Canadian Health Care System

Profit Motive: What’s Wrong with American Health Care?
by Kathleen Bushman

Edwards has the smile and the hair of a Kennedy, but will his health care policy alleviate the strangling cost, anxiety, and stress the working class is enduring as a consequence of our present system? Does Edwards, or any of the Democratic candidates, offer a health care plan that will relieve middle class suffering as the cost of health care has become the leading cause life disruption, behind home foreclosures and bankruptcies?

We Americans, by almost any standard, do not have the best health care system in the world, but we do hold bragging rights to the most expensive. Americans spend 50% more for their health care than the next most expensive country, and nearly twice the per person cost of the Canadian system.

Although Americans have by far the highest priced health care system in the world, no Americans should suffer under the delusion they enjoy the best health care system in the world. Citizens in 34 countries live longer than Americans. There are other methods of ranking a country's health care system, but to me the average life span of a country's citizens seems one of the very best methods. That fact alone should be a cause for a national sense of shame in the most powerful and fifth richest country in the world, but if that fact isn't bad enough here's another: "In mid-February (of 2004), the U.S. Centers for Disease Control and Prevention in Atlanta also revealed that the U.S. infant mortality rate now stands at 7 as of 2002, backsliding from 6.8 in 2001." Out of 195 countries ranked by the United Nations, the United States is ranked below Canada, Cuba, Ireland, Italy, Brunei, and 32 other countries which have a lower infant mortality rate. Literally every country in Western Europe has a lower infant mortality rate and a longer life expectancy than the United States. So, even as the costs of America's health care system continue to soar, the quality continues to deteriorate.

I can cite the commonly known fact that nearly 46 million Americans have no health coverage at all and over 40 million more have only minimal coverage, but I seldom see media coverage about the millions with "deluded coverage". Many Americans only discover the gaps, co-pays, and exclusions of their health care plans when they experience a medical crisis. The LA Times recently reported that "One of the (California) state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved." If a family is at risk of losing a loved one, the family should not have to wonder whether their doctor's choice of treatment options will be restricted by which option the insurance company considers the most cost effective treatment.

A for-profit system whose first goal is profit does not put patient welfare before cost considerations. Thus, even those Americans who can afford the world's most expensive health care system are not guaranteed the best available health care. If a treatment plan is expensive but the best possible care for the patient, it will often be rejected to cut costs. A less effective but cheaper treatment plan will be chosen instead.

As this Alternet article states, "There are two criteria used to judge a country's health care system: the overall success of creating and sustaining health in the population, and the ability to control costs while doing so. A recent study published in the Canadian Medical Association Journal compares mortality rates in private for-profit and non-profit hospitals in the United States. Research on 38 million adult patients in 26,000 U.S. hospitals revealed that death rates in for-profit hospitals are significantly higher than in non-profit hospitals: for-profit patients have a 2 percent higher chance of dying in the hospital or within 30 days of discharge. The increased death rates were clearly linked to "the corners that for-profit hospitals must cut in order to achieve a profit margin for investors, as well as to pay high salaries for administrators." "To ease cost pressures, administrators tend to hire less highly skilled personnel, including doctors, nurses, and pharmacists" wrote P. J. Devereaux, a cardiologist at McMaster University, the lead researcher. "The U.S. statistics clearly show that when the need for profits drives hospital decision making, more patients die."

"Conservatives love to trot out the theory that the soaring cost of America's health care is due to malpractice suits, when in fact only 0.46% of our total health care spending is spent upon awards, legal or underwriting costs - about the same as Canada's… The administration of the health care system today consumes approximately 31% of the money spent for health care. The potential savings, as much as $350 billion per year, are enough to provide comprehensive coverage to every American without paying any more than we already do." ( A Healthy Nation – Myths)

It seems evident to me that a country which spends billions on corporate welfare can well afford to consider some programs to benefit its citizens. If America is not a corporatocracy run solely for the benefit of companies such as Enron, Worldcom, Halliburton, Blackwater, and the media mega corporations, then it is time for the application of some good old American common sense. It is time for more regulation, and it is certainly time to at least see that our next Henry Ford lives past childhood.

Dennis Kucinich is the only Democratic candidate who offers a single payer not for profit health care system to cover all Americans. Since no other Democratic candidate's plan would stop the soaring cost of the for-profit system, there is only one plan America can afford: the Kucinich plan.

