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"Healthcare in Canada: It's not free, and it doesn't work" http
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PJay OD
2017-08-09 08:49:06 UTC
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"Healthcare in Canada: It's not free, and it doesn't work"

https://www.onenewsnow.com/culture/2017/08/07/healthcare-in-canada-its-not-free-and-it-doesnt-work
Gil
2017-08-09 13:29:18 UTC
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Post by PJay OD
"Healthcare in Canada: It's not free, and it doesn't work"
https://www.onenewsnow.com/culture/2017/08/07/healthcare-in-canada-its-not-free-and-it-doesnt-work
Half-truths and lies. By the way, it's really an advertisement for this
guys consulting business which hardly makes it impartial.

Gil
me
2017-08-09 13:39:59 UTC
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I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.

His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
GLOBALIST
2017-08-09 15:19:38 UTC
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Post by me
I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.
His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
So like here, if they want the best, they have to pay out of pocket
Jack Fate
2017-08-09 15:26:33 UTC
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Post by GLOBALIST
So like here, if they want the best, they have to pay out of pocket
In Spain we have both the public option and the private option.
Strangely, the rich folks prefer the public option, even the king.
Explain that, jerk off.
me
2017-08-09 17:23:48 UTC
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Explain why government "expert committees" (some people call them 'death panel') should decide how to limit health care.
Jack Fate
2017-08-09 17:43:09 UTC
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Post by me
Explain why government "expert committees" (some people call them
'death panel') should decide how to limit health care.
We don't have that here. If you're sick, you get treatment. And the
treatment is much less due to the fact that there are no vulture
"health" insurance companies.
me
2017-08-10 03:26:07 UTC
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See
http://www.reuters.com/article/us-spain-healthcare-idUSKBN0NK0FX20150429
Jack Fate
2017-08-10 11:03:48 UTC
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Post by me
See
http://www.reuters.com/article/us-spain-healthcare-idUSKBN0NK0FX20150429
Not true anymore. I go to that hospital. It's been renovated and I have
had nothing but professional and compassionate care there. I have had
three operations there, all successful. Your article is two fucking
years old and, since then, thousands of new jobs have been filled in
Madrid's health system. You do know that the RIGHT wing party was in
charge of Madrid until recently when the far left took over and changed
the health system by hiring a lot more health professionals. Austerity
causes deaths, it's true, but fortunately the tight wing austerity
loving bitch is gone. You advocate austerity and triage. So, hot shot,
you should revel in the death of that lady.
me
2017-08-10 11:58:37 UTC
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I don't advocate austerity as I don't advocate the tides.
Jack Fate
2017-08-10 12:59:36 UTC
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Post by me
I don't advocate austerity as I don't advocate the tides.
Your posts indicate you love austerity, as long as it's others who
suffer and not you.
me
2017-08-10 13:29:27 UTC
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As I frequently point out, you see things that are not there and are blind to other things that are ubiquitous.
El Castor
2017-08-10 06:56:42 UTC
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Post by me
Explain why government "expert committees" (some people call them 'death panel') should decide how to limit health care.
Forgive me for butting in, but the answer to that one exposes one of
the flaws in socialized medicine. If there are X dollars available for
treatment of illness, death panels are assigned to do the math. How
can X dollars be most efficiently spent to save the greatest number of
people that the system can afford to save -- while still letting some
who have a chance at life, die? The odds and costs of surviving
various potentially terminal illnesses are well known and are almost
always age dependent. It all comes down to cost of treatment,
likelihood of success, and the potential life expectancy of the
patient. It is more efficient to save the 50 year old and let the 70
die. Given the odds of this and that, you really don't need a panel --
a properly programmed computer could do the job, but a "panel" is more
appropriate because no one would like their fate determined by an
iPhone app, and there is another reason -- a computer would have a
hard time calculating exceptions for political connections -- and if
it could, the source code would have to be closely guarded. (-8

The prohibition of free enterprise medicine was called "Universality"
in Canada, but there has been kick back in some provinces, so it is
weakening. And there is always the US. 450,000 Canadians come to the
US every year for medical treatment.
rumpelstiltskin
2017-08-10 14:43:08 UTC
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On Wed, 09 Aug 2017 23:56:42 -0700, El Castor
Post by El Castor
Post by me
Explain why government "expert committees" (some people call them 'death panel') should decide how to limit health care.
Forgive me for butting in, but the answer to that one exposes one of
the flaws in socialized medicine. If there are X dollars available for
treatment of illness, death panels are assigned to do the math. How
can X dollars be most efficiently spent to save the greatest number of
people that the system can afford to save -- while still letting some
who have a chance at life, die? The odds and costs of surviving
various potentially terminal illnesses are well known and are almost
always age dependent. It all comes down to cost of treatment,
likelihood of success, and the potential life expectancy of the
patient. It is more efficient to save the 50 year old and let the 70
die. Given the odds of this and that, you really don't need a panel --
a properly programmed computer could do the job, but a "panel" is more
appropriate because no one would like their fate determined by an
iPhone app, and there is another reason -- a computer would have a
hard time calculating exceptions for political connections -- and if
it could, the source code would have to be closely guarded. (-8
The prohibition of free enterprise medicine was called "Universality"
in Canada, but there has been kick back in some provinces, so it is
weakening. And there is always the US. 450,000 Canadians come to the
US every year for medical treatment.
Quite a few Americans go to Cost Rica for treatment. My
son went there for major dental work. Even taking into
consideration airfare and a room rental, it cost him a small
fraction of what it would cost in the USA, without insurance,
and the work has been very satisfactory.

I dropped out of my dental plan this year because it costs
me $500 a year for the insurance which doesn't completely
cover everything, but I've scarcely spent $100 a year on
dental work for the last four years. I'm just taking my
chances. I may sign up again next year. I'm halfway
through this year with no problems.

I have no plans for dropping out of Kaiser though,
especially since I have a plate in my right arm, two
fake knees and a fake hip, and am taking medicine for
diabetes, though I don't have any big symptoms yet
except that the hair is mostly gone from my legs
below the knees, I have varicose veins on my ankles,
and sometimes in the morning I can't see the veins
on the top of my feet. That last one does freak me
out a bit, and I take another Metformin. I've been
thinking of asking my doc to up my Metformin from
one pill a day to two.

The plate in my right arm and the two fake knees
and fake hip would have cost me a hefty fraction of
a million dollars if I hadn't had insurance.

