Health Care reform from a Doctors perspective

[Bluegoat]

Bluegoat,

I live in a border town, Windsor, ONT is right across the river from us. My wife is even from Windsor. So we have a lot of experience in seeing how both systems work.

We see exactly how the Canadian system reduces cost. My in-laws have problems finding a primary care physician. I always hear conversations at family events that include something like " My doctor is retiring, does anyone know anyone who is accepting new patients"

And we even see why, OHIP regulates the amount that doctors can bill. If they reach their annual maximum, OHIP will stop paying them, even if they see new patients.

My wife got to keep her dermatologist when she moved her. Why? because he keeps a practice here in the States. He sees enough patients in Windsor to reach his annual OHIP max, but no more. The rest of his patients he sees in his office in the States.

My wife’s cousin is a nurse, but she works in a Stateside hospital. Why? Because we pay our nurses a living wage over here, the Canadian hospitals were offering her almost half what a US nurse is paid, even at a non-profit Catholic hospital (where she works)

Needless to say, medical ‘tourism’ is also big here. There are billboards in both Windsor and metro Detroit that advertise for medical services, MRI’s are probably the biggest. There are long waiting lines in Windsor for such services.

Cancer consults and treatments are also big. My father in-law (lives in Windsor) had a blood test that indicated prostate cancer. It was 5 months before he could see an oncologist under the Canadian system. My father is a retired physician and got him in to see an oncologist friend within a few days here.

It was prostate cancer that has since been treated (deo gratias)

Oh, and my Canadian wife would not go into Windsor during the last few months of each pregnancy for fear that she might go into labo(u)r over there and get stuck delivering in a Canadian hospital.

Recently, however, there have actually been more Canadian doctors returning from the US than leaving, which is an interesting change.

There are certainly imperfections in Canada’s system. But you cannot simply compare your own family’s experience if they have good health insurance. Cancer treatment is one of the cases where the US system is generally considered better (if you are insured) though there are also more incidences of cancer.

As for doctors and nurses salaries - it would be nice for them if they got paid more. But I disagree that they do not get a living wage - my family has a lot of medical personnel (mostly doctors and nurses), and all are able to afford to live at a similar standard to others.

I am shocked your wife would prefer to deliver in an American hospital, unless she was in a particularly progressive one. THe American maternity care system is notoriously bad.

 

[Bluegoat]

Right n ow we have a significant medical tourism industry for instance medical facilities from norther border states treating Canada’s overflow. If we institute socialized medicine, and depending on how it is done, those foriegn patients would no longer be paying and even more would be flooding over. We would also have even more immigrants flooding in from around the world. this will obviously drive up costs.

You do realize that universal health care normally only applies to citizens and landed immigrants? That visitors have to pay the full costs for their care? THat in places that have medical tourism, it is a money generator? And that immigration is controlled by governmentand usually those accepted have a good wad of cash or a job? (not obviously, illegal immigration.)

It is not just the total costs that is at issue, it is the cost bore by the working class. Right now we have a growing problem with the welfare class demanding more and more entitlements and refusing to work for them. As there power grows, more people in the middle class are realizing that it is easier to quit work and join the ranks of the unemployed since their quality of life would not go down much.

You keep saying this. Have your unemployment stats risen mysteriously without reference to the state of the economy?

 

[Bluegoat]

Hillary Clinton?

No, much younger, and Republican, with Barbi hair.

 

[Irish_Catholic_1]

…As for doctors and nurses salaries - it would be nice for them if they got paid more. But I disagree that they do not get a living wage…

A living wage isn’t good enough. A car mechanic can get a living wage. Personally, I want someone of a little higher caliber operating on me.

Besides, the big thing being missed here is COST: Canada does not have NEAR the population nor the government expenses that we do. We simply can’t afford governemnt healthcare, even if we wanted it… …which we don’t. If our coffers were overflowing with money, I’d say SURE, provide all kinds of stuff for the folks. But we are in a 12 TRILLION dollar debt! I doubt if Canada has ever even seen 12 Trillion dollars.

