Canada's health system is as good or better than the US new research suggests - page 2

Health care just as good, half as much as in U.S., report says Canada's health system is as good or better than that of the United States and is delivered at half the cost, new research suggests.... Read More

  1. by   Multicollinearity
    Quote from CHATSDALE
    i am in favor of broader health care benefits but i, too, have heard of people who had difficulty in getting basic things like a tonsillectomy, md decided that it wasn't necessary child was brought to us and has been healthy since surgery
    i don't see why the preventive care can't be implemented. surely would be great
    my ex was in military and we had to go to base for health care...the waits were horrible however the care if you were admitted was as good as i have ever received in a private pay hospital
    just a question if anyone knows the answer

    1] how much is the tax rate there as compared in usa?

    I don't think we can compare the tax rates because Canadians have many differences in social funding besides healthcare. For example, I have two poor elderly Canadian relatives and they receive nice, cheery government subsidized housing that would make poor elderly Americans envious. They also receive government pensions that are a bit better than our social security. These are just a couple of examples. In addition, Canada is rapidly paying down its federal debt. What are we doing in the US? Hmm?

    2] does this coover all meds?

    No. Canadian coverage does not cover medications. Most get supplemental coverage through their employers. If you are low income then you pay a percentage of the cost. Example, one of my poor elderly relatives tells me she pays 15% of the cost. Thing is - Canadian medications sell for much less than the identical meds in the US.

    3] do you have a choice of doctors/hospitals?

    Any doctor any hospital in your province from what I've heard.

    4] how does does nurses pay compare in the two countries?
    From my research, it appears that Canadian RNs earn a bit less than US RNs. However, I know of Canadian RNs who earn almost six figures by working in Native Indian facilities.

    I know two Canadians, one a physician, the other a psychologist who are working in the US to make more money. What I find interesting is that they both say if they got sick - really sick - they would high-tail it back to Canada in a hurry.
    Last edit by Multicollinearity on Apr 20, '07
  2. by   CHATSDALE
    thanks for update
  3. by   HM2VikingRN

    as described by the american press, canada's health-care system takes the form of one long queue. the line begins on the westernmost edge of vancouver, stretches all the way to ottawa, and the overflow are encouraged to wait in port huron, michigan, while sneering at the boorish habits of americans. nobody gets to sit.
    sadly for those invested in this odd knock against the canadian system, the wait times are largely hype. a 2003 study found that the median wait time for elective surgeries in canada was a little more than four weeks, while diagnostic tests took about three (with no wait times to speak of for emergency surgeries). by contrast, organisation for economic co-operation and development data from 2001 found that 32 percent of american patients waited more than a month for elective surgery, and 5 percent waited more than four months. that, of course, doesn't count the millions of americans who never seek surgery, or even the basic care necessary for a diagnosis, because they lack health coverage. if you can't see a doctor in the first place, you never have to wait for treatment. canada's is a single-payer, rather than a socialized, system. that means the government is the primary purchaser of services, but the providers themselves are private. (in a socialized system, the physicians, nurses, and so forth are employed by the government.) the virtue of both the single-payer and the socialized systems, as compared with a largely private system, is that the government can wield its market share to bargain down prices -- which, in all of our model systems, including the vha, it does.
    a 2003 study in the new england journal of medicine found that the united states spends 345 percent more per capita on health administration than our neighbors up north. this is largely because the canadian system doesn't have to employ insurance salespeople, or billing specialists in every doctor's office, or underwriters. physicians don't have to negotiate different prices with dozens of insurance plans or fight with insurers for payment. instead, they simply bill the government and are reimbursed.
    sounds like a good basis for a system!
  4. by   newyorknursey
    wow. someone did their homework. informed discussion is sooo juicy.

    345 percent more per capita on health administration in the U.S.!!!
  5. by   Simplepleasures
    Quote from multicollinarity

    Other advanced countries spend far less than us and have more to show for what they do spend as far as longer lifespan and better health.

    My Canadian relatives think Americans are stupid regarding healthcare financing, quite honestly. Sure they have complaints here and there - but they wouldn't want to live in the US system for anything. I have several Canadian relatives who live half and half in each country. So they do in fact have knowledge of both systems.
    Absolutely my own experience when talking to my German and Canadian reletives about their health care. They cannot understand how such a rich , intelligent country cannot set up a universal health care system. The German reletives seem to like their system and have less complaints than the Canadians, BUT the Canadian reletives have said they would not want to go with our brand of health insurance based care, they would prefer to keep their bank accounts solvent and not have to forclose on their home to pay medical bills. Even in this country there are surgeries and procedures that are either outrightly denied or there is a long wait to get the procedure OR to even see the MD in question.
  6. by   Kabin
    Quote from multicollinarity
    I know two Canadians, one a physician, the other a psychologist who are working in the US to make more money.
    Related to that is the issue of Canadian taxes. A Canadian engineer I worked with was glad to work in the states.
    Last edit by Kabin on Apr 24, '07 : Reason: yep
  7. by   pickledpepperRN
    The Canadian Nurses association was well represented here.