I mentioned before that I saw the ambulance bill
for my second seizure, and just the ambulance
was $5,000. I didn't have to pay any of it myself
but I told my son not to call the hospital if I have
another seizure. I'll probably come out of it OK
without medical attention, and if not, I've lived
long enough anyway. I've mentioned a peculiar
incident between those two seizures that my son
said was probably also a seizure, and I agreed
with him after I thought about it. I'm taking
seizure medicine now. My last seizure was
Feb 15 2015, right ON my 70th birthday. I've
mentioned before that I share that birthday with
Michael Praetorius (who also died on his Feb
15 - his 50th birthday), Galileo, and Susan B.
Anthony.
El Castor
2017-08-10 20:20:28 UTC
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Post by rumpelstiltskin
On Wed, 09 Aug 2017 23:56:42 -0700, El Castor
Post by El Castor
Post by me
Explain why government "expert committees" (some people call them 'death panel') should decide how to limit health care.
Forgive me for butting in, but the answer to that one exposes one of
the flaws in socialized medicine. If there are X dollars available for
treatment of illness, death panels are assigned to do the math. How
can X dollars be most efficiently spent to save the greatest number of
people that the system can afford to save -- while still letting some
who have a chance at life, die? The odds and costs of surviving
various potentially terminal illnesses are well known and are almost
always age dependent. It all comes down to cost of treatment,
likelihood of success, and the potential life expectancy of the
patient. It is more efficient to save the 50 year old and let the 70
die. Given the odds of this and that, you really don't need a panel --
a properly programmed computer could do the job, but a "panel" is more
appropriate because no one would like their fate determined by an
iPhone app, and there is another reason -- a computer would have a
hard time calculating exceptions for political connections -- and if
it could, the source code would have to be closely guarded. (-8
The prohibition of free enterprise medicine was called "Universality"
in Canada, but there has been kick back in some provinces, so it is
weakening. And there is always the US. 450,000 Canadians come to the
US every year for medical treatment.
Quite a few Americans go to Cost Rica for treatment. My
son went there for major dental work. Even taking into
consideration airfare and a room rental, it cost him a small
fraction of what it would cost in the USA, without insurance,
and the work has been very satisfactory.
I dropped out of my dental plan this year because it costs
me $500 a year for the insurance which doesn't completely
cover everything, but I've scarcely spent $100 a year on
dental work for the last four years. I'm just taking my
chances. I may sign up again next year. I'm halfway
through this year with no problems.
I have no plans for dropping out of Kaiser though,
especially since I have a plate in my right arm, two
fake knees and a fake hip, and am taking medicine for
diabetes, though I don't have any big symptoms yet
except that the hair is mostly gone from my legs
below the knees, I have varicose veins on my ankles,
and sometimes in the morning I can't see the veins
on the top of my feet. That last one does freak me
out a bit, and I take another Metformin. I've been
thinking of asking my doc to up my Metformin from
one pill a day to two.
The plate in my right arm and the two fake knees
and fake hip would have cost me a hefty fraction of
a million dollars if I hadn't had insurance.
I mentioned before that I saw the ambulance bill
for my second seizure, and just the ambulance
was $5,000. I didn't have to pay any of it myself
but I told my son not to call the hospital if I have
another seizure. I'll probably come out of it OK
without medical attention, and if not, I've lived
long enough anyway. I've mentioned a peculiar
incident between those two seizures that my son
said was probably also a seizure, and I agreed
with him after I thought about it. I'm taking
seizure medicine now. My last seizure was
Feb 15 2015, right ON my 70th birthday. I've
mentioned before that I share that birthday with
Michael Praetorius (who also died on his Feb
15 - his 50th birthday), Galileo, and Susan B.
Anthony.
We gave up on dental insurance. Very difficult to find anyone around
here who takes it. The wife and I share your appreciation of Kaiser.
Fortunately, my health has been OK, although my wife has so much steel
in her knees and back she sets off all the alarms in the airport.
Kaiser took my BP yesterday -- 117 over 67, and no BP meds. So far so
good -- as the falling man said as he passed the 10th floor. (-8
Jessye
2017-08-10 22:12:27 UTC
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Honestly, at your next appt bring along
your own high-rated home monitor and
compare your own reading to the
technician's.
rumpelstiltskin
2017-08-11 04:41:41 UTC
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On Thu, 10 Aug 2017 13:20:28 -0700, El Castor
Post by El Castor
Post by rumpelstiltskin
On Wed, 09 Aug 2017 23:56:42 -0700, El Castor
Post by El Castor
Post by me
Explain why government "expert committees" (some people call them 'death panel') should decide how to limit health care.
Forgive me for butting in, but the answer to that one exposes one of
the flaws in socialized medicine. If there are X dollars available for
treatment of illness, death panels are assigned to do the math. How
can X dollars be most efficiently spent to save the greatest number of
people that the system can afford to save -- while still letting some
who have a chance at life, die? The odds and costs of surviving
various potentially terminal illnesses are well known and are almost
always age dependent. It all comes down to cost of treatment,
likelihood of success, and the potential life expectancy of the
patient. It is more efficient to save the 50 year old and let the 70
die. Given the odds of this and that, you really don't need a panel --
a properly programmed computer could do the job, but a "panel" is more
appropriate because no one would like their fate determined by an
iPhone app, and there is another reason -- a computer would have a
hard time calculating exceptions for political connections -- and if
it could, the source code would have to be closely guarded. (-8
The prohibition of free enterprise medicine was called "Universality"
in Canada, but there has been kick back in some provinces, so it is
weakening. And there is always the US. 450,000 Canadians come to the
US every year for medical treatment.
Quite a few Americans go to Cost Rica for treatment. My
son went there for major dental work. Even taking into
consideration airfare and a room rental, it cost him a small
fraction of what it would cost in the USA, without insurance,
and the work has been very satisfactory.
I dropped out of my dental plan this year because it costs
me $500 a year for the insurance which doesn't completely
cover everything, but I've scarcely spent $100 a year on
dental work for the last four years. I'm just taking my
chances. I may sign up again next year. I'm halfway
through this year with no problems.
I have no plans for dropping out of Kaiser though,
especially since I have a plate in my right arm, two
fake knees and a fake hip, and am taking medicine for
diabetes, though I don't have any big symptoms yet
except that the hair is mostly gone from my legs
below the knees, I have varicose veins on my ankles,
and sometimes in the morning I can't see the veins
on the top of my feet. That last one does freak me
out a bit, and I take another Metformin. I've been
thinking of asking my doc to up my Metformin from
one pill a day to two.
The plate in my right arm and the two fake knees
and fake hip would have cost me a hefty fraction of
a million dollars if I hadn't had insurance.
I mentioned before that I saw the ambulance bill
for my second seizure, and just the ambulance
was $5,000. I didn't have to pay any of it myself
but I told my son not to call the hospital if I have
another seizure. I'll probably come out of it OK
without medical attention, and if not, I've lived
long enough anyway. I've mentioned a peculiar
incident between those two seizures that my son
said was probably also a seizure, and I agreed
with him after I thought about it. I'm taking
seizure medicine now. My last seizure was
Feb 15 2015, right ON my 70th birthday. I've
mentioned before that I share that birthday with
Michael Praetorius (who also died on his Feb
15 - his 50th birthday), Galileo, and Susan B.
Anthony.
We gave up on dental insurance. Very difficult to find anyone around
here who takes it. The wife and I share your appreciation of Kaiser.
Fortunately, my health has been OK, although my wife has so much steel
in her knees and back she sets off all the alarms in the airport.
Kaiser took my BP yesterday -- 117 over 67, and no BP meds. So far so
good -- as the falling man said as he passed the 10th floor. (-8
That's surprising to me, since in San Francisco every dentist
I've had accepts insurance. The insurance doesn't pay for
everything, it's true, so it's nowhere near as good as Kaiser.
One thing though is that the total amount accepted by the
dentist with the insurance company has always been less than
what the dentist would have charged without insurance. With
that in mind, after being bombarded with accident lawyer
adverts on TV over the last few days, I checked on the web
to see if I should get a lawyer in those circumstances, and
quickly decided that the answer was YES. Which lawyer? --
tricky. Like the insurance companies, the lawyers are all in
it for the money too. You really can't trust anybody: you
just have to fish around as best you can, which is hard to
do if you're seriously hurt and in the horse-spittle. (Lot of
animal metaphors there.)

