Sicko

[Cowperson]

It's Wikipedia, so be very careful, but likely a less biased comparison of the USA/Canadian health care systems than a Michael Moore film.

http://en.wikipedia.org/wiki/Canadia...stems_compared

Truth is, there are scare mongers on both sides of the equation that are effectively paralyzing reforms in both countries . . . . and both countries could probably learn something beneficial - as well as things to avoid - from the other.

That is what is somewhat remarkable about Hillary Clinton's position, that a form of universal healthcare is coming to America . . . . a genuine ball breaker.

Meanwhile, if you're willing to pay, there is a growing market for very cheap but largely effective complicated surgeries in places like India, allowing you to escape back breaking costs in America or paralyzing wait times in Canada.

Cowperson

[Thunderball]

I think we all know about Michael Moore's typically underhanded approach to making "documentaries" that have more in common with war-time propaganda than something you'd see on the Discovery Channel.

But its not about attacking the creator as much as the problems in the US system. Although, when you compare the worse of the US system with the best of Canada's, you're not exactly dealing in fact, as both have their fair share of shortcomings.

I only wish he (and others of his ilk) would show the shortcomings of all the healthcare systems in NA and Western Europe, as well as their obvious benefits... then its a starting point for real and positive discussion. Sadly, that's not the MO of Moore, and that's most likely not what "Sicko" is going to be about either.

[NuclearFart]

Sounds like an interesting movie, but Mr. Moore is in my opionion notorious of skewing and omiting pertinent details to "strengthen" his arguments. Was there any comment on sustainability of these systems? The canadian health care system is NOT sustainable from a fiscal perspective, and it will only get worse with increased demands from aging baby boomers and the rise of obesity.

And not to be an ass, but if your dad worked most of this entire life in the states and paid taxes there without any to the canadian governement, and now wants to retire in Canada to use our already limited health care.....he's a large part of the problem.

Agreed about the exorbant student loans we acrue in medical school (average debt of a graduating medical student is close to 100,000 now, and rising) and subsequent lack of aid/incentive we get from the government. Interest starts (at about prime + 2) when we graduate and payments start six months later. On a residents salary of ~50 K / year working 60 - 80 hours a week for a minimum of 2 years, it really doesnt instill much love or loyalty for the government. A minimum of 10 years of post secondary education for that? I can understand why some of my colleagues would pursue more lucrative venues or locations. Debt relief for agreement to terms of work in a province would be a good idea in theory, but it's not as easy as that. Where we end up after graduating all depends on where we match for residency which is a very competitive process and very much out of our hands. Some provinces (mainly NB) have stepped up and guaranteed a residency training spot in agreement to work 5+ years after finishing, but this does nothing to address the medical school component.

Being a GP is one of the worst doctors to be from a fiscal sense. They are definitely the least compensated for their time, especially considering they have the highest overhead costs of all doctors (~45-55% of their income). The way the current fee for service is set up, it encourages GP's to hammer patients through at a pace of 5 minutes per patient and limiting each visit to one complaint. If they don't, after taxes and overhead many GP's are making as little as 60-80K per year. That's really not very much for so much schooling, and seeing GP's in the states make triple that for half the work...

Some of the annual billing caps mentioned are also present but much more applicable to the higher paying specialist side. I do see colleagues working to that limit and then taking vacation time. And why shouldnt they?
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Yamaha Xs750 Specifications

[Tron_fdc]

Originally Posted by NuclearFart

The way the current fee for service is set up, it encourages GP's to hammer patients through at a pace of 5 minutes per patient and limiting each visit to one complaint.

So why does it take 4 hours at a clinic, with 8 people in the wait room? Too much time on CP?

I keed I keed


One thing that annoys the sh*t outta me is I have to go to a doctor to tell me I have a wrecked knee (which I knew) so he can write a prescription for physio, so I can claim it on my healthcare. I'm wasting his and my time to do it. I'm sure there's a reason for it, but it makes me stay away from the doctors office when I have medical issues.

You touched a little on subsidizing schooling; what if they were subsidized nationally? ie you agree to practise in the country for school grants?

[Bring_Back_Shantz]

Originally Posted by fotze

Also is it true that there are prescription quotas where if you subscribe X amount of Zomig you can go to a "Migraine Symposium" in Hawaii?

