Free Health Care (Canada)

[Greatguardian]

I think a small fee isn't really an awful thing. People tend to be less judicious with things that are free and tend to put more thought into what they do when it costs them something tangible. I think it's always a good idea to put a small non prohibitive price on public goods to make sure people don't abuse it as much as they would if it were free.

$30-$50 is way beyond disincentive territory for the average American. I'm not talking about "average" white, middle class, internet-savvy and college educated American, but true average, $30,000/yr American. The people who need preventative care the most are also those with the lowest standard of living, not the highest. I've lived in comfort, and I've lived as damn near homeless, and I can tell you that even in the middle $30-$50 feels like a lot of money to a lot of people - especially when the prevailing attitude is that "Health is unimportant until you're dead".

I won't dance around the issue of human nature, though. If you want a populace that knows better than to waste public funds, educate them. Changing society in order to try and influence people is ass-backwards, despite it being the go-to for just about everyone in political discourse. If the issue is with mis-management and abuse, then the problem is with the people and not the system and should be treated as such. Every system is going to be open to some form of abuse, always. The goal is to create an educated populace that knows better than to abuse it, despite being able to.

[Kuya]

A $10 fee is faster than changing culture. No reason why you can't do one while you do the other.

[hey]

$10 to see a doctor? Fuck that shit, i'll keep my private insurance.

[Greatguardian]

A $10 fee is faster than changing culture. No reason why you can't do one while you do the other.

$5-$10 is more "doable" for GP care. Though, at that point, is it really worth implementing at all? The last thing people should be worrying about is their health. It affects absolutely everything else. Poor/uninsured person gets sick/injured and can't work? That's lost revenue that the govt isn't making in taxes, and lost money that they're paying out in disability/MA/MC. The base currency of the world economy is human labor, and anything that interferes with the ability of people to work is money lost somewhere in the chain. The absolute cheapest thing for everyone involved is to encourage people to go see the correct doctor, not discourage them from seeking medical care. The more illnesses that are caught sooner rather than later, the more money the hospital system saves. The healthier the workforce, the more they are able to produce. The more they are able to produce, the more prosperous everyone is.

$10 to see a doctor? Fuck that shit, i'll keep my private insurance.

lol. You don't even have a co-pay? Not at all? Hell, I have private insurance and I still pay $150/ER visit and $30/GP.

[Greatguardian]

Holy doubles, batman

[Kuya]

$5-$10 is more "doable" for GP care. Though, at that point, is it really worth implementing at all? The last thing people should be worrying about is their health. It affects absolutely everything else. Poor/uninsured person gets sick/injured and can't work? That's lost revenue that the govt isn't making in taxes, and lost money that they're paying out in disability/MA/MC. The base currency of the world economy is human labor, and anything that interferes with the ability of people to work is money lost somewhere in the chain. The absolute cheapest thing for everyone involved is to encourage people to go see the correct doctor, not discourage them from seeking medical care. The more illnesses that are caught sooner rather than later, the more money the hospital system saves. The healthier the workforce, the more they are able to produce. The more they are able to produce, the more prosperous everyone is.



.

I don't know why you keep reiterating the same thing again but with more words. Make a campaign to educate people if you must, but that takes time, and in the mean time, you can put in place fees that are reasonable so people don't just treat public goods such are medical services like public bathrooms.

[guartz]

goddamn, why are people always fucking great social systems designed for them? If only people acted like we want them to, then our social services will work.


^ very old tune... very dangerous path.

[Kuya]

goddamn, why are people always fucking great social systems designed for them? If only people acted like we want them to, then our social services will work.


^ very old tune... very dangerous path.

Yes, guartz. That's why if policy doesn't work, rather than throw your hands up in the air and whine about how stupid people are, you rework policy so that it does actually work.

I'm not entirely sure what you were mocking, but i suspect it has something to do with how central planning is folly and how only an anarchist-capitalist system of organizing society will do.

[Greatguardian]

I don't know why you keep reiterating the same thing again but with more words. Make a campaign to educate people if you must, but that takes time, and in the mean time, you can put in place fees that are reasonable so people don't just treat public goods such are medical services like public bathrooms.

And what exactly is so wrong with people going to see a doctor when they're sick that we'd want to discourage it?

That's the core of the issue. The answer is absolutely nothing. If you don't go to the doctor until you're vomiting blood, you're just wasting taxpayer dollars. People should be going to the doctor regularly whether they need to or not - checkups, preventative care, and access to health and wellness education are all important.

