Canadian Heathcare system sucks!!

[D'rok]

No one goes bankrupt paying for medical care in Canada, they usually die before that while waiting for referrals or MRIs.

Evidence?

I spent several hours in a Canadian emergency waiting room twice this month and took a bus there both times.
The first time it was because I had dislocated my jaw. After five hours I finally saw the doctor and was told to go home because our health care doesn't cover that.

I call B.S. Big-time B.S. If that actually happened as you claim, you should consider legal action. At the very least, you should file a complaint with the Manitoba College of Physicians. Here you go:

http://www.cpsm.mb.ca/2_3_3_1_2_how_to.php

The second time was because my teenager was fainting on the volleyball court and the university phys.ed dept. was alarmed.
The triage nurse seemed particularly annoyed by my teens very presence and didn't want to let her see a doctor and told me that she was probably premenstral, I insisted, okay insisted strongly , and one hour later the doctor saw her and quickly diagnosed a heart arythmia and refered her to a specialist the next day.

Ah, so this is one of those cases where patients "usually die while waiting for referrals", but for your valiant action. And nurses are gatekeepers who can deny patients access to doctors.

Give us a break. This post reeks of lies.

 

[Rolfe]

Well, I've never been in Canada so I can't say, but the claim that a dislocated jaw isn't covered by the country's health service seems very very suspect to me.

Some "gatekeeper" nurses can be absolute dragons, and I suspect that happens everywhere. So you take a firm line, and you get past them. Move along, nothing to see here....

Rolfe.

 

[D'rok]

Well, I've never been in Canada so I can't say, but the claim that a dislocated jaw isn't covered by the country's health service seems very very suspect to me.

It's a flat-out lie.

Some "gatekeeper" nurses can be absolute dragons, and I suspect that happens everywhere. So you take a firm line, and you get past them. Move along, nothing to see here....

Rolfe.

Yup. Except even the worst dragon does not have the power to prevent someone from seeing a doctor. And getting a referral the next day is just a wee bit inconsistent with the claim that Canadians "usually die while waiting for referrals".

 

[lomiller]

Well, I've never been in Canada so I can't say, but the claim that a dislocated jaw isn't covered by the country's health service seems very very suspect to me.

More then suspect. A more likely explanation is that it was an injury that didn’t require any intervention.

The daughter sounds like typical triage, where you have pushy person in an emergency room for something that isn’t immediately life threatening. Notice that when it was identified there was a serious condition she saw a specialist immediately and received treatment?

 

[Cleon]

The funny thing is, no matter how hard they try, I have yet to hear a Canadian health care "horror story" that's really any worse than what you can find in the US.

Obscenely long wait times, check.
Understaffed, overworked, cranky, occasionally incompetent staff, check.
Triage that doesn't make you as high a priority as you think you deserve, check.

It seems to me the problems faced by UHC systems aren't substantially different than those found here in the US. Or at least I haven't seen any substantial evidence indicating otherwise.

My absolute favorite piece of anti-UHC FUD is "having a bureaucrat between you and your doctor." Uh, guys? We have that now. Twice within the past year I've had my doctor's recommendations overruled by my health insurance company, and I'm not a particularly sickly person. People who need regular treatment for things like diabetes or cancer see this crap all the time.

So, anti-UHCers, if you want to convince people, you have to do better than what you've done so far.

 

[Rolfe]

That last it really quite funny. In Britain, we absolutely do not have any bureaucrat between us and our doctors. The doctors do have guidelines and budgets and incentives, but they're all aimed at delivering care in a cost-effective manner using established best practice.

The money is earmarked to treat sick people. There is no incentive anywhere to refuse treatment to someone who needs it. Nobody gets paid to refuse treatment, nobody's profits go up if fewer people are treated.

The doctor doesn't have to consult anyone at all to treat ordinary patients in the ordinary run of things. It just doesn't happen. He's funded to do it, that's his job, get on with it.

Vested interests in the US healthcare industry can be terrible liars sometimes.

Rolfe.

 

[lomiller]

That last it really quite funny. In Britain, we absolutely do not have any bureaucrat between us and our doctors. The doctors do have guidelines and budgets and incentives, but they're all aimed at delivering care in a cost-effective manner using established best practice.

It’s the same here in Canada. In our case the doctor is a small businessman, but there may be some government involvement in recruiting or providing additional incentives for some specialists to start up a practice. Other then that I see the doctor I want, and get the treatment I want and there is no one who can override that decision.

It seems that despite all the right wing complaints about “people between you and your doctor” in the US, the system they champion is the only one where that actually happens.

