Healthcare in the United States...

[LChoy]

Originally Posted by missdpuck

There is a couple at my gym from a rural area of Ontario who say the Canadian healthcare system is terrible and told me of long waiting times even in emergencies. It's part of the reason they moved here.

Then I hear other people say that that is crap, the system is great and they never have to wait. And I meet Americans who want to move to Canada for healthcare.

Does care vary by city/province?

*Health Hat on*

Pretty much most of the responsibilities for health care in Canada is provided by the individual provinces so there will be some slight differences.
Primary care access is a problem that is facing many industrialized country at the moment. From the Alberta perspective, the population is increasing in the major cities and decreasing in the rural areas and up North.
Currently, there are 123 positions for family doctors across Alberta, 46 positions alone in Calgary. We estimate ~ 1 in 5 Calgarians don't have access to a primary care provider at the moment. At the moment, if you are in South Calgary, that population has doubled 11% in the last 2 years, so there will obviously be an increase need for health services
You can get fantasic service in small towns with minimal waiting time (assuming it's a place that hasn't had trouble with health care recruitment)
The goal is to reduce the number of people that go to the hospitals unnecessarily, hence the focus on PCNs, community care centres, mediclinics...etc. We're also encouraging doctors to work more closely with other health care providers to share the work load, to share office space with other physicians and providers (co-location), and refer patients to healthlink for general inquiries
For wait times, a lot of it depends on the available number of specialists in a particular geographical areas. It's increasingly common for people to come to Edmonton and Calgary to see a specialist.

[Cowperson]

Originally Posted by missdpuck

Does care ary by city/province?

.

You'll probably wait a lot longer in a city emergency room than you would in a rural town like High River and Black Diamond.

That's the little secret some Calgarians already know.

The problem with the health care debate on both sides of the border is that the pragmatists who could probably get something done with a combination of both systems that would bring the best of both systems together, are drowned out by the shrill partisans who are scared of compromise.

Any healthcare system anywhere in the world is under money pressure. There will never be enough money.

So it's an issue of a finite amount of money generating the greatest efficiencies within the majority approved moral standards of that particular society.

Cowperson

[missdpuck]

Originally Posted by Azure

Yes, the probably would.

Nevermind that, I could costs to US healthcare by 30% in 5 years if people quit eating so many frickin' carbs.

I've heard that the obesity rate of American teenagers is increasing but didn't really notice until recently. I ride past one high school on the way to work and deliver mail to another. I don't remeber seeing so many fat kids when I was that age, but who knows.

[Azure]

Originally Posted by Cactus Jack

Yes but the tax base is the same. 10X the population can roughly be equated to 10X the tax population unless there is some kind of anomally whereby these 270 million would either be all unemployed or high income earners. The fact is Canada has a good economy, lots of resources and 33 million people.

10x more people in an Alberta economy isn't the same as 10x more people in Alabama. Or Georgia.

We are a high earning province, they are a low-earning state. Tax revenues in each place would be different. And you can make that claim here in Canada too.

Sure, you can adjust the tax numbers to try and accommodate them. But in the end, providing health care for 10x more people would cost a lot more money than can be gained by the taxes gained from having a 10x bigger population base.

[LChoy]

Originally Posted by missdpuck

So you have no choice but to be on the waiting list under your system? I guess that's what puzzles me. That sounds like our VA clinics. A veteran neds a test to save his eyesight, but the six months he has to wait for the test means he'll likely go blind.

For a public care, yes you'll have to wait. However, we do have private clinics and facilities, but that would be out of your own pocket (unless you have special insurance, ie hockey players)
If you are waiting for something critical/life threatening, every province has a special health body that your doctor could submit a claim to, and they'll approve treatment/surgery outside of province or country if it's deemed you cannot wait any longer. This was the case when we get maternity patients from BC and Sask, or when we flown people to Montana to have their kids delievered. In this case, it would be covered

[Dan02]

Originally Posted by Azure

Sure, you can adjust the tax numbers to try and accommodate them. But in the end, providing health care for 10x more people would cost a lot more money than can be gained by the taxes gained from having a 10x bigger population base.

Your logic makes no sense to me. The US is "richer" then Canada on a per person basis, if they choose to tax differently that's their ball of wax but it's wrong to say the abiltity doesn't exist to raise the same level of funds.

Yes, there'd be 10 times the Albertans, but there'd also be 10 times the Quebecors...

[Azure]

Originally Posted by missdpuck

I've heard that the obesity rate of American teenagers is increasing but didn't really notice until recently. I ride past one high school on the way to work and deliver mail to another. I don't remeber seeing so many fat kids when I was that age, but who knows.

Same here. Driving past my old school and looking at the kids outside, I don't ever recall that many obese kids when I went to school.

Obesity rates are increasing. At a deathly rate.

And as a result, health care costs are just going to keep shooting through the roof.

I've been to the doctor 3x in the past 2 years. Once to get a fractured sternum checked, and twice to get a blood test.

