Your predictions on how we will deal with the coming health care crisi

[dre]

You're going to have to show proof of that...and I promise you that you can't do such a thing.

Pack a lunch SC!

[pinko]

If we could lower life expectancy then we wouldn't have to increase the retirement age.

In any event I don't ever expect to retire myself, though I also expect them to figure out immortality in the next couple of decades.

If you don't intend to retire then I am wondering why you feel the need to increase the retirment age. Mortality is ineveitable and once you accept that you will be much further ahead.

If you are Metis as your name suggests you will know that the data shows lower life expectancy for First Nations and Metis people. Are you offering up your people as the model for lower life expectancy?

[pinko]

Although these websites speak to the healthcare issue raging in the USA I think they are informative to our discussions about the Canadian model.

http://www.healthcare.gov/center/reports/preexisting.html

http://www.alternet.org/health/149581/republicans'_crazy_plan_to_roll_back_advances_on_health_care_would_also_wreck_the_economy/

Edited January 20, 2011 by pinko

[charter.rights]

If you are Metis as your name suggests you will know that the data shows lower life expectancy for First Nations and Metis people. Are you offering up your people as the model for lower life expectancy?

He's not Metis. He is a poser wannabe. We figured that out a couple of months back.

[Evening Star]

...but even as American facilities are so utilized, "private, American style health care sucks!"...LOL!

I don't think American health care sucks (especially considering that e.g. my family doctor practises on both sides of the border). It is the American model of health insurance coverage that I am not particularly a fan of. A system whereby Canadian public insurance is used to cover costs of care at American facilities via provincial contracts is a different issue and does not seem to contradict my stance on this. Canadian citizens are receiving quality care with socialized coverage. I would agree that in the long run, we should try to ensure that citizens can be treated within Canada.

Edited January 20, 2011 by Evening Star

[Evening Star]

Who defines "need"?

Surely there are accepted medical standards for evaluating relative need in many cases. If this means that we will sometimes have some bureaucracy following rules and standards to determine relative need and allocate resources, I'm not opposed to that. It sounds better to me than having a private for-profit bureaucracy allocating resources and services based on ability to pay.

As for the comments about politicians or hockey players paying for faster care elsewhere (and in what numbers?), is it OK if I see "allocation based on need rather than ability to pay" as an ideal to aim for in Canada, even if it's not perfect? In any case, wealthy people who pay for care somewhere else are not tying up Canadian health-care resources. My concern was more that the resources and services we have in Canada, which still have a limit to them even if it's not a zero-sum situation, should be allocated based on need. I could be swayed to the 'private option' position if it could be shown that liberalizing the health insurance marketplace would actually allow for those resources and services in Canada to be expanded. As it is, I'm not sure that it would.

Edited January 20, 2011 by Evening Star

[bush_cheney2004]

I don't think American health care sucks (especially considering that e.g. my family doctor practises on both sides of the border). It is the American model of health insurance coverage that I am not particularly a fan of.

The point of this thread is a prediction of a pending crisis on top of existing, real shortages in some areas. The current Canadian system has failed to capitalize and staff sufficient resources to meet its practical and political objective(s)in a timely manner. Hence, provincial web sites to post wait time metrics. Yet, Canada's approach is the most expensive universal access system in the world. Pointing at the Americans solves nothing, but apparently sending Canadians to America does.

A system whereby Canadian public insurance is used to cover costs of care at American facilities via provincial contracts is a different issue and does not seem to contradict my stance on this. Canadian citizens are receiving quality care with socialized coverage. I would agree that in the long run, we should try to ensure that citizens can be treated within Canada.

No, they are not receiving such coverage or care in "equal" measure.

Edited January 20, 2011 by bush_cheney2004

[Michael Hardner]

Perceptions are skewed in this country in part because of mores of the times. Everyone wants to be first at all times and when they aren't (aka in triage type scenarios) they bitch. Bitching gets the ear, thus the perception gets skewed.The adage about poor service and everyone hearing it vs good service and no one comments (or something like that) fits.

Most people, and apparantly not August1991, feel that the system works and works well, but there also exists a denial of the inherent problems in the system.

It's actually a problem - how people feel in this respect. Their impressions aren't borne out by supporting facts, and they can't be because the facts are very difficult to determine.

Instead of talking about our system, the discussion slides back into the Canada vs. USA chest thumping which is tiresome and not helpful.