    Taming of the Queue
    Not many conferences attended mostly by researchers and policy-makers
    can boast having had the Prime Minister come for lunch. But Prime
    Minister Stephen Harper made a lunchtime appearance at the 4th annual
    Taming of the Queue conference in Ottawa on April 4, 2007 to
    announce, along with federal Minister of Health Tony Clement,
    agreements between the federal government and the 13 provinces and
    territories with regard to meeting specific wait time targets in
    exchange for targeted federal funds....

    ... In their closing comments, the conference co-chairs re-emphasized the
    positive messages that were heard throughout the conference that real
    progress was being made in terms of measuring, monitoring, managing
    and, ultimately, reducing wait times in different parts of the system
    in different parts of the country. But there also remained some very
    hard work left to be done. ...

    ... The advantage of course is that work on reducing wait times for primary care, mental health and children's services will be greatly enhanced by the hard work already done in those areas that have benefited from so much research and political attention in recent years.

    Finally, it is clear that the success stories related over the course
    of the two days of the conference also very much reinforced an idea
    that has been central to the work on wait times since the issue first
    began to receive attention from researchers and politicians.
    Successful wait time strategies require champions willing to take on
    leadership roles and persevere in the face of sometimes strong
    opposition. ...

    Begins on page 21 of the paper, not the PDF:
    The opponents of single-payer national health insurance
    claim that intolerable waiting times for health care would be
    inevitable. They use the experience in Canada as proof.

    Canada has had problems with excessive queues, but, as this report
    demonstrates, they are being addressed, and with considerable success.

    While Canada moves forward with queue management and fine tuning of
    capacity, we continue to hang our heads in shame over the financial
    barriers we place in front of tens of millions of Americans, which
    prevent access to the most generously funded health care system ever
  8. by   DarrenWright
    This is going to be mildly enjoyable to address.

    First, there is a remarkable failure to seperate primary care from acute care when making these comparisons. Countries with socialized systems tend to have more aggressive primary care systems primarily because they know once the patient's health trends beyond the capabilities of primary care, their outcome will not be as good as the acute care outcomes in places like...the US.

    Second, the repetition that the majority of Canadians would refuse trade their system for one like the US is not a valid argument for two reasons; A. The majority of Americans don't want Canada's system (also not a valid argument, but just as relevant as the idea preceding it). B. 75% of Canadians live within driving distance of the 'US system' and have the unique ability to access both systems.

    And Canada IS addressing their troubled system with it's unique flaws, and one of the keys to their success has been by RELAXING the laws on privatization (making it more Americanized), not by exacting more gov't control. And if the US went to a single-payer universal type system, you will see DRAMATIC changes in the outcomes of Canadian citizens, a large number of whom currently seek medical care in the US, but would now find it more difficult to access our system, or might not be able to access it at all. We'd see a shuffling of countries who are proud of their rankings, and a reluctant change in sentiment.

    Finally, we do not place any financial barriers in front of "tens of millions" of Americans. The approximated round number of 45 million uninsured Americans is a myth. That number is calculated based over a one-year period, meaning, of that 45 million, many of them were uninsured for only a day, or a few days, or a few weeks of that fiscal year, possibly while they changed jobs or insurance companies (during which time they were eligible by federal law for COBRA coverage). Additionally, millions more are people who can afford health insurance, but exercise the great American past-time of CHOICE, and opt out, possibly saving that money for an HSA (those people technically are not insured, but still have money available for health care), or use that money to purchase a more expensive home, etc. Suddenly they are alleged victims when they have to sell the home to pay for health care, when the truth is that their home was really their insurance policy, a policy they were living in instead of buying from a broker.

    Intellectual dishonesty may become one of my trademark statements, but much of this discussion is flavored with intellectual dishonesty.
  9. by   HM2VikingRN
    Try paying for COBRA coverage......If an individual and their family cannot pay for the family coverage at the employer rate how will they pay for that coverage with a 2.5% surcharge?


