Why can't politicans talk about serious healthcare fixes?

[jbg]

Comparisons to the US are a fool's dodge...France has a much better system than Canada's but life expectancy is nearly identical. Canadians will always be satisfied with a struggling system as long as they can say/believe it is better than the USA.

I never knew that Canadians routinely compare Canada to the U.S. If we're so abhorrent (at least to Central Canada) why would you want us as your foil?

[wyly]

I never knew that Canadians routinely compare Canada to the U.S. If we're so abhorrent (at least to Central Canada) why would you want us as your foil?

a bad example serves as well of what we don't want as a good example for where we want to go...

there are few countries ahead of us in life expectancy...Japan 82.17, Singapore 82.06, Australia 81.72, Canada 81.29, France 81.09....so we're very near to the top with our public system I believe the others all have a private/public system...but we can do better by taking the best parts of other systems avoid their mistakes and making ours run more efficiently...

Edited December 15, 2010 by wyly

[Michael Hardner]

but we can do better by taking the best parts of other systems avid their mistakes and making ours run more efficiently...

And one of the best things we can do is to get involved and pay attention consistently. The government counts on the fact that we only have one eye on the quality level of public services and don't expect much better. If we voted based on how well services improved (and costs for those services) then things would be much different.

[bush_cheney2004]

Who said we're satisfied with it? The fact that we're having this discussion in the first place suggests that we have concerns and doubts. However, when looking to other models to try to improve, it makes sense to look to the US as a model of privatized coverage.

The US has public programs that dwarf anything in Canada...at the state and federal level.

And health coverage in the US does not seem to be working better than our socialized insurance system. Perhaps France and Japan (and some would say Scandinavian or even British models) are good models to consider. Perhaps America is a good model to consider in other areas, such as technological development or the sheer capacity you mention. Do we need privatized insurance coverage for those things?

Canada already has private components...it is already a two tiered system. Canada's health care professionals also chose with their feet over the past 20 years (e.g. brain drain).

On what grounds do you judge France's system to be much better (despite the nearly identical life expectancy)? I'm not denying it. I'm just curious what criteria you're using and interested in more info.

OECD

[pfezziwig]

Here's hoping 2011 will be the year we finally start talking about serious healthcare reform...I'm not holding my breath, seems like the only time major policy decisions of long term sustainable practices are made only in the face of an impending disaster, like the state of bankruptcy currently in California, Greece and Ireland are going through. Can't blame the politicans, they're just doing what the majority of canadians want them to do.

[Evening Star]

The US has public programs that dwarf anything in Canada...at the state and federal level.

Dwarf in what sense? Clearly not in terms of providing universal coverage.

Canada already has private components...it is already a two tiered system. Canada's health care professionals also chose with their feet over the past 20 years (e.g. brain drain).

In the sense that medicare doesn't cover things like dental or eye care or drugs, you're right. (I'd be happy to start moving towards more public coverage of those things.) The system does provide universal single-payer coverage for most medical services though.

I'll look into the numbers regarding the 'brain drain'.

[bloodyminded]

Dwarf in what sense? Clearly not in terms of providing universal coverage.

What he means is that the United States is superior in every conceivable way, largely thanks to the fact that he was born there.

[bush_cheney2004]

Dwarf in what sense? Clearly not in terms of providing universal coverage.

Correct, but "universal coverage" is only one dimension and objective. US programs like Medicare, Medicaid, Veterans Administration, SCHIP, etc. provide insurance coverage on a scale that is much larger than the population of Canada (i.e. program scale)

In the sense that medicare doesn't cover things like dental or eye care or drugs, you're right. (I'd be happy to start moving towards more public coverage of those things.) The system does provide universal single-payer coverage for most medical services though.

Right...the "system" provides insurance coverage, not necessarily the best care or quick access to such care. Those with the ability to pay can/do seek better options in the USA and abroad.

I'll look into the numbers regarding the 'brain drain'.

Recently, the brain drain has been mitigated, but not eliminated. Part of the strategy in Canada is to recruit medical professionals from so called third world nations, robbing them of much needed skilled professionals.

[Shwa]

Recently, the brain drain has been mitigated, but not eliminated. Part of the strategy in Canada is to recruit medical professionals from so called third world nations, robbing them of much needed skilled professionals.

Mitigated indeed.

Doctor drain turns to gain: Physicians move north

So when you refer to "so called third world nations" are you referring to the USA too?

Canada is the number one spot in the world for doctors to come and work, live and play, said John Philpott, CEO of CanAM Physician Recruiting in Halifax. Talking to physicians in the United States, theyre shocked how much more money they can make in Canada.

More detailed CIHI statistics reveal a different picture, however. The number of doctors returning to Canada from the U.S. specifically after working here previously has exceeded those going in the opposite direction every year since 2004.

On top of that, the number of American-trained doctors who came here for the first time jumped to 52 in 2008 from a low of nine in 1995...