Speaking of falling, did you hear on TV about the guy
who climbed an electrical tower lately, got electrocuted
with 115,000 volts, fell down 80 feet to the ground,
and SURVIVED (at least so far)?
http://www.ktvu.com/news/273062663-story
w***@msn.com
2017-08-12 05:34:48 UTC
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Post by rumpelstiltskin
The plate in my right arm and the two fake knees
and fake hip would have cost me a hefty fraction of
a million dollars if I hadn't had insurance.
Too bad they didn't do something different with your fake brain, besides have you plonk at everything that doesn't agree with your twisted thinking.
mg
2017-08-10 17:54:32 UTC
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On Wed, 9 Aug 2017 06:39:59 -0700 (PDT), me
Post by me
I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.
His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
"5 Myths About Canadian Health Care

by Aaron E. Carroll, M.D., M.S., April 16, 2012

How does the U.S. health care system stack up against
Canada’s? You’ve probably heard allegedly true horror
stories about the Canadian system — like 340-day waits for
knee replacement surgery, for example.

To separate fact from fiction, Aaron E. Carroll, M.D., the
director of the Center for Health Policy and Professionalism
Research in Indianapolis, identified the top myths about the
two health care systems.

Myth #1: Canadians are flocking to the United States to get
medical care.

How many times have you heard that Canadians, frustrated by
long wait times and rationing where they live, come to the
United States for medical care?

I don’t deny that some well-off people might come to the
United States for medical care. If I needed a heart or lung
transplant, there’s no place I’d rather have it done. But
for the vast, vast majority of people, that’s not happening.

The most comprehensive study I’ve seen on this topic — it
employed three different methodologies, all with solid
rationales behind them — was published in the peer-reviewed
journal Health Affairs.

Source: “Phantoms in the Snow: Canadians’ Use of Health Care
Services in the United States,” Health Affairs, May 2002.

The authors of the study started by surveying 136 ambulatory
care facilities near the U.S.-Canada border in Michigan, New
York and Washington. It makes sense that Canadians crossing
the border for care would favor places close by, right? It
turns out, however, that about 80 percent of such facilities
saw, on average, fewer than one Canadian per month; about 40
percent had seen none in the preceding year.

Then, the researchers looked at how many Canadians were
discharged over a five-year period from acute-care hospitals
in the same three states. They found that more than 80
percent of these hospital visits were for emergency or
urgent care (that is, tourists who had to go to the
emergency room). Only about 20 percent of the visits were
for elective procedures or care.

Next, the authors of the study surveyed America’s 20 “best”
hospitals — as identified by U.S. News & World Report — on
the assumption that if Canadians were going to travel for
health care, they would be more likely to go to the
best-known and highest-quality facilities. Only one of the
11 hospitals that responded saw more than 60 Canadians in a
year. And, again, that included both emergencies and
elective care.

Finally, the study’s authors examined data from the 18,000
Canadians who participated in the National Population Health
Survey. In the previous year, 90 of those 18,000 Canadians
had received care in the United States; only 20 of them,
however, reported going to the United States expressively
for the purpose of obtaining care.

Myth #2: Doctors in Canada are flocking to the United States
to practice.

Every time I talk about health care policy with physicians,
one inevitably tells me of the doctor he or she knows who
ran away from Canada to practice in the United States.
Evidently, there’s a general perception that practicing
medicine in the United States is much more satisfying than
in Canada.

The Canadian Institute for Health Information has been
tracking doctors’ destinations since 1992. Since then, 60
percent to 70 percent of the physicians who emigrate have
headed south of the border. In the mid-1990s, the number of
Canadian doctors leaving for the United States spiked at
about 400 to 500 a year. But in recent years this number has
declined, with only 169 physicians leaving for the States in
2003, 138 in 2004 and 122 both in 2005 and 2006. These
numbers represent less than 0.5 percent of all doctors
working in Canada.

So when emigration “spiked,” 400 to 500 doctors were leaving
Canada for the United States. There are more than 800,000
physicians in the United States right now, so I’m skeptical
that every doctor knows one of those émigrés.

In 2004, net emigration became net immigration. Let me say
that again. More doctors were moving into Canada than were
moving out.

Myth #3: Canada rations health care; that’s why hip
replacements and cataract surgeries happen faster in the
United States.

When people want to demonize Canada’s health care system —
and other single-payer systems, for that matter — they
always end up going after rationing, and often hip
replacements in particular.

Take Republican Rep. Todd Akin of Missouri, for example. A
couple of years ago he took to the House floor to tell his
colleagues:

“I just hit 62, and I was just reading that in Canada [if] I
got a bad hip I wouldn’t be able to get that hip replacement
that [Rep. Dan Lungren] got, because I’m too old! I’m an old
geezer now and it’s not worth a government bureaucrat to pay
me to get my hip fixed.”

Sigh.

This has been debunked so often, it’s tiring. The St. Louis
Post-Dispatch, for example, concluded: “At least 63 percent
of hip replacements performed in Canada last year [2008] ...
were on patients age 65 or older.” And more than 1,500 of
those, it turned out, were on patients over 85.

The bottom line: Canada doesn’t deny hip replacements to
older people.

But there’s more.

Know who gets most of the hip replacements in the United
States? Older people.

Know who pays for care for older people in the United
States? Medicare.

Know what Medicare is? A single-payer system.

Myth #4: Canada has long wait times because it has a
single-payer system.

The wait times that Canada might experience are not caused
by its being a single-payer system.

Wait times aren’t like cancer. We know what causes wait
times; we know how to fix them. Spend more money.

Our single-payer system, which is called Medicare (see
above), manages not to have the “wait times” issue that
Canada’s does. There must, therefore, be some other reason
for the wait times. There is, of course.

In 1966, Canada implemented a single-payer health care
system, which is also known as Medicare. Since then, as a
country, Canadians have made a conscious decision to hold
down costs. One of the ways they do that is by limiting
supply, mostly for elective things, which can create wait
times. Their outcomes are otherwise comparable to ours.

Please understand, the wait times could be overcome.
Canadians could spend more. They don’t want to. We can
choose to dislike wait times in principle, but they are a
byproduct of Canada’s choice to be fiscally conservative.

Yes, they chose this. In a rational world, those who are
concerned about health care costs and what they mean to the
economy might respect that course of action. But instead,
they attack the system.

Myth #5: Canada rations health care; the United States
doesn’t.

This one’s a little bit tricky. The truth is, Canada may
“ration” by making people wait for some things, but here in
the United States we also “ration” — by cost.

An 11-country survey carried out in 2010 by the Commonwealth
Fund, a Washington-based health policy foundation, found
that adults in the United States are by far the most likely
to go without care because of cost. In fact, 42 percent of
the Americans surveyed did not express confidence that they
would be able to afford health care if seriously ill.

Source: “How Health Insurance Design Affects Access to Care
and Costs, by Income, in Eleven Countries,” Health Affairs,
November 2010.

Further, about a third of the Americans surveyed reported
that, in the preceding year, they didn’t go to the doctor
when sick, didn’t get recommended care when needed, didn’t
fill a prescription or skipped doses of medications because
of cost.