 
I believe Feralpeg that each of the Doc's office staff bill OHIP, following OHIP's rules & the hospitals have their own staff as well. Of course, if someone else knows this to be untrue, please jump in.


Each Doctor or Office either employ a person to bill their Provincial Health Care (Ohip in Ontario, it's a different agency for each province because each province gets an amount of funding from the Federal Government based on population.

Each visit and procedure has a code and they bill the government with those codes. The government then pays them with the set amount they have decided each code deserves.

Now, we do have to pay for small things sometimes. (I paid $10 for the flu shot this year but DH did not because of his other conditions and I had to pay once for a note for my employer because I needed it to claim benefits)

If you go to a different province than the one you live in, there are some things that are not covered but I am unsure of what they are. (I assume they are not huge things but I don't have an example of what they could be...I assume it's for visit to a clinic and not a hospital for emergencies)
 

I was wondering about something else though. I wonder if part of the problem with the US system being so high to afford is not partly because of the proclivity of the US people towards suing their doctors & health care professionals so frequently. Again, this is only an observation of mine but it does seem that though we do read of an odd Canadian taking their doctor to court, it does not seem to be very frequent. But in the states, it appears to happen A LOT! I doubt it's because Canada has ALL the best doctors!!

If Doctors need TONS of insurance to protect themselves would it not stand to reason that they than have to charge more for their procedures, passing the cost on to their client's insurance, thereby making that insurance prohibitive for the common US citizen? Just a thought.

Sadly, this is true. In fact, many doctors have chosen to leave their practices in Florida due to the very high number of malpractice lawsuits. I was seeing a very good OB/GYN doctor, but she could no longer afford the insurance necessary to stay in practice.

Also, I noticed people on the CB thread saying that they don't have to wait to see doctors in the US. Well, they are doing better than I am. To get into my GP, it takes at least two weeks. I've called trying to get in when I've been sick, but they have had no openings. My GP is an excellent doctor. This has made him very popular and his practice is swamped. Most of the time, when I am actually feeling ill, I end up in a walk-in clinic. I'd rather see my regular GP, but I just can't wait to get in. For things like my yearly mammogram, I have to make an appointment a year in advance. In fact, I tried to get my appointment moved last year because I was having surgery and knew I would be too sore after to have the test. They told me they couldn't move me up (this was a month in advance). The only thing they could do would be to book me another year out. Crazy!
 
Each Doctor or Office either employ a person to bill their Provincial Health Care (Ohip in Ontario, it's a different agency for each province because each province gets an amount of funding from the Federal Government based on population.

Each visit and procedure has a code and they bill the government with those codes. The government then pays them with the set amount they have decided each code deserves.

Now, we do have to pay for small things sometimes. (I paid $10 for the flu shot this year but DH did not because of his other conditions and I had to pay once for a note for my employer because I needed it to claim benefits)

If you go to a different province than the one you live in, there are some things that are not covered but I am unsure of what they are. (I assume they are not huge things but I don't have an example of what they could be...I assume it's for visit to a clinic and not a hospital for emergencies)

Right!! Sorry about that...when I was writting my original post, I was actually thinking about Ontario & hence, OHIP, but you are 100% correct PhotobearSam about each province having different names for their insurance & slightly different coverage.
 

Sadly, this is true. In fact, many doctors have chosen to leave their practices in Florida due to the very high number of malpractice lawsuits. I was seeing a very good OB/GYN doctor, but she could no longer afford the insurance necessary to stay in practice.

Also, I noticed people on the CB thread saying that they don't have to wait to see doctors in the US. Well, they are doing better than I am. To get into my GP, it takes at least two weeks. I've called trying to get in when I've been sick, but they have had no openings. My GP is an excellent doctor. This has made him very popular and his practice is swamped. Most of the time, when I am actually feeling ill, I end up in a walk-in clinic. I'd rather see my regular GP, but I just can't wait to get in. For things like my yearly mammogram, I have to make an appointment a year in advance. In fact, I tried to get my appointment moved last year because I was having surgery and knew I would be too sore after to have the test. They told me they couldn't move me up (this was a month in advance). The only thing they could do would be to book me another year out. Crazy!


