There's Nothing Wrong with the Healthcare System

[Argus]

The increased costs are brought about by new technology and drugs.

That's the Liberal party line - but it's BS - like everything else we get from them.

In fact, health care costs are overwhelmingly driven by higher demands for wages from doctors, nurses and other health care workers.

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,

Prescription costs are rising because of the bribes paid by the pharmaceutical company to the Tories and Liberals. Period. Canada's prescription costs used to be much lower than those in the US. But since the Tories accepted money from the big pharmaceutical companies to greatly increase their trademark protection, and then the Liberals accepted even more money to soften competition laws, our prescription costs have been rising FASTER than prescription costs in the US. We now pay significantly more for the same drugs than people in many European countries. We still pay less than in the US, but the gap is much narrower now.

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

<{POST_SNAPBACK}>

Evidence? Cite? You are suggesting our wait times are not better than in France? Guess again. Do you have any information on wait times in Germany or Sweden or Finland?

[fellowtraveller]

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

Complete and utter crap.

It;s interesting to note that the provinces that are the furthest by far down the privatization route and two-tier health care are Quebec and BC, both with Liberal governments. By contrast, the oft-maligned Alberta has far less outsourced to the private sector.

Anecdotally, my family experience has been extraordinary over the past few years. We have made severe demands on the system, and it has generally responded with timely, first class and compassionate care when the situation was urgent. In less urgent circumstances, not so well....

[catch-as-catch-can]

The increased costs are brought about by new technology and drugs.

That's the Liberal party line - but it's BS.

Eureka was uncharacrtristicly wrong on several occasions in this thread, but this is not one of them. At least not if Canadian doctors were allowed to fully utilize these new technologies, as the doctors elswhere are.

And also, if they were more prudent in prescribing insurance covered drugs as the others are the cost would drop.

[Guest eureka]

Thank you for the supporting statements about drug costs, Argus, even though you do not seem to realize that you are supporting.

For the rest, you are giving, in the words of Fellow Traveler, so much crap. All that I posted is common knowledge and you can read it in the papers almosr weekly. Yes, there is evidence of wait times for those European countries. In this morning's paper, for example, you will find that in Australia and New Zealsnd, wait times arae about the same as Canada even with there two-tier systems.

Health care costs are not driven by the wage demands of doctors and nurses. Nurses had no increase in their remuneration for years in Ontario and thousands were laid off to keep the labour costs even lower.

The core components of healthcare have not risen in proportionn a decade or more. The increases are in technology and pharmaceuticals. That is unarguable and every study and Commission has found it so.

The technology side should be acceptable and we should spend even more. There are great economic benefits from better diagnosis and detection. The drug side must be addressed.

Partisanship! I blamed them all, federal and provincial. You denounce one party only.

[Toro]

The increased costs are brought about by new technology and drugs.

That's the Liberal party line - but it's BS.

Eureka was uncharacrtristicly wrong on several occasions in this thread, but this is not one of them. At least not if Canadian doctors were allowed to fully utilize these new technologies, as the doctors elswhere are.

And also, if they were more prudent in prescribing insurance covered drugs, as the others are.

<{POST_SNAPBACK}>

I agree. Technology and new drugs are a big driver of costs. Those new technologies and new drugs are extending lives. Because those new technologies and drugs are often applied in the States first, it accounts for part, but not all, of the reason why health care costs are higher in America. The price of older drugs and technologies are not rising, or at least not much.

[catch-as-catch-can]

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

Perhaps the Swiss system is, like their cheese, full of holes .... in which case Canada would end up being the best.

Now if you only persuade the Liberals to run on that in the next election, the Conservatives will be toast.

Toast of the country that is.

[Cartman]

I would like someone to respond to Eureka's argument that once a private system is allowed to operate in full force, the public system will collapse due to pressure from US firms. Thoughts? Is he correct?

[Toro]

I would like someone to respond to Eureka's argument that once a private system is allowed to operate in full force, the public system will collapse due to pressure from US firms.  Thoughts?  Is he correct?

