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RE: The Best Health Care System in the World? - 4/11/2012 11:11:27 AM   
mcbride


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quote:

ORIGINAL: papassion

Was working with some Canadians so I asked about their healthcare. Some like it but most said it sucked. Long waits and they said you still have to buy insurance if you want more involved care, whatever that means. They complained that the taxes they pay to cover their "free" healthcare was more than a US policy and they have no choice in the level of coverage.



Here are some facts. Canadian support for Medicare continues to poll around 85%, and God knows there are plenty of polls. "A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States, more than ten times as many as the 8% stating a preference for a US-style health care system for Canada, while a Strategic Counsel survey in 2008 found 91% of Canadians preferring their healthcare system to that of the U.S." -Wiki

Medicare in Canada covers everything that's medically required. If you want a face lift, or some other cosmetic procedure, you'll have to pay. To say it doesn't cover "more involved care" would be flat-out wrong. Wait times are decided by need: Urgent treatment happens immediately, but your bunion may take longer. Your ability to pay will not affect it.

The taxes your friends pay "to cover their free healthcare" are not "more than a US policy", they're far, far less. Canada spends around 10.1% of GDP of health care, and consistently gets better results, better MEASURABLE outcomes than the US, which spends 16% of it's GDP.

No, they have no choice in the level of coverage: everything they need is covered, and they will never see a bill, let alone see catastrophic bills. No HMO will dictate what treatment you can or cannot have. You can go to any hospital, and pick any family doctor.

Glad I could help.

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RE: The Best Health Care System in the World? - 4/11/2012 4:34:15 PM   
SoftBonds


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quote:

ORIGINAL: mcbride

The taxes your friends pay "to cover their free healthcare" are not "more than a US policy", they're far, far less. Canada spends around 10.1% of GDP of health care, and consistently gets better results, better MEASURABLE outcomes than the US, which spends 16% of it's GDP.



Maybe he is talking about the rich having to pay higher taxes than our rich pay for healthcare?
AKA, who cares about what it does to the poor and middle class...

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RE: The Best Health Care System in the World? - 4/11/2012 4:48:17 PM   
kalikshama


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quote:

Wait times are decided by need: Urgent treatment happens immediately, but your bunion may take longer.


This has been my experience within the VA system.

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RE: The Best Health Care System in the World? - 4/11/2012 4:55:00 PM   
dcnovice


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Status: offline 		Waits are not unknown within the ordinary American system either.

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RE: The Best Health Care System in the World? - 4/11/2012 4:57:38 PM   
SoftBonds


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quote:

ORIGINAL: dcnovice

Waits are not unknown within the ordinary American system either.


Think that was what Kalik was pointing out, referring to the US Vet health system.
Course, we all know the US military is communist anyway. Equal pay for equal rank, free health care, free housing, free food, and all run by a strict chain of discipline...
Go ahead and try to tell your staff sergeant that you want to do things a different way than "by the book."

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RE: The Best Health Care System in the World? - 4/11/2012 6:03:14 PM   
dcnovice


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quote:

Think that was what Kalik was pointing out, referring to the US Vet health system.


Yes, but I was taking the point a step further. I'm outside the VA, with the good fortune to have decent coverage subsidized in part by my employer. And I've still encountered the need to wait. When I was first diagnosed with diabetes--in DC, mind you, not some backwater where the nearest doc is fifty miles away--I was looking at three-month waits before an endocrinologist could fit me in. Fortunately, my cousin's husband is a doctor, and he pulled strings for me.

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RE: The Best Health Care System in the World? - 4/11/2012 6:18:40 PM   
erieangel


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Status: offline 		There simply aren't enough doctors in a lot of states. For most, medical school is prohibitively expensive, get through that and you'll find that many states have malpractice insurance premium rates so high that practicing medicine in those states is nearly impossible. The Republicans keep going on about the need for tort reform. I agree with them to an extent. At the same time we limit the payout for doctor mistakes, we have to limit the amount an insurance company charge a doctor for malpractice insurance.


