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

[wyly]

Patient outcomes cant be guaranteed in ANY system, but what you can do is study the doctors and the hospitals and accredit the ones that provide comparable patient outcomes to ours. Thats why groups like the JCI are important.

JCI acceptable standards are lower than minimal canadian standards...

Youre a perfect example of that western attitude that nobody can do anything right besides us.

what I'm an example of is someone who is better informed than you as to MD accreditation...

If theyre stuck in the 70's like you, and think medical care done in other countries is performed in grass huts by a guy with a bone through his nose, then they dont have to go.

oh please, the gaps in your awareness as to MD accreditation is evidence that you're the one out of touch on this issue...all universities are not equal...not all university MD graduates are equal...standards of acceptability are not equal....what is acceptable in India or Thailand does not mean it's acceptable here, not that the best MDs from those countries can't work here(many do) but they have lower acceptable standards...even the USA which has a number of of the world's top MD's has a lower standard of acceptability than canada...

[bush_cheney2004]

...even the USA which has a number of of the world's top MD's has a lower standard of acceptability than canada...

That would explain why so many Canadian health professionals moved to the USA. So much for your bloated "standards".

Love the "even in the USA" for increased credibility!

Edited January 22, 2011 by bush_cheney2004

[Evening Star]

Actually, the net movement has been in the other direction since 2004, it seems, although the numbers aren't nearly as high as the number of doctors going to the US was in the 90s: http://www.nationalpost.com/news/Doctor+drain+turns+gain+Physicians+move+north/3497414/story.html

And this may back up wyly regarding foreign-accredited doctors: http://www.nationalpost.com/news/Foreign+doctors+passing+Canada+certification+exams+study/3617664/story.html

Since doctors with US accreditation do seem to be automatically qualified for residency here, I am assuming that the standards in the US are probably not lower than ours though.

[bush_cheney2004]

Actually, the net movement has been in the other direction since 2004, it seems, although the numbers aren't nearly as high as the number of doctors going to the US was in the 90s:

But clearly there was a large "brain drain" delta in the 90's, exacerbated by the defunding of health care for the provinces. And it continues to this day for those choosing to do so.

And this may back up wyly regarding foreign-accredited doctors:

But health care professionals includes far more than just "doctors". Canada recruits nurses and other professionals from so called third world nations (e.g. Philippines) only to have them jump ship for the USA (for more money and better facilities).

Since doctors with US accreditation do seem to be automatically qualified for residency here, I am assuming that the standards in the US are probably not lower than ours though.

I suspect that as well...with Canada's medical association(s) notoriously setting up barriers to protect the entrenched status quo.

[wyly]

Actually, the net movement has been in the other direction since 2004, it seems, although the numbers aren't nearly as high as the number of doctors going to the US was in the 90s: http://www.nationalpost.com/news/Doctor+drain+turns+gain+Physicians+move+north/3497414/story.html

And this may back up wyly regarding foreign-accredited doctors: http://www.nationalpost.com/news/Foreign+doctors+passing+Canada+certification+exams+study/3617664/story.html

Since doctors with US accreditation do seem to be automatically qualified for residency here, I am assuming that the standards in the US are probably not lower than ours though.

a key point from your link..."accept international graduates only from schools that have been accredited according to globally accepted standards."...canada has consistent level of accreditation right across the country, a graduate of a medical school in vancouver is the equal of a graduate in Halifax, many countries do not have minimum standards of proficiency, their best are equal to ours but their worst are far below our minimum standard...going to a third world country for treatment is a real roll of the dice, are you getting a qualified MD our someone who wouldn't even qualify for our med schools...

