There's Nothing Wrong with the Healthcare System

[FTA Lawyer]

Obviously, I'm attempting to "stir the pot" with this topic...but I ask everyone in advance to please leave rhetoric aside in hashing this one out.

It seems to me the issue is largely one of perception. Let me give you an example.

A while back, a family in Calgary had a very premature baby born at the Foothills Hospital...where all high-risk births go for southern Alberta. It was during Christmas time and there was a bout of the flu that had taken out a number of the already reduced number of nurses on the unit.

Now appreciate that in a NICU, the nurses are specially trained, and it is extremely vital not to come to work with even so much as a hint of a cold or flu...so the situation couldn't be fixed by nurses just "sucking it up" or bringing in some casual non-NICU nurses to cover.

The family was outraged when they were told that their son could not stay there due to the staff shortage and went on a media blitz slamming the dilapitated state of our healthcare system. Everyone jumped on the "bash healthcare bandwagon" and went on an on with the kind of rhetoric I've asked be left out of this debate.

The thing is, I was giving a standing ovation for our healthcare system because I was looking at the situation very differently. They were not told "sorry your baby will have to die", they were not forced to go to an ill-equiped alternative unit to cross their fingers and pray. No, as a matter of course a state of the art STARS air ambulance whisked their son hastily to the University of Saskatchewan Hospital NICU (U of A in Edmonton had no free beds) and they were taken by ground to meet him there.

While in Saskatoon the family stayed at the Ronald McDonald House.

The son recieved top notch care throughout and came out on the other end healthy and happy.

The cost to the family, $0...(yes I know, healthcare premiums, user fees, Blue Cross benefits etc. rhetoric, rhetoric, rhetoric)

The reality is that tens of thousands of dollars were instantly expended (and completely at the ready) to ensure that the best possible care and the best possible outcome would occur. No questions asked. And the amount expended by the family compared to that covered by the system is miniscule.

One more example...

My grandfather is now 86 years old. At 85 he was diagnosed with bowel cancer. He had immediate access to first-rate surgeons and specialists and an assessment was made that the potential benefits of surgery likely outweighed the risks and that he would likely get a significant improvement in quality of life. So, likely in excess of a hundred thousand dollars was immediately allocated (for the surgery and some 6 weeks of hospitalization)...again no questions asked.

My grandfather is recovered now and back living in the farm house where he was born. Is he bankrupt? Of course not...his bill was, you guessed it...$0. (Yes, same as above rhetoric would apply here).

Now consider that over the course of his lifetime, my grandfather has been treated and "cured" of prostate cancer, had a state of the art hip replacement, and open-heart triple by-pass surgery.

If we lived in the U.S., the family farm would have been gone long ago, and maybe too my grandfather.

So when people rave about the horrible system we have I can't help but have a slightly different perspective.

Bring on the comments...

FTA Lawyer

[Canuck E Stan]

FTA,

My experience with Healthcare has been a little different. My mother was having problems with her health and as per the usual procedure, she was referred to a specialist. The next available appointment with the specialist was over three months down the road. The poor woman was in agony and three months seemed like an eternity. My father worked in the US (Detroit-Windsor daily commuter) and was thus able to take my mother to Henry Ford Hospital a few days later.

She, like your grandfather, had bowel cancer. She had surgery the next day. Unfortunately, the cancer had metastasized and she died a year later. Having the surgery in a timely manner permitted her to attend my sister’s wedding and several other important family events. Her quality of life was much improved by having this immediate surgery. If she had had to wait for surgery in Canada, she would have not had it for over four months (three to get into the specialist and another month wait for the surgery). She would have been in unnecessary pain.

There was a recent article in the Calgary Herald about people addicted to pain killers because of two year waits for knee replacement surgery. My point is that waiting times for health care are too long even though the care does not cost anything out of pocket for the recipient and the professionals providing it are generally superb.

[Guest eureka]

I could not agree more, FTA. The Canadian system has been shown to be comparable to the best with respect to waiting times, also, but that will never get through to those who think health is part of partisan politics.

Waiting times are far better than in the US since there, only those who can afford the care do not have to wait. Millions wait only for the time that it takes to die.

[Canuck E Stan]

Eureka,

In the United Stated, you either have no waiting time or no health care.

