How is Canada's medical system working out?

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MegaProjectile said:
Fox News did an editorial and I think 92% of Canadians are very happy with their coverage. Imagine that. They know going to the hospital won't bankrupt them like 60% of Americans.
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[YOUTUBE]http://www.youtube.com/watch?v=1EK5D42O8ic[/YOUTUBE]

I don't see how 92% of Canadians could be happy with this type of health care system.
 
It is a horrible truth that The United States, a country that spends more on health-care than any other, has the problems that it does.

I think that we can ALL agree something needs to be done. Insurance rates are going up astronomically every year. We must look at the source of the problems in order to solve them.

Every week day I watch two shows on the "Discovery Health" channel. They both follow doctors in ERs. The first show was filmed in Canada. The second was filmed in various hospitals throughout the U.S. Truthfully, I did not even realize the first show was filmed in Canada the first few times I watched. It was comparable to any hospital that I have been to in the U.S, barring Harberview in Seattle.

I hate to blame the big bad corporations, but in this case I think it is true. Insurance and pharmaceutical companies are the main guilty parties in this case.

Nobody should die of cancer because a CEO at an insurance company decided that it is not covered in said persons plan.

Also, many point out the wait in the Canadian health-care system. To that I say; have you been to an emergency room lately? Last time I was there i had a broken arm and waited five hours to see a physician. Now, I do believe one would get into a primary care doctor faster in the U.S, but that still needs a lot of work.

Anyways, that's enough for me.
 
chman said:
I hate to blame the big bad corporations, but in this case I think it is true. Insurance and pharmaceutical companies are the main guilty parties in this case.
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I totally agree. I don't think we can trust politicians any more than we can trust CEOs though.

chman said:
Nobody should die of cancer because a CEO at an insurance company decided that it is not covered in said persons plan.
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And nobody should die of cancer because it took 6 months to have an MRI done. The government can decline any procedure they deem unnecessary too.


chman said:
Also, many point out the wait in the Canadian health-care system. To that I say; have you been to an emergency room lately? Last time I was there i had a broken arm and waited five hours to see a physician. Now, I do believe one would get into a primary care doctor faster in the U.S, but that still needs a lot of work.
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Five hours is a lot better than 24 (average ER wait time in Canada). The two times I've had to go to the ER, I saw a doc in less than 20 minutes.
 
"Five hours is a lot better than 24 (average ER wait time in Canada). The two times I've had to go to the ER, I saw a doc in less than 20 minutes.[/QUOTE]"by medman25

I would like to see some proof of this. Twenty-four hours seems a bit much. Maybe you did get in in twenty minutes, but that is rare, unless one is in serious shape or is brought in by ambulance.

P.S. Yes, politicians in general have proven time and time again that they are not to be trusted, both sides of the isle.
 
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chman said:
I would like to see some proof of this. Twenty-four hours seems a bit much. Maybe you did get in in twenty minutes, but that is rare, unless one is in serious shape or is brought in by ambulance.

P.S. Yes, politicians in general have proven time and time again that they are not to be trusted, both sides of the isle.
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Sorry, I was about 3 hours off. Average Canadian ER wait time is 20 hours, 42 minutes:

http://www.cbc.ca/health/story/2008/05/21/ot-er-waits-080521.html?ref=rss

Average wait time in the USA - 4 hours, 3 minutes:

http://www.cnn.com/2009/HEALTH/06/25/emergency.room.care/index.html


USA: 1
CANADA: 0
 
I have seen this before. But I think that it is worth noting that the argument is only made for one city in one province. I don't see any statistics for Vancouver, Toronto, etc. In Canada each province is responsible for their own health-care (I believe).

I remember seeing a news story not too long ago about a woman in New York who died in the ER after waiting 11 hours.

Look, I'm not really trying to side with either modal of delivery. I just think we need to make some serious adjustments.

I think it is a human right not to be in pain, physically or emotionally. 😎

P.S While I do trust the news sources you cited, I am currently trying to find government statistics of both sides to see if we can get something that is positively accurate.
 
chman said:
I have seen this before. But I think that it is worth noting that the argument is only made for one city in one province. I don't see any statistics for Vancouver, Toronto, etc. In Canada each province is responsible for their own health-care (I believe).

