Canadians: tell us about your health care system

[Greg Peterson]

Uh...Rob.....what's wrong with profit in a capitalistic society?:

Capitalism is fine. But I think a myriad of examples exist from the recent past where government services were privatized and the costs went up and the service declined.

Certainly there are times when cost for treatment should have a seat at the table. But it should not by default be the primary factor in determining care.

It comes down to a moral decision. Do we value human life over profit? It really is that simple. Take the profit out our current health care delivery system it becomes vastly more available to everyone.

The CEO of United Health received $753 million for a five year compensation package. Not including the perks of limos, private corporate jet and so on.

Again it really boils down to whether we want to reward the corporate elite with lavish lifestyles or spend those resources providing care to our fellow Americans. And yes, it is that simple.

There's a lot of gnashing of teeth over the failure to enact meaningful tort reform, but tort reform would only affect the average persons ability to hold negligent doctors to account and not save any meaning full amount (less than 1% of a doctors overhead).

If we want to reduce expense in the current health delivery system lets look at the additional staffing and resources doctors have to expend to handle insurance claims. Estimates are that 25% of a private practice staffing and resources are used in insurance paperwork. The medical records field is growing by leaps and bounds. This American Life did an excellent story on the complexities of filing claims with the insurers. Each procedure has a code and no two insurers use the same exact code. And should you forget the suffix or otherwise not use the correct code, well there's a form for that too.

What the insurance companies do is immoral, unethical, evil and indefensible.

[Belinda Barfield]

It strays over the line and becomes wrong the second the profit is on "human misery" and not goods and services.

Where do you stand on profits for the funeral industry? How about profits that attorneys make on human misery? How about profits from sales of food? Food is a necessity afterall. Where to you draw the line and say this group can make a profit, but this group can't? Why would anyone sell or produce anything if there was no incentive to do so?

[Wayne Watling]

Not to be argumentative, I'm just curious. Why should a single mum with three kids pay any less for health care that a single woman, or anyone else?

So you would like to see a single non working mum/dad with 3 kids pay the same for health care as a working couple? How is this going to work in civilized society? It can't!

As a society we have to decide whether we want to give health care assistance to those who are not as well off for whatever reason. I personally think health care should be one of those services that should be, without question, given to everyone who is a citizen of the country in question. Given that, some people are obviously paying more and some less tax.

[Dan Lee]

The US infant mortality rates are appalling…

Boy this is one that gets me going. The US has the stricktest definition of what a live birth is. Exerpt from and article I read there are many articles out there that adddress this false statistic. Ive read some reoports that attempted to normalize the data and US is smoewhere around 3 or 4th


I am sure you have seen various rankings where the US falls way behind other western nations in terms of infant mortality. However, no one seems to bother to check the statistic itself . Statistics like this that are measured across nations are notoriously unreliable, as individual nations may have different definitions or methods for gathering the data.
The main factors affecting early infant survival are birth weight and prematurity. The way that these factors are reported — and how such babies are treated statistically — tells a different story than what the numbers reveal. Low birth weight infants are not counted against the “live birth” statistics for many countries reporting low infant mortality rates.

According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing less than 500 kg [sic; typo--read 500g] is not considered a living child.

But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics.Norway boasts one of the lowest infant mortality rates in the world. But when the main determinant of mortality — weight at birth — is factored in, Norway has no better survival rates than the United States....

In the United States, all infants who show signs of life at birth (take a breath, move voluntarily, have a heartbeat) are considered alive.

If a child in Hong Kong or Japan is born alive but dies within the first 24 hours of birth, he or she is reported as a “miscarriage” and does not affect the country’s reported infant mortality rates....

Efforts to salvage these tiny babies reflect this classification. Since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.
Page 30 or so of this interesting kind of dated but addressing international differences is still http://www.cbo.gov/ftpdocs/62xx/doc6219/doc05b.pdf

[Glenn Clabo]

Ken,
What's wrong with capitalism?

My first wife, who died from breast cancer, was denied healthcare by our insurance company. Although we fought it...it put us $250,000.00 in debt while we tried to keep her alive. That year the CEO of the insurance company made $27,000,000.00 in benefits...becasue his company made so much profit!

As far as who appoints or is on the boards? Who do you think is between you and your doctor now...some clerk who doesn't have a clue about the difference between a bone marrow transplant and a tooth cleaning. All they know is it's on the list...or not on the list of procedures paid for. Which... by way... is what happened to me and thousands of others.

[Belinda Barfield]

So you would like to see a single non working mum/dad with 3 kids pay the same for health care as a working couple? How is this going to work in civilized society? It can't!

As a society we have to decide whether we want to give health care assistance to those who are not as well off for whatever reason. I personally think health care should be one of those services that should be, without question, given to everyone who is a citizen of the country in question. Given that, some people are obviously paying more and some less tax.

No, I would like to see a single non working mum/dad with three kids pay the same as a single non working me, or a working mum/dad pay the same as a working me. I am not responsible for the fact that they have three kids, they are. If I wanted to pay for three kids I would have had three of my own.

I have to leave now to go to the funeral of a very dear friend, so I can't continue here. Y'all don't beat me up too bad.

By the way, I'm not arguing that insurance companies should make huge profits. I just don't understand why some think it's okay for veternarians to make a profit, but not M.D.s, or dentists, etc.

[Greg Peterson]

Why would anyone sell or produce anything if there was no incentive to do so?