Finally, about one in five of the Americans surveyed had
struggled to pay or were unable to pay their medical bills
in the preceding year. That was more than twice the
percentage found in any of the other 10 countries.

And remember: We’re spending way more on health care than
any other country, and for all that money we’re getting at
best middling results.

So feel free to have a discussion about the relative merits
of the U.S. and Canadian health care systems. Just stick to
the facts.

Aaron E. Carroll frequently blogs about this topic for The
Incidental Economist and is the coauthor of Don’t Swallow
Your Gum: Myths, Half-Truths, and Outright Lies About Your
Body and Health."

http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
El Castor
2017-08-10 20:47:41 UTC
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Post by mg
On Wed, 9 Aug 2017 06:39:59 -0700 (PDT), me
Post by me
I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.
His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
"5 Myths About Canadian Health Care
by Aaron E. Carroll, M.D., M.S., April 16, 2012
How does the U.S. health care system stack up against
Canada’s? You’ve probably heard allegedly true horror
stories about the Canadian system — like 340-day waits for
knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the
director of the Center for Health Policy and Professionalism
Research in Indianapolis, identified the top myths about the
two health care systems.
Myth #1: Canadians are flocking to the United States to get
medical care.
How many times have you heard that Canadians, frustrated by
long wait times and rationing where they live, come to the
United States for medical care?
I don’t deny that some well-off people might come to the
United States for medical care. If I needed a heart or lung
transplant, there’s no place I’d rather have it done. But
for the vast, vast majority of people, that’s not happening.
The most comprehensive study I’ve seen on this topic — it
employed three different methodologies, all with solid
rationales behind them — was published in the peer-reviewed
journal Health Affairs.
Source: “Phantoms in the Snow: Canadians’ Use of Health Care
Services in the United States,” Health Affairs, May 2002.
The authors of the study started by surveying 136 ambulatory
care facilities near the U.S.-Canada border in Michigan, New
York and Washington. It makes sense that Canadians crossing
the border for care would favor places close by, right? It
turns out, however, that about 80 percent of such facilities
saw, on average, fewer than one Canadian per month; about 40
percent had seen none in the preceding year.
Then, the researchers looked at how many Canadians were
discharged over a five-year period from acute-care hospitals
in the same three states. They found that more than 80
percent of these hospital visits were for emergency or
urgent care (that is, tourists who had to go to the
emergency room). Only about 20 percent of the visits were
for elective procedures or care.
Next, the authors of the study surveyed America’s 20 “best”
hospitals — as identified by U.S. News & World Report — on
the assumption that if Canadians were going to travel for
health care, they would be more likely to go to the
best-known and highest-quality facilities. Only one of the
11 hospitals that responded saw more than 60 Canadians in a
year. And, again, that included both emergencies and
elective care.
Finally, the study’s authors examined data from the 18,000
Canadians who participated in the National Population Health
Survey. In the previous year, 90 of those 18,000 Canadians
had received care in the United States; only 20 of them,
however, reported going to the United States expressively
for the purpose of obtaining care.
Myth #2: Doctors in Canada are flocking to the United States
to practice.
Every time I talk about health care policy with physicians,
one inevitably tells me of the doctor he or she knows who
ran away from Canada to practice in the United States.
Evidently, there’s a general perception that practicing
medicine in the United States is much more satisfying than
in Canada.
The Canadian Institute for Health Information has been
tracking doctors’ destinations since 1992. Since then, 60
percent to 70 percent of the physicians who emigrate have
headed south of the border. In the mid-1990s, the number of
Canadian doctors leaving for the United States spiked at
about 400 to 500 a year. But in recent years this number has
declined, with only 169 physicians leaving for the States in
2003, 138 in 2004 and 122 both in 2005 and 2006. These
numbers represent less than 0.5 percent of all doctors
working in Canada.
So when emigration “spiked,” 400 to 500 doctors were leaving
Canada for the United States. There are more than 800,000
physicians in the United States right now, so I’m skeptical
that every doctor knows one of those émigrés.
In 2004, net emigration became net immigration. Let me say
that again. More doctors were moving into Canada than were
moving out.
Myth #3: Canada rations health care; that’s why hip
replacements and cataract surgeries happen faster in the
United States.
When people want to demonize Canada’s health care system —
and other single-payer systems, for that matter — they
always end up going after rationing, and often hip
replacements in particular.
Take Republican Rep. Todd Akin of Missouri, for example. A
couple of years ago he took to the House floor to tell his
“I just hit 62, and I was just reading that in Canada [if] I
got a bad hip I wouldn’t be able to get that hip replacement
that [Rep. Dan Lungren] got, because I’m too old! I’m an old
geezer now and it’s not worth a government bureaucrat to pay
me to get my hip fixed.”
Sigh.
This has been debunked so often, it’s tiring. The St. Louis
Post-Dispatch, for example, concluded: “At least 63 percent
of hip replacements performed in Canada last year [2008] ...
were on patients age 65 or older.” And more than 1,500 of
those, it turned out, were on patients over 85.
The bottom line: Canada doesn’t deny hip replacements to
older people.
But there’s more.
Know who gets most of the hip replacements in the United
States? Older people.
Know who pays for care for older people in the United
States? Medicare.
Know what Medicare is? A single-payer system.
Myth #4: Canada has long wait times because it has a
single-payer system.
The wait times that Canada might experience are not caused
by its being a single-payer system.
Wait times aren’t like cancer. We know what causes wait
times; we know how to fix them. Spend more money.
Our single-payer system, which is called Medicare (see
above), manages not to have the “wait times” issue that
Canada’s does. There must, therefore, be some other reason
for the wait times. There is, of course.
In 1966, Canada implemented a single-payer health care
system, which is also known as Medicare. Since then, as a
country, Canadians have made a conscious decision to hold
down costs. One of the ways they do that is by limiting
supply, mostly for elective things, which can create wait
times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome.
Canadians could spend more. They don’t want to. We can
choose to dislike wait times in principle, but they are a
byproduct of Canada’s choice to be fiscally conservative.
Yes, they chose this. In a rational world, those who are
concerned about health care costs and what they mean to the
economy might respect that course of action. But instead,
they attack the system.
Myth #5: Canada rations health care; the United States
doesn’t.
This one’s a little bit tricky. The truth is, Canada may
“ration” by making people wait for some things, but here in
the United States we also “ration” — by cost.
An 11-country survey carried out in 2010 by the Commonwealth
Fund, a Washington-based health policy foundation, found
that adults in the United States are by far the most likely
to go without care because of cost. In fact, 42 percent of
the Americans surveyed did not express confidence that they
would be able to afford health care if seriously ill.
Source: “How Health Insurance Design Affects Access to Care
and Costs, by Income, in Eleven Countries,” Health Affairs,
November 2010.
Further, about a third of the Americans surveyed reported
that, in the preceding year, they didn’t go to the doctor
when sick, didn’t get recommended care when needed, didn’t
fill a prescription or skipped doses of medications because
of cost.
Finally, about one in five of the Americans surveyed had
struggled to pay or were unable to pay their medical bills
in the preceding year. That was more than twice the
percentage found in any of the other 10 countries.
And remember: We’re spending way more on health care than
any other country, and for all that money we’re getting at
best middling results.
So feel free to have a discussion about the relative merits
of the U.S. and Canadian health care systems. Just stick to
the facts.
Aaron E. Carroll frequently blogs about this topic for The
Incidental Economist and is the coauthor of Don’t Swallow
Your Gum: Myths, Half-Truths, and Outright Lies About Your
Body and Health."
http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
More "myths" ...

