UFC's Lesnar berates Canadian health care...

[dizzy]

I actually gave you the wrong heading in my last post; should have read: Aggregate Income and Productivity Trends: Canada vs United States, 1961-2008. (Updated: June 25, 2009) , so sorry about that.

I got to it by clicking on the "data" heading on the site I linked to, the one you refer to; the link for that is http://www.csls.ca/data/iptjune2009.pdf and I didn't read through it to find the actual stats from which they extracted the 29% difference in disposable income.

You've hit my nerd funny bone. Unfortunately, I can't go back to the CANSIMs sourced in the tables because they cost money and you haven't yet proven whether or not you're worth me spending my coin . But I'll be honest right now, when you get into the realm of PPP-adjusted GDP or PDI, deflated for CPI, the game we're playing is so purely academic that we would be able to go back and forth all night with sources that perfectly contradict the other.

I am curious why we're still fussing over the 'absolution of canada continental unification organization's' interpretation when I provided yummy OECD and CIBC data. What did you think of those? And also my previously supplied info that fully 10% of americans' private disposable income is spent on healthcare? That's on top of public and employer contributions.

Getting back to the OP, what does any of this say about the launching point, which is that the US spends twice as much?

You had mentioned earlier that americans don't want or wouldn't necessarily benefit from a canadian system. I'd agree in that I think our system is also in transition. But I don't think that the Canadian system was ever on the table. One of the shortcomings of the debate on healthcare in the US is that soundbite culture has framed much of the debate around canadian-brand healthcare. In truth, the system Obama originally proposed was much more like the swiss model.

[dizzy]

And so, the cardiologists push back against the bad press from the move that Danny Williams made:

http://www.nationalpost.com/news/story.html?id=2514581

I respect their frustration with the bad press but everyone needs to chill a bit. The nationalism around this issue is framing the debate more than the operational realities. One of the things that I find particularly good about the Canadian system is that it is plugged into opportunities by geography. For example, southern Albertans are more likely to go to Montana for overflow, because it is the shortest a-to-b line. We don't know whether Danny left for specialist expertise or because the cue suggested a more immediate opening somewhere in the states. When we know this (and whether he's traveling on his own dime or the provinces), we'll be better able to judge.

[Smallc]

If he got sent out of country for a procedure that could have been done in country, probably very quickly, he better be paying for it on his own dime. The story really speaks to everything involved in this. Unless Danny williams has a very rare problem, then there was seemingly no need for him to go to the US.

[bush_cheney2004]

If he got sent out of country for a procedure that could have been done in country, probably very quickly, he better be paying for it on his own dime. The story really speaks to everything involved in this. Unless Danny williams has a very rare problem, then there was seemingly no need for him to go to the US.

Krikey...this hurts:

The spectacle of a prominent Canadian politician seeking out important health care in the U.S. is already being seized upon by opponents of health reform in the States, who tend to portray the proposed changes there as a move toward Canadian-style care.

If Williams has to travel out of province for such procedures, then a trip south is still on the same continent!

[bush_cheney2004]

....Back to the focus of this thread, none of this explains the very high cost of healthcare in the US. Overutilization does.

True...Americans pay more because Americans get/want more. Private and public insurance dollars underwrite excess supply and satisfy the profit motive. After all, health care is not a right...not even in Canada.

[dizzy]

True...Americans pay more because Americans get/want more. Private and public insurance dollars underwrite excess supply and satisfy the profit motive. After all, health care is not a right...not even in Canada.

I'm gonna pass on responding to flag waving rhetoric. Let me know when you want to discuss the details.

[bush_cheney2004]

I'm gonna pass on responding to flag waving rhetoric. Let me know when you want to discuss the details.

In the US, health care services and products are being chased by a huge pool of PUBLIC and PRIVATE insurance dollars, as well as personal spending for elective procedures. Add defensive medicine and fee-for-service payments, and it's easy to understand why costs are high. The Americans even push old geezer scooters and penis pumps paid for by somebody else. Medical professionals specialize in order to take advantage of the money pit.

Canada rations with wait times and gatekeeping while the US rations based on ability to pay, and this has created excess capacity. Provinces take advantage of this reality with standing cross border contracts. "Wait times" are literally a foreign idea to most Americans with health insurance. Wait for what?