I'm in Florida too and have the same problem. I do not have a primary care doctor because I don't have the time to schedule an appointment several weeks out for a routine check up before I can get a primary care doctor. And even if I did it is likely they would not be able to see when I was sick. So I go to the drop in clinics and pay $50 co-pay rather than then $20 co-pay. I generally have to wait about 2 hours to be seen by a PA at one of those clinics.
 
Come on ...it's the American Dream. You work three jobs to to afford health care. You uproot your kids and move them away from extended family and friends at the drop of hat to live some place cheaper so you can buy even more insurance in case the health insurance you are already paying through the nose for it is not enough. Isn't that the life you want to live?:confused3

If that was intended towards me, we uprooted and moved some place three times as expensive, that had opportunities for REAL jobs instead of hourly crap. We all make choices in our lives, our choice was to better ourselves in many ways--not just by getting good health insurance.
 
I'm in Florida too and have the same problem. I do not have a primary care doctor because I don't have the time to schedule an appointment several weeks out for a routine check up before I can get a primary care doctor. And even if I did it is likely they would not be able to see when I was sick. So I go to the drop in clinics and pay $50 co-pay rather than then $20 co-pay. I generally have to wait about 2 hours to be seen by a PA at one of those clinics.

I can get an appointment with my GP for routine care with under a two weeks wait, and a same day appointment if I'm sick.

My son got a same day appointment with a specialist this past week--and he was a new patient.
 
If that was intended towards me, we uprooted and moved some place three times as expensive, that had opportunities for REAL jobs instead of hourly crap. We all make choices in our lives, our choice was to better ourselves in many ways--not just by getting good health insurance.


Your posts on the other thread seem to imply that people should be willing to let health insurance dictate their lives: where they live, what career they choose etc.


I simply believe that health care should be a right in civilized societies. I know you disagree, but I do not wish to debate this.
 
We cruised this past Spring with a Dr from the Boston area..he was an OB-GYN as well. He was telling us that he has now dropped the Obstetrics as his Malpractice Insurance has become outrageous and he simply can no longer afford it, which I am sure is unfortunate as he was an awesome guy and LOVED bringing babies into this world!!!!!

You know, a few years back, we had a mass exodus of our great Physicians leaving Canada destined for the U.S. Why? Because they could make the REALLY big bucks there whilst being Income capped here. I questioned the motive, being money and not 'love of their job' and now I question where or from whom these monies were being generated? Many are back now...guess they didn't like the system enough to offset the $$$$:confused3
 
I'm in Florida too and have the same problem. I do not have a primary care doctor because I don't have the time to schedule an appointment several weeks out for a routine check up before I can get a primary care doctor. And even if I did it is likely they would not be able to see when I was sick. So I go to the drop in clinics and pay $50 co-pay rather than then $20 co-pay. I generally have to wait about 2 hours to be seen by a PA at one of those clinics.

Chobie, does co-pay mean that you have to pay this much at each appointment? Is that the case with everyone with all differenty health insurances in the US?
 
Your posts on the other thread seem to imply that people should be willing to let health insurance dictate their lives: where they live, what career they choose etc.


I simply believe that health care should be a right in civilized societies. I know you disagree, but I do not wish to debate this.

Actually I don't disagree. I disagree that UHC is the only right way, and I don't beleive that people who are happy with their current plan should be forced to give it up for socialized medicine. We've got to find a way to provide basic care with money already available, and not raise taxes to do so. I've said all of that many times over, but no one seems to want to read it, and would rather just call me a liar or say that UHC is the only answer. :sad2:
 
Chobie, does co-pay mean that you have to pay this much at each appointment? Is that the case with everyone with all differenty health insurances in the US?

Yes, almost every insurance has all sort of co-pays for every situation: doctor's visits, prescriptions, hospitalizations, emergency room visits, ambulance rides etc. Many of the co-pays must be paid upfront before being seen. So, basically most of us with health insurance are not only paying huge monthly premiums, we are shelling out money every time we use the benefits we are already paying for.


Wait it gets better - some insurances pay a set amount, say 80%, depending on which providers you go to. So, if you go to a "preferred" provider they will pay more of the bill. However, that 80% is based on what the insurance company thinks is a reasonable amount and not what the fee actually is. When I had this type of insurance the 80% for preferred providers usually turned out to be 60%We switiched to HMOs because it was more reasonable for our families and we always knew uprfront what the copays would be.
 
Chobie, does co-pay mean that you have to pay this much at each appointment? Is that the case with everyone with all differenty health insurances in the US?