 

[Ziggurat]

It seems that despite all the right wing complaints about “people between you and your doctor” in the US, the system they champion is the only one where that actually happens.

I'm not fond of that talking point, because it's an appeal to emotion. The substance behind it is the issue of rationing. Healthcare will allways be rationed, because it's scarce. If you don't do it by price, it will happen by another mechanism. Most Americans don't want the government to be the ones to ration their healthcare, which is what's really behind that objection. Many fans of UHC's don't want insurance companies to be the ones rationing health care. Who is rationing health care in Canada? If there's really no one between you and your doctor (assuming you've got one, which is a problem in some places), then that just means it's the doctor who will do the rationing. Is that better? Perhaps, but of course, that's not the only issue. There's also the issue of how much medical services there are. And no matter how good a job doctors are at rationing the available medical services in Canada, the government is still basically the one deciding how much of those services there are in the first place. Which is how you end up with long waiting lists and Canadians crossing the border to get health care in the US: there's little price mechanism to increase the amount of services in response to demand.

 

[D'rok]

There is a basic level of "rationing", to use your loaded term, in the Canadian system that comes from government. The government decides what are "medically necessary" services and are therefore covered. This is decided generally. If a service is medically necessary it is covered, period. There are no exceptions based on any individual factors and there is no bureaucrat approving or denying anyone's treatment. Doctors and patients decide on treatment.

Other than that, Doctors ration health care by the hours they keep in clinics and hospitals.

And yes, they do work on Sundays.

 

[David Wong]

No one goes bankrupt paying for medical care in Canada, they usually die before that while waiting for referrals or MRIs.

That has to be one of the most blatant lies ever posted on this forum I believe.

If there's a hall of fame for such statements, this should be inducted immediately.

 

[Corsair 115]

That has to be one of the most blatant lies ever posted on this forum I believe.

If there's a hall of fame for such statements, this should be inducted immediately.

It shouldn't be surprising, really. The debate about health care in the U.S. is not about facts, it's about politics. And, given the general state of political discourse in the U.S. these days, that means it's about dirty politics.

 

[lomiller]

If there's really no one between you and your doctor (assuming you've got one, which is a problem in some places), then that just means it's the doctor who will do the rationing.

You are stretching the definition of rationing way beyond breaking. Businessmen have, and should have, the right to choose their customers. This is not rationing.

There's also the issue of how much medical services there are. And no matter how good a job doctors are at rationing the available medical services in Canada, the government is still basically the one deciding how much of those services there are in the first place.

Provincial governments are mandated to pay every legitimate claim they receive, they do not and can not restrict the number of claims they pay out or the number of procedures performed. If anyone controls the supply of medical care it’s the universities.

there's little price mechanism to increase the amount of services in response to demand.

There is little in the way of price mechanisms to increase demand in any medical system, indeed quite the opposite.

The people who set the standards for conduct and control who can/cannot practice medicine are, or at least should be, doctors representing medical practitioners as a whole. No one else is truly qualified to make such judgments. This must be the case for a properly functioning medical system, but it’s at odds with a properly function free market. Any solution based on a functioning free market with no outside management cannot, will not, work.

 

[Ziggurat]

There is a basic level of "rationing", to use your loaded term, in the Canadian system that comes from government. The government decides what are "medically necessary" services and are therefore covered. This is decided generally. If a service is medically necessary it is covered, period.

No, it's not period. A bureaucratic decision to cover a procedure is not enough to make it happen. The resources to do the procedure need to be there too. And sometimes they are not. And when they are not, the only recourse may be to wait (possibly a very long time), or to get it done across the border. Because there is not really a functioning price mechanism to increase the supply.

Furthermore, even the decision of what's "medically necessary" is an act of rationing. Don't kid yourself that it's not.

 

[D'rok]

No, it's not period.

Yes it is. It is covered, period. No covered procedure will ever be denied.

A bureaucratic decision to cover a procedure is not enough to make it happen.

That was quick switcheroo from "covered" to "happen". Did you think I wouldn't notice that?

The resources to do the procedure need to be there too. And sometimes they are not. And when they are not, the only recourse may be to wait (possibly a very long time), or to get it done across the border. Because there is not really a functioning price mechanism to increase the supply.

Of course, the degree to which waiting for covered procedures and/or border hopping for covered procedures actually happens is a talking point that is rarely factual. Statistics Canada has the facts if you are interested.

Furthermore, even the decision of what's "medically necessary" is an act of rationing. Don't kid yourself that it's not.

I refer you to the first sentence of my post. Apparently you missed it.

There is a basic level of "rationing", to use your loaded term, in the Canadian system that comes from government.

Who's kidding who here?

