so, if i'm reading correctly, you, personally, could not go back to canada and get any health care because you cannot work? or, if they would make an exception based on your age and condition, you would have to wait 6 months before receiving any treatment?
when i asked the government agency in canada last, i was younger than 65. so what i'm about to write, is that i would not have canadian coverage for 6 months. my medicare coverage here would apply, paying for whatever urgent care i may need, since the first 6 months i would have "visitor" status. they would be pleasantly surprised with how inexpensive any treatment i had there, would be so there wouldn't be an objection to paying it. i would not have to wait for treatment. i already see an ophthalmologist there, whose refractions, care and ability has been more accurate than any i've had here in the usa.
i have friends in canada who've waited excessive time periods for their treatment and/or been denied certain treatments based on age and other factors. one of my friends has gallstones needing surgery as well as surgery for another problem. at first they said they wanted to do the surgery for the stones right away. this was in february, but when they determined he needed surgery for the other problem as well, they said they wanted to do both surgeries at the same time. in april, they postponed them until he could see yet another doctor - that appointment isn't until july some time.
i'm sure that he could move the appointment with the second physician up, if his pain was considerable for either condition. it looks to me as if the consultation with the other doctor is advisable, as well as the suggestion to have both surgeries at the same time. why undergo anaesthesia twice? the umbilical route for cholecystectomy has minimal blood loss or trauma; and whatever else needs doing, might be a greater stressor. i imagine the other problem is prostate oriented, and he's been referred to a urologist who would need to coordinate with the general surgeon, and both would need access to the same surgical suite. it does seem the waiting time to see the 2nd doc is excessive. i'm sure the doctor's nurse could facilitate your friend receiving an earlier appointment......
i lived in buffalo where student nurses "moonlighted" driving canadians across the border for health care. most of the patients were heart patients on months-long waiting lists or who were denied the surgery they needed.
it seems unusual for strangers to provide transportation, unless their expertise was needed for some reason. surely by the time patients were discharged, family members could transport them! when i was a student, i wouldn't have felt comfortable dealing with a post op situation in a foreign country, where i didn't know the protocol for emergency services, or have a license as a nurse. i'm amazed that their instructors/nursing school would approve of that. buffalo as you know, retrn77, is close to the border, while if the transported patients lived in toronto or further, the chances of possible problems would be greater, due to the amount of travel required. if the patient became oxygen deprived, that would rule out small plane travel.
i do know that if a canadian patient's condition warrants it, they are moved up the waiting list. think organ transplant lists, and how you have to be critical to get one earlier, here as well as in canada. it's not a matter of where someone is in the line, but what urgency there is. sometimes heart patients worrying about the delay, makes their symptoms seem worse (which could actually be the case); and that could get them the surgery in canada sooner.
my sister's age of 80 didn't influence the 9 hour back surgery she had last january; and her amount of pain influenced their decision to do the fusion sooner than it was scheduled. she was bumped for the first date, due to an emergency surgery started earlier the day she would have had it, and her doctor expedited her next date to an earlier date than she was given at first, due to the degree of pain she had. sometimes you have to be a "squeeky wheel".....
Specializes in Labor/Delivery, Pediatrics, Peds ER.
Thanks for the clarification, Lamazeteacher. Nice to know that the U.S. would continue your Medicare in Canada for a time.
As for my friend, the other surgical need is for ulcers. I don't have any details, but I'm assuming there is danger of perforation. I don't disagree that it would be better to do two at once, just that the time frame kept increasing and increasing.
And I'm sorry I did not make it clear that the student nurses were moonlighting with an ambulance service in transporting the Canadian patients to the U.S. for their surgeries. :) I believe some were EMT's before beginning nursing school.
As far as I remember, most of the patients were picked up in Toronto, although I believe that often the patients were from other regions as well. It just amazed me that people who could get "free" care so often found that their need was urgent enough to come to the U.S. without any coverage to receive their surgeries, as the runs were at least weekly.
Canadians can get supplemental health insurance coverage for the time they're visting in the USA. My sister gets Blue Cross through a Canadian agent when she winters in Palm Springs. It pays for the continuation of her PT treatments and any doctor visits she may need, although it didn't pay for a (deemed experimental) laser back surgery technique that was unavailable in Canada and in most parts of the USA. The results weren't lasting, which is why she needed the more extensive surgery in Canada, 2 years later. The damage to her spine keeps worsening, so even that hasn't given her lasting relief from her pain.
EMT certification isn't international, either. What I don't get, is why an ambulance was required to get patients in Canada. Usually they're ambulatory to some extent if their heart disease wasn't urgent enough for immediate surgery in Canada. That gives me the feeling that whatever organization was doing the surgeries, went along with the patients' belief that they were critical, which begs the question that they could have been taking advantage of the patients' fears.