"In 2014, 52,513 Canadians travelled beyond our borders to seek
medical treatment, compared with 41,838 in 2013"
http://nationalpost.com/news/canada/number-of-canadian-patients-travelling-abroad-for-treatment-increased-by-25-study-finds/wcm/fd7f9f40-ea48-4422-bb97-520174d8324a

"A survey by the Fraser Institute found a median wait of 20 weeks for
“medically necessary” treatments and procedures in 2016 – the
longest-recorded wait time since the think tank began tracking wait
times."

"The survey looked at total wait times faced by patients starting from
the time they received a referral from a general practitioner, to the
consultation with a specialist, to “when the patient ultimately
receives treatment.”"
Median wait time by province in 2016:
New Brunswick: 38.8 weeks
Nova Scotia: 34. 8
P.E.I: 31.4
Newfoundland and Labrador: 26
British Columbia: 25.2
Alberta: 22.9
Manitoba: 20.6
Quebec: 18.9
Saskatchewan: 16.6
Ontario: 15.6
http://www.ctvnews.ca/health/healthcare-wait-times-hit-20-weeks-in-2016-report-1.3171718

https://www.theglobeandmail.com/news/british-columbia/bcs-doctor-shortage-becomes-campaign-issue-for-provinces-liberals-and-ndp/article34793897/
B.C.’s doctor shortage becomes campaign issue for province’s Liberals
and NDP

"Canadian emergency rooms plagued by overcrowding, sending gravely ill
patients into hallways
At one Halifax ER, overcrowding led to a pancreatic cancer patient
being bumped from his room — and spending 6 hours in a chilly hospital
hallway.
HALIFAX—Jack Webb had had enough.
He’d languished for six hours in a chilly emergency-room hallway, had
a broken IV in his arm, and was bumped from his room by another dying
patient during five days of struggles in Halifax’s largest hospital.
On his last day, he heard staff yell the clincher: “If he stops
breathing, don’t resuscitate.”" Note - He died
https://www.thestar.com/news/canada/2017/04/25/distinct-level-of-human-suffering-canadian-emergency-rooms-plagued-by-overcrowding.html
mg
2017-08-10 21:57:53 UTC
Reply
Permalink
Raw Message
On Thu, 10 Aug 2017 13:47:41 -0700, El Castor
Post by El Castor
Post by mg
On Wed, 9 Aug 2017 06:39:59 -0700 (PDT), me
Post by me
I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.
His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
"5 Myths About Canadian Health Care
by Aaron E. Carroll, M.D., M.S., April 16, 2012
How does the U.S. health care system stack up against
Canada’s? You’ve probably heard allegedly true horror
stories about the Canadian system — like 340-day waits for
knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the
director of the Center for Health Policy and Professionalism
Research in Indianapolis, identified the top myths about the
two health care systems.
Myth #1: Canadians are flocking to the United States to get
medical care.
How many times have you heard that Canadians, frustrated by
long wait times and rationing where they live, come to the
United States for medical care?
I don’t deny that some well-off people might come to the
United States for medical care. If I needed a heart or lung
transplant, there’s no place I’d rather have it done. But
for the vast, vast majority of people, that’s not happening.
The most comprehensive study I’ve seen on this topic — it
employed three different methodologies, all with solid
rationales behind them — was published in the peer-reviewed
journal Health Affairs.
Source: “Phantoms in the Snow: Canadians’ Use of Health Care
Services in the United States,” Health Affairs, May 2002.
The authors of the study started by surveying 136 ambulatory
care facilities near the U.S.-Canada border in Michigan, New
York and Washington. It makes sense that Canadians crossing
the border for care would favor places close by, right? It
turns out, however, that about 80 percent of such facilities
saw, on average, fewer than one Canadian per month; about 40
percent had seen none in the preceding year.
Then, the researchers looked at how many Canadians were
discharged over a five-year period from acute-care hospitals
in the same three states. They found that more than 80
percent of these hospital visits were for emergency or
urgent care (that is, tourists who had to go to the
emergency room). Only about 20 percent of the visits were
for elective procedures or care.
Next, the authors of the study surveyed America’s 20 “best”
hospitals — as identified by U.S. News & World Report — on
the assumption that if Canadians were going to travel for
health care, they would be more likely to go to the
best-known and highest-quality facilities. Only one of the
11 hospitals that responded saw more than 60 Canadians in a
year. And, again, that included both emergencies and
elective care.
Finally, the study’s authors examined data from the 18,000
Canadians who participated in the National Population Health
Survey. In the previous year, 90 of those 18,000 Canadians
had received care in the United States; only 20 of them,
however, reported going to the United States expressively
for the purpose of obtaining care.
Myth #2: Doctors in Canada are flocking to the United States
to practice.
Every time I talk about health care policy with physicians,
one inevitably tells me of the doctor he or she knows who
ran away from Canada to practice in the United States.
Evidently, there’s a general perception that practicing
medicine in the United States is much more satisfying than
in Canada.
The Canadian Institute for Health Information has been
tracking doctors’ destinations since 1992. Since then, 60
percent to 70 percent of the physicians who emigrate have
headed south of the border. In the mid-1990s, the number of
Canadian doctors leaving for the United States spiked at
about 400 to 500 a year. But in recent years this number has
declined, with only 169 physicians leaving for the States in
2003, 138 in 2004 and 122 both in 2005 and 2006. These
numbers represent less than 0.5 percent of all doctors
working in Canada.
So when emigration “spiked,” 400 to 500 doctors were leaving
Canada for the United States. There are more than 800,000
physicians in the United States right now, so I’m skeptical
that every doctor knows one of those émigrés.
In 2004, net emigration became net immigration. Let me say
that again. More doctors were moving into Canada than were
moving out.
Myth #3: Canada rations health care; that’s why hip
replacements and cataract surgeries happen faster in the
United States.
When people want to demonize Canada’s health care system —
and other single-payer systems, for that matter — they
