Entries Tagged as 'Health'

Comparison of Canadian and American health care systems

There are a number of comparisons between the Canadian and US health care systems; and like with any complex issue you can make the comparison show almost anything you want depending on the metrics chosen for the comparison and the facts included (or omitted).

Often the Canadian and American systems are compared since until the 1960s they were extremely similar, and Canadian and Americans share a large common history and to some extent culture.

This comparison on Wikipedia appears to be an honest attempt to compare and contrast the two systems, it includes a number of citations.  I recommend reading it, and considering what it has to say in light of the the current state health care in the US.

Comparison of Canadian and American health care systems

Originally posted 2010-03-16 13:03:11.

Does Canada’s Health Care System Need Fixing?

This is from an article on by Sarah Varney (KQED – San Francisco, CA, US – Public Media for Northern California) re-published on NPR.

Amid the debate about reforming heath care in the United States, it’s tough to turn on your television these days without hearing a political ad condemning the Canadian health care system.

One such ad from Americans for Prosperity features a woman talking of her experience with getting treatment for cancer.

“I survived a brain tumor, but if I’d relied on my government for health care, I’d be dead. I am a Canadian citizen. As my brain tumor got worse, my government health care system told me I had to wait six month to see a specialist,” the woman says.

The ads are provocative, but just how accurately do they portray Canada’s system?

At a small doctor’s office in the gritty working-class neighborhood of East Vancouver, Dr. Larry Barzelai meets with John and Bessie Riley, who have been his patients for more than 20 years.

John Riley was recently diagnosed with colon cancer. Contrary to the woman in the TV ad, he says his experience getting in to see specialists has been “nothing but good” so far. “Everything’s gone bang, bang. I’ve had no waiting times for anything,” he says, adding that his only out-of-pocket expense has been the cost of getting to the doctor’s office.

Socialized Insurance, Not Socialized Medicine

Canada has a universal health care system that’s paid for through income taxes and sales tax. All Canadians are covered, and they can see any doctor they want anywhere in the country with no copays or deductibles. Some things aren’t covered: optometry, dentistry and outpatient prescription drugs. Many Canadians have private insurance to cover those services, though some struggle to pay for them out of pocket.

U.S. critics of Canadian health care like to call it socialized medicine, but it’s more like socialized insurance — meaning the risk is pooled together. And while the individual provinces and territories set their overall health budgets and administer the health plans, the delivery of medical care is private. Doctors run their own businesses and then bill the government.

Barzelai says physicians in Canada earn a good living and aren’t faced with the same administrative hassles that American doctors gripe about. “Medical costs here are half of what medical costs in the States are,” he says. “At the same time, our infant mortality is lower, our life expectancy is longer, our rates of obesity are a lot less. So there’s got to be some positive aspects of living in Canada and with the Canadian medical system.”

The Commonwealth Fund, a respected and nonpartisan U.S. health research organization, looked at deaths that could have been prevented with access to quality medical care in the leading 19 industrialized countries. In the latest survey, the United States ranked last and Canada came in sixth.

Professor Bob Evans, one of the grandfathers of the health economics field, has been studying the Canadian and U.S. systems since they were founded around the same time in the mid-1960s. He says that what many Americans hear about Canada — rationed care, long wait lists and a government bureaucrat who gets in between a patient and doctor — is “absolute nonsense.”

“Are there cases of people who wind up not getting the care they need at appropriate times? Yes, of course there are,” says Evans, who is with the Centre for Health Policy Research at the University of British Columbia in Vancouver. “This is a huge system and it’s a very complicated one and things do go wrong. But as a general rule, what happens here is that when you need the care, you get it.” But that wasn’t always the case.

‘The Most Frustrating Moments In Our System’

When federal spending on Canadian health care declined during a recession in the 1990s, lines for non-urgent procedures — and some urgent ones — grew. A few years later, Canada’s Supreme Court found that some patients had in fact died as a result of waiting for medical services. Stories of the deaths and of residents traveling to the U.S. for medical care dominated Canadian news coverage.

In response, Canada’s government poured billions of dollars into reducing wait times in the five medical areas deemed most troublesome, including cancer care, cardiac care and joint replacement surgery. And wait times for these services has dropped: Most provinces now report those times on publicly available Web sites. Such data — and public accountability — don’t exist in the U.S.

