SHAME! Our 'Health Care" is the pits in comparison. :(

[Guest Peeves]

I bet the MDs in France are paid a lot less than ours are. They make a good income, but nothing compared to the US. And our physicians compare themselves with the US.

That's the overall problem. I agree with the Fraser Institute that we should try to emulate the European countries more, with a mix of public and private insurance. What the Fraser Institute won't tell you, is that the private insurance in Europe is almost all non-profit. The Fraser Institute are just shills for the private, for profit, insurance companies in the US. And that's the problem. We're close to the US. As soon as we open the market (more than it already is) to private insurance, the big boys in the US will swoop in and try to create the same costly mess as they have down there. And ideologues like Harper would be all for it.

I think we can make intelligent reforms within our single payer system. We'd have to break the monopoly power of the doctors tho. One way is to use Nurse Practitioners, as I've said. Also, pay the docs less and don't use the fee for service model. In return for paying them less, we would forgive any student loans they have, but only if they've established a long term practice in Canada. If they move to the states, hound them for every last dollar.

http://news.national...th-care-future/

Excerpt;

In the U.K., the C.D. Howe authors note, the government spends about the same percentage of GDP as Canada on the sector, but manages to cover 85% of the total cost of health care, compared to 70% here, with similar health outcomes. How does it make the dollar – or pound – stretch further?

The report stresses that GPs are generally paid a yearly lump sum per patient – called capitation – and are partly responsible for their patients’ drug and hospital costs. All of which creates incentives for family doctors to use the system’s resources more responsibly, they argue. Capitation is, in fact, being experimented with already in Canada.

The message of gazing beyond North America for health-care lessons was also central to a report issued last year by the University of Western Ontario’s International Centre for Health Innovation. To date, though, it seems the provincial politicians and bureaucrats who actually run Canada’s system are peering no further than their own borders.

AKA shortsighted!

[bush_cheney2004]

Now there's an understatement. Healthcare costs at 150% of ours, yet the manage to not even cover 15% of the population.

Not ever designed to cover the entire US population. And based on these atrocious wait times in Canada, what constitutes coverage leaves much to be desired.

And their population density is 10 times what our is.

Not in all states....most Canadians huddle close to the US border anyway.....not the Arctic Circle.

[Canuckistani]

Not ever designed to cover the entire US population. And based on these atrocious wait times in Canada, what constitutes coverage leaves much to be desired.

Not in all states....most Canadians huddle close to the US border anyway.....not the Arctic Circle.

What's the wait time for an uninsured person?

Yep, most of us huddle near the border. But Canadian healthcare costs are based on the total population - ie all those remote reserves, etc.

See what I added to my previous post re coverage in the US. We don't want to go down that road - not ever.

[wyly]

I bet the MDs in France are paid a lot less than ours are. They make a good income, but nothing compared to the US. And our physicians compare themselves with the US.

That's the overall problem. I agree with the Fraser Institute that we should try to emulate the European countries more, with a mix of public and private insurance. What the Fraser Institute won't tell you, is that the private insurance in Europe is almost all non-profit. The Fraser Institute are just shills for the private, for profit, insurance companies in the US. And that's the problem. We're close to the US. As soon as we open the market (more than it already is) to private insurance, the big boys in the US will swoop in and try to create the same costly mess as they have down there. And ideologues like Harper would be all for it.

I think we can make intelligent reforms within our single payer system. We'd have to break the monopoly power of the doctors tho. One way is to use Nurse Practitioners, as I've said. Also, pay the docs less and don't use the fee for service model. In return for paying them less, we would forgive any student loans they have, but only if they've established a long term practice in Canada. If they move to the states, hound them for every last dollar.

paying MD's less isn't going to work...our GP's are under paid, and out of that pay they need to run an office and pay staff...our GP Mds' are paid less than a number of euro countries(france, UK, netherlands, switzerland, denmark) as well many euro countries have better social benefits than we do...Denmark used offer free uni tuition(not sure that still applies)... Edited December 5, 2012 by wyly

[bush_cheney2004]

What's the wait time for an uninsured person?

Depends on the circumstances...clinics and hospitals cannot refuse care for months or years as in Canada.

Yep, most of us huddle near the border. But Canadian healthcare costs are based on the total population - ie all those remote reserves, etc.

