Er $$$

[allendo]

I was looking @ EM job listings in the areas I'm from (south east Texas between Houston and Dallas) and I saw hourly wages around 175. Is this common among ER salaries? Most of the programs were still searching for FP docs with ER experience!! Thats how rural we are!

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[Sessamoid]

It's not uncommon in your area. That's a bit high for most of the country.

 

[typeB-md]

sess, do you see ER physicians becoming government workers at any time in the future? let's say if we go to a government funded basic healthcare system.

 

[Jeff698]

sess, do you see ER physicians becoming government workers at any time in the future? let's say if we go to a government funded basic healthcare system.

Pardon me for jumping in here, but I don't see this happening. If it does, it will be part of all physicians working for the government and I really don't see that in the cards.

Our system of paying for health care is clearly broken and will, sooner rather than later, have some type of 'fix' applied. However, especially in the political environment we have now (Republican congressional control for the near to medium term +/- the presidency), I don't think we'd adopt a government DELIVERY system.

I think it is much more likely (and, IMHO, preferable) to see a type of government supported private INSURANCE system.

Take care,
Jeff

 

[typeB-md]

Pardon me for jumping in here, but I don't see this happening. If it does, it will be part of all physicians working for the government and I really don't see that in the cards.

Our system of paying for health care is clearly broken and will, sooner rather than later, have some type of 'fix' applied. However, especially in the political environment we have now (Republican congressional control for the near to medium term +/- the presidency), I don't think we'd adopt a government DELIVERY system.

I think it is much more likely (and, IMHO, preferable) to see a type of government supported private INSURANCE system.

Take care,
Jeff

it just seems that the ER would be a prime place to 'fix' the problem seeing as most of the non-insurance population uses it as it is right now. i could see them making ER docs employees of government run hospitals.

 

[bikerboy]

I dont envision docs ever being government employees ala the NHS in the UK. Perhaps something similar to Canada where docs are private contractors and eat what they kill just like here in the states, but the difference in Canada being that all patients are insured by a single carrier: the government.

I personally would support some sort of improved health care insurance as ideally this would get people back to seeing a PCP for their diabetes/COPD/CHF management and out of the ED. Hopefully this would result in a net cost savings overall and a reduced number of GOMERs in the the EDs.

 

[Atlas]

It is my belief that anything the government touches gets screwed up somewhere. Plus, if the health care system ever went "socialized" or whatever, the demand for ER docs would decline as would their salaries. I'm not in favor of having to pay my loans, malpractice, and 60% taxes on 1/2 the income in order to pay for people who cannot or choose not to afford healthcare. I'm sorry. I know that sounds harsh and selfish; however, we have a right to make a living too. I just hope that never happens because we'd all be screwed.

 

[GeneralVeers]

There is no solution to the medical cost problem. As a whole the average insured American gets superior care to any other country in the world.

The Canadian solution is not a "solution". After growing up there, I can tell you that it's turning into soviet-style medicine. Few resources, few doctors, and no access to the standards of care that we enjoy in the United States.

My Uncle just died up there last year. He had a massive heart attack in Niagara Falls, Ontario (pop ~100,000). The city has no cath lab, not even an MRI machine. There is one CT scanner at the city hospital. The nearest cath lab is 200 miles away in Hamilton. They let him sit in ICU for nearly 2 days before putting him in an ambulance. He died on the cath table when they finally got him there.

Back to EM $$$. Why is the published "median" EM salary $180,000? Every ER doc I've talked to in Indiana is making well over 200K, some are making 300K.

 

[Sessamoid]

We don't really have a private system, as the government pays by far the largest share of the total health care dollars in this country. It's a hybrid private/public payor system that leaves a significant portion of the population almost completely uncovered. I don't think it likely that we'll ever see a all-encompassing public health service which employs all physicians, or even all emergency physicians.

At the same time, I don't think there's any argument that our current system is in many ways very broken. While you may argue that the Canadian system is also broken, it is broken in different ways but which still results in better overall health for its population as compared to the US version. Plus, it's cheaper.

