What would a single payer system look like?

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So as we enter 2016 we have a democratic candidate opting for a single payer system or rather "Medicare for all". Now whether something like this could or should pass, what would the healthcare system look like with this in place. Please note that this is not a political argument as far as democrat vs republican or anything like that. I am simply curious to see how the system would change and if the change would be better, worse, or the same. Please feel free to post your thoughts!

It is not like Medicare. The payer is the provincial government but the providers are government hospitals. Each province in Canada manages its own provincial health plan, therefore different rules, different premiums or no premium at all. Even when there is premium, assistance is available when the insured cannot pay. The funds come at the federal level but the amount each province receives, and is not related to how much a province contributes through income taxes. Hospitals are provincial government hospitals. I am guessing that the smaller population of Canada (compared to the US) makes healthcare easier to run. Prescription medications dispensed at Pharmacies are generics. Most people who are employed take out supplemental medical plans paid for y their employers to take care of getting more benefits than what the provincial plans provide. My experience is there is practically no wait times when it comes to hospitalization and treatment of young children, the younger they are, the faster they get attention. There is no out of pocket.

I forgot..a primary care physician is the gatekeeper. You can't see a specialist without your PCP sending you to one. Hospital beds are not private single patient rooms.

At least in British Columbia, heart surgery patients are sent to California if they need to. paid for by the province's Medical Services Plan.

The plans are available only to those who have social security numbers - landed immigrants, citizens, contract workers with valid contract visa. Every services in the country is tied to having that SSN. Of course, hospitals will treat anyone regardless of status in case of emergency. The hospitalization cost is way lower than the US. In provinces where there are premiums, the amount is in the $100plus range for a family. There is wait times.

Specializes in Critical Care.
At least in British Columbia, heart surgery patients are sent to California if they need to. paid for by the province's Medical Services Plan.

I'm curious where you're getting that info from. I've worked at a hospital that frequently traded patients with BC. We'd get Canadians who were down here visiting in our ED who would go to the cath lab where it would be discovered they need emergent open heart. Whenever possible we shipped them back up to Canada for surgery, usually after pleading from the province and the patient themselves to have the surgery done in BC. We've also received Americans who transferred to us after getting open heart in BC. We've even sent patients up there on ECMO and IABPs, so they seem pretty capable.

Also, there's not really any evidence that Canadians come to the US for healthcare in any significant amount, but if a province were to contract out cardiac surgeries, it wouldn't make sense to send them to one of the most expensive healthcare markets in the country.

Got that info from the BC MSP. They say they do it - of course, I don't know how much. I am assuming that the patients would be sent by MSP itself (pre-authorized?) and not the situation where the Canadian walked into ED itself because US healthcare (CA healthcare) is very expensive compared to Canadian. Canadian hospitals are quite capable of course but they may be having a situation of not enough beds/spots for the patients and the treatment has to be done soon.

Specializes in Critical care, tele, Medical-Surgical.

With Medicare in the USA we can choose our specialists. Our family practice physician is not a gatekeeper. I trust him, because he recommends excellent specialists, but we are keeping our ophthalmologist.

We have a supplement now because Medicare only pays 80%. When (if) we get Medicare For All it will be improved to include dental and not require a supplement.

I don't recommend a Medicare Advantage plan because that means giving up regular Medicare for private, and often for-profit insurance. They limit providers and often use gatekeepers.

Worse. This is the same system Canada uses and sometimes you have to wait for years for surgery or necessary procedures. Government red tape will come into play as someone up there in Washington decides if you need or do not need a procedure. Yes, there will be little to no cost. Yes, you will sacrifice quality and quantity.

Teri, RN, BSN

Specializes in Critical Care.
Worse. This is the same system Canada uses and sometimes you have to wait for years for surgery or necessary procedures. Government red tape will come into play as someone up there in Washington decides if you need or do not need a procedure. Yes, there will be little to no cost. Yes, you will sacrifice quality and quantity.

Teri, RN, BSN

One of the main things the ACA did was to tell private insurers that they can't refuse as much coverage as they have been, so between the government and private insurers it's hasn't been the government that we have to worry about denying coverage.

While there are longer wait times for elective procedures in Canada it's not due to single payer, it's because they choose to use wait times to control costs, and they don't wait "years", the longest waits are for hip replacements, which averages 86 days. They could easily fix wait times and more with an extra $10 billion per year and they'd still only be paying about $6000 per person for healthcare, compared to more than $9000 in the US, and even with the wait times they have better overall outcomes than we do.

Specializes in Acute Care, Rehab, Palliative.
Worse. This is the same system Canada uses and sometimes you have to wait for years for surgery or necessary procedures. Government red tape will come into play as someone up there in Washington decides if you need or do not need a procedure. Yes, there will be little to no cost. Yes, you will sacrifice quality and quantity.

Teri, RN, BSN[/quote

That's baloney. You don't wait years for necessary surgery or procedures. You wait for elective non emergency surgery.

Worse. This is the same system Canada uses and sometimes you have to wait for years for surgery or necessary procedures. Government red tape will come into play as someone up there in Washington decides if you need or do not need a procedure. Yes, there will be little to no cost. Yes, you will sacrifice quality and quantity.

Teri, RN, BSN

That is very misinformed in your part. Yes there are longer wait times for certain non life threatening surgeries but is not a big grim landscape the way they like to make it seem from here.

An emergency procedure will take place over a non emergency one. Also when you have everyone insured of course there is gonna be a wait time. We are just spoiled down here to have everything when we want it.

Imagine if the whole population of the US had access to healthcare, how much of a hiccup it would cause in our current providers.

With Medicare in the USA we can choose our specialists. Our family practice physician is not a gatekeeper. I trust him, because he recommends excellent specialists, but we are keeping our ophthalmologist.

We have a supplement now because Medicare only pays 80%. When (if) we get Medicare For All it will be improved to include dental and not require a supplement.

I don't recommend a Medicare Advantage plan because that means giving up regular Medicare for private, and often for-profit insurance. They limit providers and often use gatekeepers.

Our family has members who receive their health care from Medicare Advantage plans. The PCP gatekeepers have been very good doctors, and my family members have seen a very wide range of specialists, most of whom I would rate very highly. For the most part, my family members have received very good care, and have been happy with their care and with their doctors.

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