But the programs are delivered by province, not the entire Canadian population. Again, stop comparing apples to oranges.

See what I added to my previous post re coverage in the US. We don't want to go down that road - not ever.

That's fine....as the Americans don't ever want to face what Canadians do on a regular basis....suffering in a long, patriotic line for health care services (except for those with the means to pay for something faster).

[wyly]

looking up salaries for MD's I see a Framer in calgary who can make $150K per is higher than the average canadian GP at 107K...

but you can't only go by salary when comparing nations pay rates, there are other factors involved,social benefits(dental care, UI, maternity leave, vacation pay, etc.) ...

[Wayward Son]

I bet the MDs in France are paid a lot less than ours are. They make a good income, but nothing compared to the US. And our physicians compare themselves with the US.

This is true...well maybe...although the often heard claim that physicians in France make an average salary of about $55,000 have been shown to be bogus when documents were leaked showing that physicians made a lot more then that. A lot more (like $700,000 euros average for radiologists in some hospitals). Following that leak the organization for General Practitioners admitted that in 2005 the average for their members was $105,000 US. That was average take home, after tax, salary. That is probably about the same as the average GP in Canada after overhead and taxes. It should also be kept in mind that:

1) MDs in Canada (and the US) carry large debts from school. Those in France do not.

2) I believe MDs in France can work a maximum of 35 hours a week, and they receive a lot of vacation time which drops their average hours/week further. MDs in Canada average over 50 hours a week, and that factors in any vacation time they may or may not take.

3) MDs in Canada pay overhead and malpractice insurance (which I have heard that for instance in the case of OBGYNs in Ontario is 7000/month - no idea if that is true).

4) MDs in France also get significant tax breaks on their salaries compared to other French citizens (hence the higher after-tax take home).

5) MDs in Canada pay for their own benefits. Other health care workers in Canada don't. And you can be sure that Physicians in France get some pretty nice benefits. I think that we would save far less money then people think in switching in NPs for MDs.

So it is difficult to compare. Canadian MDs on average probably make more, maybe significantly more, but it cost them a lot more, and they work a lot more hours. And while physicians in Canada certainly make more then the average Canadian, they are also starting their career significantly later then most, and starting with significantly more debt then most.

Edited December 5, 2012 by Wayward Son

[guyser]

Depends on the circumstances...clinics and hospitals cannot refuse care for months or years as in Canada.

Neither can Canada

[wyly]

thanks for that backup wayward...as I said a straight comparison is very very difficult...

I recall a local(calgary) news article a few years back where a MD/GP quit because he said he was working very long hours to make ends meet and after paying staff and office expenses it just wasn't worth while...his new job was as an EMT in an ambulance, he said he had fewer hours of work, less stress, none of the hassles of running a business and in the end his take home pay was better as well....

[Canuckistani]

paying MD's less isn't going to work...our GP's are under paid, and out of that pay they need to run an office and pay staff...our GP Mds' are paid less than a number of euro countries(france, UK, netherlands, switzerland, denmark) as well many euro countries have better social benefits than we do...Denmark used offer free uni tuition(not sure that still applies)...

I believe most European MD's are paid a salary, not fee for service. Have you got a link for GP earnings of canada vs the countries you mentioned?

So if France has 50% more docs per capita than we do, better outcomes and spends significantly less per capita than we do, then the Fraser Institute is right, we should be copying their system. As long as we keep out the American for profit insurers, I'd be all for it. Wonder how that would fly under NAFTA.

Edited December 5, 2012 by Canuckistani

[wyly]

I believe most European MD's are paid a salary, not fee for service. Have you got a link for GP earnings of canada vs the countries you mentioned?

here are two...but again you don't know the unseen aspects, if you are on salary in canada you get 10days vacation pay, france is 37 days, some countries give huge discounts on (or even free) education, dental care, parental support(leave, daycare) if a MD is on salary he/she doesn't pay staff or office expenses...

french social benefits- http://www.cleiss.fr/docs/regimes/regime_france/an_index.html very generous and worth a lot...

http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/

http://mdsalaries.blogspot.ca/

So if France has 50% more docs per capita than we do, better outcomes and spends significantly less per capita than we do, then the Fraser Institute is right, we should be copying their system. As long as we keep out the American for profit insurers, I'd be all for it. Wonder how that would fly under NAFTA.

actually our per capita cost with france is very similar, ours is a bit lower I believe...again demographic population density effect cost/access as well...and our average lifespan is equal to that of france so where are they getting better bottom line outcomes? access? sure they have more MD's per capita and better access due to geography/population density...

