Michael Moore's 'Sicko' Scrutinizes Canada's Healthcar

[SkyhookJackson]

You are so full of it. There are many, many people of means who care a great deal about those less fortunate than themselves. Americans are, at the core, a caring people (taking away the black eyes such as yourself). Uninsured Americans do not have faster services, yada, yada, yada. Without the elusive high credit card limit they often go without. Uninsured Americans who do not qualify for Medicaid are given minimal care unless it's a life or death situation. I know that for a fact because I've lived it. On another board I frequent there was a fairly well known political activist who developed pancreatic cancer. He was uninsured. There was one surgeon at one hospital who would give him his only chance for survival. The hospital demanded $50,000 up front, cash on the barrel head. We raised the money online in about a week and he had the surgery. Sadly, since he was uninsured, he was discharged to his home on the other side of the nation prematurely, didn't receive adequate follow-up, and died. He probably would have died anyway, given the survival rate of pancreatic cancer, but an insured person wouldn't have been treated in that fashion. I'm afraid, BC2004, you're in for a rude awakening very soon. There will come a day when there are no bake sales and car washes to benefit sick people trying to pay medical bills.

Sorry to hear that story.

Canada led the research on pancreatic cancer with a new drug called erlotinib. It helped improve survival rates.

I think if the U.S. is to ever get universal care, it will start from the state level and move to the federal level.

Don't let the naysayers get you down.

Thanks. This issue drives me particularly nuts because the solution to fixing it seems so obvious. There is a bill wending its way through our Congress that might someday see the light of day, especially if the Democrats win a supermajority in both houses and the White House. It's HR 676 sponsored by Reps. Dennis Kucinich and John Conyers. http://kucinich.us/issues/universalhealth.php

[Renegade]

Some times things get to the breaking point. I think that is what happened with car insurance at some point in a number of Canadian provinces and it eventually went over the tipping point.

It is easier for people to ignore the problem when it is affects 10 to 15% of the population. However, when people start to face the problem themselves with costs and healthcare, they push the demand for change. I think that is what happened with prescriptions in the U.S. It remains to be seen whether what they came up with will be the overall solution.

I'm not sure it has reached the breaking point in the US. Most estimates have the number of uninsured at around 46 million. That is about 15% of the population. Regardless, there can be changes made to the system which addresses the concerns of the majority without completely tearing up the system and starting over. As well, while the majority seem to be concerned about their personal medical coverage, I'm not sure they are concerned about implementing universal coverage.

[M.Dancer]

I remember being in Florida a few years ago when there was a shortage of employees for store front jobs....jobs where they employee had to interact with the general public. Fast food restaurants and chain retailers were offering very basic healthcare as part of their remuneration package to attract talent.

[SkyhookJackson]

I remember being in Florida a few years ago when there was a shortage of employees for store front jobs....jobs where they employee had to interact with the general public. Fast food restaurants and chain retailers were offering very basic healthcare as part of their remuneration package to attract talent.

The problem with "very basic healthcare" is that it's very basic - fine as long as you stay healthy, not so much if you become ill. That's one reason I'm glad Michael Moore focused on the insured, rather than the uninsured. People are paying through the nose for coverage, believing they're safe and secure, until something happens. It's also rampant in other areas of insurance. Take Hurricanes Rita and Katrina, for example. Senator Trent Lott (R-MS) lost his house and filed a claim, assuming he was covered. State Farm said "too bad, so sad, we don't cover water damage." The house had been taken out by the wind long before the water arrived, but Lott had to sue to have his claim paid. I don't think he views the insurance industry through rose-colored glasses anymore.

[bush_cheney2004]

I'm not sure it has reached the breaking point in the US. Most estimates have the number of uninsured at around 46 million. That is about 15% of the population. Regardless, there can be changes made to the system which addresses the concerns of the majority without completely tearing up the system and starting over. As well, while the majority seem to be concerned about their personal medical coverage, I'm not sure they are concerned about implementing universal coverage.

