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Author Topic: Universal Health Care: Canadian Style
Occasional
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Where undercover proves Universal Health Care is not universal or much care.
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Belle
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Are you kidding me? Did that nurse tell that man in the clinic that he just had to call the number and try to get a family doctor and that it might take two or three YEARS???? And that he shouldn't worry because he's "young and has time?"

I am floored. Completely blown away.

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DarkKnight
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American Style update: US Health Care Plan to Boost Taxes on Rich
quote:
House Democrats readied legislation Tuesday that imposes penalties on employers who fail to provide health insurance for their workers and on individuals who refuse to buy it, part of a sweeping effort to overhaul the nation's health care system.

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Omega M.
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Unfortunately, you can probably find equally horrific stories of the U.S. healthcare system.
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Mucus
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Technically, health-care in practice is not so much "Canadian" as it is effectively run by the provinces. For example, Ontario's is called OHIP
http://en.wikipedia.org/wiki/OHIP

Quebec's has major issues for reasons that are unfamiliar to me at the moment.
For example,
quote:
More residents in Quebec than any other province preferred the U.S. system, with nearly a fifth of Quebecers saying American health care is superior.

That may be due to more difficult spots in La Belle Province, where many lack a general practitioner or feel their emergency-care is lacking, Walker suggested.

"There are more touch points in the Quebec health-care system where there seem to be problems than we observe in Ontario and other parts of the country," he said.

The poll also suggests 70 per cent of Canadians think their health-care system is working well or very well, while the remainder feel the system is either not working well or not working well at all.

Quebec residents were most split, with 52 per cent saying the system works well and 43 per cent saying it doesn't.

http://www.google.com/hostednews/canadianpress/article/ALeqM5haqIdwLkO0bfRWlsx51kCcdeG0GQ

A full breakdown of the provinces here:
http://www.harrisdecima.com/en/downloads/pdf/news_releases/071009E.pdf

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Samprimary
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quote:
Originally posted by Omega M.:
Unfortunately, you can probably find equally horrific stories of the U.S. healthcare system.

More. You could find more, even accounting for the population difference. Canada's health care system is a great example of a public healthcare system that is in bad shape, but even then it's in better shape than ours.

I am not surprised that Breitbart's enthusiastic expose managed to miss all the reasons why, while he was busy equivocating the canadian system versus our own as though it were guaranteed that this were the system we are unquestionably heading towards.

And they aren't even poking at canada's general system. They're just running to the most dysfunctional out of all of them quebec's provincial one.

There are comments from me on this board as early as 2006-2005 openly talking about canada's mess of a healthcare system. One of the things I said about it and I'm pretty sure I've said it here is that Canada's healthcare makes an excellent foil for conservatives who are vehemently in opposition to public health care. You can point at it and draw up endless horror stories and anecdote and pictures of rotting regional care centers and then go "so therefore socialized medicine sucks, QED."

This video is a not-so-subtle repetition of a pattern that was stale in 2004. It also manages in a very consistent way to ignore the substantive debate over our healthcare options, which consistently and across all viable metrics show that our system makes theirs look good. That ain't a pleasant truth.

I would actively prefer that the actuarial profit model be a good one for healthcare. It isn't. Most of the HMO's and hospital networks today openly admit that there's a general cutoff date where they agree they ave few functional contingencies involving their continued operation, due to exacerbating collapses within our own health care structure.

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Juxtapose
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quote:
Most of the HMO's and hospital networks today openly admit that there's a general cutoff date where they agree they ave few functional contingencies involving their continued operation...
I'd really like to read more about this, Sam. Do you have any links handy?
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Belle
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I have seen what most people would call the worst of the health care system in the US. I took an uninsured friend to Charity Hospital in New Orleans once for unidentified abdominal pain. She was not bleeding, not critical...on the outside, didn't even look all that sick.