Our waiting time in Canada does need inprovement.Obvoiusly Eureka, you have never been involved in having pain and having to wait to get attention for your health problem.Canada's health care as it stands is for the healthy.

[Guest eureka]

Why "obviously"? I have no personal health situation of the kind. I have been exposed to great and urgent need on three or four occasions, though for family.

It was there and it was great. Interestigly, the needs arose in Quebec, B.B., and Ontario. All passed muster.

Waiting times do need improvement: they do everywhere and in every country. That does not call for partisan slamming of the ystem. Partisanship should come into it only where some party wants to damage the system, As the Liberals did when they cut funding even though, as I have argued in the past, the Provinces aksed for it. The federal government knew better and should have protected the systen from provincial opportunism

As, also, when this Conservative party is hell-bent on the destruction of Public healthcare.

[Canuck E Stan]

YOu were fortunate with your family crisis to have the immediate attention you needed. In my family it didn't occur,and in many other families the situation is the same.The shock of being told that you must wait three or more months(sometimes years) to receive attention is depressing for the family and especially to the one that requires the attention.

The system at that point has failed the one who requires it.

Who said the Conservatives are hell bent on destroying the system?

When I need attention for health I need it NOW not sometime in the future.I really don't give a sh*t if the bill goes to private or Public.

To me the issue is the health problem, and to get the health problem resolved as soon as possible.Who pays the bill and who gets the cheque is secondary.Too much politics and not enough health care for those that desperately need it seems to be the issue for too many healthy people. Ask those who are in pain and on long waiting lists about health care, not those like you or I ,who are healthy.What ever it takes to make the sick better is the answer,and if it involves private health care so be it.

[August1991]

So when people rave about the horrible system we have I can't help but have a slightly different perspective.

Bring on the comments...

Another health thread? OK...

Longish post ahead.

If we lived in the U.S., the family farm would have been gone long ago, and maybe too my grandfather.

False. If Americans want, they have health insurance. Do you pay your dental bills?

I am tired of this English-Canadian refrain of how life in the US is a wild-eyed lottery. I am also tired of the English-Canadian refrain of how life is either safe or wild-eyed - as if there are only two health systems in the world. (The refrain is also like the wife's voice in a guy's mind as he contemplates adultery.) (English-Canada has a big problem with the US.)

The family was outraged when they were told that their son could not stay there due to the staff shortage and went on a media blitz slamming the dilapitated state of our healthcare system. Everyone jumped on the "bash healthcare bandwagon" and went on an on with the kind of rhetoric I've asked be left out of this debate.

I don't know this case but, when services are allocated by committee, it is well-advised to make a stink. You can call that the August1991 Rule of Bureaucracy.

The son recieved top notch care throughout and came out on the other end healthy and happy.

My experience too.

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Several years ago, I worked on a contract with a guy who had operated an ambulance service in New York State. Curious, I asked him why ambulance trips cost so much more than a taxi ride. "Liability insurance," he answered. "But in Canada?", I asked. He said he couldn't speak for ambulance costs in Canada but the question did get him on to the US/Canada health system question. (True, he was a NY Democrat.)

"You Canadians go to a doctor when you feel a little sick. Too many Americans wait until it is serious. That's why health care takes up so much more of our GDP than it does yours. An ounce of prevention... "

Later, I checked. US ambulance trips cost more than Canadian ambulance trips. Their liability insurance is partly but not completely made up by our unionized workers. Also, you are more likely to die in a Canadian ambulance than an American ambulance.

----

This April, a friend's sister was riding on a motorcycle in Vermont when the proverbial bus hit. She was air-transported to Montreal and my friend flew in from Europe. She was in a coma for two weeks, and life support for weeks after. My friend told me about this in Europe this past summer and said, "There was never any question about money at any point. She's English, he added. She was in Montreal General. My Dad and I stayed with the boyfriend, the moto's driver, in Longueuil."

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I think bureaucracy (like armies) work well following established orders or instructions. Individuals work well with specific orders or instructions. IOW, the system does not care but individuals do. Canada's current health system is a mixture of both.

IMV, without serious reform, our health system will become a mess. It already verges on the twilight zone of a black-market. The established orders are irrelevant and individual health workers follow the specific orders of patients.

