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Main Forums => Living With HIV => Topic started by: bufguy on July 13, 2009, 03:25:53 pm

Title: Canadian Healthcare
Post by: bufguy on July 13, 2009, 03:25:53 pm
As the debate on universal healthcare continues in the United States many of us look to the Canadians and their system for direction. I was reading that although healthcare; as in doctors visits, hospitalization etc. is covered in full, prescriptions are not. How does an HIV positive person in Canada pay for the prescriptions? As a healthy HIV positve American with very good health insurance my meds are by far my biggest expense, albeit paid for by insurance.
Are there any Canadians that can tell me how's this dealt with in Canada?
Title: Re: Canadian Healthcare
Post by: Scotian on July 13, 2009, 05:52:11 pm
I live in Nova Scotia.  When I made my first visit to the ID clinic, one of the questions I was asked was if I had separate insurance to cover prescription costs. I am self-employed and do not have 'private insurance'.  The doc said no problem. That was pretty much the end of the conversation. No paperwork, no jumping through the hoops. I just call the hospital pharmacy every three months, and pick up my meds. Free.
Health care is 'universal' in Canada. Rich and poor have equal access to doctors/specialists/medical care, hospitals, labs, cat scans etc etc. There is a growing trend to set up 'private' clinics so that those with the resources who can pay to get an MRI or certain procedures faster - without the wait times for the public/free services. But there is no 'line jumping' at hospitals because of who or how much you have. However,  if I needed a prescription drug for an unrelated medical issue, I would have to pay for that. Unless you are on social assistance or 65 yrs or older...then again it is free.
I'm not sure--but I believe all provinces in Canada provide free HIV meds for those who can't pay.
I also have access to a nutritionist and psychologist etc through the clinic at no cost.  When I was first diagnosed and couldn't work for 8 months( severe anxiety) my GP even made arrangements with a pharmaceutical company to get me free  'anti-anxiety/anti-depressant'  meds for a year on compassionate grounds. (I'm no longer on the meds. )
It's a great country....for other reasons as well as the free meds. ;D
Title: Re: Canadian Healthcare
Post by: Joe K on July 13, 2009, 07:45:11 pm
My partner and I just moved from Florida to Montreal and the difference in health care is vast.  In Canada, each province administers the health system for that province and we have full universal health care, with no deductibles, nor copays, except for medication.  The province of Quebec requires a copay for drugs, but the cap is $77.23 per month, no matter how many drugs you need.  If you require an unusual or expensive drug, it must be approved by the provincial government, but you get the drug within 10 days.  Our doctor has done that twice for us, with no problem.  Since the government pays for all drugs, there are no drug advertisements here, except for voluntary drugs like Viagra. 

When I lived in Florida, I had to go weekly to a county run pharmacy, where I would wait anywhere from 2 to 4 hours to get my drugs and they treated us like we were the scum of the earth.  It was not unusual for them to have not filled all of your drugs and you could either wait hours, or come back another day and start all over.  Also, all my drugs were on different prescriptions, and so I went each week to get my drugs and averaged 12 hours a month, waiting for drugs.  In Canada, I call the local pharmacist, order my drugs and they will even DELIVER THEM TO ME for free.  We pay a combined $160 per month in drug copays, versus the $7,600 we paid through Medicare Part D in 2007.

You tell me which system is better.  And what ever you do, stop calling universal health care socialized medicine, because they have nothing in common.  We have access to the best care, our HIV specialist is incredible and we believe in treating the whole person.  That means that you get the supplements that you need, including medical pot, either as smoke or in a pill, that would shame marinol.  When I need to see a psychiatrist, specialist, psychologist, etc., I just make an appointment and go.  Yes you may have to wait a few weeks to get into to see someone, but you never have to wait for emergency care, as you can go to either a hospital or a local health clinic.

Lastly, we pay 12.5% combined provincial and federal taxes that pays for all of our social services.  Most states now charge 7-8% in taxes, so for just a little more in taxes, universal care could be a reality for America, but not until you tell the special interests groups that all Americans have a right to health care.
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 13, 2009, 07:57:35 pm
That's not a great comparison.  In Pennsylvania I spend less than both your Canadian and Floridian experience, meaning zero.  And I get them refilled once monthly with no hassle and no wait, in fact if I so chose the pharmacy would deliver them to my house.  And yes I'm on Medicare D with ADAP picking up whatever isn't paid by Med-D.  And it was the same when I live in New York.

So in fact, the issue was Florida.  I don't know why anyone would live there with HIV that was not on private insurance.
Title: Re: Canadian Healthcare
Post by: Joe K on July 13, 2009, 09:06:45 pm
No it wasn't Florida, that was the problem, it was that I made too much to qualify for ADAP.  You are lucky, you get ADAP, but thousands of poz Americans, don't get squat because they don't qualify for any kind of assistance.  But my point remains, that America spends far more, per person on health care than almost any country in the world.  I assure you, America will get universal coverage, when it becomes too expensive to do otherwise.

edited to add: The real issue should be how much a country pays for its health care and everyone has equal access.  You are fortunate to have lived in two states that had the money, most states do not, as shown by the patients who continue to die, while on ADAP waiting lists.  We also have to rely on Congress to renew funding for ADAP, whereas universal covers all medical costs, under one centralized system.
Title: Re: Canadian Healthcare
Post by: GNYC09 on July 13, 2009, 09:26:47 pm
Here is a funny cartoon about the U.S. healthcare system by Adam Zyglis/The Buffalo News /Cagle Cartoons... :)

[attachment deleted by admin]
Title: Re: Canadian Healthcare
Post by: Inchlingblue on July 14, 2009, 01:24:00 am
No it wasn't Florida, that was the problem, it was that I made too much to qualify for ADAP.  You are lucky, you get ADAP, but thousands of poz Americans, don't get squat because they don't qualify for any kind of assistance.  

Very true. The system is broke and needs fixin' The problem is not "Florida," Miss P, nor any other particular state, it's the whole country. I most likely would not qualify for ADAP, so if I lost my insurance I'd be screwed@! It should not be that way, people with chronic conditions fearful of losing their jobs or their insurance and also not having the freedom to just move anywhere they want, because the social services are so uneven. And besides ADAP covers meds and other HIV  related things (blood work) but it is not  comprehensive health insurance.  Miss P you have both ADAP and Medicare. For those that do qualify for ADAP, many do not also have Medicare, meaning, they would be screwed if they needed medical attention other than the bare bones provided by ADAP.  

There would be no need for ADAP if this country had health care the way they do in Canada (but with Rx coverage) and in most other industrialized "rich" countries.

Last I read, about a month ago, there are 99 people on ADAP waiting lists. The list is probably longer by now and will get even longer as the economy continues to tank. ADAPs nationwide are starting to cut back since they are losing funding, instituting waiting lists or cutting back on services. ADAP is not the answer, it's a band-aid, what we need is universal health care.

 
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 14, 2009, 12:17:33 pm
I had to wait two years after SS approval to get on Medicare, and no I wasn't screwed over with my medical care -- New York state payed for a private insurance premium for me and there was complete continuity in terms of my treatment as I stayed with the same doctor.  In fact this policy was more expensive in terms of premium cost than my premium when I was employed (i.e. what my employer paid versus what New York state paid).

So yes, it is a state thing.  Nowhere in my post should it be construed as my saying that this is the ideal. nationally for medical coverage long term -- and stating that I did so is a fallacy.  My only point was that the delivery of HIV care in the state of Florida isn't representative of what happens in every other US state.
Title: Re: Canadian Healthcare
Post by: Inchlingblue on July 14, 2009, 06:08:44 pm
A few months ago I had asked a Canadian member of the forums (Dale Parker) about the Canadian system and this is what he said, which sounds like you need some sort of private insurance in order to get meds?

Hi Inchlingblue:
We do have universal health care but that applies to hospitals.  If you get put in hospital be it for stitches or a heart transplant it is free. Any medical treatment or drugs that you get in hospital are covered.  Most doctors fees fees (at their offices are covered).  If you want a non medically necessary procedure such as a boob job or face lift you have to pay from your pocket.  
   When you go to your doctors office and he gives you a perscription you have to pay for it out of your own pocket.  That is unless you have company or private insurance coverage.  My father worked for a very good company and all of his perscriptions cost him twenty five cents each. The company I worked for had us pay 50% and the insurance paid 50% but that was only up to a maximum of $1000.00 per year.  They treated their employees like crap. Very small companies (2 to 50 employees) may not have any company insurance.  Those people will have to either purchase private insurance or pay full price for their drugs.
If you are on welfare (meaning you can't work and the government is paying your way) the government pays for your drugs.
   That's the basics of Canadas universal health care system.
I hope this answers your question.

LINK:

http://forums.poz.com/index.php?topic=26780.msg333634#msg333634
Title: Re: Canadian Healthcare
Post by: fearless on July 14, 2009, 07:29:48 pm
One thing that should not be forgotten in this debate is that no matter where in the world a person lives the simple fact is that the cost of medical treatment is increasing.

If you dig below the surface a little, you will most likely find that every country with 'universal health care' is currently struggling to deal with the issue of how to maintain funding/reign in costs whilst at the same time maintaining adequate services and keep their systems running adequately.

We have universal health care in Aus but there are co-pays for each prescription (currently up to $32.90, but my HIV drugs are about $26.30 per script per month, and rising annually, but with caps on out of pocket expenses. Most doctors will also charge a small co-pay for each visit, and many services also have a co-pay - again each patients annual out of pocket expenses are capped at about $1200 a year). If you earn over a certain salary you are obliged to also have, as a minimum, private hospital insurance, or you pay an additional 1% tax to the government.

I pay a Medicare Levy of 1.5% of my taxable income (about $1,500), about $1,100 in private health insurance, about $950 for my HIV meds. All up about $3,500 as a basic annual minimum - this does not include any doctors co-pays, dental, optical or anything that may pop up during the year.

Our system tries to work on a principle that those who can afford it should pay a little more towards their health care costs, and those that can least afford it pay less. The greatest strain is probably born by middle income earners with families who may earn too much to receive too many extra benefits and reductions but not enough to be able to comfortably afford all the costs involved.

Another factor for the US is the cost of drugs in the US. I found this on our PBS site:

Manufacturer prices for Australia's top-selling pharmaceuticals in Australia:

are at least 162 per cent higher in the US (and 84 per cent higher when discounts are taken into account)
are at least 48 per cent to 51 per cent higher in the UK, Canada and Sweden
are similar to pricing in France, Spain, and NZ

Manufacturer prices for Australia's top-selling new innovative pharmaceuticals are similar to those in all of the comparison countries, except the US and UK (in which prices are 104 per cent higher and 54 per cent higher).

We all pay in some way, whether through additional taxes, health insurance premiums, or co-pays.

I guess, from my perspecitve, the difference between countries with universal health care systems versus the US system is that a) everyone has access to at least a minimum level of health care (which differs in each country); b) noone end up a bankrupt because of illness; and c) the cost of health care is significantly higher in the US than elsewhere.

edited to ad: my costs have risen substantially over the last 10 years. prior to 2000, i was not compelled to take out private health insurance or pay additional tax as a penalty, our copays were much smaller for prescriptions, and the Medicare Levy was only about 1.2% of our income.

edited again: generally, 'families' get greater concessions and overall lower caps for 'out of pocket expenses'. with changes in Federal laws on 1 July my partner and I can now be considered a 'family' for medicare and taxation benefits purposes so I may be able to reduce my costs over the next financial year.
Title: Re: Canadian Healthcare
Post by: Turkmenbashi on July 14, 2009, 09:10:45 pm
Just a follow-up to Inchingblue's post. While it is true that prescriptions are not covered in Canada (unless you are over 65 or on welfare), all provinces have special programs that cover HIV medications. I am in British Columbia and pay nothing for mine. I was not required to provide any information about my job/income either.
Title: Re: Canadian Healthcare
Post by: Joe K on July 14, 2009, 09:56:11 pm
I must repeat that each province administers health care and you only pay a copay for drugs in Quebec, no matter what the rest of the provinces do.  You do not have to have HIV, nor be on pension or disability to get drug coverage in Quebec.
Title: Re: Canadian Healthcare
Post by: megasept on July 14, 2009, 10:42:08 pm
As the debate on universal healthcare continues in the United States many of us look to the Canadians and their system for direction. I was reading that although healthcare; as in doctors visits, hospitalization etc. is covered in full, prescriptions are not. How does an HIV positive person in Canada pay for the prescriptions? As a healthy HIV positve American with very good health insurance my meds are by far my biggest expense, albeit paid for by insurance.
Are there any Canadians that can tell me how's this dealt with in Canada?