Yes, that's pretty much where the US is on this issue. There are several grassroots and very vocal groups who advocate for universal access, but the pragmatists are more aligned with reality. Today the Congress is working on renewal and extension of the SCHIP program to cover more lower income children. However, there is growing concern from market forces that more and more governmnet funded healthcare will erode their membership and profits from privately funded care. Healthcare is not a right, but it is big business.

[Pliny]

I haven't read the whole thread here but I read the first and last pages.

I think the argument of cost that has been tossed around, the "Americans pay more but they get more." argument is not

Are the total costs of medical expenses in Canada included in the argument, i.e., is what Canadians purchase in the US in medical services included in our total costs or is it just what is paid out from Health Canada.

If the latter is the case then it is not valid to argue that Americans are paying more. Lots of our healthcare dollars are spent in the US. Is that amount also included in the total American cost of healthcare. How many people from other countries fly to America for expensive medical treatments?

Americans unarguably are getting more.

Another, I think valid point, is is to ask what percentage of American healthcare expenditures are elective or cosmetic. We do not have the choice of purchasing any elective or cosmetic medical procedures in Canada whatsoever.

Obviously, we Canadians are getting less and paying more.

It may seem a bit of a radical point of view but healthcare insurance, whether private or public, is, in my view, just insurance that the providers of healthcare will receive compensation for their services. In the private sector, health insurance companies can be held accountable, and will fail if they do not provide their service according to customer demand. The monopolistic system in Canada is not accountable and all failures are inevitably attributed to "lack of funding" as it trundles along unheeded.

I might even argue that Canadians live longer because they have less access to medical care and not better care.

When a person has to look after himself he does. If he can't do it himself he forges relationships that enable him to do so as to the best of his abilities. If all he needs to do is wait in line for services from the government that is what he will do and he will have plenty of time to gripe and demand better service - which inevitably means "More funding is necessary". He also, under the socialized system, loses his ability to forge symbiotic and loving relationships.

I'm more on the American side than the Canadian but both systems undoubtedly have problems.

[Riverwind]

If the latter is the case then it is not valid to argue that Americans are paying more. Lots of our health care dollars are spent in the US.

Right - do you have a cite? My understanding that cross border health care purchases are an insignificant amount when compared to the total amount spent. That would make that argument a red herring.

We do not have the choice of purchasing any elective or cosmetic medical procedures in Canada whatsoever.

That is a complete falsehood. The dubious ban on private medicine in Canada only covers procedures that would normally be covered. Plastic surgery is not covered which means you are free to get it in Canada if you want. Furthermore, I suspect that plastic surgery is a small part of the total amount of money spent on medical care in Canada and the US.

Obviously, we Canadians are getting less and paying more

Every citizen in Canada is covered with no deductible, no maximums and no co-payments. That coverage is superior to what most Americans get even if they have a good plan from their employer. Now there are some problems with waiting lists for some types of procedures in Canada, however, those problems are not a huge issue for most people - especially when you compare it to the nonsense that many Americans have to put up with when forced to deal with an HMO. Edited July 17, 2007 by Riverwind

[Pliny]

If the latter is the case then it is not valid to argue that Americans are paying more. Lots of our health care dollars are spent in the US.

Right - do you have a cite? My understanding that cross border health care purchases are an insignificant amount when compared to the total amount spent. That would make that argument a red herring.

We do not have the choice of purchasing any elective or cosmetic medical procedures in Canada whatsoever.

That is a complete falsehood. The dubious ban on private medicine in Canada only covers procedures that would normally be covered. Plastic surgery is not covered which means you are free to get it in Canada if you want. Furthermore, I suspect that plastic surgery is a small part of the total amount of money spent on medical care in Canada and the US.

Obviously, we Canadians are getting less and paying more

Every citizen in Canada is covered with no deductible, no maximums and no co-payments. That coverage is superior to what most Americans get even if they have a good plan from their employer. Now there are some problems with waiting lists for some types of procedures in Canada, however, those problems are not a huge issue for most people - especially when you compare it to the nonsense that many Americans have to put up with when forced to deal with an HMO.