And last but not least, I repeat my previous post:

And you want the Federal Government to fix it? The same folks who bribe fellow members for their votes with millions of dollars in earmarks, and who have run up a 12 Trillion dollar debt? Pulleeezz!

There is no more corrupt institution than the Federal Government. They make the insurance companies look like angels.

 

[marci]

A living wage isn’t good enough. A car mechanic can get a living wage. Personally, I want someone of a little higher caliber operating on me.

Besides, the big thing being missed here is COST: Canada does not have NEAR the population nor the government expenses that we do. We simply can’t afford governemnt healthcare, even if we wanted it… …which we don’t. If our coffers were overflowing with money, I’d say SURE, provide all kinds of stuff for the folks. But we are in a 12 TRILLION dollar debt! I doubt if Canada has ever even seen 12 Trillion dollars.

Another thing people always overlook is that when comparing how the US would implement gov health care with other countries, it becomes clear that cost would be much greater in the US. For example, Mexico has gov healthcare, but one also doesn’t need a perscription for many common drugs. If your child gets an ear infection you go to the Pharmacia and get amoxacilina. If you get a bladder infection, you go in tell the pharmasist and you get the pain killer and the antibiotic. No doctor visit, no waiting for hours for your prescription to be ready. The same thing goes in Russia. Also, they don’t have the lawsuit issues that we have here, which are also not being addressed in the bill.

When you combine the regulation in the US, legal issues, the FDA, illegal imigrants, unhealthy lifestyles, etc., with gov care, you are creating a situation which is very different from other countries.

 

[Bluegoat]

Besides, the big thing being missed here is COST: Canada does not have NEAR the population nor the government expenses that we do. We simply can’t afford governemnt healthcare, even if we wanted it… …which we don’t. If our coffers were overflowing with money, I’d say SURE, provide all kinds of stuff for the folks. But we are in a 12 TRILLION dollar debt! I doubt if Canada has ever even seen 12 Trillion dollars.

Another thing people always overlook is that when comparing how the US would implement gov health care with other countries, it becomes clear that cost would be much greater in the US. For example, Mexico has gov healthcare, but one also doesn’t need a perscription for many common drugs. If your child gets an ear infection you go to the Pharmacia and get amoxacilina. If you get a bladder infection, you go in tell the pharmasist and you get the pain killer and the antibiotic. No doctor visit, no waiting for hours for your prescription to be ready. The same thing goes in Russia. Also, they don’t have the lawsuit issues that we have here, which are also not being addressed in the bill.

When you combine the regulation in the US, legal issues, the FDA, illegal imigrants, unhealthy lifestyles, etc., with gov care, you are creating a situation which is very different from other countries.

It really seems to me that people are looking for excuses, rather than simply saying they do not want to pay for the care of other people, even if it means they get none.

A smaller population does not make health care less expensive. In the case of Canada, which is huge geographically, it adds significant cost because care must be provided over very large areas which are sparsley populated. This is a real challenge, and it costs a bundle.

As for drug costs - these are indeed a problem everywhere, but they are usually dealt with separately from a universal health care system.

Lawsuits are also related to the way insurance companies operate, though they are not actually a very big % of what is spent on health care, even in the US. If I recall correctly, the administrative costs and overhead required by having that kind of system of private insurance actually costs more than the payouts.

But these things can all be dealt with if people want to, and many particular circumstances can be addressed. Illegal immigration would be one, though that is much more far reaching than just health care.

 

[Irish_Catholic_1]

It really seems to me that people are looking for excuses, rather than simply saying they do not want to pay for the care of other people, even if it means they get none…

Dude:
Cost, and our budget crisis, is not an “excuse”, its a FACT.
At this time, we are coming dangerously close to a collapse of the dollar and a REAL worldwide economic calamity. I don’t think you fully understand the grave state we are actually in. And if we go down hard, you guys fall with us

 

[marci]

It really seems to me that people are looking for excuses, rather than simply saying they do not want to pay for the care of other people, even if it means they get none.

What I am trying to do is ensure that people have a choice when it comes to how to direct their own healthcare and their own lives for that matter. The truely poor in this country already have healthcare. It’s called medicaid, WIC, SChip, and many other state programs.

