How do we fix Canada's Healthcare crisis?

[jdobbin]

People don't realize that healthcare is usually included by most US employers and the same would most likely happen here.

Costco, Wal-Mart, and most all US based companies provide healtchare plans for their employees. If you work at Burger King you are out of luck and have to use the HMO system.

Oh yeah, the HMO system has no waiting times.

Let see some evidence of that. HMOs ration health and deny coverage.

[Argus]

I honestly wonder what country you people are living in. Do any of you have first hand knowledge of the health care system? Can you honestly say it is bad?

Yes, it is clearly bad. You can't say a system works well when it takes 10 hours to have a basic broken arm or wrist set in a hospital.

It takes far too long for cancer treatment, far too long to even get in to see a specialist before the treatment. It takes far too long for diagnostic tests, and far too long for basic operations. Get used to it? I don't choose to. Why should Canadians get used to it when those in other countries do not face such waits?

It takes so long because we don't have enough people to perform these procedures. If we have a private system, how exactly is the number of doctors going to increase? We have 50,000 doctors and that's it. Public or private, that number is not going to go up. Or do you intend to let anyone off the street be a doctor in a private system?

The number of doctors is a product of poor decisions made by politicians and their policy wonks. Much of the disability in the health care system is also due to incompetence and bureacratic waste and mismanagement. The system needs to be streamlined, and private money added. I really don't see the problem with user pay to a limited extent, to a small fee to see your doctor, or to have a diagnostic test done more quickly. If you want to spend your money on cigarettes, beer, and big SUV while mine goes into the bank - well, so what if I now have money to spend on my health and you don't. How is that unfair to you?

[normanchateau]

Saturn, the reality is that the doctors and nurses that would move over to "higher paying" private positions are the ones that will move to the States if Canada doesn't offer the private option. It already happens with droves of RN's from Alberta (and we have the highest pay as per the UNA CBA in the country). So that leaves us with the option: Give them the pay and benefit of working in the private sector, or just hold the door open when they move out of the country.

Your number of 50,000 doc's is not static. We are losing them now, so if the residency spots are not being made available the number will dwindle.

What is the number leaving now?

Good question. Large numbers of Canadian physicians who moved to the US are now returning to Canada. In 2004, more returned to Canada than left for the US. The Canadian Institute for Health Information tracks the numbers. Here are some data:

http://www.chsrf.ca/mythbusters/pdf/myth19_e.pdf

[Saturn]

Saturn, the reality is that the doctors and nurses that would move over to "higher paying" private positions are the ones that will move to the States if Canada doesn't offer the private option. It already happens with droves of RN's from Alberta (and we have the highest pay as per the UNA CBA in the country). So that leaves us with the option: Give them the pay and benefit of working in the private sector, or just hold the door open when they move out of the country.

Your number of 50,000 doc's is not static. We are losing them now, so if the residency spots are not being made available the number will dwindle.

We can have a lot more residency positions but the medical associations are against it. Because more doctors mean shorter waiting lists and shorter waiting lists mean no privatization. The reason the americans don't have the shortage we do is because they are smart enough to allow foreign doctors (Canadians for example) to practice in the US. We don't allow anyone from outside the country to practice in Canada. So the flow of doctors goes only one way - from Canada to the US and from overseas to the US (often via Canada).

I know of at least a dozen foreign doctors who came to Canada to realize that they have two options - move to the US and practise medicine or stay in Canada and wash dishes. Which would you choose? Somehow they are good enough for the Americans but not for us, so we would rather wait 8 months to get the treatments we need.

[Saturn]

Saturn, the reality is that the doctors and nurses that would move over to "higher paying" private positions are the ones that will move to the States if Canada doesn't offer the private option. It already happens with droves of RN's from Alberta (and we have the highest pay as per the UNA CBA in the country). So that leaves us with the option: Give them the pay and benefit of working in the private sector, or just hold the door open when they move out of the country.

Your number of 50,000 doc's is not static. We are losing them now, so if the residency spots are not being made available the number will dwindle.

What is the number leaving now?