[dizzy]

In the US, health care services and products are being chased by a huge pool of PUBLIC and PRIVATE insurance dollars, as well as personal spending for elective procedures. Add defensive medicine and fee-for-service payments, and it's easy to understand why costs are high. The Americans even push old geezer scooters and penis pumps paid for by somebody else. Medical professionals specialize in order to take advantage of the money pit.

Canada rations with wait times and gatekeeping while the US rations based on ability to pay, and this has created excess capacity. Provinces take advantage of this reality with standing cross border contracts. "Wait times" are literally a foreign idea to most Americans with health insurance. Wait for what?

I agree with most of this. The one exception is to acknowledge that wait times also exist in the US for everyone but the rich. There's also the very big issue of exclusion due to 'pre-existing conditions'. The spectrum of insurance options in the US is broad and, indeed, each comes with its own advantages and disadvantages. At my income level (let's say upper middle income) and for those who make less, I see nothing to gain from the status quo or proposed structures for insurance provision.

Despite being a fan of two-tiered healthcare, I guess I have two sets of major concerns based on the American experience. The first is with respect to bureaucratic waste. HC administration in the US consumes 25% of healthcare spending. We're not talking profits here, but money consumed in filing papers to determine eligibility and to process claims. Our system can maintain lower admin costs because it is single payer. What I'd like to research is the difference in size-of-bureaucracy between (privately insured) dental and (publicly insured) doctor services here.

My second, bigger concern is with respect to overutilization. That doctors overprescribe and engage in a disproportionately high number of invasive procedures because it is more profitable to do so (irrespective of the benefit to the patient) is probably my biggest concern. That it seems to happen to the point of financial and physical abuse in the medicare program is criminal.

I do expect that overall spending in Canada has to rise for people to get the service they want, but I expect a more modest adjustment of $500 per capita, primarily to invest in early detection technology and to bring back a few more specialists to accomodate people in less-populated regions. Our intervention-stage load is sufficient and, while more specialists might be nice overall, it's really not the problem. What I would also like to see is an increase in authorities for registered nurses. I don't need to see a doctor every time I want to discuss my cholestoral levels or get my kids runny nose checked out. A nurse would do. When I get my travel shots updated, I go to a privately-run travel medical clinic where someone considerably less qualified than a nurse uses a computer to crosstab one's health issues with each vaccination's side effects. It costs me $15 for the visit and my insurance company pays for the drugs. quick, easy, cheap. We should also give pharmacists (who frankly know much more about the products they're handling than do doctors) authority to prescribe certain drugs and renew others. I believe that they have already begun this in BC.

FTR, One thing I'm not afraid of is profit incentive. Some of the debate in Canada seems to hang on this point. But, let's be honest; our single payer system is already engaging mostly private entities. If that doctor is running his own proprietorship, then we can claim that the insurance payments amount to 'income'. But, in the real world, most of their practices are run by incorporated bodies, so we already have a profit motive in play.

Most of the debate on both sides of our border is crippled because we keep obsessing on each other's programs. I'd rather look at places like germany for our reform and I believe that obama was looking to switzerland, not canada, when he developed the original plan.

EDIT: BTW, thank you for climbing down from the flag pole.

Edited February 3, 2010 by dizzy

[wyly]

Canada rations with wait times and gatekeeping while the US rations based on ability to pay, and this has created excess capacity. Provinces take advantage of this reality with standing cross border contracts. "Wait times" are literally a foreign idea to most Americans with health insurance. Wait for what?

our health care is NOT rationed, wait times are exactly that, a shortage of MD's dictate who soon you can see a specialist...the USA shares this same MD shortage and also has wait times, or do you wish to call that rationing as well?...

[wyly]

If he got sent out of country for a procedure that could have been done in country, probably very quickly, he better be paying for it on his own dime. The story really speaks to everything involved in this. Unless Danny williams has a very rare problem, then there was seemingly no need for him to go to the US.

yup, my Cardiologist friend tells ne the same thing, there is no delay in treating heart issues if you come in complaining of chest pains, pressure in the chest or any other heart symptoms you go straight to the head of line, treatment is immediate...so if he went to US it was very likely for something rarely seen here, that even in the US only a few cardiologists do it...if that's not the case there will be political issues for williams to face when we comes back..

[bush_cheney2004]

our health care is NOT rationed, wait times are exactly that, a shortage of MD's dictate who soon you can see a specialist...the USA shares this same MD shortage and also has wait times, or do you wish to call that rationing as well?...