I'll maintain that it's not only cheaper overall for people to "treat UHS like a public restroom", but more beneficial to the economy and society as a whole as opposed to the opposite route of actively discouraging the act of seeking medical advice. Clearly the process of people growing up to such a state where they can use UHS responsibly is something that would take a lot of time, but if we're only left with those two options in the interim then the former is highly preferable.

[guartz]

Yes, guartz. That's why if policy doesn't work, rather than throw your hands up in the air and whine about how stupid people are, you rework policy so that it does actually work.

You missed my sarcasm. I'll spell it out. I was making fun of socialist mentality that when their programs don't work as expected, the first reaction is to reeducate the public. And unless I missed the point you guys just made, that's exactly the type of solution you guys reached.

[Kuya]

And what exactly is so wrong with people going to see a doctor when they're sick that we'd want to discourage it?

That's the core of the issue. The answer is absolutely nothing. If you don't go to the doctor until you're vomiting blood, you're just wasting taxpayer dollars. People should be going to the doctor regularly whether they need to or not - checkups, preventative care, and access to health and wellness education are all important.

I'll maintain that it's not only cheaper overall for people to "treat UHS like a public restroom", but more beneficial to the economy and society as a whole as opposed to the opposite route of actively discouraging the act of seeking medical advice. Clearly the process of people growing up to such a state where they can use UHS responsibly is something that would take a lot of time, but if we're only left with those two options in the interim then the former is highly preferable.

Oh, okay.

You missed my sarcasm. I'll spell it out. I was making fun of socialist mentality that when their programs don't work as expected, the first reaction is to reeducate the public. And unless I missed the point you guys just made, that's exactly the type of solution you guys reached.

Greatguardian wants to reeducate the unwashed masses. I think a few fees here or there might be enough, but i don't have any problems with a public campaign if it proves useful. I don't have a problem with it, since i don't have an ideological issue with it.

[Kaylia]

http://www.montrealgazette.com/healt...860/story.html

MONTREAL — A girl coughing up blood waited until early morning to see an emergency room physician. She arrived at the ER in the middle of the night recently. The hospital was backlogged, one doctor was working the midnight shift, and he was on a “code blue” resuscitating a dying patient. Everyone else waited and waited and waited.
http://www.montrealgazette.com/health/6103292.bin
This is what every corridors look like. You don't get a [free] room unless you pay 200$/night..assuming they aren't all occupied already. And this isn't temporary measure, this is where you will spend the next few days more often than not.

I have a few aunts and cousins who have been nurses for over 20 years and they all say the long waits are a direct result of mismanagement and a lack of doctors and hospital beds due to budget cuts that have been going on for over a decade. This is all information given to me by people who have seen the degradation of the health care system first hand so take it as you will.

All B.C. nurses btw.

It's mostly due to the poor administration, because the budgets weren't cut (they have been growing faster than inflation rate).

If given the choice to live in a left-wing shithole or a right-wing shithole, i'd much rather the former, but i suppose i'll have to take your word for it because i know nothing of Quebec.

To be honest, the left/right debate is hardly an issue. Every problems should be looked at individually, and I don't believe one side is better everywhere. Ideologically speaking, I tend to side with the left more, but in practice, I found some of the left-wing decisions to be very counter productive here (in canada). In usa, I doubt I would be on that arbitrary side.

Without taking any austerity measure, most of our system could use a strict reform, and that's not something I expect to see from any of our left-wing parties. It's why I tend to side on the opposite end, even if my opinion is actually quite centered.

I'll take 1 and 2, and leave number 3. Efficiency in the private sector means cost cutting, and cost cutting when it comes to health and labour isn't generally in favour of the consumer (health) or labour.

http://www.cmaj.ca/content/166/7/884.1.full
The Canadian Institute for Health Information (CIHI) recently reported that Quebec shows a net loss in the interprovincial migration of physicians,1 and this poor performance is compounded by the departure of physicians to other countries. In all, 653 doctors have left Quebec in the past 5 years. Their average age was 40.8 years, so they were at the peak of their productivity. Why are they leaving?

In theory, yes. In practice, not really. Private hospital offer infinitely better work condition than our public hospital if you look at the pay check, and the depression/burnout rate.

For the consumer, the end result is obviously piss poor right now for our public health care.

[Greatguardian]

Oh, okay.Greatguardian wants to reeducate the unwashed masses. I think a few fees here or there might be enough, but i don't have any problems with a public campaign if it proves useful. I don't have a problem with it, since i don't have an ideological issue with it.