    Recent years have seen the rapid growth of private think tanks within the
    neoconservative movement that conduct “policy research” biased to their
    own agenda. This article provides an evidence-based rebuttal to a 2002
    report by one such think tank, the Dallas-based National Center for Policy
    Analysis (NCPA), which was intended to discredit 20 alleged myths about
    single-payer national health insurance as a policy option for the United
    States. Eleven “myths” are rebutted under eight categories: access, cost
    containment, quality, efficiency, single-payer as solution, control of drug
    prices, ability to compete abroad (the “business case”), and public support
    for a single-payer system. Six memes (self-replicating ideas that are promulgated
    without regard to their merits) are identified in the NCPA report.
    Myths and memes should have no place in the national debate now underway
    over the future of a failing health care system, and need to be recognized as
    such and countered by experience and unbiased evidence.
    Most of what you have promulgated against single payer falls along these lines of being as you say "intellectually dishonest"
    Last edit by HM2VikingRN on Jun 9, '07
  10. by   ZASHAGALKA
    Quote from HM2Viking
    Try paying for COBRA coverage......If an individual and their family cannot pay for the family coverage at the employer rate how will they pay for that coverage with a 2.5% surcharge?
    Maybe you don't know how COBRA coverage works. You have a few months to purchase the coverage and once purchased, it backdates to the day you last had coverage.

    So, if you are between jobs, and it takes 2 months to get insurance at your new job, then you don't have to buy the COBRA insurance UNLESS YOU HAVE A PROBLEM IN THE GAP. If you buy it at that point, even after the fact, it is still effective.

    So, COBRA coverage can span the gap between jobs even if you never purchase it. In actuality, this is exactly why COBRA is worded the way that it is: and it is why it is so expensive - it is one of the only retroactive (after the fact) "insurance" policies you can buy.

    Besides, most normal people get some type of separation package from their jobs when they leave them, even if it's just accumulated sick leave or a 401(k) plan (that could be used for an emergency). So, anybody that reasonably plans should be able to purchase COBRA, if needed. Or, maybe it's too much to ask people to reasonably plan for their lives?

    2nd, that 45 million uninsured? It's a two yr rolling period of anybody uninsured for any period in that 2 yrs. For example, I changed jobs about 2 yrs ago. I was technically uninsured for a month (although COBRA would have backed me up, had I needed it). So, add 4 more people to the uninsured total (me and my 3 boys) even though that's not just a statistic, it's a danged lie.

    But when you want the numbers to say what you want them to say, why, just manipulate them.

    Last edit by ZASHAGALKA on Jun 9, '07
  11. by   DarrenWright
    Quote from HM2Viking
    Try paying for COBRA coverage......If an individual and their family cannot pay for the family coverage at the employer rate how will they pay for that coverage with a 2.5% surcharge?
    This overlooks the beauty of COBRA. Most people don't take quit their job until they have a new one in the bag. Then once they quit their job, they have 18-36 months of eligibility, but here's the cool part; they don't have to pay a dime for it during those 18 months if they don't want it. If, however, they decide to enroll, they are covered retroactively to the first day they were eligible. So the beauty of this is that someone in transition who chooses to take a 6 month break between jobs is eligible for coverage, but doesn't have to enroll unless they want to, or have a need for coverage. There is a good chance they won't need to enroll, but they are essentially covered by virtue of federally mandated eligibility, and don't have to pay a dime until they decide to take advantage of eligibility.

    And while a 2% surcharge may be considered high, if the enrollee is either 10% or $50 dollars short for a payment, the employer is required to provide full coverage.

    Bottom line is that if someone doesn't think they can afford to take advantage of COBRA for whatever period of time they decide to take between jobs, then they shouldn't take a very long break; I took a 6 week break between my last two jobs.
  12. by   ZASHAGALKA
    There are two issues with healthcare at the moment:

    1. Finding a way to provide coverage to 15% of the people too poor or too unconcerned to cover themselves. Yes, a good chunk of that is purposely uninsured. In that mix is a way to provide somewhat more consistent primary care.

    2. Finding a way to use healthcare as a proxy to socialize the American gov't.

    At 8.8 Trillion dollars, the federal debt is a massive drain on the private economy. Add several more trillion with programs such as gov't restricted healthcare and you will crash the private sector economy, which is the ultimate point of gov't restricted healthcare. At THAT point, the gov't will pull a 1930's takeover of the economy. This is just a backdoor attempt to socialize the economy by using socialism to destroy the economy.

    It never fails to amaze me how the answer for runaway socialism always seems to be more socialism.

    Many of the current healthcare problems come from gov't intervention. The neo-mercantile view of gov't meddling in how businesses operate have helped to create the 3rd party payor system that is a mess. Know why your employer pays for your health insurance? The gov't capped incomes during WWII so employers had to come up with other ways to entice employees. The results: fringe benefits. The gov't liked the idea of it so much, it instituted tax savings for employers to do just that. The result: health insurance from your employer became defacto coverage.

