Universal vs. Private Healthcare

[SweetErika]

I don't want to start a heated, GB-style debate, but I'm curious about your views and experiences on private vs. universal health care.

We just finished watching "Sicko", and I thought it brought up some interesting points on universal vs. private healthcare systems.

If you're in the U.S., do you like our healthcare system as it is now, or would you prefer universal healthcare, assuming the quality of your care would be equal or greater than it is now? Do you think a universal system, where people pay more taxes but get free (or very inexpensive) care, would work in the U.S.?

If you're in a country with universal/socialized healthcare, do you like the system? Do you think you get quality care and a good value for your tax dollars, or other money you put into the system? Or do you believe you'd be better off with a private system, where you pay less in taxes, but have to pay for all of your care and medication, or pay a part of it in addition to health insurance premiums (e.g. at 27, my premiums are about $200/month, and for that I get 80% coverage on most things, but still have to pay $30 for office visits and $10 to 50% of drug costs; the premiums increase sharply with age, generally, and someone who's in their fifties might get the same plan for $700/month)?

Any other thoughts on the subject?

 

[wicked woman]

I'm Canadian so live in a country where there is universal health care.

My opinion on this matter is determined by the basic premise that I don't believe health care is a privilege of only those who can afford it. Because of that, I have to think universal health care is the better choice over private health care.

I'm not saying our system has no problems. We've got long wait lists for some service. Women being flown to other hospitals to deliver their baby. We've a shortage of doctors in certain parts of the country. And frankly it probably is more expensive than private health care for someone who's rich. But people aren't refused health care because they can't afford it. Families don't go bankrupt due to medical bills.

It's that basic to me. People have a right to good health care. Period.

$700/mo for health care...after taxes! wow!

 

[fire_breeze]

If you're in a country with universal/socialized healthcare

The way I understand it about how Canadian healthcare works, federal finances medicare and gives the monies to the provinces, but there are certain conditions. While there is free health care, what is covered changes from province to province (although doctor visits, life-saving surgeries and things of that nature is covered) and there is a shift to a double tier system... but that's an entirely different story!

do you like the system? Do you think you get quality care and a good value for your tax dollars, or other money you put into the system?

I do like the system. Yes, I can't see my GP whenever I would want, and if I must see a doctor, then I have to go to the clinic early in the morning and make an appointment. BUT, the doctors are good, and everything (medical, that is; dental at least isn't) is free. However, that being said, there are a few downfalls. For diagnostics (MIR, Ultrasound, etc) there is a long wait time-period (about 3-8 months). So, if someone needs an MIR tomorrow, then s/he will have to go to a private diagnostic centre, which insurance may or may not pay for it (mine doesn't, for example. When I needed an MIR and ultrasound on my leg, I paid for it, because I wouldn't wait 7 months). GPs can call up the hospital and put a 'rush', but it's not always the case. it's done only if there is a priority (cancer, etc).

Furthermore, surgery is free, if it's medically justifiable (which varies province to province). Case in point: I had a breast reduction two years ago. Sent by my GP (who wrote the recommendation telling that in her professional opinion, I need this surgery in order to ensure a healthier life) I went to a plastic surgeon who also works for medicare and he agreed to take me on. This was in March. In early December, I was in the hospital, on the table, in surgery. For it to be medically justifiable, the surgeon must be able to remove a minimum amount of matter per breast without 'making the patient look flat' (his words, not mine). If, in his opinion, he can't remove the minimum, then it would be considered to be cosmetic surgery, and I would have to pay for it. He was able to remove 3 times the minimum per, I didn't pay a single penny (except for parking), and now I have great breasts and my back doesn't hurt.

Most people have some sort of insurance to defer whatever costs that both the provincial medicare won't cover. Medication, for example, is often half paid by the province (at least in mine), half by the individual (and if they have insurance, then almost always free). As far as I know, dental isn't covered (but there are exceptions. If accident causes damage, then you are covered and I think children under a certain age is covered). For hospital stays, to upgrade from a general room which is free (6-8 patients) to a semi-private (2-3) or private room (1) will fall under insurance. And I like it. I would much rather pay the taxes knowing that I will have access to meadicare, and a good one at that, and while I may not be able to have everything free, what I need is.

Or do you believe you'd be better off with a private system, where you pay less in taxes, but have to pay for all of your care and medication, or pay a part of it in addition to health insurance premiums. Any other thoughts on the subject?