But that’s not to say there still aren’t frustrations with waiting for medical care in Canada.

Jocelyn Thompkinson is a peppy 29-year-old who was born with a neural tube defect similar to spina bifida. “I haven’t been able to walk since I was 8, and I’ve had lots of surgeries, lots of medical interventions of various types,” she says at BC Children’s Hospital, in a leafy Vancouver neighborhood. “But beyond that, I hold a job, I have a pretty much normal life.”

She credits an army of Canadian doctors and physical therapists for giving her that normal life, though there have been roadblocks. “Of course there were some times when I had to wait for care, and those are always the most frustrating moments in our system,” Thompkinson says. Several years ago, when she was on a long waiting list for a pain clinic in Vancouver, she traveled to Seattle and then Texas to get care. The visits and tests cost her $1,800.

Few Canadians actually go south for medical care, though. Canadian researchers say it’s a bit like getting struck by lighting — it’s extremely rare, but when it happens, everyone talks about it.

Provincial governments do pay for Canadians to receive specialty care in the U.S. in some cases. For example, a shortage of neonatal beds means a small number of women with high-risk pregnancies are sent to U.S. hospitals to deliver their babies.

It doesn’t happen often, though, and public opinion polls continue to show strong support for publicly financed, universal health care in Canada.

NPR.com

Originally posted 2010-03-11 02:00:20.

Health Insurer’s “Gift” For College Grads

United HealthCare announce this week that it would be voluntarily implementing one of the requirements of the new health care law early.

That is the requirement that allows young adults who are no longer full-time students to remain on their parents policies until they are 26.  [All insurance companies will have to comply with this requirement by September 1, United HealthCare is implementing it on June 1]

WOW… how generous.

Statistically the healthiest group of American’s will be offered insurance… a group that will most likely be [mostly] unemployed because of the economy [thus not having corporate health care coverage] — seems a little self serving to me; after all, they aren’t giving the insurance away.

Originally posted 2010-04-21 02:00:58.

Riddle me this…

You go to the grocery store to purchase a food item and the price is clearly marked.

You go to a car dealership and purchase a vehicle and the price is marked, and you agree ahead of time to what you will pay.

You buy a house and again your agree upfront how much it will cost.

You have a contractor build you a house and they provide an estimate of how much it will cost, and get your approval ahead of time for any changes to the cost.

So why when you go to the doctor, clinic, or hospital are you given absolutely no idea what it will cost?

And to make it worse, have you ever called your insurance company and ask them to tell you how much they will pay for any given procedure or test?  They will refuse, and tell you that you have to have your doctor file for a pre-authorization.

I can certainly tell you why health care in this country is such a mess — the whole system is designed to prevent a patient from having any control over his health care and specifically his health care costs.

For me I’ve decided that anything a doctor orders will need to get a pre-authorization or will need to have a (signed) statement by the attending physician that a delay in treatment would likely negatively impact my health (or be life threatening)… If my insurance won’t pay for the procedure, then either the medical provider is trying to charge too much, or there’s not a compelling reason to do it.

While insurance companies and doctors have setup nice legal barriers to litigation, I think it’s time “we the people” force the issue that medical providers and insurance companies make us part of the system, and respect our choices by providing us enough information up front to make care decisions…

Originally posted 2011-08-04 02:00:01.

Michele Bachmann – an ideological loony tune

Rep Michele Bachmann (R-Minn) made a statement on CNN’s “The Situation Room” (hosted by Wolf Blitzer) that’s being reported by virtually every news outlet today.

She’s saying she lost her health care coverage (because of Obamacare — but she didn’t provide any hard reason) and refuses to use the exchange because it’s glitchy — but here’s the interesting thing: she states in her argument that it’s the DC exchange (that’s not the same thing as HealthCare.gov — the national exchange for states that didn’t want to invest in their own exchange — DC actually operates it’s own exchange).

If you watch the video (linked below), you’ll also notice she’s obviously reading from a teleprompter — her eyes are fixed on something other than the hosts she’s talking to.

