IT'S TIME FOR UNIVERSAL HEALTH CARE

ehBeth, understood. I agree that it's not a text book single payer system. However, let me highlight one term in the above excerpt:

Quote:

on a complementary basis

As far as I understand the Canadian system, the government pays virtually 100 percent of all costs that arise from hospital and physician care. So that seems to be consistent with a single payer system.

However, it doesn't cover prescription drug costs, dental care, and several other additional services. There, you have the option to either pay for that out of your own pocket, or to choose an additional insurance that covers all of that. Right?

To me, that would sound like a modified single payer system. I think Canada calls it a "public system," right?

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georgeob1 wrote:

You probably have a good point there. However I think you will concede that these feedback systems work far less efficiently where government is involved. The potential for various unions and professional groups to unduly influence government to sacrifice the people's interest to those of unions and the like is amply demonstrated here in our public education system. (I educated my children in private schools and was well rewarded for the expense).

I tend to agree, but I don't know if you can declare this (whenever the government gets involved, things go downhill) ex cathedra as a rule.

Sure, a government run system will skew market forces. On the other hand, the rationale behind a completely state run system might be to get influence the forces of supply and demand. The obvious point (which is the one you already referred to) would be that you create a monopoly, and have completely different dynamics when negotiating with pharmaceutical companies, medical equipment manufacturers, etc. etc.
Essentially, you create a monopolistic entity in a free market environment. At least in theory, this could actually work to the benefit of the system.

georgeob1 wrote:

In the case of pharmaceuticals we are one of the few countries that tolerates a relatively free market. The result is that U.S. consumers are largely financing the profits and research investments of the increasingly international firms that develop drugs. I would favor legislation that prohibited any pharmaceutical firm from charging more for their products here than they charge any government sponsored single buyer elsewhere in the world. I suspect that would very quickly raise the costs for Canadians and others, and lower them here.

Good point. That's certainly an important aspect. However, I doubt that the US is "one of the few countries that tolerates a relatively free market." I'm pretty sure that most countries with a statutory health care system don't get involved in the area of prescription drugs to the level where you can't speak of a free market anymore.
Putting regulation in place or even making exclusive deals makes arguably more sense in a single payer system. I admit that I don't know too much about how this compares across countries.

georgeob1 wrote:

I agree with you here. As I said earlier our present system combines several of the worst aspects of both free market and government operated systems. The only thing I dread more than what we presently have are the half-baked proposals being put forward by the current crop of presidential candidates (not a vintage year for us).

Well, I think it's the nature of health care systems that they are constantly being redesigned. The time patients have to stay in hospitals seems to decrease continuously, nixing the need to have an overly large number of hospital beds constantly available. On the other hand, new therapies and equipment tend to be ever more expensive than what was previously common.

But you're right, the current proposals are certainly of interest. I also doubt that the American system can be simply transformed into any kind of other system. I guess even a new universal health care system would likely leave the insurance companies in place.

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I know that the US has the UK provide us with flu vaccines, but I'm not sure whether they are a branch of a US company. I'm sure many drug companies are international corporations.

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ehBeth wrote:

It's called universal health care. There are private insurers, provincial and federal and municipal self-insureds, public insurers, and private self-insureds. You're required to have coverage, but there are a lot of ways to get it.

Sounds like the Romney plan for Universal health Care, we have here in Massachusetts. Laughing

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Not really.

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old europe wrote:

ehBeth, understood. I agree that it's not a text book single payer system. However, let me highlight one term in the above excerpt:

Quote:
on a complementary basis

As far as I understand the Canadian system, the government pays virtually 100 percent of all costs that arise from hospital and physician care. So that seems to be consistent with a single payer system.

Still a no for you there.

The Canadian system has a lot of government controls - controlling the number of publicly-funded hospitals/beds/new doctors/new nurses/new physiotherapists/new occupational therapists etc. However, private insurers pay more of the hospital and physician costs than you think.

Remember this?

Quote:

The financing of health care in Canada is divided as follows for each dollar spent:

60 cents by public insurance plans set up by the provinces;

15 cents directly from the pockets of citizens;

13 cents by public programs other than insurance (including direct spending by the Federal government),private programs (such as hospital foundations) and public or private research programs;

and,

12 cents by complementary health insurance plans obtained on a group or individual basis from a private insurer.