I think a system of very basic universal coverage for all citizens with a higher level of coverage or service provided by the private sector is where we should be headed.

Providers are hamstrung by having to practice according to some nebulous "standard of care". This almost inevitably ends up being far more expensive than we see in other modern countries. But we have to do it to allay the possibility of being sued for not providing the best care. The tort system needs to change to make it acceptable to provide lower but still acceptable levels of care for those with only the basic coverage. What is considered "acceptable" by a jury of uneducated laymen usually defaults to the best care that could be provided.

The other thing that I haven't been convinced of is that a private health care system is actually more efficient than public one. Competition in the free market is supposed to lead to efficiencies, but I just haven't seen much proof that the American system is even vaguely as efficient as many of the more socialized systems seen in most other first world nations. Instead, the inefficiencies and profits of the private system go to the salaries of the unbelievable numbers of health care administrators and executives in HMOs, insurance companies, drug companies, hospital management companies, contract management groups, nursing home corporations, medical device companies, and their stockholders. Ideally, the efficiencies earned would more than offset the costs of the profits paid to these people. I haven't been convinced that's even close to the case so far.

 

[RichL025]

...But we have to do it to allay the possibility of being sued for not providing the best care. The tort system needs to change to make it acceptable to provide lower but still acceptable levels of care for those with only the basic coverage. What is considered "acceptable" by a jury of uneducated laymen usually defaults to the best care that could be provided.

I'm afraid I don't see that happening... in effect, you would have to look at a jury and tell them that person A is entitled to less medical care than person B because he makes less money. Rightly or wrongly, Americans see health care as a "human right" to which all are equally entitled. The fact that this may bear no resemblance to reality does not in any way change the public perception. A change in the tort law like you describe would never happen in today's legal / political climate. And to be honest, I'm not sure _I_ would be comfortable with such a change - in effect, legalizing the inequities (note that I do not deny that they exist in fact to some extent)

...The other thing that I haven't been convinced of is that a private health care system is actually more efficient than public one. Competition in the free market is supposed to lead to efficiencies, but I just haven't seen much proof that the American system is even vaguely as efficient as many of the more socialized systems seen in most other first world nations. ...

I hear you, but is it possible you cannot see the forest for the trees? Sorry, not the right analogy. See the post above where the poster describes an uncle waiting 2 days for what should have been an emergent cath, in a city of 100K with one CT and no MRI. In what US city of 100K would that happen? I'll have to plead ignorance on resource availability for the UK and France, but in Germany (mid-90s when I was there) there was an equally slender number of MRIs & CTs (don't know about cath labs). And as late as the early 90s, in the UK people in renal failure in the UK were not eligible for HD if they were over 60 - not enough HD centers (source: ethics textbook & personal conv. with UK HD tech).

In the US, free market pressures ($$$) would increase the number of HD centers in the latter example.

Does it work as efficiently as libertarians would like? Hell no, because like you said, people are skimming off what they can, and what makes the most money is not neccessarily the best care for the patient.

I will opine that this _may_ be a case of the lesser evils... like some wag once said about democracy - it's a horrible political system, only slightly better than most alternatives.

Not denying the system is broke, I'm just not sure the answer lies in copying what other countries have. We should definitely look to them for ideas, I just don't think anyone out there has the "right answer".

 

[typeB-md]

I'm afraid I don't see that happening... in effect, you would have to look at a jury and tell them that person A is entitled to less medical care than person B because he makes less money. Rightly or wrongly, Americans see health care as a "human right" to which all are equally entitled. The fact that this may bear no resemblance to reality does not in any way change the public perception. A change in the tort law like you describe would never happen in today's legal / political climate. And to be honest, I'm not sure _I_ would be comfortable with such a change - in effect, legalizing the inequities (note that I do not deny that they exist in fact to some extent)

in short, why do you believe that healthcare is a human right? just curious.

