Canadian Premier Will Have Heart Surgery in the US

[lets-retire]

Leaving the fact that a prominent Canadian has left the country to obtain health care in ours, I'll make one comment. His million dollar procedure is money US citizens are not spending, but is added to the per capita amount that US citizens spend on health care, further inflating the amount Americans appear to spend.

 

[Bikerdude]

His procedure is not available in England? Maybe too far to travel or problems with bumping someone from the wait list there?

 

[Meadbh]

On the one hand, I want to keep an open mind until I know what procedure he had. If the procedure is available in Canada, even if Danny Williams had to go to another province, I would prefer that he had it in this country. If the procedure is not available in this country, maybe there's a reason. Not even a health system the size of Canada's can do everything for everybody. Outsourcing rare procedures is one way to avoid white elephants and underutilized services for zebra indications. Perhaps the market is the best way to match supply and demand for loss leaders.

On the other hand, Mr. Williams, while the Premier of Newfoundland and Labrador, is also a citizen and a multimillionaire. I guess he has the same rights as anyone else to make his own decisions.

It's unfortunate that being in the public eye practically requires politicians to explain their most private details, things that I personally think are nobody's business but their own. I feel sad, for example, that the leader of the federal New Democratic Party (a previously very fit and healthy guy) felt he had to have a press conference yesterday to announce that he has prostate cancer. TMI, IMHO!

 

[eridanus]

It would appear that there are some medical care innovators among US insurance companies, too...

Insurers aim to save from overseas medical tourism - USATODAY.com

Until recently, most Americans traveling abroad for cheaper non-emergency medical care were either uninsured or wealthy. But the profile of medical tourists is changing. Now, they are more likely to be people covered by private insurers, which are looking to keep costs from spiraling out of control.

It's ironic that the citizens of a country whose employer-based, pre-existing condition, health care plan has been repeatedly shoved in our faces as a shining model of "what works" can't get the care they need under their program.

This speaks volumes about America's health care system, and couldn't come at a better time.

 

[TomCat]

I do find it amazing that those of us that have quality (and very expensive) health care insurance think everything is just right...never looking beyond your own situation.

When the statement is made..."certainly we need to cover the uninsured but not as proposed"...it is never accompanied by any proposal that can get the job done. Truth is that many are just fine as we are...with many millions not insured for health care...and MANY more joining the ranks each day.

More of you may consider it a problem as your health care costs skyrocket...or you lose your coverage altogether. BTW...I personally have been fully insured since I was in college (40+ year ago)...but wife and I are now paying close to $13K per year (for a high deductible/out-of-pocket plan) as self employed...and increasing very rapidly.

My macro proposal would

1st Drop any pre-exisiting condition requirement from ALL medical insurance.

2nd Require insurance companies to provide "community" pricing where all coverage must be priced the same...wether you are a mega corp or a sole proprietor...maybe a small % addition for admin costs. Thus any buyer could shop the coverage and get identical pricing as large company w/o reagrd to pre-exisiting.

3rd Drop the cross state lines insurance buying restrictions

4th Establish a buying co-op that compares pricing and coverages from many/all commercial insurance companies from across the country...info only and NO gov plan.

5th Deal with the uninsured within the commercial insurance offerings...debate what subsidies/tax breaks to support purchase.

6th Establish long-term goals for coverage %...maybe ten years or so...to allow cost control, creativity and debate to play a factor.

Very macro and contemporaneous...but it is not "Canadian plan" but it does start "reform".

Don't gripe about other countries when many/most indutrialized countries outperform our health care system...when you consider the ENTIRE population...but certainly not for us with expensive plans...we are just fine...TomCat

FWIW...Tom Cat

 

[samclem]

Tomcat,
What advantages do you see in people continuing to get their health insurance through their employer? And, how will we avoid sky-high premiums under your plan if we don't require that everyone buy insurance? If insurers have to insure all comers, and if the rates are the same for everyone, then it makes perfect sense to wait until you're sick or injured to buy insurance.
But, I agree with the overall approach you've outlined.

