Heath Care too expensive?

[Carbon882]

Free Health care is currently benefiting me and some members pretty well. It does have its downsides and people use that (Including Trump) to bash on it. FreeHealth care happens to have very slow and congested service and people talk about how they waited months for it while they could have just payed for it and got it done right away.

The problem I have with Privatised heathcare is that f you can't afford it you are pretty much dead.

 I think we should either mix our Healthcare system or cut it and increase social welfare funding. I believe welfare is more cost effective at getting people what they need rather than running a whole heathcare service.

 

[cannuck]

All of the other former G7 countries EXCEPT the US have fully socialized medical insurance,  but no restriction on who (public or private) can deliver services.   We already have a "mixed" system, except the problem is that legislation gives government monopolies on service delivery.   STUPID, IMHO.  I should be able to take what is covered by our government's sick care insurance and get it payment to ANYONE who is qualified to deliver.  Similarly, I should be able to elect to cue jump by just paying whoever is willing to deliver that service in MY timeframe and at my expense.

[Michael Hardner]

2 hours ago, Carbon882 said:

Free Health care is currently benefiting me and some members pretty well. It does have its downsides and people use that (Including Trump) to bash on it. FreeHealth care happens to have very slow and congested service and people talk about how they waited months for it while they could have just payed for it and got it done right away.

The problem I have with Privatised heathcare is that f you can't afford it you are pretty much dead.

 I think we should either mix our Healthcare system or cut it and increase social welfare funding. I believe welfare is more cost effective at getting people what they need rather than running a whole heathcare service.

 

What we need to do is get citizens who understand management to be engaged and hold healthcare managers to a higher standard than simply keeping their political bosses happy.

[bush_cheney2004]

Universal health care insurance is just another entitlement program...it is not a right...and it certainly isn't "free".

 

[Argus]

37 minutes ago, Michael Hardner said:

What we need to do is get citizens who understand management to be engaged and hold healthcare managers to a higher standard than simply keeping their political bosses happy.

Why bother? Health care is fine. Hey, have you seen that new Beyonce video?

We had a federal election and nobody talked about health care. Ontario just had a provincial election. Nobody brought it up. We're having  municipal elections now. There have been a number of stories in Ottawa over the past couple of years about us having zero ambulances available fairly often because the city hasn't kept up hiring with the growth of the population. Nobody has brought it up in the election.

Long wait times? People forced to spend days in hospital hallways? No ambulances available? 

Big yawn. Hey, pot is gonna be legal soon! Yippee!

Canadians are content with their health care as it is. And will remain so no mater how bad it gets. That being the case, what possible reason would politicians have to try to improve it?

Edited October 14, 2018 by Argus

[Michael Hardner]

1 hour ago, Argus said:

1. We had a federal election and nobody talked about health care. Ontario just had a provincial election. Nobody brought it up. We're having  municipal elections now. There have been a number of stories in Ottawa over the past couple of years about us having zero ambulances available fairly often because the city hasn't kept up hiring with the growth of the population. Nobody has brought it up in the election.

2. Canadians are content with their health care as it is. 

1. Exactly.  The perfect fusion of liberals and conservatives could simply hold public health to the task of providing 'value' ... improving health while watching costs.

2. Fringe politicians can get attention by saying refugees are ruining Canada, so why can't a centrist politician just point to costs and wait times and say 'THIS' ? and get a little attention ?  This is everyone's fault: the public, media and politicians.  

[Argus]

53 minutes ago, Michael Hardner said:

2. Fringe politicians can get attention by saying refugees are ruining Canada, so why can't a centrist politician just point to costs and wait times and say 'THIS' ? and get a little attention ?  This is everyone's fault: the public, media and politicians.  

No politician, fringe or otherwise, has said refugees are ruining Canada. We don't allow fringe politicians in Canada anyway. You have to be a duly registered and accepted member of one of the few political parties. And once ensconced there you may not speak your opinion, but may only regurgitate the party's positions. And the parties are not interested in health care in large measure because no one is forcing them to be interested. I think this is largely a case where the public has given up, reconciling themselves to the fact nothing is going to be done anyway.

I honestly think that the Tories could rouse the public and win the next election by proposing massive changes to our health care system to emulate the best of Europe, but that would require at least a middling degree of bravery, and that's not something we've seen from them since Mulroney.

[Machjo]

5 hours ago, Carbon882 said:

Free Health care is currently benefiting me and some members pretty well. It does have its downsides and people use that (Including Trump) to bash on it. FreeHealth care happens to have very slow and congested service and people talk about how they waited months for it while they could have just payed for it and got it done right away.

The problem I have with Privatised heathcare is that f you can't afford it you are pretty much dead.