It was at night, the hospital was busy, she had no insurance and no money. We had to wait, and it was a fairly long wait...2 hours. Then a doctor examined her and immediately had her admitted and treated - it was an ovarian cyst large enough to need surgery.

My husband is a paramedic who takes people with no insurance and no money every day he works. I would put the emergency care in the US up against any system in the world...if you need urgent care at a hospital you get it regardless of your ability to pay.

Where the US does have problems is in preventative care and general care. There, if you're uninsured, you probably cannot afford a family physician and regular visits. So yes, we do have places we need to go in order to have the best possible system for all citizens.

I am unconvinced however, that the Canadian system is the right direction.

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Strider
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as far as I understand it, the question isn't "is the Canadian system the right direction?" but rather, "is universal health care the right direction?"
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twinky
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Bill Moyers interviewed a former health care PR executive recently, who (among many other things) touched on the general/preventative care issue:

quote:
WENDELL POTTER: I was. I went home, to visit relatives. And I picked up the local newspaper and I saw that a health care expedition was being held a few miles up the road, in Wise, Virginia. And I was intrigued.

BILL MOYERS: So you drove there?

WENDELL POTTER: I did. I borrowed my dad's car and drove up 50 miles up the road to Wise, Virginia. It was being held at a Wise County Fairground. I took my camera. I took some pictures. It was a very cloudy, misty day, it was raining that day, and I walked through the fairground gates. And I didn't know what to expect. I just assumed that it would be, you know, like a health-- booths set up and people just getting their blood pressure checked and things like that.

But what I saw were doctors who were set up to provide care in animal stalls. Or they'd erected tents, to care for people. I mean, there was no privacy. In some cases-- and I've got some pictures of people being treated on gurneys, on rain-soaked pavement.

And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia and Kentucky, Tennessee-- all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth.


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Samprimary
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quote:
Originally posted by Belle:
I have seen what most people would call the worst of the health care system in the US. I took an uninsured friend to Charity Hospital in New Orleans once for unidentified abdominal pain.

No, the worst systems tend to be highly rural ones. They're not independently sufficient and the states have to bribe professionals with taxpayer money to get them to stay in their networks. Places like South Dakota ("Where Health Care Goes to Die") end up having to fly the few specialists they have around the state. It's fantastically inefficient. It's experiencing gradual collapse that has amped up in recent years.

yes, we get the system to 'work,' in a limited way. You yourself state: " I would put the emergency care in the US up against any system in the world...if you need urgent care at a hospital you get it regardless of your ability to pay."

Well, think about it.

You are describing even the medical system you were shocked and appalled over. At the very beginning they were asked if the reason for entry was urgent.

Yes, canada's problems are legion in the healthcare department. So are ours. ours are worse. While NEITHER you or me think canada's healthcare system is the right direction, even if we swapped all our problems for theirs, we'd come out a bit better in the end if we adopted the borkum Ontario system. Breitbart is trying to express the notion that this system sucks worse than ours.

Oh, if only he could see why that's not true.

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Samprimary
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quote:
Originally posted by Juxtapose:
quote:
Most of the HMO's and hospital networks today openly admit that there's a general cutoff date where they agree they ave few functional contingencies involving their continued operation...
I'd really like to read more about this, Sam. Do you have any links handy?
Alas, I am completely failing you right now. I ranted about that sometime in 2006 but I have lost all my links to the stories I read. I remember aspects of it, though. It had to do with the '40 cent figure' which is

um, heck, I'll just copy-paste the one remaining post of mine I can find about this.

quote:
as the populace ages, hospital networks are candidly announcing that their long-term operation is not expected on the current system.

Here's a terrible fact, for a hospital operation: On average, they will only receive, as payment, about 40 cents out of every dollar that they bill in total.

Already, it is standard practice in hospitals to immediately cut half off of the total bills for an uninsured person who has had to receive medical care. This loss-operation procedure is in an attempt to recoup as much as possible by trying to minimize chances that an uninsured patient will bankrupt, leaving the hospital with nothing.

