Coronavirus All Purpose Thread: The unnecessary Dumb Dumb 4th wave

[81MC]

Originally Posted by Azure

I have a hard time believing that competing with high American salaries are the reason we can't get more effective and efficient health care.

I would love to see some data on that.

From 2010.

2nd largest expense - prescribed drugs. More than double public health and research. Sounds about right

[calgarygeologist]

Originally Posted by Fuzz

Awesome, does that mean there will be one app that works across Canada for verifying?

Originally Posted by Firebot

Yes it will be standardized and tamper proof. Avoids all the provincial differences that was present and a question mark.

“I’m happy to confirm that all provinces and territories have confirmed that they will be moving forward with a standardized national proof of vaccination,” Trudeau said, speaking to reporters.

I'm not smart enough to understand this technology stuff but the QR codes and data are issued by the Provincial authorities. The only thing that the Government of Canada has done in terms of standardizing is the design/layout of the information and allowing the Canada watermark to be on the proof.

[opendoor]

Originally Posted by Azure

I have a hard time believing that competing with high American salaries are the reason we can't get more effective and efficient health care.

I would love to see some data on that.

All the data you need is the fact that we pay nurses 40-50% more than a lot of European countries but still have shortages.

People often bring up Germany as a model because they have an excellent health care system. Well, what is fundamentally different about their system that would introduce huge efficiencies if we copied it? Most doctor services are delivered privately (as they are in Canada), hospitals are mostly run by non-profits (vs. health authorities in Canada), and they have a mix of public and private health insurance (about 90% public). But like I said above most of the people on the private insurance are on it because it's cheaper for high earners (flat fee vs. % of income), so it's not bringing in more money through 2-tier care. In fact, as the chart above shows, Canada has more privately funded care than Germany does.

So the only real major difference is who runs the hospitals. Would shifting to that model be more efficient? It might be, and it's definitely something we should consider. But as with anything, you're not going to see dramatically different results through finding efficiencies; you'll get some benefits at the margins, but the basic market costs of health professionals, equipment/technology, and drug costs in Canada aren't going to change dramatically as a result, so we still need to invest more money into the system than European countries do if we want to achieve similar results/metrics.

[Azure]

From what I understand the reasons are not just about the money. Tenure, getting placement, training issues, restrictions on how many can go to school, regulatory issues, work hours, AND wage / financial problems leading to doctors heading south etc.

“Some provinces fare much worse than BC and Quebec is an example,” said Damien Contandriopoulos, a University of Victoria School of Nursing professor. The situation in Victoria, he said, is about close to the Canadian average. Across Canada, 15.3% or about 4.7 million people do not have access to primary healthcare providers including family doctors, according to 2017 Statistics Canada data released last year. While BC’s 18.2% was higher than the national average (and means about 900,000 in the province had no access to primary healthcare providers) it was not the highest. Quebec and Saskatchewan were at 22.3% and 19.4%, respectively.

Physicians have a right to decide where they want to practice, which means supply will not be equal among places. As Winner pointed out in his March editorial, it’s been apparent for decades that BC doctors are increasingly staying away from family practice. As early as the 1980s, he wrote, “the family practice model we were all working in was becoming less attractive to the next generation of doctors, who were able to work in walk-in clinics.”

The problem, as experts told Capital Daily, is not necessarily a shortage of qualified professionals graduating from med school; Ross noted that BC has already upped its intakes of med students and residency spots. Rather, as family doctors age out, a more realistic solution may be to reform the province’s decades-old model of family doctors as the primary gatekeepers to healthcare. Instead, Ross argues, BC could do well to pursue coordinated teams of nurse practitioners, midwives and other professionals taking on the role of primary care; lightening the load on the Island’s physicians.

Contandriopoulos says Canada has been sedate in making the shift to these “intraprofessional teams,” despite vast scientific evidence showing their success in other countries. A key change, he said, is shifting the “fee for service” model, in which physicians are paid by the visit. Whether a doctor visit is for a sore throat or for the first stages of leukemia, they’re all paid the same. As one doctor told Capital Daily, it’s akin to a dentist charging the same for a tooth polish as for complex dental diagnostics.

https://www.capitaldaily.ca/news/doc...ria-healthcare

Doesn't seem to just be a 'we don't pay them enough' issue, though we almost certainly should pay them what the market dictates, and that means competing with the Americans.

