Gary Mar wants private health care in Alberta

[joe_mullen]

Originally Posted by SebC

I'd suggest this means we need to pay GPs more, or specialists less, to fix the market imbalance that stems from fixed prices.

there is something to that. i think you also need to provide medical students with more exposure to family medicine during their "formative" years and sell them on the benefits of being a family physician (better hours, no/limited call).

[Sr. Mints]

I forked out $770 I didn't really have for an MRI last November, because I'd still be waiting for one. I waited 36 hours for that MRI, and the whole situation soured me on the system we have now.

Had I not paid for the MRI, I wouldn't have gotten into three specialists I currently see, would not have had my humungous bladder diagnosed, and would be receiving treatment for chronic pain.

I'll admit that I am rather ignorant on the subject, but I'm not a fan of a two-tiered system based much on what I know of the American's system. Unless you need acute care (and I think our current system isn't so broken that people who are in need of acute care aren't getting exceptional treatment--cause I believe they are) what we have now needs some kind of fix.

[SeeBass]

I dont get what the big deal is about private health care.

If there are 10 people waiting in line and two people leave the line and go elsewhere are there not only 8 people in line?

These people pay taxes for a product they will not use, is this not a great result too?

So what if one building takes cash and another doesn't. Set the pricing structure then if it is a concern about a mass exodus of public employees to the private structure. If they limit the price for certain procedures would it not help keep the gap of wages close to being competitive?

There are many of us that look down on the US system as being an island of stupidity for not keeping up with the rest of the world. Then I don't see how we can not look at ourselves as being just as silly for not having both options like the rest of the planet too.

[FFR]

I think, as it currently stands, specialists and surgeon's in Alberta are given a specific budget - or number of surgeries they can perform each year. Once they have used all of those surgeries, they cannot do any more (whether they have the availability or not). This is due to funding amounts. (On a side note, I agree that non-medical professionals in the health care field need to be slashed.) I work in an industry where we deal with specialists and surgeons regularly - this is my understanding of the system, though if I'm wroing, please correct me.

In any case, I think a two tiered system could work as long as you set boundaries and say that physicians/specialists/surgeons have to fill their quota in the public system in order to offer private services. This way, the level of service to the public system stays the same and the specialists can fill their year with persons willing to pay through a private system.

[joe_mullen]

Originally Posted by SeeBass

I dont get what the big deal is about private health care.

If there are 10 people waiting in line and two people leave the line and go elsewhere are there not only 8 people in line?

These people pay taxes for a product they will not use, is this not a great result too?

So what if one building takes cash and another doesn't. Set the pricing structure then if it is a concern about a mass exodus of public employees to the private structure. If they limit the price for certain procedures would it not help keep the gap of wages close to being competitive?

There are many of us that look down on the US system as being an island of stupidity for not keeping up with the rest of the world. Then I don't see how we can not look at ourselves as being just as silly for not having both options like the rest of the planet too.

except, now you have even less doctors to take care of those 8 people in line. while a two-tiered system does work quite well in other countries, it wouldn't fix any problems here until there are enough doctors and their distribution amongst the specialties/primary care evens out.

[Slava]

Sure, lets have two tiered healthcare, but base it on something other than money. We could base it on age, sex, weight, where you were born, whatever. It would accomplish roughly the same thing though in terms of stream-lining things.

Someone is bound to tell me how dumb this is. "Its not fair", "You can't control those factors", "Why does a woman get healthcare before a man....just because we have a penis?" or "But those factors have nothing to do with health". Well in reality having more money has nothing to do with health either. There is no reason that a guy who can cut a cheque should get healthcare first. I say that as a guy who could afford to cut said cheque....

[VladtheImpaler]

Originally Posted by afc wimbledon

doctors still use leaches in Alberta, ye gods!!

In fact, they do. A friend of mine goes into the PLC every month or so to get said treatment.

Don't we have a two-tiered system already, in that anyone that can afford it, and doesn't want to wait, goes south of the border, or even India (fertility treatments), to get medical care? Why should others benefit from this economic activity? Why not keep the money here?