That kind of thing used to be the case in the States, but the rules have since changed to prevent hospitals/doctors from getting incredibly huge benefits from purchasing/prescribing certain drugs.

In Canada, the government negotiates and dictates the price of drugs, so doctors don't really get exposed to that type of thing as much.

[Tron_fdc]

Originally Posted by Bring_Back_Shantz

That kind of thing used to be the case in the States, but the rules have since changed to prevent hospitals/doctors from getting incredibly huge benefits from purchasing/prescribing certain drugs.

In Canada, the government negotiates and dictates the price of drugs, so doctors don't really get exposed to that type of thing as much.

Yeah, from my experience in Asia it's much easier....you just fork over a bunch of cash and everyone's happy.

I agree with fotze though. WTF is going on? I sit in the same wait area for 3 hours, go to the holding cell to wait a bit more, see my doc for 5 minutes, and leave to the same people in the wait area. Is there a code red everytime I go in? People dying? Are the nurses getting shagged?

I'm not upset at it, I'm just kind of curious.

[Cowperson]

Maybe I wear better deodorant than you guys, but anytime I need a doctor appointment I ask for the first appointment in the morning and I pretty much stampede right in . . . . . almost no wait. And that's for a doctor who is so busy he doesn't take new patients anymore.

Try asking for the first appointment of the day.

Cowperson

[BlackEleven]

Originally Posted by HOZ

Umm.... maybe you should try and understand my quotes before trolling me.

I did attack Mikey's movie quality. He does not even have the slightest integriy, honesty or fairness whatsoever. (Attacking the quality of the movie)

I didn't say his movie sucks because he is a champaigne-socialist wanker and hypocrit that lives in a 80,000 a month apartment in Manhanttan. (ad-hominem)

Understand?

From your own words:

Ad hominem - the attack on the person and not his ideas

You said Moore's movie quality is bad because he "does not even have the slightest integriy, honesty or fairness whatsoever". Without seeing the movie you have already dimissed the message based on your opinion of its creator.

I did attack Mikey's movie quality. He does not even have the slightest integriy, honesty or fairness whatsoever. (Attacking the quality of the movie)

If you were really attacking the quality of the movie and not Moore, why begin your sentence with 'he', a pronoun refering to a person, instead of 'it', a pronoun refering to a thing.

This is not specifically directed at you -- there is a lot of it in this thread -- but I don't think its fair to dimiss everything this movie has to say, before even seeing it, based solely on one's opinion of Michael Moore.

[Azure]

Thing is...how the heck does the US afford universal health care? IIRC, they already pay more person, or is it per capita than Canada?

You're looking at trillions of dollars if you want universal health care. In Britain...they had to contract out certain surgeries to private companies because the public system couldn't keep up with them.

Maybe that is what Canada should do....

Another thing...I've done IT work at the local clinic...it is simply mind-boggling how much the doctors sit around.

And didn't Castro go to Spain for medical help? Or is that simply a rumor?

[NuclearFart]

Originally Posted by Tron_fdc

So why does it take 4 hours at a clinic, with 8 people in the wait room? Too much time on CP?

I keed I keed


One thing that annoys the sh*t outta me is I have to go to a doctor to tell me I have a wrecked knee (which I knew) so he can write a prescription for physio, so I can claim it on my healthcare. I'm wasting his and my time to do it. I'm sure there's a reason for it, but it makes me stay away from the doctors office when I have medical issues.

You touched a little on subsidizing schooling; what if they were subsidized nationally? ie you agree to practise in the country for school grants?

Well, so you knew you had a wrecked knee and perhaps 50% of the time its as simple as that. Still the MD has to act as a bit of a gatekeeper on these limited resources you require there after. There is not enough subsidized physio/meds/ct's...etc to go around that any yahoo should walk in off the street and obtain whatever he thinks he wants. The role of the MD in this situation is to dispense such resources appropriately and fairly so we can all get it if/when we need it. Furthermore, is your knee damage appropriate for a referral to an orthopedic surgeon for urgent surgical repair? Maybe it is, but it can wait 1 month. You aren't going to be able to make that decision.

The other side of the coin, is that what if there is more to your knee than it just being wrecked? What if you had a bone tumour which made your knee more succeptible to minor trauma causing the destruction? What if you're a hemophiliac and you've bled into the joint space? What if there is a concurrent infection of the knee that will cause further damage if left untreated? What if you've actually have a first onset flare up of rheumatoid arthritis causing your wrecked knee? The list of what-ifs goes on and on and the MD is there to assess these what-ifs. You as a patient don't know, what you don't know.