Good question. Large numbers of Canadian physicians who moved to the US are now returning to Canada. In 2004, more returned to Canada than left for the US. The Canadian Institute for Health Information tracks the numbers. Here are some data:

http://www.chsrf.ca/mythbusters/pdf/myth19_e.pdf

This doesn't include the number of foreign doctors who move to the US though. Roughly 20% of all foreign doctors who come to Canada later leave for the US because they cannot get licenced in Canada. That's a substantial number of physicians.

[mikedavid00]

Oh, there we go...it's all the evil immigrants that cause all your problems. Pfff.

And it's this hear no evil speak no evil attitdude in this country that is destroying us because we can't face the problems that are destroying this country.

[mikedavid00]

EVERYONE of the people who took medicine that I knew when I was in school has went to the US and stayed there. But you're right - it's all the greedy Dr's fault.

That's because the US pays more. We pay doctors very little. In order to pay them more to stay or live here, we would have have to double their wages which we cannot afford. It's a loosing proposition. We're screwed unless major change happens.

[Saturn]

I honestly wonder what country you people are living in. Do any of you have first hand knowledge of the health care system? Can you honestly say it is bad?

Yes, it is clearly bad. You can't say a system works well when it takes 10 hours to have a basic broken arm or wrist set in a hospital.

It takes far too long for cancer treatment, far too long to even get in to see a specialist before the treatment. It takes far too long for diagnostic tests, and far too long for basic operations. Get used to it? I don't choose to. Why should Canadians get used to it when those in other countries do not face such waits?

It takes so long because we don't have enough people to perform these procedures. If we have a private system, how exactly is the number of doctors going to increase? We have 50,000 doctors and that's it. Public or private, that number is not going to go up. Or do you intend to let anyone off the street be a doctor in a private system?

The number of doctors is a product of poor decisions made by politicians and their policy wonks. Much of the disability in the health care system is also due to incompetence and bureacratic waste and mismanagement. The system needs to be streamlined, and private money added. I really don't see the problem with user pay to a limited extent, to a small fee to see your doctor, or to have a diagnostic test done more quickly. If you want to spend your money on cigarettes, beer, and big SUV while mine goes into the bank - well, so what if I now have money to spend on my health and you don't. How is that unfair to you?

What is unfair is that your approach will lead to a US system which is 50% more expensive and is still about as bad as ours. You would rather see $30-$50 billion going into the hands of insurance companies than going into the treatment of patients. This will raise the cost of health-care to unreasonably high levels not just for you but for everyone else as well. If you want to pay too much, that's fine, but you will make everyone else pay too much as well. Your actions affect others in a negative way. That's what's unfair. Now if you really want to pay too much, you are always free to go to the US for health care - they will always take your money.

The number of doctors is a product of poor decisions made by politicians under the pressure of the medical associations. The reality is that the medical profession is a self-regulated one and the medical associations give certification only to as many doctors as they want. The politicians don't have the guts to stand up to the medical associations (except for Tommy Douglas but he is long gone). Canadians are effectively being held hostage by the medical associations who will keep us waiting in lines until they get their way.

[mikedavid00]

I'm suggesting that our Country is not 'rich' enough to be able to fix our health care problems.

The French and Germans can afford it but we can't??

Because the do not let in even close the amount of people that we do each year. People who use their system pay into it. It really is that simple.

If you beleive that needless immigration and family sponsorship doesn't affect our country at all, then there's really no getting you to understand why our system has fallen appart over the years.

There's a cause and effect reason for everything. We had the money to supply Canadians with healthcare: not the rest of the world.

[jdobbin]

That's because the US pays more. We pay doctors very little. In order to pay them more to stay or live here, we would have have to double their wages which we cannot afford. It's a loosing proposition. We're screwed unless major change happens.

If this was the case, we'd be losing ever more doctors and nurses. According to the link earlier, the trend has reversed. Some of the reasons given are that the malpractice insurance is keeping some doctors from going south.

Please cite your source that says we are losing more doctors than gaining them.

[mikedavid00]

Why should Canadians get used to it when those in other countries do not face such waits?

