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.
You're cherry picking the data that supports your view and then saying that makes it fact and not opinion. That isn't impartial reasoning. That's Micheal Moore style editorializing.
I didn't cherry-pick data, and noone has shown conflicting data.
Also, (ignoring the fact that you have no proof that lifestyle choices or preventative care are good but hospital care is bad in Canada)
I never said that.
why would you think preventative care isn't a part of the health care system worth considering when comparing two countries?
IT IS PART of the consideration, and I've included it! You have to keep it in context, though. You can't just use one benchmark (i.e. life expectancy), and say that the system is better. You see, preventative care starts at home, and there is no wait time for this in either country. Americans have by-in-large simply refused to take advantage of it.
Preventative care is what allows us to detect all those illnesses that are treated in hospitals EARLY when outcomes to treatment are the best. I would rather find breast cancer early and only need a lumpectomy than late when I'd need a mastectomy and radiation or chemo. If it keeps me alive longer, I don't really care where I was treated.
I agree, and I thought I'd point out that the US has a better survival rate than Canada for breast cancer; it's one area where we've gotten a grip on preventative care.
The myth of the Canadian hordes crossing the border for healthcare is about as meaningful as the myth of millions of Americans lacking any healthcare access at all.
First, it's not a myth that Canadians cross the border for healthcare, and it's very meaningful, because it reflects a problem with obtaining that care in their supposedly paid-for system.
I swear, I have the exact opposite conversations with Canadians about health care down here. It never fails to surprise me that people read a few articles that support their preconceived views and then become 100% convinced about systems they've never worked in or been treated in. One of my Canadian nursing colleagues does it, and I've learned it doesn't matter what the reality is, her mind is made up (she thinks EVERYTHING down here is worse than "back home"). I think that's the case here and I accept that and will let it alone. It's been an interesting conversation though, thanks:) I am glad you're happy with the US system, and we both agree that it doesn't need to adopt the Canadian one.
I'm very sure you do, and I'm not surprised. Something I think it's important to consider is the access that Canadians have to the US system. I sincerely believe that acute-care and surgical outcomes would change in Canada if access to US healthcare was suddenly shut off. And it's meaninful to note that privatization is growing in Canada out of the necessity to expand services.
When it comes to volunteer fire departments, it's not just about funding. It's about the fact that BILLIONS are saved because noone has to pay for the wages of 70% of the nation's firefighters! Additionally, the majority of their funding comes from private donation, subscription fees, billing (private owners and their insurance for fire suppression activites), bingo, raffles (some fire departments make fantastic amounts of money on car/gun/money raffles), and business revenue, such as social hall rental or running an ambulance service. Few of these departments were started with a dime of tax dollars.
I never said police protection was inadequate; I simply pointed out that the current system of police protection wasn't so 'socialized' as was previously implied, but was instead a public system that was heavily subsidized by private police protection.
13% of all fire departments are career or mostly career and protect 62% of the U.S. population
87% of fire departments are volunteer or mostly volunteer and protect 38% of the population
Specializes in primary care, hospital bedside, QI.
It's nice to see this debate. I hope that we as nurses have witnessed just about enough of the consequences of nationalizing an industry. We in the U.S. have not had a free market in health care for almost 50 years and every problem of overcharging and inefficiency can be traced to too much state and federal regulation and interference with our ability to do our jobs. Look at the 3 states left in which ARNP's can't order pain meds that are scheduled drugs by state law. Is this compassionate? Not a chance. Based on skills? Of course not. It's one of a million examples of how patients get the shaft when governments are allowed to exceed their role and purpose.
When it comes to volunteer fire departments, it's not just about funding. It's about the fact that BILLIONS are saved because noone has to pay for the wages of 70% of the nation's firefighters! Additionally, the majority of their funding comes from private donation, subscription fees, billing (private owners and their insurance for fire suppression activites), bingo, raffles (some fire departments make fantastic amounts of money on car/gun/money raffles), and business revenue, such as social hall rental or running an ambulance service. Few of these departments were started with a dime of tax dollars.
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I am a nursing student and currently work work as a paramedic at a full-time midwestern fire department. Realistically, full-time FDs are a great example of why socialize medicine won't work. Most fire depts handle EMS calls to keep up their call volumes and budget. There are HUGE inefficiencies, excessive OT, excessive staffing (3 and 4 man crews on apparatus that handles 3-4 calls a week), and a general disdain for emergency medical calls despite the fact that they equal 70-80% of the volume of responses. This generally mediocre attitude present in many firefighter/paramedics is why I chose to go into nursing over full-time fire/EMS work. Don't get me wrong, most of them are great guys, just not up to the same work ethic as me. In public safety, from my experience, money is no object and cost control is far down the priority list. While Socialized medicine may cut out the "profit" from the "big. bad corporations" one must also consider government waste.
Privatized EMS, such as American Medical Response (those of you in CA may be familiar with AMR), are a much more efficient model of EMS ad public safety protection in a fast yet efficient manner. I fully agree that changes need to occur in the current system, but work with the current privatized system before replacing one cost burden (profit) with another (government waste).
It is pretty annoying to see people who do not live in a Universal Healthcare system pick random news articles and facts and post them as irrefutable evidence that 'it does not work'.