I couldn't find any statistics on foreign purchases, not just Canadian, of American medical services doing a quick search but I have two brothers-in-law that did not want to wait four months, not for treatment but just to see a specialist, for prostate cancer and both went to the States for immediate state of the art treatments not available in Canada even if you did wait.

they spent $40,000 American each. I have no idea how many seek treatment in the US but I would like to know. The amount may be insignificant in comparison to the total but unless you have some statistics I think it is at least deserving of a mention.

It is against the Canada Health Act to purchase medical services privately in Canada, with the exception of Quebec since 2006. You should know that. Much of what is called private healthcare in Canada is funded publicly. Some things such as ambulance rides are private but subsidized publicly and private insurance such as Blue Cross provide for the greater percentage of private expenditure.

Here is a good article I found on it. http://www.cbc.ca/news/background/healthca...vs_private.html

Makes it quite unclear what private healthcare is. Read the article carefully.

I am not here to argue the American system is great, by the way, but the Canadian one isn't either.

An interesting statistic I found at the WHO site is that the per capita "government" expenditures on healthcare is $2120.90 in Canada and $2724.70 in the US. The US is by far not a totally private system. Medicare and Medicaid account for approximately 40% of total healthcare spent in America.

Is your handle Riverside because you work or live there? Oh pardon me, it's Riverwind. Forget I asked that but if I am not mistaken you have some stake in the medical profession?

Edited July 18, 2007 by Pliny

[guyser]

but I have two brothers-in-law that did not want to wait four months, not for treatment but just to see a specialist, for prostate cancer and both went to the States for immediate state of the art treatments not available in Canada even if you did wait.

they spent $40,000 American each. I have no idea how many seek treatment in the US but I would like to know. The amount may be insignificant in comparison to the total but unless you have some statistics I think it is at least deserving of a mention.

I would be very ineterested to know why they had to wait to see a specialist. Did they live remotely..?...no specialist anywhere nearby..?....couldnt make the trip for other reasons until 4 months later?

They could have saved themselves $40G's as most Prostate Cancer is very slow growing.

To me something is missing here.

[Riverwind]

It is against the Canada Health Act to purchase medical services privately in Canada, with the exception of Quebec since 2006.

It is only illegal to purchase services that are covered. Services that are not covered, such as plastic surgery, may be purchased. Your link makes that distinction clear.

An interesting statistic I found at the WHO site is that the per capita "government" expenditures on healthcare is $2120.90 in Canada and $2724.70 in the US. The US is by far not a totally private system. Medicare and Medicaid account for approximately 40% of total healthcare spent in America.

Yet despite spending that money 15% of their citizens have no coverage at all. The american system is very inefficient and only really provides better care to the minority of citizens that have good employer health plans.

[mikedavid00]

Yet despite spending that money 15% of their citizens have no coverage at all.

sigh..

And what are the age groups of these 15% of *citizens* who do not have coverage.

I'm waiting.

[bush_cheney2004]

Yet despite spending that money 15% of their citizens have no coverage at all. The american system is very inefficient and only really provides better care to the minority of citizens that have good employer health plans.

Americans with private insurance also do quite nicely, as do patients on Medicare, Medicare or SCHIP. The Americans who do receive healthcare services get them faster (on average) than Canadians. Americans pay more, but they also get more because of excess capacity, productivity, technology, R&D, defensive medicine, and doctor ratios....that's why there is so much waiting going on in Canada. In a pinch, the provinces just (quietly) send their patients to the United States.

Edited July 18, 2007 by bush_cheney2004

[Riverwind]

And what are the age groups of these 15% of *citizens* who do not have coverage.

I gave you those stats a long time ago. The majority are the working poor and their children. Edited July 18, 2007 by Riverwind

[Guest American Woman]

And what are the age groups of these 15% of *citizens* who do not have coverage.

I gave you those stats a long time ago. The majority are the working poor and their children.

I missed those stats. Would you mind sourcing that information again? I have to say, I find it difficult to believe that the majority of uninsured Americans are the "poor" and their children; especially since there are programs to provide health care to children of the poor. I'm guessing that the majority of the uninsured are middle class, not poor enough to qualify for public assistance and not wealthy enough to afford health insurance.

