

The fact that the CPP is solvent is important from the point of view of ensuring that Canadians don't have to see increases in the CPP rate or won't suffer cuts in benefits.

This allows Canadians to properly budget for their retirement where some choose to pay into the system and others choose not to based on their individual circumstances and preferences for risk.

[Alta4ever]

So instead of trying to improve upon our system, you've been trying to destroy it then. I wouldn't expect you to get far that way.

YOu can't fix something that is fundamentally flawed.

In our system a patient is drain on hospital resources. Each hospital is given certain amount of funding each year, and each patient eats into that, so they are then less able to buy newer and more up to date equipment and higher more/better staff.

[Progressive Tory]

Its all in respone to one smarmy poster who needs a link as proof of everything.

Anyone we know?

[Smallc]

You can't fix something that is fundamentally flawed.

It isn't nearly so flawed as you think. Yes, you had a bad experience with it, but that doesn't mean that the entire system is flawed.

[Alta4ever]

It isn't nearly so flawed as you think. Yes, you had a bad experience with it, but that doesn't mean that the entire system is flawed.

When people sit on waiting lists, it is flawed.

[Chris in KW]

YOu can't fix something that is fundamentally flawed.

In our system a patient is drain on hospital resources. Each hospital is given certain amount of funding each year, and each patient eats into that, so they are then less able to buy newer and more up to date equipment and higher more/better staff.

If you mean that the health care system will never be able to save every patient, then yes, I guess it's fundamentally flawed.

And yes, each patient IS a drain on resources. Not sure how you'd propose a system where that's not the case.

There are some clear-cut situations where more money and resources will save lives, or buy time.

However, I think in developed countries, we will reach a point where we're pouring so much money and resources into health care that we will see rapidly diminishing returns on healthcare investments. This is especially becoming a problem in our old age -- many of us seem unable to accept the inevitable fact of our own deaths. Does it make sense (budget-wise) to put an 85-year old in intensive care to prolong his bout with some incurable disease? Most hospitals try to avoid that, even though it may seem cruel to that person's family.

The point is not that we shouldn't treat old people, but that we have to think about health-care investment in terms of what it is achieving. And the people who make the budgets will never be able to satisfy everyone. We can spend our entire GDP on health care... we'll all still die.

How's that for a gloomy thought of the day!

[Smallc]

When people sit on waiting lists, it is flawed.

First, there are waiting lists for nearly everything nearly everywhere. What we have to do is bring the waiting lists that are too long down to manageable level.

Second, when someone has a borken arm, you don't fix it by chopping them up into pieces.

[Alta4ever]

First, there are waiting lists for nearly everything nearly everywhere. What we have to do is bring the waiting lists that are too long down to manageable level.

Second, when someone has a borken arm, you don't fix it by chopping them up into pieces.

How do you purpose to bring waiting lists down? They only thing that our current system will allow for is more cash pumped into a failing system. Their are fixes without the need to go to American style health care. There are fixes that allows us to change our system, while still allowing universal access, but people like friends of medicare are scared of any changes, yet we are doomed to collapse under the present system.

In Alberta if the current growth trend continues the entire budget of the province will be consumed by the health care costs in a few short years.

[Smallc]

How do you purpose to bring waiting lists down? They only thing that our current system will allow for is more cash pumped into a failing system.

Its not money that's needed. There's already a great deal of money going into the system. It's doctors and diagnostic equipment that are needed and many provinces are making progress towards improving things.

There is also no way we can still have universal access while at the same time not paying as much for it.

[Alta4ever]

Its not money that's needed. There's already a great deal of money going into the system. It's doctors and diagnostic equipment that are needed and many provinces are making progress towards improving things.

There is also no way we can still have universal access while at the same time not paying as much for it.

What pays for that equipment? what has been removed from the budgets to make room for that equipment and what happens when it gets overloaded, or their isn't the staff to run them more then 6 hours a day?

[waldo]

How do you purpose to bring waiting lists down? They only thing that our current system will allow for is more cash pumped into a failing system.

perk up, bucky - as Alberta weasels it's way towards increased privatization, your pinhead Health Minister has been instrumental in hiring an 'outside health care visionary' to head Alberta's health care system... an Australian, no less! - crikey, apparently there were no qualified persons in Alberta or Canada.

Alberta appoints new president of province's health-care system

an Aussie "agent of change" who was primed to say the right thing out of the gate... "Public funding of health services is a core principle of medicare and that, as far as I’m concerned, is not on the agenda".

as the linked article states:

"He might, however, look at expanding private delivery of publicly funded services to bring wait times down, as he did in Queensland. There, he also introduced a system where operating rooms stayed open on weekends. He also changed the funding system to reward hospitals that met certain targets, rather than funding hospitals in a way that rewarded long waiting lists."

the revamped hospital funding approach is one of his claims to fame: hospitals would no longer receive a fixed yearly budget... rather, they would be funded, ultimately, on the number of patients processed. Get 'em up, move 'em out, Rawhide!

[Smallc]

What pays for that equipment? what has been removed from the budgets to make room for that equipment and what happens when it gets overloaded, or their isn't the staff to run them more then 6 hours a day?