Great question...But I was surprised to read a fellow POZ insured American finds his biggest expense is HIV drug co-pays. My meds: $100 monthly. My insurance premium is $958 (I am single)! Maybe you have an employer who pays most of your premium (why employers need relief as well)? Am i right?

 8)  -megasept







Title: Re: Canadian Healthcare
Post by: Inchlingblue on July 15, 2009, 03:07:40 am
Great question...But I was surprised to read a fellow POZ insured American finds his biggest expense is HIV drug co-pays. My meds: $100 monthly. My insurance premium is $958 (I am single)! Maybe you have an employer who pays most of your premium (why employers need relief as well)? Am i right?

 8)  -megasept

So you pay $1,058. per month? That's a lot. Is it a HIPAA policy?








Title: Re: Canadian Healthcare
Post by: bmancanfly on July 15, 2009, 08:59:58 pm
I thought you needed to be a Canadian citizen to get healthcare in Canada.  Do they allow HIV+ non citizens into the country on a permanent basis?
Title: Re: Canadian Healthcare
Post by: northernguy on July 16, 2009, 02:11:50 am
That's not a great comparison.  In Pennsylvania I spend less than both your Canadian and Floridian experience, meaning zero.  And I get them refilled once monthly with no hassle and no wait, in fact if I so chose the pharmacy would deliver them to my house.  And yes I'm on Medicare D with ADAP picking up whatever isn't paid by Med-D.  And it was the same when I live in New York.

So in fact, the issue was Florida.  I don't know why anyone would live there with HIV that was not on private insurance.

The important thing to remember is that the Canadian provinces do not require you to fall below a certain income level to get free or cheap HIV drugs.  They're free whether I make $10k a year, or $100k a year. (There's a very strong egalitarian streak running through Canadians, that holds that the rich are no better, nor more entitled to anything, than the poor).  As mentioned, here in BC HIV drugs are at no cost when you enroll at the BC Centre for Excellence in HIV.  You can find the list of what's covered here:
http://www.cfenet.ubc.ca/content.php?id=113
Title: Re: Canadian Healthcare
Post by: megasept on July 16, 2009, 02:19:25 am
INCHLING:

If by "HIPPA policy" you mean a "guaranteed acceptance" type policy (for folks like POZ, they don't want in their insurance pool), nope, not yet. All five recent increases have been due to my age surpassing 50, and well, something like premium inflation. All nonsense.

I do plan on switching to Guaranteed Acceptance policy (higher deductibles, lower annual costs for me) starting September. I have been prevented from doing so for 3 years (COBRA "protections").

 8) -megasept











[/quote]
Title: Re: Canadian Healthcare
Post by: Luke on July 16, 2009, 02:38:02 am
I thought you needed to be a Canadian citizen to get healthcare in Canada.

You do not need to be a citizen - just a registered (i.e. legal) resident.
Title: Re: Canadian Healthcare
Post by: Luke on July 16, 2009, 04:23:57 am
Another factor for the US is the cost of drugs in the US. I found this on our PBS site:

Manufacturer prices for Australia's top-selling pharmaceuticals in Australia:

are at least 162 per cent higher in the US (and 84 per cent higher when discounts are taken into account)
are at least 48 per cent to 51 per cent higher in the UK, Canada and Sweden
are similar to pricing in France, Spain, and NZ

Manufacturer prices for Australia's top-selling new innovative pharmaceuticals are similar to those in all of the comparison countries, except the US and UK (in which prices are 104 per cent higher and 54 per cent higher).

That is very misleading. In Europe, hardly any of the drugs would ever be supplied at anywhere close to the manufacturers list price.

The only time branded drugs would ever conceivably be charged at the manufacturers list price is when the drugs are supplied on a private prescription – i.e. one that hasn’t been supplied through the public health system – because the various public health services are all part of purchasing consortia which have separately negotiated prices at which pharmacists are reimbursed for branded pharmaceuticals.

That doesn’t however change the basic thrust of Fearless’ argument though. Where we have universal healthcare; those who work do contribute, through taxation, towards the provision of that service.

The universal National Health Service here in the England costs as near a damn it £100 billion (US$ 164 billion) / year to run (for doctors, nurses, community nurses, physiotherapists, dentists, surgeries, hospitals, ambulances, paramedics, drugs, the massive bureaucracy it takes to run it all etc.), and that is raised through taxation of both employers and employees – so, in one way or another, we are collectively contributing just shy of £2,000 (US$ 3,300) for every man, woman and child – but the crucial factor is that the burden is shifted, deducted at source and shared according to ability to pay and is equally accessible to those who can’t pay.

You don't pay anything to visit a doctor or hospital for treatment, but prescriptions supplied by the National Health Service in England are filled at a standard charge of £7.20 (US$ 11.80) per drug – with 100% exemptions for drugs supplied to hospital in-patients, the unemployed, those on low incomes, the over 60s, children under sixteen (or under nineteen if still in full-time education) and patients with certain chronic conditions – and everyone being able to cap their maximum annual cumulative out-of-pocket prescription charges at £104 ($US 170).

As an HIV patient, I don’t pay any prescriptions charges for any of the drugs supplied in the specialist management of my HIV and side-effects (of either the HIV or the drugs), I have never even been asked to prove my identity or entitlement to care, let alone endure any sort of questions about my financial circumstances, and every four months I simply get handed a carrier bag with £3,000 worth assorted drugs in it (or, if I prefer, get them delivered to my home / place of work).

The downsides of that sort of publicly funded, limited budget, healthcare is that there are always unpalatable choices to make and there is always a point at which the depth of your pockets can begin to affect the treatment you can get: doctors are actively discouraged from prescribing some drugs which show only a marginal benefit over cheaper alternatives .. or that single massively expensive drugs, costing more than £30,000 (US$ 50,000) for each additional year of life they offer (i.e. expensive cancer drugs which generally only extend the life by a few extra months) would generally be judged to be unaffordable / uneconomical .. or that there is always at least one ongoing public row about which clinical stage of disease a certain treatment should be available (e.g. is a certain Alzheimer’s drug available as a preventative treatment at the first sign of the condition - or is it only offered as a treatment once the condition advances to a certain stage, which may have been delayed by many years had it been offered as a preventative). In other words, there is a point at which someone will ask whether it is worth offering you a certain treatment.

Ultimately, the average resident of nations providing universal healthcare will spend a significantly smaller percentage of their earnings on healthcare; but there are compromises made for what is perceived as the greater good, and those nations which currently offer it have also had those systems in place for a long time (since 1948 here in England), so the healthcare industry has very different expectations.

How do you go about changing those expectations in a country where healthcare is traditionally provided by private enterprise? Collectively something like US$ 2.3 trillion is spent on healthcare in the United States every year - that is US$ 7,500 for every man, woman and child as against the US$ 3,300 in the UK - and that is a lot of taxes and a lot more than most people can stomach. Certainly you will get more leverage on the prices charged by the drug companies; but, in order to make it affordable, how do you go about forcing the rest of the industry into to accepting very different standards of profit and living? And will the patients also understand that they need to accept compromises in order to make universal care affordable? Will they be less litigious? Will they accept that certain conditions may get less aggressive treatment, or that they may have to wait a few weeks for certain specialist treatments / diagnostic procedures, or that there may come a point where it is uneconomical to prolong life?

It takes a lot more than just a political will for change - but, that said, life expectancy is lower in the United States than it is in all but one of the developed nations currently offering universal healthcare, so the compromises for the greater good clearly can pay off.

What is also interesting to note is how the myth has developed that universal healthcare is prohibitively  expensive; yet Canada, Australia, New Zealand, Japan and all the EU countries actually have a lower per capita tax funding of their universal health services than the United States government has without any such universal healthcare.

Edited for typo
Title: Re: Canadian Healthcare
Post by: Ann on July 16, 2009, 07:39:15 am
As someone who has lived under both the American and British health care systems, I can tell you that without doubt, neither is perfect.

However.

The British system is far superior. Sure, sometimes compromises are called for, but at least there IS compromise. In the States, if you don't have health insurance or have very poor coverage, you're simply shit out of luck whether you're talking about seeing a doctor to obtain antibiotics or trying to access expensive chemotherapy. I know, I've been that uninsured American. Would I go back? NO WAY. The American health care system is barbaric and inhumane. I'm staying put to reap the benefits that I paid into (tax etc) for years.

Ann
Title: Re: Canadian Healthcare
Post by: RapidRod on July 16, 2009, 09:57:19 am
U.S folks think long and hard. This video is a little a rough but you'll get the point.

http://www.pjtv.com/?cmd=video&video-id=2153 (http://www.pjtv.com/?cmd=video&video-id=2153)

You may have to register but it's free...
Title: Re: Canadian Healthcare
Post by: Luke on July 16, 2009, 10:07:26 am
U.S folks think long and hard. This video is a little a rough but you'll get the point.

http://www.pjtv.com/?cmd=video&video-id=2153 (http://www.pjtv.com/?cmd=video&video-id=2153)

You may have to register but it's free...

Hardly what you would call neutral and unbiased. In fact, more like a crock of shit (like everything else that is pimped by Pajamas Media) ;)
Title: Re: Canadian Healthcare
Post by: RapidRod on July 16, 2009, 10:46:46 am
Hardly what you would call neutral and unbiased. In fact, more like a crock of shit (like everything else that is pimped by Pajamas Media) ;)

Was what the Nurse and Doctor said incorrect?
Title: Re: Canadian Healthcare
Post by: Luke on July 16, 2009, 10:55:29 am
Was what the Nurse and Doctor said incorrect?

As general comments, absolutely. About specific situations, quite possibly not; but if you are going to take out of context situations and use them to paint an entire system as wrong on the basis of that, then you really are just pimping rather tragic propaganda (which is exactly what the fascists at Pajamas Media have always specialised in doing).
Title: Re: Canadian Healthcare
Post by: RapidRod on July 16, 2009, 12:18:56 pm
All that was being made of it, is, it isn't all hunky dory as some try to make it out to be.
Title: Re: Canadian Healthcare
Post by: David_CA on July 16, 2009, 12:24:10 pm
I know I've waited in the ER for HOURS in the past.  I don't know how long it would have taken, as I was only seen when a Dr. accosted me as I was leaving out of frustration at having waited so long.  I know I didn't have a really serious injury (cut finger), but it happened at work (plus I had insurance) and was 'required' to go by my job.  I'm sure the video is very biased.  I had a co-worker years ago that still went back to Canada for many medical issues.  This sort of argument shows that the process needs tweaking, not that it's a failure as a whole.  I hear people here in the US with insurance bitch about waits, paperwork, coding issues and billing, co-pays, etc.  No system is perfect.  At least the first guy in the video is pretty hot!

Title: Re: Canadian Healthcare
Post by: Luke on July 16, 2009, 12:26:54 pm
All that was being made of it, is, it isn't all hunky dory as some try to make it out to be.

I haven't seen anyone here say it is perfect. It would be a brave person who said that of any man-made system .. but when you consider that the US tax dollar already pays twice as much towards the provision of healthcare than any other leading industrialised country with universal healthcare, yet has a lower life expectancy, poorer quality of care and no universal healthcare, then the Canadian system is probably still a lot better than doing diddly-squat.  

Edited to add: I should add that the quality of care claim comes from Donald Berwick, the Professor of Health Policy and Management at the Harvard School of Public Health (http://en.wikipedia.org/wiki/Donald_Berwick)
Title: Re: Canadian Healthcare
Post by: bufguy on July 16, 2009, 03:06:26 pm
WOW!.. this is the kind of debate that every American should be part of now that we are trying to reform health care. I live in Buffalo and have a lot of friends in Canada. The only complaints I hear from Canadians are for long waits for non urgent procedures. An American with insurance can get a hip replacement scheduled within weeks, while a Canadian might have to wait months. Some Canadians come here to Buffalo for MRI's because there is no wait here.
As a government employee I have great insurance and pay only a few hundred dollars per year in co pays for doctor visits and prescriptions, but I can't imagine what I would do if I were unemployed. From what I can see the Canadian and British systems are preferable.
Its amazing how the right wing Republican, Christians politicians are against universal healthcare.....what would Christ do?
Title: Re: Canadian Healthcare
Post by: RapidRod on July 16, 2009, 07:27:00 pm
What would Christ do? Ask his father to heal him...   ;)
Title: Re: Canadian Healthcare
Post by: David_CA on July 16, 2009, 10:57:25 pm
Rod, out of curiosity, what, if anything, would YOU like to see change with our healthcare system?  What would your suggestions be to 'fix' it?
Title: Re: Canadian Healthcare
Post by: RapidRod on July 17, 2009, 07:20:46 am
Rod, out of curiosity, what, if anything, would YOU like to see change with our healthcare system?  What would your suggestions be to 'fix' it?