 

[doc05]

Back to EM $$$. Why is the published "median" EM salary $180,000? Every ER doc I've talked to in Indiana is making well over 200K, some are making 300K.

why?

(1) salaries in Indiana may not be representative of salaries in other parts of the country
(2) it's always best to underreport earnings in any "physician salary" survey -- in every specialty -- to minimize the "doctors earn too much money" attitude of the lay public.

 

[Jeff698]

in short, why do you believe that healthcare is a human right? just curious.

I don't think he does (or, if he does, he didn't say so). He said the majority of Americans think it so.

I agree completely with this. It doesn't much matter that I think the whole issue of defining it as a right is missing the point. Most Americans feel it is a 'right' and I don't see that changing. Especially with HMOs and other employer provided health insurance doing such a great job of hiding the real costs of health care from the end user.

On the median salary question, I think a large part of it is that those numbers combine academic and private practice salaries and don't factor in benefits. Academic positions typically pay less in salary but have more benefits. Private positions are typically the reverse. Regional differences also play a big role.

Take care,
Jeff

 

[GeneralVeers]

At the same time, I don't think there's any argument that our current system is in many ways very broken. While you may argue that the Canadian system is also broken, it is broken in different ways but which still results in better overall health for its population as compared to the US version. Plus, it's cheaper.

Whether or not the Canadian system has "better overall healthcare" as you say is a matter of opinion. Most of the surveys that rank countries in terms of healthcare are biased towards a more socialistic view. At one point, 20 years ago the Canadian system was superior. I doubt this is still a case. There is a massive shortage of primary care doctors in Ontario, to the point where patients can't even find a doctor who can take them. Furthermore the average wait time for chemotherapy is 6 weeks, 8 weeks for Radiation treatment. CT scanners are not widespread, and cath labs are unheard of except in the larger centers. To me, all these things are not indicative of a system that provides "superior" healthcare to the United States. Considering the horrendous amount of taxes that Canadians pay, they are definitely not getting their money's worth.

 

[Sessamoid]

Whether or not the Canadian system has "better overall healthcare" as you say is a matter of opinion. Most of the surveys that rank countries in terms of healthcare are biased towards a more socialistic view. At one point, 20 years ago the Canadian system was superior. I doubt this is still a case. There is a massive shortage of primary care doctors in Ontario, to the point where patients can't even find a doctor who can take them. Furthermore the average wait time for chemotherapy is 6 weeks, 8 weeks for Radiation treatment. CT scanners are not widespread, and cath labs are unheard of except in the larger centers. To me, all these things are not indicative of a system that provides "superior" healthcare to the United States. Considering the horrendous amount of taxes that Canadians pay, they are definitely not getting their money's worth.

It's odd then how Canadians are so much healthier than we are despite having fewer high-tech medical toys at their disposal, isn't it? On top of that, most of Canada is too cold for a significant part of the year to get outside for outdoor activities. Despite that, Canadians seem to be in better health than residents of Los Angeles, where we have almost nothing but perfect weather 365 days a year.

More expensive toys does not equate to better health, and arguably doesn't equate to better health care depending on your priorities. American health care consists of waiting until people get ill then fixing them when they do get ill. Most of the rest of the world is more focused on preventing people from becoming ill in the first place. Only when we encounter a crisis do Americans act decisively. For an example, see the flu vaccine shortage last year.

Despite spending around twice as much PER CAPITA as the rest of the industrialized world, Americans have nearly the worst health by many diverse metrics of all the first world.

 

[RichL025]

in short, why do you believe that healthcare is a human right? just curious.

Jeff correctly pointed out that I personally did not say that, although I am sympathetic to the view. Without derailing this thread into a long philosophical discussion (in which I would probably mangle any philosophical terms I would try and use), I'll just agree with Jeff that it is viewed as such by most americans, and further, the UN Declaration on the Rights of Man (1948) explicitly mentions health care (Article 25).

 

[RichL025]

It's odd then how Canadians are so much healthier than we are despite having fewer high-tech medical toys at their disposal, isn't it? ...

