Here Today... Gone To Hell!

This isn't about which is cheaper, but which has better health care over all.  Here is a link to a good debate worth reading from people that have lived in both countries.

http://www.washingtonmonthly.com/features/2000/0003.gladwellgopnik.html

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

It talks about wait times and lack of doctors and difficulty finding a doctor.

Great question!  ::)

"Which is better?..." (keep in mind, affordability has nothing to do with this question, right?)   :hihi:

Canada hands down...there is no comparison ;D

you can't lump Canada as a whole because some provinces have different troubles in different areas concerning wait times, doctor availability etc...the actual size of the province and its populations very greatly and what may work for Ontario may not work for Manitoba or British Columbia. I lived in the US for 5 yrs and I can honestly say that the US does not take care of it's inhabitants as Canda, on the whole, cares for theirs. Please don't get me started on my mother's quituple bypass again or my recent broken leg extravganza but I can assure you all again that top notch,quality care was provided, free of charge. Yes we have to pay for prescriptions, but the people who cannot afford it, social assistance takes care of it for you...or 75% of people if not more have standard health benefits package where they work or you can also, like the US purchase personal health coverage to pay for drugs,eyeglasses and such.

If its cheap and sux, who wants that.  Lots of people in the US have subsized health care like Canada.  The focus is on Quality, after we determine that, then we can talk quality vs. cost.  Its like saying and Epiphone looks like a Les Paul, so must be the same and its a lot cheaper...  We know the Gibson is better quality usually, but costs a lot more.

you are incorrect.. it is not subsidized health care in Canada.. it is free and equal care. It doesn't fucking matter if you have a penny to your name or a millionaire, you get the same level of health care. Tell me what kind of shape would YOUR family be in, even with health insurance, if your mother spent 12 weeks in hospital leading up to surgery, a quintuple bypass, ensuing care afterwards in one of the leading Cardiac Care centres in Canada,with world class Cardiologists...not to mention kidney failure and dialysis,kidney specialists and testing, and then a couple months down the road your break your leg, dislocate your ankle 3 surgeries on it,physiotherapy, blood clot, numerous bloodwork and drug therapy and a father with a heart attack and then angioplasty? not to mention the extended hospital stays with all 3? I can tell you where we are..fucking healthy and not a penny out of pocket. So don't talk about things you do not know..subsidized health care, please ::)

Lisa, it is subsidized.  The Gov't subsidizes it.  How do you think the doctor gets paid.  If its not from you directly, its subsidized.  Look, in the US, we subsidize farmers to grow crops in the fucking desert.  It just means with out the subsidation, you could't get the medical care.  Its not a bad thing, its just how it works. 

ok..that is not what I thought you meant. Here it is called OHIP and everyone has it.So, yes, you are correct in a sense, the governement pays for it...but that extends to just basic health care as well..if you have a sore throat and go to the doctor, you still do not pay for it. It is like France but not quite so posh because it does not extend to dental. BUT if in fact you can't afford a dentist or need dental work for your children, the government pays for that as well. If you do not have dental and make below the poverty level, which Ibelieve is somewhere near $22 000, you still can get free dental..in Ontario anyway. I worked two jobs and was a divorced mum when my kids were small and I never paid a cent for any of our dental for over 12 years. I lived and made many friends when I lived in PA and NY state and I never felt so bad when I knew of people who had sick kids or they themselves were sick and didn't go to the doctor because they couldn't afford it. As a Canadian citizen if I required health care while living in the states, especially Ny state, I drove home to Niagara and got it for free...and we had health care insurance in the US! I just feel quite strongly about this and I feel slightly defensive in 'arguement' simply for the fact tha most of Americans have no idea how it really works and they go by what the read or hear and it doesn't pertain to every Province in Canada, especially Ontario. I grew up in this fine country and I can say without a shadow of a doubt, and I may be a lucky one but no one I have ever known or know now has ever waited for essential service or testing or any kind of health care service including family doctor and I am 40! pretty good track record if you ask me. Sorry if I miss understood you

Lisa, its cool.  I actually would like to here what you have said.  You may want to read my first link, he has two people that lived in France and Canada and US.  Its a good read to see what they say. One guy says what you says, the other says opposite. 

I suppose it depends where you live in Canada...I promise to read the links by tomorrow ;)

I'm a US citizen.