One argument is "well, there will be even less doctors in the public system because a portion will 'defect' to the private sector". But, remember the operation of the market... If there are more opportunities to make money here, there will be more doctors and more nurses, who either come here, or stay here, when they would have left otherwise. It's obviously a very complex dynamic, and hard to predict exactly how the balance will work out. But I do know it's too simplistic to say "there are only 100 doctors, and if you introduce private care, 25 of them will leave the system". There might now be 105 doctors or a 115. Will the percentage of patient units (individual procedures) leaving "public" for "private" be the same or less/more? These are tough questions.

However, I see it as elementally fair that if someone wants to pay, they should be able to do so. People cry that it's not "fair" for the "rich" to get better (faster?) care. Why? The "rich" can get better houses, better cars, can send their kid to Harvard as opposed to U of C, etc, etc, so what's the harm? Is it just jealousy, and you don't want your neighbour to be able to do something that you can't afford?

There is already a "private" tier in place that few of you know about. I can send a client of mine to a "public" specialist (most commonly orth. surgeon) and I guarantee that he will see my client before he will see you because I pay him $3,500 to do so. The trick used to get around the restrictions is that it's called an "assessment" as opposed to "treatment", but the effect is no different than having a two-tiered system.
What about that other second tier in our system - corruption (for lack of a better term)? Anybody with friends or family "inside" the system can and does jump the line when they need to. Because I have the aforementioned business relationship with specialists, I can get surgery on very short notice, and I will jump ahead of you, and you will pay for it. The list goes on...

So, I say, might as well bring it out into the open and call it what it is. Let the people who want to pay cut the cheque. Someone more knowledgeable in the workings of health policy than I am can design an efficient framework I believe...

[4X4]

I don't know what needs to be done, but something sure as hell has to be. In the last year, I've become pretty acquainted with the health care system (taking the same person to the hospital for a few different reasons), and it's ridiculous how long wait times are.
If that's what "free" is getting me, then sign me up to start paying. Bring back AHC premiums, bribe doctors, kill puppies, I don't care, just get our clinics and hospitals staffed.

This reminds me that the only thing I do miss about my BB is Word Mole.

[Kavvy]

Originally Posted by Dion

There's nothing stopping a person from crossing the border into the States to get the quicker treatment he/she wants.

Canada has the best heathcare system in the world. We have a very decent public system, which allows us free to cheap decent healthcare, for everyone. Additionally, if you would like to cough up the extra bucks for some of the best heathcare quality, you head down to the states and pay what they pay.

This 1 way reletonship is very unique. I don't know of any other country in the world that has citizens that can choose between two healthcare systems so easily. Why create a new private option when we already have one south of our borders?

[GreenTeaFrapp]

Originally Posted by 4X4

I don't know what needs to be done, but something sure as hell has to be. In the last year, I've become pretty acquainted with the health care system (taking the same person to the hospital for a few different reasons), and it's ridiculous how long wait times are.
If that's what "free" is getting me, then sign me up to start paying. Bring back AHC premiums, bribe doctors, kill puppies, I don't care, just get our clinics and hospitals staffed.

Maybe it's an Alberta thing but in Ontario I've never had a long wait when I needed medical attention. You should try moving to Ontario.

[peter12]

A fair and balanced two-tier system, of the like seen all over the developed world (minus the USA), could only be a very, very good thing for all Albertans.

[GreenTeaFrapp]

Originally Posted by fotze

or at least move less of our money to Ontario.

Ah, you Albertans wouldn't know what to do with that money anyway. You'd probably just waste it on a new rink for the Oilers.

[Jedi Ninja]

^ It's almost like the Alberta government is intentionally trying to make the system look bad. Calgary is especially brutal.

I have a special hate-on for Calgary Lab Services, even with the new appointment system, it's a complete joke. I'd be totally in favour of allowing Labcorp to operate up here.

[Fire]

Sounds like a good idea to me, plus we should be adding user fees to public health care system.

[Vansmack]

I have always thought a two tiered system would be an attractive option so long as there is a stipulation stating that a doctor can only work a certain percentage of the time privately. I think it would provide more incentive for doctors to move to Calgary. I also think that the private care should be heavily taxed with extra money moving to increase the quality of public care.

Basically, the only way I support this is if the current level of care in the public system is improved.

[LChoy]

Just a quick nitpicky thing

I use to work for Alberta Health and Wellness in Primary Care, so I studied and develop policy for this type of stuff

First off, technically speaking, all of our health care is delivered privately but publically paid. The doctor that sees you don’t work for the state, they work for themselves. However, you don't pay them directly; your physician (or medical assistant) instead bills AHW for the cost of your visit. AHW pays for all of this out of government revenue including taxes and royalties.

