Canadian Health Care Issues

[Kroeran]

If the safety valve of market based healthcare is eliminated in the US, Canada will likely loosen the screws a bit more and move more decisively to two tier.

As with all policy change, these things are decided by a handful of super-rich guys over drinks (not that there is anything wrong with that), and once the opportunity to fly to Boston or the Mayo and pay top dollar for the best health care is eliminated, these same rich guys and privaleged politicians will insist on "best health care" being available in Canada.

Also start looking for clinics opening up just across the border in Mexico, Grand Bahama, Bermuda, and in floating clinics just outside the national boundry at sea.

 

[samclem]

Also start looking for clinics opening up just across the border in Mexico, Grand Bahama, Bermuda, and in floating clinics just outside the national boundary at sea.

While all the senators are busy raking in pork in exchange for their vote on the present bill, I wouldn't be surprised if at least one state sees the opportunity to become the "medical destination for North America." Let docs and hospitals know that they'll get favorable tax treatment and be allowed to treat any patient they choose, and put out the welcome mat for new customers. If this new scheme goes the way of almost every govt health care system, they'll soon have plenty of business.

 

[Kroeran]

yes, Nevada and the Native Reservations will want to get in on this.

 

[FUEGO]

You've expressed a great deal of dissatisfaction with your family doc. I'd think you owe it to your family to go out and find one you prefer. Health issues can pop up without warning and needing to depend on a doc and staff you dislike and have lost confidence in would be a bad thing. There may come a time when we have less choice about selecting docs, but for now your doc is your doc because that is your choice.

I think "frustration" would be a better way to put it. I'm not sure that a new doctor would be better in most respects though. The truth is that we just don't consume a lot of medical services in a given year. I think we average roughly 2-3 visits per year total for our family, roughly half of which are to this doctor (other than annual physicals).

However just yesterday I had a very pleasant experience with this doc's office. Got immunization records for my daughter's kindergarten enrollment. A little phone tag, but they got back to me quickly, faxed authorization forms, and promised to mail me the records (hence saving me an errand to their office).

I would guess that a large part of my frustration arises from general BS that every doc's office has - byzantine insurance policies/claims/filing, forms to fill in, paperwork, authorization sheets, etc. That's a criticism of the health insurance and HIPAA more than the doc though.

We'll stick with the doc for now. Odds are our insurance will change, we'll have to switch docs anyway, or we'll have a spiffy new govt insurance of sorts that may necessitate changes anyway.

 

[TomCat]

I think your points 1-7 would offer a great starting point for healthcare insurance "reform". Too bad special interests and politics takes over instead of logic and compromise...Thanks...TomCat

I don't think it's a simple problem, and I know you don't either. I'm fairly sure that oversimplifying the problem will not lead us to either a solution or to greater understanding of the problem. So, let's not do that.

Yes, I think insurance can play an important role in helping people pay for unexpected medical expenses, just as it plays a role in helping them pay for non-medical unexpected expenses. And, while I personally would like to see a different answer, I believe (based on what our present society demands) that the most constructive, least damaging role our government can play is to:
1) Require that individuals buy insurance (eliminating adverse selection)
2) Provide the outlines for the minimum standard required policy. It would provide "free" preventative care, meaningful co-pays, and no lifetime cap. No-frills care: no private rooms in the hospital, etc.
3) Establish rules that insurers must take all comers without underwriting and charge them all same rate for the standard policy..
4) Provide additional outlines for standardized optional supplemental policies (to foster efficient price competition in these policies).
5) Allow cross-state competition
6) Provide a clearinghouse for medical cost information and objective measures of medical care quality to better inform consumers
7) Provide subsidies to pay for medical insurance and care. But before any American is forced to pay for the care of another, the recipient must have spent a substantial portion of either their annual income or total assets on their own care.

Market based and without rationing. And get everyone used to the fact that good medical care costs money, and that, like food and shelter, they are responsible for providing for themselves unless they truly can't.

Sometimes I think the folks most afraid of the government takeover of
US medical care are Canadians. Hopefully they and US citizens will still have some place to go to get timely quality care in the future.

 

[Kroeran]

Too bad special interests and politics takes over instead of logic and compromise.

This is my area of expertise professionally, so listen up.

Indeed, after a few years, you figure out that it is not about a shortage of ideas or logic, but rather, its all about who decides, and who has the ear and influence over the "decider", and then what is their particular self interest.

As a general rule, any policy issue has several "levels of truth".

The first level of truth is how the issue is perceived by the beneficial or entitled clients of a program or participant under a regulatory regime, which is normally the pov expressed in the mass media.

The second level of truth is how the issue is perceived by the university academics or professional research staff in a department, who do not have a personal stake in the game and are trained to see the big picture. This is the pov expressed in ignored academic papers and in shelved internal research documents, and is as close to true "truth" as you are going to get.

The third level of truth is how the issue is perceived by the deliverers of the program or overseers of the regulatory regime, who have a stake in the jobs and power associated with the policy. Guess what happens when they are given control of the performance measurement and policy development process?

The fourth level of truth is how the issue is perceived by the man on the street who has no direct stake in the issue, and how that particular program or policy plays into their emotional needs, irrational fears and prejudices (think, immigration, energy, abortion, health policy..oh hell, I guess all of them).

The Fifth level of truth is how the program or policy is valued or plays into a substantive issue which is not part of the ground level policy debate - ie. the positive impact of illegal immigration and the grey labour market on the cost structure of US service, construction and manufacturing industry

The sixth level of truth is how a program or policy is used as a card in the international trade negotiation multilateral and bilateral poker game that is played between national leaders in high stakes tit for tat.

I have seen odd and unexplainable offsetting events happen on opposite sides of an international border, and the only explanation is that a call was made the night before.

 

[Meadbh]

This is my area of expertise professionally, so listen up.

I have seen odd and unexplainable offsetting events happen on opposite sides of an international border, and the only explanation is that a call was made the night before.

Good evening Mr. Ignatieff!

 

[Kroeran]

Ha! you are of course speaking of the greatest asset of the non-naturally governing party!

I have a retired friend who's core purpose in life is to write scathing letters to the editor against Iggy, and he is way to good at it....I told him to lay off...Iggy is far too valuable to Stevey.

that being said, I personally support whoever is good for the Country from either side of the black rod, and I believe Canada has been blessed over time with good leaders for the particular challenges of each era.

in 100 years we are all going to prostrate before the image of Johnny for outlawing corporate and union donations to political parties.

and it was Paul who sent the troops into the south....funny how the border started opening to cattle that very same week.