Canadian Heathcare system sucks!!

[Gord_in_Toronto]

What a curious drift this thread has taken.

 

[Patrick_R]

What a good use of tax dollars...

 

[Matthew Best]

And much funnier too, apparently, although I'm evidently too old to understand the humor.

Once again, you seem to be reading things that aren't there. Nobody said it was funny, except you.

 

[Matthew Best]

What a good use of tax dollars...

Nobody's tax dollars have been expended, you'll be glad to know.

 

[Ziggurat]

Nobody's tax dollars have been expended, you'll be glad to know.

That's simply not true.

 

[Matthew Best]

I'm afraid it is. We don't use dollars here.

 

[Ziggurat]

I'm afraid it is. We don't use dollars here.

Try the veal, and don't forget to tip your waitress.

 

[Matthew Best]

Ah. I didn't realise I was conversing with a comedian.

 

[shawmutt]

Get a room you two.

 

[lomiller]

I your definition of rationing is more then suspect, but if you use a comparable definition you favor rationing medical care based on wealth. Not a particularly palatable goal for a supposedly free country as it implies a country ruled by an aristocracy.

If there is insufficient supply of care (which as pointed out earlier generally isn’t true in Canada, though there are exceptions) then the way to deal with it is to let the doctors determine who should be treated.

 

[Ziggurat]

I your definition of rationing is more then suspect, but if you use a comparable definition you favor rationing medical care based on wealth. Not a particularly palatable goal for a supposedly free country as it implies a country ruled by an aristocracy.

No. Price rationing is not the same thing as rationing based on wealth. And you support rationing of most goods based on price up in Canada. Does that make you an aristocracy? Don't be absurd. A free market, whatever its drawbacks, is not an aristocracy. Really, you can do better than that.

 

[lomiller]

As previously stated I strongly disagree with your definition of rationing. It makes no sense whatsoever.

If you are going to apply it to supply of a good/service that is life threatening to go without, then absolutely you are “rationing” based on wealth because in the end the service will go to whoever has the most wealth.

 

[Ziggurat]

As previously stated I strongly disagree with your definition of rationing. It makes no sense whatsoever.

If you are going to apply it to supply of a good/service that is life threatening to go without, then absolutely you are “rationing” based on wealth because in the end the service will go to whoever has the most wealth.

No. Whoever is willing to pay enough. There is a difference, though you may choose to pretend it does not exist.

 

[D'rok]

No. Whoever is willing to pay enough. There is a difference, though you may choose to pretend it does not exist.

I think you're being disingenuous here. It isn't just a question of will; it is also a question of ability. All the will in the world won't get me treatment if I don't have the ability to pay for it and I have no other options but to pay for it.

The distinction between "coverage" and "treatment" doesn't hold water if removing coverage de facto removes the possibility of treatment for those without the ability to pay. Not even Medicaid covers everyone unable to afford private insurance or out-of-pocket treatment.

Wealth is unavoidably a component of rationing in your system.

 

[Ziggurat]

I think you're being disingenuous here. It isn't just a question of will; it is also a question of ability.

And by saying it's a matter of wealth, you are denying that willingness to pay is a factor.

All the will in the world won't get me treatment if I don't have the ability to pay for it and I have no other options but to pay for it.

You want an example of where the distinction between ability and willingness to pay matters? In the fact that some people choose to forgo buying health insurance. The number of such people is not small.

The distinction between "coverage" and "treatment" doesn't hold water if removing coverage de facto removes the possibility of treatment for those without the ability to pay.

That happens for some treatment. For many forms of treatment, including sometimes very expensive treatment, that's not the case. In fact, emergency treatment is available regardless of ability to pay. So the distinction is very much relevant, and to ignore it is to badly misunderstand the situation in the US.

 

[D'rok]

And by saying it's a matter of wealth, you are denying that willingness to pay is a factor.

I don't believe I have made that denial. It appears that you are trying to deny, or at least minimize, that ability is a factor.

You want an example of where the distinction between ability and willingness to pay matters? In the fact that some people choose to forgo buying health insurance. The number of such people is not small.

What is the number? What is behind the choice? Are you suggesting that all of these people can afford coverage but simply choose not to get it? Or is the "choice" sometimes really the non-choice of food and shelter vs. health care?

That happens for some treatment. For many forms of treatment, including sometimes very expensive treatment, that's not the case. In fact, emergency treatment is available regardless of ability to pay. So the distinction is very much relevant, and to ignore it is to badly misunderstand the situation in the US.

What happens to the bill in those cases?

 

[Rolfe]

I sometimes wonder if this constant pressure to push more and more money towards healthcare provision is damaging the US economy in more ways than the obvious.

The obvious is of course the effect on business competitiveness. Providing healthcare coverage for employees and their families is a significant drain on businesses, and this is acknowledged. When General Motors is spending more on employee health coverage than on steel, I submit you have a problem.

