Would you support this to improve healthcare?

Moonlight Graham · July 22, 2010

Here's the proposal:

Much of the problem for Canada's long wait times and lack of GP's is that many Canadian doctors (and nurses) have left to work in other countries for more money, most notably the U.S (aka the "brain-drain"). This is quite ridiculous & not fair to taxpayers since taxpayers subsidize all these doctor's lengthy/expensive educations, then they skip south for more money while Canadians are left with a weaker healthcare system.

So to discourage this, and to even encourage more people to become doctors, how about taxpayers/government offer to pay for the entire education of any medical doctor provided they finish school and stay in the country to work. If they leave to work in another country permanently (or for a prolonged period) they have to pay back their education tuition.

There can be variations/tweaks to this (ie: maybe after working for 15-20 years in Canada a doctor could be free to leave with no payback etc.), but this is the general idea. Thoughts?

Edited July 22, 2010 by Moonlight Graham

Smallc · July 22, 2010

Programs like this already exist in some provinces...and for the most part, this isn't a problem anymore. The number of health practitioners is actually growing faster than the population as a percentage. This used to be a problem. It isn't now. Things simply haven't caught up yet, and may never catch up.

Moonlight Graham · July 22, 2010

Things simply haven't caught up yet, and may never catch up.

What do you mean by "caught up"?

Smallc · July 22, 2010

What do you mean by "caught up"?

At current, the number of physicians and nurses is growing faster than the population as a percentage in most provinces. Because there is a shortage, the shortage takes time to correct, since the rate is not all that much bigger than the rate of population growth. It will probably never catch up though, because people will get old and retire soon.

William Ashley · July 22, 2010

Here's the proposal:

Much of the problem for Canada's long wait times and lack of GP's is that many Canadian doctors (and nurses) have left to work in other countries for more money, most notably the U.S (aka the "brain-drain"). This is quite ridiculous & not fair to taxpayers since taxpayers subsidize all these doctor's lengthy/expensive educations, then they skip south for more money while Canadians are left with a weaker healthcare system. So to discourage this, and to even encourage more people to become doctors, how about taxpayers/government offer to pay for the entire education of any medical doctor provided they finish school and stay in the country to work. If they leave to work in another country permanently (or for a prolonged period) they have to pay back their education tuition. There can be variations/tweaks to this (ie: maybe after working for 15-20 years in Canada a doctor could be free to leave with no payback etc.), but this is the general idea. Thoughts?

Shouldn't good doctors have scholarships and grants anyway? These programs already exist, atleast in part.

I wouldn't not support it, but I don't think it would be legal. It would violate mobility rights of the constitution - right to enter and leave canada.

Incentives for any in demand occupation should be considered as long as there is a gainful return on it. Canadians have stellar medical care. Part of the problem is that people are too reliant, and there are public funds going to programs that need not exist at the level they currently exist.

Ultimately I think hospitals should be self sustaining and if they make more money by having more doctors then they will meet a threshhold. Let the market control itself.

I think it still makes sense to have public health insurance but the government is too heavily cross bred with the commercial and public medical sector - to many government dollars - and government oversights (eg government control medical private databases etc..)

Medicine should be a private issue, we should concentrate on health living, not medicating and fixing bad lifestyle choices, you wanna live bad, then pay for it with the insurance plan - and see how insurance is more expensive with people who have poor lifestyles for a reason - you don't get that with we'll pay for all your needs health funding from the government. Too much money is spent on patching up unhealthy choices. With an aging non working public dependent population it just won't fly. You want a doctor then go to a country that has them - flights are cheap these days. I do think we ought to invest in this, and to make a long story short. I see absoluntely no problem with free education (I support universal access to education) thing is though if you take away the money it becomes purely grades, - this ain't a bad thing, canada would benefit from expanded medical schools thing is though how do you keep the quality of doctors up when you have so many.

Canada could make a lot of money doing this. Thing is though if they are so smart - why don't they already have full funding via scholorships and grants.... if so, what is gonna make them stay?

Edited July 22, 2010 by William Ashley

Handsome Rob · July 22, 2010

I see Mr. Ashley, so when you get hit by a car next week, you would prefer to go the HMO route? Feasible, but what of your yet undiagnosed heart murmur. Have you any thoughts of the scope of the cost? Or the difficulties in finding an insurance provider?

wyly · July 22, 2010

the brain drain isn't an issue any more, and many that appear to leave now do so for training and then come back...