<{POST_SNAPBACK}>

Why would it?

[Argus]

For the rest, you are giving, in the words of Fellow Traveler, so much crap. All that I posted is common knowledge and you can read it in the papers almosr weekly. Yes, there is evidence of wait times for those European countries. In this morning's paper, for example, you will find that in Australia and New Zealsnd, wait times arae about the same as Canada even with there two-tier systems.

Did I suggest we immitate Australia or New Zealand? BTW, what do you have in the way of statistics or numbers for those countries vs Canada? Not to mention price comparisons. Do they put as much money into their systems as we do?

Health care costs are not driven by the wage demands of doctors and nurses. Nurses had no increase in their remuneration for years in Ontario and thousands were laid off to keep the labour costs even lower.

I don't know about no "increase in renumeration for years" but they've made up for it since, and are one of the major problems with the system. Registered nurses earn something in the neighborhood of $60,000. This is too much for most of what they do, and their union has actively resisted introduction of lesser trained nurses, ie, Practical Nurses. The plain fact is that 90% of what nurses do could be done by your mother with little or no training. There should be far fewer registered nurses and more practical nurses. Even THEY are overtrained and overpaid for much of what they do, though.

Partisanship! I blamed them all, federal and provincial. You denounce one party only.

<{POST_SNAPBACK}>

You blithered and blathered. I spoke the truth.

[Argus]

The increased costs are brought about by new technology and drugs.

That's the Liberal party line - but it's BS.

Eureka was uncharacrtristicly wrong on several occasions in this thread, but this is not one of them. At least not if Canadian doctors were allowed to fully utilize these new technologies, as the doctors elswhere are.

And also, if they were more prudent in prescribing insurance covered drugs, as the others are.

<{POST_SNAPBACK}>

I agree. Technology and new drugs are a big driver of costs. Those new technologies and new drugs are extending lives. Because those new technologies and drugs are often applied in the States first, it accounts for part, but not all, of the reason why health care costs are higher in America. The price of older drugs and technologies are not rising, or at least not much.

<{POST_SNAPBACK}>

"What therefore needs to be changed is a system that cannot find a way to get out of the following vicious circle. Health care professionals insist on being paid more by provincial governments who then pass on the demand to the federal government. Additional transfers are immediately swallowed up by salary increases, and the cycle continues unabated. "

Kirby

"Labour costs amount to about 75% of spending in health. In 2001-02, more than half of the budget increase for health went to salary increases - $390 million – primarily to support new salary agreements with physicians and nurses. The cost of those salary increases will grow to $835 million by 2003-04. Those added dollars will ensure that Alberta’s doctors and nurses are better paid, but it will not provide any additional services, reduce waiting times, or address other issues in health. "

Alberta health care increases

"The new $1.6-billion health tax that the Liberals will inflict upon

all modest- and middle-income Ontarians will go directly into the

pockets of doctors, nurses and support staff with little or no

improvement in service provided to Ontarians."

Ontario budget increase going to doctors/nurses salaries

[Argus]

I would like someone to respond to Eureka's argument that once a private system is allowed to operate in full force, the public system will collapse due to pressure from US firms.  Thoughts?  Is he correct?

<{POST_SNAPBACK}>

Why would it?

<{POST_SNAPBACK}>

Have the public systems collapsed in Europe?

[Toro]

That's interesting Argus.

It would be interesting to know where the growth in healthcare expenditures over the past 10, 20 years has come from.

[mcqueen625]

I disagree that there is nothing wrong with our healthcare system in Canada. One of the glowing things wrong is that while the money spent on healthcare continues to climb, I contend that much of that increase is due to a vast increase in the numbers of adminstrative personnel throughout the system, while the number of people who actually work with the patients, and their support personnel has decreased drastically.