 

[TomCat]

Tomcat,
What advantages do you see in people continuing to get their health insurance through their employer? Perhaps making tax deductible with any means of purchase? My thought is it would be nearly impossible to "change" employer role...but it could evolve if you "equalized" with private purchase.And, how will we avoid sky-high premiums under your plan if we don't require that everyone buy insurance? If insurers have to insure all comers, and if the rates are the same for everyone, then it makes perfect sense to wait until you're sick or injured to buy insurance. Got me here...haven't figured out these two issues.
But, I agree with the overall approach you've outlined.

Great input...my primary impetus would be to "begin" the process of "reform". I do believe it is nearly impossible to get anything major through congress at this point...perhaps compromise will become more common when congress changes to more balanced in Nov 2010. I am a centrist and one fact I do not like is congress and presidency controlled by one party...no matter which one! TomCat

 

[Gone4Good]

I like the system here, too, because I am reasonably rich, employed, and healthy. For now.

The later being an absolute prerequisite for the former.

 

[Gone4Good]

My macro proposal would . . . .

1st Drop any pre-exisiting condition requirement from ALL medical insurance.

2nd Require insurance companies to provide "community" pricing

3rd Drop the cross state lines insurance buying restrictions

Requirements 1 & 2 are the primary reason why insurance costs differ so much between states. High cost New Jersey enforces 1 & 2 whereas low cost Texas does not. The entire "benefit" of point number 3 is that it circumvents the high cost requirements of 1 & 2. If 1 & 2 are universally applied throughout the U.S., point 3 will be of very little value.

There is no magic cost reduction to be had in allowing people to buy insurance across state lines. The savings come almost entirely from allowing insurance companies to deny coverage to sick people, which kind of defeats the purpose of health insurance.

 

[ziggy29]

There is no magic cost reduction to be had in allowing people to buy insurance across state lines. The savings come almost entirely from allowing insurance companies to deny coverage to sick people, which kind of defeats the purpose of health insurance.

I don't know. Sometimes it comes because there are mandates that some states cover X while other states have no such mandate. In that case it would make sense for someone who has no reason to care about being covered for X to shop elsewhere, or else they are paying for mandated coverage that is of little to no concern to them.

Frankly this is a lot more complicated than simply "big bad insurance companies screwing people" -- which is a popular rallying point but is only one piece of a much bigger problem. And we do the issue (or constructive dialogue) little justice to look at it that way. Same as when some view tort reform as a magic bullet.

 

[M Paquette]

There is no magic cost reduction to be had in allowing people to buy insurance across state lines. The savings come almost entirely from allowing insurance companies to deny coverage to sick people, which kind of defeats the purpose of health insurance.

Well, a company could decide to shop for states with the most favorable rules for their business model, and set up shop with that as their home state. That could improve the company's margins. It might not be the best for persons insured by that company, and would probably have little effect on the actual cost of medical services. (Cutting re-imbursement to doctors and hospitals typically results in fewer doctors or hospitals accepting that insurance. See UHC and their cutbacks a few years ago where many doctors, and Quest Diagnostics were not in their plan any more.)

I suspect that a simple rule to allow interstate insurance sales, with companies operating under the rules of their 'home state' would simply result in a race for the bottom, with a few states competing for the [-]tax base[/-] insurance business by promulgating ever more favorable regulations.

 

[Gone4Good]

I don't know. Sometimes it comes because there are mandates that some states cover X while other states have no such mandate. In that case it would make sense for someone who has no reason to care about being covered for X to shop elsewhere, or else they are paying for mandated coverage that is of little to no concern to them.

Another term for that is "adverse selection". As in . . . I'm perfectly happy not having coverage for cancer, because I don't have cancer. My state doesn't mandate that my insurance company provide it, so I don't have it (and I might not even know I don't have that coverage, but boy is my insurance cheap). However, as soon as I get diagnosed, I'm going to sign up for that out-of-state plan where they have guaranteed issue laws and can't deny me coverage for pre-existing conditions.