I suppose that I am a little biased... I grew up with a universal health care system. Even when I lived in Europe for half a year (Hungary, to be exact), there was free health care (it's just semi privatised, and the people are complaning). So I always had it, and I suppose that I've come to regard health care as a right as a citizen, where my health is taken care of. Yes, I pay taxes... BUT I get to see a doctor when I'm ill, my medication is cheap, and surgeries are free. The taxes also insures the well-being of children, those who may otherwise may not be able to afford it and the old. And that, for me, is more important than to be able to save a few extra dollars in not paying taxes.

 

[WriterDom]

assuming the quality of your care would be equal or greater than it is now?



There is no question the quality will go down. Just like with public education. It's great for the masses but if you can afford it, you send your kids to private schools.

 

[SweetErika]

WW and Fire, thank you for your input. You both touched on exactly the type of things I was wondering about.

The movie was biased to be sure. We don't hear about long waits in Canada or other countries for tests like MRIs and ultrasounds, doctor shortages, hospital overcrowding, etc., to be sure, but Hubby and I still felt it had some important points.

We know what it's like to worry about paying medical bills and put off seeking treatment because it's going to hit us financially. It would actually be better for us to get divorced so our future child and I could have affordable health care through the state, and we wouldn't have to worry about astronomical bills from the delivery and neonatal care. And we're certainly a lot better off financially than MANY here...it's just the catastrophic stuff that really hurts us.

So, how nice would it be if we didn't have to worry so much about paying through the nose to take care of ourselves? Or not being able to get insurance because we have conditions the companies don't want to pay for? Or being denied when we need an expensive treatment? Or not being able to afford the rising insurance and health care costs as we get older?

Even if we had to pay for some private insurance, tests, medications, etc., in addition to higher taxes, I can see where it'd be a big relief to not have to worry so much. If you multiply that stress reduction by all Americans, and I think we'd have a much healthier, happier country on the whole.

assuming the quality of your care would be equal or greater than it is now?



There is no question the quality will go down. Just like with public education. It's great for the masses but if you can afford it, you send your kids to private schools.

Do we really have that great of a system now? The World Health Org. puts us at #37 yet we're one of the richest nations. If poorer, capitalistic nations can have a better system than we have now, why can't we?

How do you, personally, measure quality, WD? What areas do you think the quality would go down if we moved to a universal system?

Moreover, do you like the system the way it is now? Or would you make changes? If so, what would you change?

 

[simplegirl]

I'm Canadian and always had access to universal health care. I guess I am biased when it comes to that, because, in this day and age, I see health care as a right and not a priviledge. Medication for certain conditions are enough to bankrupt people without the benefit of insurance (such as cancer and rheumatoid arthritis), and that's without worrying about hospital bills and doctors. I just can't wrap my brain around trying to afford all of it. wow. It's just mind-boggling.

Yes we have waiting lists, but things are prioritized, according to urgency, and we do suffer from a shortage of doctors. BUT, no one ever gets turned away. I can't imagine a parent not being able to bring a sick or injured child to the hospital because they simply can't afford it. Yikes. How heart breaking.

SweetErika, you pay $30 out of pocket even WITH insurance for a visit at the doctor's? A family physician here gets paid about that for the visit by universal insurance. (probably around $40).

Things like medication, dental, optometrists, eyeglasses and cosmetic surgeries are not covered by universal insurance (you need separate private insurance for those).

There are certainly pros and cons to both systems. We do pay and awful lot of tax. But if I personally had to chose between the two, I would choose universal. But again...I am biased. I've never had to experience the other side of the coin.

 

[WriterDom]

33% of the uninsured live in households making over $50,000 a year. Another 25% could qualify under a government program but either don't know it or don't choose to. I guess what we'll end up doing is requiring everyone to have insurance and paying it for those who can't afford it. Medicare is breaking the bank as it is. There is nothing free about free health care. Someone is paying for it.

I'm more worried about all the kids growing up obese now. They'll be 40 years old and disabled. Wards of the state. By then Walmart will have cart lanes for all people not capable of walking around the store once.

 

[WriterDom]

Yes we have waiting lists, but things are prioritized, according to urgency, and we do suffer from a shortage of doctors. BUT, no one ever gets turned away. I can't imagine a parent not being able to bring a sick or injured child to the hospital because they simply can't afford it. Yikes. How heart breaking.

.

I'm pretty sure it's a law that ERs can't turn anyone away because they can't pay.

 

[elib257]

I live in England so I'm fortunate enough to have the NHS.

I don't really know much about the politics of healthcare in general all I can add is my experience.

