HaHa said:
I copied this from the article:
"How do these non-single-payer nations provide such excellent care? These nations employ a system that blends a flexible mixture of public and private, with most doctors, nurses and other professionals working for private medical groups, not for the government as in the Canadian or British-style single payer systems. Many hospitals also are in private hands, while others are in public hands."
Could one of our Canadians comment? I thought that Canada had a sole health insurer and controller, the Canadian government, but at the same time the doctors were private, in that they billed rather than worked on salary. Somewhat like a franchise owner is a private business, but with many controls and stipulations on his freedom.
Haha
Responding re: Canada
Doctors are in private practice and set up practice in clinics that they and their partner physicians manage similarly to the USA. Their income is based on how many patients they see, how many operations they perform, etc. Fees paid for each service are determined by each province's health care system (not unlike USA managed care systems, e.g. PPO's). There are some differences from province to province because health care is administered on a provincial basis, but must provide services under the principles of the Canada Health Act to maintain some equality and consistency across Canada, or risk losing Federal funding (which comes from the General Revenue account and thus the taxpayer).
Capital and operating budgets for hospitals, infrastructure, equipment, number of beds and staff, etc are controlled ultimately by each of the provinces, and in Alberta at least, through regional health boards. For example, the Calgary Health Region contains multiple hospitals and serves over 1 million people. It operates under budgets allocated from the provincial government, but makes local decisions on how much of that money is spent. The government, via budget controls for services, thus indirectly controls the amount of beds available, number of operating rooms available, and amount of equipment available.
Thus the government does provide budgetary pressure and seeks to try to manage costs, resulting in some waiting times for some procedures. Bottom line though is that urgent treatment, with few exceptions, gets done quickly, e.g. a heart attack victim goes in for a double, triple, quadruple bypass instantaneously. A hip joint replacement however may have a 6 month waiting list.
Generally speaking, all basic services, e.g. doctor appointments, lab fees, etc. are 'free' to the user except for prescription drugs administered by doctors via their clinics. If people want more than basic coverage, e.g. private hospital room and prescription drug protection, they can buy additional health insurance from private providers.
Hope that helps.
Has anybody ever thought that the civil lawyers (as well as incompetent doctors), who sue over stupid things is a leading cause of the increased medical bills. If the doc's were competent they wouldn't make major mistakes leading to a lawsuit. If you want to make a European laugh tell them about suing McDonald's because someone was burned by hot coffee. Our society is so sue happy then we complain about the increased prices. Well DUH, someone has to pay when the person being sued loses millions of dollars.