I remember seeing a news story not too long ago about a woman in New York who died in the ER after waiting 11 hours.

Look, I'm not really trying to side with either modal of delivery. I just think we need to make some serious adjustments.

I think it is a human right not to be in pain, physically or emotionally. 😎

P.S While I do trust the news sources you cited, I am currently trying to find government statistics of both sides to see if we can get something that is positively accurate.
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This is true, I don't have a stat for the country as a whole but you can look up ER wait times for other provinces in CA if you're interested. They aren't any better.
 
Well I don't know how the stats are compiled, but as a Canadian in a major centre, I would say a wait time of about 4 hours is normal. In a small centre, I have experienced no wait times at all. They do triage you of course, so if your problem is neither emergent nor urgent, I guess you might be waiting a long time as more serious cases come in.

For example, "In Alberta, emergency room wait-times average six hoursIn Alberta, emergency room wait-times average six hours" from this recent article http://www.cbc.ca/canada/edmonton/story/2009/03/06/edm-four-hour-rule.html

Looks like BC has longer wait times - more than 10 hours.

That 20 hours and 42 minutes is the average wait time for one ER in a western Quebec - kind of MISLEADING to title that "average" wait time in Canada in your story link, don't you think?

Regarding PCP availability, it depends on how busy they are and how many patients they have. I can usually see my doc same/next day for something that has come up. Physicals take a bit of time to schedule. My gynecologist can be scheduled with a few days. All at no cost to me.
 
MedMan25 said:
Sorry, I was about 3 hours off. Average Canadian ER wait time is 20 hours, 42 minutes:

http://www.cbc.ca/health/story/2008/05/21/ot-er-waits-080521.html?ref=rss

Average wait time in the USA - 4 hours, 3 minutes:

http://www.cnn.com/2009/HEALTH/06/25/emergency.room.care/index.html


USA: 1
CANADA: 0
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The problem with these stats is that the Canadian number usually reflects the wait to either be admitted or discharged (following evaluation) and the American number usually reflects the wait to initially see a doctor. Big difference.
 
Regardless of wait-times or whatever. The president of the CMA (who i'm sure is more knowledgable and experienced with Canada's system) has stated the system is in peril. Why are there individuals who only think US's system is crap? I know physicians in England and Australia, they all tell me the systems are problematic and in trouble there as well. There just isn't enough money and resources available. Take home point? Medical care is expensive in the modern era and there's many issues with health care delivery in many modernized nations. US isn't the only place. People need to stop looking at the other side of the fence. The grass is ALWAYS greener.
 
There is no perfect system of health care delivery; it just comes down to what problems you are willing to tolerate. Personally, I'm fine with waiting for care if it means that care is available, and basing a system on preventative care makes much more sense to me than basing it on acute or primary care. Additionally, I'm not a fan of for-profit health systems, as they tend to lower the quality of the care provided.
 
I will say once again; I am not defending either mode of delivery. There is obviously no perfect system.

A couple points I left out though. Using the ER as primary care, which is what most uninsured end up doing, is a costly way of doing things. Couple that with the sheer amount of unnecessary test due to the fear of prevalent malpractice suits and you have a huge strain on the system.

Those things, along with huge rises in premiums, and outrageous drug prices, is a perfect storm of financial ruin.

Further, there are too many interests involved for there to be any kind of easy solution. In fact, it would probably be more productive to tackle one issue at a time. "Inch by inch it's a cinch, mile by mile, it will take a while."

We (America) need to stop comparing out problem to those of other countries. We have a much higher population than Canada, and different issues.
 
chman said:
We (America) need to stop comparing out problem to those of other countries. We have a much higher population than Canada, and different issues.
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I agree completely. If the government wants to fix healthcare, they have all the tools to tackle each issue independently.

The last thing we need is another government run anything. Government run healthcare in the United States might fix a hundred problems, but it would create thousands more.
 
I would not rule a government option out. In if that is the case, does that mean we get rid of the government plans we already have (medicare/medicade)?
 