When you're a child everything is free i.e. seeing a doctor, prescriptions, eye test, dental care etc.

If you're a student in full time education you get free everything. Although I think this may have changed to if you're in full time education and aged 16-19. But I just missed it and so never had to pay a thing.

If you're on social welfare you get free everything.

Now I'm not a student I have to pay for prescriptions and eyecare. I don't mind giving a little because I can afford it and I know that to maintain a completely free health system would be nigh on impossible.

When I was 15 (about a week off 16) I had a nose job (septo-rinoplasty (sp?)). It was a HUGE job and I read in the paper about a year later that to have it done privately it would have cost about £15,000. It was done for purely cosmetic reasons after I had been dropped on my head whilst in a dancing competition - the external bit of my nose had moved about an inch to the right and my septum was compensating by moving to the left it was a mess. It was all free and I am very grateful.

My dad had colon cancer about 6 years ago. He had to go to the GP several times before they would even perform an internal examination. However once this had been performed he was in an operating theatre within two weeks after various tests and scans. He was in hospital for about a month and a half, had chemotherapy one week out of a month for 6 months, had checkups every year for 5 years and now will have to go every other year for a while (I don't know how long). Unfortunately they couldn't save the lower part of his colon and so he has to use a colostomy bag but he gets this free and all of the paraphernalia (including wipes and disposable bags). We can afford private healthcare but were told by the specialist doctor that his treatment would be no quicker if done privately (and I don't see how it could be!). Again we were very grateful.

Contraceptives and STD checks are all free on the NHS which I think is fantastic.

However, new laws on the payment of dentists has meant that many dentists are reverting to private practice and there have been horror stories of people queueing for days trying to get themselves into an NHS dentist. But again we have no problems there having 3 NHS practises within a 20 minute drive from us.

This is a loooong post! But as you can see I am really pleased with our healthcare and I can't imagine it any other way. If anything I think that we should be paying more so that the service can be improved - although from my experience I don't think it could be.

 

[Eilan]

The health insurance through my husband's retirement system sucks ass. The deductible for out-of-network care is $1000--per person (it's $750 per person for in-network care, which isn't that much better). And, of course, the facility we use, which is a five-minute drive from our house, is out-of-network, but I'm not making a 100-mile round trip to see in-network docs!

My five-year-old had to have a well check to attend preschool and we had to pay $411 out of pocket, plus the $15 co-pay.

If my husband were to get another job that provides health insurance, he'd have to drop the retirement system's coverage. I'm not sure that would be a bad thing!

ETA: I'm overdue for a GYN appointment, but I don't feel that I can justify the expense.

 

[PertPerth]

I live in Australia. I think that we have an okish system, but there definitely room for improvement! The biggest difference is CHOICE of who you see and the time it takes to get an appointment.

There is an extra health care tax if you don't have private health insurance.

A new policy has been introduced (about 5 years ago) that if you're over 30 and haven't joined private health insurance, then you will pay a premium on top of normal health insurance cover. It goes up every year over the age of 30 (can't remember the exact figures, but something like 5% each year. So if you you're 40 and only NOW want insurance, you'd be paying an extra 50% compared to what you would have paid if you had joined private cover and STAYED covered. It doens't matter the insurance.)

If you're a low-income earner or have a concession of some kind, you can get a health-care card. This will entitle you to "free" or "bulk-billed" doctors visits. Else you have to pay a "gap" which is about $20 for a 15 min visit ($50 full charge).

All optometrists bulk-bill for eye exams. Glasses cost more.

I'm under 30 and never plan on not having private insurance.

As a single on a plan which doesn't cover having a baby (waiting period of one year) I pay about $1200 a year. It covers me for hospital and some extras - I am always out of pocket at the doctor and dentist and for scripts. Dentist and other specialists I do get a small % back, but it's capped.

My father had his knee replaced in the private system - phoned up and was operated on in 6 weeks; choice of doctor and hospital. He would have been out of pocket for whatever option he's got with his health insurance (ie mine is $500) and the "gap" of the doctors (in his case, just a little extra). My neighbour went through the Medicare/government system, waited 6 months; no choice of doctor etc and didn't pay anything. I think she's also on a pension, so her GPs also bulk-billed.
After an operation, the government pays for 25% of the "scheduled fee" and the private insurance company pays the other 75%. The extra is up to the patient to pay.

Not sure about the public dentists. Dental care is still very expensive (ie just for a check up, I'm still out of pocket about $80 per visit - after my private health rebate).