 I think we should either mix our Healthcare system or cut it and increase social welfare funding. I believe welfare is more cost effective at getting people what they need rather than running a whole heathcare service.

 

Here's the catch. When we legally prohibit the private sector from providing services that the public sector provides, we force all but the wealthiest (i.e. those who can afford to travel abroad for private healthcare) into the waiting queue. In the name of ensuring that the moderately-wealthy suffer as much as the poor, we force them into the queue even if it inflicts more punishment onto the poor. In other words, the goal is less about helping the poor and more about punishing the wealthy even if it hurts the poor even more.

If we allowed private provision of the same services that the state provides, the moderately-rich might choose to bow out of the queue and pay their own way and so... get this... allow the poor to get services more quickly too. Now one argument is that private services would compete with public funding for the few qualified physicians. In the short term, that's true and so might not shorten the public queue at least initially (though it won't worsen it either). In the long term though, due to more money going to healthcare overall with the moderately rich spending more money money on it that they presently are not legally allowed to do in Canada, they would attract more physicians to Canada to fill the increased demand. As the market adjusts, the queue for public services would slowly start to shrink and so start to benefit the poor who can't afford private health care. The European, Hong Kong, Singaporean, and other experiences can vouch for this. Two-tiered actually helps the poor in the long run by allowing the moderately rich to bow out of the queue,, add more funding to the industry, and so attract more physicians. And let's not confuse two-tiered with the US one-tiered. I that respect, the US and Canadian systems share more in common with one another (the US mostly one-tiered private health-care and Canada mostly one-tiered public health care) than they do with some of the best systems on the world all of which are two-tiered).

 

At the end of the day, to prohibit a truly two-tiered system (again, not to be confused with the US' mostly one-tiered system) has a a goal not so much to help the poor but to punish the moderately rich at the expense of the poor all for the sake of maintaining ideological purity rather than basing decisions on actual research.

[bush_cheney2004]

5 minutes ago, Machjo said:

....At the end of the day, to prohibit a truly two-tiered system (again, not to be confused with the US' mostly one-tiered system) has a a goal not so much to help the poor but to punish the moderately rich at the expense of the poor all for the sake of maintaining ideological purity rather than basing decisions on actual research.

 

No, the U.S. is actually n-tiered, with a varied mix of public and private insurance and providers.   But it is a common mistake and excuse for health care debates in Canada to fall into the typical U.S. comparison instead of other working public-private models in other nations.

I agree with you that Canada's health care "system" is under-capitalized because of government monopolies and CHA restrictions on private competition.   Health care is a business, and investment will not increase unless there is incentive to do so.

[cannuck]

21 minutes ago, bush_cheney2004 said:

Health care is a business, and investment will not increase unless there is incentive to do so.

No, sick care in the US is a business.   In the rest of the G7, it is a social service.   Businesses are allowed to bill the universal insurance provider (state) just as for several other social services provided to or by the state

[bush_cheney2004]

6 minutes ago, cannuck said:

No, sick care in the US is a business.   In the rest of the G7, it is a social service.   Businesses are allowed to bill the universal insurance provider (state) just as for several other social services provided to or by the state

 

Nope...there are also for-profit private insurance and providers.  Example from Germany:

 

Quote

All in all, there are more than 2000 hospitals in Germany. About half the hospitals in Germany are public, with about 30 of them being university clinics. One third of the clinics are private but non-profit, while the other hospitals in Germany are for-profit clinics. Their numbers are increasing.

https://www.internations.org/germany-expats/guide/29459-health-insurance/hospitals-in-germany-16000

 

 

Edited October 14, 2018 by bush_cheney2004

[Machjo]

27 minutes ago, bush_cheney2004 said:

 

No, the U.S. is actually n-tiered, with a varied mix of public and private insurance and providers.   But it is a common mistake and excuse for health care debates in Canada to fall into the typical U.S. comparison instead of other working public-private models in other nations.

I agree with you that Canada's health care "system" is under-capitalized because of government monopolies and CHA restrictions on private competition.   Health care is a business, and investment will not increase unless there is incentive to do so.

Sorry, but I didn't mean in absolute terms. Both Canada's and the US' systems are mixed to varying degrees, but still, the US system is far more private than public just as the Canadian one is far more public than private, with the European, Hong Kong, Singaporean, and others finding a healthier balance between these two extremes and providing better health care systems overall. In many respects, the Canadian and US systems resemble one another more than either do other systems in that they both strive to conform to some notion of ideological purity (free-market capitalist in the US and equal access to health care for all in Canada) rather than to adopt a pragmatic approach to learn from the best systems even if they aren't so ideologically pure in either direction.