The whole system needs fixed, but not by rushing into it like they did the stimulus package and the tarp funds. They have no idea how they are going to pay for it and rushing in to force it to be voted on before the August recess is ridiculous. There is no such thing as taxing the rich.  You’ve heard the old saying shit rolls down hill and that is what would happen. You believe, those rich people got into their status by being stupid? They are going to recoup their losses by increasing the prices of their goods and who ends up paying?  Your middle class that are taxed to death now, and those small businesses that employee most of the work force in the US will end up closing their doors and the unemployment rate will sky rocket. Remember it wasn’t that long ago they said without the stimulus package unemployment would go over 8%, well guess what, with the stimulus package unemployment has went over 8%. You can’t fix this system over night like they are trying to do.  Now David what are YOUR suggestions in fixing the system? Is there anything that our govenment haven't stuck their hands into that didn't turn into a mess?
Title: Re: Canadian Healthcare
Post by: Luke on July 17, 2009, 07:55:30 am
Taxation shouldn’t actually be the problem. As I have already pointed out, the US already spends more tax dollars per head of population on healthcare than any other country in the world – it just doesn’t spend it efficiently and wastes huge swathes of cash on administering disparate claims procedures and stigmatising processes to decide who is poor enough to need help.

Re-deploy that spend, plus the $200 billion in annual tax credits that are currently given to people taking out private insurance  (which in itself is almost enough per capita to fund half the universal healthcare system of any other country in the world) and you guys already have the makings of a system that really would be the envy of the world.

Do it properly – making it about slow and methodical reorganisation and redeployment - and the long-term gain could actually be the odd spare trillion sloshing around to reduce national debt and/or lower taxes.

Edited for typo
Title: Re: Canadian Healthcare
Post by: Luke on July 17, 2009, 08:00:29 am
Of course … whether you can actually trust a politician to do anything right is a very different matter ;)
Title: Re: Canadian Healthcare
Post by: mjmel on July 17, 2009, 08:02:43 am
Despite the efforts at a revamp I worry that it's going to be a mess,..a continued mess. We are bitching now (rightly so) and we will be bitching after the 'revamp' when many fall through the loop holes and complications caused by changes. I agree with Rod to a degree. When US politicians (who do not actually deal with living without coverage/healthcare) rush to fix something they could end up with just a patch instead. Later, there's regret and more finger wagging. And those who suffered before are left suffering again.
The politicians, (the so called, 'we'), need to restructure the healthcare system but not in a rushed manner...........like they seem to be doing in these very days.

Mike
Title: Re: Canadian Healthcare
Post by: mjmel on July 17, 2009, 08:03:31 am
Of course … whether you can actually trust a politician to do anything right is a very different matter ;)

BINGO!

Mike
Title: Re: Canadian Healthcare
Post by: RapidRod on July 17, 2009, 08:04:43 am
Of course … whether you can actually trust a politician to do anything right is a very different matter ;)
Luke that is an UNDERSTATEMENT....... ;)
Title: Re: Canadian Healthcare
Post by: David_CA on July 17, 2009, 08:45:25 am
Now David what are YOUR suggestions in fixing the system?

You know, I'm really not sure what my suggestions are, which is why I'm trying to learn more about what other countries are doing to cover their citizens.  We don't have to re-invent the wheel, only make it work for us in the US.  Sometimes, I think we (as a country) put our blinders on and either plod along saying that things are fine or just jump in without studying what others are doing. 

At any rate, I'm not going to criticize those who are trying to improve the system; my criticism is more directed to those who've gotten us here in the first place.

Taxation shouldn’t actually be the problem. As I have already pointed out, the US already spends more tax dollars per head of population on healthcare than any other country in the world – it just doesn’t spend it efficiently and wastes huge swathes of cash on administering disparate claims procedures and stigmatising processes to decide who is poor enough to need help.

Re-deploy that spend, plus the $200 billion in annual tax credits that are currently given to people taking out private insurance  (which in itself is almost enough per capita to fund half the universal healthcare system of any other country in the world) and you guys already have the makings of a system that really would be the envy of the world.

Do it properly – making it about slow and methodical reorganisation and redeployment - and the long-term gain could actually be the odd spare trillion sloshing around to reduce national debt and/or lower taxes.

There is so much BS overhead in our current system of insurance coverage.  For example, my state-sponsored insurance (State employee) uses Medeco to administer its drug benefits.  Medeco allows and pays a bit over $2700 per month for a 30-day supply of Atripla.  The cash price for it is somewhere around $1600.  If I use Medeco's mail order pharmacy, guess what the cost to the State is - $2700 per month.  That extra $1000 per month would obviously cover a large percentage of another persons prescriptions.  My insurance will also cover my CPAP machine.  The cost passed on from the DME supplier is around $2800 for the equipment.  I can order this same equipment, new with warranty, for around $705.  What's the State's response to the increasing cost of healthcare?  We have our benefits cut and co-pays increased.  Great, this will save the State less than $200 (in increased co-pays) a year for me vs. the over $14,000 (for one year, one drug, and one piece of medical equipment) that could be saved!

Yes, I'm one expensive employee, but a large portion of 'my' cost is due to inefficiencies in the current system.  I think the real problem with our current system is that there is so much overhead (costs) padded in various administrative fees, etc that the entire thing becomes a huge burden for businesses to provide for employees or for individuals. 

I don't have a solution, but there has to be one somewhere between fully govt. subsidized healthcare and the current system.  Unfortunately, it's probably going to be easier and quicker to make a drastic change than it will to correct the padded costs built into our current system.

Title: Re: Canadian Healthcare
Post by: GSOgymrat on July 17, 2009, 09:36:17 am
Luke is correct in that Americans are already spending the money on healthcare, we just do it very inefficiently and with great inequity. People criticize the government but Medicare has much lower administrative costs than private insurance.

Here is an example of how I see the system not working. I work part-time at a county mental health center. I saw a man yesterday who was discharged from a community hospital's psychiatric unit after having a psychotic episode and trying to kill himself. The doctor at the hospital discharged him with a month's worth of medication and a prescription for refills. The medication is working great but cost $400 a month. The man is currently unemployed, uninsured and cannot pay for the medication. At the mental health center we don't have any samples of the medications, we don't have any money for medication assistance, the hospital refuses to give him more medication and the man hasn't even applied for Medicaid. The man goes home with nothing other than a recommendation that if he starts hearing the voices again to go to the emergency room.

This man is probably going to become psychotic again when the medication runs out. He may hurt himself again or hurt someone else (expense). He's going to end up in the emergency room, probably via law enforcement (expense) with no ability to pay (expense). He's going to take up a bed in the emergency room for an average of 2.5 days because the local psychiatric hospitals run full (expense). He's going to be admitted to a psychiatric unit again with no ability to pay (expense). Unless his employment situation changes or he manages to get medicaid this is going to happen all over again. So instead of giving this guy $400 worth of medication the community is going to pay thousands of dollars for law enforcement, emergency room care and inpatient treatment.

I would like to say this situation is an exception but it happens all the time. Almost twenty percent of psychiatric patients who are admitted to our inpatient unit have no insurance and are not eligible for county assistance. That doesn't take into account the people who have insurance, Medicare or Medicaid but cannot pay their deductables or co-pays. The only reason our unit continues to operate is because the hospital charges people who are insured and people who get other kinds of treatment (such as surgery, which makes a big profit) inflated prices.

This is just the little corner of healthcare that I work in. I'm sure there is all kinds of waste and shortsightedness in other areas.
Title: Re: Canadian Healthcare (Like the US is "Hunky-Dory" Now???)
Post by: megasept on July 18, 2009, 02:57:15 am
The whole system needs fixed, but not by rushing into it like they did the stimulus package and the tarp funds.

"rushing into it" ??? LOL. I'll be dead long before genuine universal healthcare comes to this part of North America. Pres. Truman dangled universal healthcare in front of the AFL-CIO's unions and they refused the offer...about  60 years ago.

If we're gonna get swayed by one-sided videos, why not watch the section on France in "Sicko"? I found that part interesting. Especially how the well-off MDs (lower compensation and lower costs like malpractice insurance than here) earn more when they provide PREVENTIVE CARE to their patients, saving money and lives.

One of my private insurers sent me a letter years ago telling me i could not see my HIV specialist more than two times a year! After a year and three appeals they dropped it. CORPORATIONS RATION HEALTHCARE, including plenty people on this Site really need or needed. Rod, when I get the "public option" you would oppose, I will complain for sure, about this or that, as I do with anything important to my existence. Squeaky wheel.

At this moment we have cabinet members and other government leaders that don't oppose the mission of the departments they head (recent history, lest we forget). We already pay for government. Everyone in the US already pays for Walmart and other cheap employers offering crap compensation (healthcare) to their employees. It's time to get something better for our buck! Universal healthcare would be better for business, unless you happen to be in the bloated, bureaucratic, parasitic, healthcare insurance business.

US Senators get SOCIALIZED medical care (not insurance) at Walter Reed. I don't hear them complaining about THEIR own "socialism". Even "single-payer" is not socialism, and that (regretfully) is NOT ON ANYONE"S AGENDA now.

My real healthcare problems aren't with government, but with CORPORATE middlemen who keep jacking me up. My MDs and support staff are dedicated, yet IMPERFECT, employees of a public university which makes them... :o government employees. Fire departments used to be PRIVATE, so they let some buildings burn to the ground because their competitors insured them. Kind of like US healthcare today.

My insurance premiums went up 110% (5 separate increases) IN UNDER 3 YEARS! Where's MY "level playing field" that America's healthcare industry (weird term) is being reassured about?  >:(

 8) -megasept

PS The "rush" before recess, is once the kids come back from play another 60 years will pass before the US gets around to top to bottom Federal reform of healthcare. TACTICS.
Title: Re: Canadian Healthcare
Post by: Luke on July 18, 2009, 06:04:40 am
I was just having a clear-out and found something which I thought might interest you all ...

In May 2007 the New York based Commonwealth Fund - a highly respected private charitable foundation whose stated purpose is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency – published its third international comparative study of the health care systems in six countries (Australia, Canada, Germany, New Zealand, the United Kingdom and the United States).

I think the overall rankings diagram speaks for itself.

What is also interesting to note is that the more coordinated and universal the system of healthcare is – i.e. less bureaucracy associated with means testing and checking eligibility - the cheaper a nation's healthcare appears to be. In other words, the cost of running the bureaucracy, to ensure that you only offer care to those who are entitled, actually appears to be higher than the cost of the care you deny through that bureaucracy, so it actually seems to be cheaper to offer the same level of basic service to all and do away with the stigmatising means testing.

http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf (http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf)

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Title: Re: Canadian Healthcare
Post by: RapidRod on July 18, 2009, 03:02:04 pm
Luke, look at the mess Mass is in trying it in their state. Bankrupted.....http://www.nytimes.com/2008/04/05/us/05doctors.html (http://www.nytimes.com/2008/04/05/us/05doctors.html)

http://www.washingtonexaminer.com/opinion/Universal_coverage_First_look_at_the_disaster_in_Massachusetts_011109.html (http://www.washingtonexaminer.com/opinion/Universal_coverage_First_look_at_the_disaster_in_Massachusetts_011109.html)
Title: Re: Canadian Healthcare
Post by: megasept on July 18, 2009, 03:11:34 pm
WOW!.. this is the kind of debate that every American should be part of now that we are trying to reform health care. I live in Buffalo and have a lot of friends in Canada...
Its amazing how the right wing Republican, Christians politicians are against universal healthcare.....what would Christ do?

Christ threw the money lenders out of the Temple...Maybe something analogous here.  ;)

While living briefly in W. Germany in 1975 I was surprised that my many conservative Bavarian (Southern Germany) neighbors ALL SUPPORTED universal government-run healthcare. Most were staunchly CDU (Christian Democratic Union) or CSU (Christian Social Union) parties. Conservative, Catholic, and totally in favor of government-run universal healthcare. Our "own" US conservative politicians are generally pimped out by corporate healthcare interests.