With regards to wait times, alot of that is a product of the system. As I've said an afternoon might be booked in the ideal "5 min / patient" system, but as is often the case this never works out. The so called hand-on-the-doorknob-consult whereby you think you are done with a patient and you turn to leave putting a hand on the doorknob and the patient suddenly says something like "oh by the way doc, I woke up this morning and my chest really hurts". Further time delays occur when an intial complaint is more serious than initially expected. Or the patient is a very poor communicator, or demented. The delays are multifactorial in cause, but that again is a product of the system. Should a doctor book less patients over more time? Well she/he's trying to make a decent living and the current system discourages anything but this. A salaried approach would be the solution to this, as long as it's competitive.

As for kick backs from the drug industry, there is very little of that in Canada. It's pretty regulated, and most doctors choice of prescription (when there are options), are dictated by the optimal therapeutic choice and whether or not the patient can afford it.

And yes, a national aid/susidization of medical school costs in exchange for guaranteed service contracts would be the proper way to go about it. The canadian army essentially offers this at the moment.
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house wives Webcam

[NuclearFart]

Originally Posted by Azure

Another thing...I've done IT work at the local clinic...it is simply mind-boggling how much the doctors sit around.

I have no idea where you might have seen that, unless you're exaggerating, or the GP has had alot of patient no-shows. Virtually all GP's I've worked with barely even have enough time to eat a sandwhich for lunch while standing, let alone sitting around. Unless you misinterpreted them reviewing charts or writting notes on each patient in the paperwork; paperwork which I should mention often doesnt get done until after work, often taking a couple hours to complete without payment.

And yes, as one astute poster has figured out, if you are the first patient to be seen, you will be seen on time because the day hasnt been bogged down yet.
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UNIVERSAL HEALTH

[The Unabomber]

[quote=ken0042;913552]My solution- free education for doctors. Have some sort of system in place that for every two or three years of practicing medicine in their home province, they write off one year of schooling costs.

I have known people who became doctors and are faced with almost $100K worth of student loans. Their solution is to find the quickest way of paying those off. If they know that they never have to pay them off, then all of a suddent they aren't looking at starting their practice elsewhere.

I really don't understand why the Canadian government doesn't want to recognize educated immigrants that move to Canada. Why do we have a doctor that practised in another country cleaning floors of an office building? Why not put him through a 3-6 month course to ensure that he is on the same page with the other doctors in this country and let him start working. That would give us more manpower right now, then with something in place like Ken said above we would be working towards something better.

[burn_baby_burn]

Moore was on Howard Stern this morning. Very interesting interview. I am as right wing as they come. But I love his films. Like he said on the radio this morning. It is his opinion. And the movie is shot from his point of view. You need to keep that in mind when you watch his films.

An intersting point he made on the Stern Show. One of Sterns employee's who is Mr. Right Wing Republican came into debate Mr. Moore on his new film. The Stern staffer said that if a person cuts his finger off, he should have to pay to have it sewn on with his own money. The tax payers should not have to pay for that. Mr. Moore asked the staffer who would flip the bill if his house was on fire and the fire department came and put it out? Do the fireman ask for payment up front before they put the fire out? He said the fire department is socialist and Americans don't have a problem with it. So why does America get so upset about universal health care?

[Tron_fdc]

Originally Posted by fotze

Good post Fart, you killed Tron there.

We are all just curious of these things that you would never be able to ask because it would come across poorly. Is it safe to assume the elderlyier the patient the more time it takes?

Also, cow, I agree, morning appts are far superior.

As if man, I knoiw WAY more than a GP when it comes to my injuries..

I've always wondered WTF was going on behind the scenes. Not like I'd ever ask my doctor though, for fear of him prescribing ultra strength laxitives and not painkillers.

[Azure]

Originally Posted by NuclearFart

I have no idea where you might have seen that, unless you're exaggerating, or the GP has had alot of patient no-shows. Virtually all GP's I've worked with barely even have enough time to eat a sandwhich for lunch while standing, let alone sitting around. Unless you misinterpreted them reviewing charts or writting notes on each patient in the paperwork; paperwork which I should mention often doesnt get done until after work, often taking a couple hours to complete without payment.