You do realize that a system like that can't possibly work, right? The state with the least regulation ends up setting the rules for every other state. Any state that tries to mandate some higher level of coverage ends up getting swamped with sick people who aren't insurable in the other markets. Allowing people to buy insurance across state lines is nothing more than a back door way of deregulating the health insurance market. Which is what many of the supporters of this actually want. But if your goal is to make sure sick people have access to care, I don't see how this helps. The argument that it lowers costs so people can afford it is laughable because it only lowers costs for healthy people, but it does so at the expense of the sick who either pay more or go without insurance. Which is an ideal solution for those who never plan on getting sick.

But hey, that's how a free market for health insurance would work, so it must be the right thing to do (according to some).

Frankly this is a lot more complicated than simply "big bad insurance companies screwing people"

I don't believe I said that. The point is, providing health care to sick people is expensive. So it logically follows that providing health insurance to sick people is going to be expensive. States with tough regulations force companies to bear the costs of insuring the sick, and those costs are reflected in higher rates. You can lower those rates by getting rid of the regulation but don't expect to get coverage for sick people that way.

 

[samclem]

Here's an example that Premier Williams might do well to review.

(CNN) -- Rep. John Murtha of Pennsylvania, a longtime fixture on the House subcommittee that oversees Pentagon spending, died after complications from gallbladder surgery, according to his office. He was 77.



The Democratic congressman recently underwent scheduled laparoscopic surgery at National Naval Medical Center in Bethesda, Maryland, to remove his gallbladder. The procedure was "routine minimally invasive surgery," but doctors "hit his intestines," a source close to the late congressman told CNN.

It is very sad and regrettable that Congressman Murtha passed away after this routine surgery. But, I'm sure that could happen at any hospital. The important thing isn't the medical result, but to take the deeper lesson from this. All of us, US and Canadian residents alike, need to just use the government-provided health care if it is available and not complain or seek any advantages that might come from private medical treatment.

 

[Gone4Good]

All of us, US and Canadian residents alike, need to just use the government-provided health care if it is available and not complain or seek any advantages that might come from private medical treatment.

Are you saying that government run health care killed John Murtha?

 

[samclem]

Are you saying that government run health care killed John Murtha?

Well, yes, is there any doubt? It appears that the care he received at this government-run hospital did kill him. That's not to say this kind of thing doesn't frequently happen elsewhere, or that the health care was substandard, or that it was substandard because it was government-run. That would require a lot more analysis and evidence.

 

[eridanus]

That's not to say this kind of thing doesn't frequently happen elsewhere, or that the health care was substandard, or that it was substandard because it was government-run. That would require a lot more analysis and evidence.

Yes, it would. But don't let that stop you.

 

[M Paquette]

The National Naval Medical Center in Bethesda is considered the flagship of Navy medicine and provides the highest quality of care. There's a reason that it provides services for the President of the United States, members of the President's cabinet, Congress, Senate, as well as all branches of the armed services.

Bad things can happen in surgery, even with the best surgeons and staff. There are no guarantees.

 

[Gone4Good]

Well, yes, is there any doubt? It appears that the care he received at this government-run hospital did kill him. That's not to say this kind of thing doesn't frequently happen elsewhere, or that the health care was substandard, or that it was substandard because it was government-run. That would require a lot more analysis and evidence.

So if you don't know the answer, and if it's possibly all the same, why bring it up?

This is a technique I've noticed on certain "news" shows that is used to perpetuate falsehoods without actually taking responsibility for doing so. "I'm not saying xyz, but isn't it interesting . . . "

 

[samclem]

A lot of sensitivity and jumping to conclusions around here.