[Canuckistani]

here are two...but again you don't know the unseen aspects, if you are on salary in canada you get 10days vacation pay, france is 37 days, some countries give huge discounts on (or even free) education, dental care, parental support(leave, daycare) if a MD is on salary he/she doesn't pay staff or office expenses...

french social benefits- http://www.cleiss.fr...e/an_index.html very generous and worth a lot...

http://economix.blog...countries-make/

http://mdsalaries.blogspot.ca/

actually our per capita cost with france is very similar, ours is a bit lower I believe...again demographic population density effect cost/access as well...and our average lifespan is equal to that of france so where are they getting better bottom line outcomes? access? sure they have more MD's per capita and better access due to geography/population density...

I posted per capita costs some time back. France is significantly lower than ours, but very similar as percentage of GDP. France has been held up as the top system in the world, including in many outcome measures.

I don't believe that the pop/area piece is the driver for our higher costs/lower service. Remember Frances costs include prescription and dental coverage, etc. I think we just don't use our healthcare dollars in the most effective manner, and part of that is likely that we have healthcare a provincial responsibility instead of federal, the way it should be. Equal coverage for every Canadian, right across the land.

[guyser]

Again with the assault the messenger tactic.

Attack 1..Fraser institute.

Attack 2 Mr Agar.

Attack 3 Talk radio.

Atack 4 continuing use of manure

ok then that's special..........not!

LOL.

I was merely replying to wyly's post in which he understood that density differences can play a large part as to why country X may have better results while looking at data.

I would not expect, and have not been surprised with your responses, that you would understand that. I guess you're on the same level as talk radio? Yikes, that cant be good.

This thread still not going as you hoped huh? Oh well, something will come again soon for you to parade some faux outrage.

[wyly]

I posted per capita costs some time back. France is significantly lower than ours, but very similar as percentage of GDP. France has been held up as the top system in the world, including in many outcome measures.

it depends on which source you use I have seen canada rated both higher and lower and virtually the same as france, we are in the ball park price wise with the euro countries, and everyone trails the USA by a considerable margin...

I don't believe that the pop/area piece is the driver for our higher costs/lower service. Remember Frances costs include prescription and dental coverage, etc. I think we just don't use our healthcare dollars in the most effective manner, and part of that is likely that we have healthcare a provincial responsibility instead of federal, the way it should be. Equal coverage for every Canadian, right across the land.

of coarse it does a geographically smaller country has lower infrastructure costs, it's economical to build bullet trains between european cities because of population density, between canadian cities it becomes uneconomical...the same applies to hospitals and schools, economy of scale...

[wyly]

the best possible country to country we could find for direct comparison is australia... both large land mass with relatively small populations...

[Wayward Son]

thanks for that backup wayward...as I said a straight comparison is very very difficult...

I recall a local(calgary) news article a few years back where a MD/GP quit because he said he was working very long hours to make ends meet and after paying staff and office expenses it just wasn't worth while...his new job was as an EMT in an ambulance, he said he had fewer hours of work, less stress, none of the hassles of running a business and in the end his take home pay was better as well....

When I quit working as a flight paramedic back in 2009, I could pretty much guarantee (well at least based on newspaper reports of the average GP income in Ontario for that year) that I was making more money then the average GP, before even counting the benefits that I received, while working fewer hours, with significant downtime at work between calls, more vacation - and while I do have a university education, it is not required, related or a benefit - so most enter the job without the massive student debt, and none face the years spent working 24 - 36 hours straight at a stretch for roughly minimum wage as residents, or the 8 years of lost earning potential from undergrad and medical school that physicians deal with. I also partied like crazy during the same years that they were stressed out trying to out compete countless other hopefuls to get actually get accepted into medical school.

Edited December 5, 2012 by Wayward Son

[wyly]

which is why it is so hard to compare countries, we don't all the extra costs and benefits involved, there are just such vast differences that straight dollars and cents comparisons fail to draw the entire picture...