I live in one of the poorest areas in the country, right on the border. There are county health clinics all over town, and believe me they are top notch. My husband has tried to implement employee coverage at his business for years, but he can’t get enough of the employees to sign up for it. The excuse is always the same, why should I pay 75 or 100 dollars a month when I can go to the clinic for free?

Don’t assume that everyone who argues against gov take over of HC are a bunch of greedy bleeps that take pleasure in the thought of millions of poor people dying in the streets. Maybe, just maybe, it’s because we know it will be a disaster and will not do what it’s champions promise it will do.

 

[wabrams]

Your speach is judged that way because it is extremely predictable and no originality to it. It sounds like the Bush?Limbaugh bots I hear all the time. With the exception of a little of what RA says it is very vanillla and eye rolling. You all sound alike Now some may want to lump me in with all the liberal here, until I go off about money printed out of thin air, and the taking advantage of that system of doing things. Then you know I’m very independant. If you want to know who I am most like, read up on Chuck Harder. He is the closest to me out there,although Not identical in opinion to me either. If you are predictable you are going to be judged. That is human nature and I most certainly do not proclaim to be above that.

Again, I ask where is your proof?

 

[Irish_Catholic_1]

…It sounds like the Bush?Limbaugh bots I hear all the time…

You should be so fortunate to be as smart as Rush

 

[wabrams]

Cancer treatment is one of the cases where the US system is generally considered better (if you are insured) though there are also more incidences of cancer.

If you look purely at the number of incidences, then ew will always have higher numbers b/c we have a much larger population.

I am shocked your wife would prefer to deliver in an American hospital, unless she was in a particularly progressive one. THe American maternity care system is notoriously bad.

I would like to see some proof of this.

You do realize that universal health care normally only applies to citizens and landed immigrants? That visitors have to pay the full costs for their care? And that immigration is controlled by governmentand usually those accepted have a good wad of cash or a job? (not obviously, illegal immigration.)

Problem is, this “reform” they are trying to pass will also give illegal immigrants free healthcare.

 

[St_Francis]

It really seems to me that people are looking for excuses, rather than simply saying they do not want to pay for the care of other people, even if it means they get none…

I really take offense to this. It is very rude to assume that the reason people have a different point of view on something than you do is that they are greedy or mean or whatever. Suppose I said that those who advocated government-paid health care were just too lazy to pay for their own insurance?

That’s just a cheap shot and not any form of argument.

 

[royal_archer]

You keep saying this. Have your unemployment stats risen mysteriously without reference to the state of the economy?

Unemployment has gone up significantly since Obama pulled ahead in the polls in August/September 08. However I was refering to the general trend that goes back a few administrations. Did you realize that 1 in 3 Americans is on public assistance of some sort?

 

[royal_archer]

A living wage isn’t good enough. A car mechanic can get a living wage. Personally, I want someone of a little higher caliber operating on me.

Besides, the big thing being missed here is COST: Canada does not have NEAR the population nor the government expenses that we do. We simply can’t afford governemnt healthcare, even if we wanted it… …which we don’t. If our coffers were overflowing with money, I’d say SURE, provide all kinds of stuff for the folks. But we are in a 12 TRILLION dollar debt! I doubt if Canada has ever even seen 12 Trillion dollars.

And last but not least, I repeat my previous post:

Maybe if Canada picked up their fair share of the slack defending the free world we wouldn’t have that discrepancy.

 

[royal_archer]

But these things can all be dealt with if people want to, and many particular circumstances can be addressed. Illegal immigration would be one, though that is much more far reaching than just health care.

Illegal immigration and high unemployment/under employment are major issues that we are dealing with here. Adding socialized medicine will just further mask the under lying problems and allow therm to grow. We need to address these other issues before worrying about trying to reinvent the health care system.

 

[kfinstad]

… I have yet to see something convincing here that suggests that the cost of a universal system would be somehow far different than in other countries.