always end up going after rationing, and often hip
replacements in particular.
Take Republican Rep. Todd Akin of Missouri, for example. A
couple of years ago he took to the House floor to tell his
“I just hit 62, and I was just reading that in Canada [if] I
got a bad hip I wouldn’t be able to get that hip replacement
that [Rep. Dan Lungren] got, because I’m too old! I’m an old
geezer now and it’s not worth a government bureaucrat to pay
me to get my hip fixed.”
Sigh.
This has been debunked so often, it’s tiring. The St. Louis
Post-Dispatch, for example, concluded: “At least 63 percent
of hip replacements performed in Canada last year [2008] ...
were on patients age 65 or older.” And more than 1,500 of
those, it turned out, were on patients over 85.
The bottom line: Canada doesn’t deny hip replacements to
older people.
But there’s more.
Know who gets most of the hip replacements in the United
States? Older people.
Know who pays for care for older people in the United
States? Medicare.
Know what Medicare is? A single-payer system.
Myth #4: Canada has long wait times because it has a
single-payer system.
The wait times that Canada might experience are not caused
by its being a single-payer system.
Wait times aren’t like cancer. We know what causes wait
times; we know how to fix them. Spend more money.
Our single-payer system, which is called Medicare (see
above), manages not to have the “wait times” issue that
Canada’s does. There must, therefore, be some other reason
for the wait times. There is, of course.
In 1966, Canada implemented a single-payer health care
system, which is also known as Medicare. Since then, as a
country, Canadians have made a conscious decision to hold
down costs. One of the ways they do that is by limiting
supply, mostly for elective things, which can create wait
times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome.
Canadians could spend more. They don’t want to. We can
choose to dislike wait times in principle, but they are a
byproduct of Canada’s choice to be fiscally conservative.
Yes, they chose this. In a rational world, those who are
concerned about health care costs and what they mean to the
economy might respect that course of action. But instead,
they attack the system.
Myth #5: Canada rations health care; the United States
doesn’t.
This one’s a little bit tricky. The truth is, Canada may
“ration” by making people wait for some things, but here in
the United States we also “ration” — by cost.
An 11-country survey carried out in 2010 by the Commonwealth
Fund, a Washington-based health policy foundation, found
that adults in the United States are by far the most likely
to go without care because of cost. In fact, 42 percent of
the Americans surveyed did not express confidence that they
would be able to afford health care if seriously ill.
Source: “How Health Insurance Design Affects Access to Care
and Costs, by Income, in Eleven Countries,” Health Affairs,
November 2010.
Further, about a third of the Americans surveyed reported
that, in the preceding year, they didn’t go to the doctor
when sick, didn’t get recommended care when needed, didn’t
fill a prescription or skipped doses of medications because
of cost.
Finally, about one in five of the Americans surveyed had
struggled to pay or were unable to pay their medical bills
in the preceding year. That was more than twice the
percentage found in any of the other 10 countries.
And remember: We’re spending way more on health care than
any other country, and for all that money we’re getting at
best middling results.
So feel free to have a discussion about the relative merits
of the U.S. and Canadian health care systems. Just stick to
the facts.
Aaron E. Carroll frequently blogs about this topic for The
Incidental Economist and is the coauthor of Don’t Swallow
Your Gum: Myths, Half-Truths, and Outright Lies About Your
Body and Health."
http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
More "myths" ...
"In 2014, 52,513 Canadians travelled beyond our borders to seek
medical treatment, compared with 41,838 in 2013"
http://nationalpost.com/news/canada/number-of-canadian-patients-travelling-abroad-for-treatment-increased-by-25-study-finds/wcm/fd7f9f40-ea48-4422-bb97-520174d8324a
See Myth #1, above, which references a study that used three
different methodologies that was was published in the
peer-reviewed journal Health Affairs.
Post by El Castor
"A survey by the Fraser Institute found a median wait of 20 weeks for
“medically necessary” treatments and procedures in 2016 – the
longest-recorded wait time since the think tank began tracking wait
times."
See Myth #4. Canada doesn't have long wait times because it
is a single-payer system. Canada made a conscious decision
to hold down costs by creating wait times. Single-payer
systems, however, do not automatically create longer wait
times. Medicare, for example, is a single-payer system and
it is not associated with longer wait times.
Post by El Castor
"The survey looked at total wait times faced by patients starting from
the time they received a referral from a general practitioner, to the
consultation with a specialist, to “when the patient ultimately
receives treatment.”"
New Brunswick: 38.8 weeks
Nova Scotia: 34. 8
P.E.I: 31.4
Newfoundland and Labrador: 26
British Columbia: 25.2
Alberta: 22.9
Manitoba: 20.6
Quebec: 18.9
Saskatchewan: 16.6
Ontario: 15.6
http://www.ctvnews.ca/health/healthcare-wait-times-hit-20-weeks-in-2016-report-1.3171718
https://www.theglobeandmail.com/news/british-columbia/bcs-doctor-shortage-becomes-campaign-issue-for-provinces-liberals-and-ndp/article34793897/
B.C.’s doctor shortage becomes campaign issue for province’s Liberals
and NDP
"Canadian emergency rooms plagued by overcrowding, sending gravely ill
patients into hallways
At one Halifax ER, overcrowding led to a pancreatic cancer patient
being bumped from his room — and spending 6 hours in a chilly hospital
hallway.
HALIFAX—Jack Webb had had enough.
He’d languished for six hours in a chilly emergency-room hallway, had
a broken IV in his arm, and was bumped from his room by another dying
patient during five days of struggles in Halifax’s largest hospital.
On his last day, he heard staff yell the clincher: “If he stops
breathing, don’t resuscitate.”" Note - He died
https://www.thestar.com/news/canada/2017/04/25/distinct-level-of-human-suffering-canadian-emergency-rooms-plagued-by-overcrowding.html
See Myth #5.
"The truth is, Canada may “ration” by making people wait for
some things, but here in the United States we also “ration”
— by cost.