60 - 70% is not quite the same as virtually 100%

~~~

There are private clinics and small private hospitals in a number of provinces. There is almost no payment available from government for services provided at those facilities.

The Shouldice Clinic - one of my favourites (it has a great location and clubby atmosphere)

Quote:

4) How much does the surgery cost?
The accounting staff will provide an estimate of charges, once you have either been examined at the hospital, or we have received your completed medical questionnaire. Residents of Ontario who have a valid health card are covered by the provincial health care system for the cost of surgery.

5) Do you take XYZ insurance?
We deal with many insurance companies. While many companies will pay us directly, some will only reimburse the patient. In that case, the hospital would complete all paper work and have it ready for you on discharge from the hospital. You could pay for your medical services by cash, personal cheque or credit card.

The Ontario government will, in this case, pay for the surgery (the surgeon's actual time) and ward space - but not a room, nursing care, the operating room, any medication, nor the work-up time, nothing else.

The Ontario government controls the Shouldice in these ways

Quote:

SURGICAL STAFFING

* 12 full time surgeons
* surgeons licensed by the College of Physicians & Surgeons, Ontario

HOSPITAL LICENSING

* 89 semi-private licensed beds
* licensed by the Ministry of Health, Province of Ontario
* inspected annually by the Ministry of Health

http://www.shouldice.com/admin.htm

~~~

It's a messy system, likely to get messier before it settles down, but it seems to work pretty well. (new reports release today on continuing improvements in patient care)

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Miller wrote:

Sounds like the Romney plan for Universal health Care, we have here in Massachusetts.

Not quite, but it could be a decent role model for Massachusetts.

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old europe wrote :

Quote:

hamburger wrote:
"what youtube CONVENIENTLY forgot to mention "

oe wrote :
Quote:

Well, to be fair, that wasn't youtube, that was the author, director and producer of that video clip, Stuart E. Browning. He's also behind the "Free Market Cure" series. "Free Market Cure" is purportedly "dedicated to correctly diagnosing the problems with the U.S. health care system" - but doesn't really offer any possible improvements to the system and limits itself instead to bashing mostly the Canadian system.

you are absolutely correct , old europe !
i should have probably said :
"what the SPEAKER on youtube forgot conveniently to mention" .

some points i might add :
imo what the report on youtube actually shows , is what happens when a conservative government almost succeeds in gutting a public health care system by trying to starve it to death .
unfortunately , they might still succeed because people often have a short memory and don't realize that consequences being suffered today are a result of that "common sense revolution" .
the federal (conservative) government however has stated that they are commited to a public health health care system .

i think an interesting point is that the ontario health care sytem was actually started under a CONSERVATIVE government !
those were the RED TORIES ! i think it's somewhat unique to canada that we have RED TORIES (officially called "progressive conservatives") and OTHER conservatives - they have a tendency to come together at times and go their separate ways at other times ! (WE ARE CANADIANS ; WE LIKE TO BE UNIQUE ! Laughing

)
-------------------------------------------------------------------------------------
initial credit for starting a PROVINCIAL health care system goes to a firebrand BAPTIST PREACHER and provincial premier of saskatchewan - TOMMY DOUGLAS ! .
he had witnessed the devastion that the depression had brought to the peoples of the prairies and was determined to bring universal health care to them and reduce their suffering .
btw he was voted THE GREATEST CANADIAN in 2004 - even though he was rather small in stature !

TOMMY DOUGLAS - THE GREATEST CANADIAN
-------------------------------------------------------------------------------------

getting back to the youtube report : imo it is almost criminal to shamelessly misuse the misfortune that befell this couple and present it as a failing of universal health care !
as i said : it was the deliberate gutting of the system by a conservative government that caused the crisis .
a premier comparing health-workers in our hospitals to workers in a hoola-hoop factory shows the crudeness and uncaring manner of (former) premier harris .

'nuff said ! (for now anyway :wink: )
hbg

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Premier Harris - that'd be part of the 'mess' I referred to.

The system's recovering from what he did, but it's got a way to go yet.

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Miller wrote:

ehBeth wrote:
It's called universal health care. There are private insurers, provincial and federal and municipal self-insureds, public insurers, and private self-insureds. You're required to have coverage, but there are a lot of ways to get it.

Sounds like the Romney plan for Universal health Care, we have here in Massachusetts.

Is Romney's healthcare system now in full effect? What are your views on it?

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ehbeth wrote :

Quote:

Premier Harris - that'd be part of the 'mess' I referred to.

The system's recovering from what he did, but it's got a way to go yet.

yes , it's amazing how he was able to ALMOST destroy the public health care system .

what is also amazing is , that people have a very short memory span !
not many will admit that they voted for harris , and if they do , they'll say : "why does it take so long to fix it , I WANT SERVICE NOW ? and it takes money , too ? " .
hbg

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ehBeth wrote:

The Canadian system has a lot of government controls - controlling the number of publicly-funded hospitals/beds/new doctors/new nurses/new physiotherapists/new occupational therapists etc. However, private insurers pay more of the hospital and physician costs than you think.

Remember this?

Quote:

The financing of health care in Canada is divided as follows for each dollar spent:

60 cents by public insurance plans set up by the provinces;

15 cents directly from the pockets of citizens;

13 cents by public programs other than insurance (including direct spending by the Federal government),private programs (such as hospital foundations) and public or private research programs;

and,

12 cents by complementary health insurance plans obtained on a group or individual basis from a private insurer.

60 - 70% is not quite the same as virtually 100%

Dunno. Question is how much the government rate on health expenditures actually tells us about the system in place. It might tell us something about how much the system is socialized, though.

