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2014 Healthcare Apocalypse


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Because you get people terrified of common sense.

People think it is queue jumping...but really, if there are two parallel systems you have two different queues: one that's free and one that costs. Obviously those who can and want to pay for treatment NOW will, so now your line is shorter because people moved themselves out of it, what's the problem?

I think it's "misery loves company".

When I lived in London, England a thousand years ago, they had a two tier system. The problem was that the doctors in private practice set their own prices, and paid themselves handsomely. The doctors in the public system were paid by the government, and it was a fraction of what the private guys got. It was pretty pathetic at that time. Apparently it is better now. Anyone know how they fixed it?

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So what would each party likely do to remedy this?

Sorry if I ask too many questions, I like to learn.

The question that needs to be asked is why is the healthcare system not working? What is wrong with it that makes it dysfunctional? There was a time in Canada when central health care worked well...I remember from when I was young, getting to see a doctor wasn't a problem. Bottom line is we do not have the resources; doctors, nurses, equipment, or money to make the system work. The reality is whether through taxes or from our wallets we are going to have to pay to acquire those resources or we will continue to have a lacklustre healthcare system. A two tiered system could help reduce wait times but having a parallel private system does nothing to improve the resources available in the public system.

I think we need to keep the public healthcare system. However, The Harper government stands for smaller government and more streamlined, efficient utilization of resources so I think the first step is to stop the bureaucratic waste and make healthcare more efficient. Second, eventually someone will have to introduce a healthcare tax that goes directly into improving access to healthcare through more resources. People will disagree with me but there simply isn't enough money available to bring about the large scale changes that need to happen. Adding 6% a year merely keeps up with inflation and when you factor in the aging population and increased strain on healthcare we are actually losing ground. Nobody likes more taxes but people don't mind paying when they're getting a good service in return. I think it's a step that needs to be taken.

One idea I've heard for the recruitment of medical staff is to utilize a similar strategy as the Canadian Forces uses for recruiting pilots. The government could offer to pay (or reimburse a graduate) for some or all of the costs associated with medical school in return for signing on to serve a given community for a set period of time.

I know people will disagree with me on some of these points and I know the issue of a new tax is always a prickly subject but I believe it's what needs to happen.

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People think it is queue jumping...but really, if there are two parallel systems you have two different queues: one that's free and one that costs. Obviously those who can and want to pay for treatment NOW will, so now your line is shorter because people moved themselves out of it, what's the problem?

And how would you balance this against those with serious illnesses? Imagine having some serious form of cancer but having insufficient money to move to the alternative private queue. Do you think the value of a life is solely a monetary matter?

My wife had thyroid cancer about five years ago. After some initial dilly-dallying due to needing to diagnosis what exactly the lump was, once it was determined, she had her first surgery in short order, and a second one to remove her thyroid. It happened fast because the risk was high. Putting aside any ideological leaning I may have, to imagine that my wife would have had her health, possibly her very life, sacrificed on the altar of two-tier health care is not something I would be on board for.

If we want to have a second private tier for some things like hip replacements and other such medical issues, I could contemplate it. But if we're talking about the most serious and life-threatening illnesses, no, I wouldn't put one of my family's life on the line just so a millionaire can get to a cardiologist or oncologist faster. I won't begrudge him the private room or the better meals, but on the balance, his life isn't worth one nickel more than my wife's or my kids'.

Edited by ToadBrother
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When I lived in London, England a thousand years ago, they had a two tier system. The problem was that the doctors in private practice set their own prices, and paid themselves handsomely. The doctors in the public system were paid by the government, and it was a fraction of what the private guys got. It was pretty pathetic at that time. Apparently it is better now. Anyone know how they fixed it?

I'm guessing heavy regulations.

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When I lived in London, England a thousand years ago, they had a two tier system. The problem was that the doctors in private practice set their own prices, and paid themselves handsomely. The doctors in the public system were paid by the government, and it was a fraction of what the private guys got. It was pretty pathetic at that time. Apparently it is better now. Anyone know how they fixed it?

It's somewhat the equivalent in the US of being able to afford a good lawyer versus getting a public defender.

A two-tier system strangles the public system.

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It's somewhat the equivalent in the US of being able to afford a good lawyer versus getting a public defender.

A two-tier system strangles the public system.

How? The defendant gets a legal person defending him in court, and those public defenders have the same law degree as the other guys. Its not like a defendant has to defend himself

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How? The defendant gets a legal person defending him in court, and those public defenders have the same law degree as the other guys. Its not like a defendant has to defend himself

And every - oh, let's say licensed car mechanic is equally talented as all the rest?

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How? The defendant gets a legal person defending him in court, and those public defenders have the same law degree as the other guys. Its not like a defendant has to defend himself

Conservatives should be smarter than this since they are all free-markety. If you open up a private system where people can charge higher and make more money than in the public system (which is true especially in this case, as the attraction of shorter lines/wait times would be attractive to many), then there will be a rush of doctors and nurses flooding the private system.