Then there are the obvious charity cases, which mostly include the desperately poor, single mothers, homeless, and warded elderly. Hospitals have to take in anyone whose life is in danger, for the most part, and policemen keep dumping these 'financial liabilities' on their doorstep. The transient population is full of ailing individuals with the side effects of poor health, poor nutrition, and wanton drug and alcohol abuse, not to mention violence. Whenever one of these individuals gets cut up or starts having a seizure or something, the paramedics get to scoop him off the street and dump him at the nearest hospital, which has to at least get him stable before being able to dump him back on skid row.

So many come in that the hospital starts running at a loss. Then another financial disaster comes walking in the door: the warded elderly. Poor folk living in standardized care. Not a dime to their name. Often senile or demented. The homes and caretakers have to take these old folk to the hospital whenever they exhibit distressing medical symptoms, and they end up going a lot. Because they're old.

And there's a lot of these old folks. All the treatment they will receive will involve strictly nothing 'optional' (no matter how beneficial) so that means that they keep getting cycled back and forth between the hospitals and the homes with a minimum of preventative treatment. All of this comes at a loss to the hospitals, which start suffering.

The Maryland medical network is expecting total collapse in 2011-2013, and they talk about this candidly. They just know that the present system is inherently unmaintainable if they are required to provide services to the financially insolvent, and if they continue to receive such a paltry total sum of their bills from even those who they bother to charge. The people who can pay are gouged to try to keep the hospitals in operation, and this includes the HMOs.

And the HMO's have to respond to this gouging by continuing to deny treatment to as many people as they possibly can. But they see their profit margins fading as the medical costs ratchet up and the hospitals have to extort more and more out of them just to keep running, so they too are casually (if tacitly) talking about a lack of long-term sustainability. Even today, nearly all HMO's in America are running quarter-to-quarter, which means they are making plans that they admit are only designed to work in the present day. They see it coming.

Rural healthcare networks are in the worst shape, and are approaching more imminent collapse. A rural area has a very small population to treat, but it is mandated by the state that this area have coverage. So hospital networks have to run all the rural hospitals at a major loss. As urban population hospitals start to run into the red, they can't float rural hospitals. The whole thing is imploding.

This is from 2006 I believe (timestamps are lost). Back then I was candidly saying that "it's not about if we will socialize health care; it's a question of when" this is earlier than I anticipated and I expect that is derived from the economic meltdown.

I actually believe that the enhanced timeframe of our conversion is problematic overall.

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Belle
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See, I would consider a possible broken wrist urgent. He described a wrist injury with pain and numbness and to me, that needs an x-ray fairly quickly. They waited over 4 hours without even seeing a doctor. I would guess that most US emergency departments would have x-rayed that wrist long before four hours was up.

Maybe I'm wrong. Maybe all my previous experience in ER's was just luck. But I've been to ER's for injury or illness myself, and taken others, and never waited more than 2 hours.

Right now we do have a shortage of doctors willing to work in rural areas or in the inner cities. How is switching to a single payer system going to solve that? I think we would wind up with the same problems we have now. There are counties in my state where there is no practicing ob/gyn. In the entire county. That's because the county is very poor, and very rural, and no one with a medical degree wants to live and work in a place without good schools for their kids, or good facilities. Again, how is switching to a single payer system going to solve that?

These are questions directed at everyone or anyone. I'm not trying to defend the US system or say it's perfect. I really would like to know how to solve some of the problems we have now, and why switching to a universal or single-payer system is going to help. So far I can see that it would cut down on administrative costs because doctors won't have to worry about filing for so many different types of insurance. Okay, that may be true. Then again, I don't know that for certain without more details.

So what else? What other types of advantages might we see in this type system that would address the problems the rural and poor communities have with getting quality health care?

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kmbboots
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quote:
Originally posted by Belle:
I have seen what most people would call the worst of the health care system in the US. I took an uninsured friend to Charity Hospital in New Orleans once for unidentified abdominal pain. She was not bleeding, not critical...on the outside, didn't even look all that sick.