8) -megasept
Title: Re: Canadian Healthcare
Post by: Luke on July 18, 2009, 03:30:38 pm
Luke, look at the mess Mass is in trying it in their state. Bankrupted.....

Interesting. Is that just ineptitude? I haven't actually been following what they have been trying to do in Massachusetts, so I genuinely don't know; but like I said in my first post, it takes a hell of a lot more than just a political will to make a change - it takes a fundamental shake-up and complete cultural shift on the part of both patients and the healthcare industry.

The fundamental problem with implementing universal healthcare through a compulsory insurance system, rather than direct taxation, is that you still saddle the system with a huge administrative overhead.

Edited to add:

Because it is funded through direct taxation, the UK system works on the basis that, unless there is a good reason to think otherwise, there is just an automatic assumption that you are entitled to care and there are no questions asked. The anti-immigration lobby complain that this leaves the system vulnerable to 'health tourists', which it in theory  does, but the money actually lost in treating these ineligible health tourists (people who just come to the UK for no other reason than to take advantage of the health system) actually only amounts to a piddling £30 million a year, which doesn't even register as a fraction of a percentage of the cost of running the system. On the other hand, it would cost high hundreds of millions, if not several billions, to implement a system to check eligibility - so the administration is a completely unnecessary burden on a system.
Title: Re: Canadian Healthcare
Post by: pozniceguy on July 18, 2009, 03:53:30 pm
I have been watching the "news" releases and reading  the post you folks have put on here...I still see a lot of posing/ citing of specific cases and general lack of knowledge of what is being proposed and what is actually available in US regarding   health care...
In any discussion about any subject in the Congress, sponsored by the president or not, there are two fundamental questions....how much does it cost and who is paying????      ..the answers to these questions are NEVER EASY....AND VARY FROM STATE TO STATE AS WELL AS FEDERAL... so far   NO ONE HAS BEEN WILLING TO SAY  HOW MUCH?????......the Budget office keeps pointing out that it will not be paid for by any of the possible suggestions..but they are being ignored....very few of the "congressmen believe that the presidents statement about "saving our way out of this" will ever happen...they have a long history to shore up that sort of failure from the past  attempts to use that method for other programs......
I have seen many " quotes" that say we are paying more and getting less than other similar countries.....the actual facts seldom bear that out.....because what we get or at least what we have available is frequently not readily available in other countries........all of the countries that have "national" health systems have faced major funding issues about how to pay for it.....or who is paying for it is more accurate...
If anyone accepts the fundamental issues surrounding  "free choice"  competition, and or states rights  then you can be assured that nothing substantial will change........

the usual "tax the rich" solution falls flat because the amount to be raised would put too many people back to the old ways of income tax that saw rates in the 40/ 50 % for marginal income....raising taxes on any group of persons or goods( a form of VAT or flat tax) will bring down more politicians than a bomb at the Capitol....so what do "WE DO"  ????? the choices are so limited ( if you subscribe to any of the above philosophies)    that the proverbial "punt" is in order......in the areas of the country ( usually bigger cities )  there are many "clinics " sponsored by various groups  some private  some public supported....people without insurance and some with insurance that cant afford the co pays use these clinics.....good service????varies all over the place unfortunately.....people in less populated areas have a double hit  no services because few service providers are willing to live there...doesn't matter who is paying....,  a possible solution is to fund these clinics   where they exist with a combination of fed and local monies ( some already do this)...and provide incentives for providers to live/work in those areas where there is a lack of available services.....still leaves part of question of who pays and how much....but it gets the issues in front of the real stake holders...some areas are so poor they couldn't raise enough to afford a clinic or a service provider  at that point we have to step up and decide how much of their pain is going to be shared by those who can afford it......all the sob stories...incidents...horrible examples always come down to availability and cost usually in that order....If any funding bill ever gets past the Congress..no matter what legislation they pass....the issue of who gets what and under what conditions must be addressed.....if they keep up the varieties of "earmark" type funding such as ryan white and other dedicated programs that wont cut it...a more broadly defined " healthcare" fund needs to be in place..with states/cities/counties funding some share of the "pain" for those that havent the means to provide services...

I will stop now but this will be a very hot subject to continue with in Boston....the Old PaY State...as we used to call it.....near bankruptcy because of many of theses issues...

Nick
Title: Re: Canadian Healthcare
Post by: Luke on July 18, 2009, 04:05:10 pm
.because what we get or at least what we have available is frequently not readily available in other countries

Or is this just a myth that you are repeating? Name one single common treatment (i.e. not an experimental treatment) which is available in the US, but isn't available in another leading industrialised country. Just one treatment that isn't available in one other country.
Title: Re: Canadian Healthcare
Post by: pozniceguy on July 18, 2009, 05:19:01 pm
Luke, .I didnt say "not available"  I said not readily avalialble....I have lived in England,,travelled extensively in Europe and Asia and lived in many parts of the USA    The services and procedures available in Tonopah Nevada are not the same as available in Las Vegas, In England the services/ procedures available in Upper Hayford are not the same as what is available in London  and so on throughout the world.....In the USA there are many places where latest services are available in relatively smaller locations than are available in larger cities in Europe.....try getting any kind of Laser surgery in Italy any city outside of Rome..or just consider what is available to the residents of Hudson Bay versus Ontario or Montreal.  The American "system" if you can call it a system..encourages the "newest" latest" and "best treatments possible,.many times at the expense of good and practical treatments.....
the town I currently live in has 21 dentist offices,two Hospitals and a dozen private physicians  with all the latest equipment and facilities serving a population of 25000......just 50 miles from here south of Dallas I dont live in Dallas...there are towns of 20,000 with no dentists..and few Dr and no bus service..to get to the nearest good services in Dallas...

an unfortunate result of the "system" that depends on competition, unstable funding and the high cost of maintaining a "private"practice for DRs....

Nick
Title: Re: Canadian Healthcare
Post by: Luke on July 18, 2009, 05:32:38 pm
Sorry nick, but you were quite clearly talking about services that were available in the US and not available in other countries. I still challenge you to name something that isn't readily available in other countries. A simple Google search will show just how readily available laser surgery is in Italy .. just as a similar search will show that Upper Heyford (which, for the benefit of those who don't know, is a village and not even a town in its own right) is a mere 2 miles from some of the most advanced medical facilities in the UK, offering: http://www.northamptongeneral.nhs.uk/OurServices.aspx (http://www.northamptongeneral.nhs.uk/OurServices.aspx) .. and all of 70 miles by road/rail from Central London if you still can't find what you need there .. or in Oxford, Birmingham, Reading, Swindon, Bristol or Bath.

Given that I do sort of agree with most of the rest of what you said, maybe it was just a point badly made .. or I am just too stupid to understand ;)
Title: Re: Canadian Healthcare
Post by: Dennis on July 18, 2009, 07:33:02 pm
Due to the slow process of approval from the FDA in the U.S., many medical procedures are usuallly approved and readily available in other countries first.

Lasik surgery was first being used in Germany in the late 1980's to treat near-sightedness. The FDA didn't approve LASIK until 1998.

I also, believe elsewhere in the world a persons own stemcells are being used to treat heart disease. A procedure not yet approved in the USA.

Browsing a link that Miss P supplied to another forum member regarding facial wasting, it stated that some U.S. residents travel to other countries to receive facial filler, not yet approved in the U.S.

Google medical tourism.
Title: Re: Canadian Healthcare
Post by: Ann on July 18, 2009, 07:50:12 pm

...because what we get or at least what we have available is frequently not readily available in other countries



Or is this just a myth that you are repeating? Name one single common treatment (i.e. not an experimental treatment) which is available in the US, but isn't available in another leading industrialised country. Just one treatment that isn't available in one other country.


I have to agree with Luke here that this sounds like a myth to me too. Remember, I've experienced BOTH US and UK healthcare. I've never come across a single, non-experimental treatment that was available in the US that wasn't also available in the UK.

On the other hand, when I was going through the hep c treatment, I met many US residents (in online hep C support groups) who couldn't do the treatment because they weren't able to work during the treatment. If they couldn't work, they weren't covered by their insurance, therefore couldn't pay for it, and therefore had to quit treatment. None of them were able to obtain any kind of medical leave. The only US residents I met who didn't have this problem were the minority of people who managed to struggle to work everyday, the even smaller minority whose employer granted them a paid (with benefits) leave of absence, or those who had already been granted disability status and were no longer employed. (and we all know how difficult disability status can be to come by in the US)

Everyone I've known on hep C treatment in the UK was given a med cert so they didn't have to work during treatment, and their treatment was fully paid for by the NHS.  NO PROBLEM. No questions asked. You need the treatment, you got it plus time off work so you could concentrate on your treatment and get better. No hassles with an insurance agency. No hassles, period. Just treatment. COMPASSIONATE treatment.


Luke, .I didnt say "not available"  I said not readily avalialble....


Nick, you seem to be saying that sometimes one has to travel to access treatments. True, no matter where one lives. However, again as a person who has lived in both the US and the UK, the UK is MUCH more travel friendly than the US. When I lived outside a major US city, I found it next to impossible to get on without a car. Here in the UK, I haven't had one in 17 years and it hasn't made the slightest difference to my healthcare. The NHS pays for me to travel to Liverpool for my hiv care - that includes local taxis to and from the Manx airport, taxis to and from John Lennon airport to the Royal Liverpool Hospital, and the airfare itself. Can you see that being done in the US? Yet look at the charts provided by Luke a few posts earlier... the UK is at the bottom for expenditure.

You know, as an ex-pat American, I think I can speak with some insight. And my insight is that Americans let their pride get in the way of getting health-care right. You all think that the American way is the best way, the most innovative way, and when you're proven wrong, you'd rather get sick and be at mercy of an outdated, cruel system than admit that maybe someone else in the world has a better idea of how to do things. It's a pity.

Ann
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 18, 2009, 08:14:09 pm

You know, as an ex-pat American, I think I can speak with some insight. And my insight is that Americans let their pride get in the way of getting health-care right. You all think that the American way is the best way, the most innovative way, and when you're proven wrong, you'd rather get sick and be at mercy of an outdated, cruel system than admit that maybe someone else in the world has a better idea of how to do things. It's a pity.

Ann


Uh, not "you all" -- just the conservatards.
Title: Re: Canadian Healthcare
Post by: Ann on July 18, 2009, 08:20:34 pm

Uh, not "you all" -- just the conservatards.


Yes, I do apologise Miss P. I know better than to tar "you all" with the same brush. I should have said many Americans and the vocal majority ...

Am I forgiven?


Title: Re: Canadian Healthcare
Post by: Dennis on July 18, 2009, 11:27:24 pm
7 Reasons to Consider Traveling for Medical Care

http://health.usnews.com/articles/health/2008/10/01/7-reasons-to-consider-traveling-for-medical-care.html?PageNr=2

Here's #4

4. Specialty treatments. Some procedures and prescriptions are simply not allowed in this country. Either Congress or the Food and Drug Administration has specifically disallowed a certain treatment, or perhaps it's still in the testing and clinical trials stage or was only recently approved. Such treatments are often offered abroad. One example is an orthopedic procedure known as hip resurfacing, a less expensive alternative to the traditional hip replacement still practiced in the United States. While this procedure has been performed for more than a decade throughout Europe and Asia, it was only recently approved in the United States, and its availability here remains spotty. Hundreds of forward-thinking Americans, many having suffered years of chronic pain, have found relief in India, where hip resurfacing techniques, materials, and instrumentation have been perfected, and the procedure is routine.

Title: Re: Canadian Healthcare
Post by: Ann on July 18, 2009, 11:49:21 pm
India.

Imagine that.
Title: Re: Canadian Healthcare
Post by: Dennis on July 19, 2009, 12:46:01 am
And Europe

"While this procedure has been performed for more than a decade throughout Europe and Asia, it was only recently approved in the United States..."

Just pointing out, that yes, there are quite a few medical procedures approved elsewhere before they are approved in the U.S.A. Because you or I haven't come across, or needed a procedure ourselves, doesn't mean they don't exist. Just as there are medications approved for use in some contries and not others. Thus, one reason, other than cost, while medical tourism is so big. However, allow to me add that there are also treatments available in the U.S. that aren't available everywhere else.

