I see comments about things like they don’t have enough government MRIs and so private MRI services have started in a couple of places.
Seems to me that if an opposition candidate ran on the platform of more MRIs, then the government would quickly decide to buy more.
Same with the complaint that they don’t fund all experimental Mexican cancer cures.
Those sorts of things are all open to public debate and revision. In the US, we don’t even know whether something is covered until you’ve done it and submitted it to your HMO board with your fingers crossed.
American insurance companies.
Well, of course, that’s why we have them pouring over the border…well, hobbling, crawling, rolling in wheelchairs, same difference!.. to get American care! We’ve even had to plant land mines all along the wilderness areas. Canadian specific land mines, they’ve got little signs posted above them saying “Please Step Here. Thank You for Your Cooperation!”
In both French and English, of course.
Apparently the incoming president of the Canadian Medical System thinks so…
I don’t read Dr. Doig as saying that the Canadian system is beyond repair. Rather she seems to be saying that she wants some changes. One of things she wants is private insurance. I don’t understand how private payment as opposed to public payment will in anyway decrease the load on Canadian physicians or make the system any more efficient or humane or less expensive. Maybe there is some magic in that non-government money that will suddenly increase the supply of medical personnel and facilities or decrease the supply of sick people . Maybe Dr. Doig is counting on private pay patients being more profitable, allowing her to abandon those low-pay public patients so that she can play golf three days a week and get the hell out of Toronto for the five month winter.
The Canadians I have met seem perfectly content with their present system. It is worth noting that there is no significant sentiment for the patterning of a US health system on the Canadian model.
That’s the Canadian Medical Association, which is a physicians advocacy and support organization, not the health care system. And far from thinking the system is beyond repair the CMA is making suggestions on how to improve it.
Shockingly none of the suggestions are ‘copy the US model’ or ‘abandon universal health care’.
There is no abandoning UHC once you get it. Also, I don’t claim the US model should be copied. I merely responded to the OP
People tend to ration their own care when they must contribute to the payments. It’s not less sick people but less people going to the doctor with the common cold.
As a side note…the Americans I have met seem perfectly content with their present system. That certainly isn’t a ringing endorsement of our system. It just means most people have never been really sick.
Canada has been moving back towards private care models for quite some time. More and more services are being approved for private clinics. It’s on a province-by-province basis. And of course, a good chunk of our health care system has always been free-market: dentistry, optometry, podiatry, chiropractic, prescription drugs, and other major health care sectors are partially or completely private in Canada, and always have been. But now we’re starting to extend that to diagnostic services, some surgeries, and other treatments the government used to cover. Most of this latter stuff is voluntary - you can still get government health care, but you’re free to spend your own money and see out your own care if you don’t want to sit on a waiting list.
Governments are really lousy at managing health services. That’s what this boils down to. When politicians constantly intervene in technical matters, nothing good comes of it. Also, when you have politicians controlling the purse strings (backed by taxpayer money), the various professional unions start playing politics to grab as much of the pie as they can. So you get these cycles of boom and bust - when the economy is strong and the government’s tax receipts are increasing, health care workers start agitating for more money. They threaten strikes and sit-ins, and almost always get their way. So health care costs skyrocket. Then the economy hits hard times, governments start running deficits, and the only place to cut is health care, because it’s the big ticket item for non-mandatory spending.
From my perspective, being married to someone who has worked her way up from being a line nurse to a health care executive, this seems to be the pattern:
- Nurses and doctors demand more money. They get it.
- Times get tough, and cutbacks need to be made. But you can’t easily cut salary, so services are cut instead. Beds are closed, and new hiring is stopped.
- Nurses work long hours and are overworked because their salaries are so high the hospital can’t afford to hire more of them. Quality of care starts to suffer. The Nursing union starts to fight for better working conditions - higher pay for shifts and overtime, guarantees of adequate staff coverage, etc. This saves money in the short term (as opposed to just giving salary increases), but it complicates nursing management.
- The result is that health care costs start to climb again. Nurses start collecting huge overtime pay and shift differential pay and other benefits. More services get cut to compensate.