I know cardiac surgeons aren't above "grandstanding" their prowess. A decade or 2 ago, they were competing with each other in CA, to see how many more bypasses one surgeon could could do, and how little time it took them, than another. Someone got up to 7! It wasn't necessary to do so many, an investigative team discovered, and so the number of bypasses allowed by the regulating body has been curtailed, They even found that none, in some cases were necessary. Collateral circulation occurs many times, giving as much benefit for patients as the surgery. Sometimes it is necessary to wait and see.....
If your friend had an inflammatory process going on with the ulcer(s) condition, it could be that they were caused by the pylori microorganisms, which needed to be treated with antibiotics, before it was safe to go in surgically. I can't imagine the US doctors would operate anyway, but stranger things have happened, for greed. With that going on, it could be that Canadian surgeons wanted the infection gone before doing the minimal
procedure for the gallstones, treating the patient for pain rather than risk peritonitis, or by operating before antibiotic treatment was effective to get rid of the inflammation/infection, make the patient more susceptible to MRSA or worse.
Some medical professionals aren't great at explaining sufficiently to patients what their condition is, which leads to them "jumping the gun" and going to the US on a "fool's errand". My sister says that NPs are working at most doctors' offices in Canada, and they explain things better. Possibly your friend would benefit by making an appointment with the NP to get more clarity. Canada hasn't implemented the PA program that our doctors originated in reaction to NPs, who can work more independently. I'd imagine that's because they want someone with more hands on experience performing assessments, and treating patients.....
The system has drawn lines to prevent over-utilization of assistance programs, and they're very severe. Incomes for those who get food stamps or medicaid/medical, have to be below $14,000/year. Applicants' bank accounts are checked, documentation of all income is required, and the amount determined according to how many people live in the home of those who apply; and whether those cohabiting can contribute to the income, etc.
There is a move in some states, to have recipients work at some level, but with the jobless rate what it is, that can't take work from those seeking employment. The "Workforce" facilities (used to be called "unemployment") have lists of those people on unemployment, for prospective employers. I do recall contacting some of them who were certified NAs, and they never returned my calls, so I reported them to the counselors there. There is a requirement for those getting unemployment payments, to actively seek work.
When disability is the reason for not working there are various agencies tracking and keeping watch over thoswe receiving payments on that program, as well as workers' compensation. My sister (who isn't a nurse) was an investigator in Canada with Equifax, who looked into those people suspected of abusing the system. She said that she found more people who were justified in taking assistance there....... and she had some stories to tell about those who weren't. I think nurses do that here, and that qualification may not be necessary.
I have read through this entire thread and not said anything, other than kudos to some posts that I agree with, but this just got me... $14,000?? Where did you get that info from? That is sure NOT the case where I live. Maybe 14,000 for SINGLE people with no children, but if thats the case, you should do just fine on that. Throw a couple of kids in there and the minimum goes WAY up. For instance, Im a single mother of 2, have been an LPN for 8 years, I work full time, but I am BARELY over the state poverty level. I am JUST over the cut off for food stamps, and my children still qualify for SoonerCare (medicaide). I provide their healthcare, I am lucky to work for a place who provides awesome benefits. But my point is, I dont know where your number of $14,000 comes from, but it is incorrect.
I can also vouch for the fact that there are a lot of people out there who would be able to get insurance for their families if they would prioritize. I dont see why I should have to pay for other people to be insured when they could be doing it themselves. There are people out there who truly DO need help and I have NO PROBLEM whatsoever helping them. But when you are able to work but dont, when you make absolutely no contribution to society at all, thats when I have a problem. Most people who truly need help will do anything in order for that help, they want to make their lives better, they dont want to live on the system forever. I know. Been there, dont that!! Now I am proud to say I support myself and my children (even if it is pay check to pay check) by myself with no assistance from any state agency. Sure, I might be giving up some of those extra things, like weekly mani-pedis, but OH WELL! My children and our health are worth it!
Each state sets its own guidelines regarding eligibility for its assistance programs. Those communities wherein the cost of living is high, have higher amounts set for eligiblility. That is the figure for a single person, where the cost of housing, food, utilities, etc. is quite high. Therefore the $14,000/year doesn't go very far. I got that figure from a person who qualified for assistance, and saw the paperwork with that amount on it. It wouldn't be appropriate to qote any figure without having accurate information, and I had it, when I wrote that.
I know that many people think that there are a lot of people who abuse "the system", yet I haven't met any of them doing Public Health Nursing and Home Health. I have met doctors who abuse Medicare and Medicaid, though. Seniors who don't drive and need to use taxis to go to see their doctor(s) when they need medical care, or to the grocery store (few stores deliver).