It depends on your insurance. Some people have no co-pay while others might have a $40 co-pay. It also depends on if you are seeing an in-network or out of network provider.
 
Actually I don't disagree. I disagree that UHC is the only right way, and I don't beleive that people who are happy with their current plan should be forced to give it up for socialized medicine. We've got to find a way to provide basic care with money already available, and not raise taxes to do so. I've said all of that many times over, but no one seems to want to read it, and would rather just call me a liar or say that UHC is the only answer. :sad2:

I apologize. I did not see that statement and I agree that there should be way to for people to continue with paid insurance should they wish. I am willing to pay more in taxes, however, because I think it would even out over time. Every year our insurance premiums go up and the COLAs have not offset the increase. My husband is a teacher, has taught in two states, and in both state every increase in pay (which would be highly trumpeted in the news) would be offset by a decrease in what the state pays for health benefits (which would not be reported in the news:rolleyes: )
 
My first disclaimer...I haven't read every single post, I'd go cross eyed!

I come from the perspective of having used 2 UHC systems different from each other, and I am the first one to say that every system has it's fault, be it private or universal.

In Australia they have a "two tiered" system and the system has changed alot since I've moved to Canada. They have a base UHC system which covers everyone which comes with it's own frustrations. You do not get to choose your Dr who treats you (outside of your family Dr) and yes you have to wait for ELECTIVE surgery, meaning if you are not going to die, you wait while those less fortunate are treated.

If you would like to see a particular specialist, as in you would like to choose specialist A over specialist B then you will have to pay. The government has a set of accepted charges that a Dr can charge..and they refer this as the "bulk bill charge"..ie the government says a visit to a GP that the government will pay is $25, a Dr can charge more than this, say, for example $30 and you are left to pay $5. This does not happen very much on the GP level, but on the specialist level the "gap" could be great.

So enter the second tier in the system...private insurance. These premiums are paid by individuals and the government actually gives you incentives through the taxation system to join them, or rather if you do not join and you earn X you will have to pay an extra levy on you tax. The private insurance covers you for the "gap" in Dr's visits and is very similar to private insurance in Canada, covers Dental, Ambulance etc.

When I started my first full time job back in 1995, the Australian goverment had recently passed a law that took away employer health plans, because they deemed that an employer should not be in the business of providing heatlh care to its employees for they may choose not to provide a comprehensive coverage.

Another aspect of the Australian system, is the pharmaceutical benefits system. The goverment subsidizes certain drugs to make them more economical for people and I LOVE this system. From my memory the most an individual will ever pay for drugs from this list in $750 per year and after you have reached that limit all you have to pay is the dispensing fee...when I left it was $2.50 per prescription. My mother who is diabetic well and truly reaches the limit ever year and thanks to this system is well protected and will not go brankrupt from medical expenses.

So basically the system works like...you have access to health care BUT if you can afford it then use the private system in conjunction with the public system.
 
Sorry just saw this thread.
Another Canuck here who is happy with our system. It's not perfect but I am glad we have it.
 
We had a government promote 2 tier healthcare a few years ago, and recently went through a provincial election, where this was briefly discussed. Both times I was adamantly opposed to it (as it was promoted), because it would destroy our Government run system. How many doctors would stay in the public system, with a capped income and partial control, when they could open their own for- profit clinic, and demand their own fees. Our current hospitals would be robbed of staff, as they were recruited to private hospitals. The only people that would benefit would be the upper class, who cold afford the bill or the exhorbitant insurance fees. The lower middle class, and poor would be stuck using a heavily depleted public system.
 
I disagree that UHC is the only right way, and I don't beleive that people who are happy with their current plan should be forced to give it up for socialized medicine.

Agreed...although,whenever I hear the term "socialized medicine" ,I get visions of a run down,dilapidated Soviet era hospital system :goodvibes.
What we have in Canada is far from that.

We've got to find a way to provide basic care with money already available, and not raise taxes to do so.

'The money available" is dwindling and the astronomical,mind boggling $ being spent at this time cannot go on indefinitely.
The problem is,whenever you have "for profit" Hosptals and Medical Insurance companies, the satisfying of the shareholders is always going to be #1.
Thats just the way things work with corporations ,conglomerates and multi nationals.