Then if you’re lucky, the economy goes through another boom, new money comes into the system, and everyone gets a bit of breathing space. Then the whole cycle starts over again.
In Alberta, we actually cut nurses salaries in the 1990’s to balance the budget. Not by much, mind you - no more than equivalent pay in the private sector would routinely be cut in recessions. The unions howled, but we did it. But then when the oil industry took off, the Union basically took the attitude that since they took it on the chin in the 90’s, they were owed - big time. So they demanded huge raises, and got them. Nursing salaries went up something like 20-30% over the space of three years. But now times are tough again, and even in relatively wealthy Alberta our health care system is way over budget. So… we’re closing more beds and trying to restructure services.
Injecting an inherently political process into something as complex as health care is just a prescription for mismanagement, misallocation of resources, and inefficiency. That’s why provincial governments are increasingly letting the private sector enter the market. The more treatment that gets offloaded to the private sector, the easier it is for the government to manage the rest of it.
As far as contentment goes… Yes, Canadians say they are happy with our health care. But 70% of Americans say the same thing. And a large majority of people in the UK also say that, although their system has terrible outcomes and really does have ‘death panels’, which really do make decisions about whether or not to just let granny die because she’s too expensive to treat.
The reason large majorities say this is because it’s a small minority of people who actually USE the system, and those areas that see large percentages of the population are generally the best, because politicians understand where their bread is buttered. So Canada has good emergency care, and good maternity care. But where you have to look to see the systems breaking down is to look at the care that goes towards those who are not as politically powerful or politically correct. For instance, you often see good treatment for breast cancer in countries with socialized medicine, because breast cancer is politically correct and heavily lobbied for. Treatment of prostate cancer, on the other hand, may not be so good. It’s the same phenomenon that sees governments funding politically correct diseases at much higher levels than their true risk should dictate.
Where the socialized systems really fall down is in their treatment of the elderly, especially when it comes to the increasing need for ‘quality of life’ treatments. These don’t show up in the life expectancy statistics or other common measures of health outcomes, so they’re the first on the chopping block. For example, the average wait time for a hip replacement in Alberta right now is 33 weeks. And we have one of the best provincial health care systems.
This BBC article from 2004 lists waiting times in Scotland for elective surgeries. Cataract surgery: 8 months. Hip replacement: 11 months. Knee replacement: 12 months. Slipped disc repair: 5 months.
Those are the kinds of treatments that really suffer under socialized medicine. And they can make life miserable for the people who need them.
The health care system is getting BETTER for having some more privately funded health care; it relieves pressure from the public health insurance system and given people more options. My honest perception is that health care in Ontario is better than it used to be.
Such problems as exist are repairable.
I have lots of Canadian friends. None of them would trade for our system. One had a heart transplant. He is not rich. If he were in America he would be dead or dead broke.
People bitch. Everybody has annoyances when dealing with huge programs. But our system is barbaric.
The MRI is actually two separate issues, the machine itself and the staff to run it. Once bought, the scanner can run 24 hours a day if we wanted to , but its only funded for roughly twelve hours.
I can remember two storys in the news in the past regarding them, one was one of the bluejays, shot right past the line and got an MRI done in a day , howls ensued until it was pointed out that it was paid for in cash.
The second was Pets getting MRI scans , when a line up of patients exist. Same thing, pet owners were paying cash after hours , which helped pay for the machine.
Regarding the cures for cancer, I think those were alternate holistic type cures that were not approved by Health Canada and would be a last resort for patients who are not responding to conventional therapy.
Declan
Norway has free medical care from king to peasant, and also the highest per capita income.
Have a friend who has waited for painful years for Medicare to pay for her hip replacements. This year she’ll be 65 and she can’t get it because her temp agency provides SHIT for insurance, but extremely-expensive shit, and she can’t take the time off.
And this year, the peasant is Tor Hegdahl. Next year, somebody else’s turn.
Injecting an inherently political process(like democracy) into something as complex as the management of an entire country is just a prescription for mismanagement, misallocation of resources, and inefficiency.
Is Canada beyond repair ? I sure hope so.