I'm not that big of a drain. But someone who is severely obese needs to go get blood tests, and get their blood pressure checked and a whole slew of other tests constantly.

He's a drain.

So, if people would quit eating so many carbs, there would be less people needing health care.

[Cactus Jack]

Originally Posted by Azure

And? So those of us who have family stuck on waiting lists should just shut the hell up?

Why does it always have to turn into a 'well the US has waiting lists too.'

There are waiting lists here in Canada. Long waiting lists.

And trust me, if you needed knee surgery, you would be on a waiting list too. And if you lived in Manitoba and needed a MRI, you would be on a waiting list too.

There are problems here in Canada with our health care system that need to be fixed too. Standing on our pedestal and telling the whole world how awesome our health care is because our family received good health care doesn't change the fact that there are thousands of other people who can't receive that kind of care.

In fact, doing that is very similar to the people in the US who DO receive good quality health care, and they're standing on their pedestal too telling the whole world how awesome THEIR health care is. Despite the fact that there are people going bankrupt overnight paying for surgery that their insurance company refused to cover.

Someone is a little oversensitive. That's exactly the point I was trying to make. People in this thread earlier were talking about long waits in Canada and that is the chief problem of our system at the moment. Someone was asking how the system worked and if there was no alternative to waiting lists. There is none in Canada, unless your wait happens to be a 2 week wait which could be the case.

Conversely, in the US you can pay to jump the line but otherwise face similar wait times.

We were doing a good job of discussing this topic rationally until you came along and overreacted. You and I have argued over this before and vehemently support opposite systems but please try not to drag everything down into a pissing contest.

[Azure]

Originally Posted by Dan02

Your logic makes no sense to me. The US is "richer" then Canada on a per person basis, if they choose to tax differently that's their ball of wax but it's wrong to say the abiltity doesn't exist to raise the same level of funds.

Yes, there'd be 10 times the Albertans, but there'd also be 10 times the Quebecors...

And simply adding 10x more the people who will supposedly add 10x more tax revenue won't actually cover 10x the health care cost. Because the cost won't just be 10x more.

Low income people pay less taxes and still demand the same quality of care than someone who makes $400,000/year.

The tax rates would need to be adjusted to accommodate the differences, but there will always be a problem with having enough money.

I'm starting to become convinced that health care will always be a deficit creating social service. Trick is to minimize that deficit as much as possible. Or be a resource rich province like Alberta that can afford to spend more money on health care than other places.

[Azure]

Originally Posted by Cactus Jack

Someone is a little oversensitive. That's exactly the point I was trying to make. People in this thread earlier were talking about long waits in Canada and that is the chief problem of our system at the moment. Someone was asking how the system worked and if there was no alternative to waiting lists. There is none in Canada, unless your wait happens to be a 2 week wait which could be the case.

Conversely, in the US you can pay to jump the line but otherwise face similar wait times.

We were doing a good job of discussing this topic rationally until you came along and overreacted. You and I have argued over this before and vehemently support opposite systems but please try not to drag everything down into a pissing contest.

In the US if you have good coverage, you get good care. I know from family and friends down there that have good plans that they have never seen a waiting list in their life.

For any kind of surgery. Knee, Hip, etc, etc.

The problem in the US is cost, and as an extension of that, access. If you have money you get access. If you don't have money you don't get care. Assuming you're not covered.

There are ways to bring down those costs. Its just that nobody wants to go down that road.

[Flame Of Liberty]

Originally Posted by Cactus Jack

If we had 300 million people, the only thing that would go up would be the administrative costs but the system would still be what it is today, thankfully. 10X the people means 10X the tax revenue to run it. Take away the resources? Why would you do that when they are here? That is the backbone of the Canadian economy, that would be like saying take away money and shut down all for profit companies in the US.

Because not every country is sitting on oil&gas. Just like Chavez can run his little socialist miracle because his country is floating on gas, Canada can run more expensive health care system and revenues from natural resources can hide flaws and cost ineficiency. However that system is not universaly applicable to a random country which doesn't have the benefit Canada has. Ie you cant really boast that Canada has some kind of a great universal system in place.

[LChoy]

Originally Posted by Cactus Jack

Someone is a little oversensitive. That's exactly the point I was trying to make. People in this thread earlier were talking about long waits in Canada and that is the chief problem of our system at the moment. Someone was asking how the system worked and if there was no alternative to waiting lists. There is none in Canada, unless your wait happens to be a 2 week wait which could be the case.

Conversely, in the US you can pay to jump the line but otherwise face similar wait times.

We were doing a good job of discussing this topic rationally until you came along and overreacted. You and I have argued over this before and vehemently support opposite systems but please try not to drag everything down into a pissing contest.

See post #45

[mykalberta]

You can jump waiting lines in Canada.

Its called flying down to the US and paying for it out of pocket. I have done it with a knee injury I got durring football, my dad has done it, my grandpa did it. Its very easy, just book a flight to Seattle or Portland or drive down to Spokane.