While we do need some administration in the system it has become top heavy with accounting types who's only goal it seems is to insure that they still have a job when a decision is made to cut personnel costs. An example of this is in my city of Saint John, NB where the provincial government just finished bragging about the expansion they just completed on St. Joseph's Hospital in the downtown. The problem is that this is not even an active care hospital anymore since the ER has been closed and has been replaced with basically a daytime walk-in clinic. For after-hours requirements people must spend in the order of $12.00 by taxi to get to the Regional Hospital quite a distance from the downtown, certainly not within walking distance. The other aspect of this expansion at St. Joseph's is the fact that virtually all of the expanded space is set aside for administration office space. Just what we need more beancounter's who's only qualifications are to study budget figures. In the meantime medical personnel have had their jobs eliminated or cut back to part-time and term positions.

If we are going to have healthcare facilities we need to have medical professionals making the decisions which affect patients care, not a person with BBA, MBA, CA, CPA, CGA or some other such professional initials after their names,. We need to have people with MD, RN, BN, LPN, etc. following their names, because they are the people who actually are responsible for taking care of patient needs. Accounting types we can do without, but they seems to have inserted themselves into many operations where they are not qualified to gives an opinion on how the operation is to function unless our only concern is the almighty budget. At a workshop I once attended the guest speaker spoke about the way government and industry are employing people with BBA, MBA to runs operations in various fields when they have no expertise as to what the organization's function really is. He contends that their only concern is to operate the entity in a way that stays within budget or trims costs from the entity. In his field, which is Criminology, he contended that these types could care less that prisons are no longer safe facilities because the people who have been hired are concerned with dollars only and people are just a hinderence to their plans. If a few less guards represents a significant saving, then they slash the jobs of those gueards. Never mind the fact that those guards who are left are in not safe and neither are the prisoners they are supposed to be guarding, the fact is that these people have managed to trim some costs and that is all government concernes themselves with, until someone get's injured, and then they will somehow find a way to blame the guards, never the beancounter who suggested those cuts in the first place. The same thing is happening in our healthcare system, we have allowed beancounters to make decisions that are affecting patient care and nobody in government wants to admit that we do not need the amount of administration which is presently in our healthcare system.

[Guest eureka]

Europe does not have NAFTA and the nations of Europe have control of their economies and healthcare. There is no reason that they should collapse.

Also, two-tier in Europe does not mean what so many seem to think. In Holland, I think, the choice must be made between public or private and, once made, cannot be changed. There is no using whichever is the most opportune at a time.

In Germany, doctors are not allowed to earn more from private practises than public. and, therefore have no incentive to move to a private system.

As I have posted in the past, Canada is at the lower end of the spectrum, compared to Europe, in public proportions of expenditure. The range is from 70 to 90% and Canada is around 70. We have as much two=tier as any Western European country. The ways are different, not more or less.

McQuuen, you are so right about bureaucracy and its effect. The issue, though, is not so much local as governmental. I posted on one thread about the interview with a doctor from Northern Ontario, that I heard on the radio. He maintained that doctors in private practise are bogged down with paperwoek reporting.

He said that the ampunt could easily be reduced to give doctors 10% more time for patients. The number of extra patients that would allow doctors to see would cure the desperate shortage of doctors in Northern Ontario. Obviously, that would apply globally.

When it is considered that the largest part of America's higher costs are those of administration, locally there more than in Canada with the requirements of HMO's and insurers,it is easy to see the danger we face if private care gets its beachhead.

Argus, trotting out figures about earnings and recent increases (in total figures rather than individual increase) is no argument. The fact is, that, in Ontario at least, medical personnel had no increases for several years. Thousands of nurses were laid off and moved out of the province or to the US. The recent increase has allowed some to be rehired. Many thousands of non-professional personnel were also laid off.

[Toro]

Europe does not have NAFTA and the nations of Europe have control of their economies and healthcare. There is no reason that they should collapse.

Europe is far, far more integrated than North America. Thus, if we are to use the European model as an example, the solution would be for Canada to become more integrated with the US.