Title: Re: Canadian Healthcare
Post by: Luke on July 19, 2009, 05:53:04 am
GSO mentioned on another thread about going to Brazil for Sculptra treatment for his HIV-related lipoatrophy. It isn't that it isn't available in the US; but it is expensive and even his insurance wont cover it, so going to Brazil for the treatment makes it an economical option.

Here, because lipoatrophy is seen as a traumatic and stigmatising side-effect of my condition, I wouldn't even have to ask for it. I would simply be offered it free of charge by my doctor, as a matter of course, as part of my normal coordinated HIV care. No paperwork and no worries -  my doctor would simply make an electronic referral and I get an appointment. All I have to do is turn up at the designated time and place (and as Ann says, even my travel costs are covered if I can't afford them).

I am getting more than $15,000 worth of HIV treatment ever year and I have just had $25,000 worth of re-constructive orthopaedic surgery. Not once have I even been asked to prove my identity and entitlement - and the only time I have been asked about income and employment is as part of the coordinated assessment to see if I need help to access other support services and benefits that I would be entitled to. As I was complaining to Ann the other day: I actually want to work, but my employer would rather I stay at home on full pay whilst I recover fully from surgery and undergo physio (also provided free of charge).
Title: Re: Canadian Healthcare
Post by: Luke on July 19, 2009, 06:44:26 am
However, allow to me add that there are also treatments available in the U.S. that aren't available everywhere else.

Exactly, but that is about regulatory / marketing constraints - or perhaps the location of a specialist in a particular cutting-edge field of medicine - not because the standard of medical care available is in itself backward, or rationed.
Title: Re: Canadian Healthcare
Post by: BT65 on July 19, 2009, 07:41:01 am
Ms. P. is right about this-it isn't every American that doesn't want better health coverage.  It is mostly the far-right conservatives, who have everything paid for anyway, and get the best care of whatever their problem is.  At the volunteer job I do, I see tons of people every day who don't know how they're going to take care of their health, because a lot of them have lost their jobs, and with the jobs goes the insurance. 

I'm on Medicare (and Medicaid when I can make the spend-down amount to be covered).  When I go see my doctor, the stupid health system his clinic is associated with bills me whatever Medicare doesn't cover.  I pay them $10/month, but now my bill is in the $300's.  I don't think I'll ever get them paid off.  So, even when one has Medicare here, that doesn't mean there's no more medical bills.  It sucks all the way around.
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 19, 2009, 09:15:41 am
GSO mentioned on another thread about going to Brazil for Sculptra treatment for his HIV-related lipoatrophy. It isn't that it isn't available in the US; but it is expensive and even his insurance wont cover it, so going to Brazil for the treatment makes it an economical option.

No, you got that wrong -- he was getting a non-FDA approved filler, not Sculptra.  I think it's a PMMA-based permanent filler.  Dermik Pharmaceuticals actually has a patient assistance program for Sculptra and you can get it for free or a sliding scale.  I think I'm headed down that road in a couple of months.

But GSO went to Brazil for a permanent filler, and not just his face but in his buttocks.  I also think that there are products approved here, but they'd not specifically approved for HIV lipoatrophy.


Here, because lipoatrophy is seen as a traumatic and stigmatising side-effect of my condition, I wouldn't even have to ask for it. I would simply be offered it free of charge by my doctor, as a matter of course, as part of my normal coordinated HIV care. No paperwork and no worries -  my doctor would simply make an electronic referral and I get an appointment. All I have to do is turn up at the designated time and place (and as Ann says, even my travel costs are covered if I can't afford them).

Yeah, not let one of the AIDSmeds conservatards tell me why I shouldn't get the same.  I've gone an entire fucking decade living with facial lipoatrophy.
Title: Re: Canadian Healthcare
Post by: Luke on July 19, 2009, 10:11:16 am
No, you got that wrong -- he was getting a non-FDA approved filler, not Sculptra.  I think it's a PMMA-based permanent filler.  Dermik Pharmaceuticals actually has a patient assistance program for Sculptra and you can get it for free or a sliding scale.  I think I'm headed down that road in a couple of months.

For example, my insurance won't pay for me to have Sculptra, PMMA or any other cosmetic treatment for lipoatrophy so I went to Brazil and paid out of pocket.

http://forums.poz.com/index.php?topic=28019.msg345802#msg345802

I think we may have to split the points on that one ;)
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 19, 2009, 10:17:12 am
Oh sorry, yeah I misread that but yes there's a split issue between procedures/products being FDA approved, but still being labelled as "cosmetic" by those dastardly insurance companies that right wingers like to defend.

Now, how ANY HIV-positive person can defend this boggles the mind.
Title: Re: Canadian Healthcare
Post by: Dennis on July 19, 2009, 11:18:34 am
Regrdless of the reasons, the fact remains there are still medical procedures available elsewhere that aren't available in the U.S.A., with the primary reason being regulation. And their all not just cosmetic. Stem cells have been used for years overseas to treat heart disease. Only this year, I believe, has this same procedure made it's way to the U.S.

Exactly, but that is about regulatory / marketing constraints - or perhaps the location of a specialist in a particular cutting-edge field of medicine - not because the standard of medical care available is in itself backward, or rationed.
Title: Re: Canadian Healthcare
Post by: GSOgymrat on July 19, 2009, 02:18:20 pm
Just for clarification my insurance won't pay for anything to correct lipoatrophy. Sculptra does have a patient assistance program which would allow me to get the product for free but to have it injected would be $500 per session and require 6 sessions. So it would have cost me $3000 to have just my face done with a temporary filler and by going to Brazil I got face and buttocks treated with a permanent filler by a doctor who specialized in treating lipoatrophy for I think around $2200.

The US is one of the wealthiest countries in world and if other countries can provide healthcare we can too. As I see it we have a couple of major problems. One, people don't like change and the major players in healthcare- pharmaceutical companies, insurance companies, hospitals and doctors- do not want the healthcare industry to change in any way that would reduce their profits. Two, many Americans (not all) have an aversion to paying for other people's benefits. This to me is ironic in a so-called "Christian" nation. Three, people want to choose their providers, have immediate access to the latest treatments, free medications and all the bells and whistles but they don't want to pay higher taxes. Four, many Americans (once again, not all) don't see healthcare as something everyone should have, like police protection. If you had police who didn't come to your home when you were being robbed because you didn't have "law enforcement insurance" people would think that was ridiculous but we accept that some people are not going to receive medical care because they don't have health insurance.
Title: Re: Canadian Healthcare
Post by: Joe K on July 19, 2009, 02:43:48 pm
The only way to alter American health care is to change both the culture and administration of health care. Medical care and reporting need to be the same, no matter who the provider is.  There should be one standard claim form that every provider uses to determine coverage and there should be incentives to keep patients healthy.  But none of this matters if you don't have the medical staff and that is where a major change is warranted.

Most medical professionals will emerge from university, owing thousands of dollars in school loans, that they must repay and the fastest way to do that is to increase the care and test and procedures, so you can get the maximum payments allowed.  If we were to change how medical students are financed, by offering them an option for public service, in return for debt forgiveness, they would have less incentive to provide excessive care, just to cover their debts.  We also need to change malpractice insurance and litigation.

America is sue happy and just because something bad happens to you medically, does not automatically make that malpractice.  Malpractice insurance is outrageous and while I lived in Florida, I lost three doctors, who left the state, due to excessive malpractice insurance premiums.  If we formulated a basic care plan, developed by medical professionals, and doctors/nurses followed such a plan, they should receive a sort of "implied immunity" when it comes to malpractice claims that may arise from that very care.  This does not mean that you could not sue for malpractice, just that there are many times, when medical professionals, do all they can possibly due and yet the patient still dies.  So is that malpractice or possibly a testament to the limits we have in regards to medical science.

We can also bring our cost under control, by using the massive buying power of the Federal government (Medicaid, Medicare, Veterans) to secure reasonable pricing for services and drugs.  While America is a free market country, there are some things that should not be used to profit at the expense of citizens.  Surely there is a way to sustain medical research, while limiting the rocketing costs of such research.  Maybe drug companies could reduce their profits, to stockpile resources to help stabilize their costs.

Then there is the administrative waste that exists and that I believe is the most pressing issue.  If the Feds rooted out fraud in the government run systems, they would save hundreds of billions every year.  When I lived in Florida, someone got my Social Security number and this clinic was billing Medicare almost $10,000 per month, for services that I never got, nor knew nothing about.  The first time I discovered this, I contacted Medicare and advised them of the fraud.  They promptly sent a letter to the provider, demanding the return of the payment, but when the same company billed them the next month, Medicare paid it again.  Repeat cycle, same result = insanity.

The biggest obstacle that Americans have, in regards to universal health care, is the unwillingness of too many parties to compromise.  Congress is falling all over itself, in what I believe is a very irresponsible rush to pass major health care reform, before they go on vacation.  Will they ever learn?  Either way, America needs to change how we view the role of health care and once we can agree, that everyone needs it, the other details can be addressed, in the proper place and time.

I believe that compromise is the key to attaining universal health care and all ideas should have a fair hearing.  Maybe we need to throw out our concept of a health system and envision one that would work and then strive to alter our current system.  No matter what we choose to do, compromise is the only way to really attain anything.
Title: Re: Canadian Healthcare
Post by: fearless on July 19, 2009, 08:40:30 pm
the other thing that seems to be missed when talking about 'universal coverage' is that it does not have to mean the end to private hospitals and private health insurance.
Those who are not happy with the standard of care of level of care under the universal system are free to continue paying for their private health insurance and receiving the treatment they were previously getting.
Title: Re: Canadian Healthcare
Post by: tokyodecadence on July 20, 2009, 12:10:33 am
I don't know if this has been said before, mainly because every response is an epic novel hahahaha. But, many Americans (even Americans that are for UHC) are skiddish about it, well, because they've never experienced it.


They've been through the anal raping of paperwork and insurance claims and blah blah.
Or they've even seen spoofs about the shitty medical coverage on TV and in movies (That particular episode of *every* sitcom where someone goes to the hospital for treatment of something, only to discover that they no longer have insurance, or went and was told to leave, in a joking, sitcom, mechanical applause/laughter manner, of course).
Or they've seen their parents/relatives struggling to pay bill after bill after bill.


It really *is* the American way. Americans don't know any other system personally. It's one of those "it held up this long, what's the use in rocking the boat?" mentalities. And Americans have a dislike for change, until change is dangerously staring them in the face, and they're left with no other choice. Let's hope that doesn't happen this time.


Note: I'm not implying ANYTHING in this response, I merely stating why a lot of Americans have a hard time simply accepting a new way of thinking. Especially on something like Medicine, and medicine in a society that's based on quick fix (diet pills, viagara, Sleep aids, restless leg syndrome...what ever the hell that is) satisfaction, and hard set manners.


But I think things are going to be turning around here in the next 5-10 years, not completely, of course, but the direction is getting there. But another thing I think that people need to realize is that the government cannot do EVERYTHING on its own. If we want some sort of change, we need to actually take an active roll in making the change happen, not simply electing someone to office and hoping for the best. Checks and balances, people. No change in the history of the United States, or any country, has EVER been easy, and it certainly isn't going to happen that way now. It's going to take work. More importantly, it's going to take TIME.




Personally, being A: A young American, B: Someone who'd like to consider themself a member of the up and coming creative class, and C: Someone who's been exposed to different types of Health Care systems (my dad's from Brazil, and I spent of a lot of time there as a child, where by law, heath care is free to anyone), I am MORE than willing to stick around and be apart of the country's turn-around. If no one's here to pitch in, who will? As someone said earlier, with the right direction, the U.S. has the potential for a stellar UHC. However, as someone else also said, you should never trust a politician. That's why Americans shouldn't just sit around and expect a politician to do anything for them, not without taking an active roll in the politician's decision making.



Once again, not implying anything about anyone as far as who's right or wrong for their beliefs. Just Throwing this out there.  ::) VOU!
Title: Re: Canadian Healthcare
Post by: Robert on July 20, 2009, 12:47:52 am
the other thing that seems to be missed when talking about 'universal coverage' is that it does not have to mean the end to private hospitals and private health insurance.
Those who are not happy with the standard of care of level of care under the universal system are free to continue paying for their private health insurance and receiving the treatment they were previously getting.

the insurance companies are  trying to have it both ways.

First they say they can't compete with the gov't because it would be so much cheaper (uneven playing fields, yadda, yadda, yadda.)

Then they argue that anything run by the government is inefficient and costly.