So, Bluegoat, you’re driving down the value of the U.S. dollar (USD), by investing in savings accounts, in Euroes, because they have a higher interest rate, higher yield, than here in the U.S… No wonder, you think, that American healthcare is inexpensive–you have one USD for every sixty-eight hundredths of a Euro (EUR).

That’s quite a contrast in terms of cost, universal healthcare, according to my U.S. representative for my district, is estimated to be at least, 1.2 trillion USD, and he pointed to a few areas, either understated, or overstated, and therefore, the estimate of 1.2 trillion USD is distorted; nonetheless, were the purchase of such a universal healthcare system to be purchased in EUR’s, the cost would be an estimated 800.5 billion EUR. Universal healthcare in America, against universal healthcare in EUR, dominated countries, is much more expensive in the U.S., and cheaper in EUR countries, with rounding-up, it is 134%, or one and one-third, more expensive here in the U.S., for universal healthcare. Nonetheless, there are people here more-than willing to pay for EUR, and therefore, for EUR universal healthcare. It doesn’t even look like the Chinese would get a very good deal, but it might be worth their while in some other terms. Who knows!

Moving away from Europe, and focusing on universal healthcare, say in Venezueala, or Costa Rica, the contrasts appear to be even more dramatic: using the Costa Rican Colon (CRC), the cost of universal healthcare, in the U.S., using Costa Rican Colons would be approx. 665.28 trillion CRC, and 2.577 quadrillion Venezuealan Bolivar (VEB).

It would be more cost effective to establish universal healthcare as maintained by such a Banana Republic as Costa Rica, in every country S. of the Rio Grande R., and have U.S. citizens fly to such countries for healthcare. There would be considerable benefits, and in terms of medication, much of the healthcare could be done by mail, cash out-of-pocket: the expenses would be covered by foriegn governments, and medical-tourism, which would make such care affordable to those having financial difficulties, for whatever reason(s), by freeing our U.S. taxes collected–to subsidize those whom we may trust: would need to be subsidized, and they could probably enjoy a round-trip ticket to a different climate, and culture. Who knows! There is Africa as well. Using the Nigerian Naira (NGN), they would need to pay: 180.18 trillion NGN to cover our universal healthcare under the Democratic Party–they would probably go for the Republican healthcare plan, because it is much cheaper. In terms of affordability, it seems the Democratic Party has a need to become more empathetic, rather than thinking about these things in terms of the wealthy people, that they are today, and more in terms of the poor people that they will be tomorrow, because they are determined to drive us, and the remainder of the world, without Euroes and British Pounds, into poverty.

It doesn’t even look like the Chinese would find it worthwhile to pay for our universal healthcare system, on the Democratic Party side, but all countries in terms of affordability, would probably purchase the Republican healthcare plan: given a choice between the two with what they have available, to use as payment.

 

[LittleSoldier]

It is nice to hear something other than the standard “punnish the working class, they have to much money” routine.

If someone were to be a doctor, do you think they really need to spend 12 years in basic education? If we allowed students to move at their own pace through basic school subjects we might be able to get them into college sooner and reduce the total cost to educate them.

Why don’t all doctors start out as Nurses and then get additional responsibilities as they gain experience finally moving up into the realm of surgeon or whatever other specialty. I could see qualifying nurses in CFR and greatly reducing the need for full doctors. (CFR- Cold, Flu, Runny nose. A nurse could easily address basic sicknesses and refer unusual symptoms to a doctor.)

There are nurses in the USA who are licensed as anaesthesiologists. I think it’s great.

 

[Irish_Catholic_1]

Maybe if Canada picked up their fair share of the slack defending the free world we wouldn’t have that discrepancy.

Canada, Old Europe, and all the rest of them

 

[Irish_Catholic_1]

…I have yet to see something convincing here that suggests that the cost of a universal system would be somehow far different than in other countries.

One word: POPULATION

 

[LittleSoldier]

Right n ow we have a significant medical tourism industry for instance medical facilities from norther border states treating Canada’s overflow. If we institute socialized medicine, and depending on how it is done, those foriegn patients would no longer be paying and even more would be flooding over. We would also have even more immigrants flooding in from around the world. this will obviously drive up costs.