[Guest eureka]

I really do not think Europe is more integrated:.and there is nothing like NAFTA there. It is NAFTA that makes the difference since, under Chapter 11, once Canada lets in an American privateer, it cannot stop the flood.

I posted elsewhere the memo from the American Chief negotiator that read that the Canadian economy would be totally integrated into the American within twenty years. Fortunately, Mulroney went and we have resisted complete absorption. We have, however, gone a long way down the road.

We have also given up control in that, if we do certain things, with energy and water as with Healthcare, then the Americans have the right to come in with all their economic tank divisions.

There is nothing like that in Europe.

[cybercoma]

I really do not think Europe is more integrated:.and there is nothing like NAFTA there. It is NAFTA that makes the difference since, under Chapter 11, once Canada lets in an American privateer, it cannot stop the flood.

I posted elsewhere the memo from the American Chief negotiator that read that the Canadian economy would be totally integrated into the American within twenty years. Fortunately, Mulroney went and we have resisted complete absorption. We have, however, gone a long way down the road.

We have also given up control in that, if we do certain things, with energy and water as with Healthcare, then the Americans have the right to come in with all their economic tank divisions.

There is nothing like that in Europe.

<{POST_SNAPBACK}>

Fearmongering.

[catch-as-catch-can]

In Germany, doctors are not allowed to earn more from private practises than public. and, therefore have no incentive to move to a private system.

But surely they don't put limits on how many operations an individual doctor can do.

This bonus alone would easily triple many a private doctor's take home pay here in Canada.

[Toro]

Eureka

Surely you are kidding. The EU is not only an economic union, its a political union too. Its silly to say that NAFTA is more integrated than the EU. The EU has a common Parliament, a common budget, common labour laws, labour mobility, a common currency, etc.

[Guest eureka]

Of course I am not kidding. There is nothing in the EU that orders, for example, that if , say, an Austrian company sold a bottle of water to Germany, the horde could descend on Austria and start exporting its water.

That is NAFTA.

[Toro]

Countries in the EU have given up much, much more sovereignty in the EU than any country in NAFTA.

[Guest eureka]

I wonder whether they really have given up more. A country, member of the EU, can have a provate component to its healthcare without being legally obliged to allow any other member to operate a private health service in its jurisdiction.

The same would apply to many other areas of the economies.

What is Sovereignty would be pertinent. The free movement of goods across a border, labour and social mobility, the harmonising of many practises, is less of a loss of sovereignty than ceding control of the economy in my opinion.

[FTA Lawyer]

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.

<{POST_SNAPBACK}>

Argus,

Not quite sure of your logic in calling my family "whiny" when I'm saying we're not complaining about the system, and all you did in your post was whine...about such horrible things as your sore wrist.

In fact, my case is probably summed up by YOUR whiny post...in general, Canadians expect perfection from both the healthcare system and medicine itself. This is simply unattainable. In a perfect world your elderly mother would not wait 8 hours in the ER to have her fractures fixed up...but it was a non-life-threatening injury (in spite of which she lived) AND she got fixed up...again without needing to mortgage her house.

Would it be more pleasant to go straight through the door and into 1st place in line every time you are ill or hurt? Of course. Is that possible? Of course not.

I'm not saying there is no room for improvement...there always will be. But medicine is an inexact science and when one considers the mammoth task of keeping every citizen in Canada as healthy as possible, so long as the person gets the treatment they need, the wait to get it is not necessarily inherently unacceptable.

I had to wait one month to see a neurologist after an unexplained seizure when I was in university. Many like yourself would scream in outrage. I however choose to analyze like this:

1. I was managed on medication prescribed by an ER doctor duirng my wait (I won't even get into the background dollars behind the research and development of the medication that was simply there at the ready for me);

2. My life was not at risk during the month wait;

3. Had my situation become emergent I would have been put to the front of the line immediately;

4. I received access to a pre-eminent neurologist at the University of Calgary medical centre;

5. I was given CAT, EEG, MRI testing (again, tens of thousands of resource dollars);

6. The decisions with respect to above tests were made based on my need for such tests, without any consideration of what they cost;

7. I got the treatment I needed.

Bravo again Canadian healthcare system...