There is also a "safety net". You can use medical expenses over the amount of $1500 as a tax deduction - but you need proof.

If I think of anything else, I'll edit this post.

 

[emap]

I'm not sure the US should go to a universal health system, in many ways there actually is the formation of one anyway, states give out healthcare to those of low income.

What is really needed is a reworking of the laws governing healthcare. Not to mention getting more nurses and doctors. Which generally is the problem people have with the health system. It's not that easy to find a doctor.

Not all insurance companies let you go to out of company doctors, which in many cases can lead to two hour drives just to get a check up. I've never asked, but so far as I know doctors only work with certain insurance companies because some take forever to pay, or try and pass the buck on the bill.

What is needed is a rework so that all insurance will work with whichever doctor you decide to go and see. Take away the having to find a doctor to see, make it so you can just look in the yellow pages and see the closest to you. Not to mention setting up a gradation system where you have no co pay costs so much a month, 10% co pay costs so much per month and so on. Removing the age increase would of course have to go in there. Would mean higher charges to teh younger but well hell why should you pay more because your 40 instead of 30?

 

[SweetErika]

SweetErika, you pay $30 out of pocket even WITH insurance for a visit at the doctor's? A family physician here gets paid about that for the visit by universal insurance. (probably around $40).

Yep. AND I have to pay 20% of the (insurance allowed) cost of all procedures done at the doctors, such as labs, pap smears, tests, equipment/supplies I'm given there, surgery and other procedures. The $30 is for being examined by, and talking to, the doctor.

Our doctors usually bill the insurance about $120 for a standard office visit (15-30 minutes). Of that, my insurance allows $100, IIRC, and ends up paying $70 of that since I pay the $30 copay. Each insurance company has a set amount they'll pay for each type of visit/procedure, so doctors try to over-bill just in case that limit is higher than they thought. The cash price is usually a little lower, but it's still not affordable by any means for most people.

They should pay your docs more if they want to solve the shortage problem. It looks like those working for NHS in the UK make a fair living. $40 is nothing!

My insurance rates increase about every two years. My husband's just increased by 40%. Meanwhile, they keep revising the plans to make us pay more and more out of pocket. The insurance companies are certainly NOT losing money; in fact, many of ours have had record profits in recent years, or their boards have received outrageous "bonuses." There is a state agency that regulates rate increases, but they don't seem to deny any increases the companies request.

33% of the uninsured live in households making over $50,000 a year. Another 25% could qualify under a government program but either don't know it or don't choose to. I guess what we'll end up doing is requiring everyone to have insurance and paying it for those who can't afford it. Medicare is breaking the bank as it is. There is nothing free about free health care. Someone is paying for it.

Let's say I'm in a family of four making $50k a year. We'll assume that's after tax income, so it comes out to about $4000/month. Here's a breakdown of our health care expenses:

Hubby $200/month for high deductible insurance
Me $220
Kid 1: $220 (my plan is the same rate for ages 0-29 and kids get sick enough to have no deductible)
Kid 2: $220
That's $860/month in premiums alone. We now have $3140 left to spend.


I have to go to the doctor about twice a month. That's $60 in office visit copays. It's not something I can help if I want to live a semi-normal life. I also spend about $30 in copays for treating a neck injury.

My medication copays average about $60/month. Again, I'm not taking these medications for fun.

Hubby spends about $20/month on medication for severe psoriasis and one other medication. It would be more like $80, but we can't afford the expensive medication, so we go with the generic steroidal cream.

I'm assuming I'd have to take each kid to the doctor once a month on average ($60) and both of them would probably use about $30 in medication. Only generics are $10, and brand names range from $45-50% of the cost of the drug, so I think $30 for 2 kids is probably about right, since sometimes they have to have brands and/or try more than one medication. Correct me if I'm wrong, Eilan.

That's another $260 per month, and I'm NOT counting the 20% of labs, tests, procedures or hospital visits we have to pay. I'm also NOT counting if Hubby needs a doctor visit or his $1750 deductible or the $100 copays for ER visits kids and adults need sometimes.

I'm also NOT including dental insurance premiums and bills, which are also very expensive here.

$3140-260= 2880 left to pay our bills.

Our mortgage and insurance comes to $2000, so we'd have $880 left to pay for utilities, school loans, vehicles, gas and insurance to get to work, feed and clothe a family of four, and pay incidental expenses. Our property taxes alone are over $3000/year, BTW.

