Free Health Care (Canada)

[Caiyuo]

Really not sure what's expected of me from this statement!

that was a complete stab in the dark since I hadn't seen you posting much, but I remembered you mention having dealt with a lot of medical bills on top of it being a pretty pervasive topic so I figured it might be another thing you'd have a lot of useful insight on.


Also a chance for a shitty healthcare pun

[Pirian]

The best example I can give you is our support toward the most common "left" topic
http://www.thestar.com/living/article/679824
"There is compelling evidence that Canadians across all demographics would prefer a public over a for-profit health-care system," Nik Nanos of Nanos Research said of the poll, commissioned by the Canadian Healthcare Coalition. Support was strongest in Quebec, at 87.6 per cent and lowest in Ontario at 84.1 per cent. "

This may or may not have to do with the current discussion, but I wanted to juxtapose two thoughts you acknowledged. On the one hand you expressed Canada's terrible execution of free healthcare in the form of long wait times and crowded hospitals, but with this new statistic added in quotes above, you have also suggested that the overwhelming majority of Canadians still support their free healthcare system.

Thus, I propose to you that free healthcare, even at its worst, is still more favorable than a for-profit healthcare system, at least in the Canadian's view.

[Kaylia]

^
It's only true if we assume that public opinion is always the best opinion.

[Pirian]

^
It's only true if we assume that public opinion is always the best opinion.

Oh, I didn't say anything about the "best opinion", as that can be very subjective, and is not necessarily relevant. I was merely putting forward the idea that despite all the problems, the vast majority of Canadians prefer "long wait times and crowded hospitals" over the mere possibility of being faced with overwhelming debt due to an unforeseen medical problem. In other words, they are willing to put up with so much bad because they know that if something very serious arises then money will not be a deciding factor in whether they are able to get treatment.

[archibaldcrane]

84 to 87% is pretty damn unanimous.

[Kaylia]

Oh, I didn't say anything about the "best opinion", as that can be very subjective, and is not necessarily relevant. I was merely putting forward the idea that despite all the problems, the vast majority of Canadians prefer "long wait times and crowded hospitals" over the mere possibility of being faced with overwhelming debt due to an unforeseen medical problem. In other words, they are willing to put up with so much bad because they know that if something very serious arises then money will not be a deciding factor in whether they are able to get treatment.

I'm simply saying that leaving the decision to the population isn't always the best idea. While the majority win, the debate should never be stopped because that majority is "content with what they have".

With that said, I don't think the population is content with our current system (the support is dropping every years)

http://www.ctv.ca/CTVNews/MSNHome/20...h_care_090710/
"Quebec residents were most split, [B]with 52 per cent saying the system works well and 43 per cent saying it doesn't."

And whenever you try to change how it works, here is what you get

http://www.canadafreepress.com/index.php/article/28274
"By cancelling its planned $25-user fee for seeing a doctor, Quebec caved in to special interest groups that refuse to acknowledge the necessity of changing how we pay for health care in this country."[/I]

The following papers is actually very interesting for any Canadian who care about healthcare. It's not partisan as far as I can tell, and does raise many good points
http://www.queensu.ca/cora/_files/MendelsohnEnglish.pdf

Only about 1/3 of Canadians say they support “two-tiered” or “privatization”
models, with most Canadians strongly opposed to these proposals. The strong opposition
to “two-tiered” health is in tension with Canadians’ belief that individuals should be able
to use their money as they see fit to protect their own health. Canadians are sensitive to
the desire amongst many Canadians to spend their own money if they are facing a
lengthy wait for treatment. While there is strong opposition in Canada to people being
able to pay to go to the front of the line for procedures, when Canadians are faced with
the proposition: “should Canadians be allowed to have the option of using private
facilities with their own resources if they cannot get timely access in the public system,”
73% say so. This is a crucial value tension: Canadians want to nurture the public system,
but they fully sympathize with someone who wants to spend their own money to get the
care they need.

Canadians very much like the Canadian health care model, but most are
increasingly aware that it has not evolved to respond to technological and scientific
changes, nor to the way Canadians think and behave. Many Canadians have become
more informed and empowered health care consumers, and reforms to the health care
system must respond to this change. Any reform, however, must recognize that there
remain important socioeconomic differences on many questions: women, the elderly,
those who are more economically vulnerable, and residents of Atlantic Canada and
Ontario are especially resistant to changes that could damage accessibility and the public
system. Most Canadians, including the more economically secure, remain deeply
committed to a system that guarantees all Canadians access to good quality health care.