The thing is, I know many people who have no health insurance at all, can't afford it, and don't qualify for government help (that 16% in Wiki was in 2006, and I'd imagine the percentage is higher now - we could be possibly looking at close to 1/4 of American citizens who do not have health insurance).  They work lower income jobs, but make just enough so that they do not qualify for help.  Health care will be one of the last things they'll have money available for.  Even if you do qualify for help, it can be a pain in the ass, in many cases, because you have to submit proof of income on a regular basis.   

And health insurance is so expensive.  Plus, if you have pre-existing conditions, most insurance companies won't deal with you. 

Even with good health insurance, the mental health care part of it sucks.  It's no wonder why there's so many people with mental health problems roaming the streets.   

The health system, in America, sucks, and something needs to change.   

Agreed.

Which is why the US needs universal health care.  According to Wiki (which is sometimes suspect, but I'll go with it), life expectancy is longer in Canada and infant mortality is lower.   That says something, to me, about possible quality of care.   

Wait time?  I live in America, and know that if I go to the local ER, unless I'm having life-threatening symptoms - I'm going to wait.  Waiting 4 hrs or more in the ER, for non life-threatening things, is normal.  Waiting to get into a specialist is often a month or more.  So what's the difference?  We wait, anyway. 

 

 

im canadian, if i have no outside insurance through work or anything,  here's how it pretty much is...

if i got hit by a car tomorrow-  i would get scraped off the street and taken into a hospitol and they would save my life free of charge. (exept the ambulance bill)

where i guess in the states if i got hit by a car with no inusance?  im assuming the amblulance would take me to the hospitol where they would do nothing? and of course the ambulance bill.

Its illegal in the u.s for a hospital to not give care, especially immediate life-threatening situations. However, beyond immediate life-threatening and other special cases the degree of the care you can recieve depends on if you, medicaid or similar thing, or your insurance company will pay for it.

In the case of the situation you described they would save your life and than charge you thousands upon thousands of dollars for doing it.

In a canada to usa comparison you have to factor in cost because U.S. will not treat for certain things or provide care if you cannot pay for it. The richest people in the U.S. get the best care they can get because they can pay for it. However those without insurance or those millions with insurance that get fucked by their insurance companies (i know from personal experience) can only get so much done.  :smoking:

sucks to be you america

I think most hospitals would take an emergency, but if it's a non emergency, they can and will turn you away.

However, if you were lucky enough to survive a car accident, you'd easily be stuck with bills totaling thousands, some easily get up to 100k. If you are unable to pay them, they will just place a judgment against you, ruining your credit, and depending on the state, could possibly garnish your wages, tax returns, put liens against any assets, and even your bank accounts.

The flip side to that coin, is that you can have insurance, and they'll still deny the claim, make you fight it for months, and still leave you owing thousands in medical bills when it's all over.

Not even, dude.  There have been many instances where patients have bled to the death in the waiting room.  The only attention she received was from the janitor who had to clean up the mess.

http://www.msnbc.msn.com/id/19207050

That's fucked up.

there's plenty of horror stories in both Canada and the U.S.

both need fixing. neither has the ideal set-up.

Depends on the hospital.

You're right in that, if it's  PRIVATE hospital they can refuse treatment for non-emergent cases.  For emergent cases, they have to stabalize the patient, but can then transfer them.

If it's a PUBLIC hospital or a non-profit, you can't turn anyone away, regardless of their ability to pay.

Some of the BEST hospitals (like, for example, my workplace) are actually non-profit hospitals OR public hospitals.



That largely depends on the hospital, too.

They have the option to do that.  But there is LOTS of access to what we call "free bed care", too.  I will say...the trick is asking for access to it (or having a family member ask for access to it) while you're still in the hospital.  And before you make the point....I agree it's not the BEST time for someone to have to make decisions regarding finances.   You're pretty preocupied with patient care...either yours or your loved one's.  The system sucks...and it can be just as cut throat and heartless as you depict.  But it doesn't always HAVE to be.

And also realize that one of the reasons hospitals are often so aggressive in their collection efforts is because they have to be.  With what we get from government programs (and with the aging population and those earning under the poverty level being 2 pretty large population sects...a good sized % of our patients fall into one of those categories), we simply couldn't pay the bills.  And we're a NON-PROFIT.  The system actually screws the institutions almost as much as it screws the patients.  The doctors fair a bit better...but with Malpractice insurance rates so high, not MUCH better.  The real winners in all this are the HMO's....