Despite spending around twice as much PER CAPITA as the rest of the industrialized world, Americans have nearly the worst health by many diverse metrics of all the first world.

Just think of how much worse off we'd be if we _didn't_ spend twice as much per capita <g>.

Seriously, no doubt that we need to spend more on preventive medicine, but the fact is we have the unhealthiest population of the first world. "Supersize it, please!" And patients who think "exercise" means vacuuming the house.

That being said, even if we didn't have such a fat, lazy citizenry (hope I don't sound bitter), we would still have need of things like HD centers, CTs and MRIs. And there is a certain subset of the population who will still get CAD due to bad genes, even though they lived "right". All the preventive medicine int he world won't help them, and if that cath lab isn't there when they need it, they die.

 

[EctopicFetus]

Seriously, no doubt that we need to spend more on preventive medicine, but the fact is we have the unhealthiest population of the first world. "Supersize it, please!" And patients who think "exercise" means vacuuming the house.

This is the reason our measurables suck. Look at any of the data on eating habits and excercise and we are near the bottom. Take a walk through a mall or supermarket and count how many 300 lb adults there are. I mean this is amazing. Certainly this is worse in the midwest but it is true everywhere.

 

[bigfrank]

(2) it's always best to underreport earnings in any "physician salary" survey -- in every specialty -- to minimize the "doctors earn too much money" attitude of the lay public.

Agreed. The highest paid docs don't even consider reporting. That's why one should always add 30-50% to all salary surveys.

 

[EctopicFetus]

So what would you folks say is the NATIONAL average SALARY for EM docs? 250+K?

 

[Jeff698]

Take a walk through a mall or supermarket and count how many 300 lb adults there are. I mean this is amazing. Certainly this is worse in the midwest but it is true everywhere.

Hey now! Don't forget us Houstonians. I think we lead the nation in fattest population for the past several years.

We Texans....we always have to have the biggest of everything...even asses.

Take care,
Jeff

 

[GeneralVeers]

It's odd then how Canadians are so much healthier than we are despite having fewer high-tech medical toys at their disposal, isn't it?
More expensive toys does not equate to better health, and arguably doesn't equate to better health care depending on your priorities.
Despite spending around twice as much PER CAPITA as the rest of the industrialized world, Americans have nearly the worst health by many diverse metrics of all the first world.

You are absolutely right, but you're lumping personal choices and cultural choices with healthcare. I was speaking only to actual medical costs like hospitalizations, primary care, pharmaceuticals, etc. in which Canada is way below what I consider an acceptable standard of care. If I ever got sick, I would in no way want to be treated in Canada (I'm a Canadian citizen BTW).

Just because Americans CHOOSE to smoke, drink, be fat, and not exercise doesn't necessarily reflect on the healthcare system. Americans are reasonably healthy despite their horrendous lifestyle choices due to the quality of care that's available. If we combined Canada's pitiful tertiary care (and increasingly pitiful primary care) with U.S. lifestyle choices, everyone would have died out in America long ago.

The single best thing the government could do for public health in this country would be to ban cigarettes outright. I wouldn't make it a criminal offense to possess them, but to distribute them should carry jail time.

 

[la gringa]

i think banning cigs right off is a bit too harsh - i do feel very strongly, however, that smoking in public places should be banned. it is injurious and noxious to the health of others, who often have no choice but to be around it. i'm asthmatic and sometimes can't even have a drink at a bar or go to a club b/c of the amount of secondhand smoke. banning public smoking will start a shift in how americans view smoking, since it would make it a less accessible activity.

 

[leviathan]

There is no solution to the medical cost problem. As a whole the average insured American gets superior care to any other country in the world.

The Canadian solution is not a "solution". After growing up there, I can tell you that it's turning into soviet-style medicine. Few resources, few doctors, and no access to the standards of care that we enjoy in the United States.

