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US dead last in health care


Canuckistani

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It's great, when you don't have to use it. Anyway, the boomer gen will likely force some positive change to our ailing system, as enough people will be sick at one time.

No the system will continue to get worse and worse for the reasons I stated on the previous page. Healthcare costs will continue to increase faster than the rate of inflation, until the government can afford to provide less and less service. Like I said before its a macro economic problem. Theres two separate economies... the healthcare economy... and everyone else. Wages are rising in the healthcare economy, but they are stagnant for everyone else. Healthcare costs will double in the next decade, and again in the decade after that if the trend is not reverse, and the trend cant be reversed without radically changing our trading policy.

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Interesting tidbit about referrals out of province / country:

What costs are covered if I am approved for treatment outside Manitoba?...

In the United States:

If you are referred for medical care outside Canada, and your referral is approved, you
may have to pay
some of the costs for your medical and hospital services.

For medical and hospital services provided in the U.S., Manitoba Health will cover:

  • doctor bills
    , at the same rate a Manitoba doctor would receive for similar services; and


  • hospital bills
    , up to 75 per cent of insured hospital services.

If your costs for medical and hospital services exceed these coverage limits,
it is your responsibility to pay the difference
, unless you qualify for special assistance based on financial hardship. This is because costs for such services in the U.S. are generally much higher than costs for the same services in Canada.

So why would a province with "free health care rights" refer an eligible patient to the U.S. and make them pay the difference in costs ?

Edited by bush_cheney2004
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MRIs, maybe. The other two, not at all.

Even MRIs, not. Manitoba has a LOT of excess capacity for MRI's right now (at least in Winnipeg). I've had several in the past few years, and my longest wait so far has been 6 days. The biggest factor is your doctor. If s/he tells the diagnostic centre that your case is serious, they slot you in to the next available spot. If your doctor thinks your situation is not so serious, you get slotted at the end of the schedule to leave spots open for cases that are.

Depends on the doctor an the location.

Yep. I can get in to see my doctor within one day, ALWAYS. My kids have always been able to see their pediatrician the same day, ALWAYS.

That depends on the province.

It must. It seems that the people with the greatest dissatisfaction with their care are in Ontario. There's something really wrong with their provincial government's administration of the health care when they have both a high number of patients without a doctor, and a high number of doctors who can't find work. With their population density, they should be able to take advantage of economies of scale in ways that Manitoba never could, There's no excuse for our system being anywhere close to as good as theirs, never mind that it appears to be vastly superior.

That isn't true. There are urgent care centres in most major cities now for non emergent cases.

Absolutely. Anyone can get in to see a doctor within a couple of hours at the most for non-emergencies. You show me someone who waits for 5+hrs, and I'll show you someone who is deliberately trying to make their experience as miserable as possible for the express purpose of complaining about it. If you won't even spend five minutes on the phone calling to see what the waiting rooms are like at various places around town, you deserve what you get.

I did this not too long ago. I had received stitches a few days prior for a skate cut, and the wound appeared like it might be infected. My doctor was at a conference, and couldn't see me until the next day, and recommended that I go to emerg. I went to St. Boniface hospital E.R., but when I was told it could be several hours before they might deal with my not-really-an-emergency, I then decided to call around. By the third call, I found a clinic that said they could see me immediately if I drove right over, so I did.

Edited by Bryan
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I have had multiple contacts with the system btw, in the last 6 months alone. Most were satisfactory.

Results of studies show that those whom have contact with the system are mostly satisfied, while those who have little contact with the system are the ones dissatisfied with it. This seems to suggest that people have an unfounded anxiety about care not being there when they need it. It doesn't help that conservatives wrongly contest that the system is unsustainable so they can advocate privatization. This just fosters public anxieties about the system that seems to work quite well for those who need it, according to their responses about satisfaction.
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Results of studies show that those whom have contact with the system are mostly satisfied, while those who have little contact with the system are the ones dissatisfied with it. This seems to suggest that people have an unfounded anxiety about care not being there when they need it. It doesn't help that conservatives wrongly contest that the system is unsustainable so they can advocate privatization. This just fosters public anxieties about the system that seems to work quite well for those who need it, according to their responses about satisfaction.

This is the type of issue that demands "information" not "impressions". Being satisfied with the system is important, but there are objective measures that are set by managers and health professionals that should be commonly, if not universally known and understood by the public.

Whether or not the system is unsustainable or not is to a degree an opinion, but also an opinion based on numbers and facts. There is no public forum wherein such facts are agreed upon and discussed. That is a problem, if not the problem.

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....Whether or not the system is unsustainable or not is to a degree an opinion, but also an opinion based on numbers and facts. There is no public forum wherein such facts are agreed upon and discussed. That is a problem, if not the problem.