I think medicare / medicaid are both great examples of why the government should NOT be involved in healthcare. Neither of those programs are solvent. Together they account for a vast share of the projected federal budget deficit.
 
chman said:
I would not rule a government option out. In if that is the case, does that mean we get rid of the government plans we already have (medicare/medicade)?
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that would be nice...
 
i think medicare/medicaid is broken (duh).. these taken together with social security is a huge drain on the federal budget. while entirely eliminating them would likely be a bad idea, i think they need to be fixed/shrunk in a big way.
 
Medicare and Medicaid aren't going away any time soon.

First, seniors vote (and are a huge voting bloc), and they fight reductions in Medicare tooth and nail. Second, Medicaid is the life blood of many institutions (a lot of "self-pay" patients end up as "no-pay" patients, and enrolling them in Medicaid has helped to keep hospitals open).

There are a lot of free-market cultists out there who believe that all forms of government programming are bad ideas, but fail to see that they can produce beneficial and solvent programs, and that free market approaches look good on paper, but end up lowering overall quality of care (for those fortunate enough to be enrolled in a private insurance program).
 
Agreed. I was just curious to see if he wanted to make an intelligent argument like I like to think I did.
 
Quix said:
Medicare and Medicaid aren't going away any time soon.

First, seniors vote (and are a huge voting bloc), and they fight reductions in Medicare tooth and nail. Second, Medicaid is the life blood of many institutions (a lot of "self-pay" patients end up as "no-pay" patients, and enrolling them in Medicaid has helped to keep hospitals open).

There are a lot of free-market cultists out there who believe that all forms of government programming are bad ideas, but fail to see that they can produce beneficial and solvent programs, and that free market approaches look good on paper, but end up lowering overall quality of care (for those fortunate enough to be enrolled in a private insurance program).
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when medicare was proposed, the life expectancy was ~70. now it's ~78, yet the minimum age for eligibility remains the same. free market vs government debate aside, isn't this a fundamental problem?
 
I'm not saying these programs are great. But what do you suppose we do with our senior population with out them?

Also, seniors use health-care much more than younger people do. Therefor, a government option for younger people would not be as strenuous to the system.

My point is that uninsured populations, malpractice suits, and unnecessary tests currently cost the system a ton of money. If those problems were eliminated, we would have enough to provide minimal care to our uninsured population. 🙂
 
Quix said:
There are a lot of free-market cultists out there who believe that all forms of government programming are bad ideas, but fail to see that they can produce beneficial and solvent programs, and that free market approaches look good on paper, but end up lowering overall quality of care (for those fortunate enough to be enrolled in a private insurance program).
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Name one entitlement program that is solvent according to the CBO.
 
MegaProjectile said:
You think a single payer is more dangerous than the privatize system we have now? The "dangerous" Canadian system beats our health-care system in any objective metric:Malpratice,student debt, quality of life, work-hours, life expectancy, birth rate mortality, overall health-care cost.....I could go on....

The one problem commonly cited for the Canadian system is wait-time. However, that's because the US pays doctors more and so it attracts a good number of Canadian doctors each year. That is going to change soon since the US system of high pay is unsustainable. Coupled with less work-hours, lawsuits and low student debt that Canadian doctors enjoy, I doubt we would continue to see that deflection in the future.
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Big ++. Currently, our (Canadian) problem is a shortage of doctors, most of which have been shipped to the States. We just increased the size of medical school classes/year at every major university. Slowly we are adding more doctors but still bunches of people without a regular family doctor. Imagine we had kept all of our doctors - it would lower waittimes because people would actually have a family doctor to visit (so they wouldn't clog ERs).
 
TexasFight said:
I don't see any single payor systems in the world making more medical innovations than private ones (i.e. The US). We have the world's best medical care, admittedly to those who have access. ...
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Actually, the U.S. has the 37th's best healthcare and pays the 3rd highest for it.
 
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I think you missed his point, that we have the best care available if you have the money to pay for it. Read his statement more carefully.
 
I know, but i believe that healthcare should be available to everyone. It just shows, overall, that Americans in general are getting subpar care.