Since doctors with US accreditation do seem to be automatically qualified for residency here, I am assuming that the standards in the US are probably not lower than ours though.

no their not, not all US schools graduates are acceptable...my MD friends tell me that used to be the case but now every country is questionable even the US...one of friends studied his specialty at John Hopkins so he's familiar with both Canadian and US medical systems...

and not all US MD's are acceptable either...in the US there are specialty MD's that can be either certified or board eligible, those who are board eligible have studied their chosen specialties but have not taken their final exams but that doesn't prevent them from hanging up their shingle and practicing as internal surgeons or whatever...in Canada an specialty MD must be certified before they're allow to take up their chosen specialty....Canada's and the US best MD's are equivalent in quality but the US has a lower minimum standard of quality...

my medical friends tell me there are exceptions made for "star" MD candidates, people who are well known for their expertise and superior educational background...but even then it's not a guarantee of ability as I was informed of an Israeli MD who had a glowing educational background and all the right credentials and references, he was fired after 6 months as after it was determined his knowledge was equivalent to that of a third year canadian med student...

Edited January 22, 2011 by wyly

[dre]

JCI acceptable standards are lower than minimal canadian standards...

what I'm an example of is someone who is better informed than you as to MD accreditation...

oh please, the gaps in your awareness as to MD accreditation is evidence that you're the one out of touch on this issue...all universities are not equal...not all university MD graduates are equal...standards of acceptability are not equal....what is acceptable in India or Thailand does not mean it's acceptable here, not that the best MDs from those countries can't work here(many do) but they have lower acceptable standards...even the USA which has a number of of the world's top MD's has a lower standard of acceptability than canada...

oh please, the gaps in your awareness as to MD accreditation is evidence

Horse shit. Youve done absolutely nothing to show that standards in accredited facilities would not be acceptable to Canadians. Not one fuckin thing. And you havent provided anything to dispute the fact that this industry is growing rapidly... apparently an awfull lot of people that actually research this option find the quality acceptable.

What matters is PATIENT OUTCOMES, and thats what the JCI measures. If you visit a JCI accredited hospital (whether its in Canada, or the US, or India) like millions of patients from the west have, you can expect a comparable quality of care.

But go ahead... keep forcing our medical payer into the worst deals in the entire world. Just dont whine to me when the cost keeps increasing 5-10% per year, and the government is forced to run huge defecits or raise taxes. Because thats exactly what youre advocating by supporting medical protectionism.

[bush_cheney2004]

Horse shit. Youve done absolutely nothing to show that standards in accredited facilities would not be acceptable to Canadians. Not one fuckin thing....

Yes he has....his "medical friends" have told him so. That is undisputable proof that Canada has the most qualified medical professionals in the entire universe!

[dre]

If you have so much confidence in what you are trying to promote I would like to suggest that you put your own money (not to be confused with taxpayer money) into the venture you have been describing. The solutions to our healthcare problems must lie within the borders of Canada and not in some pie in the sky scheme dreamed up by some so called visionary. I don't want my taxes paying for someone's vacation to India or anywhere else. The bottom line is care is available here in Canada and there is absolutely no need to supplement it with a trip abroad.

don't want my taxes paying for someone's vacation to India or anywhere else.

Utterly irrational. The government would pay between 50% and 90% LESS for these procedures. What you are arguing for is to pay the most taxes humanly possible.

If you have so much confidence in what you are trying to promote I would like to suggest that you put your own money

Im seriously considering doing some kind of dental trip, and If I need a major procedure I would be just fine with practicing what I preach. But the key here is for the Canadian government to start value shopping. It makes no sense for me to use offshore medical resources as things are now unless Im on a waiting list because the government takes more than 50 thousand dollars a year from me in income tax, and a huge portion of it goes to pay for healthcare in the Universal Price Gouging system. If they give me some of my money back to cover the procedure, and share of the huge ammount of money they would save, then Ill gladly go. The queue will be shortened by one patient, the tax payer will save a bunch of money, and Ill get a fistfull of cash for my efforts.

Its either that... or they raise taxes a lot more, or ration services a lot more. When they do both of those things just remember you got what you wanted.

[wyly]

Horse shit. Youve done absolutely nothing to show that standards in accredited facilities would not be acceptable to Canadians. Not one fuckin thing. And you havent provided anything to dispute the fact that this industry is growing rapidly... apparently an awfull lot of people that actually research this option find the quality acceptable.

