U.S. HC Spending Compared to other countries

[ivinsfan]

This past summer, I went through 45 radiation treatments at our local cancer center. Every day in the waiting rooms, I sat and I spoke with the Canadians there begin treated for their cancers. A couple times my doctor [who serves on the hospital board] complained in my presence about the number of patients that come here for 'medical tourism'.

The standard reason that I heard from the tourist patients is that in Canada they do not have enough radiation oncologists.

I have met these people 'In Real Life', so I do not have any inter-webbz link to prove the existence of these real people.

I am certain that you will want to argue this because you have found some inter-webbz article that proves real life does not exist.

I live in real life and I can easily discuss what goes on In Real Life. How that is reflected by the inter-webbz is a mystery.

I am just glad that my personal radiation treatments are over.

I am happy for you that they are over and hope you are doing well. However based on the above comment your doctor is a tool. No cancer patient or any patient for that matter deserves to be complained about as a "medical tourist"...

 

[ShokWaveRider]

This past summer, I went through 45 radiation treatments at our local cancer center. Every day in the waiting rooms, I sat and I spoke with the Canadians there begin treated for their cancers.

Did they mention that it was fully covered at no cost to them (Including Travel and accommodation) by their CANADIAN socialized HC system? My BIL had the same thing, if the waits were long in Canada, they asked if he wanted to get treatment in the USA at no cost to him, and fully covered by OHIP (Ontario Heath Insurance Plan). He did. Canadian HC plans have a negotiated rate with US providers for such scenarios. There is nothing new or wrong with that.

However, if the wait is not so long and/or not life threatening, the patient can opt to do the same at their cost. Again that is normal in any system. Would be like going to Thailand for dental treatment or hip surgery.

 

[MRG]

I am happy for you that they are over and hope you are doing well. However based on the above comment your doctor is a tool. No cancer patient or any patient for that matter deserves to be complained about as a "medical tourist"...

+1

I used to travel to Rochester MN. often. Many people from all over the world went there for treatment. What's the problem? There's a large local, non medical, economy based on providing services for these folks.

 

[Offgrid Organic Farmer]

I am happy for you that they are over and hope you are doing well. However based on the above comment your doctor is a tool. No cancer patient or any patient for that matter deserves to be complained about as a "medical tourist"...

That is the commonly used term. I cant help that.

This cancer center / hospital is a non-profit corporation. His complaint was more about the requirement on the hospital to treat all patients who show-up for treatment, and their budget crisis in balancing out the expenses.

Did they mention that it was fully covered at no cost to them (Including Travel and accommodation) by their CANADIAN socialized HC system? My BIL had the same thing, if the waits were long in Canada, they asked if he wanted to get treatment in the USA at no cost to him, and fully covered by OHIP (Ontario Heath Insurance Plan). He did. Canadian HC plans have a negotiated rate with US providers for such scenarios. There is nothing new or wrong with that.

However, if the wait is not so long and/or not life threatening, the patient can opt to do the same at their cost. Again that is normal in any system. Would be like going to Thailand for dental treatment or hip surgery.

No, they want to have cancer centers near to where they live.

It is interesting how my prostate cancer wants to leave my prostate, to metastasize through-out my body and to kill me. Yet some would say that was a 'non-life-threatening' or an elective procedure. Any cancer that is spreading through your body, is threatening to kill you. To call that 'non-life-threatening' or elective, is a bit of an insult.

You can not see my cancer. You can not see most of the cancers that are treated here. But most of these cancers are trying to kill the patient. Which in my eyes, if the very opposite of 'non-life-threatening'.

My understanding is that this is a matter of politics between provinces. If you live in Newfoundland and you need a procedure that is not offered in Newfoundland, you can not drive to New Brunswick to get treatment. Your only 'elective' option to save your life is to drive down into the USA.

Living in a border town region is interesting in what you can pick up along the way.

 

[ivinsfan]

OOF it's not the term "medical tourist" that's the problem it your doctor complaining about them that is the problem. But I'm pretty sure you knew what I meant.

No one said your cancer wasn't life threatening the poster explicitly said if the wait for treatment in Canada wasn't considered life threatening some patients choose to get treatment sooner in the US, which seems to be the very thing your doctor was complaining about. What side are you on, exactly.


And before someone else does, I will point out that no hospital is required to give long term cancer treatment for free to anyone who shows up on their doorstep.

 

[Midpack]

This past summer, I went through 45 radiation treatments at our local cancer center. Every day in the waiting rooms, I sat and I spoke with the Canadians there begin treated for their cancers. A couple times my doctor [who serves on the hospital board] complained in my presence about the number of patients that come here for 'medical tourism'.

The standard reason that I heard from the tourist patients is that in Canada they do not have enough radiation oncologists.

I have met these people 'In Real Life', so I do not have any inter-webbz link to prove the existence of these real people.

I am certain that you will want to argue this because you have found some inter-webbz article that proves real life does not exist.