[Nancy]

Germany spends 25% more than Canada, per capita, in dollar terms. The previous chart was expressed as a % of GDP.

https://data.oecd.org/healthres/health-spending.htm

[peter12]

opendoor does exactly the same thing that people call Cliff out on but yet, nobody calls opendoor out. Why is that?

[opendoor]

Originally Posted by Azure

From what I understand the reasons are not just about the money. Tenure, getting placement, training issues, restrictions on how many can go to school, regulatory issues, work hours, AND wage / financial problems leading to doctors heading south etc.

https://www.capitaldaily.ca/news/doc...ria-healthcare

Doesn't seem to just be a 'we don't pay them enough' issue, though we almost certainly should pay them what the market dictates, and that means competing with the Americans.

That's fair. I do think Canada absolutely needs to modernize and do things like bringing in more nurse practitioners (BC is slowly moving in that direction). I just don't think it's necessarily going to result in cheaper health care delivery. If we're going to improve our system, it'll largely come from devoting more resources to it, which I would wholeheartedly support.

[PeteMoss]

Originally Posted by Firebot

https://globalnews.ca/news/8286078/c...ederal-travel/

A federal standardized vaccination passport was badly needed and great to see it happen.

https://twitter.com/user/status/1451192894304370690

Is that breaking news? That is exactly what my 'new' proof of vaccine looks like in Ontario that came out last week. You can still use the old easily forged one however.

[PeteMoss]

Originally Posted by Azure

The scary thing is that nobody is talking about solutions to the almost certain reality of anti-bodies not being as strong 6-8 months after vaccination.

Booster shots & booster mandates are going to create more issues. There is absolutely no way we get consistent 70% booster shot rate.

Vaccine mandates work fine while we know the antibodies are there. But what about next year? How will we handle sporting events then? Booster mandate if you want to attend a sporting event? I find a hard time believing that will go over very well.

I'd know why we'd be so worried about a vaccine mandate. We force people to do all kinds of things to improve safety and keep them out of hospital.

I'd rather mandate vaccines than pay a ton to deal with a surge of sick of people. Obviously you still need to spend as result of the aging and other issues mentioned here.

[csnarpy]

Originally Posted by PeteMoss

Is that breaking news? That is exactly what my 'new' proof of vaccine looks like in Ontario that came out last week. You can still use the old easily forged one however.

Pretty close to the Alberta one as well.

[Fighting Banana Slug]

Originally Posted by peter12

opendoor does exactly the same thing that people call Cliff out on but yet, nobody calls opendoor out. Why is that?

I must have missed the part where opendoor invoked identity politics and tribal tendencies.

[MoneyGuy]

Ontario MPP busted for misusing photos to advance his anti-vax views. Family is angry.

https://www.google.com/amp/s/www.cbc.ca/amp/1.6218286

[CASe333]

Originally Posted by peter12

opendoor does exactly the same thing that people call Cliff out on but yet, nobody calls opendoor out. Why is that?

What specific grief are you talking about?

In my experience opendoor generally uses data in every post and sometimes gives their opinion based on the data.

Cliff starts out with an opinion and then doesn't support it with anything substantial.

Do you have any examples that refutes this?

[Azure]

Still waiting on the data to say that the reason our health care system isn't very good is solely because of a brain drain to the US by our doctors and nurses because we can't compete on wages.

[GGG]

Originally Posted by Azure

Still waiting on the data to say that the reason our health care system isn't very good is solely because of a brain drain to the US by our doctors and nurses because we can't compete on wages.

What metric of “good” are you looking for.

The following statement is true:

In systems of equal efficiency and quality the per capita costs of the Canadian system will be higher than in a system that is not competing for labour in the US.

What are you looking for in terms of evidence?

[Azure]

It is a misleading statement at best, and leads to the impression that our system sucks cause we can't afford to pay our doctors & nurses better.

A 30 second Google search leads to 20 different reasons why doctors leave, and 10 reasons why they come back.

I put it in the same category as two tier system = US health care.

Misleading and stupid.

[CliffFletcher]

Originally Posted by CASe333

Cliff starts out with an opinion and then doesn't support it with anything substantial.