The idea that Gary is proposing is that physicians can charge the patient directly for services provided rather than wait in the public line. Currently under the Canada Health Act, physicians are not allowed to charge for services that are covered under the Universal Health Services. This is why people go to the States or other forms of medical tourism. As mentioned above, there are ways to get around this too (ie if a member of the flames wrench their knee, the team has specialists and MRIs).

Our public pay system is a source of national pride in our country. There are sensitivities when people mention change to it. However, from a policy planning perspective, we look to the more successful OECD countries like France and Scandinavia. Realistically speaking, the top performing countries in health care have a mix of public and private payer.

To combat other health services from moving away from the public system, each country sets up a combination of policies and mechanisms to ensure a balance. These include allowing full practice roles for health professionals (ie allowing nurses to perform physicals and most common procedures), different pay structure (salary vs Fee for service), government partnerships with private clinical outfits, expansion of home care and community health services...etc

In Alberta, there are a lot of things we look at to improve the system here including the examples I mentioned above. Other things to consider though:

- Increase more chronic disease and mental health issues away from the hospital. There can be a thousand ER doctors and nurses working at the Foothills, but doesn’t matter if there are no beds upstairs to move them out of the ER
- Develop universal standards with allied countries to facilitate foreign health workers to practice in Canada. Most health workers already have the knowledge and background, they would need the technical skills with our equipment and protocols. Popularize the intern system with these foreign health workers similar to what we do with medical interns and residence. After which, foreign professionals write the Canadian medical practice exam and can begin practicing here in Canada

[You Need a Thneed]

I don't get the whole 2 tier debate. We already have two tier health care, period.

Isn't Alberta the province where there is the least private health care? Or close to it?

[chemgear]

Originally Posted by SeeBass

If there are 10 people waiting in line and two people leave the line and go elsewhere are there not only 8 people in line?

These people pay taxes for a product they will not use, is this not a great result too?

It is the 8 people left in line that scream bloody murder and demand that the other 2 get dragged back in line like everybody else so that the line is now longer but is also "more fair."

[Devils'Advocate]

Originally Posted by SeeBass

I dont get what the big deal is about private health care.

If there are 10 people waiting in line and two people leave the line and go elsewhere are there not only 8 people in line?

These people pay taxes for a product they will not use, is this not a great result too?

So what if one building takes cash and another doesn't. Set the pricing structure then if it is a concern about a mass exodus of public employees to the private structure. If they limit the price for certain procedures would it not help keep the gap of wages close to being competitive?

There are 10 people in a grocery line being served by two cashiers and we decide that one cashier will charge a premium for faster service, say a $10 surcharge. So 2 of the 10 in line decide to pay the extra money for faster service.

Is the guy 8th in line better off now since he is no longer 10th in line? I'd rather be 10th in line being served by 2 cashiers rather than 8th being served by 1.

Or are you absolutely assuring me that the number of health care workers in the public system will remain exactly the same?

I also think it is a human rights issue. I do not believe that the man with $1,000,000 in his bank account deserves to get his pacemaker before the man with $10 in his. Your worth as a human being is not determined by your net worth.

[VladtheImpaler]

Originally Posted by Devils'Advocate

There are 10 people in a grocery line being served by two cashiers and we decide that one cashier will charge a premium for faster service, say a $10 surcharge. So 2 of the 10 in line decide to pay the extra money for faster service.

Is the guy 8th in line better off now since he is no longer 10th in line? I'd rather be 10th in line being served by 2 cashiers rather than 8th being served by 1.

Or are you absolutely assuring me that the number of health care workers in the public system will remain exactly the same?

I also think it is a human rights issue. I do not believe that the man with $1,000,000 in his bank account deserves to get his pacemaker before the man with $10 in his. Your worth as a human being is not determined by your net worth.

Fallacious on several counts.

1) You are assuming there won't be more providers attracted by the income potential. That is plainly wrong, though the exact numbers are tough to project.

2) You are confusing human rights with envy.

3) The person with the $1M will get his pacemaker first regardless. He'll get one in USA. At least this way, the economic benefits of this activity will stay in Canada.