I live in real life and I can easily discuss what goes on In Real Life. How that is reflected by the inter-webbz is a mystery.

I am just glad that my personal radiation treatments are over.

I am truly sorry for your health issues, and hope you're better now.

And I am not disputing your experience, it's consistent with what I shared in the post you're quoting, it appears Canada probably has the longest wait times of all the OECD countries reporting.

If you choose to ignore the data from all other countries and use your local experience between Maine and the Canadians just across the border, that's your choice. But you may miss the big picture we're all subjected to, and how your health care costs and outcomes compare to what's clearly possible based on dozens of other developed countries with universal health care. As I said in another post on this thread, that's why the electorate in the US largely doesn't care, willfull ignorance...

 

[pb4uski]

.... Insurance companies in the USA make record profits. ....

Not sure if you know this or not but ACA put limitations on how much insurance companies can charge for health insurance... generally speaking they can only charge 125% of their claim costs... the 25% goes to cover taxes, overhead/general administration and profit. The 125% is for the individual and small group markets... it is 117.6% for large groups. You'll often see this expressed as minimum claim ratios of 80% and 85%, respectively.

There have been some instances where insurers paid rebates to policyholders because it ended up that the premiums that they charged exceeded the limits.

So what this means is that the principal reason that premiums are increasing is due to increased claim costs. If an insurer were right at the limit and increased premiums 20%, then at least 16% of the increase is attributable to the insurer expecting higher claim costs and at most 4% of the increase contributes to taxes, overhead and profit.

 

[ShokWaveRider]

Canada probably has the longest wait times of all the OECD countries reporting.

This all depends on location, when we lived in Canada, wait times were about 2 - 8 weeks for non doctor or specialist services, i.e. MRIs, CAT scans, minor surgery, anything urgent has very little if no wait time at all (Just like here in the USA), Is that long, maybe for some? Where we are now in the USA it is about the same.

I had a cyst removed that was not life threatening, the biopsy was done in the docs office at diagnosis time, results took a week. Removal was scheduled for 2 weeks later. That was in Calgary, Alberta.

My sister had congestive heart failure, went to the emergency room, was admitted immediately into hospital and spend 2 weeks there. All at zero cost to her other than her taxes. She was in Mississauga Ontario covered by OHIP.

So just like in the USA it is subject to a lot of things.

The KEY point to all this is that, other than taxes and any Provincial HC premiums, there is no Insurance funny business that comes into play.

 

[zaqxsw]

This is what the USA government will NOT be able to ignore. Forget Republican vs. Democrat. Mid-term elections already called it out. Any political group ignoring this dynamic will suffer.

 

[Gearhead Jim]

Our older daughter took an 18 month contract for a high paying job in London, starting in April. She is covered by the British National Health System.


She's healthy but had several poor experiences already, it seems that preventive medicine is not understood there. She made an appointment for an every-3-year skin check at a dermatologist and cleaning/checkup from a dentist. In both cases, the doc asked "what's wrong with you today?". When told that she didn't know of any problems at the moment but wanted to be checked, each doc seemed astounded and sternly told her that they don't treat illnesses that don't exist.
She travels to weird third-world countries where medical care is almost non-existent, and carries some antibiotics to stay alive until getting back to civilization if injured or sick. Nope, NHC won't write her a prescription unless she's sick, "just go to a doctor" who may be three days travel away.
Bizarre.


Her company decided to give her US health insurance also, so she comes back here for routine medical/dental work and uses NHS for emergencies.


But I guess the British NHS is less expensive...

 

[ShokWaveRider]

The opposite is true here In the USA. Docs will see you and charge for basically anything. Preventative treatment in the UK is OK for Colonoscopies, Mammograms etc. but at longer intervals. Honestly I prefer it that way.

Your daughters situation is very different. Her company should have paid for her to go to a private clinic in the UK which would have looked after her. It was the same for me in the USA, UK and Canada when I used to travel to obscure places and Vaccines were required, or desired but not covered by normal insurance. however, my company paid for the services to get me all up to date. I think that is normal.

 

[Alan]

Our older daughter took an 18 month contract for a high paying job in London, starting in April. She is covered by the British National Health System.


She's healthy but had several poor experiences already, it seems that preventive medicine is not understood there. She made an appointment for an every-3-year skin check at a dermatologist and cleaning/checkup from a dentist. In both cases, the doc asked "what's wrong with you today?". When told that she didn't know of any problems at the moment but wanted to be checked, each doc seemed astounded and sternly told her that they don't treat illnesses that don't exist.
She travels to weird third-world countries where medical care is almost non-existent, and carries some antibiotics to stay alive until getting back to civilization if injured or sick. Nope, NHC won't write her a prescription unless she's sick, "just go to a doctor" who may be three days travel away.
Bizarre.


Her company decided to give her US health insurance also, so she comes back here for routine medical/dental work and uses NHS for emergencies.