I've said all of that many times over, but no one seems to want to read it, and would rather just call me a liar or say that UHC is the only answer. :sad2:

I've read them and your opinion is your opinion. Its obvious that no matter what others participating on this thread say,they'll never convince you that a UHC system is better for you. But, as has been mentioned time and time again in previous posts, there are more folk to consider than just ourselves. That would be selfish. The "I'm All Right Jack" attitude is just not acceptable in countries such as ours.

Please read my previous post and I think you'll agree that the writer makes some valid points (based on unbiased studies and reports I would say).
Let me ask you a question.
If they were to implement a Universal Health Care system in your state and you got the same care with perhaps a little bit more waiting time for elective surgery (and if you chose to pay a bit more money you could go to a private facility). If the increase in your taxes were to balance out (or perhaps be less money) than what you pay for insurance coverage,would you not consider it as a viable option ?
 
Agreed...although,whenever I hear the term "socialized medicine" ,I get visions of a run down,dilapidated Soviet era hospital system :goodvibes.
What we have in Canada is far from that.

I never said is was. I do contend however that socialized is the correct definition. You can wrap it up in pretty paper and call it what you want, but bottom line, it's socialized.

'The money available" is dwindling and the astronomical,mind boggling $ being spent at this time cannot go on indefinitely.

I absolutely agree and ahve said so exhaustively.

The problem is,whenever you have "for profit" Hosptals and Medical Insurance companies, the satisfying of the shareholders is always going to be #1.
Thats just the way things work with corporations ,conglomerates and multi nationals.

But the for profit health insurers should be the problem of those who choose to use those insurers. I am happy with my healthcare, even if it means they make a little money off my premiums. I understand that not everyone feels that way, and I think the best way to make our system better would be to make it easier for people to buy into private plans--and make those plans more competitive. As far as hospitals, the vast majority are either public or non-profit. The last time I was hopitalized it was in a non-profit. My entire bill was paid by my insurance except a co-pay for medication. I didn't wait for weeks or months to get the surgery, even though it wasn't a life threatening situation.

I've read them and your opinion is your opinion. Its obvious that no matter what others participating on this thread say,they'll never convince you that a UHC system is better for you. But, as has been mentioned time and time again in previous posts, there are more folk to consider than just ourselves. That would be selfish. The "I'm All Right Jack" attitude is just not acceptable in countries such as ours.

And like I said, I agree that something needs to be done. But there are huge amounts of tax dollars being wasted in this country that could be used towards health care spending--like this ridiculous tax rebate. Perhaps they should use that to buy into the medi's for the uninsured working poor? Instead they are giving it to people who will use it to go to Disney World.

Please read my previous post and I think you'll agree that the writer makes some valid points (based on unbiased studies and reports I would say).
Let me ask you a question.
If they were to implement a Universal Health Care system in your state and you got the same care with perhaps a little bit more waiting time for elective surgery (and if you chose to pay a bit more money you could go to a private facility). If the increase in your taxes were to balance out (or perhaps be less money) than what you pay for insurance coverage,would you not consider it as a viable option ?

I'm always willing to look at a new plan, but I don't want to be forced into giving up the coverage I currently have if it turns out that it's better. And every plan that's been put on the table so far would have been worse, and would have cost me thousands in additional taxes over and above what I'm already paying for insurance. I want to choose my doctors and I want to choose my hospital (there are some around ehre that I wouldn't take my dog to).

The best way to make providers do a better job is to increase competition and allow them to earn what the market will bear. If patients are automatically sent to "X" hospital because their last name starts with "V" or they live on "X street" then the hospitals have no incentive to do a better job. If a doctors income is capped, what incentive do they have to provide the best in care? The best way to have health insurers offer the best rates and most services per dollar is to make them compete for the business with each other--something that's not being done very well in the US.

We have our insurance through DH's job. They have 13,000 employees and 7-8 plans to choose from. That's a lot of leverage with the various insurers to put their very best plan on the table at teh best possible price. If each county/parish became a buying consortium that allowed the currently un and under-insured residents to choose from 2-3 plans (more in very dense population areas) don't you think the insurers would put thier best foot forward to try to get and retain that business?
 
If there were as many letters/emails written to local and federal representatives re: this, as posts written to the DIS, perhaps your politicians would listen??? You have so much info, let it be heard other than at the DIS? On the Canadian board, where we can't really help you to change your country's health plans or lack of same? You have amazing enthusiasms and insights ducklite.
 















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