FTA Lawyer.

P.S. For fun, ask your elderly mother...I bet she can tell you of times when a broken hip from a fall would never have even received attention from a medical doctor, let alone state of the art treatment in a hospital (albeit with an 8-hour wait).

By the way hope your wrist is okay.

[Argus]

Not quite sure of your logic in calling my family "whiny" when I'm saying we're not complaining about the system, and all you did in your post was whine...about such horrible things as your sore wrist.

By "your whiny family" I was referring to your story of the family that bitched so much because it was flu season, even though every possible step was taken to accomodate them". As to my "sore wrist", RSS can be a career ending injury when one's career depends on rapid keyboarding.

In fact, my case is probably summed up by YOUR whiny post...in general, Canadians expect perfection from both the healthcare system and medicine itself.

That's total BS. We're not talking perfection. We're talking competence. A nine or ten hour wait is nowhere in the neighborhood of satisfactory by any reasonable measure.

This is simply unattainable.  In a perfect world your elderly mother would not wait 8 hours in the ER to have her fractures fixed up..

Like, in France, you mean?

There are no rules guaranteeing speedy delivery and easy access, but the public demands it. Anne Durand, a French citizen who works in Montreal as a translator, says that if the French were made to queue and wait interminably for care like Canadians do, "there would be 10 million protesters in the street tomorrow." She says the French love their health system and are willing to pay top dollar for it because the care is not only rapid, but superb and intimate

Would it be more pleasant to go straight through the door and into 1st place in line every time you are ill or hurt?  Of course.  Is that possible?  Of course not.

It's late Friday afternoon in the emergency waiting room at Lariboisière Hospital. Unable to sit still, Mathilde Huet springs to her feet. "Am I going to die of old age before I see a doctor?" she inquires to no one in particular. Her rant is cut short by a hacking cough. "It's shameful," she mutters hoarsely. Mrs. Huet, 67, slipped on the stairs of her apartment, landing hard. Minutes later, she was transported to hospital by the pompier-ambulancier, examined by a nurse, and in less than 10 minutes after her arrival, ushered into an exam room by a doctor. In France, the emergency room is for minor health problems like this one. Serious cases like trauma or strokes go directly to a specialized ward. Mrs. Huet's arm was bruised and cut in the fall, and she has an unrelated chest infection, but gets the full treatment: X-rays (negative), a dressing, and a prescription for painkillers and antibiotics. The whole ordeal takes less than an hour, but she is indignant. "The doctor should have come to my home. This is humiliating," she growls

Andrepicard

[FTA Lawyer]

Not quite sure of your logic in calling my family "whiny" when I'm saying we're not complaining about the system, and all you did in your post was whine...about such horrible things as your sore wrist.

By "your whiny family" I was referring to your story of the family that bitched so much because it was flu season, even though every possible step was taken to accomodate them". As to my "sore wrist", RSS can be a career ending injury when one's career depends on rapid keyboarding.

In fact, my case is probably summed up by YOUR whiny post...in general, Canadians expect perfection from both the healthcare system and medicine itself.

That's total BS. We're not talking perfection. We're talking competence. A nine or ten hour wait is nowhere in the neighborhood of satisfactory by any reasonable measure.

This is simply unattainable.  In a perfect world your elderly mother would not wait 8 hours in the ER to have her fractures fixed up..

Like, in France, you mean?

There are no rules guaranteeing speedy delivery and easy access, but the public demands it. Anne Durand, a French citizen who works in Montreal as a translator, says that if the French were made to queue and wait interminably for care like Canadians do, "there would be 10 million protesters in the street tomorrow." She says the French love their health system and are willing to pay top dollar for it because the care is not only rapid, but superb and intimate

Would it be more pleasant to go straight through the door and into 1st place in line every time you are ill or hurt?  Of course.  Is that possible?  Of course not.