I'd be in favor of paying for an MD's entire education in return for a service contract as a GP when they graduate...

but there are other things to consider...limited room for more medical students....shortage of instructors to teach students...government cut backs that prevent graduates finding jobs...many graduates now go on to specialize instead of general practise creating a shortage at the GP level...a high percentage of women are now MD's and a number take time out(years) to start families ....there's no single quick fix solution for healthcare issues...

Edited July 22, 2010 by wyly

dre · July 22, 2010

A better idea would be to crush medical protection, castrate various medical associations etc.

Theres thousands of doctors around the world that would gladly come to Canada and work 1/4 of what our doctors make. Flood the market with cheap foreign health professionals, and export the patients to countries that dont price gouge whenever possible.

One idea I had was to allow patients to shop globally for medical services and pass on half of what they save to them. Right now our medical system refuses to cover such operations completely... blatant price inflating protectionism.

The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the US, for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the US costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the US is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the US runs about $1,250 in South Africa.

So lets say a heart valve replacement that costs 100 000 dollars in Canada costs 10000 in India. Thats a 90 000 dollar saving. So allow patients to keep half the saving in return for organizing treatment at JCI accredited foreign facilities. In this example the patient would come out of it with about 30 000 cash (after airfare, accomodation etc), and the government would also save 45 000.

Any patients willing to travel abroad to save money on major surgery would get a fistfull of cash for their effort and the government would save money on every single operation.

eyeball · July 22, 2010

I think I like dre's idea best.

Argus · July 22, 2010

I think I like dre's idea best.

Suuuuuure. Nothing like flooding the country with health care practitioners who may or may not be at all qualified, who may or may not have legitimate credentials, and who may or may not have much of a grasp of the language.

You use them. I'll stick with doctors who are licensed, thanks.

Argus · July 22, 2010

At current, the number of physicians and

nurses is growing faster than the population as a percentage in most provinces. Because there is a shortage, the shortage takes time to correct, since the rate is not all that much bigger than the rate of population growth. It will probably never catch up though, because people will get old and retire soon.

And yet you think there's no problem..... :rolleyes:

dre · July 22, 2010

Suuuuuure. Nothing like flooding the country with health care practitioners who may or may not be at all qualified, who may or may not have legitimate credentials, and who may or may not have much of a grasp of the language.

You use them. I'll stick with doctors who are licensed, thanks.

Patient outcomes in places like India and other medical tourism destinations are comparable. But people with these antiquated beliefs that have them thinking that medical procedures abroad are performed in grass huts by guys with bones through their nose are welcome to pay 10 times as much for a Canadian or American doctor.

In any case the JCI accredits foreign facilities so you have a pretty good idea as far as patient outcomes and quality.

eyeball · July 22, 2010

Suuuuuure. Nothing like flooding the country with health care practitioners who may or may not be at all qualified, who may or may not have legitimate credentials, and who may or may not have much of a grasp of the language.

You use them. I'll stick with doctors who are licensed, thanks.

Who said anything about doing away with qualified regulators to make sure health care practitioners credentials are legitimate? Isn't that what civil servants like you are for?

And what language are you talking about? I assume you mean human languages - there are more people speaking different one's of these in Canada every day. It stands to reason some of these will be doctors. I suspect a lot of patients would like to be consulted in the language they're most fluent in, given it should reduce the chance of confusion.

ToadBrother · July 22, 2010

Theres thousands of doctors around the world that would gladly come to Canada and work 1/4 of what our doctors make. Flood the market with cheap foreign health professionals, and export the patients to countries that dont price gouge whenever possible.

I'm sure there are. And what percentage of them are any good?

Shady · July 22, 2010

how about taxpayers/government offer to pay for the entire education of any medical doctor provided they finish school and stay in the country to work.

That doesn't tackle the problem of skyrocketing healthcare costs.

eyeball · July 22, 2010

That doesn't tackle the problem of skyrocketing healthcare costs.