See, I'd think that if you have a kind of universal health care system where people pay higher taxes, and in turn all basic health care services are provided by the government, you still have a single payer system - no matter what services you can choose to pay for on top of the basic, universal coverage. (Not necessarily speaking about Canada here, though.)

Likewise, if you have a system like the American one which is quite far from being a universal health care system, you can still get relatively high figures for the public expenditure rate on health care.

For the United States, for example, the rate is currently about 45.1% for public health care spending (according to the OECD health report). Which is admittedly not very high, but still higher than e.g. in Greece. Which has a universal health care system.

I'd think that the kind of system in place is determined by whether basic health care is financed by a single fund or by multiple payers/insurance companies. After that, the rate of public financing would depend on what is covered by that health care system, and by how much people choose to pay on top of that.

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I would like to see a system that is somewhat like the Canadian system where the government pays for the basics so that everybody is covered, then some co-pays and insurance for the extras. Since the US has Medicare that cares for everybody over 65, we need to have a system that will cover everybody else with some form of company sponsored, employee contribution, private pay, or other government and insurance coverage. There must be a way to have universal health care by sharing the cost between the government,employers, private insurance, and consumers.

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c.i. :
the money for canada's health insurance comes from various sources : taxpayer premium , sales taxes , general revenue .
employers with more than a few employees also contribute .
the "extended health benefits" - drugs , dental etc. - are usually provided by emploer in full or shared with employees .
there is also a limited amount of private extended health insurance - usually rather expensive .
btw hospitals are generally NOT run by any kind of government but by local health board . the hospitals generally operate on the money allocated to them by the ministry of health on an annual basis - not on fee for service .
for major construction/expension it is usually a mixture of government grants + fundraising (both corporate + individual contribution) .
it's a bit of a hodgepodge .
hbg

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hbg, That's how the community hospital is operated; it's funded by the county with subsidies from the federal and state.

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Advocate wrote:

Miller wrote:
ehBeth wrote:
It's called universal health care. There are private insurers, provincial and federal and municipal self-insureds, public insurers, and private self-insureds. You're required to have coverage, but there are a lot of ways to get it.

Sounds like the Romney plan for Universal health Care, we have here in Massachusetts.

Is Romney's healthcare system now in full effect? What are your views on it?

This plan became law in Massachusetts on July 1, 2007. Anyone, who doesn't enroll in this plan will be subjected to a penalty, the amount of which will grow with time.

The cost of the plan to each participant ( over the povertry level ), up to and including age 64 is based on age and locale of residence within the Commonwealth. In the age range of 20-30, the approximate premium is $300/month. In the age range of 60-64, the premium can be $700+/month.

At age 65, the individual usually enters the medicare and SS program.

At first it looks like a good plan, as more and more residents are now covered by health insurance.
One disadvantage is that it is compulsory. There's no way to get out of it, exxcept to leave the State.

The cheaper the health insurance ( as the plans will vary in cost depending on the provider ), the less is covered and the more stringent the control by the plan becomes ( approvals, etc ).

Basically, again, you get what you pay for.

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The basic problem: All anybody has ever heard so far about "fixing" the American system is plans to throw more money at our present system or to allow it to cover a few more people. That's like throwing gasoline on a fire to try to put it out. A real solution has to lower the costs, regardless of who pays for it or how they pay for it.

The first and most obvious thing you'd do would be to eliminate the bullshit lawsuits, i.e. eliminate lawsuits against doctors while ensuring that a doctor who ever screws up in a non-defensible manner loses his license to practice. THAT would cut the cost of health care in America in half. It would also greviously wound one of the two most major pillars of financial support for the rogue demoKKKrat party (the other being the NEA and other govt. unions). That of course should not bother anybody whose opinions are worth worrying about.

The next two or three things you'd do:

Break the power of the pharmaceuticals to set prices for drugs in America.

Eliminate the gigantic costs of bringing any new medicine to the market.

Enact laws to prevent med schools from artificially limiting the number of physicians in the country.

Do any other "trust busting" (Teddy Roosevelt's term) needed to repair the system.

Heave the illegal aliens. Let anybody who needs "guest workers" provide his own medical services for them.

A hundred years ago in America there was no socialized medicine and medicine was generally affordable.

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Quote:

Eliminate the gigantic costs of bringing any new medicine to the market

Without cash, how could there possibly be basic research? Cool

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Quote:

A hundred years ago in America there was no socialized medicine and medicine was generally affordable.

1907?

Which "medicines" were available then, that you'd like to use today?

Which "medicines" available today, would you care to dispense with? Cool

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Interestingly, the drug companies pay for only about half the research being conducted. Half is paid for by us taxpayers, through grants to universities, etc., with the resulting discoveries picked up by the drug companies free of charge. They then charge full fare as branded drugs, with full patent protection.

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IT'S TIME FOR UNIVERSAL HEALTH CARE

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