My Uncle just died up there last year. He had a massive heart attack in Niagara Falls, Ontario (pop ~100,000). The city has no cath lab, not even an MRI machine. There is one CT scanner at the city hospital. The nearest cath lab is 200 miles away in Hamilton. They let him sit in ICU for nearly 2 days before putting him in an ambulance. He died on the cath table when they finally got him there.

Back to EM $$$. Why is the published "median" EM salary $180,000? Every ER doc I've talked to in Indiana is making well over 200K, some are making 300K.

How many 100k cities in the US have a wealth of high-tech scanners and procedural labs? Living in a metropolitan canadian city (Vancouver), I and anyone I know has never had a problem getting any sort of procedure done.

I think problems with the US system are the number of people who can't even afford/neglect to pay insurance, doctors who always need to worry about whether the patient is insured, and patients who neglect to see their doctor to avoid having to pay medical fees that their insurance doesn't cover or that still require paying a deductible (whereas in Canada you go in to see your doc without needing anything in your wallet besides your MSP card).

Now, both the Canadian and US healthcare systems have their flaws, and I don't have a personal opinion as to which one I think is better. As a person who can afford insurance, I would personally rather live in the US, but thinking on a more broader spectrum, as a nation, perhaps the Canadian system better serves the entire population (especially the lower class).

 

[GeneralVeers]

Now, both the Canadian and US healthcare systems have their flaws, and I don't have a personal opinion as to which one I think is better. As a person who can afford insurance, I would personally rather live in the US, but thinking on a more broader spectrum, as a nation, perhaps the Canadian system better serves the entire population (especially the lower class).

I'm not going to disagree there. Which system is better is a matter of priorities. What I object to the Canadian approach is that it significantly reduces the health care of most Canadians in order to provide coverage for a few.

In the United States the figure quoted during the last election was 20% of the population is uninsured. That means that approximately 80% have reasonable access to quality care. I'm not sure that's such a failure. The trick is, how do we provide care for those other 20%? I'm not willing to sacrifice the quality of my own insured healthcare, and I'm sure most Americans would say the same. Which is better? 80% having reasonable care or 100% having barely adequate care?

 

[Homer Doughnuts]

So what would you folks say is the NATIONAL average SALARY for EM docs? 250+K?

Im going to go ahead and add 30 % - 50 % to that, as per doc05. SOOOOOO that would mean an avg of 325,000 to 375,000 kickass

 

[Sessamoid]

Which is better? 80% having reasonable care or 100% having barely adequate care?

Logical fallacy. I don't think that's it's such a simple binary choice. Let me ask you, would you rather your both your wife and child got hit by a car or only your child?

 

[GeneralVeers]

Logical fallacy. I don't think that's it's such a simple binary choice. Let me ask you, would you rather your both your wife and child got hit by a car or only your child?

I wouldn't want either, which was exactly my point. I supposed if one had to pick, they'd choose the child.

 

[RichL025]

How many 100k cities in the US have a wealth of high-tech scanners and procedural labs? Living in a metropolitan canadian city (Vancouver), I and anyone I know has never had a problem getting any sort of procedure done.

No offense to your healthcare system, but if you'll read the posts above you'll see at least one instance of personal knowledge where a canadian city of 100K did not have a cath lab.

And do you really deny that people in the Canadian NHS don't have to wait long periods of time for outpatient scans? Because if that isn't an accurate characterization, there's a whole lot of slander goin' on in your southern nieghbor...

... but thinking on a more broader spectrum, as a nation, perhaps the Canadian system better serves the entire population (especially the lower class).

I definitely agree with you here.

 

[GeneralVeers]

Does the healthcare system exist solely to benefit the "lower classes"? In Canada even the perceived benefit to the disadvantaged is in question. Since there's a serious shortage of primary care docs, even worse than in the United States, how are the poor going to get health care if they can't even find a family doc who will take them?

I still haven't received an answer to my original question. Is it okay to lower the healthcare standards of the majority of the population in order to possibly benefit the minority?

 

[leviathan]

No offense to your healthcare system, but if you'll read the posts above you'll see at least one instance of personal knowledge where a canadian city of 100K did not have a cath lab.