Canada's health system has become Soviet. And like the Soviet system, it is tempered by the fact that it is composed of human beings - so, it is human. In Canada's health system, like the Soviet Union, people rely on the kindness of strangers.

I wonder whether talk of health care reform in Canada is a Gorbachev, perestroika phase or still a Brezhnev phase. But at some point, now or in the future, Canadian health professionals will do as Soviet bureaucrats. Try to do good but be utterly confused and make a mess of all - while watching others rip off the system.

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The people living in this place in northern North America must find our own way (since we must not be American). After all, we Canadians may have all the advantages of being American but we're not American.

So, let's figure out a way to do workable health care, long-term. But non-American style.

[Guest eureka]

Last year, two million Americans were forced into bankruptcy as a consequence of medical costs.

This is a non-argument. How can anyone inhis right mind not oppose access by income or wealth.

[daddyhominum]

She, like your grandfather, had bowel cancer. She had surgery the next day. Unfortunately, the cancer had metastasized and she died a year later. Having the surgery in a timely manner permitted her to attend my sister’s wedding and several other important family events. Her quality of life was much improved by having this immediate surgery. If she had had  to wait for surgery in Canada, she would have not had it for over four months (three to get into the specialist and another month wait for the surgery). She would have been in unnecessary pain.

<{POST_SNAPBACK}>

I think this was the issue that led to the court case in Quebec resulting in a ruling that an individual had a right to obtain private care when the public care was too slow.

As FTA related, the Canadian system is excellent protection for critical care and financial cosequences. But, as you relate, it is currently providing inadequate service to many needs not identified as critical.

It is a good system that was once much better.

[August1991]

Last year, two million Americans were forced into bankruptcy as a consequence of medical costs.

This is a non-argument. How can anyone in his right mind not oppose access by income or wealth.

<{POST_SNAPBACK}>

And how many Canadians died, Far North or Labrador coast, because they didn't have access to imediate health care? How many Torontonians died because of a bad diagnosis?

Eureka, compare comparables. FTA Lawyer started the thread without partisanship.

The question is how to organise a "system" for millions in which thousands, let's be honest, will die this year.

The State - even Socialism - cannot prevent death.

[Toro]

I am tired of this English-Canadian refrain of how life in the US is a wild-eyed lottery.  I am also tired of the English-Canadian refrain of how life is either safe or wild-eyed - as if there are only two health systems in the world. 

Amen to that.

For myself, I prefer the American system as I get better treatment than I did in Canada. But I believe that there should be better care for the poor in the US. What gets me is that in Canada, the proponents of medicare frame the argument as if its binary - Medicare or the American system. That's ridiculous.

A story. My grandfather moved to Vancouver Island from Saskatchewan. Within days of arriving in BC, he wanted to go see a cancer doctor. He had to wait for 3 months to establish residency before being able to see one. Because he lived up Island, there aren't that many cancer doctors, and so my father had to pull strings to get him in ASAP even after having to wait 3 months to see one.

[cybercoma]

FTA,

My experience with Healthcare has been a little different. My mother was having problems with her health and as per the usual procedure, she was referred to a specialist. The next available appointment with the specialist was over three months down the road. The poor woman was in agony and three months seemed like an eternity. My father worked in the US (Detroit-Windsor daily commuter) and was thus able to take my mother to Henry Ford Hospital a few days later.

She, like your grandfather, had bowel cancer. She had surgery the next day. Unfortunately, the cancer had metastasized and she died a year later. Having the surgery in a timely manner permitted her to attend my sister’s wedding and several other important family events. Her quality of life was much improved by having this immediate surgery. If she had had  to wait for surgery in Canada, she would have not had it for over four months (three to get into the specialist and another month wait for the surgery). She would have been in unnecessary pain.

There was a recent article in the Calgary Herald about people addicted to pain killers because of two year waits for knee replacement surgery. My point is that waiting times for health care are too long even though the care does not cost anything out of pocket for the recipient and the professionals providing it are generally superb.

<{POST_SNAPBACK}>

I'm almost inclined to believe we're in a unique situation down here in Windsor. Our lack of specialists and whatnot has caused hospitals to send patients to Detroit for help and forced OHIP to cover the expenses. I think it may just be because we're such a blue collar town, there's not enough people in Windsor becoming doctors and wanting to stay here. The particular situations we run into may not be indicative of the entire state of the system.