The OP was about a Canadian politician who was eligible for government health care but has elected to seek out private care at his own expense. Here we have a US politician who was eligible for government health care and elected to use it rather than seek out private care. Parallel situations, that's all.

After all, Senator Edward Kennedy, well known champion of public health care, elected to use private care for his own cancer treatment. And, he didn't survive his disease. So, all of these are just individual cases, not ones that can be used to draw conclusions about the relative quality of health care at either govt or private health care providers.

Edited to add: According to this site, which shows the results of studies covering 1208 laparoscopic gall bladder removals, there was one death among this group of 1208 operations and it was "not directly related to this procedure." Of course, each case is different, and Senator Murtha was 77 years old.

 

[Gone4Good]

The OP was about a Canadian politician who was eligible for government health care but has elected to seek out private care at his own expense. Here we have a US politician who was eligible for government health care and elected to use it rather than seek out private care. Parallel situations, that's all.

"I'm not saying xyz, but isn't it interesting . . . "

 

[mark500]

He's doing something that reflects a common seemingly hypocritical phenomenon with lefties.

Universal health care is good for everyone else, but not me. Do you think anyone in Congress or the president will ever go to a nurse practitioner for care?
Same with private schools. Lefties send their kids to private schools while expressing their support for public schools.

 

[TomCat]

He's doing something that reflects a common seemingly hypocritical phenomenon with lefties.

Universal health care is good for everyone else, but not me. Do you think anyone in Congress or the president will ever go to a nurse practitioner for care?
Same with private schools. Lefties send their kids to private schools while expressing their support for public schools.

A diversionary arguement that avoids the primary question...should all Americans...ie; the poor...be entitled to health care? That question has nothing to do with what someone of "means" chooses to do for their health care.

American health care is quite good...for those who can afford it. If you compare TOTAL population health care statistic we (US) are fairing quite poorly...no pun intended. It is those w/o health care insurance who would be provided for much better if they lived in Canada...or any other industrialized country. I am fine...I am sure Mark is fine...WE are not the issue...it is those who cannot afford health insurance coverage (an ever increasing number) who have the problem.

Mark...how do you propose to provide health care for the "poor"...make them wait until a crisis and show up at the emergency room as uninsured? That is how it is handled now.

Irony is that if we knew the cost of uninsured care within our emergency room and community hospital system...we could probably pay for basic health insurance for the amount already being very inefficeintly spent in emergency care.

Notice my lack of deragatory "terminology"...not sure what labels ad to the debate. TomCat

 

[Rich_by_the_Bay]

Notice my lack of deragatory "terminology"...not sure what labels ad to the debate. TomCat

Amen.

 

[Bikerdude]

American health care is quite good...for those who can afford it. If you compare TOTAL population health care statistic we (US) are fairing quite poorly...no pun intended. It is those w/o health care insurance who would be provided for much better if they lived in Canada...or any other industrialized country. I am fine...I am sure Mark is fine...WE are not the issue...it is those who cannot afford health insurance coverage (an ever increasing number) who have the problem.

.TomCat

I agree American health care is good and I like it that way. While expensive, its nice to be treated quickly when needed. I also agree that the poor here would be better off with a Canadian type HC plan. Hey, if someone else is paying your HC you should not mind waiting in line for some procedures. As for costs of HC how much is too much to pay? Should we force young healthy people to have HC insurance? I can't see how we can expect the insurance companies to treat preexisting conditions unless we require everyone to have insurance. These are the hard choices that have to be made but special interests on ALL sides are making it difficult if not impossible.

 

[youbet]

but special interests on ALL sides are making it difficult if not impossible.

There ya go........

Push for single payer and folks with cheap (to them), deluxe insurance such as union members and gov't employees throw a hissy fit that they don't want to give it up. Push for changes to private insurance rules and regulations and the uninsured and their advocates and the poor scream that they need more than catastrophic coverage, they need first dollar coverage for routine care. Middle class worker bees want coverage that might allow them to stop working or stop working sooner. And on and on and on.........