[Machjo]

2 minutes ago, bush_cheney2004 said:

 

Nope...there are also for-profit private insurance and providers.  Example from Germany:

 

 

 

And according to the World Health Organization, Germany's ranks 25th, Canada's 30th. so clearly we can learn from the more mixed systems that outperform ours rather than to just buckle down in the name of ideological purity.

[cannuck]

1 minute ago, bush_cheney2004 said:

 

Nope...there are also private insurance and providers that don't depend on the government.  Example from Germany:

 

 

 

Yes, agree that they have such, but my point about them is that in ALL of the other 5, there is nothing to stop private insurance or private service delivery, but the state provided insurance remains.  You have a similar system in the US - something like 60% of the population is now covered by government employment, GI/VA, medicare or medicaid - the rest is private.   Difference is: in the US if you don't fit into the 60% of privileged to get sick care from the state, you may or may not be able to afford required medical care to stay alive.  Overall, you pay twice as much as Canadians to get poorer outcome - and then critiize our system that actually works.

 

[bush_cheney2004]

1 minute ago, Machjo said:

.... In many respects, the Canadian and US systems resemble one another more than either do other systems in that they both strive to conform to some notion of ideological purity (free-market capitalist in the US and equal access to health care for all in Canada) rather than to adopt a pragmatic approach to learn from the best systems even if they aren't so ideologically pure in either direction.

 

Nevertheless, the U.S. "system" is far better capitalized with excess capacity compared to Canada's, which must survive on a starvation diet for government scheduled procedures.   The U.S. system is not a free market...it is a mix of for-profit, non-profit, and public insurance/providers.

[bush_cheney2004]

3 minutes ago, Machjo said:

And according to the World Health Organization, Germany's ranks 25th, Canada's 30th. so clearly we can learn from the more mixed systems that outperform ours rather than to just buckle down in the name of ideological purity.

 

Ideological purity is a political issue in Canada...the so called "3rd rail of politics".  

Canada will learn and do nothing as long as it remains locked into binary comparisons to the United States.

[Machjo]

20 minutes ago, cannuck said:

Yes, agree that they have such, but my point about them is that in ALL of the other 5, there is nothing to stop private insurance or private service delivery, but the state provided insurance remains.  You have a similar system in the US - something like 60% of the population is now covered by government employment, GI/VA, medicare or medicaid - the rest is private.   Difference is: in the US if you don't fit into the 60% of privileged to get sick care from the state, you may or may not be able to afford required medical care to stay alive.  Overall, you pay twice as much as Canadians to get poorer outcome - and then critiize our system that actually works.

 

Ironically, Canadians' focus on the US system might actually undermine the Canadian system too. For example, Canadians notice how our system surpasses the US system and then smugly assume that ours is the best in the world (because of course Canada's world consists of Canada and the US) while overlooking the fact that around 24 other states around the world (including Morocco's) surpass Canada's.

Another Canadian error is to assume that if one extreme doesn't work, the answer is to turn to the other extreme. In other words, since Canadian mostly public health care surpasses the US' mostly private care, then certainly the more public and the less private it becomes, the better it will be. Of course it's a fallacy, but I think some Canadian voters probably buy into such a simplistic argument while ignoring that perhaps a happy-medium system could surpass even the Canadian system by far.

Edited October 14, 2018 by Machjo

[Machjo]

5 minutes ago, bush_cheney2004 said:

 

Nevertheless, the U.S. "system" is far better capitalized with excess capacity compared to Canada's, which must survive on a starvation diet for government scheduled procedures.   The U.S. system is not a free market...it is a mix of for-profit, non-profit, and public insurance/providers.

I agree, but still the US system is comparatively speaking a more free market and government strives to try to make it so, just as the Canadian system, for all of the free-market components within it, strives to be as public and as non-private as possible. There is still an ideological attempt at making it a pure system in either direction, with both systems having to compromise since clearly a mixed system would work better as other states have shown and as Canada and the US strive to reject.

[bush_cheney2004]

6 minutes ago, cannuck said:

Yes, agree that they have such, but my point about them is that in ALL of the other 5, there is nothing to stop private insurance or private service delivery, but the state provided insurance remains.  You have a similar system in the US - something like 60% of the population is now covered by government employment, GI/VA, medicare or medicaid - the rest is private.   Difference is: in the US if you don't fit into the 60% of privileged to get sick care from the state, you may or may not be able to afford required medical care to stay alive.  Overall, you pay twice as much as Canadians to get poorer outcome - and then critiize our system that actually works.

 

 

Very well...we can dispense with any notion that only the U.S. has health care as a business...so do many other nations.