Honest to God.

My ex-gf went to the Dominican Republic for a 1 week all inclusive type thing. Anyhow, they were sea-dooing and she injured her back. She went to a private hospital in near city and stayed for 2 nights.

She said that it was air conditioned, she had a phone, TV, and a room all to herself. She also got assigned a Doctor. She could pick up the phone and dial the doctor directly to come to her room. She got xrays, a menu for food and the best care.

I saw pictures from the room, I swear it was a huge room with large windows, nice painted walls, wicker chairs, picture hangings, track lighting.. I couldn't beleive it. I wish I still had those pics.

And then she got escorted out on a wheelchair with the Dr. and 2 nurses and they took pics to say goodbye and even the nurse gave her a goodbye card.

I was in shock.. I really wish I had those pictures but she deleted them all off my computer.

[normanchateau]

The French and Germans can afford it but we can't??

There's a cause and effect reason for everything.

Yes, there is a cause and effect for everything. French physicians make about 55,000 per year.

Source:

http://ezraklein.typepad.com/blog/2005/04/...h_care_fra.html

[Michael Hardner]

mikedavid:

Much of your evidence seems to come from personal experiences. It might convince you, but it's not enough to prove a point objectively. I'll remind you, at this point, of your contention that many truck drivers in India have a degree. I asked you to prove that, and you didn't post on the thread again.

I'm not convinced that immigration is the cause of the failure of the healthcare system, as you seem to be.

[jdobbin]

The Dominican Republic must be the healthiest country in the world!

[jdobbin]

mikedavid:

Much of your evidence seems to come from personal experiences. It might convince you, but it's not enough to prove a point objectively. I'll remind you, at this point, of your contention that many truck drivers in India have a degree. I asked you to prove that, and you didn't post on the thread again.

I'm not convinced that immigration is the cause of the failure of the healthcare system, as you seem to be.

He hasn't really cited any evidence of what he believes.

[mikedavid00]

I am not the one to normally flame posters, but Sir you leave yourself open to such abuse when you post that tripe.

This country would be doomed without immigration.

Drivel.

We NEED those folks.

For what? Taxi drivers and cleaning staff?

Perhaps your neck of the woods is not aware that Alberta would open the floodgates to get people in. They are closing stores, reducing operating hours , offering $11 an hour for 7-11 clerks beacuse there is not enough people.

Then the answer would seem to be to retrain and move people from other parts of Canada.

I don't find 7-11 workers making $11 an hour a problem. That's a healthy good good thing and a sign of high employment.

The US actually has this problem because some areas in the US just have trouble finding a certain worker to work the low wage jobs.

So the US created an immigration class called the 'unskilled labor' class. Basically, if they PROVE that they could not hire an American to do the job, then the business can sponsor in a worker who will ONLY be given a workers permit that has a max life of 4 years and then can only be renewed once. After that, if he's not a citizen, he must go back to where he came from. And no, he's not allowed healthcare, not allowed to go on welface, and his wife is NOT allowed to work. The only service he'll get is his kids will be able to go to school.

You gotta love that policy.

[normanchateau]

mikedavid:

Much of your evidence seems to come from personal experiences. It might convince you, but it's not enough to prove a point objectively. I'll remind you, at this point, of your contention that many truck drivers in India have a degree. I asked you to prove that, and you didn't post on the thread again.

I'm not convinced that immigration is the cause of the failure of the healthcare system, as you seem to be.

He hasn't really cited any evidence of what he believes.

And he ignores data on the number of Canadian physicians returning from the US and ignores data on lower physician salaries on Europe.

[mikedavid00]

That's because the US pays more. We pay doctors very little. In order to pay them more to stay or live here, we would have have to double their wages which we cannot afford. It's a loosing proposition. We're screwed unless major change happens.

If this was the case, we'd be losing ever more doctors and nurses. According to the link earlier, the trend has reversed. Some of the reasons given are that the malpractice insurance is keeping some doctors from going south.

Please cite your source that says we are losing more doctors than gaining them.

