Gary Mar wants private health care in Alberta

[GreenTeaFrapp]

Originally Posted by VladtheImpaler

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.

If the limiting factor is the number of doctors, I doubt that privatization will increase the supply. I highly doubt that many people who have medical aspirations don't become a doctor because doctors don't make enough money.

[Coys1882]

I don't understand why the pay service clinics can't still be under the CHR umbrella. What does the doctor care then which one he works at? If he's being paid the same regardless they won't all flood to private clinics would they?

This all comes down to 'I don't like rich people having more than me.' Personally if I couldn't afford it I'd rather people who can get out of my way.

[VladtheImpaler]

Originally Posted by GreenTeaFrapp

If the limiting factor is the number of doctors, I doubt that privatization will increase the supply. I highly doubt that many people who have medical aspirations don't become a doctor because doctors don't make enough money.

Come on - don't be thick. I am not saying more little kids will go to medical school.
I am saying more doctors/nurses will choose to practice in this jurisdiction than otherwise would have. Presumably, all those medical professionals we hear about moving to USA do it for the money, so if they could make more money here, some of them would stay. Similarly, some practitioners from socialist enclaves like Saskatchewan, Manitoba and the Maritimes , might be lured here by the prospect of more money... It's just like if Alberta suddenly decided to allow huge punitive damages in tort cases, like some US jurisdictions do. You can bet there would be more PI lawyers here as a result. How many? Obviously, impossible to predict, but economic forces dictate so...

[Azure]

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.

Imagine if all that money went into our economy instead.

[GreenTeaFrapp]

Originally Posted by VladtheImpaler

Come on - don't be thick. I am not saying more little kids will go to medical school.

I am saying more doctors/nurses will choose to practice in this jurisdiction than otherwise would have. Presumably, all those medical professionals we hear about moving to USA do it for the money, so if they could make more money here, some of them would stay. Similarly, some practitioners from socialist enclaves like Saskatchewan, Manitoba and the Maritimes , might be lured here by the prospect of more money...

But it's a zero sum game. If Alberta starts doing it then the other provinces, when they can't keep doctors, will start doing the same. When that happens, the number of doctors will be the same and only people with money will get better care.

I also don't think that competing with the US for doctors on the basis of salary will work out well. Especially when many might choose to move to the US because of other factors, like warmer weather.

[VladtheImpaler]

Originally Posted by GreenTeaFrapp

But it's a zero sum game. If Alberta starts doing it then the other provinces, when they can't keep doctors, will start doing the same. When that happens, the number of doctors will be the same and only people with money will get better care.

I also don't think that competing with the US for doctors on the basis of salary will work out well. Especially when many might choose to move to the US because of other factors, like warmer weather.

Of course it's a zero-sum game. But what do I care about Manitoba and New Brunswick? Alberta benefits. Albertans have more money if they try match, so, again, we come out ahead.
Again, I didn't say all doctors/nurses will stop going to the US. I said "some". Given that most of us assume that quality of life is better here, allowing people to earn more here will certainly keep some of them from leaving. Obviously, those moving to Oklahoma because they love tornadoes will still leave.

[Slava]

So Vlad how do you keep doctors in the public system? The public system can't afford to match the private salaries (almost surely, otherwise we'd have no influx of doctors).

Also how do you stop the private clinics from just cherry picking the easy and cost efficient procedures? In that case the public system is still left holding the bag for the inefficient and costly procedures.

[VladtheImpaler]

Originally Posted by Slava

So Vlad how do you keep doctors in the public system? The public system can't afford to match the private salaries (almost surely, otherwise we'd have no influx of doctors).

Also how do you stop the private clinics from just cherry picking the easy and cost efficient procedures? In that case the public system is still left holding the bag for the inefficient and costly procedures.

Well, I said right at the end of the first post that someone with more expertise than I will have to design the framework. I suspect it's something along the lines of "you have to spend minimum of 75% of time within AHC" or "you have to give AHC 30 hrs/week, and anything extra is yours" or whatever. I suspect that the market will dictate which services the private sector provides... if there is a great deal of demand for orth procedures, I expect we'll see a lot of orth clinics... Obviously, there is a lot of demand for private MRI's now, so we have several private radiology providers...