[guyser]

It's actually a problem - how people feel in this respect. Their impressions aren't borne out by supporting facts, and they can't be because the facts are very difficult to determine.

Instead of talking about our system, the discussion slides back into the Canada vs. USA chest thumping which is tiresome and not helpful.

You have long asked where is the info, and you are correct. We do need to have this to measure where we are, where we can improve and how to do so. Keep it up.

Yes there is a segment of posters who feel the need to chest thump about C vs A .....and it goes both ways.

Silly people who only want to feel good, not provide quality info

[PIK]

Could you be one of those Reform Party types? By the way at one point in time your ancestors were immigrants.

Yes they were and they stake out some land and work hard and long to get where we are now, did they get money ,job, free health care, free dental, welfare, not one cent and that my friend is a stupid thing to say,to compare a immigrant from late 1700's/ 1800's to one today.

[PIK]

How about union waste, how much money is wasted , that could be used for the health care, like today , in ottawa they are saying that next year the police budget is in trouble and the #'s of police on the street is going to drop ,because they will have no money and why, because of police retiring, so you say so what if they are retiring, well because of one reason, they have to pay out so much money for sick days it is going to effect the safety of the citizens of that city. Sick days are for being sick not pay or holidays, which in turn means these people are going to work sick, so they don't use thier sick days, and keep then for retirement which means others get sick and have to take off work. How much does that cost us. Don't people in this country get tired of paying all this tax money , that justs goes out the window, or do most of you here have a set up like that ?

[Evening Star]

No, they are not receiving such coverage or care in "equal" measure.

Clarify?

[PIK]

Enough of the rant. I like the idea of 2 teir,we have it already but we are still in denial about it. But if we could set up a system with both ,using the OHIP card,I am all for. For the argument that people with money will get it 1st from the private side, well would that not help open up the public side. And a nother note I heard someone say, ''we have to many women wearing high heels in the hospital then we do running shoes''. That is something I have notice at my hosp, since I have spent alot of time in dealing with my eldarly parents, that there seems to be alot of dept heads ,every little dept has a head person , but yet not enough nurses ,who in my mind are the real heroes of the health care system. And we all know about doctor shortages, my new doctor has 400 patients ,she replaced one with 1500. And in the 3 years I have had her, she has been pregnant twice and only works mornings, so I can't even get into see her.

[guyser]

How about union waste, how much money is wasted , that could be used for the health care, like today , in ottawa they are saying that next year the police budget is in trouble and the #'s of police on the street is going to drop ,because they will have no money and why, because of police retiring, so you say so what if they are retiring, well because of one reason, they have to pay out so much money for sick days it is going to effect the safety of the citizens of that city. Sick days are for being sick not pay or holidays, which in turn means these people are going to work sick, so they don't use thier sick days, and keep then for retirement which means others get sick and have to take off work. How much does that cost us. Don't people in this country get tired of paying all this tax money , that justs goes out the window, or do most of you here have a set up like that ?

...pssst, Police budget is the city's problem, Health is a Prov/Fed problem.

[August1991]

It doesn't matter if it's abortions, radiology, neonatal care, brain surgery, or imaging....the system you are defending has not and cannot meet the needs of all Canadians in a timely or efficient manner. That's why it is called "wait time".

The way provinces deal with the "crisis" today is to use external services and facilities.

B_C, the way our provincial governments deal with excess demand is through "wait times". That is, rationing.

B_C, they don't pay for Canadians to go to the US for treatment except in extreme circumstances. Instead, they make Canadians wait. This waiting cost is borne privately by Canadians and yet shows up in no government budget or even in reported health cost statistics.

For older people, or people with contacts, this cost is lower. They can avoid the queue or tolerate it. For younger people, or people outside the "system", it is a nightmare.

Pinko strikes me as a classic example. Apparently, his son is a doctor so he has easy access to the medical system. (When a friend recently asked whether he shoudl marry a particular woman, I said that it was a good idea because she worked as a hospital administrator.)

Canada's health system is Soviet and it engenders an "I'm alright, Jack" mentality. It's also foolishly wasteful as people do all kinds of crazy things to obtain a coveted slot on a waiting list.

Most people, and apparantly not August1991, feel that the system works and works well, but there also exists a denial of the inherent problems in the system.

Geyser, in my initial response to the OP, I linked to a CBC article based on Statscan study that some 4 million Canadians do not have a family doctor.

If you have a family doctor, then "you're alright". But if you don't have one, what do you do?

This is the tip of the iceberg.