The best quote:

I’m not gonna waste an hour on that thing.
· Michelle Bachmann

That’s fine with me; she can just pay the IRS fines for not complying with the new law (the law that the Supreme Court has already ruled is constitutional) and continue to be a burden on society (something she appears to be very good at).

While I’ll be one of the first to rant on how botched the roll out of the national health care exchange has been; I’ll also quickly point out that states had the option of coming up with their own exchanges, and the ones that did aren’t having anywhere near the number of issues.  I personally didn’t care for the health care reform, my feeling was that we needed to implement a single payer system much more like what Canada has (but that didn’t happen because health care dollars line the pockets of too many senators and representatives).

I’ll be honest, I think Michele Bachmann is crazy (and probably should be in a padded room), but this is just absolutely ridiculous — get over it, and vent on your insurance company, they’re the real villains in all this.

Bachmann: I lost health insurance

Originally posted 2013-11-15 13:00:25.

Flu and Pneumonia Vaccinations

Winter is quickly coming, and for any one with any health issues or concern a flu and pneumonia vaccination shouldn’t be put off.

The vaccines are available this year as of tody (1 Oct 2008) and take approximately thirty (30) days before they’re effective.  You can get the vaccine at your doctors office, county health clinic, or a number of pharmacies, groceries, and employers offer clinics at low costs (some insurance will pay for flu vaccinations including Medicare); and if your insurance will not pay the full cost and you have an HCSA the cost is payable by that.  If you have no insurance, or your insurance will not cover the cost check with your local heath department to see if they provide low / no cost vaccinations — and check the grocery stores, pharmacies, senior centers, recreation centers, etc in your are to find they schedule and costs.

The flu vaccine is offered as an injection or an inhalant; the combo flu / pneumonia is just an injection; and the pneumonia is just an injection.

A flu vaccination should be gotten every year; and a pneumonia vaccination every five to ten years as recommended by your physician.

Remember, if you’ve had any major illnesses and are over the age of 35 you shouldn’t consider keeping these vaccinations current optional; same if you’re over 55 or in a high risk group or have a compromised immune system.

NOTE:  The flu vaccination should cost no more than $25; the pneumonia may run as high as $35; the combo vaccine should be available for about the same cost as just the pneumonia, $40 at most.

__________

These links may help you locate a flu clinic in your area; remember you local health department may be able to direct you to a clinic even if they do not offer flu shots.

Pharmacies

Grocers

Originally posted 2008-10-01 12:00:02.

US Health Care Reform

Today US President Barrack Obama is supposed to deliver a revised plan to overhaul US Health care… but yesterday Warren Buffet hit the nail on the head while speaking on CNC he said the country’s out-of-control health care costs — at US $2.3 trillion a year and growing — are like “a tapeworm eating at our economic body.”

Mr Buffet underscored that he would support overhaul legislation proposed by the US Senate, but that he would prefer existing proposals be scrapped in favor of a new plan targeted at addressing costs.

“What we have now is untenable over time,” said Mr. Buffett, noting the U.S. health-care system eats up about 17% of the country’s economic output, compared with about 10% for Canada and many other countries. “I believe in insuring more people. But I don’t believe in insuring more people until you attack the cost aspect of this. And there is no reason for us to be spending 17% or thereabouts when many other developed countries are spending, we’ll say, 9 or 10%. They have more beds, they have more nurses, they have more doctors, they even have more consultations by far.”

The major obstacles to any real reform would be the power health care lobbyists (representing pharmaceutical companies, insurance companies, doctors, and other health care related entities) as well as the American public.

Without reform, the cost of U.S. health care — already the most expensive in the world — is forecast to jump to around 25% of the US economic output by 2025.

My feeling is that since the Democrats couldn’t come up with a plan that they could all get behind when they had control of the House, Senate, and Presidency it’s extremely unlikely that they can build bi-partisan support for much of any real reform now.

American politics is always a shining example that change isn’t always progress.

Originally posted 2010-03-04 02:00:40.

Actually, that’s not in the Bible

(CNN) – NFL legend Mike Ditka was giving a news conference one day after being fired as the coach of the Chicago Bears when he decided to quote the Bible.

“Scripture tells you that all things shall pass,” a choked-up Ditka said after leading his team to only five wins during the previous season. “This, too, shall pass.”

