B.C. lawsuit set to reignite debate about private health care

[square]

What section of the charter of rights are they saying is being violated?

[dre]

Getting diagnostic tests in BC takes 3-6 months unless you have an emergency and it is ordered by the hospital.

Some tests you can get faster by paying a private clinic.

Others one has to wait for.

That's a huge whopper right there. I can walk in and get tests the same day my doctor gives me a form. CT, US, RAD, BLOOD. Pretty much everything.

[TimG]

That's a huge whopper right there. I can walk in and get tests the same day my doctor gives me a form. CT, US, RAD, BLOOD. Pretty much everything.

Any tests that do not require access to a trained technician running an expensive machine are quick. As soon as you need access to that technician you will wait unless it is related to a emergency at a hospital.

[Smallc]

Any tests that do not require access to a trained technician running an expensive machine are quick. As soon as you need access to that technician you will wait unless it is related to a emergency at a hospital.

Xrays are available immediately. Non urgent CTs within 1 week in many cases. They both need trained technicians (a CT requires more than 2 years). The problem area is MRIs. An MRI takes much longer, and needs a person with more training than most nurses to operate it. Those issues, combined with higher salaries south of the border cause an issue.

Edited September 4, 2016 by Smallc

[TimG]

Xrays are available immediately. Non urgent CTs within 1 week in many cases.

Well I do not have much experience with CT scans. I do know that I was misdiagnosed and treated incorrectly because it took 8 weeks to get the ultrasound that showed what was really going on. In the long term it made no difference to the "system" since the final outcome was "good" but it was a very difficult time for me and my family.

That is why I said the needs of the system and the needs of the individual cannot always be reconciled. For that reason, government has no business prohibiting individuals from offering or buying services which the "system" is unable or unwilling to provide in a timely fashion.

[Smallc]

Well I do not have much experience with CT scans. I do know that I was misdiagnosed and treated incorrectly because it took 8 weeks to get the ultrasound that showed what was really going on. In the long term it made no difference to the "system" since the final outcome was "good" but it was a very difficult time for me and my family.

You're right - Ultrasound is the other weak area - mostly because of a shortage of technicians in that case.

[dre]

A parallel private system is one where private clinics can offer services that are covered under the public system.

Private clinics can already offer services that are covered under the Canada Health Act. Most clinics are privately owned, and doctors are not government employees.

[dre]

Any tests that do not require access to a trained technician running an expensive machine are quick. As soon as you need access to that technician you will wait unless it is related to a emergency at a hospital.

Not me. Took me 2 days to get my last ultrasound. Iv had so many CT scans in the last year that I can remember, and Iv never had to wait long for any of them.

[TimG]

Not me. Took me 2 days to get my last ultrasound. Iv had so many CT scans in the last year that I can remember, and Iv never had to wait long for any of them.

Good for you. Does not change my point because not everyone has your experience. People should have a choice that does not require them to go to another country. Edited September 5, 2016 by TimG

[cybercoma]

Changing who the payer is will do nothing to solve our problems.

Changing who the payer is will significantly increase our problems. Having a profit-motivated private insurance company deciding what they will cover and won't will lead to all kinds of red tape and issues for people. Not to mention the fact that hospitals will have to set up massive administrations to wade through all of that BS, causing healthcare costs to skyrocket for not only the insurers, but also the government for the patients they cover. A private-payer system does not work. Single-payer healthcare systems are the best in the world for providing the best care to the most people. Full stop.

[cybercoma]

Not a different payer but an additional payer. Everyone would still be paying the same taxes. Those who wanted to, could pay additional money for additional/faster medical services. That means more total money is devoted to healthcare. So assuming more money can buy more equipment, more personnel, shorter wait times, then private health care could help to address the problem.

That said, as soon as you have private health care, then the richer parts of society no longer care as much about the quality of publicly paid health care, which could result in its eventual erosion. That is of course the main argument against it, and it has some validity.

That's true but the bigger problem with introducing additional private-sector insurers is what i mentioned in my post above this one. It will drastically inflate the costs to the public payer because hospitals will have to navigate a bigger shit storm of red tape.

[cybercoma]

A parallel private system is one where private clinics can offer services that are covered under the public system.

Every other OECD country allows this. Not Canada.

Do you just make things up because they sound good to you? Because two seconds of looking would show you that you're wrong. That's also not to mention that doctors can work privately but they have to choose. They're not allowed to receive any money whatsoever from the government payer if they take private money. This was put into place to prevent doctors from double-dipping as they were in the past. If a doctor wants to set up a private clinic and not accept any money at all from the government, that doctor is free to do so.

[cybercoma]

So instead of answering the question you pic nits? It not only bans private insurance it bans doctors who offer services privately from offering them through the public system and makes it virtually impossible for them to work in or offer surgery in any hospitals.

Doctors screwed themselves in this regard by double dipping. They'd bill patients, then turn around and bill the government. Since it's a major expense and headache to police this, the government decided that doctors have to determine whether they'll accept private payment or public payment but not ever both.

[cybercoma]

Getting diagnostic tests in BC takes 3-6 months unless you have an emergency and it is ordered by the hospital.

So there's waits, except when there isn't. And the people who need it most have no wait at all but you don't want to acknowledge that.

[cybercoma]

Private MRI clinics are against the Canada health act.

Someone ask Argus to cite the section of the Canada Health Act.

[cybercoma]

Not me. Took me 2 days to get my last ultrasound. Iv had so many CT scans in the last year that I can remember, and Iv never had to wait long for any of them.