Edited January 21, 2011 by August1991

[August1991]

Surely there are accepted medical standards for evaluating relative need in many cases. If this means that we will sometimes have some bureaucracy following rules and standards to determine relative need and allocate resources, I'm not opposed to that. It sounds better to me than having a private for-profit bureaucracy allocating resources and services based on ability to pay.

ES, that's all fine and good until the day "the panel" decides that "your case" (ie. your spouse) does not merit treatment. Then you and your children start to lobby whoever you know to have the decision rescinded.

Our health system now revolves entirely around such scenarios. It's incredibly wasteful but these costs show up nowhere, in any budget.

It's called rationing and it's what our politicians will do "to solve" (deal with) the health care crisis.

Edited January 21, 2011 by August1991

[Evening Star]

August1991, I'm not an expert but what you describe just does not sound like the health care system I'm familiar with. Nor does it sound similar to anything else I've read by informed people.

And I think that bush_cheney2004 is right about provincial payers' contracts with US providers: http://content.healthaffairs.org/content/21/3/19.full.html

. Periodic formal contracts between provincial payers and U.S. providers have a long history, but a few such contracts have received considerable attention on both sides of the border.14 Most notable have been contracts for the provision of radiation therapy for cancer patients, in response to backlogs created by shortages of radiation technicians. For example, Quebec contracted with three radiation centers in Vermont and Maine in October 1999 for treatment of patients with breast and prostate cancer; 1,030 patients were treated during the subsequent year.15 Ontario contracted with three health care organizations in Michigan, New York, and Ohio in March 1999 to provide treatment for patients with breast and prostate cancer, and 1,416 patients had been referred as of 31 October 2000.16 This is equivalent to approximately 8.5 percent of all prostate and breast cancer patients treated with radiation therapy in Ontario during the same time frame.

[wyly]

Enough of the rant. I like the idea of 2 teir,we have it already but we are still in denial about it. But if we could set up a system with both ,using the OHIP card,I am all for. For the argument that people with money will get it 1st from the private side, well would that not help open up the public side. And a nother note I heard someone say, ''we have to many women wearing high heels in the hospital then we do running shoes''. That is something I have notice at my hosp, since I have spent alot of time in dealing with my eldarly parents, that there seems to be alot of dept heads ,every little dept has a head person , but yet not enough nurses ,who in my mind are the real heroes of the health care system. And we all know about doctor shortages, my new doctor has 400 patients ,she replaced one with 1500. And in the 3 years I have had her, she has been pregnant twice and only works mornings, so I can't even get into see her.

not enough MDs and nurses? talk to your MLA about more university funding for MD and nurse...of course that'll require cutting from other programs or higher taxes, you choose...

[wyly]

The answer is "SOMETHING ELSE".

The key to reducing healthcare costs is not two-tier care in Canada or a private system. Health costs are going up EVERYWHERE in the west regardless of what kind of system is used so the PRIVATE VS PUBLIC argument is a completely and total red herring.

The real silver bullet is to force Canadian health providers to compete with providers in places like India, Thailand, NewZealand, etc.

This could be done with a very simple change to the Canada healthact that will allow people to volunarily organize procedures done in JCI accredited facilities around the world, and pocket 1/2 of what they save the government.

Lets take open heart surgery as an example. Providers in Canada will typically bill out over 100 thousand dollars for these types of operations. But a JCI accredited hospital in India will do the same operation for about 10 thousand. Thats a saving of 90 thousand dollars. So Health Canada pays the 10 thousand for the procedure, and cuts the patient a check for 45 000. The patient will use that to organize their travel and accomodations to india (or wherever) and they get to pocket the rest to send their kids to college for a year, buy a new car, or whatever they want.

The government just saved 45 thousand dollars on the procedure, and demand on our system was reduced.

Since the foreign facilities is JCI accredited they know the facility is modern and offers comparable patient outcomes, and partipation in this "medical tourism" program was completely voluntary, nobody can complain.

People are already doing this... the JCI is getting stronger and stronger, and millions of people from the west are fleeing to foreign markets to escape price-gouging. Theres no reason for Health Canada to not cash in on those savings as well.

Theres consumer confidence issues, and a lot of Canadians that havent done any research on patient outcomes in various host countries picture getting operated on in a grass hut by a guy with a bone through his nose. But as more and more people are lured into this program that will change, and demand for Canadian based health services will be reduced which is the ONLY WAY TO BRING DOWN PRICES... PERIOD.