Individually, yes, if you have the money - you win. But even if you make $50,000/year, you can still be pretty hardpressed if you develop a long-term illness.
 
Simplify said:
Name one entitlement program that is solvent according to the CBO.
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Well that's an arbitrary constraint. First, you are assuming we're being constrained to current levels of income with increased projected spending. If revenues go up (or are cut in other programs, assuming a zero-sum allocation scheme), then theoretically any program is solvent. Second, federal programs aren't limited to entitlement programs - infrastructure, military spending, etc., are all under the purview of the federal budget, which opens up the idea of solvency to a number of different programs. Focussing solely on entitlement programs is being dishonest. Third, there is no reason to assume that federal spending on healthcare is a closed system - shifting resources currently being spent on private insurance to a public system radically off-sets cost of universal coverage, and the shift to a preventative system lowers long-term costs (since we are nipping small problems before they become big problems). The demand you are making isn't simplifying, it's simplistic, and ideologically driven.

EDIT:

And on that note, I'm off to give a lecture on scarcity in medical resources.
 
Quix said:
The demand you are making isn't simplifying, it's simplistic, and ideologically driven.
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Attacking my board name, while cute, doesn't further your agenda which is clearly idealogical.

There are a number of viable actions the government could take to facilitate cost-reduction, here is a small list:

1. Tort reform
2. Individual mandate
3. Tax credits for individuals
4. Allow purchases of insurance across state lines
5. No rejection for pre-existing conditions
6. No dropping of coverage due to illness
7. Reduce duplication of diagnostic tests
8. Increase subsidy for medical education
9. Graduate more physicians, PAs, NPs
10. Non-profit insurance companies

A single-payer system is not without its own set of problems. I don't think single-payer is inherently evil, but I don't think it is the best way either. The biggest problem we have in the medical field today is a lack of efficiency. As a former government and military employee, I can tell you with some authority that efficiency isn't even in the government's playbook. If you think government can cut costs you're utterly delusional. The U.S. government, at all levels, works on a "use it or lose it" fiscal philosophy. In order to maintain their fiefdoms, managers overspend in the current year and overproject for the next. This is why government programs always balloon in size until they are eventually cut or killed.
 
Simplify said:
Attacking my board name, while cute, doesn't further your agenda which is clearly idealogical.

There are a number of viable actions the government could take to facilitate cost-reduction, here is a small list:

1. Tort reform
2. Individual mandate
3. Tax credits for individuals
4. Allow purchases of insurance across state lines
5. No rejection for pre-existing conditions
6. No dropping of coverage due to illness
7. Reduce duplication of diagnostic tests
8. Increase subsidy for medical education
9. Graduate more physicians, PAs, NPs
10. Non-profit insurance companies

A single-payer system is not without its own set of problems. I don't think single-payer is inherently evil, but I don't think it is the best way either. The biggest problem we have in the medical field today is a lack of efficiency. As a former government and military employee, I can tell you with some authority that efficiency isn't even in the government's playbook. If you think government can cut costs you're utterly delusional. The U.S. government, at all levels, works on a "use it or lose it" fiscal philosophy. In order to maintain their fiefdoms, managers overspend in the current year and overproject for the next. This is why government programs always balloon in size until they are eventually cut or killed.
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i like ALL of these things. 👍
 
Quix said:
I'm not a fan of for-profit health systems, as they tend to lower the quality of the care provided.
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Quix said:
... free market approaches look good on paper, but end up lowering overall quality of care (for those fortunate enough to be enrolled in a private insurance program).
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Would you mind supporting or qualifying those assertions for us?
 
Simplify said:
Attacking my board name, while cute, doesn't further your agenda which is clearly idealogical.