But I guess the British NHS is less expensive...

I’m surprised that her high paying job didn’t come with health insurance as that is very common and has been for decades. Health insurance came with the jobs I had between leaving university and moving to the USA in 1987. Our son moved back to England last year and his job is not high paying but his company still provides health insurance. Over 4 million folks in the UK have health insurance, most through employment. Earlier this year I visited my NHS doctor here as my wife didn’t like the look of a mole on my back. I don’t have any history of skin cancer or any of my family but my doctor didn’t question my request for an exam and he not only agreed that the mole looked suspicious but he saw 2 other lesions that he didn’t like the look of and referred me to a dermatologist. 6 weeks later I’d had the mole and lesions incised, tested and fortunately negative results. I’m sorry to hear that your daughter had a bad experience.

While working in the USA I occasionally had to travel to India and it was my company not my insurance that paid for the vaccinations needed and daily pills in case of exposure to malaria. I used to travel to Europe and the UK a lot on business and my US health insurance covered me. I could go onto their website and check the hospitals and specialists that were in network in the places I was traveling.

 

[Gearhead Jim]

Shokwave and Alan-
Her company did/does indeed pay for private health insurance, she moved to England in a big hurry and it took a while to get everything organized. I should have mentioned that before, but my point is that the standard NHC was really falling short.


Like the sign in the auto repair shop said;
"You can have it fast, cheap, or good. Pick one."

 

[ShokWaveRider]

but my point is that the standard NHC was really falling short.

Like the sign in the auto repair shop said;
"You can have it fast, cheap, or good. Pick one."

I think Alan (Not Typing for him), all of my relatives in the UK, and All of my friends in the UK, all of which use the system every day, would probably disagree with you on an overall service basis.

Yes all systems have their issues and will experience some things that their recipients are not happy with. But on the whole it works. Also there are way fewer cases of folks not being able to afford their medications. There are also virtually Zero cases of folks going bankrupt because of HC. The complete opposite of what we have here in the USA, with HC being a prime, if not the main reason for most bankruptcies.

I can list plenty of similar things that have occurred with my USA friends and myself, that have not been up to par too. Mostly from a billing perspective I will admit, but also our fair share of service issues.

I think (IMHO) if the insurance companies were not in the middle of HC service in the USA it would most likely improve by leaps and bounds.

 

[Alan]

Shokwave and Alan-
Her company did/does indeed pay for private health insurance, she moved to England in a big hurry and it took a while to get everything organized. I should have mentioned that before, but my point is that the standard NHC was really falling short.


Like the sign in the auto repair shop said;
"You can have it fast, cheap, or good. Pick one."

By coincidence I just read a post today from one of our regular members on the US/UK Expat forum I frequent. She is British, and her American husband had just taken himself to the ER here where he was worried about an old bullet wound from a gun accident 35 years ago. He said that he was treated like a celebrity as this was the first American they had seen and no one there had ever seen a gunshot wound before so he had several doctors drop by. (The wound was high up on his thigh and x-rays revealed calcification rather than bullet fragments were causing his discomfort).

Nothing to do with this thread, I just thought the story was pretty funny.

 

[haha]

Do the HC providers push more tests and procedures b/c of money? This concerns me. I always wondered if a disease was eradicated, would the HC industry lose money. I'm thinking of diabetes and cancer.

Pretty much the only diseases that have been eradicated or nearly so Are communicable diseases where someone in a university or NIH lab will work immunological magic. He or she are not bothering his/ her own or their confreres’ living. Maybe they even enjoy bombing those fat cats driving around in their Mercedeses. And imagine the bonuses with something as successful as the measles or polio vaccines. At least I hope Drs. Sabin and Enders got some good bonuses!

Ha

 

[NoMoreJob]

I haven't read all the posts so sorry if this duplicates another comment....But wouldn't our per capita spending number include all the $$ spent by those coming to the U.S. for treatment? I have no idea what this number would be but it seems to be a common occurrence especially for complicated (expensive) treatments.

 

[brett]

There are two things that we like about the health system in Canada.

The first is that we can retire at any age and not concern ourselves with the impact of health insurance premiums on our retirement. It is not part of the financial discussion.

The second is that we will never be forced to sell our assets or declare bankruptcy because of medical bills.

 

[Rianne]

There are two things that we like about the health system in Canada.

The first is that we can retire at any age and not concern ourselves with the impact of health insurance premiums on our retirement. It is not part of the financial discussion.

The second is that we will never be forced to sell our assets or declare bankruptcy because of medical bills.

Nor will you be refused treatment. Or have sleepless nights worrying if pre existing conditions will be declined if ACA overturned.

 

[6miths]

Yes never having to worry about whether one is covered is huge. Not related to employment or location in the country. No concern whether someone is in or out of network, no surprise bills, no deductible, no maximum, no one trying to kick you out of the plan if you get sick. No system is perfect but peace of mind is pretty valuable.