What's left isn't nearly enough to cover childcare, so I'll be limited to the amount I can work, or Hubby will have to bring home ALL the bacon.

The kids don't qualify for assistance programs because it tops out at 250% of the federal poverty level, which is $4302/month BEFORE taxes. If we get divorced and say we don't live together, however, I could get assistance for myself and our future child. That's the only way we can qualify under the current system because the limits don't take into account the cost of living near larger cities in this state, and we make just enough to disqualify ourselves.

Could we swing it? Maybe, if we don't want "luxuries" like fruits and veggies and whole grains, small gifts, and do want to spend at least 3 hours a day commuting via bus, only wear second-hand clothes, etc.

But it's not realistic or a plan for a happy, healthy life. We'd always be worrying about getting into and out of debt.

More than likely, we'll only have ONE kid and we're going to have to find a way to swing that, too, because babies need prenatal care and a lot of doctor visits.

Which would you choose, always being right on the edge of a financial catastrophe, or not insuring part, if not all, of your family?

I'm pretty sure it's a law that ERs can't turn anyone away because they can't pay.

They have to stabilize people who are in emergent situations. That doesn't mean they treat them for free, or don't try to collect, or don't ruin their credit, or force them into bankruptcy if they have some money.

This isn't about the poor who qualify for assistance programs, or rich who choose to not insure themselves because they can pay the medical bills or figure their money's better spent elsewhere. It's all about giving those of us in the middle a solution for affordable health care, whether that's capping costs and/or what insurance companies can charge, or supplementing our private insurance like they do in Oz or providing us with affordable insurance.

In my mind, what's happening now isn't working for a lot of people, and we need some kind of meaningful change. I don't know what that should be exactly, but given all the money our government (federal and state) wastes, it seems ridiculous for them to say change would cost too much.

 

[alaskabibear]

(sorry, this got a bit long - but it's a complicated subject)

In general, we have two major problems with the healthcare system in this county and both stem from the same root - which is greed. By far the worst offenders (most greedy) are the insurance companies. ( Think about the money that is spent on "healthcare" that is in reality corporate profit for those who own the insurance companies - think about how much real "healthcare" could be bought with just the proifits that these companies rake off the top every year!) The other problem is the mindset of (many of) our doctors who think that they should be able to charge whatever they can squeeze out of sick and dying patients (I liken them to the witch doctors and snake oil salesmen of old who would swindle a person of their last bowl of grain for a promise of health while growing obese from their own largess).

What we as a nation have not yet agreed upon is that healthcare is a human right to be provided by the society in which we live. There are many such "services" that advanced societies provide for the people living in them, such as; education for all, postal service, clean drinking water, mental health services, law enforcement, etc. Now it goes without saying (but I'll just mention it anyway), the people of the society also pay for these things through their government. When the people of a society do not band together to demand and pay for these things, it simply means that those who can afford them get them and those who can't don't. This is not the way of a great society.

As small business owners we are spending approximately $700.00 per person per month for health care for our employees (yes, that's $8,400.00 per year per employee). If it were just that, I suppose that we could keep on doing it. But, and this is the real stinker, the insurance company has become so involved in the "approval" process (actually should say the "denial" process) that they only pay a fraction of any charge while arbitrarily and unilaterally making determinations on the type of medical services approved and how much of the doctor/hospital charge they will allow as "customary and normal" (which of course is never what the doctor charges). Then, when we try to appeal or "fight" the insurance company's decision we find that we are all alone fighting a huge corporation with hundreds (if not thousands) of lawyers, bean-counters and general boobs aligned against us, our employees and our doctors. Ultimately we find that we have no recourse to their decisions. The bottom line is that we pay a lot of money for insurance and then pay a lot more to the doctor for "uncovered/non-approved" services.

What to do? I want to say that insurance companies should be eliminated as the scammers that they are. But, then I think of all of the bad stories we hear about the service our Veterans receive from Uncle Sam and wonder if it wouldn't just be a total fiasco if the government gets too involved. One thing is for sure (IMHO), if we adopt a policy that requires every citizen to purchase health insurace from the existing private healthcare insurance system we will be legislating a "License to Steal" for those companies that will be a strangle hold on the American people for life. When the basic human rights of citizens become profit centers for some nameless corporation then greed eventually trumps rights and the society fails.( In fact, ABC News has been doing some stories on the problems with this "private" insurance for our older citizens on Medicare. The stories are just too sad and should not even happen in a civilized society. But, when you put a profit motive on healthcare, what do you expect?)