Some recruiters, though, say family doctors, pediatricians, emergency physicians and psychiatrists can make more for similar work in Canada as much as $50,000 to $100,000 more, according to Mr. Philpott. He said he relocated one doctor from Wisconsin to Newfoundland, doubling her income in the process.

Edited December 16, 2010 by Shwa

[Evening Star]

Correct, but "universal coverage" is only one dimension and objective. US programs like Medicare, Medicaid, Veterans Administration, SCHIP, etc. provide insurance coverage on a scale that is much larger than the population of Canada (i.e. program scale)

Do you mean that in terms of absolute numbers, US programmes cover more than 34M people, since the US has 10x our population and tax base? If so, that point seems both obvious and, frankly, moot if the US programmes still leave many tax-paying citizens uninsured.

Right...the "system" provides insurance coverage, not necessarily the best care or quick access to such care. Those with the ability to pay can/do seek better options in the USA and abroad.

This is just Wikipedia but the quoted numbers don't suggest that the cross-border health care traffic is actually that substantial: http://en.wikipedia.org/wiki/Health_care_in_Canada#Cross-border_health_care

At least one of the quoted studies can be found here: http://content.healthaffairs.org/content/21/3/19.full

Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectible relative to the use of care by Canadians at home.

[bush_cheney2004]

Do you mean that in terms of absolute numbers, US programmes cover more than 34M people, since the US has 10x our population and tax base? If so, that point seems both obvious and, frankly, moot if the US programmes still leave many tax-paying citizens uninsured.

But it is not moot.....size matters. Also, does Canada's Health Act include coverage for legal residents and illegal aliens? Equal access to care in remote regions? A prescription drug benefit?

This is just Wikipedia but the quoted numbers don't suggest that the cross-border health care traffic is actually that substantial

It's not substantial, but it does exist as a matter of provincial policy to close gaps in facilities and long wait times. The excess capacity in the US is part of Canada's "system". Where will the USA, with 10X the population turn for such a convenient option....Canada?

Edited December 17, 2010 by bush_cheney2004

[bloodyminded]

Mitigated indeed.

Doctor drain turns to gain: Physicians move north

So when you refer to "so called third world nations" are you referring to the USA too?

You're going to hurt his superiority complex. Not friendly, Shwa.

[wyly]

Do you mean that in terms of absolute numbers, US programmes cover more than 34M people, since the US has 10x our population and tax base? If so, that point seems both obvious and, frankly, moot if the US programmes still leave many tax-paying citizens uninsured.

This is just Wikipedia but the quoted numbers don't suggest that the cross-border health care traffic is actually that substantial: http://en.wikipedia.org/wiki/Health_care_in_Canada#Cross-border_health_care

At least one of the quoted studies can be found here: http://content.healthaffairs.org/content/21/3/19.full

interesting stat in that link, canada has more MD's per thousand patients than the US and more nurses as well....can we assume from that anericans have shorter wait times is because many americans just can't afford healthcare so don't go?

[Guest TrueMetis]

interesting stat in that link, canada has more MD's per thousand patients than the US and more nurses as well....can we assume from that anericans have shorter wait times is because many americans just can't afford healthcare so don't go?

Two words: population density.

Edited December 17, 2010 by TrueMetis

[wyly]

Two words: population density.

explain?...most of our population is crowded together as well...

[Guest TrueMetis]

explain?...most of our population is crowded together as well...

Well yes but the people who aren't are way the hell out there, some have probably never seen a doctor at all. It's not the whole issue but it would add to almost all the issues with health care. And of course many of the densely populated areas in Canada aren't that densely populated when compared to Europe or the US.

Here's a map illustrating it. My link Where I live it looks to be about 1 person per square kilometer. Here's one of the US for comparison (though it uses miles instead)

Edited December 17, 2010 by TrueMetis

[wyly]

Well yes but the people who aren't are way the hell out there, some have probably never seen a doctor at all. It's not the whole issue but it would add to almost all the issues with health care. And of course many of the densely populated areas in Canada aren't that densely populated when compared to Europe or the US.

Here's a map illustrating it. My link Where I live it looks to be about 1 person per square kilometer. Here's one of the US for comparison (though it uses miles instead)

but our MDs are in the same population centers that most canadians live...some people in calgary drive to small centers outside the city for ER care where there are fewer MDs but much fewer patients as well..

[Guest TrueMetis]

but our MDs are in the same population centers that most canadians live...some people in calgary drive to small centers outside the city for ER care where there are fewer MDs but much fewer patients as well..

I'm not saying it is a large effect but it is definitely an effect. If you live far to the north where there aren't these types of services and your back gets injured what are you going to do? If it is not something serious enough to warrant going to the hospital immediately your probably going to set up an appointment. If you have to work you probably can't take the time off to go and get your back checked out, so your probably going to have to keep changing you appointment date. Making wait times slightly longer than they actually are. (Note this is speculative)