I suppose the opposite is true as well, in a location where care is particularly good, the specific situations from that place my not tell you the state of the system as a whole.

[cybercoma]

Last year, two million Americans were forced into bankruptcy as a consequence of medical costs.

This is a non-argument. How can anyone inhis right mind not oppose access by income or wealth.

<{POST_SNAPBACK}>

because it's not about the american healthcare system.

[Guest eureka]

This is a comparison of "comparables," August. As you should know by now, vastly greater numbers of Americans die through "wait" times or non-treatment. Life expectancy in the US is lower precisely because of the inadequate system. And it does not have the difficulties of the North to challenge resources.

You should also be aware that it is Quebec, the French side, that has brought us closer to a US style. It is not an "English Canadian refrain." I believe that you would see things clearer if you relieve yourself of that false dichotomy.

The reason, Toro, that we do have to see this in the light of an American style system, is that such a threat is reality. Once we do open up in the wake of the Chaouli case, we will have irrestible pressures from American sources: that is what NAFTA will do. The overtures are being made now. There are many Canadian interests that would be happy to see this. The love of money will always overpower ideas of social justice for some.

Wait times do need improvement in Canada but they are not nearly so desperate as a partisan press is making out. Canada is farly average in that. What Canada needs most to inprove every aspect of the system is more health professionals and an overhaul of the system that would reduse the numbers of routine cases that clog the emergency rooms.

[Toro]

The reason, Toro, that we do have to see this in the light of an American style system, is that such a threat is reality. Once we do open up in the wake of the Chaouli case, we will have irrestible pressures from American sources: that is what NAFTA will do. The overtures are being made now. There are many Canadian interests that would be happy to see this. The love of money will always overpower ideas of social justice for some.

Wait times do need improvement in Canada but they are not nearly so desperate as a partisan press is making out. Canada is farly average in that. What Canada needs most to inprove every aspect of the system is more health professionals and an overhaul of the system that would reduse the numbers of routine cases that clog the emergency rooms.

<{POST_SNAPBACK}>

No pressure from American sources in healthcare are irresistable.

The problem is that healthcare costs in Canada, as it is elsewhere around the world, is growing at a faster rate than the economy. Canadians do not want to pay anymore taxes than they are already paying. There is no never-ending source of taxpayer funds. Thus, you either allow alternative sources of funding or cut other government programs, which means welfare and education.

When there is insufficient funds, you have rationing. Clearly, its a serious enough problem when the Supreme Court says its so. Maybe if there is a healthcare professional reading this, they can correct me, but as I understand it, In Ontario, certain doctors are not paid much once they have worked a certain amount of hours. Thus, there is no incentive to work more, which is essentially rationing.

[theloniusfleabag]

I have a question...why is heath care considered a 'right'?...

(as I am 'left', I definitely support Universal Health care, but....)

I have spoken with a couple of doctors (just MDs, not specialists) who believe we need to change the system. Their criteria seems to be that when people die on waiting lists, changes need to be made. I myself am on a waiting list of over a year, though it is for something 'non-critical', though I have had reasonably good service with several minor injuries. The worst case was a four-hour wait with a broken arm. They did offer me something for the pain, but I declined the bag of ice...another time with a broken rib I was whizzed right through, though there wasn't anything they could do (just a fracture, so while incredibly painful, untreatable).

I favour a two-tiered system. We have it now, people I know go to the US or Europe because they have the money, gov't and pro-athletes have their own 'team doctors', etc.

A 'blended system', just as a 'mixed economy', is (or can be) the right fit for Canada.

[Toro]

theloniusfleabag

Canada already has a two-tierd healthcare system. If the rich want something right now, they go to the States.

[Guest eureka]

Core health service costs are not growing faster than the economy. The increased costs are brought about by new technology and drugs. Drug costs cuuld be contained in many ways. The most beneficial would be to stop pharmaceutical companies from incurring huge costs, recouped by gouging the public, from developing expensive drugs that are no improvement on the ones they replace or compete with,

Pressure from American sources will be irrestible once we allow the first private source in - as the SCC decision would do. NAFTA makes it so. The SCC saying it is a serious problem does not make it so. This decision may be the most ill considered a Canadian Supreme Court has ever made and, the reasons for that have been given on other threads. They include the SCC not listening to expert testimony and accepting anecdotal evidence.