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RE: The Best Health Care System in the World? - 4/11/2012 6:54:17 PM   
Lucylastic


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Status: offline 		Agrees with McBride. I waited more than six weeks for my tumour to be removed, but it was mostly because my surgeons were heads of their departments, Obgyn and Bowel oncologist and their scheduling was the cause of the wait. Of course I was unhappy, but I didnt pay anything before during or after. I pay taxes every week, that works.
You can get supplemental care and private/ cosmetic/ services Insurance, which is offered by many many employers, that gives a co pay on prescriptions, dental and optical services, plus other servcices not covered by Ohip (ontario health coverage for all citizens of Ontario)


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RE: The Best Health Care System in the World? - 4/12/2012 12:28:33 AM   
tweakabelle


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From: Sydney Australia
Status: offline 		The Australian system pretty much replicates the Canadian system, though I think we spend a little less (from memory, c9.5% of GDP) on it.

When Medicare was introduced here in the 1980s, virtually all of the arguments currently articulated by proponents of the US health care system were advanced against it, up to and including the mass resignations of GPs. The Right and conservatives fought it tooth and nail. None of the predicated disasters eventuated.

Nowadays Medicare enjoys public support at about the same levels as in Canada, and all political parties, left and right, agree it is a good system and part of the national furniture. Aussies cannot understand why many ordinary Americans continue to oppose such health care - to almost all Aussies the kind of healthcare systems adopted here and in Canada are so superior to the US model it's a no-brainer.

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RE: The Best Health Care System in the World? - 4/12/2012 5:27:18 AM   
kalikshama


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quote:

Think that was what Kalik was pointing out, referring to the US Vet health system.

Course, we all know the US military is communist anyway. Equal pay for equal rank, free health care, free housing, free food, and all run by a strict chain of discipline...


If I had more time, I'd argue that it is socialist rather than communist, but since I don't ATM here's wiki:

http://en.wikipedia.org/wiki/Veterans_Health_Administration#VA_Today

VA Today

Overall Evaluation

"Patients routinely rank the veterans system above the alternatives, according to the American Customer Satisfaction Index." In 2008, the VHA got a satisfaction rating of 85 for inpatient treatment, compared with 77 for private hospitals. In the same report the VHA outpatient care scored 3 points higher than for private hospitals.[15]

"As compared with the Medicare fee-for-service program, the VA performed significantly better on all 11 similar quality indicators for the period from 1997 through 1999. In 2000, the VA outperformed Medicare on 12 of 13 indicators." [16]
A study that compared VHA with commercial managed care systems in their treatment of diabetes patients found that in all seven measures of quality, the VHA provided better care.[17]

A RAND Corporation study in 2004 concluded that the VHA outperforms all other sectors of American health care in 294 measures of quality; Patients from the VHA scored significantly higher for adjusted overall quality, chronic disease care, and preventive care, but not for acute care.[13]

A 2009 Congressional Budget Office report on the VHA found that "the care provided to VHA patients compares favorably with that provided to non-VHA patients in terms of compliance with widely recognized clinical guidelines — particularly those that VHA has emphasized in its internal performance measurement system. Such research is complicated by the fact that most users of VHA’s services receive at least part of their care from outside providers." [6]

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RE: The Best Health Care System in the World? - 4/12/2012 8:32:31 AM   
tweakabelle


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Status: offline 		What a revelation kalikshama!

So the US can do 'socialised medicine' after all. Not only can the US do it, but when it does, it delivers a better quality system than the private health care system that the rest of the US relies upon, according to the clients of both systems.

This revelation strikes me as the final nail in the coffin of the current US system. 'Socialised medicine' offers better coverage, better quality healthcare and does it for a lot less .... what more could anyone ask for?

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RE: The Best Health Care System in the World? - 4/12/2012 10:18:07 AM   
SoftBonds


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quote:

ORIGINAL: tweakabelle

What a revelation kalikshama!

So the US can do 'socialised medicine' after all. Not only can the US do it, but when it does, it delivers a better quality system than the private health care system that the rest of the US relies upon, according to the clients of both systems.

This revelation strikes me as the final nail in the coffin of the current US system. 'Socialised medicine' offers better coverage, better quality healthcare and does it for a lot less .... what more could anyone ask for?


FREEDOM!!!!

To mangle a Mel Gibson quote:
Sure, they may give ya cheaper health care, they may take better care ov ya, but you'll still be slaves!