This is the ONLY approach that will work. If demand on Canadian services INCREASES (which is is, and will), then PRICES WILL GO UP. It doesnt matter if the providers are public or private, or what you write into the Canada Health act. Its simple economics.

here you go again with this JCI poo again...there is guarantee to the quality of the physician you will get in foreign countries, not even in the usa...

you cannot expect canadian hospitals, MD, nurses and support staff to compete with India or Thailand and their cost of living differences, it a ludicrous idea...

and millions of Canadians are not fleeing the country for medical care...

Edited January 21, 2011 by wyly

[wyly]

There is no crisis other than in the thick heads of the ill informed and that includes you. Speaking as a senior my medical needs are being adequately met and I don't anticipate that will change. The USA, on the other hand, has one hell of a mess on its hands.

other than a shortage of walk-in clinics that cause people to crowd into ER's I don't see a real crisis either, the boomers will cause a finanical and shortage issues in the future...

[August1991]

August1991, I'm not an expert but what you describe just does not sound like the health care system I'm familiar with. Nor does it sound similar to anything else I've read by informed people.

Each province is different but if I were someone in my 40s/50s with elderly parents, I would want to have a few contacts in the health system to know how it works, and who to contact. Any parent in their 20s/30s with children should also know how the system works.

It helps to have someone in the family, or a trusted neighbour/friend, in the medical system. The rules are arcane and difficult.

To my knowledge, there is still no direct bribery although an invitation to a condo in Arizona or Fort Lauderdale (among friends) is welcome for very critical cases.

----

Evening Star, four million Canadians (according to Statscan) have no family doctor. If you have a family doctor, and you can make an appointment, then you believe the system works. "You're alright". And if 60% of Canadians (let's say) have such access, then politicians will get re-elected.

For most now, the perception is that people wait but the State takes care of people. This will change.

I have seen the Soviet system, and Canada's health system. There is little difference. Sadly, people struggle to solve their own problem while State bureaucrats struggle with the organisation. Our health system will meet its Gorbachev.

My advice is to have good contacts.

Edited January 21, 2011 by August1991

[Bonam]

I have seen the Soviet system, and Canada's health system. There is little difference. Sadly, people struggle to solve their own problem while State bureaucrats struggle with the organisation. Our health system will meet its Gorbachev.

Main difference between our system and the Soviet system for health care is that ours is better funded and more modern, and probably our bureaucracy is more efficient and less corrupt. That's about it. Besides that they are (were, since the Soviet system no longer exists) indeed very similar. Government provides the funding, everyone has access, insufficient available services result in wait times.

[pinko]

I find it odd that certain individuals here don't want comparisons made to the American healthcare model yet want to look at the Russian system. I see no reason to limit these comparisons and if anything these comparisons should be extended to other countries in Europe and elsewhere.

Edited January 21, 2011 by pinko

[pinko]

Each province is different but if I were someone in my 40s/50s with elderly parents, I would want to have a few contacts in the health system to know how it works, and who to contact. Any parent in their 20s/30s with children should also know how the system works.

It helps to have someone in the family, or a trusted neighbour/friend, in the medical system. The rules are arcane and difficult.

To my knowledge, there is still no direct bribery although an invitation to a condo in Arizona or Fort Lauderdale (among friends) is welcome for very critical cases.

----

Evening Star, four million Canadians (according to Statscan) have no family doctor. If you have a family doctor, and you can make an appointment, then you believe the system works. "You're alright". And if 60% of Canadians (let's say) have such access, then politicians will get re-elected.

For most now, the perception is that people wait but the State takes care of people. This will change.

I have seen the Soviet system, and Canada's health system. There is little difference. Sadly, people struggle to solve their own problem while State bureaucrats struggle with the organisation. Our health system will meet its Gorbachev.

My advice is to have good contacts.

That is quite the opinion you offer. I am wondering if you could expand on your so called knowledge of the Soviet system. Secondly what background, if any, do you have in the healthcare system?

[bush_cheney2004]

....B_C, they don't pay for Canadians to go to the US for treatment except in extreme circumstances. Instead, they make Canadians wait. This waiting cost is borne privately by Canadians and yet shows up in no government budget or even in reported health cost statistics.

I disagree...utilization of foreign facilities and excess capacity is a purposeful cost saving strategy for both peak demand and some routine procedures. I do agree that wait time is a cost borne by Canadians in the absence of varying domestic capacity (depending on province).