There are a number of viable actions the government could take to facilitate cost-reduction, here is a small list:

1. Tort reform
2. Individual mandate
3. Tax credits for individuals
4. Allow purchases of insurance across state lines
5. No rejection for pre-existing conditions
6. No dropping of coverage due to illness
7. Reduce duplication of diagnostic tests
8. Increase subsidy for medical education
9. Graduate more physicians, PAs, NPs
10. Non-profit insurance companies

A single-payer system is not without its own set of problems. I don't think single-payer is inherently evil, but I don't think it is the best way either. The biggest problem we have in the medical field today is a lack of efficiency. As a former government and military employee, I can tell you with some authority that efficiency isn't even in the government's playbook. If you think government can cut costs you're utterly delusional. The U.S. government, at all levels, works on a "use it or lose it" fiscal philosophy. In order to maintain their fiefdoms, managers overspend in the current year and overproject for the next. This is why government programs always balloon in size until they are eventually cut or killed.
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Sonny Jim, we could easily get into a condescend off, since I teach and research this for a living and have worked at all levels of hospital administration at a number of institutions, and can say with some authority that you are generalizing from your own impressions to the system as a whole, which is delusional, inappropriate and ideological in nature. Or we could explore each of these and see whether how compatible they are with proposed models and the status quo.

First, my "ideologically driven agenda" is based on current trends in health care delivery, which are stressing cost-benefit and cost-effectiveness analyses at the mesoallocation level, which is pushing hospitals to increase patient:staff ratios (i.e., increasing the individual workload by taking in more patients while concomitantly hiring fewer clinical staff to care for them), and substitute alternative clinical staff for the traditional MD/DO's (i.e., hiring more PA's, CRNP's, and DNP's under the overall supervision of a reduced number of MD/DO's), which reduces the overall quality of individual patient care. Market forces do not produce optimization of care. We are seeing a proliferation of "Dollar Menu Burger" care, not "Filet Mignon" care, because it is more cost-beneficial and cost-effective to do so.

Second, I agree that wasteful spending is a huge problem, driven by a number of forces. The practice of defensive medicine produces unnecessary tests and inappropriate treatments, fee-for-service models cause billing for unnecessary procedures, relying on acute and chronic care (which by their nature are more expensive than preventative approaches to medicine), lack of coverage producing an overreliance on emergency rooms (tying in to the acute/chronic problem above), pennies on the dollar compensation by third-party payers driving up billing rates, the cost of malpractice insurance (and the tendency of lawyers and patients to see hospitals as ATMs), etc., but even by addressing these issues, we are still facing a huge burden on health care delivery that is antithetical to for-profit health care delivery. The actual costs of care are felt ultimately by hospitals and patients.

Third, the reforms you propose are not a zero-sum game - they are entirely compatible with a universal health care model. Many of these, however, are entirely incompatible with a market approach to health care delivery.

4. Allow purchases of insurance across state lines
5. No rejection for pre-existing conditions
6. No dropping of coverage due to illness
...
10. Non-profit insurance companies

These are fundamentally antithetical to for-profit insurance companies. They are, at heart, businesses whose primary responsibility is to their share-holders, and each of these decreases their return on investment. It's not coincidental that these very issues are directly opposed by current lobbying efforts - they represent decreased revenues, and for-profit insurance companies have not historically been altruistic.

Federal programs are compatible with insurance portability, pre-existing conditions, etc., etc., and have been implemented successfully in many countries. There is no sound reason to insist on a model that only provides for private-sector health coverage.
 
MissMuffet said:
Would you mind supporting or qualifying those assertions for us?
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I address these indirectly in my response to Simplify, but I'll draw out the larger point to address your question directly.

On paper, one would expect a system that is designed to increase competition and maximize return on investment to spur growth, development, and improve the quality of care (i.e., making your product more attractive by making it better and cheaper than your competitor).

In practice, this has played out differently. While the U.S. does offer incredible medical technology, it's biggest problem is access to these resources. If you are starving and have no money, it doesn't matter that you have fifty five-star restaurants in your city. But this is glib and superficial.

In practice, what we see is a profit-motive impacting all levels of health-care delivery.

For insurance companies, there is a strong motive of return-on-investment. This translates into preferential coverage of those people likely not to get sick (since they present a constant positive revenue stream), with either limited or zero coverage offered to those who are likely get sick or who have pre-existing conditions. Family history of illness, personal risky behaviors, etc., are all potentially disqualifying conditions for coverage. This produces a system in which there are those who will be uninsured or underinsured, because they are low or negative return-on-investment patients. There is also a Catch-22 with these people; many people earn too little to afford private insurance, but earn too much to qualify for state or federal assistance programs.

