US Quality of Health Care vs. Canada Quality of Health Care

[pilferk]

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

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.......

[pilferk]

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

[Layne Staley's Sunglasses]

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

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.......

Skid Row of all places. 

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.

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.

[SLCPUNK]

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

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

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

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.

BINGO!

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

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

[freedom78]

Great question! 

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

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 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. 

[Lisa]

^exactly, well said

[Bandita]

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.

[SLCPUNK]

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

Too bad, so sad they say.

[Bandita]

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.

[SLCPUNK]

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

[Smoking Guns]

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. 

[Dr. Blutarsky]

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

[AxlsMainMan]

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

[pilferk]

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

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).

Quality. In a comparison with five other countries, the Commonwealth Fund ranked the United States first in providing the ?right care? for a given condition as defined by standard clinical guidelines and gave it especially high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients. But we scored poorly in coordinating the care of chronically ill patients, in protecting the safety of patients, and in meeting their needs and preferences, which drove our overall quality rating down to last place. American doctors and hospitals kill patients through surgical and medical mistakes more often than their counterparts in other industrialized nations.

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.