[Slava]

Originally Posted by VladtheImpaler

Well, I said right at the end of the first post that someone with more expertise than I will have to design the framework. I suspect it's something along the lines of "you have to spend minimum of 75% of time within AHC" or "you have to give AHC 30 hrs/week, and anything extra is yours" or whatever. I suspect that the market will dictate which services the private sector provides... if there is a great deal of demand for orth procedures, I expect we'll see a lot of orth clinics... Obviously, there is a lot of demand for private MRI's now, so we have several private radiology providers...

Ya, I'm so far against private health that I'm the wrong guy to have this discussion with I suppose. It has zero to do with helping people and making the system work better, and everything to do with making money in anyway possible. I support that part of it just fine for business applications, but not for a service that everyone should have equal access to.

I agree that there are already examples of private care, and frankly its a disgrace that the public system has had to pay to use those facilities at times due to overloads of their own. I just think that public care is a necessity for the welfare of our citizens.

The problem is that as soon as you open the door for private clinics and doctors you are bleeding away the talent and resources of the public system. The best doctors will undoubtedly move, as well as the best adminstrators and best equipment will be there as well. Its not long after that the public system continues with de-insuring certain procedures and voila: no pay, no care. I hope we never see that day.

[VladtheImpaler]

Originally Posted by Slava

Ya, I'm so far against private health that I'm the wrong guy to have this discussion with I suppose. It has zero to do with helping people and making the system work better, and everything to do with making money in anyway possible. I support that part of it just fine for business applications, but not for a service that everyone should have equal access to.

I agree that there are already examples of private care, and frankly its a disgrace that the public system has had to pay to use those facilities at times due to overloads of their own. I just think that public care is a necessity for the welfare of our citizens.

The problem is that as soon as you open the door for private clinics and doctors you are bleeding away the talent and resources of the public system. The best doctors will undoubtedly move, as well as the best adminstrators and best equipment will be there as well. Its not long after that the public system continues with de-insuring certain procedures and voila: no pay, no care. I hope we never see that day.

Again, though, we already have a 2-tiered system as I pointed out. The "insiders" already get preferential treatment on the taxpayer. The insurance industry (of which I am a part) already gets preferential treatment by calling things by a different name. You know, it's like the old Soviet system. Yeah, everybody is nominally equal, but some are more equal than others.

Again, I believe that you can have a well-functioning combination of private and public, as demonstrated in Europe - this is a question of policy design. As I stated in the discussions about Obamacare, I believe universal government health care is the best system overall with a private option. No system is perfect and all have flaws. I think the American system is the worst of all (among the "have" nations).

[Slava]

Originally Posted by VladtheImpaler

Again, though, we already have a 2-tiered system as I pointed out. The "insiders" already get preferential treatment on the taxpayer. The insurance industry (of which I am a part) already gets preferential treatment by calling things by a different name. You know, it's like the old Soviet system. Yeah, everybody is nominally equal, but some are more equal than others.

Again, I believe that you can have a well-functioning combination of private and public, as demonstrated in Europe - this is a question of policy design. As I stated in the discussions about Obamacare, I believe universal government health care is the best system overall with a private option. No system is perfect and all have flaws. I think the American system is the worst of all (among the "have" nations).

Its a really limited two-tiered system at this point though? If I need a hip replacement or knee reconstruction though I'm on the list, right?

Honestly, I'm a total hypocrite when it comes to this. If I got a major illness I would be across the line getting treatment and pay for it. I just don't want the public system here to force people into that.

Its also great for a guy like me to say "who cares if it costs you $25 to go to a clinic, I'd pay." The reality is that for many families that is not an option. More people than we're aware of would be seriously debating what to do if it cost them money to go to a clinic; thats not a good way to keep a healthy and productive population.

[SeoulFire]

Every time I need some sort of health service I am reminded that you get what you pay for.