Ditka fumbled his biblical citation, though. The phrase “This, too, shall pass” doesn’t appear in the Bible. Ditka was quoting a phantom scripture that sounds like it belongs in the Bible, but look closer and it’s not there.

Ditka’s biblical blunder is as common as preachers delivering long-winded public prayers. The Bible may be the most revered book in America, but it’s also one of the most misquoted. Politicians, motivational speakers, coaches – all types of people – quote passages that actually have no place in the Bible, religious scholars say.

These phantom passages include:

“God helps those who help themselves.”

“Spare the rod, spoil the child.”

And there is this often-cited paraphrase: Satan tempted Eve to eat the forbidden apple in the Garden of Eden.

None of those passages appear in the Bible, and one is actually anti-biblical, scholars say.

But people rarely challenge them because biblical ignorance is so pervasive that it even reaches groups of people who should know better, says Steve Bouma-Prediger, a religion professor at Hope College in Holland, Michigan.

“In my college religion classes, I sometimes quote 2 Hesitations 4:3 (‘There are no internal combustion engines in heaven’),” Bouma-Prediger says. “I wait to see if anyone realizes that there is no such book in the Bible and therefore no such verse.

“Only a few catch on.”

Few catch on because they don’t want to – people prefer knowing biblical passages that reinforce their pre-existing beliefs, a Bible professor says.

“Most people who profess a deep love of the Bible have never actually read the book,” says Rabbi Rami Shapiro, who once had to persuade a student in his Bible class at Middle Tennessee State University that the saying “this dog won’t hunt” doesn’t appear in the Book of Proverbs.

“They have memorized parts of texts that they can string together to prove the biblical basis for whatever it is they believe in,” he says, “but they ignore the vast majority of the text.”

Phantom biblical passages work in mysterious ways

Ignorance isn’t the only cause for phantom Bible verses. Confusion is another.

Some of the most popular faux verses are pithy paraphrases of biblical concepts or bits of folk wisdom.

Consider these two:

“God works in mysterious ways.”

“Cleanliness is next to Godliness.”

Both sound as if they are taken from the Bible, but they’re not. The first is a paraphrase of a 19th century hymn by the English poet William Cowper (“God moves in a mysterious way, His wonders to perform).

The “cleanliness” passage was coined by John Wesley, the 18th century evangelist who founded Methodism, says Thomas Kidd, a history professor at Baylor University in Texas.

“No matter if John Wesley or someone else came up with a wise saying – if it sounds proverbish, people figure it must come from the Bible,” Kidd says.

Our fondness for the short and tweet-worthy may also explain our fondness for phantom biblical phrases. The pseudo-verses function like theological tweets: They’re pithy summarizations of biblical concepts.

“Spare the rod, spoil the child” falls into that category. It’s a popular verse – and painful for many kids. Could some enterprising kid avoid the rod by pointing out to his mother that it’s not in the Bible?

It’s doubtful. Her possible retort: The popular saying is a distillation of Proverbs 13:24: “The one who withholds [or spares] the rod is one who hates his son.”

Another saying that sounds Bible-worthy: “Pride goes before a fall.” But its approximation, Proverbs 16:18, is actually written: “Pride goeth before destruction, and an haughty spirit before a fall.”

There are some phantom biblical verses for which no excuse can be offered. The speaker goofed.

That’s what Bruce Wells, a theology professor, thinks happened to Ditka, the former NFL coach, when he strayed from the gridiron to biblical commentary during his 1993 press conference in Chicago.

Wells watched Ditka’s biblical blunder on local television when he lived in Chicago. After Ditka cited the mysterious passage, reporters scrambled unsuccessfully the next day to find the biblical source.

They should have consulted Wells, who is now director of the ancient studies program at Saint Joseph’s University in Pennsylvania. Wells says Ditka’s error probably came from a peculiar feature of the King James Bible.

“My hunch on the Ditka quote is that it comes from a quirk of the King James translation,” Wells says. “Ancient Hebrew had a particular way of saying things like, ‘and the next thing that happened was…’ The King James translators of the Old Testament consistently rendered this as ‘and it came to pass.’ ’’

When phantom Bible passages turn dangerous

People may get verses wrong, but they also mangle plenty of well-known biblical stories as well.