That's highly possible, but my question is, is lacking a cath lab in a city of only 100k a bad thing? I have no experience so I don't know if that is really a bad thing or not. I know in Vancouver and its surrounding suburban cities (pop. 2 million) we have cath labs in pretty much all of our major hospitals, so perhaps it's a question of population distribution. When 80% of Canadians live within 100 miles of the Canada-US border, that might be an explation for why a 100k town way up north is lacking a cath lab.

And do you really deny that people in the Canadian NHS don't have to wait long periods of time for outpatient scans? Because if that isn't an accurate characterization, there's a whole lot of slander goin' on in your southern nieghbor...

Yeah, our wait times are ridiculous for a lot of elective surgeries and imaging, there's no doubt about that. But how do they compare to the American system? Again, these are things I don't know. I do know that in our emergency departments, wait times are also long, but the wait time is probably on par with American hospitals in spite of our socialist healthcare system.

 

[leviathan]

Does the healthcare system exist solely to benefit the "lower classes"? In Canada even the perceived benefit to the disadvantaged is in question. Since there's a serious shortage of primary care docs, even worse than in the United States, how are the poor going to get health care if they can't even find a family doc who will take them?

I still haven't received an answer to my original question. Is it okay to lower the healthcare standards of the majority of the population in order to possibly benefit the minority?

Again, I really don't see this being a reality. They talk about it on the news, but I've never personally seen someone who couldn't find a family doctor, or at the very least someone who couldn't get to a walk-in clinic. When people come in for non-emergent issues in the ED where I'm at, we give them a list of current family physicians who are taking new patients. There is an Ontario website that lists current doctors accepting patients as well, and the list is quite large if I recall correctly. Now if you're out in some isolated rural town, that might be a little more difficult to find healthcare, but is that any different in the US?

 

[GeneralVeers]

Interesting, Leviathan. Not practicing in Canada I don't have firsthand knowledge of primary care. I do read the Toronto Star every day (yes I realize it's a socialist propaganda paper) and if you believe what their articles say, the primary care system is collapsing. The worst thing the province ever did was put salary caps on the doctors.

The Fraser Institute did a study of wait times this year. You can read it at the Fraser site. Essentially the wait times for anything tertiary care is much higher than in the United States. As I mentioned they list cancer patients as waiting a median time of 8 weeks for radiation treatment, which is something patients in the U.S. can get within one week, and next day emergently. The county hospital in Indianapolis sends the cancer patients to the University for treatment, and they are treated like all the other patients.

 

[oldManDO2009]

I would like to point out the we have a national health insurance – it is called Medi-Care and any number of State sponsored programs. The hallmark of these types of health insurance programs are cost overruns, fraud and any number of other fiscal problems that continues to escalate the cost of government provided insurance.

I think (IMHO) that the best form of national health insurance would be a personal premium provided to each individual based on age and health. For example, a twenty year old would receive 1200 dollars per year in actual cash premiums to pay for his/her health insurance and an 80 year old with renal failure might receive 80,000 dollars per year. This would be paid directly to the insurance company that the individual chose to provide such a service. The benefits are that the government gets out of the business of health insurance and health care. Each person could choose an insurance company that would provide desired benefits. Insurance companies would have less incentive to only fill their ranks with young healthy individuals and competition would manage cost. The taxes we pay for Medi-Care might easily cover such a program. This idea was barrowed from a Fortune magazine editorial and poorly paraphrased.

FYI – thanks for clarifying salary surveys – they do seem a bit ambiguous.