It was at night, the hospital was busy, she had no insurance and no money. We had to wait, and it was a fairly long wait...2 hours. Then a doctor examined her and immediately had her admitted and treated - it was an ovarian cyst large enough to need surgery.

My husband is a paramedic who takes people with no insurance and no money every day he works. I would put the emergency care in the US up against any system in the world...if you need urgent care at a hospital you get it regardless of your ability to pay.

Where the US does have problems is in preventative care and general care. There, if you're uninsured, you probably cannot afford a family physician and regular visits. So yes, we do have places we need to go in order to have the best possible system for all citizens.

I am unconvinced however, that the Canadian system is the right direction.

But then those uninsured people with no money end up with enormous hospital bills. It isn't like they get treated for free in those emergency rooms. Many lose whatever savings they had and often their homes.
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fugu13
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There are regular stories in the US of people dying on emergency room floors. I think that qualifies as more than a four hour wait. Even if "most" would have X-rayed it long before, there are numerous places where that never would have happened. I bet most emergency rooms in Canada would get to the wrist in a reasonable time, too.

The question is how the overall system performs, not the acceptably average parts of it.

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Samprimary
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quote:
Originally posted by Belle:
[QB] See, I would consider a possible broken wrist urgent. He described a wrist injury with pain and numbness and to me, that needs an x-ray fairly quickly. They waited over 4 hours without even seeing a doctor. I would guess that most US emergency departments would have x-rayed that wrist long before four hours was up.

If we're playing anecdote tag, I have had to wait in a hospital with friends for far more evidently serious injuries for as long as four hours. Here. In the U.S. I am not surprised Breitbart would have to wait that long because

1. It's the Ontario health system which has terrible wait times anyway, and
2. When he was asked if he could move it, he said yes.

"urgent care" has a definition that is typically related to 'does not require immediate attention but has some potential to get worse if not treated in a 24 hour period'

Which puts it below emergency care (which even in Ontario you can get promptly).

quote:
How is switching to a single payer system going to solve that? I think we would wind up with the same problems we have now.
We wouldn't; I wish I had time to explain that but I will get back to this thread, of course.
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Belle
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quote:
But then those uninsured people with no money end up with enormous hospital bills. It isn't like they get treated for free in those emergency rooms. Many lose whatever savings they had and often their homes.
My friend paid nothing. All hospitals have indigent care policies.
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Samprimary
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quote:
Originally posted by Belle:
My friend paid nothing. All hospitals have indigent care policies.

Correct. If you're insured or solvent, YOU paid for your friend. The costs get transferred to those who can pay.

It's a terrible socialism imposed on the system by those hoping to avoid socialism.

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aspectre
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"Where undercover proves Universal Health Care is not universal or much care."

Your point? For every negative annecdote concerning the Canadian system, one could easily find hundreds of more serious complaints -- by both policy holders and health care providers -- against American medical insurance companies.

As for using emergency rooms to cover those without insurance.....'nuff said.

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Kama
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[Roll Eyes]

maybe I should do an alternative video about Luxembourg. Luxembourg is one of these weird countries that don't have private healthcare (or, if you wish, all healthcare is private. You take an appointment, pay, and then get reimbursed by the government).

My experiences:
-visit to a clinic due to abdominal pain - about 30 minutes to see a doctor.
-blood test - 1 minute for formalities
-getting a new family doctor appointment - 1 day

but I guess that wouldn't make a popular video.


oh yes, and my boyfriend is treated for leukaemia in the UK (another UHC country), and, surprise surpise, he got treated with super priority from the moment he went to his family doc. oh yes, he spends half a day at the clinic as the outpatient now -- I consider this a small price to pay for a totally cost-free treatment which goes well into thousands of pounds.