Two examples: The scripture never says a whale swallowed Jonah, the Old Testament prophet, nor did any New Testament passages say that three wise men visited baby Jesus, scholars say.

Those details may seem minor, but scholars say one popular phantom Bible story stands above the rest: The Genesis story about the fall of humanity.

Most people know the popular version – Satan in the guise of a serpent tempts Eve to pick the forbidden apple from the Tree of Life. It’s been downhill ever since.

But the story in the book of Genesis never places Satan in the Garden of Eden.

“Genesis mentions nothing but a serpent,” says Kevin Dunn, chair of the department of religion at Tufts University in Massachusetts.

“Not only does the text not mention Satan, the very idea of Satan as a devilish tempter postdates the composition of the Garden of Eden story by at least 500 years,” Dunn says.

Getting biblical scriptures and stories wrong may not seem significant, but it can become dangerous, one scholar says.

Most people have heard this one: “God helps those that help themselves.” It’s another phantom scripture that appears nowhere in the Bible, but many people think it does. It’s actually attributed to Benjamin Franklin, one of the nation’s founding fathers.

The passage is popular in part because it is a reflection of cherished American values: individual liberty and self-reliance, says Sidnie White Crawford, a religious studies scholar at the University of Nebraska.

Yet that passage contradicts the biblical definition of goodness: defining one’s worth by what one does for others, like the poor and the outcast, Crawford says.

Crawford cites a scripture from Leviticus that tells people that when they harvest the land, they should leave some “for the poor and the alien” (Leviticus 19:9-10), and another passage from Deuteronomy that declares that people should not be “tight-fisted toward your needy neighbor.”

“We often infect the Bible with our own values and morals, not asking what the Bible’s values and morals really are,” Crawford says.

Where do these phantom passages come from?

It’s easy to blame the spread of phantom biblical passages on pervasive biblical illiteracy. But the causes are varied and go back centuries.

Some of the guilty parties are anonymous, lost to history. They are artists and storytellers who over the years embellished biblical stories and passages with their own twists.

If, say, you were an anonymous artist painting the Garden of Eden during the Renaissance, why not portray the serpent as the devil to give some punch to your creation? And if you’re a preacher telling a story about Jonah, doesn’t it just sound better to say that Jonah was swallowed by a whale, not a “great fish”?

Others blame the spread of phantom Bible passages on King James, or more specifically the declining popularity of the King James translation of the Bible.

That translation, which marks 400 years of existence this year, had a near monopoly on the Bible market as recently as 50 years ago, says Douglas Jacobsen, a professor of church history and theology at Messiah College in Pennsylvania.

“If you quoted the Bible and got it wrong then, people were more likely to notice because there was only one text,” he says. “Today, so many different translations are used that almost no one can tell for sure if something supposedly from the Bible is being quoted accurately or not.”

Others blame the spread of phantom biblical verses on Martin Luther, the German monk who ignited the Protestant Reformation, the massive “protest” against the excesses of the Roman Catholic Church that led to the formation of Protestant church denominations.

“It is a great Protestant tradition for anyone – milkmaid, cobbler, or innkeeper – to be able to pick up the Bible and read for herself. No need for a highly trained scholar or cleric to walk a lay person through the text,” says Craig Hazen, director of the Christian Apologetics program at Biola University in Southern California.

But often the milkmaid, the cobbler – and the NFL coach – start creating biblical passages without the guidance of biblical experts, he says.

“You can see this manifest today in living room Bible studies across North America where lovely Christian people, with no training whatsoever, drink decaf, eat brownies and ask each other, ‘What does this text mean to you?’’’ Hazen says.

“Not only do they get the interpretation wrong, but very often end up quoting verses that really aren’t there.”

 

By John Blake, CNN

Originally posted 2011-08-25 02:00:03.

Mythbusting Canadian Health Care

This is from an article by Sara Robinson published on Campaign for America’s Future.

1. Canada’s health care system is “socialized medicine.”
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is “single-payer insurance.” In talking to Americans about it, the better phrase is “Medicare for all.”

