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

[PIK]

Right now there is a mayor of a small town in ONT needs life saving surgery for pancreas cancer, that is only done in America. The operation will give him 5-7 yrs instead of dying before Christmas. The Government said no, we cant afford it. But if he needed a sex change down in America the government will pay for it.

[Smallc]

Right now there is a mayor of a small town in ONT needs life saving surgery for pancreas cancer,

Pancreatic cancer gas a 4% survival rate. What are his odds with the surgery?

[TimG]

Pancreatic cancer gas a 4% survival rate. What are his odds with the surgery?

Well that is why we need a private payment option. The system cannot afford to pay for high risk/low outcome interventions so it can reasonably refuse this man's request. What is not reasonable is saying that he is not allowed to buy private insurance when he was healthy that could have covered these situations

[Smallc]

Well that is why we need a private payment option.

He has the option of private payment in this case.

[?Impact]

It doesn't bother you that many European countries pay less than us but have much more effective, efficient health care systems, does it?

It would if that were really true, but Canada consistently ranks as one of the best health care systems in the world. Australia is generally the one country that ranks as high (sometime higher) than Canada. European countries, like Canada and the US, have grown the cost of healthcare over the past several decades. European countries with higher cost of healthcare than Canada (latest OECD data) are: Austria, Belgium, Denmark, France, Netherlands, Sweden, and Switzerland; of course non of them are close to the cost of health-care in the US. What specific European countries are you referring to?

[dre]

It would if that were really true, but Canada consistently ranks as one of the best health care systems in the world. Australia is generally the one country that ranks as high (sometime higher) than Canada. European countries, like Canada and the US, have grown the cost of healthcare over the past several decades. European countries with higher cost of healthcare than Canada (latest OECD data) are: Austria, Belgium, Denmark, France, Netherlands, Sweden, and Switzerland; of course non of them are close to the cost of health-care in the US. What specific European countries are you referring to?

The best measure of a health system isn't whether or not there horror stories or some failures of the system. All systems fail.

The best measure of a health care system are infant mortality rates and life expectancy. Canada is 12th in the world. That's pretty damn good, but being number one would be better.

Japan is ranked number 2, and they have single payer universal healthcare.

Italy is ranked number 3 and they have single payer universal healthcare.

Iceland is ranked number 6 and they have single payer universal healthcare.

So anyone that tells you that you cant build an excellent healthcare system around single payer UHC, or suggested that privatization is the only way to fix things is quite frankly an idiot.

But...

Hong Kong is ranked number 1 and they have a two tier system.

Singapore is ranked number 5 and they have a two tier system.

So really public VS private is not a deterministic factor. All this talk about who the payer or payers should be is totally besides the point. You need to look at the complexities of each system like I tried to do in a previous post.

Its also worth noting that a successful national healthcare system isnt just about nurses, doctors, and hospitals. Its about preventative care, nutritional awareness (labels on foods), programs to encourage excersize and good health habits, etc.

Edited September 2, 2016 by dre

[Bonam]

The best measure of a health care system are infant mortality rates and life expectancy. Canada is 12th in the world. That's pretty damn good, but being number one would be better.

You have to be careful with stats like that, because they may not reflect the reality of the health care system but fold in other social/economic factors. For example, infant mortality rates go up and life expectancies go down in countries that are engaged in warfare, even if the healthcare system itself remains as good as it was. Or, if you look at a country like the US, these averages may be strongly skewed downwards by the bottom 10-20% of the population that don't have insurance / can't afford healthcare, but if you look at how the healthcare system actually performs for the middle class you would see better results.

Anyway, infant mortality and life expectancy are certainly things to look at but they don't tell the whole story. If you're rich, the best healthcare you can get anywhere on Earth is generally in the US, even though no aggregate stats are gonna show you that.

Also, it should be noted that the majority of all medical innovation (development of new pharmaceuticals, medical equipment, and procedures) happens in the US. All other countries, comprising over 95% of the world's population, contribute less to the advancement of medicine and healthcare than the US does. All those fancy new diagnostic machines that Canada has to come up with the funds to buy? Invented in the US. None of the stats you mention place any weight on medical innovation, without which life expectancy and infant mortality would not be continuing to improve around the world.

Would your rather pay x for healthcare and know that the healthcare that exists now is the best that it's ever gonna be, or pay 2x for healthcare and know that in 20 years, many of the things that are life-threatening today will be easily prevented, cured, or treated?

[TimG]

He has the option of private payment in this case.

Only because he was not allowed purchase excess coverage insurance when he was healthy.

[dre]

You have to be careful with stats like that, because they may not reflect the reality of the health care system but fold in other social/economic factors.

Good point and I just got done editing my post with regards to that.

Its also worth noting that a successful national healthcare system isnt just about nurses, doctors, and hospitals. Its about preventative care, nutritional awareness (labels on foods), programs to encourage excersize and good health habits, etc.

If you're rich, the best healthcare you can get anywhere on Earth is generally in the US

Sure but a national healthcare system needs to be measured by how it performs overall.... not how it might work for a select few.

All other countries, comprising over 95% of the world's population, contribute less to the advancement of medicine and healthcare than the US does. All those fancy new diagnostic machines that Canada has to come up with the funds to buy?

Sure but even in UHC countries the government does not make medical equipment or run pharmy companies. Those things are privately produced and there would be profit in making them and investing in them regardless of who the payer is.

[TimG]

Japan is ranked number 2, and they have single payer universal healthcare.

No they don't. They have up to 30% co-pays on all treatments. Low income people can get co-pays refunded at tax time. People have the option of buying private insurance to cover the co-pays.