/rant [Smile]

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Kama
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oh and his experience is very much like what I saw on ER (the series) which last time I checked took place in the US [Wink]
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Orincoro
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quote:
Originally posted by Omega M.:
This kind of thing will never stop happening. I repeat. This kind of thing will never stop happening. Maybe we all have doctors on call 7 days a week in 50 years, but there'll be something else equally egregious for us to worry about when that happens. Count on it. Then look at the big picture and try to do the right thing.

Half a day? HALF A DAY??? CHRIST ALMIGHTY! You mean to tell me that a health care system that is set up to treat 50 million people makes you wait half a day for non-urgent care??? I'd rather pay thousands of dollars a year and deal with a for-profit insurance company that will do whatever it can to deny my claims or dump me so that I can wait 45 minutes. Worth it!
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Orincoro
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quote:
Originally posted by Samprimary:

It's a terrible socialism imposed on the system by those hoping to avoid socialism.

Isn't that the definition of neoconservatism? "We will do anything to avoid state control. If the state has to take over in order to avoid it, we are willing to do that."
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Kwea
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quote:
Originally posted by Belle:
I have seen what most people would call the worst of the health care system in the US. I took an uninsured friend to Charity Hospital in New Orleans once for unidentified abdominal pain. She was not bleeding, not critical...on the outside, didn't even look all that sick.

It was at night, the hospital was busy, she had no insurance and no money. We had to wait, and it was a fairly long wait...2 hours. Then a doctor examined her and immediately had her admitted and treated - it was an ovarian cyst large enough to need surgery.

My husband is a paramedic who takes people with no insurance and no money every day he works. I would put the emergency care in the US up against any system in the world...if you need urgent care at a hospital you get it regardless of your ability to pay.

Where the US does have problems is in preventative care and general care. There, if you're uninsured, you probably cannot afford a family physician and regular visits. So yes, we do have places we need to go in order to have the best possible system for all citizens.

I am unconvinced however, that the Canadian system is the right direction.

Belle, that isn't even close to a worst. 2 hours for a non-critical patient is a short wait, honestly.

I've waited with someone whimpering in pain for 5 hours before we were seen....and he HAD insurance. 9 months ago, at an award winning hospital no less.

And even indigents are still responsible for the bills, and we strictly limit what can and can't be treated there. We wait until the collapse, then spend 3-4 times more than in would have cost to treat them when they were low priority just to stop them from dying.

And their credit still takes a hit, if they have a credit rating. Even though medical bill aren't suppose to affect them.

You have to have less than $2000 in ASSETS (not cash) in order to even qualify for Medicare, and the approval process takes forever.

Hospitals end up foot the bill more often than not, and a lot of them are close to having to close their doors because of it.


Not trying to slam you, Belle....I am just amazed at a lot of what I see working in the hospitals these days. [Frown]

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Synesthesia
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I've had asthma attacks 2 times and went to the emergency room both times.
I waited over 8 hours both times to see someone, and I got smacked with a huge bill I couldn't pay EVER. (I did try to pay one of those bills, but my payment was late and they got angry)

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kmbboots
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quote:
Originally posted by Belle:
quote:
But then those uninsured people with no money end up with enormous hospital bills. It isn't like they get treated for free in those emergency rooms. Many lose whatever savings they had and often their homes.
My friend paid nothing. All hospitals have indigent care policies.
So she got no bills? Didn't have her credit rating pummelled?

What about people who aren't quite "indigent"?

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Saephon
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I developed a minor abrasion in my right eye back in February. I didn't know what the problem was, only that I woke up from a nap one evening and my eye was almost completely swollen shut and in immense pain. The kind of pain where you'd cry every 10 minutes. And any exposure to light magnified the pain several times over.

I went to the ER promptly, got there around 8pm on a Tuesday night. It wasn't overly crowded, but they must've had five times as many receptionists as they had nurses or doctors. I had insurance, I described my pain as immense; waited 4 hours; I was pretty much the last person there to be treated. They strictly attended to people in the order in which they came, regardless of the severity of affliction. Everyone else in the waiting room looked to be fine to me, while I'm sitting in this cramped chair under bright fluorescent lights, with my hand over my eye, tears coming out every once in a while.