I think that we must 1) abolish the for-profit health insurance scams (or seriously regulate them), 2) charge a flat tax per person for health care, 3) establish and regulate fair prices for drugs and medical services, 4) put forth effort and financial resources to encourage more people to become health care providers, 5) and provide universal health care for every citizen of this country. ( and of course the rich can still obtain whatever enhanced level of healthcare that they want - just like they do now.)

 

[Not Normal]

I'm pretty sure it's a law that ERs can't turn anyone away because they can't pay.

Yes, but the person or family does not have the right to turn down paying the bill sent by said ER.

It is my opinion that one of the biggest faults of the United States was allowing the healthcare industry to be a for profit industry.

 

[alaskabibear]

And Don't Forget Tort Reform

One other important aspect of the problem with our current healthcare system is the runaway malpractice industry (and no surprise, another problem born of GREED).

I have spoken to a couple of physicians I know about this and they say that their single largest expense is malpractice insurance (there we go again with the insurance!!!). Plus another "hidden" cost is what is known as defensive medicine where doctors order a lot of unnecessary procedures and tests simply to cover their butts in case a malpractice lawsuit does come about.

So, we must add tort reform back into the discussion in order to come up with any real solution. (when one identifies all of the special interests and the money they stand to loose with healthcare reform, it's not surprising that nothing has been done yet. It will be a huge job to get it done, and I fear that we will only come up with a "patch job" that preserves the status quo for those who are currently profiting from the system while giving the appearance of change.)

 

[elib257]

One other important aspect of the problem with our current healthcare system is the runaway malpractice industry (and no surprise, another problem born of GREED).

I have spoken to a couple of physicians I know about this and they say that their single largest expense is malpractice insurance (there we go again with the insurance!!!). Plus another "hidden" cost is what is known as defensive medicine where doctors order a lot of unnecessary procedures and tests simply to cover their butts in case a malpractice lawsuit does come about.

So, we must add tort reform back into the discussion in order to come up with any real solution. (when one identifies all of the special interests and the money they stand to loose with healthcare reform, it's not surprising that nothing has been done yet. It will be a huge job to get it done, and I fear that we will only come up with a "patch job" that preserves the status quo for those who are currently profiting from the system while giving the appearance of change.)

I think the law has had this effect on lots of different professional areas. I don't know whether it's a good or bad thing... I'd sure as hell want to know that my doctor had insurance to cover the costs if anything really did go wrong but equally then there are those litigous types who will sue for anything.

I didn't do any particular medical law in my degree but as part of the torts of assault and battery and the criminal non-fatal offences against the person we had to do a little. Here in England a doctor will be covered for any mistakes provided a 'reaonable body of professionals' would have acted in the same way (the 'Bolam test'). What I think really works about this test is that it doesn't have to be the majority of other doctors just a few reasonable practioners will do. Generally it works well. It doesn't mean that doctors don't have to insure obviously but it saves them from being prosecuted for mistakes made 'in the heat of the moment' and sued by any particularly litigious patients - thus premiums are lowered.

 

[albertaboy]

I live in Canada and basic univeral health care is paid for through out taxes and in my province health insurance premiums. Basic health care is pretty good but access is no where near as good as the US for profit system.

I think it is inevitable and proper that we move to a more mixed system of public and private care.

One of the most interesting set of study results I've ever seen was one about low income users of health care in Canada and the US. For years we have assumed the low income Canadian was way better off, but this study showed that low income canucks don't get any more access than they do in the US.

The difference up here is the reason is apathy and ignorance while in the US it's income.

 

[simplegirl]

In Canada, by law, doctors must have insurance to practice medicine.

The main disadvantage to our system, I think, is the overloading. By this, I mean that yes, there are terrible wait times at ERs, for tests, and specialists, due in part to having "free" access to healthcare. It has engendered abuse of the system. People no doubt consult for a multitude of boo-boos that they would probably never bother to investigate, if they had to pay out of pocket to consult. But, as a result, we do tend to find some illnesses much earlier that we would have otherwise.

Again, part of the pros and cons to each system.

 

[alaskabibear]

The above two posts bring up an often mentioned concern about universal health care - that being that if the profit incentive is removed we will have far fewer medical providers (and thus, overloaded systems).

Do any of you guys know the ratio of medical providers to population in Canada vs. the USA?

It seems that any universal plan should include a component to encourage and enable more young people to enter the various medical fields. (I think the general opinion is that currently most (not all) people go into the industry to make a lot of money - and that will probably change with public health care). The little I have read leads me to think that health care providers in other countries are more upper middle class type of jobs, whereas here, doctors are often the wealthy.

