healthcare in Canada vs US

I am a foreign podiatrist (that is, in the foreign state of Alabama)Here unscrupulous patients and lawsuits do abound.Yet, I really seem to be enjoying the fat of the land, which seems (to me) to be unethically pushed by the BCBS PMD program that is so prevelent here in northern Alabama.Moreover, I personally don't carry any health insurance for my family (its too expensive and I do work in Haiti instead).I personally would like to see Medicare drop its 65 y/o criteria, but still require Americans to work/earn proportionate points based on age, workforce capability, and the like. Methinks, this is not socialized medicine but perhaps a form of "right" healthcare (if there be such a thing).Any comments?(Shraf, I hope I didn't offend your thread. Perhaps this was discussed elsewhere)

No, more likely because it's easier than trying to squeeze it out of *insurance companies*.As I mentioned below, one of the primary reasons the US system is soooo costly and soooo wasteful is because of all the money and effort spent by insurance companies trying to deny claims and shift the burden of responsibility onto some one else. When there is only one state-run insurance program this can't happen, simply because there is no one else on to whom the burden of responsibility can be shifted.This is the scenario of corporate greed that triggers the inhuman treatment of patients documented below by Yaro and others. It seems like many claims are simply rejected out of hand, without any real grounds, on the mere hope that a large proportion of people will not contest the decision.For example, when my wife was bitten by a cat in a mobile home park in Florida and ended up with a serious infection in her arm, Blue Cross initially rejected her claim for coverage on the grounds that it "appeared to be a work-related injury" (!!!??). It appears they reviewed her employment status and perceived the opportunity to possibly shift responsibility for coverage to Workman's Compensation. Even when you win your fight over these decisions, both sides have to spend a lot of money (= time and effort) in the dispute, wasting valuable resources that could have gone toward actual care of the patient.(added in edit) I should have mentioned that private health insurance companies also increase costs for the actual care providers, the doctors themselves. Many now have to retain fulltime, professional assistance just to minimize their own rates of claims rejection.This message has been edited by EZscience, 05-23-2005 12:19 PM

What you may be forgetting is the real, underlying reason that our society feels that healthcare is a responsibility of all of us.We believe that no one should die of being poor.Nor should they be incapacitated, unable to work or put through unnecessary suffering because of lack of money.There are differences between our society and the one to our south. This is one of them.We do not do the best job of managing the implementation of the basic principles but that is definitely where we start. This comes from the top down and the bottom up.Where we might be going wrong is to allow this to become an idealogical purity issue. The tendancy is to think that everyone should have everything paid for by all of us. This is already not done or attempted but we forget that maybe we should think through what and who should be covered in what way.Over and over you hear the politicians saying "No two tier system!" When we already have more than two tiers. Instead they need to work through what we really want to protect people from.

Just to clarify: what I meant was that Canadian doctors have realized that it's easier to get money from governments. We don't actually have private insurance companies here. (While we do have Blue Cross, etc., they are only allowed to provide "extras". To my knowledge, by far the greatest portion of doctors' incomes comes from governments.)Since health care is such a political issue in Canada, governments are only too happy to throw money at it.As for your post reflecting the American situation, you have my sympathies.

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People who think they have all the answers usually don't understand the questions.

Yes, of course. I was agreeing with you. I just meant that Canadian doctors would never trade their system for the US one any more than the patients would.

Yes, you touch on the contrasting ideologies of Canadian versus American societies. You just can't 'sell' the same ideologies down here as you can up there - even to people who would seemingly benefit the most from them like the 'trailer-park Republicans'. Seemingly there is this deep distrust of government that extends to its management of health care (although they have never had that reference point), not to mention that the party that capitalizes most on this distrust is the one that creates the most government !So in Canada, people seemingly expect more social responsibility from their government, forcing them to maintain a health care system, whereas down here the very idea is poo-pooed as pinko-socialism. Yes, I remember being offended by this sentiment when I lived in Canada and paid taxes there. I was always in favor of modest user fees to ensure responsible use of health services. But once you get to 'income tests' it becomes a delicate balancing act. Sure the rich should pay more for coverage, but once you are old, the system rewards those who have never saved a dime and penalizes those who have saved all their lives, like with the Social Security 'clawback'.