My sister has been an Equifax private investigator, and did see some instances of abuse of government assistance programs, but most recipients were truly needy. It is necessary for everyone to work when they can, yet extenuating circumstances exist these days. We need to keep in mind that we should "Judge not, lest we be judged".
I thought I was finished replying to this thread but have another point to offer.
Lamaze, I find myself agreeing with your last post with one exception. There is a lot of abuse. I have seen it on my floor, and treated patients who had no need to be there. It is also not just patients and Doctors who abuse, but medical suppliers. That alone costs the system a lot.
I have no fear of being judged, and am sure, neither do you. :)
It is a sad comment on the state of ethical (actually lack thereof) practice these days, that so many so-called professionals waste tax payers' money. It occurres to me that those who have the highest earnings, are inurred to the cost of things, by virtue of the abundance they experience. Also, it needs to be studied whether high earners (doctors, administrators, executives in insurance companies, etc.) have guilt in some degree over the ease with which they could/do/have bilked the government, patients, and "the system".
Many guilt ridden folks have a need to be caught, which makes them exaggerate their actions, leading to discovery. I hate to appear (because I am) chauvanistic regarding Canada, but you really see very little of the pilfering, lying, doctoring of records, etc. there (from what colleagues there tell me, who are still working).
My classmates and I will celebrate our 60th anniversary of our graduation from nursing school in Montreal this fall.
It was instilled in us repeatedly that a slight infraction of rules would lead to the degredation of all nurses. When it became known that American doctors defrauded the government in their zeal to make the most money possible by any means, my first reaction was to doubt their sanity. Yet everyone knows that "money is the root of all evil". I still can't imagine enjoying anything myself, from "ill gotten gains".
Realistically we live now in a world in which violence occurs horribly and frequently, children aren't taught to pick up their toys, much less their trash, and drinking problems occur in 1:10 people. Drugs are as rampant. That was so before terrorists created mind shattering destruction here and abroad. Soldiers return from war in PTSD, having nowhere to turn for help and the derision of civilians and their fellow military. A Vice President himself is known to reap the spoils of war on a level so obscene as to doubt that any justice exists.......and on and on.
The only way I can see to avoid desperation and severe depression, is to take pride in one's own ethics, and teach them well to others. The beauty in life is that we can turn it around in a good direction, if in the past shady deals enticed us. (Geez, I'm looking at this and thinking that I sound like I'm preaching, and I am.)
There may be no ark to build in case another heavenly punishment is dealt, to deliver us from modern Sodom and Gmorrah. The televised scenery in the Gulf of Mexico is certainly proof of the result of averice and prioritising money, gold, etc. That reminds me of the River Stixx. It is our own indulgment in filthy fuel that got us here, when we turned away from seeing the potential it has for destruction.
Let's do our best individually to elevate our conscience and that of others through our example, to do good. We wouldn't have the President we have now, if most of us really worshipped all the criminal actions that have been exposed in so many levels and aspects of public life, so obviously those who are the "dark side" are the minority. Certainly we have the ability to turn from those activities, leash revenge, and walk on the path of good.:dncgcpd:
The main reason I tend to disagree with some of your posts is that you mostly aim high. I agree with a lot of what you say, but remember, a lot of the fraud and abuse is committed by those at the bottom. There is a lot of people thinking "what's in it for me", or "How can I get the most out of the system". People are relying on the state too much, and not trying to work things out for themselves. To fix the system you have to aim at both top AND bottom. It won't work trying to fix only one.
I can't speak for Canada as I have never been there, and don't know anyone from there. But I'm from Ireland, and there is a lot of abuse in that system. If you don't have to pay for it, just go in for any little thing that you might not even go to a Doctor here with. There are waiting lists for most treatments, not enough nurses, and poorer outcomes then those in the US. I know people who work in the UK, and its the same, if not worse there. And there is no shortage of money being pumped into the system.
When I came to The US I had $1000 to my name, a bed in my brothers place and what I could carry with me. I worked at slightly above minimum wage, and had a little above high school education. I moved from job to better job, and got myself an education. I'm now an RN with my own house, and doing OK. I say all this to show, if I can do it, anyone can. I am nothing special. I believe in the strength of people. Let them do it, and kick others in the backside and force them if they won't. If they are spoon fed, why should they move on. All that said, those who truly can't do it should receive help. That is what a safety net is for.
Lamaze, I'm going to stop here again. I don't want to get into another tit for tat as I believe you truly believe in what you say, and care deeply about the needy. I even agree with much of what you say, and respect you for it. But I think people should be encouraged to stand on their own two feet where they can, and be helped where they truly can't.