Then Obama comes back and says if that's the case (cheap but inefficient and yet costly (uh?),) then, like all good capitalists, the consumer will turn right back around and go back to his private coverage.  The insurance companies, he says, don't have a thing to worry about. 

Now the current argument is that everything is moving too fast.  (Yeah, right.  Clinton first proposed this 15 years ago.)  What they're really saying is that they need more time to find other excuses.

robert
Title: Re: Canadian Healthcare
Post by: northernguy on July 20, 2009, 03:33:21 am
...I've been through the anal raping of paperwork and insurance claims and blah blah.
Or they've even seen spoofs about the shitty medical coverage on TV and in movies (That particular episode of *every* sitcom where someone goes to the hospital for treatment of something, only to discover that they no longer have insurance, or went and was told to leave, in a joking, sitcom, mechanical applause/laughter manner, of course)....

I remember going to the university clinic when I had just come of age.  They mailed something to my house afterwards.  I called them and said "Um,. I'm not sure what this is, but you've sent me some sort of bill for $XX".  Turns out I had come off my parents government coverage and had not registered for my own government health coverage.  I quickly got it sorted out.

The only time in 44 years I've ever seen a bill from a doctor or hospital.
Title: Re: Canadian Healthcare
Post by: megasept on July 20, 2009, 04:05:21 am
Due to the slow process of approval from the FDA in the U.S., many medical procedures are usuallly approved and readily available in other countries first.


To my surprise, "non-FDA approved use" doesn't mean unavailable, prohibited, or necessarily not covered by insurance.

I've had 3 types of procedures/medicine "not approved" for that particular use. 2 of 3 were covered (paid) by insurance at time of treatment, and now all 3 are covered.

 8)  -megasept
Title: Re: Canadian Healthcare
Post by: Luke on July 20, 2009, 04:49:26 am
If the Feds rooted out fraud in the government run systems, they would save hundreds of billions every year.

And, in a true system of universal healthcare, the vast majority of the consumer fraud will vanish in an instant, because there is neither the need nor the opportunity to commit the fraud in the first place. The fraud becomes pointless.
Title: Re: Canadian Healthcare
Post by: bufguy on July 20, 2009, 07:30:47 pm
People here in Buffalo were going to Canada for arthroscopic hernia surgery in the 80's long before it was available here and we were going to Canada for laser eye surgery in the early 90's before it was available here. We are no more progressive.
Title: Re: Canadian Healthcare
Post by: thirtysomething on July 21, 2009, 12:25:19 pm
I've been living in Canada for 3 years now. I'm not on meds yet but I do go for routine blood test every 3 months. I do not pay anything for doctor's visit or blood tests. 

I've been to a hospital emergency room once here in Toronto. I was, at first, reluctant to go the hospital as I feared that I may be discriminated because of my HIV status. But on the contrary, I was provided kind of royal service when the nurse at the counter found out that I'm poz. She took me in immediately and there were 2 nurses and a doctor taking care of me all the time for the 4 hours that I was there, and I had to pay nothing! I was pretty happy about it :)

Title: Re: Canadian Healthcare
Post by: David_CA on July 21, 2009, 12:54:02 pm
Out of curiosity, does anybody know how medical salaries - doctors, nurses, practitioners, techs, etc - compare in the US and Canada (and to the UK as well)?  I do have a Dr. in the family, but he's not in one of the 'big earning' specialties and is close to retiring, anyway!  ;)
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 21, 2009, 01:13:00 pm
I would assume salaries in Canada for healthcare workers would be competitive with the US or else they'd be flooding over the border.
Title: Re: Canadian Healthcare
Post by: David_CA on July 21, 2009, 01:23:53 pm
I would assume salaries in Canada for healthcare workers would be competitive with the US or else they'd be flooding over the border.
Well, I would assume so as well, but I was more curious as to real data.  That's one argument I've heard against any sort of health system, other than what we have now.  You know, salaries won't be good so that will effect the quality of Dr's, nurses, etc. 
Title: Re: Canadian Healthcare
Post by: Luke on July 21, 2009, 01:39:23 pm
Out of curiosity, does anybody know how medical salaries - doctors, nurses, practitioners, techs, etc - compare in the US and Canada (and to the UK as well)?  I do have a Dr. in the family, but he's not in one of the 'big earning' specialties and is close to retiring, anyway!  

In the UK ....

It all depends on location. The following are fairly typical out-of-London salaries and cost of living allowances would need to be added for London (approximately £7,000 / $11,500 for nurses and more for doctors).

A fairly average salary for a junior doctor would be:

Year 1       -  £35,000 ($57,500)
Year 2       -  £42,000
Thereafter -  at least £45,000, rising to £70,000 ($115,000) if they are training to be a specialist.

A consultant or a specialist would earn an absolute minimum of £75,000 (with the average being over £130,000 / $214,000, and up to £200,000 / $330,000) + whatever they earn in private practice.

Fairly normal earnings for a general practitioner would be around £110,000 / $181,000 - but could easily be double that if they perform minor surgical procedures (removing cysts etc.), offer preventative clinics ('new mother', diabetic, 'healthy heart' and asthma clinics), run their own practice or are partners in a practice (and even more if they also do private practice).

The starting salary for a newly qualified NHS nurse is just over £18,000 / $30,000 and rises to over £50,000 / $82,000 a year for a nurse consultant. A senior staff nurse / community nurse would earn around £36,000.

At those levels there is a pretty sizeable brain-drain of medical staff to the US and Gulf states (a fair few to Australia and New Zealand too, but we probably take as many as we lose to them) .. and we in turn drain the talent from other countries.

The median annual salary for full-time employees in the UK, across all industries, is £25,000 ($41,000) and the average would probably be closer to £21,000 ($34,500)
Title: Re: Canadian Healthcare
Post by: Assurbanipal on July 21, 2009, 02:58:43 pm
I would assume salaries in Canada for healthcare workers would be competitive with the US or else they'd be flooding over the border.

Per the AMA, while the absolute number of Canadian doctors has increased over time, they represent a small and declining percent of doctors practicing in the US, going from about 2% in 1970 down to about 1.25% in 2000 -- based on where they went to medical school.  http://www.ama-assn.org/ama1/pub/upload/images/373/internettable.gif 
(see the section IMGs/USMGs -- n.b. IMG stands for International Medical Graduate)

Also, Canadian statistics show that, in recent years, Canadian doctors have been less likely to immigrate out of Canada at all than they were in the past.

http://secure.cihi.ca/cihiweb/en/smdb_2007_fig7_e.html (http://secure.cihi.ca/cihiweb/en/smdb_2007_fig7_e.html)

Title: Re: Canadian Healthcare
Post by: David_CA on July 21, 2009, 03:03:05 pm
Thanks Luke.  I'll have to find corresponding figures for the US.  I know that my ex- graduated with a 2-year RN degree in '96 and started at over $36,000 working nights in a hospital.  The Canadian doctors' figures (which I cannot find now, for some reason!) were a bit higher than those in the UK and somewhat lower than those in the US.  However, net income of the US vs Canadian doctors was very close / comparable due to 'reduce overhead' of dedicated staff for billing and handling insurance and lower malpractice insurance. 
Title: Re: Canadian Healthcare
Post by: Inchlingblue on July 21, 2009, 03:03:32 pm
Michael Moore's Sicko addresses this question of doctor's salaries, it's really worth watching.
Title: Re: Canadian Healthcare
Post by: Luke on July 21, 2009, 03:30:34 pm
Thanks Luke.  I'll have to find corresponding figures for the US.  I know that my ex- graduated with a 2-year RN degree in '96 and started at over $36,000 working nights in a hospital.  The Canadian doctors' figures (which I cannot find now, for some reason!) were a bit higher than those in the UK and somewhat lower than those in the US.  However, net income of the US vs Canadian doctors was very close / comparable due to 'reduce overhead' of dedicated staff for billing and handling insurance and lower malpractice insurance.  

For procedures carried out for the National Health Service, all medical staff in the UK are covered by the NHS's own negligence scheme. They would only have to fund their own cover for procedures carried out in private practice.

The other thing you have to bear in mind is currency fluctuations. 12 months ago, the $ value of those salaries would have been around 20% higher.

Nurses would also have been paid a bursary during their training and had their training funded by the NHS.
Title: Re: Canadian Healthcare
Post by: BT65 on July 21, 2009, 06:19:41 pm
That's another thing-college shouldn't break people.  A college education should be free (up to a point of course).
Title: Re: Canadian Healthcare
Post by: GSOgymrat on July 21, 2009, 06:28:34 pm
That's another thing-college shouldn't break people.  A college education should be free (up to a point of course).

Now that's just crazy talk. ;)
Title: Re: Canadian Healthcare
Post by: fearless on July 21, 2009, 08:45:34 pm
These are some figures I tracked down for Aussie salaries. Salaries for felathcare workers do vary from State to State though, but would be fairly similar.

Current exchange rates are $1 aussie will buy you 80 US cents and 49 pence - but this can and does vary substantially.

Nurses - nursing assistant - $39,194 + 9% employer contribution to superannuation (retirement/pension fund), up to senior nurses on $93,123 + 9%. A director of nursing will get $125,000 + 9%, and a District Director $152,000 + 9%.

Doctors - intern $48,000 - $76,000 + 9%, registrar - $77 - $119K + 9%, Career medical officer - $110 - $151K + 9%. A specialist gets $160-$350K + 9%.

A general practioner can expect to earn between $100-$250,000 and in private practice $200-$500K+.

By comparison, average annual salary for full time work in Aus at Feb098 was $63,986 + 9% super and the minimum wage is $14.31 per hour (+ 9% super).
Title: Re: Canadian Healthcare
Post by: bocker3 on July 21, 2009, 09:53:01 pm
That's another thing-college shouldn't break people.  A college education should be free (up to a point of course).

I know this is a bit of a hijack, but........  Really???? 
This is not a must have, like healthcare.  Why don't we provide free food and free housing to everyone?  Hell why should anyone work at all -- let's have the government pay for everything.  Where does this end?

Mike
Title: Re: Canadian Healthcare
Post by: tokyodecadence on July 22, 2009, 01:11:20 am
That's another thing-college shouldn't break people.  A college education should be free (up to a point of course).


Um, they're called SCHOLARSHIPS. Millions of dollars a year in scholarship funds go unused, due to lack of applicants. And they range from grades-based merit, to heritage, to school funded scholarships. College money's out there,  a lot of people are just too lazy to search for it :p Not all of them of course, there are always certain stipulations. And then there are most who simply depend on Students loans solely, without considering working during school. Big mistake.
Title: Re: Canadian Healthcare
Post by: bobino on July 22, 2009, 01:48:04 am
I'm afraid I completely disagree with those who think that we can't pay for universal health care in the U.S. through taxation.  Although the right wing has been enormously successful in convincing Americans that high levels of taxation for the richest Americans will lead to some kind of economic disaster, historical experience demonstrates the falsity of that argument.  The upper marginal tax rate for the richest Americans was north of 70% in the 1950s and 60s, and the U.S. enjoyed phenomenal prosperity.  Mind you, the tax system was very steeply progressive at the time, which meant that only the very richest paid the highest marginal rate on the top portion of their income.  

It is true that the middle class today bears a larger portion of the tax burden than before, but this is because we've cut tax rates for the rich and flattened out our formerly progressive tax system.  So today, our top marginal rate is somewhere around 38%, and that rate applies whether you make $250,000 per year or $1,000,000,000 per year.  To me, that makes no sense as a matter of policy.

I'm also skeptical of claims that the country somehow cannot afford the price of universal health insurance.  We were somehow able to afford the $1 trillion the Bush tax cuts cost us over 10 years, and we've managed to find close to $2 trillion (so far) for the war in Iraq.  Cost would appear to be no object as we throw more troops into Afghanistan, and the Pentagon continues to receive some $500,000,000,000 per year.  I find it interesting that those in Congress and the press who cry loudest about the cost of health care seem to have no such concerns when it comes to other matters.  Apparently, they're happy to see billions spent to kill people but highly reluctant to spend a dime to make the lives of actual Americans better.  

Finally, Ann is absolutely right.  Many Americans just refuse to accept that other countries actually do certain things better than we do, and health care is one of them.  Conservatives appeal to this misplaced "patriotism" to make Americans fearful of adopting the best health care practices from other nations.  But when Cuba's infant mortality rate is actually lower than ours, what, exactly, are we supposed to be proud of?
Title: Re: Canadian Healthcare
Post by: tokyodecadence on July 22, 2009, 02:33:57 am
I'm also skeptical of claims that the country somehow cannot afford the price of universal health insurance.  


