health care reform?

[petek]

The Canadian government doesn't control health-care each of the individual provinces have their own province-wide universal health care systems. What the federal Canadian govt does is lay down the "rules" the provinces have to follow if they want any federal subsidies for health care. Technically any province could opt out of the federal plan if they wanted and go it alone. Much the same as the US govt does forcing states to impose 21 y.o. age limits on drinking etc if they want to receive federal monies for highway improvements etc.
There isn't any federal department that is involved in the day to day administration of doctors and hospitals at all. Each province runs its own doctors and hospitals and can pretty much run them as they want so long as there is no profit involved. For profit hospitals are illegal in Canada. Every province is free to set it's own formulary as to what is covered and what is not and they aren't the same in every province so something that is covered here in Ontario may not be covered elsewhere etc. Those things are generally of a minor nature though. Nowhere in Canada would a person pay out of pocket for a necessary surgery or life threatening event. They may pay for the ambulance ride to the hospital though and you'll pay extra for a private room over a ward room or a two person room.
For example a private room in our local hospital costs about $300 day if you don't have private insurance thru your employer etc, a semi-private 2 person room is about $250 a day. If you don't have the money, insurance or are just cheap then you get a "ward" room with up to 4 people in it.
The ambulance to the hospital here is about $60 if you don't have private insurance to cover it.
Those prices could be totally different in another province.

As well any provincial government and our own federal govt that gets elected usually every 4 years are extremely leery about tinkering with our health care systems. It's probably the hottest issue in the country, hotter than the US gun control and abortion fights. A politician or a political party could go down in flames here quickly, faster than can happen in the US usually if he tried to pull a fast one or make hugely unpopular changes.

 

[ronhic]

mmmmm.....sounds like the Commonwealth and European countries have health high on the agenda and whilst there are many differences, basically it means if we get sick, we can afford to go to hospital or a doctor and know that we will be looked after (generally speaking) and obtain medicines without causing bankruptcy.....with or without private health cover.

...and lets not forget the reciprocal arrangements that Australians have with nine other countries....

Is it any wonder travel insurance to the US is the highest priced in the developed world.

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www.medicareaustralia.gov.au

 

[jeffg]

A fact that isn't brought up very often in our media is that America's health care system is already socialized, and has been for a very long time. You can walk or be brought into any hospital or county health clinic in the U.S., and you will receive emergency or urgent care -- free of charge if you can't pay -- and the cost for this care is passed onto taxpayers.

All Obama wants to do is replace this current and hugely inefficient socialized system with one that costs *much* less.

 

[launderess]

Not Exactly

Yes, under federal and some local laws hospitals cannot refuse "emergency" care, and not-for profit hospitals must provide a certian level of charity care. It does not automatically follow if one cannot pay one simply walks away and that is that.

Many, many hospitals not only run credit checks, but take down enough information to turn your upaid charges over to a collection agency. Also when one is provided with emergency care, it tends in most instances to be just that. One will be treated until the crisis is either over or stable, then either discharged or transferred to a place such as a city or country run hospital which by their nature and statute take in all persons.

In response to what many hospitals see as deluge of persons seeking emergency care for free, many hospitals are closing their emergency rooms period. This means the only way to be admitted is by a doctor who can do so.

 

[jeffg]

You missed the point, L. The issue isn't whether people are treated -- they ARE treated -- it's how much this treatment winds up costing us. Our current system is incredibly inefficient and expensive, we pay something like EIGHT TIMES as much for the EXACT SAME CARE as other industrialized countries.

 

[launderess]

Tell You What Should Be Done

The United States already spends vast sums on health care, including via the tax deduction for workers health insurance than any other nation, with by many markers dismal results.

Create a national "health care plan", that provides a basic level of insurance for all. If persons want more coverage they can purchase that on the open market.