Canada's wait times are systemic, and often exceed one month by design. Provinces are now required to post wait time metrics and demonstrate improvement because of the outcry and politics...there is no equivalent in the USA, which does not have universal access as a goal. American facilities are contracted to handle provincial gaps and ponderous waiting.

What are they waiting for?

[bush_cheney2004]

...so if he went to US it was very likely for something rarely seen here, that even in the US only a few cardiologists do it...if that's not the case there will be political issues for williams to face when we comes back..

I would think so...he jumped to the head of the line, just like Jean Chretien!

PM proves health care not equal for all Canadians

Calgary Herald

Tue Jan 15 2002

Page: A15

Section: Comment

Byline: Ezra Levant

Source: For The Calgary Herald

How will Jean Chretien respond to Premier Ralph Klein's free market-health care proposals?

Will he attack Alberta, as he did in the last federal election campaign, with negative ads on television, accusing Klein of bringing U.S.-style health care to Canada?

Or will he punish Alberta financially, as he did in the mid-1990s, by threatening to fine Alberta, dollar for dollar, for inviting private capital into health care?

Whatever Chretien does to our province, and whatever capitalistic acts he accuses Klein of engaging in, Albertans should know this: Jean Chretien takes his own family to private health clinics. In fact, he doesn't just use U.S.-style private clinics. He actually goes to private clinics in the U.S.

And he flies to those U.S. private clinics on Canadian government jets, paid for by Canadian tax dollars.

According to access-to-information documents obtained by the Canadian Alliance, on Feb. 8, 1999, Chretien and two aides flew from Vancouver to Minnesota, home of the Mayo Clinic. According to air force flight logs, they flew back to Ottawa that afternoon with Chretien's daughter. And on Dec. 11 of the same year, Chretien went back to the clinic, this time just with his wife and his aide.

These trips were courtesy of the Canadian Forces 412th Squadron, which has flown literally thousands of nautical miles taking Chretien back and forth to the clinic.

There is nothing wrong with Chretien wanting the very best in health care for his family -- even better care than he thinks he can get in Canada.

And there is probably nothing wrong with him spending tax dollars to fly to these international clinics. For security reasons alone, the prime minister should not have to fly on regular, commercial flights like the rest of us.

But it is wrong for Chretien to avail his family of private, U.S. health care while condemning Alberta for wanting to provide that same quality of care to all our citizens.

Of course, Chretien is not the first Canadian politician to receive private care.

Robert Bourassa, the late Quebec premier, flew to the U.S. for cancer treatment. Joe Clark, the leader of the federal Progressive Conservatives, paid cash for a suite at Toronto's private Shouldice Hospital, where he had a hernia operation in the late 1980s....

[wyly]

Canada's wait times are systemic, and often exceed one month by design. Provinces are now required to post wait time metrics and demonstrate improvement because of the outcry and politics...there is no equivalent in the USA, which does not have universal access as a goal. American facilities are contracted to handle provincial gaps and ponderous waiting.

What are they waiting for?

more doctors, just like in the US...MD's can only see so many people in a day, it's demographics...

[bush_cheney2004]

more doctors, just like in the US...MD's can only see so many people in a day, it's demographics...

"Demographics" do not explain outrageous wait times just for imaging and diagnostics. US patients with the ability to pay do not wait nearly as long because of mandated procedure queues as patients in Canada. Clearly, the provinces are using excess American capacity to fill their gaps.

[wyly]

I would think so...he jumped to the head of the line, just like Jean Chretien!

you know no such thing...if it was common ailment he could have been helped here with no wait time...

Bourassa is a lame example he DIED, he ignored his doctors and waited to long to undergo treatment his trip south was one of desperation and your vaunted US super cancer MDs failed...had he sought help sooner he likely would have lived his cancer was among the easiest type to cure if treated early but one of the most deadly if ignored...I had two co-workers with the same cancer, one sought help quickly listened to his MD's and is alive 30 years later, the other ignored the MD's and was dead in 5 yrs...

[bush_cheney2004]

you know no such thing...if it was common ailment he could have been helped here with no wait time...

That's even worse....he chose to do the Mayo Mambo instead.

Bourassa is a lame example he DIED, he ignored his doctors and waited to long to undergo treatment his trip south was one of desperation and your vaunted US super cancer MDs failed...

Irrelevant....they have the right to make such choices. He probably had to go south if the disease reached an advanced stage because he felt he had less of a chance in Canada. Like I said before, when people's asses are on the line from around the world, they don't fly to Winnipeg!