Look at Japan's health delivery system. Aside from 50% of the hospitals currently operating at a loss, the systems serves every one well. And fixing the hospitals operating at a loss is a relatively small matter.

Every two years the government sits down and produces a price list for every procedure. I.E. - A doctor receives $4.90 to stitch up a cut less than 40MM in length.

Japan has the highest per capita use of MRI's. And while the cost of an MRI is minuscule, at least one Japanese company produces MRI machines (Toshiba). Innovation isn't stifled by low cost access.

[Greg Peterson]

Dan - good point on the infant mortality rate.

But how do explain our lower life expectancy? Or the quality of life in later years?

Our system is broken, pure and simple. Anytime someone is forced to become an indentured servant to an insurance company because they were unfortunate enough to become ill, I have to wonder just how much progress we as a nation have made.

Not much in this regard. The people flocking to the defense of those that would have no qualms destroying their lives if it meant they could get another dollar out of them fail to see the irony. It would indeed be funny were the results not so inhumane.

[Dan Lee]

Dan - good point on the infant mortality rate.

But how do explain our lower life expectancy? Or the quality of life in later years?

Our system is broken, pure and simple. Anytime someone is forced to become an indentured servant to an insurance company because they were unfortunate enough to become ill, I have to wonder just how much progress we as a nation have made.

Not much in this regard. The people flocking to the defense of those that would have no qualms destroying their lives if it meant they could get another dollar out of them fail to see the irony. It would indeed be funny were the results not so inhumane.

Lower life expantancy well I suppose the fact that we consider any baby that takes a breath a live birth will probably skew that statistic as well. What is the US like 78 years for a male vs 82 for some of the top rating countries?

How is quality of life (by definition a subjective title) calculated?
I guess my pont is that statistics get thrown around few people really research them.
I started trying to fact check IM stat some time ago cause it just didn't pass the smell test to me. Ive never seen anything that attempts to rebut articles like the one in my previous post.

[Greg Peterson]

What is the US like 78 years for a male vs 82 for some of the top rating countries?

I'd call four years difference significant.

As for health related quality of life (I left out the health related part originally), here is a quote from the CDC's page:

"In public health and in medicine, the concept of health-related quality of life refers to a person or group's perceived physical and mental health over time. Physicians have often used health-related quality of life (HRQOL) to measure the effects of chronic illness in their patients to better understand how an illness interferes with a person's day-to-day life. Similarly, public health professionals use health-related quality of life to measure the effects of numerous disorders, short- and long-term disabilities, and diseases in different populations. Tracking health-related quality of life in different populations can identify subgroups with poor physical or mental health and can help guide policies or interventions to improve their health."

You can Google health related quality of life.

HRQoL has always been around. Health care providers need this information, usually gathered in an informal manner. They simply ask their patient how they feel, how they have been feeling lately, has anything changed, anything been compromised or reduced, how do you feel about this in general.

There may be a combination of factors influencing our low position on the international HRQoL scale.

[Rob Robinson VT]

I don't think that anyone here is lobbying against health practitioners (doctors, nurses, technicians, labs, etc.) making a living and/or profit. And, quite frankly, that part of our health care system doesn't appear to be broken. What IS broken is how we pay for those services and, therefore, who has access to them. Going to a single payer system would NOT in and of itself change who provides the services, only who pays for them. It would standardize procedure codes and reimbursement rates, vastly reduce paperwork and administrative costs and eliminate profit from the system which pays for health care. Profit is not inherently bad, profit at the expense of the well-being of our citizens is not only bad, it's downright evil and immoral. Just my $.02 worth.

[Glenn Clabo]

http://www.youtube.com/watch?v=14A1zxaHpD8

The helping "men" become doctors indicates how old this is.

[Dan Lee]

Greg-
Got this quick blurb from Wiki about LE(OK you get what you pay for, don't have time right now to look into what factors influence LE calculations). Anyway IM stats are not comparably calculated and they effect the LE, so who knows the real LE stats are

"Also note that in countries with high infant mortality rates, the life expectancy at birth will be lower and may not reflect the life expectancy a person who has survived his/her first year of life would have."


BTW
The numbers I cited were for overall M and F not just Male as I stated

[John Pratt]

Where do you stand on profits for the funeral industry? How about profits that attorneys make on human misery? How about profits from sales of food? Food is a necessity afterall. Where to you draw the line and say this group can make a profit, but this group can't? Why would anyone sell or produce anything if there was no incentive to do so?

Well Said!!

[John Pratt]

I would really like to know about malpractice insurance and tort reform in Canada also.

I really can't complain about my health insurance, it is great. I pay $464.00 a year for a family of 6. YES, that's right, $464.00 a year. I did give up 24 years of my life to get that coverage though.

An earlier post said that the problem is that everone thinks nothing should be free or something to that effect. I disagree, I think the problem is that everyone thinks everything should be free. There is a cost to everything. Medical school, Malpractice insurance, employees, research, etc. If you told me I was going to pay $400,000 for medical school to make $40K a year as a doctor, then you probably wouldn't see me at medical school. I really feel for some individuals who cannot afford insurance, while others I have no sympathy for. Life is frought with tough choices and I think too many people are not willing to make those choices or decisions. I do think that the current system in the U.S. needs some changes, but a complete overhaul of the best medical system in the World (when you take away access) seems a bit drastic. Why cant we take it a couple of chunks at a time (preexisting conditions, Tort reform, etc) and see where we need to move from there. All the talk about money hungry insurance companies isn't entirely accurate either. Last I heard they were operating on about a 2-3% profit margin.