[VladtheImpaler]

Originally Posted by Slava

Its a really limited two-tiered system at this point though? If I need a hip replacement or knee reconstruction though I'm on the list, right?

It's 2-tiered in the sense that if you "know someone" you go first. If your wife or her best friend work for AHC, you'll go first. Because the surgeons make a lot of money doing business with me, I'll go first... The term is corruption. Perhaps not corruption in the Russian or Nigerian sense, where you pay a bribe, but certain people get preferential treatment...

[Hoj]

What also needs to be of funding focus is the issues that result in medical problems we have today that is over-burdening our health "care" system. Things like the social determinants of health are vastly under-funded. I understand that it is politically difficult to address issues that do not show immediate benefits and are more long-term in nature are a hard sell but it is truly what will alleviate our health care burdens in the future. Remember that health care or provision is not everything to do with us having good "health".

[Azure]

Originally Posted by Slava

Its also great for a guy like me to say "who cares if it costs you $25 to go to a clinic, I'd pay." The reality is that for many families that is not an option. More people than we're aware of would be seriously debating what to do if it cost them money to go to a clinic; thats not a good way to keep a healthy and productive population.

Health care spending is spiralling out of control because people are abusing the system.

Either you implement user fees to help pay for everything, or find some other way to control spending while still offering decent care, or you precious universal health care system is going down the drain because we won't have the money to pay for it.

[zuluking]

Originally Posted by Hoj

What also needs to be of funding focus is the issues that result in medical problems we have today that is over-burdening our health "care" system. Things like the social determinants of health are vastly under-funded. I understand that it is politically difficult to address issues that do not show immediate benefits and are more long-term in nature are a hard sell but it is truly what will alleviate our health care burdens in the future. Remember that health care or provision is not everything to do with us having good "health".

It never has been. It's about disease \ sickness management and emergent care. Nothing wrong with that, but promotion and care of actual health has very little to do with our current health care system.

[Azure]

If hockey players can have surgery on their blown out knee two days after it happens, while the rest of us have to wait for weeks on end on a waiting list, then we DO have a waiting list.

I suppose it is more fun to stick our head in the sand and keep on denying that our health care system is in dire need of reform, and if we don't do something about it soon, spending will grow to the point where we can't control it anymore.

Unless everyone loves sitting in a waiting room for 6 hours just to get 5 stitches.

Hell, I know a lot of people who aren't even bothering with preventive measures like a yearly checkup, including bloodwork and a complete physical because it is a massive headache to actually find a decent doctor at a clinic where you don't have to sit and wait even IF you have an appointment.

[Azure]

Originally Posted by zuluking

It never has been. It's about disease \ sickness management and emergent care. Nothing wrong with that, but promotion and care of actual health has very little to do with our current health care system.

But it should be more heavily involved in our public education system.

I know huge strides have been made to reduce the amount of drug users as well as smokers, but obesity is a huge problem, and it will become an even bigger drain on the system if we don't start educating our kids in such a way that they can actually reverse the trend.

[Slava]

Originally Posted by VladtheImpaler

It's 2-tiered in the sense that if you "know someone" you go first. If your wife or her best friend work for AHC, you'll go first. Because the surgeons make a lot of money doing business with me, I'll go first... The term is corruption. Perhaps not corruption in the Russian or Nigerian sense, where you pay a bribe, but certain people get preferential treatment...

Well that kind of thing will never be eradicated, its human nature. There are way more problems healthcare than this. Its no different than any other profession in that sense: friends with a hockey player = free tix, friends with a carpenter = cheap side jobs, friends with a stock broker = hot stock tips.

[SebC]

Originally Posted by Azure

I suppose it is more fun to stick our head in the sand and keep on denying that our health care system is in dire need of reform, and if we don't do something about it soon, spending will grow to the point where we can't control it anymore.

True, but other places that have private health care have the same problem with rising healthcare costs.

Originally Posted by Lchoy

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

If we still had the Calgary General, we (Calgary) would have roughly double the number of beds that we do now. Thanks for that, Ralph Klein and people who voted for him.