 

[albertaboy]

The ratio is way higher in the US.

 

[SweetErika]

The above two posts bring up an often mentioned concern about universal health care - that being that if the profit incentive is removed we will have far fewer medical providers (and thus, overloaded systems).

Do any of you guys know the ratio of medical providers to population in Canada vs. the USA?

It seems that any universal plan should include a component to encourage and enable more young people to enter the various medical fields. (I think the general opinion is that currently most (not all) people go into the industry to make a lot of money - and that will probably change with public health care). The little I have read leads me to think that health care providers in other countries are more upper middle class type of jobs, whereas here, doctors are often the wealthy.

I don't know where this map and data comes from, but it shows the following:

Canada's patient to doctor ratio: 470:1

The US's ratio: 390:1

Canada's 2006 census data breaks it down by province, and it looks like the average ratio for the nation is about 550:1.

It sounds like the major problem for doctors is the government-regulated payments for services haven't been keeping price with inflation, so a lot of doctors don't want to practice there. Nurses and other healthcare workers' salaries are also relatively low, apparently. As a result, docs and nurses are leaving Canada for countries where they can make more, like the US, after they've completed their training. I also read they government puts a quota on how many docs can be in medical school at any given time, which makes sense if the government is paying for all of the school and training.

From what I understand, NHS docs in the UK are paid pretty fair salaries and bonuses based on how much they work and how well they care for their patients. Maybe a similar system would help Canada attract and retain health care professionals.

 

[alaskabibear]

I don't know where this map and data comes from, but it shows the following:

Canada's patient to doctor ratio: 470:1

The US's ratio: 390:1

Canada's 2006 census data breaks it down by province, and it looks like the average ratio for the nation is about 550:1.

It sounds like the major problem for doctors is the government-regulated payments for services haven't been keeping price with inflation, so a lot of doctors don't want to practice there. Nurses and other healthcare workers' salaries are also relatively low, apparently. As a result, docs and nurses are leaving Canada for countries where they can make more, like the US, after they've completed their training. I also read they government puts a quota on how many docs can be in medical school at any given time, which makes sense if the government is paying for all of the school and training.

From what I understand, NHS docs in the UK are paid pretty fair salaries and bonuses based on how much they work and how well they care for their patients. Maybe a similar system would help Canada attract and retain health care professionals.

It sounds like the land of "golden opportunity" may be hurting the Canadian system. If many of the doctors and nurses that were trained in Canada are coming here for the opportunity to make more $$$, then we are not only hurting our own people with this greed driven medical system of ours, but also our neighbors to the north (and I wonder south too?)

But it seems that in order to bring healthcare salaries back down to "normal" standards it is important to somehow make it easier and cheaper for more young people to enter the field (something isn't working since even with the high salaries we still have shortages). Perhaps a broader system of Nurse Practitioners , PA's and two year Nurse degrees would help relieve the strain along with laws that would allow them to actually practice more hands-on care. Granted, one rightly expects to earn a better than average salary after working through so much education - but IMHO the current US physician compensation is way too much. That is why any "universal healthcare plan" should have increased training as an important part - no one wants to go to a system where we actually have worse/less care.

As can be seen from just this little Thread Topic - it's a complicated problem with many contributing factors. And they all need to be addressed simultaneously or we will end up worse off instead of better. But to answer the original question, I think it is imperative that we begin down this road - it is the only humane thing we as can do as a society. To sit by and watch as more and more people are dropped to the gutter, while others spend their excess on things like $49,000 bottles of wine...

 

[mjl2010]

But to answer the original question, I think it is imperative that we begin down this road - it is the only humane thing we as can do as a society. To sit by and watch as more and more people are dropped to the gutter, while others spend their excess on things like $49,000 bottles of wine...

So If I work my ass off and make a decent living and happen to have $49,000 and want to spend it on a bottle of wine, I should do something else?

I'm not trying to start a fight, but that statement sounds like you're saying those who make it owe it to someone else? I've got a big problem with that.

I'm fortunate that after working my butt off for more than twenty five years, I'm comfortable and make a good living owning my own business. But I've worked hard and for a long time to get here. I don't have 49k to spend on a bottle of wine and wouldn't if I did. Yet, there's plenty of people saying because I've done well for myself, I should pay more (higher percentage) of my income just to support others. I don't think so.