What matters is PATIENT OUTCOMES, and thats what the JCI measures. If you visit a JCI accredited hospital (whether its in Canada, or the US, or India) like millions of patients from the west have, you can expect a comparable quality of care.

But go ahead... keep forcing our medical payer into the worst deals in the entire world. Just dont whine to me when the cost keeps increasing 5-10% per year, and the government is forced to run huge defecits or raise taxes. Because thats exactly what youre advocating by supporting medical protectionism.

and what have you shown? "not one f***** thing" ...other than many people flee from expensive private care they can not afford in the USA and for cosmetic surgery...

as evening star's link pointed out average grade for foreign students "58%, compared to 97% for the Canadians", so much for JCI's standards of acceptability which are much lower than ours...those JCI hospitals in India are accepting MDs from schools with an average of 58%, that's why they end up driving taxi's in canada...but you want Canadians to travel to India and potentially put themselves in the care of an MD who may have graduated with 58% and not even qualify for residency in Canada...

Edited January 22, 2011 by wyly

[dre]

and what have you shown? "not one f***** thing" ...other than many people flee from expensive private care they can not afford in the USA and for cosmetic surgery...

as evening star's link pointed out average grade for foreign students "58%, compared to 97% for the Canadians", so much for JCI's standards of acceptability which are much lower than ours...those JCI hospitals in India are accepting MDs from schools with an average of 58%, that's why they end up driving taxi's in canada...but you want Canadians to travel to India and potentially put themselves in the care of an MD who may have graduated with 58% and not even qualify for residency in Canada...

Those JCI hospitals have COMPARABLE PATIENT OUTCOMES and at the end of the day thats what matters.

but you want Canadians to travel to India and potentially put themselves in the care of an MD

I want them to decide that for themselves instead of you forcing your antiquated horseshit on them. It would be completely up to patients to decide for themselves.

And if you dont feel that the accrediation system is strong enough to ensure the standard of care Canadians expect then we should work to strengthen it... not invoke the government as an agency that protects a whole industry from global competition. Thats a recipe for the exact kind of upward pressure we have on prices now. If you want to push for increasing medical costs through your advocacy of protectionism then you better dream up some way to pay for it. By 2050 the number of people over 65 will have increased by a factor of 4, and the number of people over 85 will have increased roughly by a factor of 8. And the ammount we spend each year will keep rising, and has increases consistantly for almost 20 years.

Your way of thinking ingores the economic conequences and will lead to a healthcare crisis in this country.

[August1991]

I take it the Geyser comment is directed at me. I notice you have avoided describing your background, if any , in the healthcare field. I am well aware of information like that contained in the CBC article you have highlighted. I am inclined to focus more broadly on the issues at hand over an extended period of time rather than cherry pick like you have. There is nothing earth shattering in that article.

Are you one of those 4 million people without a family doctor?

No, I'm not. But my neighbours are. (They asked me and I asked my doctor's receptionist... ) They are looking for contacts in the same way people did in the Soviet Union. Eventually, they will find a doctor.

And then, "They'll be alright."

-----

Pinko, that's how the Soviet system worked. And that's how Canada's health system works now.

In Canada, IMHO, we are still a decade or so from direct bribes.

And then a decade later, we'll have a Gorbachev and a decade after that, a complete collapse in our Soviet health system, and our Soviet education system.

The Soviet system lasted for about 70 years (1917-1991).

I'm optimistic. Maybe our modern Soviet unionized health/education system, created in the 1960s, will last also for 70 years - to around 2030 or so.

Edited January 23, 2011 by August1991

[Smallc]

In Canada, IMHO, we are still a decade or so from direct bribes.

Whatever you say.

[pinko]

No, I'm not. But my neighbours are. (They asked me and I asked my doctor's receptionist... ) They are looking for contacts in the same way people did in the Soviet Union. Eventually, they will find a doctor.