Canada's system works as long as one is willing to wait months or years for routine tests and procedures, suffer longer disability, and lower quality of life on a wait list.

 

[Machjo]

5 minutes ago, bush_cheney2004 said:

 

Ideological purity is a political issue in Canada...the so called "3rd rail of politics".  

Canada will learn and do nothing as long as it remains locked into binary comparisons to the United States.

I agree, and that's harmful to Canada. Imagine a hypothetical scenario in which the US system was the worst in the world and the Canadian one the second worst. According to the present popular mind set in Canada, we'd tap each other on the back for a job well done while ignoring all of the other countries with a far superior system to ours.

[Machjo]

2 minutes ago, bush_cheney2004 said:

 

Very well...we can dispense with any notion that only the U.S. has health care as a business...so do many other nations.

Canada's system works as long as one is willing to wait months or years for routine tests and procedures, suffer longer disability, and lower quality of life on a wait list.

 

Or willing to travel abroad for it... but then that just adds to travel costs and pushes Canadians to fund private health care abroad too. Heck, it makes for a good business opportunity.

 

I remember once considering, if Canadians really refuse to fully copy better systems, to at least exempt indigenous reserves from these rules. That way, a private business could set up a hospital on a reserve and Canadians who wanted private health care could go there. It would also provide tax revenue for the reserve rather than ship it abroad.

[bush_cheney2004]

1 minute ago, Machjo said:

Or willing to travel abroad for it... but then that just adds to travel costs and pushes Canadians to fund private health care abroad too. Heck, it makes for a good business opportunity.

 

Some Canadians are so committed to the health care entitlement mentality, they even want reimbursement for their hospital parking ramp costs.

 

Quote

I remember once considering, if Canadians really refuse to fully copy better systems, to at least exempt indigenous reserves from these rules. That way, a private business could set up a hospital on a reserve and Canadians who wanted private health care could go there. It would also provide tax revenue for the reserve rather than ship it abroad.

 

Some Canadians have tried (e.g. private MRI clinics), only to be slapped down by the government monopoly and status quo.

[Machjo]

10 minutes ago, bush_cheney2004 said:

 

Some Canadians are so committed to the health care entitlement mentality, they even want reimbursement for their hospital parking ramp costs.

 

 

Some Canadians have tried (e.g. private MRI clinics), only to be slapped down by the government monopoly and status quo.

But politically speaking, to propose allowing it on reserves could blend with the politically correct notion of indigenous sovereignty. In the age of reconciliation, should Canada really be telling indigenous peoples what kind of health care system they can get? Put it that way in an election campaign, and the NDP would blow a fuse. Just look at how Jagmeet Singh reacted to Romeo Saganash's opposition to compulsory official bilingualism for supreme court judges because it would discriminate against unofficially bilingual indigenous candidates. He ended up trying to play both sides of the fence and the NDP's policy on the matter has been divided and muddied ever since with no one still knowing where exactly the NDP stands on the issue. Present private health care in the same vein, and suddenly even the NDP would be stuck between defending mostly one-tiered public health care and indigenous sovereignty.

To be honest, I loved how Saganash's position threw the NDP into chaos on that matter and the NDP still hasn't resolved it yet.

Edited October 14, 2018 by Machjo

[bush_cheney2004]

1 minute ago, Machjo said:

But politically speaking, to propose allowing it on reserves could blend with the politically correct notion of indigenous sovereignty. In the age of reconciliation, should Canada really be telling indigenous peoples what kind of health care system they can get?

 

Probably not, but government excess follows government funding.  

Better to confront the problem head on with a better public-private mix that we see working well in nations like France.  

 

[Machjo]

12 minutes ago, bush_cheney2004 said:

 

Probably not, but government excess follows government funding.  

Better to confront the problem head on with a better public-private mix that we see working well in nations like France.  

 

Agreed. Perhaps it takes a politician who could galvanize voters by pointing out how Morocco's system surpasses Canada's, how Canada's sits thirtieth on the scale, and how all of the superior systems are more open mixed systems and how Canada's more closely resembles the US system than it does the others. Even in the rankings, with Canada's 30th and the US' 35th, we sit closer to the US than we do to France. Put it that way, and it might wake some voters up and put the anti-mixed-system politicians on the defensive. Right now they can stay on the offensive always comparing us to the US. Replace the US with France and the other 29 countries above us, and suddenly that would change the debate. If a politician insists on comparing Canada to the US, the other could challenge his US-centric views. Politically, this might wake the public up to realizing just how US-centric we really are in our health-care system in that it seems more like an irrational reaction to the US one than an actual attempt to create a better system.

Edited October 14, 2018 by Machjo