Canada's health care system sucks

[dre]

Like I said, how hard can it be to bring over non-Canadians to fill these roles ?

Lobbying can't make problems go away, and somebody needs to point that out.

Like I said, how hard can it be to bring over non-Canadians to fill these roles ?

Hard, because you have to crush medical associations and trade groups. Youll need to start recognizing the credentials of foreign doctors, and domestic doctors will go to WAR with you over that. Not to mention that once they got here, they would be represented by the very medical associations that have worked so hard to drive up costs.

And as I pointed out... the doctors salaries arent the only problem. Its the entire lifecycle of a medical facility and every single widget, service, and unit of labor involved in it.

I think in the future the medical establishment in Canada will for the most part just do front line care, minor operations, emergency care, etc. Theyve quite simply priced themselves out of any long term role beyond that.

And people are starting to wake up. Medical tourism is one of the fastest growing industries in the world. I would liken the current situation to the late 1990's... when Canadian and US computer programmers were often making upwards of 200k per year... but companies were starting to wake up to the fact that there was thousands of good offshore developers willing to work for $15 bux an hour.

The gig is almost up for our price gouging medical establishment.

[Michael Hardner]

The gig is almost up for our price gouging medical establishment.

We need to give them the problem to fix then. I had a project that was being interfered with by an internal group within our company. Eventually I had to say "your objections indicate a deep knowledge of the subject matter area, it strikes me that this project is within your control and your domain".

They agreed, so guess who did the project ?

Some dude named Barrack demos the new US Healthcare.gov site

Yes we can.

[Bonam]

Because medical associations have lobbied to make sure that foreign trained doctors degrees are not honored here.

So you can bring him here... But he would be driving cab... like the majority of indian doctors in Canada.

But theres other things in play besides the massive web of protectionism that protects the medical industry from foreign competition.

Lets look at the life cycle of a medical facility in India VS one in Canada or the US.

1. A piece of land is purchased to build the hospital on. (the land in Canada costs 10 times what it does in india).

2. A permitting and approval process takes place (this costs 10 times as much in Canada as it does in india).

3. A surveyor comes in and surveys the property (this costs ten times as much in Canada).

4. An excavation company digs the hole and prepares the property for construction (this costs ten times as much in Canada).

5. A civil contruction company installs sewers, drains, and water mains (this costs ten times as much in Canada).

6. A crew comes in to build the foundation (this costs ten times as much In Canada).

7. A construction crew builds the building (10X as much).

8. A roofer roofs it (10X as much).

9. A painter paints it (10X as much).

10. Electrical and plumbing (10X as much).

11. Janitorial staff is hired (10X as much).

12. Doctors (10X as much).

I gotta stop because you already get the idea.

Every single part of the operation costs way way more. Every resource costs way way more here from janitors, to nurses, to doctors, right up to administrators.

CANADA

CAN

NOT

COMPETE.

This isn't exactly unique to medicine and health care. Almost everything is much more expensive in Canada than in India. Also, people earn much more in Canada than in India. You can outsource medicine, you can outsource everything else on the same grounds, but what will be left for Canadians to do?

[bush_cheney2004]

Many tings....but not everything. A 2010 Chevrolet Camaro with CBU import duty will cost more in India:

chevrolet camaro 2010 Price in India: 1,065,960 INR.

chevrolet camaro 2010 Price in USA: 22,680 USD.

chevrolet camaro 2010 Price in Australia: 26,649 AUD.

chevrolet camaro 2010 Price in Canada: 28,051 CAD.

chevrolet camaro 2010 Price in Europe: 17,766 EUR.

[dre]

This isn't exactly unique to medicine and health care. Almost everything is much more expensive in Canada than in India. Also, people earn much more in Canada than in India. You can outsource medicine, you can outsource everything else on the same grounds, but what will be left for Canadians to do?

This isn't exactly unique to medicine and health care. Almost everything is much more expensive in Canada than in India. Also, people earn much more in Canada than in India. You can outsource medicine, you can outsource everything else on the same grounds, but what will be left for Canadians to do?

Thats a good point, and raises an interesting phisophical question about the path that the west is on in general. I only agree with it to a certain extent so Im going to apologize for the "free trade" paradigm here.

But according to free traders we would outsource mostly just the labor. The actually doing of the operations and the goods used in them. The role of the Canadian medical sector then would be administrative, and we would do research work etc... plus doctors here would still do emergency work, front-line care etc.

In any case we cant really stop this, short of making it illegal for Canadians to leave the country. The Canadian medical apparatus has done it to themselves. I predict medical tourism will grow for at least 20 years straight until it accounts for about 1/2 of all procedures that cost over 5 thousand dollars.

[Bonam]

Thats a good point, and raises an interesting phisophical question about the path that the west is on in general. I only agree with it to a certain extent so Im going to apologize for the "free trade" paradigm here.

But according to free traders we would outsource mostly just the labor. The actually doing of the operations and the goods used in them. The role of the Canadian medical sector then would be administrative, and we would do research work etc... plus doctors here would still do emergency work, front-line care etc.