And then, "They'll be alright."

-----

Pinko, that's how the Soviet system worked. And that's how Canada's health system works now.

In Canada, IMHO, we are still a decade or so from direct bribes.

And then a decade later, we'll have a Gorbachev and a decade after that, a complete collapse in our Soviet health system, and our Soviet education system.

The Soviet system lasted for about 70 years (1917-1991).

I'm optimistic. Maybe our modern Soviet unionized health/education system, created in the 1960s, will last also for 70 years - to around 2030 or so.

[pinko]

August1991:

You do realize there are no credible sources to support your claim that the Canadian healthcare system is like that of the former Soviet Union.

Here is an excerpt describing the model employed here in Manitoba.

"Teams may include practitioners such as

family physicians, nurse practitioners,

primary care nurses, social workers,

psychologists, psychiatrists, psychiatric

nurses, pain therapists, audiologists, wound

care specialists, and community developers

depending on availability and need. Two

providers from the same discipline can be

considered collaborative if they fulfill

different functions.

In smaller communities, a primary health care

team can comprise as few as two or three

providers, whereas in urban areas there can

be up to 50. Team size reflects the availability

of providers and the size and needs of the

community."

http://www.healthcouncilcanada.ca/docs/rpts/2009/TeamsInAction_Manitoba_Summary.pdf

Edited January 23, 2011 by pinko

[pinko]

"Utterly irrational. The government would pay between 50% and 90% LESS for these procedures. What you are arguing for is to pay the most taxes humanly possible."

No. What I am arguing for is a made in Canada solution that doesn't include some hair brained scheme combining a vacation and a medical procedure.

[bush_cheney2004]

August1991:

You do realize there are no credible sources to support your claim that the Canadian healthcare system is like that of the former Soviet Union.

Sure there are....from other Canadians (David Gratzer)...like this:

....Therein lies the dirty truth of Canadian health care. It is just like the old Soviet system: everything is free, nothing is readily available. Of course, it's entertaining to talk about people queuing for toilet paper in Moscow in 1976. It's far less funny to think about Canadian breast cancer patients waiting months for radiation therapy in 2006.

Oh...and look...Mr. Gratzer is from...Manitoba!

http://en.wikipedia.org/wiki/David_Gratzer

Edited January 23, 2011 by bush_cheney2004

[pinko]

Sure there are....from other Canadians (David Gratzer)...like this:

....Therein lies the dirty truth of Canadian health care. It is just like the old Soviet system: everything is free, nothing is readily available. Of course, it's entertaining to talk about people queuing for toilet paper in Moscow in 1976. It's far less funny to think about Canadian breast cancer patients waiting months for radiation therapy in 2006.

http://en.wikipedia.org/wiki/David_Gratzer

Oh...and look...Mr. Gratzer is from...Manitoba!

So what. Just because some no name posits such a view doesn't make it the case. How about something credible for a change. By the way I notice he is linked to a neocon think tank and the discredited economic model offered by Milton Friedman.

Edited January 23, 2011 by pinko

[bush_cheney2004]

So what. Just because some no name posits such a view doesn't make it the case. How about something credible for a change. By the way I notice he is linked to a neocon think tank and the discredited economic model offered by Milton Friedman.

But you were the one who touted the value of an "inside the system" opinion...surely you do not have the experience and credentials of a published Dr. Gratzer. He is not some "no name" on this issue....you are.

[Pliny]

Oh...and look...Mr. Gratzer is from...Manitoba!

So what. Just because some no name posits such a view doesn't make it the case. How about something credible for a change. By the way I notice he is linked to a neocon think tank and the discredited economic model offered by Milton Friedman.

In this statement you are saying that a conservative is a neo-conservative. What's the difference?

I have posted the definition and the origination of the term "neocon" many times. There is a difference.

Read the wikipedia history of the term. Conservatives are not neo-conservatives. If they were, there would be no need for the invention of the term.