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RE: The Best Health Care System in the World? - 4/12/2012 1:07:13 PM   
fucktoyprincess


Posts: 2337
Status: offline 		I think the only Americans who get state-of-the-art health care are those who are wealthy enough to pay out of pocket for at least some portion of the expenses. Most of the best specialists in New York don't even take insurance. And if you submit to insurance to cover some of the costs, generally, only a fraction of that expense will be covered. For example, most high end specialists in the city charge 2-3 times what insurance will cover for an office visit ($500-$800 is typical where insurance would likely only cover $100-$200). So the very wealthy have a huge incentive in seeing the system stay the way it is because they have great access to health care. Everyone involved in the insurance industry has a huge incentive in seeing the system stay the way it is because the insurance companies collect far more in premiums than they ever pay out (that's how insurance companies make their money). And a lot of politicians also have a vested interest due to kick-backs from industry.

Yet again, this is an issue where the middle class votes/lobbies against self-interest. For the average person, a system more like Canada/U.K. would be much, much better. But the middle class always votes as if they are rich (whether it comes to taxes, health care, you name it). Go figure.

As for medical expenses over one's lifetime, the bulk of medical expenses in one's life usually occur during the last 6 months of one's life, as doctors and loved ones make valiant attempts to save someone who is likely already on death's door. One way we have to control some of our health expenditures is to also accept the fact that we are, as humans, mortal. And that spending excessively on healthcare when one is quite aged is probably not the best thing to be doing. There is a big difference in my mind between treating a 40-yr old cancer patient, and an 80-yr old cancer patient based on where in the life cycle they are at. But our system treats both the same from a treatment and cost perspective, even though one could argue that perhaps the 80-yr old should have a more philosophical attitude towards death. Some older people do opt for less invasive treatment, and for pain control and dying with dignity, but many old people will insist on having every possible penny spent on trying to save them even though the life expectancy rates for them are low given their underlying age. One issue we must confront is our attitude towards aging and death. I don't claim to have the answers. I just feel we have a system in place that encourages selfish and wasteful behavior - where people behave as if medical science can guarantee immortality, when we all know it can't.

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RE: The Best Health Care System in the World? - 4/12/2012 1:56:46 PM   
kalikshama


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quote:

Most of the best specialists in New York don't even take insurance. And if you submit to insurance to cover some of the costs, generally, only a fraction of that expense will be covered. For example, most high end specialists in the city charge 2-3 times what insurance will cover for an office visit ($500-$800 is typical where insurance would likely only cover $100-$200).


That's interesting. I've never rec'd care in NYC, but when I received medical care from providers who did not take health insurance, they charged less as they did not have the paperwork overhead hassle. These were not rare specialists high in demand, however.

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RE: The Best Health Care System in the World? - 4/12/2012 7:13:45 PM   
fucktoyprincess


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quote:

ORIGINAL: kalikshama

quote:

Most of the best specialists in New York don't even take insurance. And if you submit to insurance to cover some of the costs, generally, only a fraction of that expense will be covered. For example, most high end specialists in the city charge 2-3 times what insurance will cover for an office visit ($500-$800 is typical where insurance would likely only cover $100-$200).


That's interesting. I've never rec'd care in NYC, but when I received medical care from providers who did not take health insurance, they charged less as they did not have the paperwork overhead hassle. These were not rare specialists high in demand, however.


I think the overhead of a practice in the city is very expensive, so it drives a different dynamic. I know my friend who took her baby to a gastroenterologist in the city and the initial visit was $800. My friend is in a position to pay that, and she made the choice to see that particular specialist. But it goes without saying that most people could never afford that. The city also gets lots of people from other parts of the country or world who seek out particular specialists here. Just a completely different dynamic. So what ends up happening in the city is very much a three-tier system. The very wealthy (from all over the world) go to whomever they want, and simply pay (and then get reimbursed for whatever their insurance company is willing to cover). Those who have less to spend on healthcare but who have insurance coverage end up at second-tier doctors who are within their insurance network. And the truly poor and/or uninsured end up either at the hospitals or at clinics located in the poorer neighborhoods where they truly do not get properly monitored care. What happens in the city is exactly how much of the Third World operates when it comes to healthcare. Shocking really that people somehow think the U.S. has great medical care. We only do for those who can afford it.

My Canadian and British friends (regardless of their level of income) never complain about healthcare. Ever. Even about the wait lists. I think overall, the system in those countries seems to more adequately address the day-to-day health issues that most people face.

Also, we end up with the problem in the U.S. of once something is covered, you get a large number of procedures being done (e.g. colonoscopies), even when not completely medically necessary, just because doctors know the insurance will cover it. Too many decisions get driven by what is covered and by what is not, and not by what is the best medical approach for a particular patient. So many $$ get spent, but not always efficiently or effectively.