To go to the original question, No. I don't want to see universal health care come to this country if it means I lose my private insurance and choice of doctors, which is what Hillary's original plan seemed to call for. I'm very suspicious of allowing government take over our health care. I see waits in Canada and England and other places for basic services and needs.

Do we need reform in this country and a way to help people who can't afford private insurance, yes we do.The solution isn't simple but just mandating universal coverage is not the way to go.

My own story on Canada's system. (I live in the states btw) I was fishing in Ontario and cut my thumb pretty badly. I could see the bone when I pulled the flap of meat back. I did my best cleaning it and asked at the resort where I could find a doctor. in fact, I asked in town and at a gas station I was buying gas at. Everyone told me I'd be far better off to drive all the way back to Minnesota and see a doctor there.

Seeing as it was over 300 miles, I dumped a ton of peroxide on it, cleaned it out with betadine from my 1st aid kit, taped it shut with duct tape and superglue. then wrapped it up in gauze and more tape. I was fine, got a nasty scar. But that was scary. People telling me the system was so bad I should drive 300 miles to get help? Maybe things are better now, this was 12 years ago or something like that.

MJL

 

[alaskabibear]

So If I work my ass off and make a decent living and happen to have $49,000 and want to spend it on a bottle of wine, I should do something else?

I'm not trying to start a fight, but that statement sounds like you're saying those who make it owe it to someone else? I've got a big problem with that.

I'm fortunate that after working my butt off for more than twenty five years, I'm comfortable and make a good living owning my own business. But I've worked hard and for a long time to get here. I don't have 49k to spend on a bottle of wine and wouldn't if I did. Yet, there's plenty of people saying because I've done well for myself, I should pay more (higher percentage) of my income just to support others. I don't think so.

To go to the original question, No. I don't want to see universal health care come to this country if it means I lose my private insurance and choice of doctors, which is what Hillary's original plan seemed to call for. I'm very suspicious of allowing government take over our health care. I see waits in Canada and England and other places for basic services and needs.

Do we need reform in this country and a way to help people who can't afford private insurance, yes we do.The solution isn't simple but just mandating universal coverage is not the way to go.

My own story on Canada's system. (I live in the states btw) I was fishing in Ontario and cut my thumb pretty badly. I could see the bone when I pulled the flap of meat back. I did my best cleaning it and asked at the resort where I could find a doctor. in fact, I asked in town and at a gas station I was buying gas at. Everyone told me I'd be far better off to drive all the way back to Minnesota and see a doctor there.

Seeing as it was over 300 miles, I dumped a ton of peroxide on it, cleaned it out with betadine from my 1st aid kit, taped it shut with duct tape and superglue. then wrapped it up in gauze and more tape. I was fine, got a nasty scar. But that was scary. People telling me the system was so bad I should drive 300 miles to get help? Maybe things are better now, this was 12 years ago or something like that.

MJL

MJL,

Perhaps my statement was a bit inflammatory, but believe me when I say it was not directed at people like you who don't have the $49,000 in the first place and wouldn't spend it on wine if you did. The originator of this Thread asked that it not become a nasty debate and I wish to comply with that request. So, I will leave it to another time or Thread to discuss the underlying issue of the greed and manipulation of our laws that allow such a thing like that to even occur.

But I would like to comment on something you said about health care. I find it interesting that you were faced with an emergency situation where you needed medical attention and could not find it. It is interesting because it should give you a first hand understanding of how many people in this country feel. However, I wonder if the ones who cannot afford to purchase the medical care that they need are not even more frightened than you were. For they can see that the medical services exist, but they are priced beyond their financial ability to access them. And this, while living in a country of such seeming wealth and plenty. And they do not even have the option of going back across the border for help.

Of course, I can here someone say; "oh, anyone can go to the emergency room if they need it." And thankfully to some extent that is true. But, that does not address the fact that those poor people will get a big bill for that visit. And of course that big bill will go into default. And the poor person now has even less of a chance at success and a happy life than before. And eventually, the poor person just quits going for medical care because the bills just climb higher and higher. Now, mind you- these "poor" folks I speak of are not those below the poverty line who actually receive good coverage. No, these are our young people working at entry level jobs, or the poorly educated who are stuck in low paying jobs - just average folks with the same needs and desires as the rest of us.

What we both agree on is that we need to do something, and it will be a complicated fix. My biggest fear is that we as a nation simply will not have the will to say that the corporate greed that currently reigns supreme must end. And until that happens, I don't really see a good solution. (Oh, and those enjoying the bottles of wine I spoke of - it's these people of whom I speak)