After that, which strangles the public system of doctor/nurse supply, the ones that make it will stay in the private system... and the few who don't will be relegated to return to the public system, therefore resulting in much lower quality of care overall in the public system. Once this is entrenched into the public system, the vast majority of Canadians will move to private care, leaving only the very poor in the public system.

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Conservatives should be smarter than this since they are all free-markety. If you open up a private system where people can charge higher and make more money than in the public system (which is true especially in this case, as the attraction of shorter lines/wait times would be attractive to many), then there will be a rush of doctors and nurses flooding the private system.

After that, which strangles the public system of doctor/nurse supply, the ones that make it will stay in the private system... and the few who don't will be relegated to return to the public system, therefore resulting in much lower quality of care overall in the public system. Once this is entrenched into the public system, the vast majority of Canadians will move to private care, leaving only the very poor in the public system.

Do you know how much money it takes to open a practice/hospital? There will be some private setups which is fine, but the public system will still be there. If that was true how come public and private schools xo-exist and teachers are flocking to both?

Teachers in both systems all have their 2 degrees, are kids in public school struggling in society? I don't think so. However, those who pay will get the best their money can buy. My point is, the public system won't be in the stone age.

The problem isn't the method of delivery, its a bottleneck at the university/immigrant credential level. That needs to be loosened up. When I see that, I smell unions and their bs.

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Here's how I see it:

This is going to be the penultimate moment for the Harper majority.

If they don't take steps towards privatization, they'll alienate the right wing in their party who may threaten to split.

If they do take steps towards privatization, they'll alienate the centre that voted for them and shove them off to the NDP.

It's a lose/lose situation for Harper.

You've been force-fed by the Liberals and NDP to think that the Federal government controls Healthcare. They don't - the Provinces do. The Feds don't operate even one hospital or pay one Doctor. Any further steps towards privatization will be taken by the provinces. What the federal government can do is with-hold some/all of the 15% of healthcare funding that is given to the provinces in the form of transfer payments. Harper has continually said that alternate methods of delivering healthcare can be tried out by the provinces...as long as those services are universally available to everyone through their Medicare cards. The key word is not privatization - it's universality.

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It's somewhat the equivalent in the US of being able to afford a good lawyer versus getting a public defender.

A two-tier system strangles the public system.

Wrong. I am a lawyer in an American state. Most states have well developed public defender systems. The PD's are competent workhorses with ideological commitment. But we have a two tier systme. It seems to work okay. So there you go.

Additionally:

Personally I do private cases, and the money from those cases permits me to work at state rates when PD's are conflicted off. My ability to do private cases (Tier A) permits me to put the expertise I develop there to state paid PD-alternative cases(Tier B ). I would argue Tier B benefits from the private tier.

This is analogous with doctors out here who charge high prices to those who can bear the cost but send some time working in free or charity clinics employing expertise paid for by the wealthy.

Edited by Sulaco
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Do you know how much money it takes to open a practice/hospital? There will be some private setups which is fine, but the public system will still be there. If that was true how come public and private schools xo-exist and teachers are flocking to both?

Teachers in both systems all have their 2 degrees, are kids in public school struggling in society? I don't think so. However, those who pay will get the best their money can buy. My point is, the public system won't be in the stone age.

The problem isn't the method of delivery, its a bottleneck at the university/immigrant credential level. That needs to be loosened up. When I see that, I smell unions and their bs.

Individual doctors won't be opening hospitals. Like in the US, groups of doctors will get together and take out a loan to open a practice. The business that practice provides easily pays off a loan. Eventually, groups of practices help to fund a private hospital.

Your education analogy falls apart when you consider that 1. There aren't wait lines to get into public schools. 2. People don't think they are going to get poorer care or die while waiting for public school. 3. People in general are more inclined to spend more money to get better healthcare than better schooling.

You've been force-fed by the Liberals and NDP to think that the Federal government controls Healthcare. They don't - the Provinces do. The Feds don't operate even one hospital or pay one Doctor. Any further steps towards privatization will be taken by the provinces. What the federal government can do is with-hold some/all of the 15% of healthcare funding that is given to the provinces in the form of transfer payments. Harper has continually said that alternate methods of delivering healthcare can be tried out by the provinces...as long as those services are universally available to everyone through their Medicare cards. The key word is not privatization - it's universality.

I never thought the Federal government controlled healthcare...and I've always been a fan of the fact that provinces control it. Shall we get universal healthcare one day, I hope the states control it. The feds do and can provide funding though, and a loss of funding could result in private healthcare in provinces.

Wrong. I am a lawyer in an American state. Most states have well developed public defender systems. The PD's are competent workhorses with ideological commitment. But we have a two tier systme. It seems to work okay. So there you go.

