By design, a monopoly produces a different kind of worker. Unwilling to have their wages capped and freedoms restricted, the best inevitably leave. Mediocrity, unfortunately, gives rise to fewer malcontents and thus is a prerequisite for stability in the system. Put it this way: if a socialized system wants to survive, it must expunge the most driven and gifted from its midst. When wages, moreover, are tied to a negotiated deal with labour, rather than, in the case of a competitive market, to the individual physician's performance, the position of the mediocre practitioner is further reinforced.
Specializes in Cardiac Surg, IR, Peds ICU, Emergency.
I work in a public health system. Mediocrity is NOT championed, and I think this article is wrong. I think the authors started with a viewpoint and just selected things to say that supported their viewpoint. It's plain ignorant to say that the best automatically flock to the private system, and that we are left with the dregs. It's ignorant of the realities of the system. The author provides NO evidence whatsoever that "mediocrity" is rampant in canada's health care.
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And I think if you talk about wages, you have to talk about cost of living. If you don't want to talk about economic realities, don't mention wages. I don't think nurses would be paid less in a public system. The nurses in canadian provinces that have higher cost of living - do get paid more. Their unions negotiate more BECAUSE of the cost of living. So maybe you need to be aware of that fact.
It's not ignorant to say that the best flock to the private system; Brain Drain is a very real problem in Canada, and Canada is one of the top suppliers of RN's to the United States.
You can't use cost-of-living as a distractor, and you have to keep it in perspective; someone pointed out top-shelf wages as being the same as Canada, and I showed a reference indicating that US wages were in fact much higher.
If you decide to inject cost-of-living, you have to be intellectually honest, meaning, if you claim that Canadian RN's living in areas with a higher cost of living make more than Canadian RN's living in an area with a lower cost of living, then when you compare those wages internationally, you have to use comparative regions. For example, the average wage for an RN in Toronto (one of Canada's costliest cities), is about $29.55 according to the Canadian Labor Market Information website. http://www.labourmarketinformation.ca/
I would post the entire link, but it's huge and keeps distorting the post (any assistance would be appreciated).
In contract, the average hourly wage for the entire US is $28.71 according to the BLS. That means that on average, any nurse in the US is making only .84 cents less than the nurse living in the most expensive city in Canada. I would like to show the comparative nurse wage for a city with a similar cost of living, i.e. White Plains, NY but I can't find that info, but maybe one of our NYC region nurses can share what the average wage is for that area.
It's tedious to take the discussion this far, but I'm only attempting to include consideration of the items that have been added to the discussion.
Specializes in Trauma acute surgery, surgical ICU, PACU.
It's not ignorant to say that the best flock to the private system; Brain Drain is a very real problem in Canada, and Canada is one of the top suppliers of RN's to the United States.
"Brian Drain" is a media sensationalist term.
Provide some real evidence that the actual health care provided in canada's system is mediocre, especially mediocre compared to what is provided to the population in the US.
The volunteer firefighters are part time. I am in awe of people who do that for their small communities!
But the career firefighters are full time. They protect those of in in cities and larger communities.
Firefighters
Career firefighters include full-time (career) uniformed firefighters regardless of assignments, e.g., suppression, prevention/inspection, administrative. Career firefighters included here work for a public municipal fire department; they do not include career firefighters who work for state or federal government or in private fire brigades.
Volunteer firefighters include any active part-time (call or volunteer) firefighters. Active volunteers are defined as being involved in firefighting.
* Estimated number of firefighters in 2005: 1,136,650 (career: 313,300, volunteer: 823,350)
* Firefighters by age group: 16-19 (3.6%), 20-29 (21.6%), 30-39 (29.1%), 40-49 (26.1%), 50-59 (14.7%) 60 and over (4.8%)
* Seventy-six percent of career firefighters are in communities that protect a population of 25,000 or more.
* Ninety-five percent of the volunteers are in departments that protect a population of less than 25,000 and more than 50% are located in small, rural departments that protect a population of less than 2,500.
Source: National Fire Protection Association, U.S. Fire Department Profile Through 2005
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Pointing at one or two particular countries health care system and saying "See! I told you it wouldn't work!" Is like pointing at a Yugo and saying cars are junk.
My whole family have been patients in a socialized health care system in one particular country. I actually had pretty major surgery in one. We experienced fantastic care and would go back in a second. I very much would like to see a similar system here in the USA.
My cousin who lives in California is listed as a volunteer because when he goes 'home' he takes call duty.
Anothers sons are away at college out of state and on the roster.
My cousin was listed when he was killed in Viet Nam.
My uncle was listed when he died a couple years ago at nearly 90 years old.
He actually could help because he still could drive and organize his former boy scouts, most of them Eagle.
I other words some of these volunteer firefighters are only available two weeks a year.
I'm certain others are available much more often because they work in the are and have an arrangement with their employer to respond if a fire occurs while at work.
I was in Breckinridge two years ago. There are still no stores. There are homes and farms, five churches, one school, dirt roads except for the highway, and really wonderful people.