See you again on other Threads.................. Nialloh
Each state sets its own guidelines regarding eligibility for its assistance programs. Those communities wherein the cost of living is high, have higher amounts set for eligiblility. That is the figure for a single person, where the cost of housing, food, utilities, etc. is quite high. Therefore the $14,000/year doesn't go very far. I got that figure from a person who qualified for assistance, and saw the paperwork with that amount on it. It wouldn't be appropriate to qote any figure without having accurate information, and I had it, when I wrote that.
I know that many people think that there are a lot of people who abuse "the system", yet I haven't met any of them doing Public Health Nursing and Home Health. I have met doctors who abuse Medicare and Medicaid, though. Seniors who don't drive and need to use taxis to go to see their doctor(s) when they need medical care, or to the grocery store (few stores deliver).
My sister has been an Equifax private investigator, and did see some instances of abuse of government assistance programs, but most recipients were truly needy. It is necessary for everyone to work when they can, yet extenuating circumstances exist these days. We need to keep in mind that we should "Judge not, lest we be judged".
I worked Pediatrics for 5 years and have been doing Public Health for 3... I see LOTS of abuses in the system. I wont go into all of that, but it is there. Im not "judging" anyone, but when I happen to forget its the first of the month and end up at the grocery store buying somethin to cook for dinner, counting my money making sure I have enough (after I got done working all day) and there are people with 2&3 baskets over flowing with junk (usually a WHOLE basket just for cokes and such) it gets a little frustrating. Like I said, been there, done that. I was on food stamps for awhile, and I got medicade for my children for awhile, but I worked and got off of it. Now that "I make too much" *really??* I see everyone else using food stamps to buy crap and I am barely scraping by... BTW, I live in Oklahoma, which has a very low cost of living compared to most other states and our state guidelines are much higher than what you stated.
Everyone has their problems and everyone needs some help from time to time. I am OK with that. I will help out people as much as it is possible for me to, when they NEED the help. Not just because they are lazy and dont want to get a job.
If abuses occur where you are, or, like the coke laden shopping basket, rules don't conform to ideals held by authorities (like junkfood served in schools), report that as a concerned citizen. "If it's to be, it's up to me" is not just a jingle!
When discharged OB patients I was assigned, had piles of hospital baby blankets in their "belongings" bag upon leaving, I used to say, "This is for the things you brought here, so I'll just put these in the laundry container, since I can't put them back in the linen cart. Now where is the blanket you brought to take this lovely baby home". You aren't less culpable for theft, if you didn't steal and see theft happening. Remember that assisting in any violation, is a crime!
Yes I am an idealist, and believe that setting a good example in life skills for others is a nursing role. It's a task that never ends, and the more of us do it, the less each of us will have to do; and the more money there will be for good medical care.
We need to all take responsibility for any flagrant disrespect for rules that occurs within our view.
And I totally agree with that... it is up to us to make changes or nothing will ever change... but what can one do? go grab the cart and inform the people that they should be buying healthy food and drinks? i dont think that would go over too well. i guess one could go ask their name and then go report them, but for what? there are no guidelines on that they can and cant buy... as long as its edible or drinkable (except alcohol) then its fair game. I think it is the system that needs an overhaul... people who abuse the system now will continue to abuse any system put into place and they are doing nothing but making it worse for the people who do need the help and who do not abuse the system.
lamazeteacher
2,170 Posts
it seems unusual for strangers to provide transportation, unless their expertise was needed for some reason. surely by the time patients were discharged, family members could transport them! when i was a student, i wouldn't have felt comfortable dealing with a post op situation in a foreign country, where i didn't know the protocol for emergency services, or have a license as a nurse. i'm amazed that their instructors/nursing school would approve of that. buffalo as you know, retrn77, is close to the border, while if the transported patients lived in toronto or further, the chances of possible problems would be greater, due to the amount of travel required. if the patient became oxygen deprived, that would rule out small plane travel.
i do know that if a canadian patient's condition warrants it, they are moved up the waiting list. think organ transplant lists, and how you have to be critical to get one earlier, here as well as in canada. it's not a matter of where someone is in the line, but what urgency there is. sometimes heart patients worrying about the delay, makes their symptoms seem worse (which could actually be the case); and that could get them the surgery in canada sooner.
my sister's age of 80 didn't influence the 9 hour back surgery she had last january; and her amount of pain influenced their decision to do the fusion sooner than it was scheduled. she was bumped for the first date, due to an emergency surgery started earlier the day she would have had it, and her doctor expedited her next date to an earlier date than she was given at first, due to the degree of pain she had. sometimes you have to be a "squeeky wheel".....