It's late Friday afternoon in the emergency waiting room at Lariboisière Hospital. Unable to sit still, Mathilde Huet springs to her feet. "Am I going to die of old age before I see a doctor?" she inquires to no one in particular. Her rant is cut short by a hacking cough. "It's shameful," she mutters hoarsely. Mrs. Huet, 67, slipped on the stairs of her apartment, landing hard. Minutes later, she was transported to hospital by the pompier-ambulancier, examined by a nurse, and in less than 10 minutes after her arrival, ushered into an exam room by a doctor. In France, the emergency room is for minor health problems like this one. Serious cases like trauma or strokes go directly to a specialized ward. Mrs. Huet's arm was bruised and cut in the fall, and she has an unrelated chest infection, but gets the full treatment: X-rays (negative), a dressing, and a prescription for painkillers and antibiotics. The whole ordeal takes less than an hour, but she is indignant. "The doctor should have come to my home. This is humiliating," she growls

I'm not saying there is no room for improvement...there always will be. But medicine is an inexact science and when one considers the mammoth task of keeping every citizen in Canada as healthy as possible, so long as the person gets the treatment they need, the wait to get it is not necessarily inherently unacceptable.

Andrepicard

<{POST_SNAPBACK}>

Okay...misunderstanding on the "whiny family" thing...my apologies.

I can't speak with any knowledge of the French system...but I will note your comment that the French are willing to pay "top dollar" for their health system because it is "rapid, superb and intimate."

I guess I'm saying that I don't really want to pay any more than we already do for our system because it seems to be taking care of me and my family quite well. And I would argue that the majority of Canadians agree with me on this point. No, I don't have any polls or stats...I'm just going by the fact that, in spite of all the political bantering about healthcare, I haven't seen 10 million or 1 million or 1,000 protesters in the streets rising up against the deplorable system.

Again, I'm always willing to try to improve things where we can... I just don't think that the amount of criticism and the painting of a system on the verge of collapse is warranted.

Also, the quotes that you have "surgically removed" from the article you cite are misleading. You leave an impression of the perfect system which provides everything we have and everything we lack. You leave out the other side which is in the same article in paragraphs like this one:

In the government's own report card, it states candidly that France promotes access to health services rather than promoting health. The emphasis on access has also translated into duplication, waste and few cost controls. "It's a system utterly devoid of checks and balances," said Gilles Johanet, a former director of the state insurer. He estimates that spending could be cut by at least 10 per cent (15 billion euros) just by eliminating unnecessary duplication.

The examples of excess are legion. By some estimates, the number of prescriptions could be halved. In Paris alone, there are 64 hospitals and clinics that do heart surgery; in the Netherlands, there are six. France has 500,000 hospital beds, at least 30,000 more than it needs. Jean-Pierre Davant, head of Mutualit française, an insurance company that sells supplementary health coverage, points to the plethora of operating rooms as proof of inefficiency. "On average, there are only two operations daily per operating room. Obviously there are far too many," he said. But with local mayors serving as chairmen of their local hospitals, the politics of closing institutions in France is even more complex than in Canada. And there is virtually no central control that would allow cutbacks even if politicians dared. "We have a system where rationing is non-existent, a taboo," said Philippe Georges, principal adviser to Health Minister Jean-François Matti. "Most systems have a codified set of rules, but the health system is like a factory where workers come in willy-nilly."

Convincing ourselves that the system is "improved" if we have non-existent wait times but only due to massive excesses in unchecked spending is simply putting our collective heads in the sand...much like mindlessly spending billions of dollars on the gun registry...but that's another post altogether.

And yes I am playing the Devil's Advocate a bit here...that's why I started the post off with the comment that I was trying to stir the pot.

As for my final comment about your wrist being okay...I put it after the "P.S." because I meant it to be sincere and not caught up with the rest of the message...I hope it was not taken as a personal insult.

FTA Lawyer.