Yep...the continued hue and cry for patient ombudsmen (see survey above) is evidence of that. Another opportunity for sunshine in government !

Edited by bush_cheney2004
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You didnt read my post. Costs are going up for the exact reasons I stated and its happening in both private and public systems. Wages in protected economies such as healthcare and education are rising faster than everyone elses wages which are being kept in check by global competition.

I understand its fun for hacks to bicker of public VS private but its a complete and total red herring.

No, because even the so-called private system in America is two-thirds public and still heavily subsidized. Why do you think a pair of crutches, which is essentially two pieces of wood costs more than a laptop?

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No, because even the so-called private system in America is two-thirds public and still heavily subsidized. Why do you think a pair of crutches, which is essentially two pieces of wood costs more than a laptop?

Spot on....between Medicare, Medicaid, Veterans Administration, federal R&D, and companion state programs there is a huge public investment and payer subsidy for U.S. health care. This is what helps to drive costs up...up...up.

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No, because even the so-called private system in America is two-thirds public and still heavily subsidized. Why do you think a pair of crutches, which is essentially two pieces of wood costs more than a laptop?

Sorry, the US is one of only two OECD countries with less that 50% public funding, in the US it's 47% In Canada it's around 70%. But as Bill Kristol famously said, ordinary Americans don't deserve a single payer system like the US military has. Or US medicare, with the famous slogan "keep your government hands off my medicare."

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Spot on....between Medicare, Medicaid, Veterans Administration, federal R&D, and companion state programs there is a huge public investment and payer subsidy for U.S. health care. This is what helps to drive costs up...up...up.

Exactly. And even the private market isn't truly allowed to compete with each other. Democrats have given health insurance companies an antitrust exemption, which means in many states there's a virtual monopoly.

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In any event, the OP cited study is an interpretation of data by third parties, while some of it might be interesting it is far from conclusive, which you have succinctly pointed out.
yes, as I stated, the study authors source data from several (recognized and authoritative) sources… in the case of the mortality section focus you had, the study sourced data from the OECD.

you were quick to question the legitimacy of “peer” country assignment/comparison… you challenged the study mortality categorization comparisons in terms of whether or not the U.S. simply has better overall diagnostic (hence reporting) capabilities, implying the related data might skew accordingly. I mentioned I’ve not read/found any like criticism of the study – I followed that up by acknowledging one of the study caveats concerning country comparisons and available data:

In any case, the study itself speaks to the difficulty in making absolute health care system comparisons between peer countries and that in particular areas, data is lacking. The study also speaks to separate active research that continues to work towards improving and strengthening health care comparisons between countries... that complete data is still evolving. That being said, where sufficient data exists the study does draw comparisons.

in your above quote, you've taken liberty and extended upon my (the study’s) offered caveat to suggest a “far from conclusive” summation of the overall study findings… even though you only commented directly on the mortality section (one study section, of many). Whether to the specific mortality section, or to the overall study, yours is an unfounded summation; I've bold-highlighted the sentence within my reply you seem to totally ignore: “where sufficient data exists, the study does draw comparisons”.

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And is its purpose to bring reflection upon and change in comparative systems, such as may be deemed necessary in Canada, or is it for Canadians to gloat about their obvious superiority over one other nation that perhaps shouldn't even be included in such a comparison, if only for the reason that Americans have in the past had a choice to make their own personal risk assessments regarding their expenditures in health care.
study purpose? Clearly, the study as written by Americans… for Americans… has principal designs on American introspection of the designated “American health disadvantage”, relative to the rest of the world’s high-income countries. Certainly, a part of that American introspection calls for consideration on the influence of the American health care system in contributing to this American health disadvantage. We certainly don’t see any of that introspection coming forward from those MLW members within this thread who claim to be Americans… those who choose instead to completely ignore the study… to wildly deflect away from the study findings. They choose, instead, to derail this thread away from its intended focus on comparative health analysis, refusing to even acknowledge the study findings; findings that show that:

- the comparative American health disadvantage continues to grow over a now 3 decades+ period of time

- the American health disadvantage is pervasive affecting all American age groups regardless of income, as observed for multiple diseases, biological and behavioural risk factors, and injuries. Detailed study extracts showing this comparative American health disadvantage have been offered within this thread… offered… and ignored.

you ask how Canadians can/might purpose this study. The study, in its comprehensiveness, makes direct and detailed reference to conditions/situation and scenarios within many of the peer review countries compared. There are clearly areas for Canadians to reflect upon, both positively and with our own required introspection on considerations for improvement towards Canadian health.