I was eventually treated properly and healed in a couple days, but I guess my point is, I did not expect that kind of "care" where I live. I reside in a very wealthy suburb of Chicago; people here live quite comfortably. I was very surprised/angry.

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Samprimary
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quote:
Originally posted by Orincoro:
quote:
Originally posted by Samprimary:

It's a terrible socialism imposed on the system by those hoping to avoid socialism.

Isn't that the definition of neoconservatism? "We will do anything to avoid state control. If the state has to take over in order to avoid it, we are willing to do that."
In effect, yes. With the added condition that certain other aspects not inherently related to neoconservatism's conceptual ideology (cronyism and so forth) got into the gears and fouled the byproduct up very very very very badly.
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Sterling
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Well... This much I will say. Medicare and Medicaid only pay a portion of costs, and an increasing number of practitioners simply don't take patients on those services because they become a slow slide into bankruptcy. Private plans put strict limits on the care they'll cover, demand large co-pays or other fees, or both. A single-payer system at least has the possibility (depending on its final form) of making it more financially feasible to be a family practitioner, pediatrician, and/or OB/GYN. Right now we have a glut of doctors going into high-paying specialties and a shortage of the ones who provide the services that everyone needs.

An expansion of some of the scholarship programs for new doctors and residents serving in underserved communities might be a good way to start as well.

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scholarette
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I was diagnosed with endometriosis at 19. At the time, we discussed surgical options. I was told my insurance would not pay for surgery at the time because it was not a severe enough impairment. At 24, when the pain became so bad I was missing 2-4 days of work a month, I finally was able to get my surgery. So, a five year wait on that for me, plus, the additional damage done from not treating things immediately.

I have a friend who uses the ER as her dr. Her credit report is so awful that she can't get any housing that checks credit. Also, she has a weird black spot on her brain scans which could be serious, as discovered when she passed out recently. But that is not immediate and requires a specialist, so she is just hoping and praying things will work out. And eagerly awaiting her boss moving her from 39 hours a week up to 40 so she'll get health care coverage. She also has a second part time job, which does not offer health care either. Yes, if she had more then a high school degree, then she could maybe get a better job, but with the two jobs and huge debt, that is extremely difficult (though she is actually slowly working on it, but it is slow going).

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AvidReader
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Saw this on Yahoo this morning. Congress is planning to make access to health care a right.

I like the concept, but boy do I hope they phrase that carefully. Perscription drug abuse is already a huge problem in this country. If doctors have to worry about infringing on your legal rights by not writing new scripts and worry about laws to keep them overperscribing, that could turn into a nightmare. I'm also not keen on telling hypochondriacs and people who refuse to take a day off work when they're sick that they have the right to go to the doctor.

As always, I hope they can find a balance of concepts here. But I doubt it.

I also found this curious:

quote:
Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages, with an exemption for small businesses. Individuals who decline an offer of affordable coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan.
Would this do anything for scholerette's friend whose boss keeps her just shy of full time so he doesn't have to pay for insurance? I wonder if Congress thought to address insurance for people with multiple part-time jobs.

I'm also curious what this would do for the unemployed. Is there going to be a government back up for routine care, or will it continue to be "get a job or wait to go to the ER" as usual?

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Lisa
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quote:
Originally posted by Saephon:
I was eventually treated properly and healed in a couple days, but I guess my point is, I did not expect that kind of "care" where I live. I reside in a very wealthy suburb of Chicago; people here live quite comfortably. I was very surprised/angry.