 

[mfrederi]

The idea about the gov. giving people their insurance premiums is not bad. However, I really feel like people have to take some responsibilities for thier health, and responsibilities for decisions they make. If Uncle Sam is going to pay for everything, then some people will abuse that system, and in the same way alot of people with good insurance feel like they have to "get their money's worth" and see the doc for anything they can think of. This type of irresponsible visit is exactly what drives up the premiums. And, don't get me started on smoking, fast food, and not exercising.... I think people should be allowed to do whatever they want, if you want to cram McD's down your mouth 4 times a day inbetween smokes, more power to you. But, at some point that person has to reap what they sow, as opposed to being supported by state and federal run programs as they slowly waste away due to COPD or DM. I hope I am not sounding insensitive, because I am certainly not suggesting that you just throw these guys out on the street because they have made bad life decisions, because we all have. Its just at some point we have to find a way to keep other's for paying such a large portion of the repurcusions of those bad decisions, but I got no idea how to go about that. Fast food tax?

 

[leviathan]

Interesting, Leviathan. Not practicing in Canada I don't have firsthand knowledge of primary care. I do read the Toronto Star every day (yes I realize it's a socialist propaganda paper) and if you believe what their articles say, the primary care system is collapsing. The worst thing the province ever did was put salary caps on the doctors.

The Fraser Institute did a study of wait times this year. You can read it at the Fraser site. Essentially the wait times for anything tertiary care is much higher than in the United States. As I mentioned they list cancer patients as waiting a median time of 8 weeks for radiation treatment, which is something patients in the U.S. can get within one week, and next day emergently. The county hospital in Indianapolis sends the cancer patients to the University for treatment, and they are treated like all the other patients.

GeneralVeers,

You're probably very right about the waiting periods for tertiary care, but I was referring to emergent care. Either way, I don't really have any statistics in front of me to debate it, I just have impressions.

 

[Jeff698]

OldMan (I love that screen name, BTW), what you are describing is similar to what the AMA proposes. Take a look at some articles on their web site here: http://www.ama-assn.org/ama/pub/category/7834.html

Take care,
Jeff

 

[GeneralVeers]

GeneralVeers,

You're probably very right about the waiting periods for tertiary care, but I was referring to emergent care. Either way, I don't really have any statistics in front of me to debate it, I just have impressions.

Unfortunately we'll never know. The Canadian government will never release the results of a study comparing Emergency care between Canada and the U.S.

I have to think though, that the paucity of CT scanners in smaller Canadian community hospitals must have some negative consequences for Emergency Medicine there.

Pretty well every community hospital greater than 100 beds down here has a CT Scanner.

 

[Future Doc B]

Pretty well every community hospital greater than 100 beds down here has a CT Scanner.

I wonder if that has anything to do with the litigious climate in the US? Do these hospitals have CT scanners because they are warranted and necessary or because they don't want to be sued?

In relation to the whole health insurance debate... I think US workers with insurance are already footing the bill for the uninsured. By paying taxes that go towards Medicare and reimbursing hospitals for treating indigent populations with no medical insurance, workers with insurance are essentially paying for healthcare services which they will not receive. So basically, you pay for your own insurance plus the costs of healthcare for someone who cannot or chooses not to carry insurance.

As far as taxes between US and Canada, when you factor in higher property taxes and medical insurance, the rates are pretty similar with Canada being only slightly higher. (There used to be a post that compared the tax brackets for both Canada and US, but I can't find it at the moment.)

BTW, this is a great debate...

 

[MS05']

The Canadian solution is not a "solution". After growing up there, I can tell you that it's turning into soviet-style medicine. Few resources, few doctors, and no access to the standards of care that we enjoy in the United States.

My Uncle just died up there last year. He had a massive heart attack in Niagara Falls, Ontario (pop ~100,000). The city has no cath lab, not even an MRI machine. There is one CT scanner at the city hospital. The nearest cath lab is 200 miles away in Hamilton. They let him sit in ICU for nearly 2 days before putting him in an ambulance. He died on the cath table when they finally got him there.


First of all, I'm very sorry to hear about your uncle. It was an unfortunate event seeing how there is a 24 hour cath lab in Buffalo, less than 20 miles away from the Niagara Falls Canadian side (probably less than that actually.) I'm not very familiar with the politics of transporting patients across country lines, but for future reference should something like this ever happen again in your family....