A Canadian doctor diagnoses U.S. healthcare
Sid9
The caricature of 'socialized medicine' is used by corporate interests to
confuse Americans and maintain their bottom lines instead of patients'
health.
By Michael M. Rachlis
August 3, 2009
Universal health insurance is on the American policy agenda for the fifth
time since World War II. In the 1960s, the U.S. chose public coverage for
only the elderly and the very poor, while Canada opted for a universal
program for hospitals and physicians' services. As a policy analyst, I know
there are lessons to be learned from studying the effect of different
approaches in similar jurisdictions. But, as a Canadian with lots of
American friends and relatives, I am saddened that Americans seem incapable
of learning them.
Our countries are joined at the hip. We peacefully share a continent, a
British heritage of representative government and now ownership of GM. And,
until 50 years ago, we had similar health systems, healthcare costs and
vital statistics.
The U.S.' and Canada's different health insurance decisions make up the
world's largest health policy experiment. And the results?
On coverage, all Canadians have insurance for hospital and physician
services. There are no deductibles or co-pays. Most provinces also provide
coverage for programs for home care, long-term care, pharmaceuticals and
durable medical equipment, although there are co-pays.
On the U.S. side, 46 million people have no insurance, millions are
underinsured and healthcare bills bankrupt more than 1 million Americans
every year.
Lesson No. 1: A single-payer system would eliminate most U.S. coverage
problems.
On costs, Canada spends 10% of its economy on healthcare; the U.S. spends
16%. The extra 6% of GDP amounts to more than $800 billion per year. The
spending gap between the two nations is almost entirely because of higher
overhead. Canadians don't need thousands of actuaries to set premiums or
thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to
90% lower administrative costs than private Medicare Advantage policies. And
providers and suppliers can't charge as much when they have to deal with a
single payer.
Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative
costs and can negotiate lower prices.
Because most of the difference in spending is for non-patient care,
Canadians actually get more of most services. We see the doctor more often
and take more drugs. We even have more lung transplant surgery. We do get
less heart surgery, but not so much less that we are any more likely to die
of heart attacks. And we now live nearly three years longer, and our infant
mortality is 20% lower.
Lesson No. 4: Single-payer plans can deliver the goods because their funding
goes to services, not overhead.
The Canadian system does have its problems, and these also provide important
lessons. Notwithstanding a few well-publicized and misleading cases,
Canadians needing urgent care get immediate treatment. But we do wait too
long for much elective care, including appointments with family doctors and
specialists and selected surgical procedures. We also do a poor job managing
chronic disease.
However, according to the New York-based Commonwealth Fund, both the
American and the Canadian systems fare badly in these areas. In fact, an
April U.S. Government Accountability Office report noted that U.S. emergency
room wait times have increased, and patients who should be seen immediately
are now waiting an average of 28 minutes. The GAO has also raised concerns
about two- to four-month waiting times for mammograms.
On closer examination, most of these problems have little to do with public
insurance or even overall resources. Despite the delays, the GAO said there
is enough mammogram capacity.
These problems are largely caused by our shared politico-cultural barriers
to quality of care. In 19th century North America, doctors waged a campaign
against quacks and snake-oil salesmen and attained a legislative monopoly on
medical practice. In return, they promised to set and enforce standards of
practice. By and large, it didn't happen. And perverse incentives like
fee-for-service make things even worse.
Using techniques like those championed by the Boston-based Institute for
Healthcare Improvement, providers can eliminate most delays. In Hamilton,
Ontario, 17 psychiatrists have linked up with 100 family doctors and 80
social workers to offer some of the world's best access to mental health
services. And in Toronto, simple process improvements mean you can now get
your hip assessed in one week and get a new one, if you need it, within a
month.
Lesson No. 5: Canadian healthcare delivery problems have nothing to do with
our single-payer system and can be fixed by re-engineering for quality.
U.S. health policy would be miles ahead if policymakers could learn these
lessons. But they seem less interested in Canada's, or any other nation's,
experience than ever. Why?
American democracy runs on money. Pharmaceutical and insurance companies
have the fuel. Analysts see hundreds of billions of premiums wasted on
overhead that could fund care for the uninsured. But industry executives and
shareholders see bonuses and dividends.
Compounding the confusion is traditional American ignorance of what happens
north of the border, which makes it easy to mislead people. Boilerplate
anti-government rhetoric does the same. The U.S. media, legislators and even
presidents have claimed that our "socialized" system doesn't let us choose
our own doctors. In fact, Canadians have free choice of physicians. It's
Americans these days who are restricted to "in-plan" doctors.
Unfortunately, many Americans won't get to hear the straight goods because
vested interests are promoting a caricature of the Canadian experience.
Michael M. Rachlis is a physician, health policy analyst and author in
Toronto
Jack Pine Savage
Hey Guys
I saw on the news up here in Canada where President Obama introduced his
new health care plan. Something similar to what we have in Canada . I also
heard that Michael Moore was raving about the health care up here in Canada
in his latest movie. As your friend and someone who lives with the Canadian
health care plan, I thought I would give you some facts about this great
medical plan that we have in Canada :
1) The health care plan in Canada is not free. We pay a premium every
month of $96 for my wife Shirley and I to be covered. Sounds great, eh?
What they don't tell you is how much we pay in taxes to keep the Canadian
health care system afloat. I am personally in the 55% tax bracket. Yes,
55% of my earnings go to taxes. A large portion of that 55% (and I am not
sure of the exact amount) goes directly to health care -- our #1 expense.
