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Author Topic: Canadian Healthcare  (Read 34624 times)

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Offline bufguy

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Canadian Healthcare
« 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?
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .
11/29/18 vl un CD4 1080/39% CD8  .86

Offline Scotian

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Re: Canadian Healthcare
« Reply #1 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

Offline Joe K

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Re: Canadian Healthcare
« Reply #2 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.

Offline Miss Philicia

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Re: Canadian Healthcare
« Reply #3 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.
"I’ve slept with enough men to know that I’m not gay"

Offline Joe K

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Re: Canadian Healthcare
« Reply #4 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.
« Last Edit: July 13, 2009, 09:13:07 pm by killfoile »

Offline GNYC09

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Re: Canadian Healthcare
« Reply #5 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]

Offline Inchlingblue

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Re: Canadian Healthcare
« Reply #6 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.

 
« Last Edit: July 14, 2009, 01:56:40 am by Inchlingblue »

Offline Miss Philicia

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Re: Canadian Healthcare
« Reply #7 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.
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Offline Inchlingblue

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Re: Canadian Healthcare
« Reply #8 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
« Last Edit: July 14, 2009, 07:49:53 pm by Inchlingblue »

Offline fearless

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Re: Canadian Healthcare
« Reply #9 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.
« Last Edit: July 14, 2009, 07:44:14 pm by fearless »
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Offline Turkmenbashi

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Re: Canadian Healthcare
« Reply #10 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.
« Last Edit: July 14, 2009, 09:15:56 pm by Turkmenbashi »

Offline Joe K

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Re: Canadian Healthcare
« Reply #11 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.

Offline megasept

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Re: Canadian Healthcare
« Reply #12 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







« Last Edit: July 14, 2009, 10:44:32 pm by megasept »

Offline Inchlingblue

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Re: Canadian Healthcare
« Reply #13 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?









Offline bmancanfly

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Re: Canadian Healthcare
« Reply #14 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?
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

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Offline northernguy

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Re: Canadian Healthcare
« Reply #15 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
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline megasept

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Re: Canadian Healthcare
« Reply #16 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]

Offline Luke

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Re: Canadian Healthcare
« Reply #17 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.

Offline Luke

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Re: Canadian Healthcare
« Reply #18 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
« Last Edit: July 16, 2009, 12:12:19 pm by Luke »

Offline Ann

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Re: Canadian Healthcare
« Reply #19 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
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Offline RapidRod

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Re: Canadian Healthcare
« Reply #20 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

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

Offline Luke

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Re: Canadian Healthcare
« Reply #21 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

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) ;)
« Last Edit: July 16, 2009, 10:09:28 am by Luke »

Offline RapidRod

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Re: Canadian Healthcare
« Reply #22 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?

Offline Luke

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Re: Canadian Healthcare
« Reply #23 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).

Offline RapidRod

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Re: Canadian Healthcare
« Reply #24 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.

Offline David_CA

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Re: Canadian Healthcare
« Reply #25 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!

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Offline Luke

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Re: Canadian Healthcare
« Reply #26 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)
« Last Edit: July 16, 2009, 12:36:37 pm by Luke »

Offline bufguy

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Re: Canadian Healthcare
« Reply #27 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?
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Offline RapidRod

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Re: Canadian Healthcare
« Reply #28 on: July 16, 2009, 07:27:00 pm »
What would Christ do? Ask his father to heal him...   ;)

Offline David_CA

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Re: Canadian Healthcare
« Reply #29 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?
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Offline RapidRod

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Re: Canadian Healthcare
« Reply #30 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?

Offline Luke

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Re: Canadian Healthcare
« Reply #31 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
« Last Edit: July 17, 2009, 08:08:16 am by Luke »

Offline Luke

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Re: Canadian Healthcare
« Reply #32 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 ;)

Offline mjmel

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Re: Canadian Healthcare
« Reply #33 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

Offline mjmel

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Re: Canadian Healthcare
« Reply #34 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

Offline RapidRod

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Re: Canadian Healthcare
« Reply #35 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....... ;)

Offline David_CA

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Re: Canadian Healthcare
« Reply #36 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.

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Offline GSOgymrat

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Re: Canadian Healthcare
« Reply #37 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.

Offline megasept

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Re: Canadian Healthcare (Like the US is "Hunky-Dory" Now???)
« Reply #38 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.
« Last Edit: July 18, 2009, 02:44:45 pm by megasept »

Offline Luke

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Re: Canadian Healthcare
« Reply #39 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

[attachment deleted by admin]
« Last Edit: July 18, 2009, 12:23:12 pm by Luke »

Offline RapidRod

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« Last Edit: July 18, 2009, 03:08:20 pm by RapidRod »

Offline megasept

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Re: Canadian Healthcare
« Reply #41 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
« Last Edit: July 18, 2009, 03:15:28 pm by megasept »

Offline Luke

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Re: Canadian Healthcare
« Reply #42 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.
« Last Edit: July 18, 2009, 03:49:52 pm by Luke »

Offline pozniceguy

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Re: Canadian Healthcare
« Reply #43 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
remember the good times...honor the past but don't live there
Le stelle la notte sono grandie luminose, nel cuore profondo del Texas

Offline Luke

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Re: Canadian Healthcare
« Reply #44 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.
« Last Edit: July 18, 2009, 04:07:40 pm by Luke »

Offline pozniceguy

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Re: Canadian Healthcare
« Reply #45 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
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Offline Luke

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Re: Canadian Healthcare
« Reply #46 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 .. 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 ;)
« Last Edit: July 19, 2009, 06:55:53 am by Luke »

Offline Dennis

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Re: Canadian Healthcare
« Reply #47 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.
« Last Edit: July 18, 2009, 07:35:21 pm by Dennis »

Offline Ann

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Re: Canadian Healthcare
« Reply #48 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
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Offline Miss Philicia

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Re: Canadian Healthcare
« Reply #49 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.
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