I don't agree with the incentive to work argument over doctors' incomes. Nowhere in the world are doctors paid better than in North America including Canada. Our problem is the feral state of American healthcare where huge incomes are possible putting pressure on the Canadian system.

There are no two tiered systems in the mold that we think of other than that we talk of adopting under the pressure of the American. So many refer to Europe but Europe is not two tiered in the issue of choice. It is no more two tiered than is Canada.

And wait times are not better than Canadian in any system except, perhaps, the Swiss where money again is what counts most.

[cybercoma]

theloniusfleabag

Canada already has a two-tierd healthcare system.  If the rich want something right now, they go to the States.

<{POST_SNAPBACK}>

It's not just the rich. OHIP will send patients from Windsor to Detroit, most often for cardiac care, because of the wait lists in this city and the shortage of specialized equipment and services. YOU pay the bill.

[Argus]

Last year, two million Americans were forced into bankruptcy as a consequence of medical costs.

This is a non-argument. How can anyone inhis right mind not oppose access by income or wealth.

<{POST_SNAPBACK}>

How many Canadians were forced into bankruptcy because of high taxes?

[Argus]

It seems to me the issue is largely one of perception.  Let me give you an example.

My elderly mother is unstable on her feet. Three times she's fallen in the past three years, and clearly broken bones all three times. Average wait in ER before a doctor saw her - 8 hours. She has a urinary tract problem now which her doctor's pills aren't fixing. She'll get to see a specialist in two months.

I have a brother in law who is a trades worker. He injuried his wrist badly. Rather than keep him waiting for months to get an MRI Workman's Compensation paid to get him an MRI in a private clinic in Quebec. Then he had to wait another couple of months before a specialist would look at it.

I once hurt my wrist. I suspected it was a form of RSS but my choice was either to keep working at the keyboard or wait until I could see a specialist - in 3 months. Luckily, it didn't turn out to be RSS or I'd have been in trouble. But I wasn't going to take three months off work in case it was RSS and I aggravated my wrist.

I don't care about your whiny family. I can give you a dozen more such exaples. Long waits for even routine services are not a matter of perception. You have no case, councellor.

[Argus]

I could not agree more, FTA. The Canadian system has been shown to be comparable to the best with respect to waiting times,

It has? By whom? Let's hear examples of how our wait times compare to those in France, Germany, Sweden, Denmark. Or the United States, for those with insurance.

[Argus]

Eureka,

In the United Stated, you either have no waiting time or no health care.

This is a complete fabrication.

[Argus]

That does not call for partisan slamming of the ystem.

heh heh. Eureka snivelling about partisanship. Heh heh!

Partisanship should come into it only where some party wants to damage the system, As the Liberals did when they cut funding even though, as I have argued in the past, the Provinces aksed for it. The federal government knew better and should have protected the systen from provincial opportunism

What makes you think the federal government, a federal government run by the likes of Martin and Chretien, is less opportunistic than provincial governments? In fact, I don't believe we've ever seen a more opportunistic bunch than the federal liberals.

As, also, when this Conservative party is hell-bent on the destruction of Public healthcare.

The amusing part is Eureka doesn't even realize how stupid it is to whine about partisanship and then take partisan shots a few sentences later.

Of course the Conservatives want to destroy public health care! Everyone knows that's the way to long-term electoral success! Why, if only they can destroy public health care they'll be rewarded by the voters with massive majorities forever! I can see how it makes perfect sense!

Or maybe it's just cause they'r eeeevvvviiiiil. Evil Tories! Nasty tories! Sadistic tories! First public health care, then the world!

But let's not bring partisanship into this, eh?

[Argus]

This is a comparison of "comparables," August. As you should know by now, vastly greater numbers of Americans die through "wait" times or non-treatment.

Evidence? Cite?

Life expectancy in the US is lower precisely because of the inadequate system.

Life expectancy might be shorter in inner city slums than here. But I'm betting that in the rest of the US life expectancy is as high or higher than here.