It is not just the total costs that is at issue, it is the cost bore by the working class. Right now we have a growing problem with the welfare class demmanding more and more entitlements and refusing to work for them. As there power grows, more people in the middle class are realizing that it is easier to quit work and join the ranks of the unemployed since their quality of life would not go down much.

As a former member of the middle class I would just like to point out that the middle class isn’t necessarily dying off because its members are realizing it’s easier to quit and then get public assistance. You know, when I was typing that sentence I suddenly started thinking about the people I personally know who have done that exact thing. So you are correct - to a point.

Maybe my own experience will help in this discussion. I’ve noticed a few things about the federal government: It does not like to reclassify people and it is in a lot of debt. I was ill for a time after a traumatic experience and was told (by a Social Security employee who was reviewing my case) that I should not get a job. I was told the same thing by nurses in the hospital where I was a patient. I was told to be a leech, but to be quiet about it. I could have joined programs where the government would pay me each month, subsidize my rent, give me food stamps, and pay for 100% of my medical costs. When I refused to participate in these programs I was labeled a “troublemaker”. I told people I wanted to be a fully participating member of society and pay for my own way. I was told that I shouldn’t be that way - just take what is offered and go away. I’m not kidding. I was really told that by Social Security and also by the hospital staff.

I did obtain employment, bought a house, replaced my sagging heap of a car, and believed that everything was still OK. I did it all on my own.
I worked for several years at the same job (a job, BTW that required at least a B.S. in a life science and hopefully a master’s degree as well - I had both). I was then seriously injured on the job, to the point that I could no longer work.

I was rewarded for my injury by having my dental and vision insurance dropped completely and was told I would have to pay for my medical insurance myself (minus a small grant). I don’t want to drag this story out and I’m sure nobody else wants me too, either. Let me just state that at the present time I have found myself in the following situation:

(1) I cannot afford the medical insurance premiums from what I am paid via disability retirement. The only insurance I can afford is catastrophic health insurance. So, I pay for those premiums PLUS I pay 100% of all my medical care, including prescriptions, lab tests, vision tests, etc. I fell down last year and was charged over $2,000 to have five stitches put in my hand. I will be paying that bill off for at least the next year. I need special prescription eyeglasses and one pair cost me over $800.

(2) What I receive in disability retirement does not keep up with inflation, even though I get a COLA every year. I am actually earning less than I earned five years ago. My workers comp settlement took 15 years to settle and I can easily lose every penny they paid me within the next two years if I fall again and get seriously hurt.

(3) I have been turned down by Social Security twice. I have been told that I am not disabled. I am disabled. I have a disabled placard to put in my car, I use a cane and a walker, I am in chronic pain, I have become “loopy” from the use of opiates for the last 12 or 13 years. I have severe clinical depression. I cannot work. I want to work. But I can’t.

(4) The middle class is disappearing. Part of that is because, yes, people lie and cheat and steal from the rest of us. But those of us who couldn’t sleep at night while lying and cheating and stealing and just want to be good people, are being punished by the government and forced into the lower class.

(5) I am one of the very lucky ones. At least I have a house and I believe I can keep up with the payments. I also have one more chance with Social Security and I will have an attorney with me during the hearing. I am hopeful that perhaps, this time, they will finally see that I really can’t work.

(6) I only consider myself “poor” in terms of money. I have an extremely rich spiritual life, belong to a parish with an excellent priest, love God, and feel blessed.

The reason I have written all this is to show that an awful lot of good people just cannot afford to pay for their health costs anymore. I feel a ton of pity for people who are literally living on the streets or those who have to continue working, even through agonizing pain, because they need that health insurance paid for.

Something needs to be done. There are people who are desperately ill and who are not receiving any health care. There are people who have to choose between medicine and food. Sometimes people who are employed don’t understand that not everyone can get Kaiser paid for by their employer or even get Kaiser at all. Disabled people cannot go out and purchase a private health insurance plan because pre-existing conditions are not covered and if a person is diabetic (like me, got some bad genes from my Mom) they will not be able to buy any health insurance under any circumstances.

So what are people like me supposed to do?