This reminds me of a study I saw awhile back (I'll see if I can find it again) that found that people who use the system are highly satisfied with it and the wait times; those most concerned about wait times and most critical of the system are people who have had little exposure to it.

[TimG]

So there's waits, except when there isn't. And the people who need it most have no wait at all but you don't want to acknowledge that.

You have no factual basis to make the claim. My argument is also not based on the question of the number of people that are force to wait. It is based on the argument that some people are forced to wait and the government has no business making it illegal for them to make their own choices. You don't argue that free of speech is not necessary because most people don't need it. You argue that freedom of speech is necessary because everyone should be entitled to express their opinion. Edited September 5, 2016 by TimG

[bush_cheney2004]

The CBC's Neil Macdonald took his attention off of Washington D.C. long enough to describe Canada's "dysfunctional" single payer health-care system:

I don't remember the fellow's name, but I do remember his rather searing question: "If I want to take whatever money I have left after the government gets finished taxing me, and spend it on my mother's eyes, you're gonna tell me I can't do that?"

The answer from Canadian nationalists, who hold this country's one-payer system to be something holy, would be, 'Yes, sorry, my friend, but your mother needs to get in line like everyone else, and suffer for days in the hospital, for the good of us all.'

That is still their answer more than 20 years later. The system is now much more uneven, sclerotic and, in a sense, corrupt (does anyone really believe VIPs spend a lot of time on waiting lists?), but somewhere deep in our Canadian hearts, we cling to the idea that outlawing private delivery of core medical care is something that makes us better than everyone else — certainly better than the dirty market-worshipping Americans, but also better than the French, the Swedes, the Italians, the Finns, the Swiss, the Australians and the British, all of whom allow private care alongside public care.

Health-care system might not make sense, but it is oh-so Canadian

[Bryan]

Xrays are available immediately. Non urgent CTs within 1 week in many cases. They both need trained technicians (a CT requires more than 2 years). The problem area is MRIs. An MRI takes much longer, and needs a person with more training than most nurses to operate it. Those issues, combined with higher salaries south of the border cause an issue.

Even MRIs don't take nearly as long as most people think (at least not in Manitoba anyway). With myself and both of my kids playing a lot of contact sports, injuries happen. We've had more than our share of MRIs. My most recent one (for my knee) was only a couple of months ago. At the time, the posted wait time was 26 weeks, but I got mine in 6 days, and that was the longest we've ever had to wait.

[Machjo]

The world's best health care systems (France, Sweden, Singapore, etc.) all share one thing in common. They are two-tiered systems with a quality public system functioning side by side with a private one.

Some of the worst systems (the US, Canada) are mostly one-tiered. The US has a poor public system and Canada a poor private one.

It's time to put blind ideology aside and copy the best systems.

[cybercoma]

Even MRIs don't take nearly as long as most people think (at least not in Manitoba anyway). With myself and both of my kids playing a lot of contact sports, injuries happen. We've had more than our share of MRIs. My most recent one (for my knee) was only a couple of months ago. At the time, the posted wait time was 26 weeks, but I got mine in 6 days, and that was the longest we've ever had to wait.

That's because the posted wait times are the provincial average. When you take into account people in remote areas, it skews the average higher. Delivery of services is a geographical issue here. Having sparsely populated areas spread over large swathes of land makes it difficult and expensive to deliver care to everyone equally. For the most people, people living in major cities or densely populated areas have much faster access to care.

Edited September 7, 2016 by cybercoma

[overthere]

The world's best health care systems (France, Sweden, Singapore, etc.) all share one thing in common. They are two-tiered systems with a quality public system functioning side by side with a private one.

Some of the worst systems (the US, Canada) are mostly one-tiered. The US has a poor public system and Canada a poor private one.

It's time to put blind ideology aside and copy the best systems.

In France, every visit to a doctor requires a user pay component. Last time I asked family, it is about 15 Euros.

Health care in UK is two tiered. The public system is more or less overwhelmed. The private system also does contract work for the public system. Guess which system attracts the best doctors and specialists?

[TimG]

For the most people, people living in major cities or densely populated areas have much faster access to care.

Which is not argument that can be used to justify prohibiting the private purchases of such services.

[Big Guy]

I suspect that this whole problem could be alleviated if the government got out of the business of putting caps on the number of people who want to becomes doctors:

Doctor Caps

“In 2009, there were almost 5,000 qualified applicants to the Michael G. DeGroote School of Medicine at McMaster University in Hamilton alone. Only 194 were accepted. At Dalhousie University Faculty of Medicine in Halifax, only 102 of almost 700 applicants made it in. It's something that happens at med schools across the country every year. What are these applicants lacking? What are they missing to make the final cut?

Maybe nothing.”

It is the provincial government which limits the number of seats in Medical schools. It is the doctors who are successfully lobbying and keeping the numbers down to protect their careers. If we allow the market to dictate the number of doctors then soon there would be no argument against a two tier system. There would be plenty to serve both systems. The Ontario Medical Association is a closed shop whose first priority is to protect income and jobs in Ontario.

Doctor Shortage

Edited September 7, 2016 by Big Guy

[Machjo]

That's because the posted wait times are the provincial average. When you take into account people in remote areas, it skews the average higher. Delivery of services is a geographical issue here. Having sparsely populated areas spread over large swathes of land makes it difficult and expensive to deliver care to everyone equally. For the most people, people living in major cities or densely populated areas have much faster access to care.

So why find ministries of health and infrastructure cooperate more to promote higher-density cities, discourage suburbanisation and maybe reintroduce agriculture into once-sprawling suburbs?

A gas tax would help with that by making living in the middle of nowhere less attractive.