Godot

This was the only part of that tripe worthy of a response. Apparently monetary concerns are the only rationale for accepting a job in your universe. Or do you expect any sane person to run screaming the other way when confronted with a puce shadow of the former Red Menace invoked by your use of the word "socialism?"
Do you think that maybe, just maybe, that some people prefer quality of life issues above and beyond the pale of the greenback (or even the golden tinge of the loonie seeing as we're talking about Canada)? Or even that the burden of care may convince some medicos that their job in their present location is far too important for them to up and flit off to greener pastures?

Please.
:boohoo: <----- This is the proper context in which to use this smilie, in case you were wondering.

RLV

Tell this to South-African doctors who were doing exactly that: emigrate to Canada.

I think that you are forgetting something: there is also private practice in Canada. Eveybody is entitled to the social system, but anybody can go to a private doctor and pay for its treatment, if they wish to.
If the doctors are specially good, they will have a market for their services in the private sector. In Catalonia we also have a social healthcare system. And, you know, some doctors work for it and they also do private practice.

Certainly, it's not free. Just as the armed forces, the roads or the firefighters are not free.
But it's far from being 'no choice'. First, because you have private doctors, if you want to pay (and can afford them). Secondly, because you can choose your doctor from a number of those in your area.

Er... precisely when you are old, your income is lower and your health care costs are higher is the moment when a socialized health care system is a blessing, I'd say.


RLV

Graeme

Actually, Vancouver is the home of many high-profile surgeons that attract patients from around the world. I assume this is true for any modern city - given any attractive place to live you're going to have talented people moving there eventually. Also, the University of British Columbia's medical research program is apparently second to none in many specialized areas, and has produced a number of medical/scientific breakthroughs in recent years.

Same with here - I had food poisoning a month ago and got into see a GP within hours. My dentist usually books a few weeks in advance, but my girlfriend can get an appointment with her dentist for days in advance.

Your choice, obviously. However it does seem that you're a bit misinformed.

Laci

Tell me, what doctors are chosen by your government whom you are able to visit?
Do you have a specific book with lists of their names & numbers?
Do you have other "better" doctors but your healthcare doesn't cover them?
Do you have a choice to go from one doctor to the other w/o your healthcare giving you a hard time?
Can you get a referral to a specialist easily? How easily?

What control do you have over your healthcare services? Name them.

These are some of the things that make it a good system compared to a mediocre system.

Lastly, just because you have a large number of doctors who you can see, doesn't mean they of a top quality. We have a glut of just "so so" doctors down here in Greenville. It's not the place to go for top notch doctors. When we had that insurance, we had a hard time getting referrals; we only could use the doctors on their list (which were below par). Sure we only paid $15 per visit but the quality of that insurance was very poor. That was HMO.

We changed to a PPO and I can see any doctor at anytime. Period. So I only pick those of high quality. They have contracts with specific doctors and I have a list of them. Funny thing, is most of these better doctors in this new insurance weren't in my old bad insurance list. Does this say something?

So if you have something like I use to have, I don't think it's so great. Honestly. Yes, we have to pay extra for a little better quality, but it's worth it. What is your alternative? Will your socialized healthcare cover you if you see anyone else besides the docs on their list?

:boohoo:

Soyin Milka

Actually, the canadian and american health care systems are about equally good at treating people. Anyone who doesn't believe me should spend 15 minutes googling with the terms:

Cancer, Surveillance, Health inequalities, Health outcomes, survival rates.

Canada was slightly better at providing care in 2002 (mortality rates are usually around 5% less, see link below about international comparisons from an aussie perspective), especially with lung cancer, but that's because of the uninsured and those covered with medicaid. These people have very bad survival rates, a phenomenon that's well covered, unlike these people (sorry, very bad pun). You can find studies about this easily, like this one:

"The effect of health insurance coverage on clinical outcomes in women with breast cancer, by comparisons between the US and the Canadian system in "New England Journal of Medecine": 329 (1993), 2039-40. "

But by and large, both countries provide very comparable care to their citizens. Canada does it for much less tho.

International comparisons from an aussie perspective (So no one can tell me it's a biased canadian commie document!)
http://www.aihw.gov.au/publications/.../ca96-c02c.pdf

This Canada-US debate is funny in a way.
Lots and lots of countries have better cancer survival rates than both of our countries. If anyone bothers looking at international comparisons, check out survival rates for Italy and Japan. Or Australian and New Zealand. Or Norway!

Canada and the USA are not number one.

Soy Beans

FoE

People pick whichever doctor they want. It's not like an HMO. If you need to see a specialist you see one. I can get on the phone right now and make an appointment with any doctor in Ottawa. If that doctor decides i need to see a specialist that appointment will be booked. If no such specialist exists in Canada they'll fly me to one. If it turns out i need surgury that can only be performed in say Texas, i'll be taken there and Canada will pay.

