Gene's Footnotes

I have never been impressed by the messenger and always inspect the message, which I now understand is not the norm. People prefer to filter out discordant information. As such, I am frequently confronted with, "Where did you hear that...." Well, here you go. If you want an email version, send me an email.

July 19, 2007

Canadian Medical Systems Cover All, Sort Of

New topic seems to be forming:

Canadian-Healthcare.org:

Canada's health care system is a group of socialized health insurance plans that provides coverage to all Canadian citizens. It is publicly funded and administered on a provincial or territorial basis, within guidelines set by the federal government.

Under the health care system, individual citizens are provided preventative [yes, they wrote that]care and medical treatments from primary care physicians as well as access to hospitals, dental surgery and additional medical services. With a few exceptions, all citizens qualify for health coverage regardless of medical history, personal income, or standard of living.

Canada's health care system is the subject of much political controversy and debate in the country. Some question the efficiencies of the current system to deliver treatments in a timely fashion, and advocate adopting a private system similar to the United States. Conversely, there are worries that privatization would lead to inequalities in the health system with only the wealthy being able to afford certain treatments....

That said:

As Canada's Slow-Motion Public Health System Falters, Private Medical Care Is Surging

Published: February 26, 2006 New York Times

VANCOUVER, British Columbia, Feb. 23 — The Cambie Surgery Center, Canada's most prominent private hospital, may be considered a rogue enterprise.

Accepting money from patients for operations they would otherwise receive free of charge in a public hospital is technically prohibited in this country, even in cases where patients would wait months or even years in discomfort before receiving treatment.

But no one is about to arrest Dr. Brian Day, who is president and medical director of the center, or any of the 120 doctors who work there. Public hospitals are sending him growing numbers of patients they are too busy to treat, and his center is advertising that patients do not have to wait to replace their aching knees.

The country's publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — is gradually breaking down. Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine.

Dr. Day, for instance, is planning to open more private hospitals, first in Toronto and Ottawa, then in Montreal, Calgary and Edmonton. Ontario provincial officials are already threatening stiff fines. Dr. Day says he is eager to see them in court.

"We've taken the position that the law is illegal," Dr. Day, 59, says. "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."...ETC

Canada's Medical Nightmare


Written By: Robert J. Cihak, M.D.
Published In: Health Care News
Publication Date: September 1, 2004
Publisher: The Heartland Institu


For decades, Canadians have cast pitying glances at us poor American neighbors who actually have to pay for our medical care while they get theirs for "free."

Yet the major candidates in Canada's recent national election both agreed the country's health care system is failing. They made the usual socialist diagnosis of "not enough money." None of the candidates mentioned government control as what ails the Canadian system.

On this side of the border, Senator Edward Kennedy (D-Massachusetts), with presidential candidate Senator John Kerry, also from Massachusetts, in tow, promotes Canadian health care to U.S. voters, in the hope we too can have "free" medical care.

From Heartland organization

.....High Costs, Low Quality

A July 2004 study by the Vancouver-based Fraser Institute, Paying, More, Getting Less, concluded that after years of government control, the Canadian medical system is badly injured and bleeding citizens' hard-earned tax dollars. The institute compared health care systems in the industrialized countries in the Organization for Economic Cooperation and Development (OECD) and found Canada currently spends the most, yet ranks among the lowest on such indicators as access to physicians, quality of medical equipment, and key health outcomes.

One of the major reasons for this discrepancy is that, unlike the countries in the study that outperformed Canada--Sweden, Japan, Australia, and France, for example--Canada outlaws most private health care.

If the Canadian government says it provides a particular medical service, it is illegal for a Canadian citizen to pay for and obtain that service privately. At the same time, the Canadian government bureaucracy rations medical services. According to another Fraser Institute survey, Waiting Your Turn: Hospital Waiting Lists in Canada (13th edition, October 2003), a Canadian health care patient, on average, must wait 17.7 weeks for hospital treatment. Those who live in Saskatchewan waited an average of 30 weeks, those in Ontario a relatively expeditious 14 weeks....

A 1992 Frasier study showed Canadian medical systems did not track data the way a business would, so there were no numbers to use to compare the system with the American system, unless you were Mrs. Clinton. (I added the last part.)

I will drill down into the Canadian numbers. I keep hearing numbers that seem impossible to believe as to the per person cost. Even assuming a bit of puffing by Dr. Beaver (you thought Grey Owl was the doctor you biased reader you,) we need to look into any savings a single payer system could present. For sure, next to the DMV, our medical billing systems in the U.S. are the most obvious examples of bad design and execution. If anything, the American medical billing is Kafkaesque. The billing system in Canada is refreshing, at least in ease of use.

While drilling down in the numbers, there is still the problem of waiting lists in Canada. One article I recently came across was entitled: Dying in Queue.

In any event, we have to get over the reflexive socialist blather that the Canadian system should be copied, especially as that system is moving to private care. The U.S. insurers and medical professionals had better come up with a solution, lest one be inflicted upon them - and us.

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