For hospitals, there is also a strong motive of return-on-investment. A hospital's primary motivation is to serve the community (assuming it's not a for-profit institution), which it can only do if it maintains a certain level of profitability or a minimal level of deficit spending. These market-driven forces cause it to cut corners in care, either by hiring less-trained clinical staff (the data support roughly equal quality of care for routine procedures between MD/DO and PA/CRNP/DNP staff, but the differences become marked when more specialized procedures are required) or increasing the demands on existing staff through hiring freezes, pay freezes, increasing patient ratios, etc. When I finally quit, the nurse-to-patient ratio on our behavioral health unit was approaching 10:1 (the overall staff-to-patient ratio was 8:1, including non-clinical staff), and these were violent and mentally disturbed patients. These numbers have been trending up for several years now (no, I do not have the data in hand at the moment, but it is publically available).

Competition works for goods that allow for genuine competition (e.g., cost-comparing cars, entertainment systems, restaurants, etc.). Health care doesn't really fit this model - many patients feel overwhelmed by the amount of information available (and do not possess the knowledge necessary to sift through conflicting reports), are unaware of what their actual coverage and liability are, and many report denials of coverage once they are locked into a system (e.g., they develop a condition that was covered in the program literature, but in practice is denied), or who develop conditions that prevent them from being able to get coverage in the future (e.g., they cannot take their coverage with them to a new job, so they either have to stay in their current position (which is tenuous), or not have coverage in the new position). So long as health care is maintained as a for-profit system, patients will get systematically screwed.
 
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Quix said:
Sonny Jim, we could easily get into a condescend off, since I teach and research this for a living and have worked at all levels of hospital administration at a number of institutions, and can say with some authority that you are generalizing from your own impressions to the system as a whole, which is delusional, inappropriate and ideological in nature.
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I agree with your analysis of the state of healthcare, but if you're going to critique me for using anecdotal experience, you can't refute me by doing the same. It is obvious that you know as much about government as I do about hospital administration. Unless our government changes how it allocates assets it will never be able to successfully manage a healthcare delivery system or control costs inherent in that system. To suggest otherwise leads me to believe you are a naif.
 
Simplify said:
I agree with your analysis of the state of healthcare, but if you're going to critique me for using anecdotal experience, you can't refute me by doing the same. It is obvious that you know as much about government as I do about hospital administration. Unless our government changes how it allocates assets it will never be able to successfully manage a healthcare delivery system or control costs inherent in that system. To suggest otherwise leads me to believe you are a naif.
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I only use my anecdotal example as a concretization of a larger trend based on publically available data and studies (PubMed). Trend specified to an example is very different than an example generalized to a trend. And I wouldn't suggest that the current payment system is a model of efficiency in comparison. The amount of time the average physician spends on paperwork in the U.S. vs. Canada is remarkable - a streamlined payment system (in the sense that the money is coming out of one pot) is a model of efficiency compared to individualized billing for thousands of providers.
 
If one is not thinking of a solution one is part of the problem. Everyone has a right to his/her own opinion. However, if all one does is criticize others, and brings no solutions to the table, the one looks stupid.😎
 
Quix said:
And I wouldn't suggest that the current payment system is a model of efficiency in comparison.
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I wouldn't either, but that doesn't lead me to conclude that the entire system should be scrapped in favor of a government intervention.
 
Simplify said:
I wouldn't either, but that doesn't lead me to conclude that the entire system should be scrapped in favor of a government intervention.
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I sincerely doubt that the entire system will be scrapped - massive changes occur incrementally, rather than in one fell swoop. But having a publically funded option that allows for universal health care is a remarkable improvement over the status quo.
 
If anyone has the "Discovery Health" channel, there is a show on as we speak called "The Critical Hour." Give it a watch and tell me what country it takes place in and if you would go there in an emergency situation. I know I would.
 