 

[Ziggurat]

Provincial governments are mandated to pay every legitimate claim they receive, they do not and can not restrict the number of claims they pay out or the number of procedures performed.

You are confusing payment for medical services with provision of medical services. Is there any requirement that the supply of medical services be large enough to meet any demand? Of course not. Nor could there be, because it would bankrupt the government to try. If you don't want to ration healthcare by price, and you don't want to ration it by denying anyone care outright, then you need to do it by some other mechanism, because it must get done. And you don't need to explicitly restrict the number of procedures performed, all you need to do is not expand capacity to meet demand. Which is rather obviously happening. So if you don't choose an explicit method of rationing, then it will get done with wait times. Increase delays sufficiently, and demand will drop.

 

[Ziggurat]

Yes it is. It is covered, period. No covered procedure will ever be denied.

"Not denied" doesn't mean "provided".

That was quick switcheroo from "covered" to "happen". Did you think I wouldn't notice that?

You are the one who introduced the word "covered", not me. You will find that word absent from my original post, and for a reason. And it's the same reason I make a distinction between "covered" and "happen": it's not the same thing. I'm not hoping you wouldn't notice, that was rather the whole point of my response.

 

[D'rok]

You are confusing payment for medical services with provision of medical services. Is there any requirement that the supply of medical services be large enough to meet any demand?

Yes there is. Section 7 of the Canada Health Act which explicitly sets out those supply and provisioning requirements. If the provinces don't meet those requirements, they don't get federal funding. They need federal funding, so they strive to meet the requirements. The specific relevant provisions are the criteria of i) comprehensiveness; ii) universality; iii) portability; and iv) accessibility.

Of course not. Nor could there be, because it would bankrupt the government to try. If you don't want to ration healthcare by price, and you don't want to ration it by denying anyone care outright, then you need to do it by some other mechanism, because it must get done. And you don't need to explicitly restrict the number of procedures performed, all you need to do is not expand capacity to meet demand. Which is rather obviously happening. So if you don't choose an explicit method of rationing, then it will get done with wait times. Increase delays sufficiently, and demand will drop.

You have a typical misunderstanding of our system.

 

[D'rok]

"Not denied" doesn't mean "provided".



You are the one who introduced the word "covered", not me. You will find that word absent from my original post, and for a reason. And it's the same reason I make a distinction between "covered" and "happen": it's not the same thing. I'm not hoping you wouldn't notice, that was rather the whole point of my response.

Read my post above to find out what happens if a service that is "covered" is not "provided". You are only displaying your ignorance and your ideological blinders.

 

[Ziggurat]

Yes there is.

No. There rather clearly (and trivially) is not. If there were, there would be no waiting lines. Nobody would have to go across the border for treatment. You can argue all you want to about how representative such cases are, but they happen. Which means that supply is not enough to meet any demand. It never is, under any system. One of the differences between systems is how to determine who gets denied treatment when demand exceeds supply. But it always happens, because it must happen. I don't need to understand Canadian health care to know that, I only need to understand reality. Now, you can argue the merits of how the Canadian system makes such determinations, but you cannot (at least if you're honest) deny that this is exactly what it MUST do: deny people treatment. Every system has to do that.

 

[Roma]

Evidence?

I call B.S. Big-time B.S. If that actually happened as you claim, you should consider legal action. At the very least, you should file a complaint with the Manitoba College of Physicians. Here you go:

http://www.cpsm.mb.ca/2_3_3_1_2_how_to.php


Ah, so this is one of those cases where patients "usually die while waiting for referrals", but for your valiant action. And nurses are gatekeepers who can deny patients access to doctors.

Give us a break. This post reeks of lies.

D'rok sweet heart, this is not the first time I have had a dislocated jaw so I was aware of the restriction to the Manitoba Health care system even before I went to the emergency room. I required then what I required now: a letter from the doctor to my social worker so that I can appeal to the government for funding for a $300. TMJ assessment. Then I will need to appeal to my social worker for coverage of all appointments and any maxfillo surgery.
Been there, done that 20 years ago. The whole process took over two years. Probably would have been quicker if I could have afforded to pay for supplemental coverage or had it covered under workers compensation but alas, I am a poor under-insured disabled single mom on welfare so life sucks for me.

As for my 14 year-old daughter she was very lucky to have seen that emerg doctor and to have received such quick and excellent care. My problem was with the triage nurse who was so annoyed and thought she was wasting her time with "premenstral" fatigue.
Unfortunately this type of attitude is not terribly unusual, I'm surprised that you haven't heard of women being treated like second class citizens in this world. I'm 50 years-old now so I'm not so shocked anymore, I just don't let people get away with it. Like being called a liar pal.