BINGO!

FYI, that's the exception, not the rule...at least at the ED's I've seen (both here at work and dealing with other professional contacts).  And what they did was 100%, categorically, unquestionably outside the law, and the code of ethics.

We saw that article back when it came out....which had been closely preceeded by an article on patient dumping in LA (They took a homeless person who had been under care and, literally, put them in a car and dropped them off under a bridge...still in their hospital gown).   BOTH institutions (and those involved), from what I remember, were fined, reprimanded, and disciplined for their actions.

But it is pretty fucked up to read about that kind of stuff.......

The US has some of the BEST healthcare in the world.

Good luck getting access to it.....

http://cthealth.server101.com/Old%20Universal%20Health%20Care/united_states_spends_most_on_health,_but_france_no__1_in_treatment.htm

It's an old article (I'm looking for an updated version from more recently)...but I think the rankings are still pretty close to the same.

We lead the world in biotech and medical research.  We HAVE some of the best clinicians, diagnosticians, surgeons, and medical professionals on the planet.

The issue is:  Not everybody SEES THEM.  They see the docs at the small community hospitals, the over run walk in clinics, etc.

Quality has to be as much about access and availability as it does about having "the best".

Edit: Found something a little more current.  It's an opinion piece, but it has some facts in it:

http://www.nytimes.com/2007/08/12/opinion/12sun1.html?_r=1&em&ex=1187150400&en=81027c4b9b038e39&ei=5087%&oref=slogin

Skid Row of all places. 



That happened with my tonsillectomy last year.  Thank God I have a great attorney.  In fact, we only cleared it up just a few weeks ago.  It was the biggest hassle.

They even threatened to send my claim over to a collection agency.

Well nobody here is denying that, but they are comparing the two systems.



Don't ask me how I know that one...

If it ever happened to me again, I would not pay.

You make a good point and (facts about Canada aside) I generally agree.

And that's why we should REJECT such silly comparisons.  Whenever any form of gov't subsidized health care (or national insurance or whatever) comes up, we make these comparisons.  The right says "Oh, in Canada they have to wait for a doctor...."  Well, assuming that that's true, why do we also assume that that has anything to do with the changes we want to make in the US?  If anything, we can look to other countries' systems, see what works best and what fails, and make changes accordingly.  People assume we're going to cut n' paste the good AND the bad of any system, whereas I believe we should do NO such thing, making every effort to create a system that avoids the problems other countries have had and to make changes where necessary if unforeseen complications arise.

Canada's system isn't perfect.  I'm sure there are instances where someone has had to wait, but I'm also certain that this is FAR outweighed by those who otherwise wouldn't be able to afford healthcare. 

^exactly, well said :)

The health insurance that is offered at my job is just awful.

Being that I work in Human Resources, I know what it costs us per employee just to cover them and just on the employer side we are footing about 10k a person who takes the plan.  The employee pays 110 dollars a month out of their check.  This is for single person coverage, it is upwards of 700 and something dollars to cover a family and about 30k a year for the employer.

This is AETNA by the way, which is one of the "better" companies.

The plan itself is a high deductable, where you have to pay $1100 out of pocket before the insurance even starts to pay every year and $2000 out of pocket for drugs. 

I work in hospitality where the average employee makes about 8 bucks an hour-housekeepers, etc.  Most of them that can have the plan don't even take it because it is so expensive and they cannot afford the deduction from their check.

We have even had employees quit recently because even making the low income they were, it was throwing them over the wage limit for getting insurance from the state (Medicaid, etc.).

Mind you also, this plan covers no dental and you can only get your vision checked once every 2 years.

The US really fails when it comes to healthcare.  I mean we have all the resources and the best doctors but like someone said above-who gets to see them????  The rich folks I guess. :no:

The right's answer to that, is that people should work harder if they want medical coverage. ^^

Too bad, so sad they say.

The funniest (not really) part of it all, is that the people that work the hardest (laborers and whatnot), make the least amount of money.  They also work in professions where more accidents and injuries occur because of the nature of the work that they do.

I know YOU are being facetious here but seriously, that is the mindset of the right....sadly.

I don't see why somebody with less earning potential should be denied access to quality health care in this country. Talk about cold.