Frankly, there are more choices in the world than the Canadian system which its ridiculous ban on private care and insurance or the US system. Canada is the only OECD country that does not allow some sort of parallel privately funded system. There is no economic or healthcare outcome justification for the ban. It is purely ideological.

Edited September 2, 2016 by TimG

[?Impact]

The best measure of a health care system are infant mortality rates and life expectancy.

Canada has consistently improved in both those categories over the past several decades. The problem is Canadian numbers are about 3 years old (I really don't know why we are slow in publishing them) where other countries publish much more current figures. You are not comparing apples to apples in either of those cases.

[dre]

No they don't. They have up to 30% co-pays on all treatments. Low income people can get co-pays refunded at tax time. People have the option of buying private insurance to cover the co-pays.

Frankly, there are more choices in the world than the Canadian system which its ridiculous ban on private care and insurance or the US system. Canada is the only OECD country that does not allow some sort of parallel privately funded system. There is no economic or healthcare outcome justification for the ban. It is purely ideological.

Canada has healthcare premiums as well. But still both Canada and Japan are considered single payer UHC systems.

https://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/

Also you can be sure that readers have noticed that you picked out one line of a post trying to poke holes, and ignored the rest.

Edited September 2, 2016 by dre

[dre]

Canada has consistently improved in both those categories over the past several decades. The problem is Canadian numbers are about 3 years old (I really don't know why we are slow in publishing them) where other countries publish much more current figures. You are not comparing apples to apples in either of those cases.

Well Im doing the best I can!

I looked at the data here... https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

And the data here... https://truecostblog.com/2009/08/09/countries-with-universal-healthcare-by-date/

It might not be perfect but its damn close and at least its an assessment based on empirical information

[TimG]

Canada has healthcare premiums as well. But still both Canada and Japan are considered single payer UHC systems.

And Japan allows for a parallel private system and private insurance and the world has not ended. That example alone should be enough to show that the opponents of such reforms in Canada are talking nonsense.

[dre]

And Japan allows for a parallel private system and private insurance and the world has not ended. That example alone should be enough to show that the opponents of such reforms in Canada are talking nonsense.

So what. 30% of the Canadian system is private as well.

Private health expenditure accounts for 30% of health care financing.^[5] The Canada Health Act does not cover prescription drugs, home care or long-term care, prescription glasses or dental care, which means most Canadians pay out-of-pocket for these services or rely on private insurance.^[4] Provinces provide partial coverage for some of these items for vulnerable populations (children, those living in poverty and seniors).^[4] Limited coverage is provided for mental health care.

The effects of privatization are often disastrous by the way. In Ontario they privatized medical diagnostics, and prevent hospitals from offering the service at no cost. The result? An increased cost to the system, a reduced access and service, and waiting lists.

Edited September 2, 2016 by dre

[TimG]

30% of the Canadian system is private as well.

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.

The effects of privatization are often disastrous by the way.

Only if government use it an excuse to reward their cronies with sole source long term contracts. If done right where companies are expected to provide competitive bids for shorter term contracts then you will only get better service at lower cost. Edited September 2, 2016 by TimG

[dre]

Every other OECD country allows this.

No they dont. Look at the link I sent you or provide a better one.

[TimG]

No they dont. Look at the link I sent you or provide a better one.

Your link is not useful. Japan and Norway offer single payer but they both allow the private system I am talking about.

http://europe-cities.com/destinations/norway/health/

Private healthcare does not play a large role in Norway due to the excellent standard of state healthcare. Some private insurers offer complementary health insurance for citizens who want to avoid hospital waiting lists or receive treatment like plastic surgery.

https://en.wikipedia.org/wiki/Health_care_system_in_Japan

In Japan, services are provided either through regional/national public hospitals or through private hospitals/clinics, and patients have universal access to any facility, though hospitals tend to charge more to those patients without a referral.

...

Health insurance is, in general, mandatory for residents of Japan, but there is no penalty for the 10% of individuals who choose not to comply.[26][27] There are a total of eight health insurance systems in Japan,[28] with around 3,500 health insurers.

Edited September 2, 2016 by TimG

[Smallc]

Only because he was not allowed purchase excess coverage insurance when he was healthy.

Which may not have covered him anyway.

[TimG]

Which may not have covered him anyway.

That is not an argument to say that such coverage should be prohibited.

[dre]

That is not an argument to say that such coverage should be prohibited.

Right but you've presented no argument whatever so ever that partial privatization would fix any of our problems, and we know that most of our problems are the result of other things.

Privatization is a red herring. Need to actually look at what the problems are and how to solve them.

[TimG]

Right but you've presented no argument whatever so ever that partial privatization would fix any of our problems

It is not about fixing problems. It is about allowing people to solve their own problems in their own way. The idea that government has solve everyone's problems is simply nonsense. It should do what it can with the money it can raise and leave the rest to individuals. It should not pass laws making it illegal for individuals to solve their own problems. Edited September 2, 2016 by TimG

[Smallc]

That is not an argument to say that such coverage should be prohibited.

He already has such coverage - but I'm not sure how I feel about private payer options. I'd have to see that it would make it better.

[Argus]

Right but you've presented no argument whatever so ever that partial privatization would fix any of our problems, and we know that most of our problems are the result of other things.

None of you people who are so determined to avoid a private system have ever managed to explain why NO OTHER COUNTRY ON EARTH bans it, other than us, Cuba and North Korea. I mean, if it's so obvious to you that our single payer system that bans private health care is the right one why don't the Swedes or Swiss or Germans agree?

[Smallc]

Canada does not ban private health care, only private insurance.