However, General Motors may be disadvantaged in another way. Look what I've just ordered. (Sorry, I found this publicity shot and I can't resist.)

It's costing me £22,500. Which I can take from my savings. I'm thrilled to bits. I'm like a kid waiting for Christmas.

However, that money could also be the cost of a hip replacement. Or a course of chemotherapy. Or a heart bypass. If I wasn't confident that I'd get these items if I needed them, would I shell out on the car? And given what I hear about US insurance companies eagerness to find loopholes to deny coverage to clients who have developed big-ticket healthcare needs, it's possible that as a US citizen I wouldn't be all that confident.

But even if I had great insurance coverage, and no worries about whether any future healthcare needs would be met, would I still be buying the car? Maybe, but maybe not. On average, British citizens pay out about half the amount US citizens do to maintain their healthcare coverage. We pay a little less in tax to fund the entire NHS than US taxpayers do just to fund Medicare and Medicaid. And then that's us done. We can access the NHS, so we benefit from our tax payments, and we don't have to pay out all over again into an insurance policy. If I'd been religiously maintaining a high-coverage health plan for the past 20 years, would I have accumulated sufficient savings to be able to boost the economy of Lower Saxony?

It's all very well declaring that people should "choose" to allocate most or all of their disposable income to health insurance, but this does have its own problems. First, that it's a miserable life if you can't buy the odd luxury because the insurance company is swallowing all your spare cash. And second, that it disadvantages the other businesses where you might otherwise have spent that money.

There's a lot of fuss being made about the downside to the health insurance industry of making healthcare spending more efficient in the USA. Well, it seems to me to be inevitable. If the country as a whole is spending twice what it needs to, then when measures are introduced to improve consumer value for money, the people who are currently trousering the surplus cash are going to feel the pinch. However, that surplus cash might actually stimulate the economy better if it were available to other sectors of the market. Like General Motors.

Hey, Henry Ford invented the motor car! Better not let him market it, because the effect on the harness-makers would be catastrophic!

Rolfe.

 

[Rolfe]

For many forms of treatment, including sometimes very expensive treatment, that's not the case. In fact, emergency treatment is available regardless of ability to pay. So the distinction is very much relevant, and to ignore it is to badly misunderstand the situation in the US.

I'd like to second D'Rok's highlighting of this. "Emergency treatment is available regardless of ability to pay."

Now can we ignore that this clearly excludes an awful lot of healthcare need, and that it's a terribly inefficient way to provide healthcare, when people with no other recourse go to A&E when they should be seeing their GP. Can we just concentrate on who pays.

First of all, it's not free. Hospitals are mandated to provide this service, but they are not mandated to give it away, and they do not appear to receive any state funds to allow them to provide the service at cost. So, if the patient has assets, he is likely to be pursued for the cost. He may well be made bankrupt.

[Digression. I told in another thread of reading about an English woman who was stupid enough to visit the USA without taking out health insurance. During her short stay she suffered a heart attack. She received high quality care, but also a bill to match. She had to pay out all her savings and then sell her home, and ended up homeless and dependent on the British state. US posters reading this story said she was doubly a fool because she should simply have welshed on the debt, that was how it was done in the USA. But I can't see how that's possible - if you have assets such as a house, surely you can be pursued through the courts for the money?]

However, the patient probably doesn't have the money in the first place. Is this really a system to boast about? Businesses (hospitals) are forced by law to provide their product to people who have no means of paying for it. Citizens are encouraged to take these goods and services from these businesses, even though they know they can't pay for them, and then welsh on the debt. The businesses then have to choose in each case between writing off the debt, or possibly spending a lot more money pursuing the debtor through the courts for their money.

Realistically, the businesses have to recoup their costs from somewhere. Provision of high-quality medical care is not cheap. Their only recourse is thus to overcharge their paying customers, on a sliding scale determined mainly by how much purchasing and negiotiating clout each paying customer has.

Now maybe I'm missing something, but I honestly have no single clue why this is a system that you would boast about.

Rolfe.

 

[ponderingturtle]

Another personal anecdote. My wife went out for a staff Christmas party, got totally drunk and passed out in a toilet. She was woken up by cleaners who couldn't persuade her to get up and leave, so they called an ambulance. The ambulance arrived shortly afterwards, asked her if she wanted to go to hospital or home - she said home. They phoned me and checked that they had the correct address and then brought her home.

Cost: zero.

I would never have had that option as an EMT in a 911 service. Of course in the private service, sure we would have taken her home if you would pay the $350+$4 a mile we charged for a BLS ambulance call. We even took credit cards.

 

[ponderingturtle]

I don't think there is a specific cost for each ambulance trip - they get paid for the night's work regardless of how many trips they make. Presumably there was petrol involved, but the cost of that was negligible.

You are wrong, the companies bill per trip even thought the staff is paid by the hour.

On another note, tipping is apreciated.