Also, I think the system is just fine in Canada. You cannot expect instant service in a public system because going for such a goal would mean wasted money in downtime waiting for another one. Waiting lists are something that is prudent to have to control spending. Its not the existence of waiting lists, just the time that needs to be debated IMO.

[Cowperson]

Originally Posted by mykalberta

You can jump waiting lines in Canada.

Its called flying down to the US and paying for it out of pocket. I have done it with a knee injury I got durring football, my dad has done it, my grandpa did it. Its very easy, just book a flight to Seattle or Portland or drive down to Spokane.

Why don't we figure out a way to offer those services and generate that revenue in Canada while maintaining the core of the same system?

Answer: Shrill hysteria.

Cowperson

[mykalberta]

Hahaha,

Friends of Medicare up here is like PETA in the US - both are equally as crazy.

Also, people in Canada believe everyone one was created equally and as such should be treated like that

[LChoy]

One in five Canadian children were considered obese between the ages of two to 11, according to a six-year survey released Wednesday by Statistics Canada

The study also found that at the start of the survey, 19 per cent of the children were overweight and 18 per cent had been considered obese. At the end of the six years, 14 per cent of the girls and 11 per cent of the boys were obese, according to their BMIs.

The University of British Columbia researchers who did the survey said the data shows a need to curb childhood obesity, which is linked to many pediatric health problems and may be an indicator of ailments in adult life.

http://www.calgaryherald.com/health/...306/story.html

Chronic and complex illness is a large drain on our health system. Unfortunately during times of bad economy, we tend to spend more on the acute side (beds, doctors, waiting lists) than on the prevention promotion side of things.
There will be further challenges coming as the population is aging, as well as the provider population. The new health workforce are not working as long hours as the older generation (avg family doctor works 3.4 days a week in parts of Calgary).
I think we all know this that's it's better to take care of ourselves now, than be treated later. However our lives have become increasingly complicated and busy that it sometimes hard to eat right and exercise

[vicphoenix13]

Originally Posted by Flame Of Liberty

And who wrote and passed the legislation that allows them to do that?

Private corporations infiltrate the American government with lobbyists who buy votes from politicians. The problem is that most right wingers in America are hypocritical when they say they don't want government intervention in health care. Sorry, but the government already allowed insurance companies to scam the system by deregulating the industry. Government got involved to help greedy insurance companies and consumers got screwed.

[jammies]

Originally Posted by Azure

Sure, you can adjust the tax numbers to try and accommodate them. But in the end, providing health care for 10x more people would cost a lot more money than can be gained by the taxes gained from having a 10x bigger population base.

On what do you base this claim? The corollary would be that in a country 10x smaller than Canada, the money spent on health care would be more than 10x less - and eventually, if you were a country of one, health care would be practically free.

There are large fixed costs that are the same no matter what level of health care you are providing - hospitals and clinics need to be constructed, drugs need to be bought, diagnosis machines purchased, etc. Then there are the human costs of staffing and administration. Nowhere does that cost MORE than 10x as much to serve 10x as many people; properly run, economies of scale should make it LESS costly for things like administration.

On the flipside, sufficiently large organizations have a tendency to not be properly run, which usually obviates the theoretical cost savings, and also tend to be inflexible, which can cause problems if you are trying to deliver a service in many different locations with different local needs. So you have to balance between being too small, and being too big.

If *I* were in charge of creating such a system, I would set it up in some ways much like a Walmart or Costco - all purchasing would be through a central agency to allow that agency to drive the costs of expensive medical equipment and drugs down. In other ways it would be much more like a municipal government model, where there would be thousands of local *elected* health organizations responsible for delivering health care and universal insurance in their area, and supported by a budget drawn half from local tax and half from federal funding derived from a per-capita flat rate, which would serve to somewhat alleviate the inevitable difference in funding available in poorer areas from richer ones.

Private hospitals and clinics would be allowed, but would have the choice of working within the system at scheduled rates and with budgetary transparency, or outside the system entirely. Much like we have in Canada now, doctors would work under the aegis of the local health authorities, and would bill directly to that authority.

I think the key is to identify what needs to be organized on each level, and divide the responsibilities appropriately. I also think that elected health boards are important, as that drives accountability.

[starseed]

Bill O'Reilly today:

O’REILLY: The public option now is done. We discussed this, it’s not going to happen. But you say that this little marketplace that they’re going to set up, whereby the federal government would subsidize insurance for some Americans, that is, in your opinion, a public option?
OWCHARENKO: Well, it has massive new federal regulation. So you don’t necessarily need a public option if the federal government is going to control and regulate the type of health insurance that Americans can buy.
O’REILLY: But you know, I want that, Ms. Owcharenko. I want that. I want, not for personally for me, but for working Americans, to have a option, that if they don’t like their health insurance, if it’s too expensive, they can’t afford it, if the government can cobble together a cheaper insurance policy that gives the same benefits, I see that as a plus for the folks.

[Azure]

I thought O'Rielly was a loon?