in reviewing the study findings, you cynically suggested the possibility of, “Canadians gloating with obvious superiority over Americans”. Well, in terms of one of those study categorizations, healthcare, Canada fares very well as compared to the United States… the study findings bear that out, particularly in terms of both access to healthcare and insurance coverage. When one highlights that 20% of Americans (children and adults under age 65) do not have medical insurance… is that a Canadian, as you say, “gloating”??? Is it “gloating”, or being factual, for a Canadian to point out the most obvious study finding:

- that Americans without medical insurance are more likely to lack a usual source of medical care, are more likely to skip routine medical care due to costs and, accordingly, are more likely to increase their risk for serious and disabling health conditions… that when Americans do access health services, they are often burdened with large medical bills and out-of-pocket expenses.

within this thread we get the usual suspects deflecting away from health discussions, presuming to challenge Canadian healthcare based on wait times and Canadians utilizing the American system. To the latter, the outstanding challenge remains for them to go beyond their dropped link references to sensationalized media/political slanted cases… to actually speak to a number of just how many Canadians travel to the U.S. for medical care (either by personal choice or as decided by provincial admin). Just how many Canadians are receiving medical care in the U.S.? Anyone? Anyone? Again, I followed up on one of the referenced link drops that presumed to showcase an agreement between Ontario & Michigan; a follow-up that ultimately showed that only 300 patients were transferred from Ontario to Michigan hospitals. 300 from Canada’s most populated province… representing almost 40% of Canada’s population. And for this (type of referenced example), the threads deflectors get away with unsubstantiated claims concerning the significance and weighted impact of Canadians leveraging the U.S. medical systems. Of course, its such a dandy deflecting talking point! Of course!

clearly, this threads deflectors don't partake in any self-examination of wait times within the U.S.… nor is so-called medical tourism ever reviewed to address the hundreds of thousands of Americans who choose to seek medical coverage outside the United States, principally due to cost savings, insurance considerations, pre-existing conditions, etc. Self-examination and introspection are simply impediments to thread deflection/derailing!

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Good points Waldo. Also don't forget how much Americans spend on healthcare. If any of the peer countries spend that much per GDP or per capita, but didn't waste it on administrative costs, high incomes for doctors or overuse of procedures and equipment, think of how much the health in these peer countries would improve. Especially if that money was put into prevention, which would include poverty alleviation.

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....clearly, this threads deflectors don't partake in any self-examination of wait times within the U.S.… nor is so-called medical tourism ever reviewed to address the hundreds of thousands of Americans who choose to seek medical coverage outside the United States, principally due to cost savings, insurance considerations, pre-existing conditions, etc. Self-examination and introspection are simply impediments to thread deflection/derailing!

Clearly, the fact is, without a doubt, the continued deflection is only yours, as, unlike in proud but delusional Canada, the United States has no federal or state universal access and care mandate. That provincial web sites would dedicate content to the referral and costs of medical care in the United States speaks volumes about known and persistent inadequacies in Canada, which does have a mandate for such a level of access and care. In short, Canada's health care system does not even meet its own stated objectives, regardless of comparisons to the country that supplements access and capabilities found to be lacking in Canada.

Canada's poor ranking among "OECD nations" is not made better by comparisons to the United States, but as usual, such comparisons are more than enough to satisfy the health care status quo "sycophants".

Edited by bush_cheney2004
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Clearly, the fact is, without a doubt, the continued deflection is only yours, as, unlike in proud but delusional Canada, the United States has no federal or state universal access and care mandate.

laugh.png the lacking U.S. mandate you so proudly tout throughout this thread is a leading contributor to the comparative health disadvantage Americans hold relative to other 'high-income' countries of the world... you know, the health disadvantage finding you deep deflecting away from.

That provincial web sites would dedicate content to the referral and costs of medical care in the United States speaks volumes about known and persistent inadequacies in Canada, which does have a mandate for such a level of access and care. In short, Canada's health care system does not even meet its own stated objectives, regardless of comparisons to the country that supplements access and capabilities found to be lacking in Canada.

you keep harping on this but refuse to provide any accounting of just how pervasive the practice is. Is there a problem for you in rising above your unsubstantiated claims on the impact/significance of the practice?

you quote my reference to U.S. 'medical tourism', yet refuse to even acknowledge any of the its key drivers mentioned; again, "cost savings, insurance considerations, pre-existing conditions"... somehow, you draw distinction between Americans seeking out-of-country health care in these circumstances and Canada/Canadians leveraging U.S. health services... whatever that number (of Canadians) might actually be.

Canada's poor ranking among "OECD nations" is not made better by comparisons to the United States, but as usual, such comparisons are more than enough to satisfy the health care status quo "sycophants".

status quo "sycophants"??? Try again, clearly you haven't used the word sycophant properly... are you getting, uhhh... flustered?

