Yes, of course. Because you can demonstrate there are huge waiting times in the free market environment. How long in advance do you have to make an appointment to get your car fixed? 5 months?
I’m not saying that they are lying at all but in the context of the discussion you were having with Spoons of an American presenting at a Canadian facility, I contend that it would more mirror my experience of arriving at an emergency room (in the province with the second highest median wait times) presenting with a situation that requires immediate resolution vs. someone who starts the process by having an appointment with their family doctor who then refers to the appropriate specialist etc. or making an appointment for an after hours clinic for minor issues (infections, prescription refills, etc).
Every time there is a discussion about healthcare, people keep trying to bring up extreme examples. Extreme examples do not describe or characterize a healthcare system accurately.
What happened when you had an acute episode and had to be taken to the emergency room is completely irrelevant to an average health care consumer. The average wait time of 5 months or so to see a specialist and have something non-emergency done definitely is.
I think it’s hilarious that the author of the article thinks that companies will give employees raises because of all the money they’ll save from dropping insurance coverage.
It makes perfect sense for “pay” to be adjusted for the cost of benefits. To an employer, compensation includes not only salary, but also the cost of providing benefits such as health insurance, pension contributions, unemployment insurance, etc. Health insurance and pension costs, in particular, are driving up employment costs even if salaries remain relatively stable. That’s why there is so much pressure now to hold the line on pay raises to pay for escalating health insurance costs. If the converse were to happen - lowered health insurance costs - a company would free up money to be used for many things, including higher salaries.
Agreed. There seems to also be an implied assumption in Terr’s post that our current American system encourages doctor quality and doctor retention. My experience is just the opposite. For many doctors my family sees (including specialists), to reap the high profits the doctors have to continuously increase their patient load. The quality doctors that manage good care and good practices (re: wait times, after care, length of visit, quality staff, etc) are turning away new patients and pruning their current patient load due to the higher time and cost required for insurance administration.
In my experience, the quality doctors are getting saturated, and the poor doctors are the ones reaping the profits of the system by trading ethical and quality care for sheer volume of patients they can process in a given time. We personally know a few doctors that are retiring from public care to go into research and contracting care professions in spite of the reduced potential salary.
Again, in the context of your exchange with Spoons you asked why an American would pay money to wait 5 months for service in a Canadian facility. You are, I feel, incorrectly applying the wait time stats for services that an American would not be partaking in. The American visitor to Canada is much more likely to be seen in an after hours clinic for non-emergency needs for which appointments can routinely be made for same-day service (they only book for same day appointments) or will be going to the emergency room for emergency care which will, again, be provided same day neither of which is a situation covered by the chart you provided.
The above is all in the specific situation of why an American seeking treatment in Canada need not be waiting five months for treatment. Your response to Spoons was indicative that you did not believe there are situations in Canada where the expected wait time for treatment is same day.
[QUOTE=Terr]
So - why in the world would the American patient do that? He likes to wait for his doctor’s appointment for five months instead of getting immediate service?
[/quote]
Or they could keep the money, post record profits, drive up stock prices and cash in nice dividends for the CEO etc.
After all, it’s not like the employees will be taking a pay cut - insurance premiums paid by a company are never part of take-home pay anyway, so why would they just give the money to their employees?
So cute when they’re naive.
Serious question. You seem to be saying that the current US system and the changes in the ACA inhibit the free market, but where in the world is there a free market in health care?
I would give my employees a significant raise if I didn’t pay over $10,000 for their health insurance each year. More for them, more for me.
You completely missed the point. Compensation isn’t only “take-home pay”, it is that plus employer-paid taxes (like SS contributions), unemployment compensation, health insurance, pension contributions, etc., etc. It all adds up to the “compensation package”.
The employee agrees to work for $X plus benefits. The employer agrees to pay $X plus all of the associated benefits and employment costs. It isn’t about “giving” employees anything. It’s all part of compensation, and is subject to change if any part is radically altered.
Talk about naive. You really think “take-home pay” is what it costs a company to employ someone?
Dual post. Ignore
No, sir, I’m fully aware what “total compensation” means - but I’m also aware that when you sign an offer letter for $40,000/year (for example) you’re agreeing to TAKE HOME that much (less taxes and your share of insurance, of course). The company doesn’t sign you on for $50,000/year then only pay you $40k because of insurance costs etc. , that’s figured in to their payroll expense for hiring you, but you never see a statement of how much that costs is to your employeer - it’s all behind the screen.
So - without having to pay insurance for the employee, what is the more realistic outsome? All of a sudden the employee gets a $10k/year raise, or the company cuts their payroll costs by around 20% and sends all the upper management on a coke-and-strippers cruise to Tahiti? And all without having to cut the employee’s pay by a dime - you still get your $40k/year.
The context of my exchange with Spoons was not about an American tourist feeling unwell and stopping at the neighborhood clinic. It was about Americans who deliberately would go to Canada to partake of Canadian health care.
False dichotomy. There are freer markets and more restrictive markets. ACA pours the restrictions on.
Thank you, Cyros; this is exactly what I was getting at.
Terr contended that Canadian physicians and health care facilities could not accept private insurance. I pointed out that this was incorrect; of course they can accept private insurance. Canadians won’t have private insurance, but people such as visiting Americans will.
I was envisioning such situations as would require emergency care: an American breaking a leg on a skiing vacation in Canada, and an American business person suffering a heart attack during a business meeting in the Canadian office, are just two examples of when an American would need immediate care in Canada. To claim that such people won’t be treated because “Canadian physicians cannot accept private insurance” is, as I stated, incorrect. Treatment will be given immediately, and it will be paid for.
To further clarify, I’ll point out that I was not thinking of such things as (for example) an annual physical from a GP or any kind of elective surgery. Though even in these situations, there is nothing stopping a Canadian physician from accepting private insurance.
Then you missed the context of the conversation. If you look upthread, the context was someone claiming that there is a “large patient-flow from the US to Canada”.
Let’s see. You said, at post 106:
I don’t see anything in there about “Americans who deliberately would go to Canada to partake of Canadian health care,” though I will grant that your statement is broad enough to include such situations. But similarly, it is also broad enough to include emergency situations where care is needed immediately.
At any rate, it seems to me that the question raised by your “AFAIU” dealt with whether Canadian physicians could legally treat private patients with private insurance; and as I pointed out, they can. It is a broad question with a simple answer.
OK. Is there a freer health care market than the pre-ACA US?
Are there companies in Canada selling “supplemental” private insurance, to augment coverage, and perhaps to help pay for additional care, better care, faster care, etc.?
This idea seems to work in Australia, where everyone who has a few dollars in their budget buys a supplemental plan, to make the public plan a little nicer in case of a health issue.
The taxes on the private plans help to fund the public plan. It benefits everyone, and preserves both free-market ideals and universal (ooh, socialist!) ideals.