More Privatization?
Canadians are only beginning to focus on the subtle distinctions between various
models that include additional private elements, such as private delivery, user charges,
private insurance, or a “two-tiered” system. The distinction between privately operated
clinics providing basic health care to everyone but paid for out of public monies, as
opposed to a parallel system in which individuals can pay, are terribly important public
policy distinctions, yet Canadians have not come to a public judgment on these issues.
For now, Canadians continue to generally resist privatization, but grasp for proposals that
can protect and improve the public health care system.

User Fees?
Many Canadians (almost half in 1995) expressed support for user fees for hospital
visits (Figure 73). The reasons behind this support require scrutiny. Canadians have some
openness to user fees because they believe these will discourage overuse by those who do
not really require care (93% of Canadians offered this view, according to the Berger
Report in 1996). As found in qualitative research, some Canadians support user fees
because they believe they are a useful way to raise revenue and ensure the long-term
viability of the system. There is greater support for user fees for those who use the system
at a higher rate than the norm (Figure 74). However, although Canadians express support
for user fees in certain contexts, Canadians do not really want to “bill the ill” and the
notion that Canadians would support extra billing cancer patients for their frequent
chemotherapy seems far-fetched. If told that some people were not getting the care they
needed, almost all express the view that the community or government should pay
(Figure 75). What these poll results show is that many Canadians believe that there are
those who take advantage of the system. Canadians’ support for user fees can be
understood as their support of a relatively pain free way to “save the system,” particularly
at a time when many Canadians have become increasingly used to user fees for a variety
of previously free public services.

[hey]

User Fees?
Many Canadians (almost half in 1995) expressed support for user fees for hospital
visits (Figure 73). The reasons behind this support require scrutiny. Canadians have some
openness to user fees because they believe these will discourage overuse by those who do
not really require care (93% of Canadians offered this view, according to the Berger
Report in 1996). As found in qualitative research, some Canadians support user fees
because they believe they are a useful way to raise revenue and ensure the long-term
viability of the system. There is greater support for user fees for those who use the system
at a higher rate than the norm (Figure 74). However, although Canadians express support
for user fees in certain contexts, Canadians do not really want to “bill the ill” and the
notion that Canadians would support extra billing cancer patients for their frequent
chemotherapy seems far-fetched. If told that some people were not getting the care they
needed, almost all express the view that the community or government should pay
(Figure 75). What these poll results show is that many Canadians believe that there are
those who take advantage of the system. Canadians’ support for user fees can be
understood as their support of a relatively pain free way to “save the system,” particularly
at a time when many Canadians have become increasingly used to user fees for a variety
of previously free public services.

That seems a bit silly to me. They could easily add a fee only to things that are frequently overused. Specifically, walk ins. They could also waive the fee for any life threatening situation.

[Kaylia]

That seems a bit silly to me. They could easily add a fee only to things that are frequently overused. Specifically, walk ins. They could also waive the fee for any life threatening situation.

They could, but like I cited in my last post, whenever they want to do it, the population suddenly become against the idea.

[Sera]

A fee for "irresponsible use of resources" IMO would be fair. Bringing your non-emergency situation to an ER? Boom, pay a fee. Bring it to where it should be? Oh lookie, no fee! People WILL learn eventually where they should be going for what.

[Kohan]

More than anything, I'm personally rather impressed that so many people are bothering to argue with BG's pchan of politics, Kaylia.

However, this thread was worthwhile, and for one reason—the post Linliel made some time ago:

Kaylia, you're a bloody idiot if you think that the fact that Quebecoise hospital waiting times herald the doom of universal health care all over the world.

Unlike Quebec, as you've shown, many other countries' governments actually give a shit about their national health care services. State governments (who run the hospitals) in Australia have been won and lost over healthcare issues. Perhaps you Quebecoise should just go and, I dunno, vote someone in who gives a shit about it?

Anyway, your question is stupid:

The real question is, is it possible to maintain this system forever in any economical and social context?

When you find someone who can predict the future "forever", let me know, ok? The more pressing question, it seems, for Quebecoise, is "what the fuck is going wrong and how can we fix it?" Whether that's a fix for your healthcare system or a reversion to private insurance is up to you, but don't you dare generalise from your shitty situation to the rest of the world without first finding out a shitload more about how it's run and public opinion and history of it.

A thing of beauty, to be sure.

[Darus Grey]

Also let's be realistic.

The reason Canada has one of the least effective UHSs is probably almost entirely to do with the fact that they're right next to the USA. Canadian Conservatives and US conservatives are basically the same breed of total whackjobs and are willing to destroy things...working things...and make people suffer, just for their own ideological satisfaction.