[Riverwind]

I missed those stats. Would you mind sourcing that information again?

See http://www.mapleleafweb.com/forums//index....ndpost&p=234698 MD wants us to believe that the 15% of uninsured consists entirely of university students and illegal immigrants. The stats don't back up his claim: 70% are US citizens and 70% are outside the the 18-25 age range. Edited July 18, 2007 by Riverwind

[bush_cheney2004]

And what are the age groups of these 15% of *citizens* who do not have coverage.

I gave you those stats a long time ago. The majority are the working poor and their children.

It's more complicated than that....."poor" has a better definition as a percentage of the federal poverty level (FPL). Hard "uninsured" facts for 2005:

http://aspe.hhs.gov/health/reports/05/unin...d-cps/index.htm

We can see that sweeping generalizations about the uninsured don't hold up to scrutiny.

While the (US) uninsured are concentrated disproportionately in certain subgroups, the uninsured are clearly a diverse population comprised of people from all income levels, racial groups and employment types.

Edited July 18, 2007 by bush_cheney2004

[Riverwind]

We can see that sweeping generalizations about the uninsured don't hold up to scrutiny.

From your link:

The 45.8 million uninsured are more likely to be poor and low income than higher income. Figure 2 shows that over half of the uninsured are below 200% of poverty, with 25% below the poverty line and 28% between 100% and 199% of poverty.

It seems the report agrees with my 'sweeping generalizations'.

[bush_cheney2004]

The 45.8 million uninsured are more likely to be poor and low income than higher income. Figure 2 shows that over half of the uninsured are below 200% of poverty, with 25% below the poverty line and 28% between 100% and 199% of poverty.

It seems the report agrees with my 'sweeping generalizations'.

No, it depends on how poor is "poor". Some federal and state programs have cutoffs well below 200% FPL.

In any event, there's a lot more to US uninsured demographics than any such generalization...the report clearly demonstrates this.

Edited July 18, 2007 by bush_cheney2004

[Guest American Woman]

I missed those stats. Would you mind sourcing that information again?

See http://www.mapleleafweb.com/forums//index....ndpost&p=234698 MD wants us to believe that the 15% of uninsured consists entirely of university students and illegal immigrants. The stats don't back up his claim: 70% are US citizens and 70% are outside the the 18-25 age range.

Thank you. There's a lot of information to sort through. Certainly, though, not all of the 18-25 age group are even university students, and illegal immigrants don't even fit into the numbers, so it's interesting how some will try to 'downplay' the situation.

It's also interesting to note what is considered "poor." Only one-third of the uninsured are in the poverty level, so I do think the majority are the middle class, albeit the lower middle class. I'll have to read up more on the issue.

[jbg]

MD wants us to believe that the 15% of uninsured consists entirely of university students and illegal immigrants. The stats don't back up his claim: 70% are US citizens and 70% are outside the the 18-25 age range.

From my own experiences during the late 1980's, when I was between roughly 28 and 34, many in that males in age group who are hardly poor are uninsured. The (incorrect) perception at that age is that insurance is not a necessity since by and large people that age get their annual checkup and otherwise often have few tangles with medicine. It's sort of the leftowver adolescent view of immortality since, in many respects, age 30 is the new 20, etc.

[SkyhookJackson]

MD wants us to believe that the 15% of uninsured consists entirely of university students and illegal immigrants. The stats don't back up his claim: 70% are US citizens and 70% are outside the the 18-25 age range.

From my own experiences during the late 1980's, when I was between roughly 28 and 34, many in that males in age group who are hardly poor are uninsured. The (incorrect) perception at that age is that insurance is not a necessity since by and large people that age get their annual checkup and otherwise often have few tangles with medicine. It's sort of the leftowver adolescent view of immortality since, in many respects, age 30 is the new 20, etc.