[dre]

"Utterly irrational. The government would pay between 50% and 90% LESS for these procedures. What you are arguing for is to pay the most taxes humanly possible."

No. What I am arguing for is a made in Canada solution that doesn't include some hair brained scheme combining a vacation and a medical procedure.

Its not a hairbrained scheme, its basic economics. Foreign resources have been used if virtually every industry and in each case theres been massive savings for the consumer. You apparently think that the global economy is a "hair brained scheme", and in some ways that case COULD be made, and I HAVE made that case before. But this is the system we find ourselves in, and in this case we have a huge looming crisis resulting from the government driving prices up in an industry through protectionism, and we have a massive potential for savings by leveraging offshore resources.

Made in canada solution = more rationing, or more taxes. End of story. Prices are NOT going to go down under this model... they are going INCREASE 5 - 10% per year.

My idea is to simply open up the market to competition, and allow patients to seek treatment abroad on a totally voluntary basis. This will alleviate the temporary stress put on the system by the aging babyboomers and put downward pressure on prices here at home. Everybody wins.

Edited January 23, 2011 by dre

[Evening Star]

But you were the one who touted the value of an "inside the system" opinion...surely you do not have the experience and credentials of a published Dr. Gratzer. He is not some "no name" on this issue....you are.

That quote wasn't really evidence though. And I'm sure that even the most extreme free-marketeer would agree that it's not that fair to compare access to toilet paper (made from dirt-cheap materials, does not require highly skilled labour, can be found for a couple bucks at the nearest corner store in any market economy) to access to radiation therapy (requires high-tech equipment and specialized experts, not instantly and cheaply available to everybody in any system afaik).

[bush_cheney2004]

That quote wasn't really evidence though. And I'm sure that even the most extreme free-marketeer would agree that it's not that fair to compare access to toilet paper (made from dirt-cheap materials, does not require highly skilled labour, can be found for a couple bucks at the nearest corner store in any market economy) to access to radiation therapy (requires high-tech equipment and specialized experts, not instantly and cheaply available to everybody in any system afaik).

Gratzer's comments were made in the context of wait time and other demonstrable gaps in services and facilities. Arguing about the comparison will not make those gaps go away. Nobody is saying that Canada is like the FSU, just that there are aspects to its healthcare system that have taken on some of the attributes of the Soviet experience (i.e. shortages, preferences, regional disparities, professional flight to other nations, etc.).

Requiring "proof" is a stalling game, just as is the dearth of data and metrics pointed out by member MH.

[M.Dancer]

The other day I see my neighbour....limping. I ask what's wrong..he say's he has a hip problem that needs surgery..which he is scheduled to get next year...meanwhile he walks in pain. I ask how long would it be if he goes to the US. He said he looked into it....one week. But the cost is 45K... about the same as it is here....I said why don't they send him to the US....he said it had something to do with keeping the economic benefits in Canada....and he hobbled away.

[pinko]

The other day I see my neighbour....limping. I ask what's wrong..he say's he has a hip problem that needs surgery..which he is scheduled to get next year...meanwhile he walks in pain. I ask how long would it be if he goes to the US. He said he looked into it....one week. But the cost is 45K... about the same as it is here....I said why don't they send him to the US....he said it had something to do with keeping the economic benefits in Canada....and he hobbled away.

You seem like a good story teller. Don't let me interfere with your fantasy.

[Michael Hardner]

atari? your comparing apples and oranges...video technology was outsourced to china and parts made for pennies per hour by chinese labour, this idea isn't transferable to our medical system... explain how our MD's and medical research staff are going to live in N America on the wages paid in developing countries?...this is something dre overlooks in his quest to drive down wages paid to medical staff here...

Pinko was asking for examples of goods going down over times. Technology and machinery goes down in costs over time, and outsourcing is only part of that. How much did VCRs cost in 1978 ? 1990 ?

Dre isn't looking to drive down wages, he's looking to reduce his own costs - there's a difference.