You can't use cost-of-living as a distractor, and you have to keep it in perspective; someone pointed out top-shelf wages as being the same as Canada, and I showed a reference indicating that US wages were in fact much higher.
You showed the wages for ONE area, just like I did. That isn't a country by country comparison and in order for it to be meaningful you have to consider cost of living. Nurses in California make a lot more than nurses in Mississippi, but that doesn't necessarily mean we live better on it. Like I pointed out, I'll never be able to buy a home with my salary here. My 25 year old colleague from Mississippi was able to buy one within weeks of starting her job out there. Which one of us is richer?
Anyways, I don't know why this topic always comes up. The US already has a semi-socialized-semi-private system and that's how it will stay because that's what the people want. Most Canadians I know have no desire to replicate the US system up there.
If you decide to inject cost-of-living, you have to be intellectually honest, meaning, if you claim that Canadian RN's living in areas with a higher cost of living make more than Canadian RN's living in an area with a lower cost of living, then when you compare those wages internationally, you have to use comparative regions. For example, the average wage for an RN in Toronto (one of Canada's costliest cities), is about $29.55 according to the Canadian Labor Market Information website. .
canada sounds similar to uk all nurses in the same grade and paid the same rate, however there is a extra for those in greatar london area, this goes across the board for all public workers in that area.
In the US, 70% of fire protection is done by volunteers. Hardly a reasonable comparison.
The public school system is doing terribly, especially when compared to non-public education.
Our "police protection" is just as privatized as health care; thousands of private security officers are hired by businesses and communities to supplement 'police protection,' and the tax-funded police departments would never be able to fill in the gaps that are protected by private officers. If our "police protection" was as 'socialized' as Canadian health care, we'd be living in anarchy.
Additionally, there are a lot of things we are able to do to protect ourselves from crime, but are not able to do for ourselves when it comes to healthcare...i.e. I can put in an alarm system, lock my car, and buy a gun, but I can't stitch my own cuts or perform my own colonoscopy.
Specializes in Cardiac Surg, IR, Peds ICU, Emergency.
"Brian Drain" is a media sensationalist term.
Provide some real evidence that the actual health care provided in canada's system is mediocre, especially mediocre compared to what is provided to the population in the US.
The term "brain drain" was not coined by the media, but was coined by the Royal Society of London (an organization for the advancement of science), and was developed in response to the loss of intellectual talent to the US.
Maybe you prefer I call it "capital flight" where people move to make more money elsewhere. Doesn't matter what it's called, the process is occurring.
I just provided the article; I don't think you can measure mediocrity. I do think you can identify policies which promote it, and the policies which promote rising above mediocrity.
Specializes in Cardiac Surg, IR, Peds ICU, Emergency.
The volunteer firefighters are part time. I am in awe of people who do that for their small communities!
But the career firefighters are full time. They protect those of in in cities and larger communities.
The volunteer firefighters are not paid.
According to the National Volunteer Fire Council, the number of volunteer firefighters in the United States declined more than 10 percent from 1983 to 2003. Yet the 800,050 volunteers in 2003 made up 73 percent of the country's firefighting force.
canada sounds similar to uk all nurses in the same grade and paid the same rate, however there is a extra for those in greatar london area, this goes across the board for all public workers in that area.
Canada doesn't have extra pay for more expensive cities though. Nurses in each province have a union which negotiates their pay scale and it's the same for all nurses in that province (based on years of experience and extra for management positions). Some provinces pay very well and some don't. It's the same in the US. That's the reason you'll meet Canadian nurses in California and New York, but not so many in Alabama or Arkansas.
Those who think high pay = good job performance understand very little about what motivates me as a nurse. I expect to make a decent living, but I worked just as hard when I was making $22 an hour as I do now.
DarrenWright
173 Posts
It's not ignorant to say that the best flock to the private system; Brain Drain is a very real problem in Canada, and Canada is one of the top suppliers of RN's to the United States.
You can't use cost-of-living as a distractor, and you have to keep it in perspective; someone pointed out top-shelf wages as being the same as Canada, and I showed a reference indicating that US wages were in fact much higher.
If you decide to inject cost-of-living, you have to be intellectually honest, meaning, if you claim that Canadian RN's living in areas with a higher cost of living make more than Canadian RN's living in an area with a lower cost of living, then when you compare those wages internationally, you have to use comparative regions. For example, the average wage for an RN in Toronto (one of Canada's costliest cities), is about $29.55 according to the Canadian Labor Market Information website. http://www.labourmarketinformation.ca/
I would post the entire link, but it's huge and keeps distorting the post (any assistance would be appreciated).
In contract, the average hourly wage for the entire US is $28.71 according to the BLS. That means that on average, any nurse in the US is making only .84 cents less than the nurse living in the most expensive city in Canada. I would like to show the comparative nurse wage for a city with a similar cost of living, i.e. White Plains, NY but I can't find that info, but maybe one of our NYC region nurses can share what the average wage is for that area.
It's tedious to take the discussion this far, but I'm only attempting to include consideration of the items that have been added to the discussion.