I don't beleive we're losing more doctors than what we are turing out. Most people consider this country their home and would prefer to stay here. Some goes for most countries. The wealthy in any society tend to stay where they are becuase life is good there.

And yes I do kow about the issue of elites keeping the medical schools small and for the priveleged family members and insiders. I've heard about this corruption. This one guy called up a radio talk show and said that his fiance has to go to Poland to study to become a doctor in order to practice in Canada because there were only 60 seats open at the UofT and the grade cut-off was extrememly high.

I'm suggesting that even if this was fixed, the Doctor shortage is not our main issue. We need massive, massive increases in infrastructer, MRI machines, hospitals, staff, etc. A doctor is just one person in the chain of medicare.

[mikedavid00]

The French and Germans can afford it but we can't??

There's a cause and effect reason for everything.

Yes, there is a cause and effect for everything. French physicians make about 55,000 per year.

Source:

http://ezraklein.typepad.com/blog/2005/04/...h_care_fra.html

I guess Dion would the answers then. lol.

But that article is 10 years old and questionable when it says that doctors in the US make $150,000 a year.

Maybe if you are a newbie working in a hosptial. Looking up payrates for a specialist like Dermatology, a Doctor makes about $200,000. NeuroSurgery median salery is $438,000.

But many doctors run their own practices which is essentially a self employed business.

http://www.studentdoc.com/ophthalmology-salary.html

[mikedavid00]

The Dominican Republic must be the healthiest country in the world!

That was a private hospital. That was thet point. I'm sure they have a poor public system.

[mikedavid00]

mikedavid:

Much of your evidence seems to come from personal experiences. It might convince you, but it's not enough to prove a point objectively. I'll remind you, at this point, of your contention that many truck drivers in India have a degree. I asked you to prove that, and you didn't post on the thread again.

I'm not convinced that immigration is the cause of the failure of the healthcare system, as you seem to be.

He hasn't really cited any evidence of what he believes.

And he ignores data on the number of Canadian physicians returning from the US and ignores data on lower physician salaries on Europe.

When you go to the US you are on a work permit and must return to the country you came from. During the last 2 years there have been many poeple entering Canada from the US becuase their work permits expired.

[normanchateau]

The French and Germans can afford it but we can't??

There's a cause and effect reason for everything.

Yes, there is a cause and effect for everything. French physicians make about 55,000 per year.

Source:

http://ezraklein.typepad.com/blog/2005/04/...h_care_fra.html

But that article is 10 years old

2005?

[Saturn]

EVERYONE of the people who took medicine that I knew when I was in school has went to the US and stayed there. But you're right - it's all the greedy Dr's fault.

That's because the US pays more. We pay doctors very little. In order to pay them more to stay or live here, we would have have to double their wages which we cannot afford. It's a loosing proposition. We're screwed unless major change happens.

Ya, $400K/year is very little. Canadian doctors are the second best paid in the world. There are gazillion doctors from other countries who would love to get this much. So if ours want to go to the US, let them and take cheeper doctors in - they are just as good. If you could hire a US programmer for $80K/year or a Spanish programmer for $40K/year, which would you choose?

[jdobbin]

When you go to the US you are on a work permit and must return to the country you came from. During the last 2 years there have been many poeple entering Canada from the US becuase their work permits expired.

Citation?

[jdobbin]

I don't beleive we're losing more doctors than what we are turing out. Most people consider this country their home and would prefer to stay here. Some goes for most countries. The wealthy in any society tend to stay where they are becuase life is good there.

And yes I do kow about the issue of elites keeping the medical schools small and for the priveleged family members and insiders. I've heard about this corruption. This one guy called up a radio talk show and said that his fiance has to go to Poland to study to become a doctor in order to practice in Canada because there were only 60 seats open at the UofT and the grade cut-off was extrememly high.

I'm suggesting that even if this was fixed, the Doctor shortage is not our main issue. We need massive, massive increases in infrastructer, MRI machines, hospitals, staff, etc. A doctor is just one person in the chain of medicare.

I keep hearing personal info rather than facts.