Honestly though, most Canadians regard our public healthcare system like our public police. Could you get better service and protection from private bodyguards and private investigators than you get from the police?

ex-idaho

You know, thats an excellent point. Up until the 1800's there was no public police force anywhere in the western world. All the crime prevention duties were handled by private firms like the Pinkertons. The problem this created was what amounted to people paying protection money to these private cops so they would recieve a higher level of safety than those that were not paying. This I think is similar to whats happening in the US healthcare system today.

If your insured you get the benefit of all the latest wonders from the world of medicine even if you don't need them. If your not insured your sent to the free clinic where NP's are likely to be the only medical professionals around. This leads to more misdiagnosed patients and higher mortality rates.

Insurance compaines do not insure those that are going to use their service. They insure those that won't. If you have a pre-existing condition in most cases your without coverage. If you have more than a couple of claims a year forget it, your policy is cancelled.

The US healthcare system is so flawed and so disfuntional that it will collapse in on itself at some point unless drastic changes are made. The most sensible change would be to go to a "socialized" system.

Laci, why are you so concerned about socialized medicine? Do you feel the same about socialized agriculture? What about any of the other highly subsidized industries in the US?

Clutch

It seems to be a real hostility! Giving rise to a "posting arc" that's hard to follow: the "Oh, I heard..." facts that turn out to be non-facts, the shifting questions and moving goalposts... The only fixed point appears to be that it ain't American, so somehow or other it must be worse.

Of course, Canada's medical system might actually be worse than the American system. That's empirically possible. But the data do not seem to show this on average. What seems plausible is that if you're poor it's probably much better to be sick in Canada than in the USA; if you're rich it's somewhat better to be sick in the USA, and if you're middle class there's probably not a huge difference.

However, there are always more poor people than rich ones. In light of the aggregate social costs of much worse health for the many compared to the aggregate social benefits of slightly better health for the few, I suspect it makes not just moral sense, but economic sense to prefer the Canadian model. And to maintain it better than it has been maintained recently!

Silent Acorns

Laci, you obviously have no idea how health care works in Canada. I broke my kneecap last year which required surgery. I saw a GP in under an hour. I had X-rays in less than 2 hours, which were checked by another doctor within 30 minutes, and I was immediately sent to emergency. After being admitted to emergency, I was dignosed by a specialist and had surgery in the hospital of my choice. Total out-of-pocket cost: $0 (CDN).

My only complaint would be that the hospital I chose had a flood of old-ladies with broken hips and they were given the remaining beds. In the end, I had to wait 36 hours to get a bed and I had surgury a few hours later (bumped by even more ladies with broken hips ...). This kind of delay is relatively rare (less than 1% of patients have to wait more than a day to get a bed - at least in my city).

The two biggest problems in the Canadian Health Care system are bed shortages and extended waits for non-urgent surgery. Both these problems are primarily due to populations increasing faster than the number of hospitals. This is primarily due to budget cutting at the provincial and federal levels in the 90s. It is a real problem with our system, which could easily be solved by putting more money into the system. Increasing Health care spending by 20% would do wonders, and it would still be much cheaper than the US system.

It's more accurate to call the Canadian system "socialized insurance" than "socialized medicine". Doctors are not paid on salary, but for each patient they see. The insurance provider (the provincial government) sets how much a doctor is paid for each procedure, but all medical decisions are 100% in the hands of individual doctors and patients. It is also up to the provincial government to supply the necessary facilities for the doctors to use, and it is in this area that governments have been faling short. But this is more a matter of political will to raise taxes to pay for public infrastructure than any inherant flaw in how health care is insured up here. The will was there in the past, it wasn't in the 90s, but it's coming back now.

scigirl

Hello Laci,

While I think that there is no perfect health care system - and fixing ours is not as easy as "do what canada does" - I think you have a few misconceptions about our health care system that I would like to clarify.

Not necessarily. You'd be surprised by what they do and don't cover. Occupational therapy for instance is rarely covered by either, even though it could possibly prevent people from having to go to a nursing home. Even the VA patients - who probably have the best health care outside of private pay - are denied the strangest things sometimes, and it is bureaucrats not medical people making these decisions.

Nope, this is false.

First of all, a lot of poor people in the United States just don't go to the hospital because they don't qualify for medicaid and can't afford the huge huge hospital bills. Colorado just passed a law stating that legal immigrants do not qualify for medicaid even if they are working and paying into it.

What does this mean? A lot of people don't even show up on the radar, and people like you can feel all nice and happy that we are taking care of our poor because they aren't dying on the hospital steps in front of you. Well we aren't taking care of our poor and uninsured.

Second of all, hospitals - including ER's - ARE starting to turn people away, because frankly relying on an ER to provide "free" health care for the poor is fucking stupid. ERs are expensive, and understaffed, and busy.

http://www.denverpost.com/Stories/0,...?search=filter

http://www.denverpost.com/Stories/0,...?search=filter

Oh by the way I'm a medical student currently working for the VA, and University Hospital, with daily exposure to nursing homes, medicaid and medicare patients. What do you do, Laci, just curious...

scigirl