We tend to take a lot of pride in our differences from the US. Besides the real ideological differences, I think we hold up socialized medicine as an ideal because "we have it and you don't". (We also like to think of ourselves as morally superior. ) When I turned 18, I had to pay a health care premium for the first time in my life. The next year, the government that introduced it was thrown out (and has never been re-elected, incidentally). I swore I would never pay another health care premium as long as I lived and I still hold to that now.

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People who think they have all the answers usually don't understand the questions.

Don't most provinces require that everyone pay some premiums for coverage (scaled to income), unless you are below the poverty line?So what if some premium increases become necessary to maintain the integrity of the system ? A lot of Canadians consider *any* user fee to be the 'thin end of the wedge', but medical costs are increasing. Shouldn't people who use the system the most pay a bit more ?
The other way to state that is to ask, shouldn't there be some incentives for individual responsibility for health maintenance ?
Kind of like cigarettes are taxed so the government can recover some of the costs of caring for smokers ?

I live in the one province - as far as I know - that has no health care premiums. (Go ahead - track me down. )My thinking is this: Government collects taxes. Government pays for health care. Why add another layer of bureaucracy to collect user fees? Isn't it simpler to take health care costs out of general revenue?As for "incentives", they used to be called "deterrent fees" here. ("If you have to pay a nominal fee to see a doctor, you'll be less likely to waste his time.") They were thrown out with the premiums and the (big-L) Liberals. If you want to get somebody's back up in this province, just mention "deterrent fees".I find it interesting that people think health care should not be free, but they have no problem with free education, free highways, etc.My taxes pay for education even though I don't have any children. My taxes pay for highways even though I don't have a car. And my taxes pay for health care even though I haven't been hospitalized in thirty years.And that's the way I likes it.

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People who think they have all the answers usually don't understand the questions.

I can sincerely relate on some levels.
I pay property taxes, mostly for education, in a state where my children are not educated (thankfully !). It would be more efficient, certainly, (providing you could convince your tax base to support it) but you have to admit that, without some incentives for conservation, the system could quickly become economically unsustainable. That was the point of my question.
If you have a good health care system worth preserving, surely you would be willing to compromise a little in order to ensure its sustainability? And that is not solid logic ?
Do you know how many hypochondriacs there are out there ?
What is wrong with a nominal fee, say 10 bucks, to encourage discretion among a user group that shares a 'free' resource provided at tax-payer largesse, equally to all, regardless of their relative contribution ?But I guess you're right. I probably wouldn't fly in Saskatchewan, the birthplace of Canadian medicare. (OK - that's my guess).

Some would say we're at that point now. But then they've been saying that for the past forty years. If that's "quickly".... Ask me again when you don't have the 10 bucks.Tommy Douglas, my greatest hero and, yes, the Premier of Saskatchewan, introduced publicly-funded health care precisely because he saw so many people in that position. You'd think so, wouldn't you? Funny how politics is seldom based on good sense.

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People who think they have all the answers usually don't understand the questions.

My point was never say never. At this point doctors here are not fighting to change back to the previous system (which was socialized), but rather to make sure they get as big a cut from the new for profit machine (or anyway to to lose money in it).It really is unbelievable that people would actually choose a worse system. But they have, they do, and they will.I really do hope Canada doesn't cave, but there is no assurance that it won't sometime in the future, especially as that is the prevailing wind (which at this point is a hurricane) around the globe. Private and money profit is considered better than public and human profit.

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holmes
"...what a fool believes he sees, no wise man has the power to reason away.."(D. Bros)