Can I ask which hospital? I had a similar thing happen to me at St. Francis in Evanston when I had a kidney infection. I've never gone back, and I do just fine at Evanston Northwestern.
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DarkKnight
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quote:
Would this do anything for scholerette's friend whose boss keeps her just shy of full time so he doesn't have to pay for insurance?
Part of it depends on how a small business is defined. I can't find any real information on how small you would have to be for the exemption but I imagine you would need to be very tiny. I haven't heard about any exemptions at all for part-time employees and from my understanding (I could be wrong) ALL employees MUST be given health insurance or both the employer and employee will be paying fines. If the business is exempt then scholarette's friend must still get health insurance on her own or else pay a penalty.
quote:
I wonder if Congress thought to address insurance for people with multiple part-time jobs.
quote:
I'm also curious what this would do for the unemployed. Is there going to be a government back up for routine care, or will it continue to be "get a job or wait to go to the ER" as usual?
quote:
Under the House Democrats' plan, the federal government would be responsible for ensuring that every person, regardless of income or the state of their health, has access to an affordable insurance plan. Individuals and employers would have new obligations to get coverage, or face hefty penalties.
They did think of that. You must have insurance or else you will pay a fine.

[ July 15, 2009, 08:53 AM: Message edited by: DarkKnight ]

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Teshi
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There aren't enough family doctors in Ontario. Most of the people I know my age don't have a 'family doctor' away from home because they don't stay put very long.

On the upside, if I visit a physician today-- an appointment with a family doctor or a walk-in clinic-- due to a real medical problem, I will not have to pay a cent, although I have no coverage at all and work part time.

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CaySedai
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I think I had to wait more than 5 hours in the ER with my mom when she was hit in the face by bullet fragments after a shooting incident on the El in Chicago. They ended up not removing the fragments. While waiting for her to get X-rayed, we saw a guy with a head wound sitting, dripping blood on the floor. Fun times.
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Omega M.
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Just to clarify, I did not say what I'm quoted as saying above! [Smile] (I'm sure it was an accident.)
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Mucus
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I admit to being slightly curious what proportion of the difference in life expectancy between Canada and the US is actually due to health-care and how much is due to it being more popular in the US to get shot in the face.
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Sterling
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quote:
Originally posted by Mucus:
I admit to being slightly curious what proportion of the difference in life expectancy between Canada and the US is actually due to health-care and how much is due to it being more popular in the US to get shot in the face.

"C'mon, Randy! All the cool kids are doing it!" [Wink]
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Sterling
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CNN report on the shortage of family practitioners

Denver Post comparison of U.S. and Canadian health system, "debunking" of "Canadian Health Care myths"

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Samprimary
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quote:
Originally posted by Sterling:
[QB] CNN report on the shortage of family practitioners

Yeah, but at least doctors themselves can attest that in the end it's really all worth it and that people should pick up the torch and

quote:
a 2007 survey by Merritt, Hawkins indicated that 57% of 1,175 doctors questioned would not recommend the field to their children.
uh oh
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Orincoro
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The *sort of* good news is that the US health care system is headed for major crisis, meaning that it's unlikely we'll be facing the same sort of problem in the future, however painful the moment is going to be. I'm a positivist in the sense that I don't think we could make things any worse without simply being forced to make them better.
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dabbler
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I think based on my anecdotal evidence of being a resident in a US teaching hospital that one easy and large impact would be made if there were an emphasis on costs associated with labs/surgeries/tests /etc both short and long term costs. In the hospital there should be estimated costs listed next to every lab test and order for immediate feedback. Our education should be focused on appropriate and reasonable care instead of a cover-your-ass model.
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andi330
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Speaking anecdotally, I had my first asthma attack when I was 20. As I was home from college (and luckily also on my weekend off from the summer camp I worked for out in the middle of nowhere) My father drove me to the nearest ER. I had insurance. In fact I had government insurance (my father is retired military) and I waited, unable to breathe for at least 2 1/2 hours to see someone. The only good thing is that we didn't go to the ER on base, it would have been even longer there.