Many of the uninsured could probably afford insurance if the insurance industry wasn't allowed to opt for the cream of the crop to insure. If you happen to be older or have any medical history, the insurance industry doesn't want you and they price their product accordingly. Most of the uninsured people I know are small business or self-employed people. It's not that we don't want to pay for coverage, it's that we can't pay for it if we're going to be screwed over. Even sorrier than the uninsured, though, are the insured who think the insurance company is going to pay the bill. Some people have used up the equity in their homes to buy health insurance, then something happens and they're still stuck with 20% of the bill at the very minimum. I guess the only advantage is that they get the bankruptcy over a whole lot faster if the equity in their homes is gone anyway. The insurance industry is really stupid. If they had pooled the risk and kept rates low across the board, we wouldn't be discussing doing away with them entirely. Greed is the downfall of all.

[Pliny]

but I have two brothers-in-law that did not want to wait four months, not for treatment but just to see a specialist, for prostate cancer and both went to the States for immediate state of the art treatments not available in Canada even if you did wait.

they spent $40,000 American each. I have no idea how many seek treatment in the US but I would like to know. The amount may be insignificant in comparison to the total but unless you have some statistics I think it is at least deserving of a mention.

I would be very ineterested to know why they had to wait to see a specialist. Did they live remotely..?...no specialist anywhere nearby..?....couldnt make the trip for other reasons until 4 months later?

They could have saved themselves $40G's as most Prostate Cancer is very slow growing.

To me something is missing here.

They live in the Peace River area in Alberta. That was my understanding but it may have been 4 months to start treatment which they did not want to wait for and which they didn't feel would have been adequate. Like most people they wanted the best for their health, not just what was offered by the monopoly here in Canada, they did the research and settled for some treatment in Atlanta.

[Pliny]

Many of the uninsured could probably afford insurance if the insurance industry wasn't allowed to opt for the cream of the crop to insure. If you happen to be older or have any medical history, the insurance industry doesn't want you and they price their product accordingly. Most of the uninsured people I know are small business or self-employed people. It's not that we don't want to pay for coverage, it's that we can't pay for it if we're going to be screwed over. Even sorrier than the uninsured, though, are the insured who think the insurance company is going to pay the bill. Some people have used up the equity in their homes to buy health insurance, then something happens and they're still stuck with 20% of the bill at the very minimum. I guess the only advantage is that they get the bankruptcy over a whole lot faster if the equity in their homes is gone anyway. The insurance industry is really stupid. If they had pooled the risk and kept rates low across the board, we wouldn't be discussing doing away with them entirely. Greed is the downfall of all.

I would say this is the case. Whether the government or the insurance companies are the payers of the bills doesn't make too much difference. Costs and not health are the main concern. The biggest supporters of our health care system are those employed in the industry. They are the ones resisting any change other than - guess - more funding. People with chronic illness would also be strong supporters without doubt.

We cannot sustain this free system as it stands and change is already occurring. Last year in Quebec the Canada Health Act was challenged as I am sure most people are aware and private care can be made available to purchase if one wants. Not in the rest of Canada yet unless you want cosmetic surgery, right Riverwind?

[Riverwind]

We cannot sustain this free system as it stands and change is already occurring. Last year in Quebec the Canada Health Act was challenged as I am sure most people are aware and private care can be made available to purchase if one wants.

You are mixing two unrelated issues. The ban on private health care services is on its way out due to the SCC ruling in 2006. The SCC only made the ruling based on the Quebec charter but the precident has been set.

That said, allowing private clients does not mean we would abandon the single payer model. Very few people want to see an end to the universal coverage and most recognize that the US heath care system is the worst in the industrialize world and has little or nothing to offer Canadians.

[bush_cheney2004]

That said, allowing private clients does not mean we would abandon the single payer model. Very few people want to see an end to the universal coverage and most recognize that the US heath care system is the worst in the industrialize world and has little or nothing to offer Canadians.

Actually, it would appear that one of the worst systems in the "industrialized world" that has universal access as a goal can be found in Canada. That only 16% of US citizens lack insurance (not healthcare) is remarkable given that universal access is not the goal.

When Canada's system fails miserably, patients are sent to the "worst" system in the industrialized world. Telling indeed.