[Canuckistani]

it depends on which source you use I have seen canada rated both higher and lower and virtually the same as france, we are in the ball park price wise with the euro countries, and everyone trails the USA by a considerable margin...

of coarse it does a geographically smaller country has lower infrastructure costs, it's economical to build bullet trains between european cities because of population density, between canadian cities it becomes uneconomical...the same applies to hospitals and schools, economy of scale...

The wait time horrors I hear about are in major centers, not the fact that somebody in Armpit has to travel some distance to an ER in the first place.

It wouldn't kill us to look at Australian health care

Now comes the wide diversion, or what to Canadians would be the Big No-No. Australia not only allows private insurance, it encourages a private system for doctors and hospital care, alongside the comprehensive public one.

In Canada, to this point anyway, any politician who suggested the Australian approach (or the quite similar New Zealand one) would be accused of anti-patriotic sentiments, immediately gunned down and buried in a political coffin marked "heresy."

Australia spends about 1.5 per cent less of its national income on health care than Canada. As in Canada, costs are rising about 6 per cent annually. Australian politicians are fretting about the increases. But the Australian population, it would appear from polls and interviews, is generally content with their system.

Emergency room pileups in Canada, a chronic problem bordering on a disaster, are far smaller in Australia. In New South Wales and Victoria, the two largest states, 70 per cent of those who appear are seen within 20 minutes, according to the national statistical agency. That's unheard of in Canada.

http://www.theglobea...article1462015/

As I've said, I'm leery of anything the brings in more for profit health insurance. I have no problem with for profit health providers (as our doctors are).

Edited December 5, 2012 by Canuckistani

[wyly]

The wait time horrors I hear about are in major centers, not the fact that somebody in Armpit has to travel some distance to an ER in the first place.

hospital shortage is a factor, if there are few rural hospitals those rural patients will go to the already maxed out urban hospitals...our newest hospital cost $1 billion, how many of those do you think a province can build without complaints of tax increases...we can't afford to build billion dollar hospitals all over the province, the population density isn't large enough to support it...

[wyly]

wait times for surgery are dependent on the number of facilities, surgeons could easily do more surgeries to ease wait times but OR time is limited...my daughter recently had a major elective surgical procedure, she waited a year for the surgery not because the surgeon couldn't do it sooner but because he was limited to a fixed amount of surgical days, a facility/bed shortage...

[Argus]

The Fraser Inst doesnt have any agenda here does it?

I can only laugh when the list of countries compared are tiny, populous countries. Of course they should be better to deliver. Imagine if Canada were the size of Manitoba?

Could you explain how population density has any correlation whatsoever to number of doctors?

Remember that the shortages aren't in the boonies but in Toronto, Vancouver, Montreal and Ottawa, very highly populated areas.

[Argus]

At least in Ontario, MD programs are no longer underfunded. Spots in medical school has increased significantly since the cuts in the 1990s and do not need to be expanded further at this time. Unfortunately, it takes a lot of years to make a physician, so deficits take many years to correct.

And where are those physicians going to do their internships and residencies when they graduate?

[Argus]

Are any of you worried what's going to happen after 2017, if the Tories have their way. Harper wants the provinces to take over more of the funding on their own and just where does he think this money is going to come from.

The provinces can raise income taxes as easily as the feds can.

In any event, one of the big flaws in our system is that one level of government can point at the other and say it's all their fault, and vice versa. If we could just hold the PM or premier to task we might see some actual progress done.

[Argus]

germany and france both roughly the size of Manitoba with populations in the 65-70 million range compared to Manitoba's 1.2 so of coarse Germans are and french are going to have better access to healthcare providers ...

Why?

[Argus]

really? you have google at your finger tips and you come up with that?...

population density Ontario-14.1 per sq Km...germany 229 per sq km...france 117 per sq km...and france has something like 50% more Mds' than we do...

Population density has nothing whatsoever to do with it. I have no idea why you people keep talking about it.

Having 50% more MDs, of course, definitely DOES. So we have to ask ourselves... why does France have 50% more MDs per person than us?

France and Germany have about 3.4 doctors per 100k population. Canada has 2.1 physicians per 100k pop, which puts us 58th in the world.

http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people