I never said re-educate. I said educate. I have a hard-on for pointing out the massive functional flaws in the American education system, coming from a family full of teachers and professors with an extended family full of MDs (fuck yeah Indian blood). You can trace a lot of our country's "problems" back to it, and that's intentional. I have no intention of getting into it with Guartz by proxy, though.

[guartz]

You should have an ethical issue with it. But I do say there is a romantic side to it, because most of this world's greatest evils seem to come from the best intentions.

[Kuya]

You should have an ethical issue with it. But I do say there is a romantic side to it, because most of this world's greatest evils seem to come from the best intentions.

I don't have an ethical issue with it, since you and I do not function under the same morals.

[hey]

lol. You don't even have a co-pay? Not at all? Hell, I have private insurance and I still pay $150/ER visit and $30/GP.

Not for most things. I don't pay a cent for dental, except for certain useless things (like white fillings on teeth no one will ever see). prescriptions, i pay $2 for generics, $5 for name brand, regardless of the drug or amount. Regular doctor visits have a $5 copay. I don't think i pay anything for most ER visits, but not 100% sure. We also pay nothing for psychologists, though back when half my family was seeing a psychiatrist, they didn't cover it all, which amounted to something like $25 per visit (for 3 people), though we never ended up paying almost any of that.

[guartz]

I don't have an ethical issue with it, since you and I do not function under the same morals.

That's because you think greater good is an actual thing.

[Kuya]

That's because you think greater good is an actual thing.

Like most people, i don't consciously engage in ethics when i make decisions. Like most people, i can be a utilitarian at one moment, and a deontologist the next. It depends on what i feel is right, which is often implicit. That may be contradictory, but i could not care any less.

[Kaylia]

Dammit Jim, you're a Physicist not a Doctor.

Preventative care is best care, and is significantly cheaper for both the patient and the hospital system. Scaring people away from going to the doctor early, when they're seeing warning signs is positively terrible and can lead to significantly more tragic and costly operations down the road. For all this jibber-jabber about freeloaders wasting the ER's time with colds, it is much worse to see people die or undergo costly, invasive surgery from 100% preventable causes because they were too broke or too inundated with this bullshit "Real men walk it off and don't waste the people's money on doctor's visits" rhetoric to just go see a fucking doctor.

Should you be going to the ER for sniffles? Hell no. But do I really care about how long you're waiting to have your broken arm looked at? Absolutely not. Last I checked, you're not dying. That automatically puts you pretty low on the radar. The problem is a lack of general care. You don't need to go to the ER for the sniffles but you should be going to a doctor if you're sick, period.

I agree entirely with you, but I would say that waiting 18 hours in a room filled with people bleeding, vomiting, and coughing is more dissuasive than anything (and you know that if the average wait time is 18 hours, somebody who want to get checked for something minor isn't going to get see a physician anytime soon). Personally, most people I know would be willing to pay 30$ or 50$ to see a physician in a reasonable time, but are avoiding it because it's too much of a pain.

I used broken bones as an example, but it's just one of the many problems. We are doing poorly in every category you can imagine. I could use my sister's thyroid exam 4 months later after the doctor issued a warning (couldn't happen faster). Or my friend's mother who had her cancer go undetected twice because they had no time do a full examination, and just sent her back home, and I could go on.

[Greatguardian]

Not for most things. I don't pay a cent for dental, except for certain useless things (like white fillings on teeth no one will ever see). prescriptions, i pay $2 for generics, $5 for name brand, regardless of the drug or amount. Regular doctor visits have a $5 copay. I don't think i pay anything for most ER visits, but not 100% sure. We also pay nothing for psychologists, though back when half my family was seeing a psychiatrist, they didn't cover it all, which amounted to something like $25 per visit (for 3 people), though we never ended up paying almost any of that.

That's handy. The cost does exist somewhere, but it's handy.

As for Kuya, I just want to iterate for clarity that I'm not talking about any sort of public campaign or awareness program, let alone indoctrination. I tend to forget the kind of crazy that people are used to in this subforum, so I'm not very clear sometimes. Improving access to and quality of general education is more than sufficient to produce generally responsible individuals. You don't need to constantly tell people that drugs are bad if they have the tools to comprehend on their own that drugs are bad, mmkay. Unfortunately, many students aren't given those tools these days - and their use is frowned upon by our popular culture and mass media.

If the problem lies in people lacking financial responsibility and societal awareness, then it's going to be a problem in any system you conceive regardless of how nice it looks on paper.