2) I would not classify what we have as a health care plan; it is more
like a health diagnosis system. You can get into to see a doctor quick
enough so he can tell you, "Yes indeed; you are sick," or "You need an
operation," but now the challenge becomes getting treated or operated on: We
have waiting lists out the ying yang -- some as much as 2 years down the
road.
3) Rather than fix what is medically wrong with you, the usual tactic in
Canada is to prescribe drugs. Have a pain? Here is a drug to take; not
"What is causing the pain and why?" No time for checking you out, because
it is more important to move as many patients thru as possible each hour for
government re-imbursement.
4) Many Canadians do not have a family doctor.
5) Some advice: don't require emergency treatment, as you may wait for
hours in the emergency room waiting for treatment.
6) Shirley's dad cut his hand on a power saw a few weeks back, and it
required that his hand be put in a splint - to our surprise, we had to
pay $125 for a splint, because it is not covered under national health care.
Plus we have to pay $60 for each visit for him to check it out each week.
7) Shirley's cousin was diagnosed with a heart blockage. They put him on
a heart surgery waiting list. He died before he could get treatment.
8) The Canadian government allots so many operations per year. When that
number of operations is done -- no more operations, unless you go to your
local newspaper and plead your case and embarrass the Canadian
government. Then money suddenly appears.
9) The Canadian government takes great pride in telling us how much more
they are increasing the funding for national health care; but the waiting
lists never get shorter. The government just keeps throwing money at the
problem, and it never goes away. But they are good at finding new ways to
tax us, but they don't call it a tax anymore; it is now a "user fee."
10) My mother needs an operation for a blockage in her leg, but because
she is a smoker, they will not do it. Despite her and my father paying into
the Canadian health care system all these years. My Mom is 80 years of age.
Now there is talk that maybe we should not treat fat and obese people
either, because they are a drain on the health care system. Let me see now,
what we want in Canada is a health care system for healthy people only. That
should reduce our health care costs.
11) Forget getting a second opinion, what you see is what you get.
12) I can spend what money I have left after taxes on booze, cigarettes,
junk food and anything else that could kill me, but I am not allowed by
law to spend my money on getting an operation I need, because that would be
jumping the queue. I must wait my turn. Except if I am a hockey player or
athlete; then I can get looked at right away. Go figger. Where else in the
world can you spend money to kill yourself , but are not allowed to spend
money to get healthy?
13) Oh, did I mention that immigrants are covered automatically at
taxpayer expense, having never contributed a dollar to the system? And they
pay no premiums.
14) Oh yeah, we now give free needles to drug users to try and keep them
healthy. Wouldn't want a sickly druggie breaking into your house and
stealing your things. But people with diabetes who pay into the health
care system have to pay for their insulin needles, because they are not
covered in the National health care system.
I send this out not looking for sympathy, but as President Obama and
Congress work on health care in the United States , you will be hearing
more and more about universal health care down there, and the liberal
advocates will be pointing to Canada as a good example of a successful
system for America to emulate.
I just want to make sure that you hear the truth about health care up
here in Canada , and have given you some food for thought and informed
questions to ask when approached about this subject.
Step wisely and don't make the same mistakes we in Canada have.
"Sid9" <si...@bellsouth.net> wrote in message
news:h5mkar$4eu$1...@news.eternal-september.org...
Sid9
"Jack Pine Savage" <m...@privacy.net> wrote in message
news:7e8n3iF...@mid.individual.net...
Maybe worse in the US. Since there are 46 million uninsured who use the
emergency room
>
> 6) Shirley's dad cut his hand on a power saw a few weeks back, and it
> required that his hand be put in a splint - to our surprise, we had to
> pay $125 for a splint, because it is not covered under national health
> care.
> Plus we have to pay $60 for each visit for him to check it out each week.
US members of Medicare buy supplementary insurance.
There's no free lunch in any country I've investigated.
You pay premiums, or Taxes, or Fees......there's no fee lunch
USA people are paying a lot more than Canadians
>
> 7) Shirley's cousin was diagnosed with a heart blockage. They put him on
> a heart surgery waiting list. He died before he could get treatment.
>
Dr. Rachlis says different. His information here is first hand.
The OP is second hand hearsay
> 8) The Canadian government allots so many operations per year. When that
> number of operations is done -- no more operations, unless you go to your
> local newspaper and plead your case and embarrass the Canadian
> government. Then money suddenly appears.
Needs evidence....other wise it's a lie
>
> 9) The Canadian government takes great pride in telling us how much more
> they are increasing the funding for national health care; but the waiting
> lists never get shorter. The government just keeps throwing money at the
> problem, and it never goes away. But they are good at finding new ways to
> tax us, but they don't call it a tax anymore; it is now a "user fee."
>
The `wait for a hip in the US can be a month...surgeons are very
busy...money is not the issue
Marcus Aurelius
agree with completely.
The single payer system of Universal health care is definitely the
most efficient, cost effective, economical, just, and efficacious form
of Universal Health care.
krp
"Marcus Aurelius" <alexan...@hotmail.com> wrote in message
news:fc95146c-61fd-413c...@r36g2000vbn.googlegroups.com...
Sure it is until you get either OLD or SICK.
Anonymous Infidel
> emergency room
off our system?
Does doofus Obama's plan cover tort reform? No.
Will his plan give services to illegals? Yes.
Does his plan give incentives for people to become doctors, nurses,
specialist? No.
Does his plan have rationed care and death panels that will decide who
gets what care and who lives and dies? Yes.
Does his plan fuck over the old? Yes.
Will his plan cost some Americans their job? Yes.
Can America afford doofus Obama's plan? No, no one is going to buy
that debt. Not China, not India, no one.