And you would of course also apply that to all other sectors: manufacturing, agriculture, technology, etc. Research and administration is not really enough to fuel an economy. The West needs to moderate policies of globalized free trade with the reality that keeping some local capability in such fields is beneficial for a whole host of reasons that I hope I don't need to get into. This is especially true in cases where people are placed in competition with foreign markets where labor costs are much lower. Once more of the world starts to reach the same standards of living (and costs) as the West, then we can look at full globalized free trade.

Let us not let economic ideology get in the way of pragmatism. Retaining our own capability to produce our own food, provide health care for ourselves, produce some of the goods and services we want to utilize, are good things. There is no reason to make ourselves dependent on foreign nations for these things when we don't have to.

In any case we cant really stop this, short of making it illegal for Canadians to leave the country. The Canadian medical apparatus has done it to themselves. I predict medical tourism will grow for at least 20 years straight until it accounts for about 1/2 of all procedures that cost over 5 thousand dollars.

That is a far too specific prediction to be of any value. Someone well versed in a topic can perhaps predict general trends, but something so specific? No. I may as well issue a prediction about the next 6/49 winning numbers. As for Canadians leaving the country, why? Canada's socialized health care system provides them with health care free of charge, and most of that time that health care is satisfactory. Few would choose to take on the stress of traveling to a foreign country to get a medical treatment that they can get "for free" in Canada anyway. I could see this done in some cases where the procedure is not available without a long waiting list in Canada, in which case people may go elsewhere to get the procedure carried out sooner, but such situations form only a small minority of "procedures that cost over 5 thousand dollars".

Edited August 12, 2010 by Bonam

[Michael Hardner]

O'Reilly Radar talks about some of the challenges to eHealth in the US.

But in this specific area of electronic records, I think the proprietary software vendors are equally challenged to show that they can meet the nation's needs. After some thirty years, they have become common only in large hospitals and penetrated only a small number of those small providers I mentioned before. The percentage of health care providers who use electronic health records is between 18 and the low 20's.

[punked]

No, those countries cost less because literally EVERY SINGLE WIDGET, PRODUCT, SERVICE, MATERIAL involved is way cheaper.

Those countries cost less for the EXACT SAME REASON why a pair of underpants, or a dvd player made in Canada would cost 5 or 10 times what a pair made overseas would cost.

Health care is a service not a product.

[dre]

Health care is a service not a product.

No a healthcare system is a whole host of products, services, facitilies, medicines, machines, etc.

[dre]

And you would of course also apply that to all other sectors: manufacturing, agriculture, technology, etc. Research and administration is not really enough to fuel an economy. The West needs to moderate policies of globalized free trade with the reality that keeping some local capability in such fields is beneficial for a whole host of reasons that I hope I don't need to get into. This is especially true in cases where people are placed in competition with foreign markets where labor costs are much lower. Once more of the world starts to reach the same standards of living (and costs) as the West, then we can look at full globalized free trade.

Let us not let economic ideology get in the way of pragmatism. Retaining our own capability to produce our own food, provide health care for ourselves, produce some of the goods and services we want to utilize, are good things. There is no reason to make ourselves dependent on foreign nations for these things when we don't have to.

That is a far too specific prediction to be of any value. Someone well versed in a topic can perhaps predict general trends, but something so specific? No. I may as well issue a prediction about the next 6/49 winning numbers. As for Canadians leaving the country, why? Canada's socialized health care system provides them with health care free of charge, and most of that time that health care is satisfactory. Few would choose to take on the stress of traveling to a foreign country to get a medical treatment that they can get "for free" in Canada anyway. I could see this done in some cases where the procedure is not available without a long waiting list in Canada, in which case people may go elsewhere to get the procedure carried out sooner, but such situations form only a small minority of "procedures that cost over 5 thousand dollars".

And you would of course also apply that to all other sectors: manufacturing, agriculture, technology, etc.

That boat sailed about 20 years ago.

Let us not let economic ideology get in the way of pragmatism. Retaining our own capability to produce our own food, provide health care for ourselves, produce some of the goods and services we want to utilize, are good things. There is no reason to make ourselves dependent on foreign nations for these things when we don't have to.

Well that really depends how much more it costs here. Domestic healthcare has a huge built in advantage over foreign healthcare. It costs money to move the patients to a place like India, and some patients cant be moved, and some dont want to.

I dont ever see us losing the capability, but I see medical tourism putting pressure on domestic providers to stop price gouging. I think this trend will actually HELP the medical industry here be more sustainable in the long term.

As for Canadians leaving the country, why? Canada's socialized health care system provides them with health care free of charge, and most of that time that health care is satisfactory.

Thats definately a stumbling block and thats why its important for the Canada health act to allow the patients to choose any accredited provider they want, and I would suggest that they split the savings with the patient as well. Until then most health outsourcing of Canadian patients will be dental, cosmetic and procedures that have waiting lists.

Canada definately has to fix that. Having our insurance system guarantee that only domestic providers can compete for our business is highly cost inflationary.