An 11-country survey carried out in 2010 by the Commonwealth
Fund, a Washington-based health policy foundation, found
that adults in the United States are by far the most likely
to go without care because of cost. In fact, 42 percent of
the Americans surveyed did not express confidence that they
would be able to afford health care if seriously ill.

Source: “How Health Insurance Design Affects Access to Care
and Costs, by Income, in Eleven Countries,” Health Affairs,
November 2010.

Further, about a third of the Americans surveyed reported
that, in the preceding year, they didn’t go to the doctor
when sick, didn’t get recommended care when needed, didn’t
fill a prescription or skipped doses of medications because
of cost.

Finally, about one in five of the Americans surveyed had
struggled to pay or were unable to pay their medical bills
in the preceding year. That was more than twice the
percentage found in any of the other 10 countries.

And remember: We’re spending way more on health care than
any other country, and for all that money we’re getting at
best middling results."
rumpelstiltskin
2017-08-11 04:41:41 UTC
Reply
Permalink
Raw Message
Post by mg
On Wed, 9 Aug 2017 06:39:59 -0700 (PDT), me
Post by me
I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.
His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
"5 Myths About Canadian Health Care
by Aaron E. Carroll, M.D., M.S., April 16, 2012
How does the U.S. health care system stack up against
Canada’s? You’ve probably heard allegedly true horror
stories about the Canadian system — like 340-day waits for
knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the
director of the Center for Health Policy and Professionalism
Research in Indianapolis, identified the top myths about the
two health care systems.
Myth #1: Canadians are flocking to the United States to get
medical care.
How many times have you heard that Canadians, frustrated by
long wait times and rationing where they live, come to the
United States for medical care?
I don’t deny that some well-off people might come to the
United States for medical care. If I needed a heart or lung
transplant, there’s no place I’d rather have it done. But
for the vast, vast majority of people, that’s not happening.
The most comprehensive study I’ve seen on this topic — it
employed three different methodologies, all with solid
rationales behind them — was published in the peer-reviewed
journal Health Affairs.
Source: “Phantoms in the Snow: Canadians’ Use of Health Care
Services in the United States,” Health Affairs, May 2002.
The authors of the study started by surveying 136 ambulatory
care facilities near the U.S.-Canada border in Michigan, New
York and Washington. It makes sense that Canadians crossing
the border for care would favor places close by, right? It
turns out, however, that about 80 percent of such facilities
saw, on average, fewer than one Canadian per month; about 40
percent had seen none in the preceding year.
Then, the researchers looked at how many Canadians were
discharged over a five-year period from acute-care hospitals
in the same three states. They found that more than 80
percent of these hospital visits were for emergency or
urgent care (that is, tourists who had to go to the
emergency room). Only about 20 percent of the visits were
for elective procedures or care.
Next, the authors of the study surveyed America’s 20 “best”
hospitals — as identified by U.S. News & World Report — on
the assumption that if Canadians were going to travel for
health care, they would be more likely to go to the
best-known and highest-quality facilities. Only one of the
11 hospitals that responded saw more than 60 Canadians in a
year. And, again, that included both emergencies and
elective care.
Finally, the study’s authors examined data from the 18,000
Canadians who participated in the National Population Health
Survey. In the previous year, 90 of those 18,000 Canadians
had received care in the United States; only 20 of them,
however, reported going to the United States expressively
for the purpose of obtaining care.
Myth #2: Doctors in Canada are flocking to the United States
to practice.
Every time I talk about health care policy with physicians,
one inevitably tells me of the doctor he or she knows who
ran away from Canada to practice in the United States.
Evidently, there’s a general perception that practicing
medicine in the United States is much more satisfying than
in Canada.
The Canadian Institute for Health Information has been
tracking doctors’ destinations since 1992. Since then, 60
percent to 70 percent of the physicians who emigrate have
headed south of the border. In the mid-1990s, the number of
Canadian doctors leaving for the United States spiked at
about 400 to 500 a year. But in recent years this number has
declined, with only 169 physicians leaving for the States in
2003, 138 in 2004 and 122 both in 2005 and 2006. These
numbers represent less than 0.5 percent of all doctors
working in Canada.
So when emigration “spiked,” 400 to 500 doctors were leaving
Canada for the United States. There are more than 800,000
physicians in the United States right now, so I’m skeptical
that every doctor knows one of those émigrés.
In 2004, net emigration became net immigration. Let me say
that again. More doctors were moving into Canada than were
moving out.
Myth #3: Canada rations health care; that’s why hip
replacements and cataract surgeries happen faster in the
United States.
When people want to demonize Canada’s health care system —
and other single-payer systems, for that matter — they
always end up going after rationing, and often hip
replacements in particular.
Take Republican Rep. Todd Akin of Missouri, for example. A
couple of years ago he took to the House floor to tell his
“I just hit 62, and I was just reading that in Canada [if] I
got a bad hip I wouldn’t be able to get that hip replacement
that [Rep. Dan Lungren] got, because I’m too old! I’m an old
geezer now and it’s not worth a government bureaucrat to pay
me to get my hip fixed.”
Sigh.
This has been debunked so often, it’s tiring. The St. Louis
Post-Dispatch, for example, concluded: “At least 63 percent
of hip replacements performed in Canada last year [2008] ...
were on patients age 65 or older.” And more than 1,500 of
those, it turned out, were on patients over 85.
The bottom line: Canada doesn’t deny hip replacements to
older people.
But there’s more.
Know who gets most of the hip replacements in the United
States? Older people.
Know who pays for care for older people in the United
States? Medicare.
Know what Medicare is? A single-payer system.
Myth #4: Canada has long wait times because it has a
single-payer system.
The wait times that Canada might experience are not caused
by its being a single-payer system.
Wait times aren’t like cancer. We know what causes wait
times; we know how to fix them. Spend more money.
Our single-payer system, which is called Medicare (see
above), manages not to have the “wait times” issue that
Canada’s does. There must, therefore, be some other reason
for the wait times. There is, of course.
In 1966, Canada implemented a single-payer health care
system, which is also known as Medicare. Since then, as a
country, Canadians have made a conscious decision to hold
down costs. One of the ways they do that is by limiting
supply, mostly for elective things, which can create wait
times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome.
Canadians could spend more. They don’t want to. We can
choose to dislike wait times in principle, but they are a
byproduct of Canada’s choice to be fiscally conservative.
Yes, they chose this. In a rational world, those who are
concerned about health care costs and what they mean to the
economy might respect that course of action. But instead,
they attack the system.
Myth #5: Canada rations health care; the United States
doesn’t.
This one’s a little bit tricky. The truth is, Canada may
“ration” by making people wait for some things, but here in
the United States we also “ration” — by cost.
An 11-country survey carried out in 2010 by the Commonwealth
Fund, a Washington-based health policy foundation, found
that adults in the United States are by far the most likely
to go without care because of cost. In fact, 42 percent of
the Americans surveyed did not express confidence that they
would be able to afford health care if seriously ill.
Source: “How Health Insurance Design Affects Access to Care
and Costs, by Income, in Eleven Countries,” Health Affairs,
November 2010.
Further, about a third of the Americans surveyed reported
that, in the preceding year, they didn’t go to the doctor
when sick, didn’t get recommended care when needed, didn’t
fill a prescription or skipped doses of medications because
of cost.
Finally, about one in five of the Americans surveyed had
struggled to pay or were unable to pay their medical bills
in the preceding year. That was more than twice the
percentage found in any of the other 10 countries.
And remember: We’re spending way more on health care than
any other country, and for all that money we’re getting at
best middling results.
So feel free to have a discussion about the relative merits
of the U.S. and Canadian health care systems. Just stick to
the facts.
Aaron E. Carroll frequently blogs about this topic for The
Incidental Economist and is the coauthor of Don’t Swallow
Your Gum: Myths, Half-Truths, and Outright Lies About Your
Body and Health."
http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
I hope El Castor remembers this when he repeats his next
made-up claim garnered from his right-wing fright rags, but
of course he won't.
mg
2017-08-11 19:45:42 UTC
Reply
Permalink
Raw Message
Post by rumpelstiltskin
Post by mg
On Wed, 9 Aug 2017 06:39:59 -0700 (PDT), me
Post by me