How do these people think Medicaid is funded?
Medicare?

13% of the GDP is spent on Healthcare in the U.S.(and climbing), yet in other developed countries, the highest you'll ever see is less than 10%.


And people that refer to UHC as "socialised medicine" need to do some research. That's like saying Social security is "Socialised retirement".

And people who are trying to use this as a red flag that the government is trying to turn the country socialist should look at things like 'no child left behind', or making every child in the country read the same books and take the same tests, and tell me that doesn't sound like socialism.


2 countries that come to mind that currently have UHC are Afghanistan and Iraq. Guess who's footing the bill there? WE ARE. So what would you rather pay taxes for; the embetterment of your own citizens and country, or to destroy another country, only to pay for their 'socialised medicine'.



SOCIALISM is when government takes over an industry. That is not what Universal Healthcare is. Under Universal Healthcare we’ll still have private doctors and private hospitals. It’ll just be a new payment system. More than half of our current system is federally funded anyway. Universal Healthcare would provide care for those Americans who need it most and would lower costs to the individuals and employers who currently contribute to health insurance companies. Estimates show that only HALF of your monthly contributions actually go to Healthcare costs. The other half goes to the middlemen. A streamlined non-profit system would cut these costs tremendously. There are, of course, other stipulations and nuances, but without having to copy and paste a 1k page bill, people should just take a gander at it themselves. :)




Here are some basic outlines of proposals. These are a tad outdated, but you get the jist :p

http://www.wilsoncenter.org/index.cfm?topic_id=116811&fuseaction=topics.event_summary&event_id=241825
Title: Re: Canadian Healthcare
Post by: BT65 on July 22, 2009, 07:10:29 am
I know this is a bit of a hijack, but........  Really???? 
This is not a must have, like healthcare.  Why don't we provide free food and free housing to everyone?  Hell why should anyone work at all -- let's have the government pay for everything.  Where does this end?

Mike

And, just how do a lot of people get trained for their jobs?  It's usually through higher education.  What does going to college have to do with free food?  I was not saying that going to school until one has, oh, 10 master's degrees should be free.  But, I do think to get people the basic training in things, even maybe up to one master's degree, shouldn't have to break people.

And Tokyo, I'm well aware that there are scholarships out there.  But, not for everyone and they don't cover 100% of college costs.  And as I'm sure you're aware, beyond a bachelor's level, pell grants are non-existent.  I wouldn't blame the entire situation on people being "lazy."  I'm sure many people have no clue about where to get scholarships, where to look, if there's enough to cover their education and living costs etc.   And a lot of people do work while going to college, but again, it doesn't cover 100% of their tuition, books and living expenses.  By the way, what's your degree in and how far have you gone, (bachelor's, master's etc.)?

Again, I'm not saying that going to college ad infinitum should be free.  But, I do believe that up to a point, the government should fund education.  No one should have to be worried about not being able to get an education.
Title: Re: Canadian Healthcare
Post by: bocker3 on July 22, 2009, 07:32:07 am
And, just how do a lot of people get trained for their jobs?  It's usually through higher education.  What does going to college have to do with free food?  I was not saying that going to school until one has, oh, 10 master's degrees should be free.  But, I do think to get people the basic training in things, even maybe up to one master's degree, shouldn't have to break people.

And Tokyo, I'm well aware that there are scholarships out there.  But, not for everyone and they don't cover 100% of college costs.  And as I'm sure you're aware, beyond a bachelor's level, pell grants are non-existent.  I wouldn't blame the entire situation on people being "lazy."  I'm sure many people have no clue about where to get scholarships, where to look, if there's enough to cover their education and living costs etc.   And a lot of people do work while going to college, but again, it doesn't cover 100% of their tuition, books and living expenses.  By the way, what's your degree in and how far have you gone, (bachelor's, master's etc.)?

Again, I'm not saying that going to college ad infinitum should be free.  But, I do believe that up to a point, the government should fund education.  No one should have to be worried about not being able to get an education.

The government DOES fund education -- through the 12th grade for everyone and to tune of millions and millions for higher education for those with NEED.
Making college free for everyone --even only for a bachelor degree should NOT happen.  People need to work for things and pay for things.  Else, we'll see more folks go to college, because it's "free" (but it's not really free, now is it) with no desire and ultimately flunk out.
Let me be clear -- programs to help the poor with college costs should be maintained and maybe even expanded, but they should remain a combo of grants and loans.
I came from a poor background -- got the max Pell Grants and a number of loans (as well as some scholarships) to go to college -- in order to make it even easier, after my freshman year I got a ROTC scholarship.  I paid the Army back with years of service -- including serving in Desert Storm.  I also paid back all of my loans.  I appreciated every bit of help that I received and am very thankful for it.  I also went on to get a Masters degree -- but only after I was working for 10 yrs and had an employer who would pay for it.
We have to get away from feeling that we are entitled to everything that is available out there -- basic needs, yes -- other things -- absolutely not.
As for how my food comment fits in....  Of these 2 things -- which is the most basic necessity for a human being:  Higher Education or Food??  If we can't guarantee everyone food, why should we guarantee them a college degree.

Mike
Title: Re: Canadian Healthcare
Post by: BT65 on July 22, 2009, 08:36:55 am
OK, Bocker, so because you did it, that means everyone should be able to do it?  And there are times when college is a "have to."  If someone wants to become a nurse, or work hands-on in the medical field, then it's a "have to;" if someone wants to become a teacher, then it's a "have to;" a lawyer, "have to."  And yeah, maybe there should be stipulations with it, like the person getting the education should have to work doing whatever the university decides is appropriate, such as working in poor neighborhoods for a certain length of time etc.

About free food, well, there are programs that help people with that.  Food stamps, soup kitchens, and food pantries (or food banks).  At food banks, at least the ones around here, all the person has to prove is their address.  And nobody has to prove anything at the soup kitchens (by that, I mean proving need, which is required for food stamps). 
Title: Re: Canadian Healthcare
Post by: David_CA on July 22, 2009, 08:55:25 am
OK, Bocker, so because you did it, that means everyone should be able to do it?  And there are times when college is a "have to."  If someone wants to become a nurse, or work hands-on in the medical field, then it's a "have to;" if someone wants to become a teacher, then it's a "have to;" a lawyer, "have to."  And yeah, maybe there should be stipulations with it, like the person getting the education should have to work doing whatever the university decides is appropriate, such as working in poor neighborhoods for a certain length of time etc.

About free food, well, there are programs that help people with that.  Food stamps, soup kitchens, and food pantries (or food banks).  At food banks, at least the ones around here, all the person has to prove is their address.  And nobody has to prove anything at the soup kitchens (by that, I mean proving need, which is required for food stamps). 

Perhaps there should be more 'assistance' for community colleges / vocational training, but I don't think standard college should be totally free.  It's already greatly discounted; check in-state vs. out-of-state tuition at any state university and you'll likely find that a large portion is already covered.  For example, at a particular university in the UNC system, for a full time student (per semester), in-state tuition is roughly $2400 and $7800 for an out-of-state student.  Those costs are totals including other 'mandatory' fees; the tuition alone is approximately $1300 and $6750 respectively. 


Title: Re: Canadian Healthcare
Post by: GSOgymrat on July 22, 2009, 09:37:12 am
I have to agree with David. Everyone should have a "free" high school education but I think people should contribute to college. There are all kinds of opportunities for scholarship, employer reimbursement, etc. Many people take college classes at a community college then finish at a university, which is very affordable. I got a scholarship from the Air Force and the Navy for four years, all expenses paid, to any school in nuclear engineering. I took the Air Force scholarship, went to NC State, realized engineering is boring and dropped it. So I went to UNC-Asheville for my bachelor's degree, worked full-time as a mental health tech at a psychiatric hospital and didn't take any loans or scholarships. For my masters I chose to go to California to an expensive private university and take out loans. I could have stayed in NC and not taken the loans but it was my choice. If I wanted to go back to school now my employer would pay for it as long as the courses benefit the hospital I work for. There are just all kinds of options available.

Anyone, at least in NC, can afford college if you are willing to work.
Title: Re: Canadian Healthcare
Post by: tokyodecadence on July 22, 2009, 09:43:07 am
And Tokyo, I'm well aware that there are scholarships out there.  But, not for everyone and they don't cover 100% of college costs.  And as I'm sure you're aware, beyond a bachelor's level, pell grants are non-existent.  I wouldn't blame the entire situation on people being "lazy."  I'm sure many people have no clue about where to get scholarships, where to look, if there's enough to cover their education and living costs etc.   And a lot of people do work while going to college, but again, it doesn't cover 100% of their tuition, books and living expenses.  By the way, what's your degree in and how far have you gone, (bachelor's, master's etc.)?


And you clearly didn't read entirely what I said. Let me reiterate it, maybe the purple box'll help.


Um, they're called SCHOLARSHIPS. Millions of dollars a year in scholarship funds go unused, due to lack of applicants. And they range from grades-based merit, to heritage, to school funded scholarships. College money's out there,  a lot of people are just too lazy to search for it :p Not all of them of course, there are always certain stipulations. And then there are most who simply depend on Students loans solely, without considering working during school. Big mistake.

I didn't call the entire situation as being lazy, sir. YOU did. It's due to lack of knowledge that the money's out there, amoung other STIPULATIONS. Of course, it also helps to actually make decent grades when schooling is free, what makes you think that someone's going to pay for your children to slack off if they couldn't get it together when schooling *was* free? And college students who think that they can't work and go to school are lying. Period. What will happen if our particular degrees call on us to do work-studies? Externships? Internships? Not only will we work, but we'll work for free.

**Note: this doesn't include people who are studying abroad, or in a condition that they wouldn't be able to maintain the two, as some study abroad programs won't allow you to have a job, or one over but a few hours a week. Yet another one of those stipulations.**

Oh, and yes, scholarships are for EVERYONE. Pick up a scholarship guide, you'll find that there are scholarships for EVERY person you can think of. Some may even surprise you. Again, lack of knowledge that the money's out there.

The government DOES fund education -- through the 12th grade for everyone and to tune of millions and millions for higher education for those with NEED.
Making college free for everyone --even only for a bachelor degree should NOT happen.  People need to work for things and pay for things.  Else, we'll see more folks go to college, because it's "free" (but it's not really free, now is it) with no desire and ultimately flunk out.
Let me be clear -- programs to help the poor with college costs should be maintained and maybe even expanded, but they should remain a combo of grants and loans.
^well said^


And, if you just need to know so bad, I'm majoring in computer sciences, and double minoring in environmental sciences and sustainability. Scholarships that I sought out and obtained are paying for 75% of my tuition, the rest is covered by the 50 hours a week that I work. Why? Because if given the choice to work a little more *now*, and not be in tons of debt *later*, I'll gladly take that option any day.

Also, in 2009, I can't think of a college that doesn't offer a payment plan.

*edited*
Title: Re: Canadian Healthcare
Post by: Dennis on July 22, 2009, 10:25:55 am
In a way, it is for many. For example, in my case, after obtaining my degree in Education and working for the stare of Florida for 3 years, the state will pay off my student loans.

I also believe that Obama proposed something similar for all college graduates where if they perform some type of community service for a period of ten years a portion of their student loans will be forgiven.

That's another thing-college shouldn't break people.  A college education should be free (up to a point of course).
Title: Re: Canadian Healthcare
Post by: Joe K on July 22, 2009, 12:10:38 pm
I will never understand why so many people expect others to pay for those things that they want.  When I decided to go to college in the 70s, my high school had loads of information on scholarships, grants, etc, and other ways that you could gain a education, ie. Peace Corps, G.I. Bill, etc., but none of those provided what I needed, so I did what I had to to get the education I wanted.

I stretched my education over five years, so my yearly costs would be lower and I could work part time during school and then full time during the summer.  My father gave me $5,000 each year to help cover my costs and I would repay him at the end of each summer for that particular year.  I worked for my college as both a bus driver and photographer and worked an average 35 hours each week.  In the summer, I went to work for the auto companies and worked 12-14 hour days, because the pay was incredible and I could make almost $4,000 for 89 days of work, which is all you could work if you were not part of the UAW.

My point being that if you want something, there is always a way to get it and by doing it the way I did it, I came away with three Associate and two Bachelor's degrees.  That education allowed me to pursue various careers and when I finally settled on Computer Science, my employers paid for all of my education through both IBM and Microsoft.