In addition, the focus is always on tertiary care instead of preventative care. Again, more expensive, but not always particularly effective.

Okay, I'm going to stop here, because I just so truly hate how our whole medical system works. And I don't think it is anyone's fault, per se. The system is just not designed properly.



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RE: The Best Health Care System in the World? - 4/12/2012 8:12:55 PM   
SoftBonds


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quote:

ORIGINAL: fucktoyprincess

Also, we end up with the problem in the U.S. of once something is covered, you get a large number of procedures being done (e.g. colonoscopies), even when not completely medically necessary, just because doctors know the insurance will cover it. Too many decisions get driven by what is covered and by what is not, and not by what is the best medical approach for a particular patient. So many $$ get spent, but not always efficiently or effectively.



Yeah, I really wish it was possible to have a system where the medical provider (or primary medical provider, aka hospital) provided health insurance. If a hospital is paid a flat fee per year per patient, they are more likely to do preventive care, and to only do what is needed. They could easily have a network of family practice doctors and specialists on contract to provide the insurance "normal care," and preventative care, all they would need is an actuary to let them know how much to charge.

When the hospital is paid per service, there is a different incentive.


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RE: The Best Health Care System in the World? - 4/13/2012 1:35:50 PM   
fucktoyprincess


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quote:

ORIGINAL: SoftBonds


quote:

ORIGINAL: fucktoyprincess

Also, we end up with the problem in the U.S. of once something is covered, you get a large number of procedures being done (e.g. colonoscopies), even when not completely medically necessary, just because doctors know the insurance will cover it. Too many decisions get driven by what is covered and by what is not, and not by what is the best medical approach for a particular patient. So many $$ get spent, but not always efficiently or effectively.



Yeah, I really wish it was possible to have a system where the medical provider (or primary medical provider, aka hospital) provided health insurance. If a hospital is paid a flat fee per year per patient, they are more likely to do preventive care, and to only do what is needed. They could easily have a network of family practice doctors and specialists on contract to provide the insurance "normal care," and preventative care, all they would need is an actuary to let them know how much to charge.

When the hospital is paid per service, there is a different incentive.



Actually a patient based approach at first glance, seems a good idea. It would really help bring preventive care into action if you thought in terms of patients over their lifetime instead of numbers of procedures, or number of hospital days.


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RE: The Best Health Care System in the World? - 4/13/2012 5:11:45 PM   
dcnovice


Posts: 37282
Joined: 8/2/2006
Status: offline 		So . . .

Heard back from the medical-supply company yesterday. Turns out my rep had been away for Easter. We got things sorted out, and I went a way jubilant that the [expletive deleted] mask would finally ship so that I could get some decent sleep again.

Got home around 7:30 this evening to a voicemail from a different rep at the same company, asking me to call and confirm the order. That means the damn thing won't even ship till Monday at the earliest.

Argh!

Good thing I have John Boehner to remind me that this is the best system on Earth.

_____________________________

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it's never enough to keep up.

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RE: The Best Health Care System in the World? - 4/14/2012 6:26:37 AM   
fucktoyprincess


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quote:

ORIGINAL: dcnovice

So . . .

Heard back from the medical-supply company yesterday. Turns out my rep had been away for Easter. We got things sorted out, and I went a way jubilant that the [expletive deleted] mask would finally ship so that I could get some decent sleep again.

Got home around 7:30 this evening to a voicemail from a different rep at the same company, asking me to call and confirm the order. That means the damn thing won't even ship till Monday at the earliest.

Argh!

Good thing I have John Boehner to remind me that this is the best system on Earth.


Well, I guess if we can't have our health we must resort to keeping our sense of humor

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RE: The Best Health Care System in the World? - 4/17/2012 5:55:31 PM   
dcnovice


Posts: 37282
Joined: 8/2/2006
Status: offline 		Mask arrived today and appears to be in good order. Hallelujah!

Looking forward to (please God) a decent night's sleep.

Thanks to you all for your kind support.

_____________________________

No matter how cynical you become,
it's never enough to keep up.

JANE WAGNER, THE SEARCH FOR SIGNS OF
INTELLIGENT LIFE IN THE UNIVERSE

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Profile   Post #: 60
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