Or better, when I injured my knee my sophomore year of college and needed to see a specialist. We were (at the time) with Kaiser Permanente because for some reason I have never understood, my father decided to go with the insurance provided by his teaching job rather than keep the military insurance for a while. Unfortunately Kaiser Permanente will not allow patients to see a doctor that is not a part of their HMO (at least they wouldn't at the time, I don't know if their policy has changed, we left right after this incident). I was attending school in Spartanburg, SC. This meant that in order to see a specialist paid for by my insurance company I had to take the Greyhound bus (always a pleasure) to Charlotte, NC, take a cab to the Kaiser building, wait around for my appointment, take a cab back to the Greyhound Station and a bus back to Spartanburg. I also had to miss a full day of class (and of course, we had to pay for the bus ticket). Before going to all this effort to get me to a doctor my father attempted to appeal their process and get me an appointment in Spartanburg. No dice. If I wanted to see a doctor and have Kaiser pay for it, it had to be their doctor.

Oh, and for those who have no money but don't qualify for Medicaid even for their kids and so have to use the ER as a PCP? I had a friend who did that. She will never be able to buy a house (she'll never fix her credit rating at this point) and she's never getting a tax refund from the state again. They take every penny of it to pay her hospital bills. I think that she determined that it would take better than 20 years of refunds to pay the bills she had amassed, and that was assuming she never had to go to the ER again.

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rivka
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quote:
Originally posted by andi330:
Unfortunately Kaiser Permanente will not allow patients to see a doctor that is not a part of their HMO (at least they wouldn't at the time, I don't know if their policy has changed, we left right after this incident).

Outside of proven emergencies, this is still true.
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Jamio
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quote:
Originally posted by dabbler:
I think based on my anecdotal evidence of being a resident in a US teaching hospital that one easy and large impact would be made if there were an emphasis on costs associated with labs/surgeries/tests /etc both short and long term costs. In the hospital there should be estimated costs listed next to every lab test and order for immediate feedback. Our education should be focused on appropriate and reasonable care instead of a cover-your-ass model.

Yes! When I was pregnant with my first daughter, we were uninsured and well bellow the income level that qualifies for free care, but we wanted to pay because we had chosen to get pregnant in those circumstances. The hospital wouldn't even give an estimate of what the birth would cost, and the only way to find out about the labs was to receive the bill in the mail afterward. Every time we wanted to refuse a lab they would pressure us to get Medicaide. We did in the end. It's still irksome, especially now that I'm always hearing about hospitals being on the brink of collapse because Medicaide only covers part of the cost and they have to write off the rest.
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TomDavidson
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When my wife was about 20, she went to the hospital with a terrible, splitting headache that left her seeing stars for about a day. She went in, then sat in the emergency room whimpering and sobbing for four hours before they triaged her. Another two hours later, she saw a doctor -- who prescribed some asprin and lectured her about the need to avoid stress, even around finals, then sent her home. When I asked if there was anything else they could do for the pain, the nurse with him sternly told me that they weren't in the habit of handing out drugs to college students.

A little while later, we found out that she'd been having complications from an accidental (and at that point, undiagnosed) pregnancy.

They charged us $600.

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andi330
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One thing I noticed watching this video. Towards the end, he talks about the price of take out in Canada v. US. He shows a receipt for a meal at Subway for $23.41. The receipt doesn't indicate whether it's Canadian dollars or US dollars, so I'm going to assume it's Canadian (after all, it is in Canada). Then he tells us what the same meal would be in the US, $18.88. This makes it seem much more expensive. Now, I don't know what the conversion rate was for Canada $ to US $ at the time he filmed this, but according to one currency converter I found online, if you convert $23.41 from Canada to US $, the price they would have paid for that meal in US dollars would have been $20.96. So it would still be more, but not as expensive as he led you to believe. While I don't doubt that there are horror stories, it makes me wonder what else he exaggerated.

Edit: The same thing goes for his gas prices. $3.83 Canadian is currently $3.44 US. Still higher than his US average gas price of $2.64, but not unheard of in parts of the US. Not to mention that any country that sells its gas by the litre ends up paying more per gallon than we do.

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