Well then I guess we should just give up, right?

[Progressive Tory]

Cluttering of emergency wards is due to a lonely and paniced public that lacks the skill of first aid and situations that are so simple the common lay person can remedy what is not a doctor neccesity. The emotional issue is paramount - I would persume that 50% of patients "waiting" are waiting to be touched and talked to - they are just plain lonely and lost --- it's a sad state of our modernity.

I couldn't agree more. I've been to a couple of those 'after hours' clinics, and the waiting room is full of people with nothing more wrong than a sniffle. It angers the hell out of me. My usual rule with the flu, is that it's the flu. You only need a doctor if the symptoms are severe or you're running a high temp.

I'm not a doctor, but I'm not an idiot either.

We take healthcare for granted and it's definitely being abused.

I'm one of the lucky ones I guess, when it comes to family doctors. He does take time and respects my dislike of prescription medicines. He now says 'I really think you need this', but only when I really do.

[jdobbin]

When people sit on waiting lists, it is flawed.

Well, that can happen anywhere. You think it is only in Canada?

[Oleg Bach]

When people sit on waiting lists, it is flawed.

A dental problem led me to believe I was about to have a brain hemorage at any moment -- the doc said - we can have you get an MRI in 8 months...lucky for me that a good dentist repaired me....If I was truely in serious trouble I would be dead if I had to wait...The doctor did say I could go to emerg and get one --- but I was not about to wait till I lost the use of half my body and my speech was slurred....There is no reason that we can not purchace a few dozen MRI machines immediately - we spend a fortune on other stuff that is not life saving.

[bjre]

Top 50 Banks of the World by market value

Company			        Country		MCap $b
1	Indl & Coml Bank of China 	China 		173.9
2	China Construction Bank 	China 		128.3
3	JP Morgan Chase 		US	 	117.7
4	HSBC 				UK 		115.2
5	Bank of China 			China 		98.2
6	Wells Fargo 			US 		98.0
7	Banco Santander 		Spain		75.0
8	Bank of America 		US		70.6
9	Mitsubishi UFJ Financial 	Japan		70.1
10	BBVA 				Spain 		45.1
11	Intesa Sanpaolo 		Italy 		44.1
12	U. S. Bancorp 			US 		43.6
13	UBS 				Switzerland 	40.9
[b]14	Royal Bank Canada 		Canada 		40.9[/b]
15	BNP Paribas 			France 		38.3
16	Citigroup 			US 		36.6
17	Bank of Communications 		China 		34.6
18	Westpac Banking 		Australia 	34.1
19	Sumitomo Mitsui Financial 	Japan 		32.7
20	Unicredito Italiano 		Italy 		32.4
21	Mizuho Financial 		Japan 		31.8
22	Banco Itau 			Brazil 		30.8
23	Credit Suisse 			Switzerland 	30.4
[b]24	Toronto Dominion Bank 	Canada 		29.8[/b]
25	Commonwealth Bank of Australia 	Australia 	29.6
26	Societe Generale 		France 		29.1
27	Bradesco 			Brazil 		28.0
28	Royal Bank of Scotland 		UK 		28.0
29	National Australia Bank 	Australia 	27.2
[b]30	Bank of Nova Scotia 		Canada 		27.2[/b]
31	China Merchants Bank 		China 		26.4
32	Hang Seng Bank 			Hong Kong 	25.1
33	Credit Agricole 		France 		24.8
34	Standard Chartered 		UK		23.8
35	ANZ Banking 			Australia 	23.0
36	Al Rahji Banking 		Saudi Arabia 	22.4
37	Deutsche Bank 			Germany		22.1
38	China CITIC Bank 		China 		19.3
39	Barclays 			UK 		18.5
40	Nordea Bank		 	Sweden 		18.0
41	PNC Financial Services 		US 		17.1
42	Resona Holdings 		Japan 		16.9
43	State Bank Of India 		India 		16.8
44	Banco Brasil 			Brazil		16.0
45	Sberbank of Russia 		Russia		16.0
46	UniBanco 			Brazil		15.8
[b]47	CIBC				Canada		15.8[/b]
48	Lloyds TSB 			UK		15.5
49	BB&T 				US		15.2
50	Standard Bank Group 		South Africa 	13.7

http://finmanac.blogspot.com/2009/01/top-5...rket-value.html

[August1991]

The big five Canadian banks — Royal Bank of Canada, Toronto-Dominion Bank, Bank of Nova Scotia, Canadian Imperial Bank of Commerce and Bank of Montreal — survived the recent turmoil relatively unscathed. Their balance sheets remain intact and their capital ratios are comfortably above requirements. Yes, Prime Minister Stephen Harper’s government may buy as much as 125 billion Canadian dollars (about $100 billion) worth of mortgages, increasing banks’ capacity to lend. But this is small change compared with the scale of Washington’s bailout.

NYT

This journalist only touches on the vast differences in Canadian and US monetary history, and repeats the argument that regulation explains the differences - but then notes that "capital ratios are comfortably above requirements".