Quix said:
I only use my anecdotal example as a concretization of a larger trend based on publically available data and studies (PubMed). Trend specified to an example is very different than an example generalized to a trend. And I wouldn't suggest that the current payment system is a model of efficiency in comparison. The amount of time the average physician spends on paperwork in the U.S. vs. Canada is remarkable - a streamlined payment system (in the sense that the money is coming out of one pot) is a model of efficiency compared to individualized billing for thousands of providers.
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Quix did you miss the original post? Lol. You can't compare Canada with the US since they are having their own problems now. It's not only the loss of physicians that's the problem either. Now from my clinical experiences I have an example:
65 y/o M pmh CAD and HTN developed left sided hemiparesis. He was in his 2nd home in Montreal. Pt went to ER and still had hemiparesis and now dysphasia. CTA was ordered showing stenosis of several cerebral arteries.
Next step to be done? Should be emergent MRI/MRA to see size of infarct and better characterize areas for possible NIR intervention or thrombolytic treatment. Uh oh, there's a waitlist even for active stroke patients (they told him ~3 days). Family decided to ship him back to US where MRI/MRA done immediately that day and NIR was able to go in with local percutaneous thrombolytics.
Too bad it wasn't optimal timing and he still had pretty significant hemiparesis upon discharge. True story. Same goes for if you break ur leg. You better be willing to go to a major city and then wait for that surgery.

Now tell me if you had an acute problem where you'd want to be.
 
Quix said:
long post supporting the "public option"
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how do you propose that a federal insurance program be administered? personally, if such an option were to be made available, i would want it run by an organization similar to the Fed, which is not really answerable to the government.
 
Thank you, Quix. I appreciate your taking the time to explain. I agree with many of the points you're making.

However, I don't think they are all relevant or adequate to support the ultimate conclusion given in the claims to which I take issue.

It's perfectly fine to disagree, but I think it's important to clarify for readers that others who also study this professionally come to different conclusions. As we all know, even when observing the same data, much relies on which numbers and variables one focuses upon.


As for my own opinion, I might agree that profit-driven insurance reduces patients' REO, and I agree that providers' making profit a priority can lower quality of care, even for the insured. I simply don't think one can claim that non-profit > profit, without several caveats and acknowledgment of other influential factors.
 
Kaushik said:
Statistics such as infant mortality are pretty bad to use to try to estimate how good a healthcare system is. From what I understand, the US is low in the infant mortality ranking because physicians here often try to save babies that other countries don't. In some other countries, they will just label a very premature baby as just a miscarriage/abortion and don't even count it in the infant mortality statistic. With such variability on what countries report, how can you use something like that to compare healthcare systems?

Life expectancy is also a poor choice. Our society is pretty unhealthy. What percentage of Americans are obese? Diabetic? With hypertension and CV disease? All these problems are a cultural/societal problem. They are NOT solely the fault of the healthcare system. Even with all these, I think I read in a different thread that if you take away stuff like trauma and MVAs, the US actually has the highest life expectancy. I think this was in the "The Truth about healthcare statistics" thread where Instatewaiter points out the flaws of the WHO rankings.
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Here you go:
http://forums.studentdoctor.net/showthread.php?t=657224
 
Note of course, that those are maximums to wait for a diagnostic MRI for a non-emergency condition. If you bust up your knee stepping off the curb and detatch tendons and go to the ER, you'll get an MRI within a few hours.

If your knee is sore and you are sad because you like to run marathons, you might have to wait a few months.
 
sindadel said:
Note of course, that those are maximums to wait for a diagnostic MRI for a non-emergency condition. If you bust up your knee stepping off the curb and detatch tendons and go to the ER, you'll get an MRI within a few hours.

If your knee is sore and you are sad because you like to run marathons, you might have to wait a few months.
Click to expand...

Are you sure about that? From my experience and other physicians from Canada, it's not a few hours but probably a few days which is a lot better than 19 weeks. This is if you're from a large city like Toronto.
 
I'm in Alberta, and I've definitely seen people in the ER be sent for an MRI within 6 hours. I don't know how common it is, and I don't know how much it depends on the severity of the injury. But 19 weeks is definitely fear-mongering when you think of an urgent MRI being needed.

I'm not saying the CDN system doesn't have flaws, but I've lived in both systems, and I prefer the Canadian flaws from a patient perspective.
 
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