I am now in Canada for a couple of months. Last night i attended a small social gathering of summe residents at this place. One was a retired Canadian. He was formerly employed (at university) in the health care system. We talked. He told me heath care decisions are not solely decided by doctors. Doctors tend to think primarily in the interests of the individual patient, he said. His belief is that in 'socialized medical care' this attitude and motivation is not acceptable. He indicated it is not socially desirable to spend large sums on health care in the last years of life. Consequently, there exist in Canada "expert committees" to essentially do cost-benefit analyses to determine what government will pay for and what it will not pay for. Such 'expert committees' essentially ration spending on health care. It is one reason Canada spends less on health care than the US.
His wife also had worked as a professor in the university teaching health care before she retired. She has cancer and gets chemotherapy every three weeks for life. I'm guessing cost-benefit calculations did not apply to her. There seems to an unusually high incidence of cancer in this area. I have met people who received little of no treatment. They simply died. Cost-benefit calculations seem not to be evenly and equally applied.
"5 Myths About Canadian Health Care
by Aaron E. Carroll, M.D., M.S., April 16, 2012
How does the U.S. health care system stack up against
Canada’s? You’ve probably heard allegedly true horror
stories about the Canadian system — like 340-day waits for
knee replacement surgery, for example.
To separate fact from fiction, Aaron E. Carroll, M.D., the
director of the Center for Health Policy and Professionalism
Research in Indianapolis, identified the top myths about the
two health care systems.
Myth #1: Canadians are flocking to the United States to get
medical care.
How many times have you heard that Canadians, frustrated by
long wait times and rationing where they live, come to the
United States for medical care?
I don’t deny that some well-off people might come to the
United States for medical care. If I needed a heart or lung
transplant, there’s no place I’d rather have it done. But
for the vast, vast majority of people, that’s not happening.
The most comprehensive study I’ve seen on this topic — it
employed three different methodologies, all with solid
rationales behind them — was published in the peer-reviewed
journal Health Affairs.
Source: “Phantoms in the Snow: Canadians’ Use of Health Care
Services in the United States,” Health Affairs, May 2002.
The authors of the study started by surveying 136 ambulatory
care facilities near the U.S.-Canada border in Michigan, New
York and Washington. It makes sense that Canadians crossing
the border for care would favor places close by, right? It
turns out, however, that about 80 percent of such facilities
saw, on average, fewer than one Canadian per month; about 40
percent had seen none in the preceding year.
Then, the researchers looked at how many Canadians were
discharged over a five-year period from acute-care hospitals
in the same three states. They found that more than 80
percent of these hospital visits were for emergency or
urgent care (that is, tourists who had to go to the
emergency room). Only about 20 percent of the visits were
for elective procedures or care.
Next, the authors of the study surveyed America’s 20 “best”
hospitals — as identified by U.S. News & World Report — on
the assumption that if Canadians were going to travel for
health care, they would be more likely to go to the
best-known and highest-quality facilities. Only one of the
11 hospitals that responded saw more than 60 Canadians in a
year. And, again, that included both emergencies and
elective care.
Finally, the study’s authors examined data from the 18,000
Canadians who participated in the National Population Health
Survey. In the previous year, 90 of those 18,000 Canadians
had received care in the United States; only 20 of them,
however, reported going to the United States expressively
for the purpose of obtaining care.
Myth #2: Doctors in Canada are flocking to the United States
to practice.
Every time I talk about health care policy with physicians,
one inevitably tells me of the doctor he or she knows who
ran away from Canada to practice in the United States.
Evidently, there’s a general perception that practicing
medicine in the United States is much more satisfying than
in Canada.
The Canadian Institute for Health Information has been
tracking doctors’ destinations since 1992. Since then, 60
percent to 70 percent of the physicians who emigrate have
headed south of the border. In the mid-1990s, the number of
Canadian doctors leaving for the United States spiked at
about 400 to 500 a year. But in recent years this number has
declined, with only 169 physicians leaving for the States in
2003, 138 in 2004 and 122 both in 2005 and 2006. These
numbers represent less than 0.5 percent of all doctors
working in Canada.
So when emigration “spiked,” 400 to 500 doctors were leaving
Canada for the United States. There are more than 800,000
physicians in the United States right now, so I’m skeptical
that every doctor knows one of those émigrés.
In 2004, net emigration became net immigration. Let me say
that again. More doctors were moving into Canada than were
moving out.
Myth #3: Canada rations health care; that’s why hip
replacements and cataract surgeries happen faster in the
United States.
When people want to demonize Canada’s health care system —
and other single-payer systems, for that matter — they
always end up going after rationing, and often hip
replacements in particular.
Take Republican Rep. Todd Akin of Missouri, for example. A
couple of years ago he took to the House floor to tell his
“I just hit 62, and I was just reading that in Canada [if] I
got a bad hip I wouldn’t be able to get that hip replacement
that [Rep. Dan Lungren] got, because I’m too old! I’m an old
geezer now and it’s not worth a government bureaucrat to pay
me to get my hip fixed.”
Sigh.
This has been debunked so often, it’s tiring. The St. Louis
Post-Dispatch, for example, concluded: “At least 63 percent
of hip replacements performed in Canada last year [2008] ...
were on patients age 65 or older.” And more than 1,500 of
those, it turned out, were on patients over 85.
The bottom line: Canada doesn’t deny hip replacements to
older people.
But there’s more.
Know who gets most of the hip replacements in the United
States? Older people.
Know who pays for care for older people in the United
States? Medicare.
Know what Medicare is? A single-payer system.
Myth #4: Canada has long wait times because it has a
single-payer system.
The wait times that Canada might experience are not caused
by its being a single-payer system.
Wait times aren’t like cancer. We know what causes wait
times; we know how to fix them. Spend more money.
Our single-payer system, which is called Medicare (see
above), manages not to have the “wait times” issue that
Canada’s does. There must, therefore, be some other reason
for the wait times. There is, of course.
In 1966, Canada implemented a single-payer health care
system, which is also known as Medicare. Since then, as a
country, Canadians have made a conscious decision to hold
down costs. One of the ways they do that is by limiting
supply, mostly for elective things, which can create wait
times. Their outcomes are otherwise comparable to ours.
Please understand, the wait times could be overcome.
Canadians could spend more. They don’t want to. We can
choose to dislike wait times in principle, but they are a
byproduct of Canada’s choice to be fiscally conservative.
Yes, they chose this. In a rational world, those who are
concerned about health care costs and what they mean to the
economy might respect that course of action. But instead,
they attack the system.
Myth #5: Canada rations health care; the United States
doesn’t.
This one’s a little bit tricky. The truth is, Canada may
“ration” by making people wait for some things, but here in
the United States we also “ration” — by cost.
An 11-country survey carried out in 2010 by the Commonwealth
Fund, a Washington-based health policy foundation, found
that adults in the United States are by far the most likely
to go without care because of cost. In fact, 42 percent of
the Americans surveyed did not express confidence that they
would be able to afford health care if seriously ill.
Source: “How Health Insurance Design Affects Access to Care
and Costs, by Income, in Eleven Countries,” Health Affairs,
November 2010.
Further, about a third of the Americans surveyed reported
that, in the preceding year, they didn’t go to the doctor
when sick, didn’t get recommended care when needed, didn’t
fill a prescription or skipped doses of medications because
of cost.
Finally, about one in five of the Americans surveyed had
struggled to pay or were unable to pay their medical bills
in the preceding year. That was more than twice the
percentage found in any of the other 10 countries.
And remember: We’re spending way more on health care than
any other country, and for all that money we’re getting at
best middling results.
So feel free to have a discussion about the relative merits
of the U.S. and Canadian health care systems. Just stick to
the facts.
Aaron E. Carroll frequently blogs about this topic for The
Incidental Economist and is the coauthor of Don’t Swallow
Your Gum: Myths, Half-Truths, and Outright Lies About Your
Body and Health."
http://www.aarp.org/politics-society/government-elections/info-03-2012/myths-canada-health-care.html
I hope El Castor remembers this when he repeats his next
made-up claim garnered from his right-wing fright rags, but
of course he won't.
My wife used to have a saying: "I want what I want when I
want it". Life is full of trade-offs and my wife and I, in
our younger days, used to argue about that once in awhile
until finally I gave up. I used to tell her, though, that
she had champagne tastes on a beer budget. Something else
that I used to tell her was that if we buy one thing that
meant that there would be something else that we wouldn't be
able to buy.

Her answer was: OH! BULLSHIT! and that would be the end of
the argument.

In the final years, I got a lot more vocal, though, and a
lot less timid. One time, for instance, she had her heart
set on going on vacation to Vegas. I asked her how much
money we had to spend and she said "500 dollars" and I said
something to the effect: "To hell with that! I'm not going
to Vegas with only $500 to spend".
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