Additionally:

Personally I do private cases, and the money from those cases permits me to work at state rates when PD's are conflicted off. My ability to do private cases (Tier A) permits me to put the expertise I develop there to state paid PD-alternative cases(Tier B ). I would argue Tier B benefits from the private tier.

This is analogous with doctors out here who charge high prices to those who can bear the cost but send some time working in free or charity clinics employing expertise paid for by the wealthy.

In what state? Because everywhere I've lived, there is a remarkably clear difference in quality between the private and public services.

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Guest American Woman

In what state? Because everywhere I've lived, there is a remarkably clear difference in quality between the private and public services.

How would you know?

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Guest American Woman

It's something I look in to since I'm interested in law.

That doesn't really answer my question. Look into how, exactly? And how many states are you talking about? I think a lot of times assumptions are made without any factual basis for them or misconceptions are accepted and passed along as the way things are.

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And how would you balance this against those with serious illnesses? Imagine having some serious form of cancer but having insufficient money to move to the alternative private queue. Do you think the value of a life is solely a monetary matter?

What balance? There are two queues. You don't have the money to get in the pay-for queue, you are in the one you are right exactly where you are now.

My wife had thyroid cancer about five years ago. After some initial dilly-dallying due to needing to diagnosis what exactly the lump was, once it was determined, she had her first surgery in short order, and a second one to remove her thyroid. It happened fast because the risk was high. Putting aside any ideological leaning I may have, to imagine that my wife would have had her health, possibly her very life, sacrificed on the altar of two-tier health care is not something I would be on board for.

I am glad your wife is ok now...cancer is a real bitch that I wish we could eradicate (genetics dictate I will probably die from it myself) But I fail to see why a two tier system would "sacrifice her on the alter". Imagine this: you have a publicly funded system. EXACTLY as it is now. No opting out of the provincial plans. No diversion of taxes. The funding stays EXACTLY the same way. Except with a second private yet of course heavily regulated tier where money talks....YOUR money. Not the governments, not the tax payers. This makes MORE money available in the public system and makes the queues shorter. Why is this so hard to comprehend for everyone?

If we want to have a second private tier for some things like hip replacements and other such medical issues, I could contemplate it.

Wouldn't worry about it...they're already here!

But if we're talking about the most serious and life-threatening illnesses, no, I wouldn't put one of my family's life on the line just so a millionaire can get to a cardiologist or oncologist faster. I won't begrudge him the private room or the better meals, but on the balance, his life isn't worth one nickel more than my wife's or my kids'.

Why would their life be threatened? If there was a separate queue with two different intakes, nothing changes. No different than say....Danny Williams going to the US for his surgery. Did that hurt any Canadians other than their feelings? Not in the least. And if you are referring to the "diversion" of specialists, the crippled system we have is already doing that. Look at the brain drain to the US. Alberta is constantly bringing South African doctors over. Why? CAUSE THEY AREN'T HERE! With tuition the way it is why would a student take out $100,000+ in student loans and stay in Canada when they can go to the US and make enough to pay the loans off in a year and live high on the hog. Then again, the potential debt load is pretty daunting too. So I would say ultimately the enemy to sustainable health care in this country is the lack of educational opportunity, underfunding and mismanagement.

It is amazing everyone acknowledges that the system is broken...and for years they have thrown more money at the problem and nothing changed yet nobody wants to look at the fact that there is a paradigm shift required. I think it is obvious something needs to change. Baby boomers are set to completely overwhelm the system and no amount of cash can fix that!

Trust me, I don't want my wife or kids lives to be valued anymore than anyone else's...but I don't want them to have an equal opportunity death either!!

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The solution is to try to keep our heads above water as best we can without utterly undermining health care until the Baby Boom is six feet under. The problem will begin sorting itself out in the next ten to twenty years.

We are sinking without the boomers being geriatrics...how the hell are we going to keep our heads above water when that entire generation is geriatric and living longer than any generation before them?

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That doesn't really answer my question. Look into how, exactly? And how many states are you talking about? I think a lot of times assumptions are made without any factual basis for them or misconceptions are accepted and passed along as the way things are.

Percentage of cases, degrees, and credentials.

Florida, Pennsylvania, Arizona, Nebraska/Iowa, and Indiana/Kentucky

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HAHAHAHA....it's funny you choose lawyers and mechanics for comparisons since they are the biggest fucking crooks out there! :P

So doctors are all crooks now?

You should tell the one giving you your next colonoscopy that.

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Percentage of cases, degrees, and credentials.

Florida, Pennsylvania, Arizona, Nebraska/Iowa, and Indiana/Kentucky

Did you personally look into the percentages of cases, degrees, and credentials of all the private lawyers and all the public defenders in all of those states? Or are you saying this information is out there; that studies have been carried out and documented in these states? I'd be interested in seeing it if that's the case.

So doctors are all crooks now?

You should tell the one giving you your next colonoscopy that.

He said "lawyers and mechanics are the biggest fucking crooks out there." Nothing about doctors being crooks.

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