That’s hilarious. I doubt there’s a poster on CP who makes more of an effort to substantiate his opinions than I do. In the last few months alone I’ve quoted and referenced dozens of articles and studies on various topics. And I actually cut back on referencing outside sources because it was taking up too much of my time and it frankly isn’t in keeping with the tenor of this forum, where snarky quips rule the day.

[PepsiFree]

Originally Posted by CliffFletcher

That’s hilarious. I doubt there’s a poster on CP who makes more of an effort to substantiate his opinions than I do. In the last few months alone I’ve quoted and referenced dozens of articles and studies on various topics. And I actually cut back on referencing outside sources because it was taking up too much of my time and it frankly isn’t in keeping with the tenor of this forum, where snarky quips rule the day.

"I put more effort into my posts than anyone here and, in fact, have had to reduce the effort to fit in with the tribal idiocy of this forum!"

Yeah, gee, wonder why Cliff isn't treated the same as opendoor. Total mystery.

[opendoor]

Originally Posted by Azure

It is a misleading statement at best, and leads to the impression that our system sucks cause we can't afford to pay our doctors & nurses better.

A 30 second Google search leads to 20 different reasons why doctors leave, and 10 reasons why they come back.

I put it in the same category as two tier system = US health care.

Misleading and stupid.

No one said it was the only factor. But when you combine high personnel costs with the fact that Canada's public health care spending per capita is 16th in the world (behind basically every Western European country), you're going to get relatively poor metrics.

Just to use the Germany comparison again, they spend 46% more per capita on public/compulsory health care than Canada does based on 2018 OECD data. Meanwhile Canada spends about 60% more on private/out of pocket care than Germany does. And 28% of Canada's total health spending is voluntary private insurance and out of pocket spending, while only 14% of Germany's health care spending meets that criteria. So I'm unclear how adding more private/discretionary health spending in Canada (who is already 4th in the OECD in that metric) is going to make our system more like Germany's. And the gap is widening, as over the last decade Germany's health spending has increased at an annual rate of 2.3% while Canada's has increased only 1.4%.

So while doing things like switching who runs the hospitals, bringing in more nurse practitioners, etc. will likely improve efficiency to some degree, it's not going to create any kind of dramatic change without significant investment. But decades of neoliberal policies in Canada focused on lowering personal tax rates at the expense of everything else has reduced our investment in health care relative to similar countries. And because we have relatively high personnel costs, it shows.

[CliffFletcher]

Originally Posted by opendoor

No one said it was the only factor. But when you combine high personnel costs with the fact that Canada's public health care spending per capita is 16th in the world (behind basically every Western European country), you're going to get relatively poor metrics.

Just to use the Germany comparison again, they spend 46% more per capita on public/compulsory health care than Canada does based on 2018 OECD data. Meanwhile Canada spends about 60% more on private/out of pocket care than Germany does. And 28% of Canada's total health spending is voluntary private insurance and out of pocket spending, while only 14% of Germany's health care spending meets that criteria. So I'm unclear how adding more private/discretionary health spending in Canada (who is already 4th in the OECD in that metric) is going to make our system more like Germany's. And the gap is widening, as over the last decade Germany's health spending has increased at an annual rate of 2.3% while Canada's has increased only 1.4%.

So while doing things like switching who runs the hospitals, bringing in more nurse practitioners, etc. will likely improve efficiency to some degree, it's not going to create any kind of dramatic change without significant investment. But decades of neoliberal policies in Canada focused on lowering personal tax rates at the expense of everything else has reduced our investment in health care relative to similar countries. And because we have relatively high personnel costs, it shows.

Demands on health care increasing even faster than spending on health care is not the same thing as cuts to health care spending, though the subsequent strains and scarcity may feel the same.

Canadians are in denial that health care spending will have to continue to increase (as it already has been for decades) as the population ages. We’re facing a future where a quarter of the population will be over 65, and where more than half of our government spending will go to health care (mostly for those over 65).

But it’s worth pointing out that most of those countries that spend more than Canada on health care have older populations - they’re ahead of us on that steep demographic/expense curve. The average age in Germany is 45.5, compared to 40.1 in Canada.

https://www.worlddata.info/average-age.php