In 10 years I have been to the doctor 4 times.  But I have spent thousands of dollars each month on the insurance.  Men between 18 and 40 hardley ever go to the doctor unless serious.  I guess Women and Children and old people are the ones that need doctors so much. Something needs to be done soon. 

Thousands of dollars each month? You need to talk to a new insurance agent...really!

A huge reason for wait times..

Medication mix-ups leading to emergency room ? study

More than one in nine visits related to misuse, says Halifax pharmacist

By JOHN GILLIS Health Reporter
Mon. Jun 2 - 7:03 PM

Pharmacists, physicians and patients all need to do a better job to make sure medications are used safely and effectively, a Halifax pharmacist says.

More than one in nine emergency department visits stem from medication-related problems and a large majority of those effects are preventable, Dr. Peter Zed found in research to be published in Tuesday?s issue of the Canadian Medical Association Journal.

Those problems were broadly defined: from people who had allergic reactions or diarrhea as a result of medicine they'd been prescribed, to those whose drugs were simply ineffective, to people who stopped taking their drugs and got sicker.
Dr. Zed, a clinical pharmacy specialist who did the research at Vancouver General Hospital before moving to Halifax's Queen Elizabeth II Health Sciences Centre emergency department, said the numbers point to a serious problem, but one that can be fixed.

"We have a really good picture now in Canada about what the actual magnitude is," he said recently. "People now have to start paying more attention to the fact that we need to do some things, all of us ? pharmacists, physicians, nurses, everybody involved in the system ? to improve the way we manage medications and expend resources where resources may be necessary to try to minimize this problem."

The study, which followed more than 1,000 visitors to the emergency department over 12 weeks, also found people whose problems were medication-related were more likely than others to be admitted to hospital and tended to have longer stays than people admitted for other reasons.

Dr. Zed said communication breakdowns between different arms of the health care system lead to some potentially harmful drug problems.

"What happens in hospital isn't necessarily conveyed back to the family physician, to the community pharmacist, to the home care nurse," he said.

And even when people make a routine trip to the pharmacy, they may not get all the information they need, Dr. Zed said.

"When you actually go to a pharmacy and you get your medications filled it's very common for a pharmacist to tell you how to take the medication," he said. "But rarely does the pharmacist probably ever tell the patient what the consequences of not taking the medication are."

As a result people who are on heart failure medication may not realize that they could get seriously ill or die if they don't take it as directed, he said.

Now that Dr. Zed and his fellow researchers have demonstrated the scope of the problem, he plans to follow up the research in Halifax by looking at some solutions.

He said chronic disease management programs in which teams of nurses, pharmacists and other health professionals work closely with people who illnesses like diabetes maintain their health through drugs, diet and other means seem to work well.

A separate American study estimated drug-related problems led to 17 million emergency room visits a year and that country and the costs associated with those problems were more than $177 billion in 2000.

Dr. Zed said making sure people are on the right drugs at the right doses and are taking them appropriately could help avoid the costs of treating illnesses resulting from drug-related problems.

http://thechronicleherald.ca/Front/9007026.html (http://thechronicleherald.ca/Front/9007026.html)

Not exactly specific to Canada:

http://www.nytimes.com/2007/08/12/opinion/12sun1.html?_r=2&em&ex=1187150400&en=81027c4b9b038e39&ei=5087%&oref=slogin&oref=slogin

(FYI, the same article I cited earlier).


Pharmecutical mistakes are one of the more common "dirty little secrets" (like surgical fires) in health care.  And usually they're the one of the most avoidable mistakes, if staff is paying attention.  But like every other industry...sometimes people go on autopilot and screw up.  In the medical profession..that's likely to cost people their lives, so screw ups are a lot less forgivable and a lot more obvious.  We've taken steps here to try to avoid them, and even eliminate (to some extent) the ability for human error.   For example, our IT systems all "red alert" any possible drug interactions and link out to patient histories to "red alert" any drug allergies.   Ditto on dosage "irregularities" (for example, someone dispensing morphine at a much higher rate than baseline for a patients weight and other factors).   There is an ability to override, when putting in the pharm order....so in the cases where it's necessary, things can be done....but you can't really "autopilot" past the "red alert".

 The mistakes still occasionally happen, but our Six Sigma project involving this has shown that we've improved vastly.  Other institutions need to wake up, recognize the issue, and take similar steps.