And Pell Grants, are available for all levels of schooling, because one of my partners, got a huge Pell Grant to attend grad school for psychology. 
Title: Re: Canadian Healthcare
Post by: Inchlingblue on July 22, 2009, 12:58:07 pm
I think part of the frustration is that certain costs such as health care and higher education have risen in the past few years way beyond levels of normal inflation so there's a sense of inequity building up. Killfoile talks about the 70s, it used to be that if you worked hard enough you could achieve many things, goals were within reach with enough effort and hard work. These days I think many people just want to give up because no matter how hard they work they still will not be able to afford certain basic things such as a good education or the proper health care if they get sick, never mind other things.

The economy has grown artificially in the past ten years or so by way of "credit default swaps," and "derivatives" etc., complicated financial instruments that were "created" by Wall Street bankers out of thin air (with the belief that real estate values could go nowhere but up), whose vales were grossly inflated creating artificial wealth and such an enormous financial bubble that it was bound to burst. It could and probably will, take years for the economy to level off to more realistic levels and begin producing actual products of the future (green energy, etc).

Bottom line: in the past 10 years the rich have gotten way richer and everyone else is worse off.
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 22, 2009, 01:12:21 pm
I think part of the frustration is that certain costs such as health care and higher education have risen in the past few years way beyond levels of normal inflation so there's a sense of inequity building up. Killfoile talks about the 70s, it used to be that if you worked hard enough you could achieve many things, goals were within reach with enough effort and hard work. These days I think many people just want to give up because no matter how hard they work they still will not be able to afford certain basic things such as a good education or the proper health care if they get sick, never mind other things.

Exactly.  I went to college in the earl/mid 80's and my parents, both in public education (one a teacher, the other an upper/county level administrator) put both my brother and I through a total of 9 years tuition (I went an extra year to get 3 minors in addition to my major) without a single loan or grant.  I just somehow doubt that this could be done with current tuition levels.

ps: and before anyone take me for a spoiled brat I'll have you know I worked weekends from the age of 15 for all spending money, and full time every single summer.
Title: Re: Canadian Healthcare
Post by: BT65 on July 22, 2009, 06:18:17 pm
It never ceases to amaze me that people think things they were able to obtain, especially when healthy, through one means or another, should mean everyone can do it.  For, if I can, then all can, right?  What about people that aren't so lucky.

But, whoa, talk about health care, that Killfiole moved to Canada for, then watch out.  It should be a right.  And I think it should be, by the way, before someone jumps on me for that.

Edited to add:  I know of no college that grants pell grants for anything beyond a bachelor's degree nowadays.
Title: Re: Canadian Healthcare
Post by: Joe K on July 22, 2009, 06:58:12 pm
I wasn't jumping on anyone, merely stating that if you want something bad enough, you can usually find a way to get it.  I would never want to limit anyone, especially if they were disabled, from getting an education, but for most people, that is not the case.  Our schools are horrible educators and college costs have gone through the roof.  My daughter was lucky, her mom married a wealthy man who could give her four years at Carnegie Mellon at an annual cost of $50K.  That is an obscene amount of money for higher education, but you can still get a solid education through a community college.

And for the record, I did not move to Canada for the health care, I came home to my birth county.  In another thread I describe my last few years and after getting death threats from a neighbor and going to court and appeals, we were granted Orders of Protection, that neither the court or police would enforce, because our Supreme Court has ruled that they do not have to enforce them.  So rather than being killed, for being gay, we headed north and it is something that I have should have done decades ago.
Title: Re: Canadian Healthcare
Post by: Ann on July 22, 2009, 08:23:21 pm
Excuse me, but this thread is about...

wait for it...









Healthcare.


Not education.


If you've got comments about education funding, start a new thread.

As always, thank you for your cooperation.

Ann

(who thinks higher education should be state funded just like health care should be state funded)
Title: Re: Canadian Healthcare
Post by: Joe K on July 22, 2009, 08:55:48 pm
Sorry for the hijack, but can anyone tell me why there is such a rush to push this through Congress, when we know that what Congress does, under artificially imposed deadlines, generally produces crap legislation.  Why can't they pass a frame work for health care reform and than take the time, to figure out how to do it, so we have results we can believe in.  All this fear mongering is just that.  You can find horror stories in any health care system, but the fact remains that without some major changes, medical costs will bring America to her knees.

I am at a loss as to why our Congress cannot get it's act together and pass some meaningful legislation for health care reform.  Health care reform is a process, not an event, so why the rush?
Title: Re: Canadian Healthcare
Post by: bocker3 on July 22, 2009, 09:04:28 pm
It never ceases to amaze me that people think things they were able to obtain, especially when healthy, through one means or another, should mean everyone can do it.  For, if I can, then all can, right?  What about people that aren't so lucky.

But, whoa, talk about health care, that Killfiole moved to Canada for, then watch out.  It should be a right.  And I think it should be, by the way, before someone jumps on me for that.

Edited to add:  I know of no college that grants pell grants for anything beyond a bachelor's degree nowadays.

There is a key difference -- healthcare is necessary for survival -- higher education, not so much.  Millions of people make it without a college degree.  Just because you want to be an RN, doesn't mean taxpayers should fund it.  However -- if you need medication to stay to alive, I think it should be funded by taxpayers.  There is the key difference that you don't seem to grasp -- if you want to be RN, find a way to be a RN and if you can't, well, then I guess you can't be an RN, kind of sucks, but that's life.  However, if you need to see a doctor, I think you have an absolute RIGHT to see a doctor, whether you can pay for it or not.  Society has an obligation to provide healthcare (in my perfect world, anyway -- let's see if it ever happens in the US).  And yes, if I could do it and others could do it -- so can you -- it might not be easy, but if you really want it, you can do it. (you isn't necessarily directed at you, BT65 -- it's a general "you")
People will use positions like this to start a horrible little "slippery slope" argument against universal healthcare.

Mike
(who tried to tie it in to healthcare -- hope I succeeded Ann -- but it is my last gasp here -- promise!)
Title: Re: Canadian Healthcare
Post by: Dachshund on July 22, 2009, 09:30:05 pm
Higher education should be affordable, it just makes economic sense for our country. The cost of the  uneducated to society is tremendously expensive. Far more expensive than providing an education,  even if it was free.

Let's use my gal BT65 as an example. I don't know her circumstances, but I'm guessing she received financial aid for school. I doubt she could have afforded it otherwise. She's graduated and looking for work in her field. After that, she becomes a taxpayer, giving into the system. Now, would you rather your tax dollars help pay for her schooling for a few years or pay for her the rest of her life?

Without help, we all know the answer.
Title: Re: Canadian Healthcare
Post by: Assurbanipal on July 22, 2009, 09:47:48 pm
Sorry for the hijack, but can anyone tell me why there is such a rush to push this through Congress, when we know that what Congress does, under artificially imposed deadlines, generally produces crap legislation.  Why can't they pass a frame work for health care reform and than take the time, to figure out how to do it, so we have results we can believe in.  All this fear mongering is just that.  You can find horror stories in any health care system, but the fact remains that without some major changes, medical costs will bring America to her knees.

I am at a loss as to why our Congress cannot get it's act together and pass some meaningful legislation for health care reform.  Health care reform is a process, not an event, so why the rush?

Well, the President said tonight “If you don’t set deadlines in this town, things don’t happen: The
 default position is inertia.”

The other thing that is not obvious if you don't spend a lot of time watching Congress, is how little time is left in the legislative calendar and how many things have to get done that must go through the bottleneck of the Senate and then a conference committee (the House has less to do and can do them faster) and the Senate also needs to get through a Supreme Court nomination, the energy bill and ...Stimulus II?  

Finally, realists know that whatever they produce, no matter how long they have to produce it,  will start as  a pile of c++p and get fixed in conference committee and then with "technical corrections" over the next few years.  That's how DC works and has for decades.  It is certainly the path Social Security took. But before you can fix it you need to have something to fix.
Title: Re: Canadian Healthcare
Post by: bobino on July 22, 2009, 11:01:56 pm
Actually, there's no "rush" on health care reform.  Health insurers and the Republicans would like you to think this is being "rushed," but that's just one of their talking points.  The fact of the matter is that health care reform has been under consideration for decades.  The difference is that right now, the political stars are sufficiently well aligned that Congress may finally be able to do something about it.  But only if the special interests don't manage to convince people that things are "going too fast."

In truth, several committees in both houses of Congress have been working on this legislation since January.  That's hardly lightning speed.  It might well have been passed by now but for the ridiculous insistence by some Democrats that it be "bipartisan."  So folks like Max Baucus (who's been bought and paid for by the insurance industry) have spent months chasing the pipe dream of getting Republican votes for health care reform . . . which will never happen.  

And although I don't always agree with him, Obama is absolutely correct about the cost of waiting for health care reform.  Millions of Americans need health care now.  Not tomorrow, not next week, not next year, and not at whatever time Republicans can be made to feel they aren't being "rushed."  They need health care now.  
Title: Re: Canadian Healthcare
Post by: Miss Philicia on July 23, 2009, 01:19:54 am
The cost of the  uneducated to society is tremendously expensive.

You mean like this?

http://www.youtube.com/watch?v=8Sq-VmBMHkw
Title: Re: Canadian Healthcare
Post by: northernguy on July 23, 2009, 09:52:16 pm
Out of curiosity, does anybody know how medical salaries - doctors, nurses, practitioners, techs, etc - compare in the US and Canada (and to the UK as well)?  I do have a Dr. in the family, but he's not in one of the 'big earning' specialties and is close to retiring, anyway!  ;)

A complete list of doctors practising in BC, and what they received in 2004/5 can be found here (scroll down to page 7).
http://www.health.gov.bc.ca/msp/legislation/pdf/bluebook2005.pdf
Of course that includes those who practice part-time.

From what I've heard, GP's can do better in Canada.   There are also fewer specialists in Canada, and the GP tends to play a larger part in healthcare.
Title: Re: Canadian Healthcare
Post by: GSOgymrat on July 24, 2009, 09:07:30 pm
This is an interesting article addressing how the culture of different countries affects how they manage healthcare:  http://www.newsweek.com/id/207410 (http://www.newsweek.com/id/207410)

Excerpt:
America's undesigned system is also an expression of our culture at its best and its worst. Health care in America is innovative, entrepreneurial, expensive, litigious, and wasteful. It is decentralized, driven by self-interest, excellent at the high end, and increasingly unequal. It resists acknowledging trade-offs or limits and is characterized by shocking gaps in basic care. As we plunge into a long-overdue comprehensive overhaul, it's useful to think not just about how we can build on what works in this hodgepodge, but also about how to bring health care into better alignment with our own national identity.
Title: Re: Canadian Healthcare
Post by: Dale Parker on August 03, 2009, 01:47:10 am
Thanks to Inchlingblue for re posting my post on the Canadian medical coverage question.  I wrote that when I was first diagnosed and was very new to the health care system.  Although I still don't know all the in's and outs of the system I can tell you what I have since found out about Ontario's (a province in Canada) health care as it relates to myself.  Currently I am under the Trillium program which is provincially funded.  Although I don't pay the full cost I do pay a deductable. It is based on my previous years earnings.  For me this is a bummer. I made just under $60,000 last year but ended up unemployed. My earnings on unemployment insurance is $18,000.00 a year.   My deductable is based on the 60K figure meaning that I pay about $1900.00 a year.  Every 3 months I have to pay $470.00 for my drugs. One month I was absolutely flat broke and couldn't afford the deductible. I found out that Ontario Works (a fancy name for welfare) could give me emergency relief to pay for the drugs.
   Since my doctor does not want me to work until my immune system gets stronger I will have to go onto ODSP. ODSP stands for Ontario Disability Service Program. This program will replace the Trillum one for my drug insurance. Under this program I will receive almost $1300.00 a month after my unemployment runs out. More importantly they will cover my total drug bill with no deductable and have some dental and eye glass coverage as well.  If / when I am able to work again 50% of any money that I make will be taken off their payment to me but I will still have the drug coverage. i.e if I find a part time job paying $400.00 a month ODSP will only pay me $1100.00.
   Canada is a great country to live in but finding out all the ins and outs of money and drug insurance programs has been super stressfull.  Although the people that I talk to at the various programs (except Trillum) are very caring and helpfull the system is very confusing and difficult to understand.
    I'm only half jokeing when I say that finding government income and money to pay for the drugs will kill me long before the aids will.  Once I get fully approved for the ODSP my life will be a lot better.