Remove Medicare and Medicaid, which were never designed to be insurance, and still aren't they are a benefit plan, and set the following parameter:

Below a certian income the federal government and the states will pick up the tab (as with Medicaid).

Above and below a certian age, the same will apply, (same as with Medicare and various federal and state children's health plans).

On the cost containment side, someone is going to have to look down and see they have grown a pair and make some hard choices. Set up a national drug formulary and let the federal government use it's mass purchasing power to control costs. Same thing for other medical supplies.

Pay doctors and others to keep persons healthy, rather than treat them when they are ill. What mainly happens in the United States is people neglect their health until something is found, then a battery of tests and treatments are ordered. Routine and proper physical exams, along with a good doctor and patient relationship goes along way. This may even mean paying physicans a certian fee per patient, sort of putting them on salary as it were.

Establish one standard billing system, and get a handle on administrative costs. One of the reasons so much fraud goes on in health care is the billing system is very disjointed and scattered, with many insurance companies, hosptials, doctors offices,and such all using different systems. Add to this Medicare and Medicaid and you have reams of paperwork, much of it duplicate.

"Cosmo, I just want to tell ya, No matter what you do you're going do die, just like the rest of us".

Americans need to begin to face up to the fact not everyone can live to 100, and or have perfect healthy infants, and or expect every medical treatment to give 100% sucess. In short a short talking to about mortality is in order.

 

[launderess]

From One Formerly Employed In Health Care

I feel your pain.

However never really minded working the "summer" holidays (4 July, Memorial Day, Labour Day), long as one had Thanksgiving and Christmas off. To me those are way more important family holidays.

 

[appnut]

Read on chirren

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finance.yahoo.com

 

[petek]

However Bob,, from that quote re England France etc.

" costs have skyrocketed and in some cases, patients have needlessly suffered and died."

Let's analyze that sentence in particular. Yes costs have skyrocketed, costs for everything have skyrocketed around the world for everything including health care in just about every country on the planet,, nothing alarmist there about universal healthcare.

"patients have needlessly suffered and died" I'm sure some have, but exactly what percentage of the population of England and France have needlessly suffered and died because of their universal healthcare COMPARED to how many people have needlessly suffered and died in the USA because they didn't have any healthcare at all. They're making a bold statement with no facts or figures or pecentages given.

I'd bet dollars to donuts that a significant percentage more people have needlessly suffered and are suffering and dying in the USA prematurely because they don't have universal healthcare and can't afford to go to a doctor or get timely treatment when they need it.

The spin put in these commentaries and what they purposely "omit" in their comparisons is to me scare-mongering 101.

 

[sudsmaster]

The American health care system is a chaotic jumble. Yes, it gives excellent care if you have top notch health insurance or unlimited resources.

But if you don't have group health insurance through an employer, you really have your back up against the wall here when it comes to health insurance.

Without group health insurance, many people are denied coverage. Or, they are dropped from their private coverage when they get sick enough to actually need it.

On top of all that, the administrative overhead for private health insurance is something like 27%. For Medicare, it's around 10%. Where does that 17% go? Into the pockets of the for-profit health insurance executives and investors.

Also, medical bills are the #1 cause of personal bankruptcy in the USA.

We pay more than twice as much as other industrialized western nations for health care, but are twice as unhealthy.

What Obama and the Dems are proposing is a sorely needed reform to our health care system. It's not government run health care; it's guaranteed affordable health insurance for everyone, where you can't be denied for a pre-existing condition and you can't be dropped just because you got sick.

 

[tcox6912]

Insurance

I am blessed to be on my partner's health insurance plan ... but, there is a one million dollar lifetime cap. I was in the hospital for 8 weeks earlier this year & had 3 surgeries during that time. The insurance total was just under $600,000 ... that means that (at 44 years old) I only have $400,000 left till I make 65 and get on Medicare. The thought of this scares the hell out of me. Even with insurance, I don't feel safe anymore because one more big hospital stay could wipe me out. Todd

 

[iheartmaytag]

The private insurance companies are too large and too powerful to ever allow universal coverage. Look at the Medicare Part D fiasco.