[wyly]

"Demographics" do not explain outrageous wait times just for imaging and diagnostics.

I can measure my previous waits from days to a few weeks...and I can find american examples where people have waited years(to never) for approvement from insurance providers

US patients with the ability to pay do not wait nearly as long because of mandated procedure queues as patients in Canada. Clearly, the provinces are using excess American capacity to fill their gaps.

Canadians do not seek american help in significant numbers (.01%), I believe last year there were less than 200 cases for Onatrio and Quebec combined...and a number of those come from reciprocal agreements with hospitals on both sides of the border to take each others overflow when as needed...and in a city like Windsor if a critcally patient needs to be sent to a larger center Detroit just across the river is much quicker than a flight to Toronto...

[bush_cheney2004]

I can measure my previous waits from days to a few weeks...and I can find american examples where people have waited years(to never) for approvement from insurance providers

I'm sure you can, but it is far easier to find longer reported provincial waits that are systemic by design. If you needed a hip replacement, you will wait far longer in Canada. Fact.

Canadians do not seek american help in significant numbers (.01%), I believe last year there were less than 200 cases for Onatrio and Quebec combined...and a number of those come from reciprocal agreements with hospitals on both sides of the border to take each others overflow when as needed...and in a city like Windsor if a critcally patient needs to be sent to a larger center Detroit just across the river is much quicker than a flight to Toronto...

Large numbers....nope, but enough numbers and provincial reports to see that excess American capacity is part of the planning to meet Canadian health care needs. I live close to the Canadian border, but it would never occur to me to seek competent health care in Canada...don't need to.

[wyly]

Irrelevant....they have the right to make such choices. He probably had to go south if the disease reached an advanced stage because he felt he had less of a chance in Canada. Like I said before, when people's asses are on the line from around the world, they don't fly to Winnipeg!

it's absolutely relevant, his treatment in the US was no better than here and the US system was only too happy to take his money in a lost cause after his Canadian oncologists told him there nothing more to be done...

I can recall another 12 year old cancer victim that was killed by the US wonder treatments, Canadian MD's told his family only an amputation of a leg would save their son from cancer, the family went to court to be allowed to take him to the US for this new wonder treatment that would save him and his leg...Canadian MD's who objected dropped their opposition and the family went to the US,they came back 3 months later after the wonder treatment failed,Canadian MD's told them sorry it's too now late the cancer is now untreatable, jr died killed by promises of wonder drugs from the U$A private care system...

[bush_cheney2004]

it's absolutely relevant, his treatment in the US was no better than here and the US system was only too happy to take his money in a lost cause after his Canadian oncologists told him there nothing more to be done...

But that's the entire issue....personal choice. For whatever reason, he had less faith or choice in his provincial options and care.

I can recall another 12 year old cancer victim that was killed by the US wonder treatments,

So what? I guarantee you that if US doctors had 100% miracle treatments, even more Canadians would bolt for the border. Forget the drama....Canadians with the ability to make that choice...often choose "American style" health care.

[Smallc]

"Demographics" do not explain outrageous wait times just for imaging and diagnostics.

Most waits are not outrageous and haven't been for a few years. Here, the maximum wait for a CT is 4 weeks, though MRI waits are still high. Most will never wait that long (not even close) and it says so on the website.

[Smallc]

Oh, and:

http://www.google.com/hostednews/canadianpress/article/ALeqM5iCuTsNj9OtPCbh7bs622ba0uTIuQ

[bush_cheney2004]

Most waits are not outrageous and haven't been for a few years. Here, the maximum wait for a CT is 4 weeks, though MRI waits are still high. Most will never wait that long (not even close) and it says so on the website.

...while improvements are welcomed...those wait times still SUCK!

[bush_cheney2004]

Oh, and:

http://www.google.com/hostednews/canadianpress/article/ALeqM5iCuTsNj9OtPCbh7bs622ba0uTIuQ

.....Mr. Williams was not impressed with Canada's alleged 99% cardiac percentile. A province of 500,000 would not be expected to have anywhere near such a capability...and it doesn't.

[Smallc]

...while improvements are welcomed...those wait times still SUCK!

No, those wait times don't suck. A one month MAXIMUM wait means that only the least sever cases will be pushed back that far. If they think I need a CT scan, i can have it today...now probably. The reality is, Manitoba has no shortage of CT scanners or MRIs (or PETs for that matter - the wait for a PET is about 2.5 weeks) and the same is true for most of the country now.