Canadian resistance to privatization is, typically, one of raised concern over possible negative impacts to the status-quo you presume on. As it stands, degrees of "privatization" is ongoing... so long as those engaged private clinics strictly adhere to Canada Health Act billing schedules. I've personally investigated this 'experimental' option being floated in various locations... you pay an up-front fee to join the clinic and you pay yearly 'membership' fees... and you realize medical care outside the mainstream, from doctors, nurses, technicians, etc,, that work exclusively within the private clinic. To me, this approach works to the detriment of the public system, removing significant resources from it... something that will only realize a continued erosion of the status quo... the one you presume upon.

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laugh.png the lacking U.S. mandate you so proudly tout throughout this thread is a leading contributor to the comparative health disadvantage Americans hold relative to other 'high-income' countries of the world... you know, the health disadvantage finding you deep deflecting away from.

There is no health disadvantage when advantage is neither mandated or desired as part of lifestyle or culture. Conflating health and healthcare was only the first mistake among many in the original op, now augmented by your confused conclusions.

you keep harping on this but refuse to provide any accounting of just how pervasive the practice is. Is there a problem for you in rising above your unsubstantiated claims on the impact/significance of the practice?

I already posted an example for Manitoba...must I do so for every province and territory to prove official sanction of "medical tourism" as a solution for inadequate resources and staffing in Canada ? Government web site content explicitly refers and limits coverage for referrals to the United States (by name), not just "other countries".

you quote my reference to U.S. 'medical tourism', yet refuse to even acknowledge any of the its key drivers mentioned; again, "cost savings, insurance considerations, pre-existing conditions"... somehow, you draw distinction between Americans seeking out-of-country health care in these circumstances and Canada/Canadians leveraging U.S. health services... whatever that number (of Canadians) might actually be.

Doesn't matter...as Canada has a CHA mandate for universal access and care that does not exist in the United States, but its provinces officially sanction care and services from the USA as a solution for demonstrated inadequacies.

.... To me, this approach works to the detriment of the public system, removing significant resources from it... something that will only realize a continued erosion of the status quo... the one you presume upon.

So like I said, you are a proponent of the current "system" and will defend it even in the face of demonstrated inadequacies. Nonbelievers will continue to seek private pay solutions in Canada and the USA.

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There is no health disadvantage when advantage is neither mandated or desired as part of lifestyle or culture.

no - the described American health disadvantage runs throughout the gamut of the study's subset categorizations, regardless of you attempting to negate the overall findings by addressing a component you choose to belittle as nothing more than your, 'American right to make unhealthy life-style choices or partake in risky behaviours'. Freedom!!!

Conflating health and healthcare was only the first mistake among many in the original op, now augmented by your confused conclusions

no - your described conflation was quickly and repeatedly addressed. You simply chose to keep beating on it as a means to perpetuate your deflection away from any discussion on the American health disadvantage. Any conclusions I have, any summations I've offered, are drawn directly from the study. You know, the study you won't touch with the proverbial 3.04800 metre pole!

I already posted an example for Manitoba...must I do so for every province and territory to prove official sanction of "medical tourism" as a solution for inadequate resources and staffing in Canada ? Government web site content explicitly refers and limits coverage for referrals to the United States (by name), not just "other countries".

so what? Your link was simply a statement on conditions surrounding medical care, whether outside the province (within Canada), or outside the province (into the U.S.). You continue to refuse to provide any numbers to qualify your emphasis on the extent of the practice... you're nothing but repeating noise. When you (or whoever it was in this thread) threw down a link presuming to showcase the transfer agreement between Ontario and Michigan... and I follow that link up to quantify it as to an actual number... and find that a grand total of 300 patients were transferred from Ontario to Michigan, I have all I need to realize you're nothing but bluster (as if I needed yet another example to confirm the obvious).

Doesn't matter...as Canada has a CHA mandate for universal access and care that does not exist in the United States, but its provinces officially sanction care and services from the USA as a solution for demonstrated inadequacies.

doesn't matter??? Clearly, to you, in a typical hypocritical stance, it doesn't matter. Your whole unqualified premise is that the U.S. health care system is significantly compromised by having to support Canada's extended reach, even though you can't qualify that extended reach. Meanwhile, hundreds of thousands of Americans travel to other countries seeking relief for high American medical costs, or insurance limitations, or outright insurance refusals related to pre-existing conditions. Somehow, you make a most self-serving distinction here. Go figure!

So like I said, you are a proponent of the current "system" and will defend it even in the face of demonstrated inadequacies. Nonbelievers will continue to seek private pay solutions in Canada and the USA.

yes, most certainly - I am a proponent of the Canadian Health Care system, particularly when compared to the American 'system' and the described study's American health disadvantage. You, in the face of the inadequacies associated with the demonstrated disadvantage, continue to defend ignore your country's health disadvantage. Freedom!!!

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