If Canada was next to virtually anyone else we wouldn't be having this discussion most likely.

and it STILL works better than our system...

that was a complete stab in the dark since I hadn't seen you posting much, but I remembered you mention having dealt with a lot of medical bills on top of it being a pretty pervasive topic so I figured it might be another thing you'd have a lot of useful insight on.


Also a chance for a shitty healthcare pun

Yeah, I've spent over $100,000 on medical bills in the US...WITH insurance...

If I wasn't such a high earning net worth individual it would have basically left me fiscally crippled for life instead of merely setting me back 1/2 a decade.

But yeah, in my political science career I focused on being an expert in world healthcare policy. As others have said, the basic jist is, if you're against UHS, you're an idiot. UHS is *the most possible efficient system there is*, as I pointed out long ago, it is actually economically impossible for a privatized healthcare system to be cheaper for a given level of care, and all the real-world data backs this up alongside the theory.

And yet we fight about it based solely on the fact that a bunch of rich white dudes want to stay in power, so they have to oppose whatever the other side is for, regardless of how fucking moronic it is. Worthless two party system.

[Myrrh_Quetz]

I couldn't imagine living in a country that didn't have a Free Health Care system with my disease. My family would probably be beyond broke and I doubt I'd have been able to afford my Transplant.

[solanis]

how did you manage to spend over $100k on medical bills despite having insurance?

[Darus Grey]

how did you manage to spend over $100k on medical bills despite having insurance?

Because on my particular plan I'm responsible for 20% of costs after a certain threshold, 20% of a lot of fucking money = a lot of money. This is also the only plan I can ever get(for now), because I have several blacklisted conditions, meaning until the new rules take effect, I am uninsurable and have no choice(free market at work!)

Most insurances in the US don't cover all medical expenses, so even if you have insurance, for 90%+ of the population, a very expensive condition is still going to bankrupt you.

[solanis]

sounds like shit-tier insurance and a shit-tier plan you should have been smart enough to avoid tbh

[Darus Grey]

sounds like shit-tier insurance and a shit-tier plan you should have been smart enough to avoid tbh

It's my student policy from when I was 17, as I've mentioned before, the only reason I've been going to school for 13yrs now is because I can't stop without losing my policy, well being uninsurable.

So yes, it's a shit policy, then again, so are pretty much all of them, I wouldn't of fared any better under most plans. Not to mention that my choices at that age were fairly limited by finances.


I also have to tell employers I opt out of health insurance, or I'm also unhirable. So it's not like I can upgrade...

[solanis]

what do you mean about opting out of health insurance? it's illegal for them to ask you about health issues.

[Darus Grey]

what do you mean about opting out of health insurance? it's illegal for them to ask you about health issues.

You think companies don't notice when they hire someone and their premium spikes 100%? especially at smaller companies where the pool is smaller. They don't have to ask to know very quickly, and as soon as they know, they'll be out to fire you for anything they can justify, happened to me 3 times before someone was nice enough to tell me what they "overheard from the boss"

[Tyche]

sounds like shit-tier insurance and a shit-tier plan you should have been smart enough to avoid tbh

Employers typically have only a selection of choices for the insurance plans to choose from that's determined by the insurance company based on the employer's risk pool. 90:10, 80:20, 75:25 is pretty common, which means the employee covers 10, 20, or 25%. Sometimes employers will also have incredibly high deductibles to offset the premiums. For instance, my last job (admittedly a high risk pool of employees), was $140 a month for 80:20 and a $5,000 a year deductible. So we had to cover the first $5,000 as well as 20% of all costs. It's not hard to envision 100k in bills for chronic patients.

[Talint]

A fee for "irresponsible use of resources" IMO would be fair. Bringing your non-emergency situation to an ER? Boom, pay a fee. Bring it to where it should be? Oh lookie, no fee! People WILL learn eventually where they should be going for what.

Except sometimes there's only situations an ER can handle, even when it's not an "emergency".

I passed my second kidney stone not too long ago. I went to a walk-in clinic and told them, "Yeah, I'm passing a second kidney stone." Except there wasn't anything they can do about it, because in order to verify the diagnosis, they have to do a PET scan ($200 charge for them to tell me this, btw). Only the ER can do PET scans, as passing a kidney stone is a "medical emergency".

So now I'm at the ER, knowing I'm passing a kidney stone, doped up on meds, and they perform a PET scan. And hey, sure enough, I'm passing a kidney stone.

All in all, this wonderful experience cost me $2,200. For something that wasn't an emergency as much as it was urgent care, that I knew what I was having, and that there was nothing I could do about it.

Greed-based health care at its finest.