    The result was also to insulate insurance companies from competition. As a result, their administrators can be brazenly sloven with how they spend money on themselves. Many like to point at insurance companies as part of the problem in an attempt to suggest that private enterprise doesn't work. Only the big fat insurance companies aren't just private enterprises: they are GOV'T INSULATED private enterprises. Their market shares are protected by gov't tax breaks to businesses (for providing healthcare) that leave the ultimate consumer out of the loop. Your gov't, at work. But, do, let's have more.

    So, everybody out there complaining that employer driven health coverage is the problem and the solution is more gov't should understand that that employer driven health care WAS a gov't solution.

    The gov't will never look out for you better than you. No matter who you are.

    Can you find support for providing gap coverage to most Americans. Yes, I think you can. America is a generous place. Can you find support for a gov't restricted healthcare plan designed as a proxy to socialize the economy? Not a chance. No way Americans will ever agree to pay that much more in taxes for that much less choice in care.

    You can talk up the platitudes of 'universal coverage' all you want. When the insured masses understand how much more gov't restricted healthcare will cost and just how restrictive it will be, the idea suddenly loses steam. Helping people is one thing. Being screwed over to do it is another. Ask Hillary about that.

    Gov't restricted healthcare is a pipe dream. Those that believe it is remotely possible do not understand the voting electorate. If it were at all possible, the progressive moment would have pulled it off in the 1930's, at its peak. That movement is well past its peak now.

    This is a center-right nation. Gov't restricted healthcare will not fly.

    If you are truly interested in improving healthcare, it would be better to promote practical solutions to the current system over progressive dreams of transforming the economy. The current system - it isn't going anywhere.

    Last edit by ZASHAGALKA on Jun 9, '07
  13. by   pickledpepperRN
    This is quite interesting. You have to register to read the entire article:
    ...The question of how to distribute the financial responsibility for America's health care bill dates back to the late '20s and early '30s...

    ...In 1929, half the country's families would have had to pay the equivalent of one month's income for a hospital stay.
    Of course, it was only the families with serious medical problems that ran into such high costs. But that was precisely the problem, according to the Committee on the Cost of Medical Care, a privately funded task force whose 1932 report is considered the first thorough review of health care costs in U.S. history. The Committee determined that, although the total cost of health care in the United States (then around 4 percent of national income) was one the nation could certainly afford, most of the burden fell on a relatively small number of people who, because of accidents or serious disease, required extensive medical care. And, while some people saved money for the possibility of future medical expenses, the Committee concluded, "[T]he unpredictable nature of sickness and the wide range of charges for nominally similar services render budgeting for medical care on an individual family basis impracticable." ...

    ...(FDR is said to have dropped health care from the Social Security Act, because he feared the hostility from state medical societies might doom the entire package.)
    In the absence of national health care, a much different system evolved. It began in 1929, in Dallas, Texas, when Baylor Hospital, desperate to fill its beds with paying customers rather than charity cases, approached the public school teachers of Dallas with a deal: If most of the teachers would agree to pay the hospital a small amount of money every month, then the hospital would agree to provide medical services to any teacher who needed it, anytime. The plan was a hit, and soon hospitals around the country, most of them facing similarly dire financial situations, began copying and expanding the Baylor plan, which eventually became the Blue Cross system. By the 1940s, it was enrolling millions of new people each year--a pace that quickly lured the commercial insurance industry, which had dabbled unsuccessfully with disability-style benefits in the early twentieth century, back into the business....

    ...As private insurance spread, the link to employment became entrenched--in part because large workforces guaranteed a large number of healthy beneficiaries to cover the costs of those few with severe illness, and in part because employers themselves found it advantageous....

    ...Government encouraged this arrangement by exempting employer health insurance from taxes--in effect, making health insurance connected to a job more valuable than cash on a dollar-for-dollar basis. By the 1970s, the vast majority of working-age Americans had private health insurance through their jobs. They still paid for this coverage indirectly, through the lost wages their employers were spending instead on health insurance. But they shared it among themselves, for relatively modest sums, rather than facing it individually, at potentially crushing levels. And most of these people seemed to think the system worked very well....
    ...But it might have worked too well. Critics had long worried about the "moral hazard" of insurance--the possibility that generous benefits might encourage people to seek care they really didn't need or to consume care with little regard for its cost...

    ...In the 1990s, this mindset led employers to switch their workers into health maintenance organizations (HMOs) and other forms of managed care. Managed care promised to hold down medical bills by restricting beneficiaries' access to medical services--and then bringing down the price of those services through hard-nosed bargaining....

    ...Individual doctors and hospitals resented the medical second-guessing, not to mention the bullying about prices. Consumers resented the limits on what doctors they could see and what treatments they could get. Soon, politicians on both sides of the aisle were looking for another way. ...