The entire industry needs to be completely overhauled. Don't allow the insurance companies to base your premiums on if you are slow paying your Sear's account. Don't allow an insurance company to dictate to your doctor what your care should be. The drug companies and insurance companies are in bed together and they are happy whoreing together; if one of us little people get pushed aside--oh well.

 

[launderess]

France

Offers perhaps the closest thing the United States could use as a jumping off poing for universal health care.

The French system is slightly like the United State's Medicare and Medicaid program in that the government is the single payer, but IIRC one purchases the plan via various insurance agents. As with most other things in France, the basic plan is the same for everyone in France (central government don't you know), but one is free to purchase priviate insurance to cover things not offered by the state plan.

 

[ronhic]

Australia

...is similar.

- There is good basic coverage for all.

- If you have additional private insurance before you're 30 and maintain it you always pay the 30yr old rate

- If you decide you don't want any private coverage, you pay extra for medicare based on your income.

The link below is quite good and if you click on the blue 'medicare' under the bolded 'MEDICARE' it takes you to another interesting link about who can and can't.

A good statistic is that in the 04/05 financial year they provided 236 million services....

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www.medicareaustralia.gov.au

 

[whitekingd]

Universal health care, yes.

But the U.S. Government doesn't run ANYTHING efficiently. We mustn't let them be in control of health care!

 

[gizmo]

One thing being missed by the "everything governments do is bad" brigade is the role a government backed insurance system has in forcing the hand of the competing private insurers.

In AU we have a very good government owned system called Medicare. You also have the right to choose private health insurance, which provides extra services not covered by medicare (dental, chiropractic, physio, etc) and offers a higher level of accommodation (private room instead of shared ward, for example.) It can also offer faster service for non-urgent procedures.

The fact that there is a low-cost option which provides excellent care is a "market force" which places downward pressure on insurance premiums and pressures the companies to process claims in a speedy, efficient and friendly manner. Most health insurance companies offer a range of "free extras" such as discounted or free gym memberships, discount purchasing or loyalty point schemes, and other sweeteners. They have to do this because they have to actively attract customers. The basic Medicare system is pretty good, few people actually fear going "uninsured", so the whole for-profit health insurance industry has to work pretty hard to attract customers. Contrast this to the USA where people are dead scared to go uninsured, as a single hospital visit could bankrupt them, so they eagerly pay exorbitant premiums to insurance companies who are difficult to deal with, slow to pay up, and whose policies are full of escape clauses, benefit limits and other nasty fine print.

More later - past bed time.

Chris.

 

[wilkinsservis]

Gizmo is right about the Austarlian system but also...

The American and Canadian systems seem to suffer with two extremes-the American with its lack of universality and the outrageous fact that those who most need health care cant get insurance to cover them and the Canadian with its lack of choice and rationing of services.

Gizmo rightly points out the downward pressure that a good universal public health insurance scheme places on private insurers making them offer good, relevant and competitive products. But I need to add that there are some important forces that the privately insured allow others to bring to bear on the public sysytem. My being able to have my arthritic hip replaced a week after diagnosis as a private patient allows the uninsured to bring moral pressure to bear on the politicians in charge of our public system by asking why other people need to wait years to have a hip replacement with its associated pain suffering and disability.

The private sector is also more responsive and adaptable to technological innovation and improvement. In recent years many new techniques have been introduced first to private patients but the skills and knowledge quickly spreads to doctors in the public system as doctors can bring pressure to bear in the public system to introduce improvements that they have already seen benefit their patients.

Hence the privately insured patient has alot to thank Medicare for in Australia in offering a rational alternative to buying the private insurance products, but also the uninsured can thank those who do insure for creating higher expectations of and greater choice in the health system in general.

Trust me I'm a doctor...

Peter