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don’t have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don’t have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid — quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren’t interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don’t realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don’t operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor’s debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family’s major expenses, expectations tend to run very high. A doctor’s mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it’s no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they’re not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don’t have to include coverage for future medical costs, which reduces the insurance company’s liability.

3. Wait times in Canada are horrendous.
True and False again — it depends on which province you live in, and what’s wrong with you. Canada’s health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don’t plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that’s just as true in any rural county in the U.S.

You can hear the bitching about it no matter where you live, though. The percentage of Canadians who’d consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country’s health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland’s grandfather.). In spite of that, though, grousing about health care is still unofficially Canada’s third national sport after curling and hockey.

And for the country’s newspapers, it’s a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it’s on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it’s certainly one of the things that keeps the quality high. But it also makes people think it’s far worse than it is.

Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I’m finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It’s the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don’t have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that’s just as true in the U.S. — and in America, the government won’t cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.

5. You don’t get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don’t get a choice. Be afraid! Be very afraid!

For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country’s top specialists that rich ones do.

6. Canada’s care plan only covers the basics.
You’re still on your own for any extras, including prescription drugs. And you still have to pay for it.
True — but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees’ premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

“The basics” covered by this plan include 100% of all doctor’s fees, ambulance fares, tests, and everything that happens in a hospital — in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn’t include “extras” like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you’d pay for a room in a middling hotel). That other stuff does add up; but it’s far easier to afford if you’re not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren’t nearly as expensive here, either.

Filling the gap between the basics and the extras is the job of the country’s remaining private health insurers. Since they’re off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month — about $300 for a family of four — if you’re stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America’s largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they’re actually likely to be safer.

Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It’s amazing.

8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.

One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they’re getting a constant level of care that ensures small things get treated before they become big problems.

The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren’t working 60-hour weeks trying to hold onto a job that gives them insurance.

9. People won’t be responsible for their own health if they’re not being forced to pay for the consequences.
False. The philosophical basis of America’s privatized health care system might best be characterized as medical Calvinism. It’s fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one’s own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One’s Own Health.

They’ll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you’ll never get sick. (Like all good theologies, there’s even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it’s a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can’t complain. It was their own damned fault; and it’s not our responsibility to pay for their sins. In fact, it’s recently been suggested that they be shunned, lest they lead the virtuous into sin.

Of course, this is bad theology whether you’re applying it to the state of one’s soul or one’s arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us — even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it’s built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.

This difference is expressed in a few different ways. First: Canadians tend to think of tending to one’s health as one of your duties as a citizen. You do what’s right because you don’t want to take up space in the system, or put that burden on your fellow taxpayers. Second, “taking care of yourself” has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you’re contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they’re still small and cheap to fix.

Third, there’s a somewhat larger awareness that stress leads to big-ticket illnesses — and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there’s a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.

The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.

10. This all sounds great — but the taxes to cover it are just unaffordable. And besides, isn’t the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we’re not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we’re actually money ahead. When you factor in the greatly increased social stability that follows when everybody’s getting their necessary health care, the impact on our quality of life becomes even more signficant.

And True — but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There’s always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.

But, as many of us know all too well, there’s also constant tension between what patients want and what private insurers are willing to pay. At least when it’s in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.

It is true that Canada’s system is not the same as the U.S. system. It’s designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It’ll be a good day when when Americans can hold their heads high and proudly make that same declaration.

You can read the complete article and more of what Sara Robinson has to say on OurFuture.org.

Originally posted 2010-03-12 02:00:29.

How serious is Obama about his own policies???

If in fact President Barrack Obama is extremely concerned about health care for US citizens, and raising the minimum wages… explain why:

  1. Many (full-time) federal employees make substantially below the proposed minimum wage; and
  2. Many (full-time) federal employees are not eligible for health care through their employer.

How much more disingenuous can you be than not “fixing” your own “house” before looking to force businesses to raise wages and provide (health care) benefits?

In the computer industry we have a phrase “eating your own dogfood“… or more colloquial, “what’s fair for the goose is fair for the gander“. 

But then again, this isn’t the first nor will it be the last time the government of the United States exempts itself for it’s own rules (laws)…

Originally posted 2014-03-18 10:00:33.