Ten bucks says that is the fault of unqualified government regulators - something that politicians apparently have even less of a clue what to do about.

wyly · July 22, 2010

I'm sure there are. And what percentage of them are any good?

my MD friends tell me that two of the major problems with imported MDs is qualification(many are not up to our standards) and language MDs must be fluent speaking as well as written, a verbal miscommuniction of symtoms can kill as can spelling errors...

eyeball · July 22, 2010

my MD friends tell me that two of the major problems with imported MDs is qualification(many are not up to our standards) and language MDs must be fluent speaking as well as written, a verbal miscommuniction of symtoms can kill as can spelling errors...

My MD friends tell me their industry is as riddled with protectionism as our dairy industry.

Speaking of verbal miscommunication, what's a language doctor do, fix your language?

Edited July 22, 2010 by eyeball

Bonam · July 22, 2010

A better idea would be to crush medical protection, castrate various medical associations etc.

Theres thousands of doctors around the world that would gladly come to Canada and work 1/4 of what our doctors make. Flood the market with cheap foreign health professionals, and export the patients to countries that dont price gouge whenever possible.

Wtf? I don't want no stone age shaman as my doctor, even though his tribe might think highly of his medical skills. Doctors working in Canada must be qualified by Canadian standards.

wyly · July 22, 2010

My MD friends tell me their industry is as riddled with protectionism as our dairy industry.

I'll ask my friend when I next see him if he thinks there's any truth to that...

Speaking of verbal miscommunication, what's a language doctor do, fix your language?

humor?

Argus · July 22, 2010

Patient outcomes in places like India and other medical tourism destinations are comparable.

Really? You have evidence of this? I wouldn't doubt there are some fine hospitals in India. There were some fine hospitals in the old USSR, too. Not many, but some. The vast majority of their hospitals, though, like the vast majority of their doctors and urses, were hopelessly inept by our standards.

Argus · July 22, 2010

Who said anything about doing away with qualified regulators to make sure health care practitioners credentials are legitimate? Isn't that what civil servants like you are for?

And what language are you talking about? I assume you mean human languages - there are more people speaking different one's of these in Canada every day. It stands to reason some of these will be doctors. I suspect a lot of patients would like to be consulted in the language they're most fluent in, given it should reduce the chance of confusion.

Given the proliferation of phony educational documents combined with the rampant corruption in many third world countries it's extremely difficult, if not impossible to check the ones from third world institutions with any degree of confidence.

Nor is it desirable to have large numbers of doctors who do not speak English properly, regardless of how many foreigners immigrants we have here. Not unless their licences come with a limitation on who they can treat.

August1991 · July 22, 2010

Here's the proposal:
Much of the problem for Canada's long wait times and lack of GP's is that many Canadian doctors (and nurses) have left to work in other countries for more money, most notably the U.S (aka the "brain-drain"). This is quite ridiculous & not fair to taxpayers since taxpayers subsidize all these doctor's lengthy/expensive educations, then they skip south for more money while Canadians are left with a weaker healthcare system.

So to discourage this, and to even encourage more people to become doctors, how about taxpayers/government offer to pay for the entire education of any medical doctor provided they finish school and stay in the country to work.

The Soviets eventually imposed a special tax on Russian medical doctors when they received an exit visa to leave the Soviet Union. Moonlight, your idea is similar. (So too the idea of changing how we accredit foreign medical doctors.)

The problem in Canada's health system is not a lack of supply. Canada does not lack for "health care providers", to use the current term.

Like the Soviet Union, Canada's health care system "misallocates resources". (We have empty hospital wings, but we also have waiting rooms.) It is impossible for bureaucrats - even very intelligent bureaucrats - to solve such problems well because the problem is beyond a bureaucratic solution.

Edited July 22, 2010 by August1991

Argus · July 22, 2010

my MD friends tell me that two of the major problems with imported MDs is qualification(many are not up to our standards) and language MDs must be fluent speaking as well as written, a verbal miscommuniction of symtoms can kill as can spelling errors...

A woman patient had to be taken to hospital after receiving "inappropriate" treatment from the foreign doctor who killed a man with a lethal overdose on his first shift providing out-of-hours GP cover.

The woman's case came to light as police investigated a possible manslaughter charge against Dr Daniel Ubani, a German national of Nigerian origin, over the death of 70-year-old David Gray last year.

Foreign doctor kills pensioner