And yes, as one astute poster has figured out, if you are the first patient to be seen, you will be seen on time because the day hasnt been bogged down yet.

No...I'm being dead serious. I ate lunch with them at times...and was in basically every room installing network stuff...they sat around, a LOT.

Now is it a problem? I always get in my appointments -5 +5 min how it was scheduled.

[guzzy]

Originally Posted by Slava

Well in Alberta we just believe that we can't afford to keep what we have, let alone to do better. To me this whole thing comes down to priorities though...we will spend money on ways to kill and maim people (national defence), but refuse to acknowledge that the same amount of good could be done by looking for ways to help and heal people.

National defence is a need not a want. Our health care system isn't underfunded, it is being dragged down by bureaucracy. Our system is in the top ten percentile for publicly funded systems but it performs in the 70 percentile. That shows the problem isn't funding, it is much larger than that. To say we need more money in health care and less on defence is just an uneducated statement.

[guzzy]

[quote=The Unabomber;913960]

Originally Posted by ken0042

My solution- free education for doctors. Have some sort of system in place that for every two or three years of practicing medicine in their home province, they write off one year of schooling costs.

I have known people who became doctors and are faced with almost $100K worth of student loans. Their solution is to find the quickest way of paying those off. If they know that they never have to pay them off, then all of a suddent they aren't looking at starting their practice elsewhere.

I really don't understand why the Canadian government doesn't want to recognize educated immigrants that move to Canada. Why do we have a doctor that practised in another country cleaning floors of an office building? Why not put him through a 3-6 month course to ensure that he is on the same page with the other doctors in this country and let him start working. That would give us more manpower right now, then with something in place like Ken said above we would be working towards something better.

Great post. I agree with the immigrant statement. Our govt needs to start closing the gaps with skilled immigrant workers in our country.

[Hack&Lube]

-edit double post

[Hack&Lube]

This film is complete propaganda like all other films by Moore. It's highly sensationalistic and full of many inconsistencies and glossing over of realities.
His visit to Cuba, for example was highly irregular and there are websites out there that show what the true average Cuban hospitals look like and it can be grim.

That said, the film is based on earnest grains of truth and it is a powerful film indeed. For a population who needs something dumbed down and dramatized like Moore presents it, it is the proper tool to really make people stop and think about how things are being run because there is an essential problem there and I shudder to think what it would be like to exist in the U.S. Health Care system and how people fundamentally treat each other.

Originally Posted by Azure

Thing is...how the heck does the US afford universal health care? IIRC, they already pay more person, or is it per capita than Canada?

The U.S. system wastes billions and billions in the accounting, bureaucracy, legal, and infrastructure of maintaining their private system with HMOs and all the red tape. Trim that off, stop making doctors and nurses thinking about being their own bill collectors, feeding lawyers, paying millions of insurance investigators, cutting out trillions of forms, paying astronomical salaries to private companies and medical company CEOs...and you'd probably have a maintainable system after several years.

The main problem is that the U.S. system is so broken and the lack of proper medical treatment is so historically engrained that there has been no preventative treatment and there are many, many, many more chronically sick people who were just never able to get help...and it would flood and crush a universal system if they tried to implement it from the start.

I look at my grandparents who have gotten free preventative medical treatment for decades up here in Canada and I shudder to think what it woudl be like if they could never afford that over all these years and their problems just piled up and got much worse over time. The worse the condition, the more geometric the rate of costs to provide proper treatment.

[HOZ]

Originally Posted by BlackEleven

From your own words:


You said Moore's movie quality is bad because he "does not even have the slightest integriy, honesty or fairness whatsoever". Without seeing the movie you have already dimissed the message based on your opinion of its creator.


If you were really attacking the quality of the movie and not Moore, why begin your sentence with 'he', a pronoun refering to a person, instead of 'it', a pronoun refering to a thing.

This is not specifically directed at you -- there is a lot of it in this thread -- but I don't think its fair to dimiss everything this movie has to say, before even seeing it, based solely on one's opinion of Michael Moore.

Fair enough, maybe for clarity I should have used "it". But he is the creator/ director/ producer/ etc. If he has no integrity, etc. How the heck would any creation of his have any being that he is a creator of "documentaries"? I have seen enough of his "documentaries" to know that that Leopard hasn't changed his spots.