First of all, that is poor research at best.
Second of all, Many countries in the world have socialized medicne, and their citizens fight very hard to keep it. If it 'did not work' then you would think that the people of these countries would change it.
Thirdly, you guys go on and on about nurse wages and healthcare wages. Well, I have read the threads about nursing wages even on this forum. Some nurses are making $14 per hour!! No nurse in Canada - even a care aide - would make that low of a wage.
And finally, I have LIVED and WORKED in both systems. I am an American who lives in Canada. I have worked in both systems. I PERSONALLY know what they are both like. I do not need to pick random quotes to support any position I have because I have experienced both. I love the system in Canada. The facilities are excellent. I love the Canadian attitude to healthcare. I much prefer it to the States.
I work as a travel nurse at times in California. Yes, the wages are excellent in California - especially the Bay Area of San Fransisco/San Jose. I also work in San Diego. However, I make an excellent wage because I have family I stay with while I am down there. If I had to support a home or a family, the wages are not that great.
The attitude of the nurses and doctors in the States is very different from the attitude in Canada. The atmosphere is very different. I much prefer the atmosphere in Canada. Just because I go to the States for the money, does not mean I like the system. When my husband and I decided to start a family, we moved to Canada. Why? Because the health care system is better. Because the education system is better. Because the living conditions are better. Because we could afford a large farm property. etc.
I love America. And most of the time I am proud to be American. But that does not mean I have to belittle other systems that are different from my own.
Bottom line is, to make such silly blanket statements as 'socialized medicine is a failure' is ignorant and pointless. I suspect this statement is made simply to provoke controversy rather than support a well researched, objective opinion.
Specializes in NICU, PICU, PCVICU and peds oncology.
Here is a single example of how skewed the OP's arguments are. Mediocrity does not naturally occur simply because a system has a single payer. This hospital operates in one of the provinces with the tightest control over health care spending in Canada's "socialized" system. It performs roughly 600 complex pediatric cardiac surgical procedures annually. Patients come to this hospital from all four western provinces and all three northern territories; there have also been patients from Newfoundland, Nova Scotia, New Brunswick, Quebec and Ontario repaired here... in other words, pretty much all of Canada. The data are from 2005, but nothing has changed there since to change the stats.
Because Canada has a less-dense population than the US, it makes more sense to regionalize certain aspects of health care, such as pediatric cardiac surgery. It's a well-documented fact that in order to maintain skill and expertise a surgeon must perform a significant number of similar surgeries each year. Regionalization allows this. It also doesn't make sense to have high-tech services available in every ten-bed hospital in every town in the area. The demand isn't necessarily there, and the expertise to maintain the service won't be either. High-quality health care isn't reliant on who pays the bills, it's reliant on the people providing it.
Here is a single example of how skewed the OP's arguments are. Mediocrity does not naturally occur simply because a system has a single payer. This hospital operates in one of the provinces with the tightest control over health care spending in Canada's "socialized" system. It performs roughly 600 complex pediatric cardiac surgical procedures annually. Patients come to this hospital from all four western provinces and all three northern territories; there have also been patients from Newfoundland, Nova Scotia, New Brunswick, Quebec and Ontario repaired here... in other words, pretty much all of Canada. The data are from 2005, but nothing has changed there since to change the stats.
Because Canada has a less-dense population than the US, it makes more sense to regionalize certain aspects of health care, such as pediatric cardiac surgery. It's a well-documented fact that in order to maintain skill and expertise a surgeon must perform a significant number of similar surgeries each year. Regionalization allows this. It also doesn't make sense to have high-tech services available in every ten-bed hospital in every town in the area. The demand isn't necessarily there, and the expertise to maintain the service won't be either. High-quality health care isn't reliant on who pays the bills, it's reliant on the people providing it.
Hey, lets not forget my old haunts! BC Women's and Children's, Mount Sinai and Sick Kids all rock too:) If I had a premie, those would be my top 3 picks.
Specializes in Recovery (PACU)-11 yrs, General-13yrs.
I know this goes back to pages 1 & 2 of the discussion, but I felt it warranted an response as I don't think an equal comparison was made.
"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."
Putting in alarms/locking cars etc are preventive acts-suturing & scopes are treatments not preventive acts. There are things we can do for ourselves in healthcare, preventive acts such as diet and exercise, monitoring BP's & BSL's etc etc, which help reduce our need for treatments. But once your locked car has been broken into & stolen/trashed/incinerated you call the police for assistance, and once your healhy, well looked after body gets cut you go to the appropriate people for assistance.
As to the socialised versus private debate, we have a combination of both in Australia that seems to work well, or as well as healthcare ever can when governments and private industry are involved. I know Aussies will argue the toss on the subject, but on the whole I think we're well served.
Specializes in Recovery (PACU)-11 yrs, General-13yrs.
An afterthought regarding mediocrity in staff-I work in a private hospital, across the road from the public hospital. The same surgeons/anaesthetists/physicians work in both establishments, and the nursing staff have taken employment in both facilities depending on what suits their need, interests or ambitions at the time, sometimes working at both facilities in the same week. So do they become mediocre when they cross the road, and "superstaff" on the way back?
This is probably going to be an unpopular post, but I'm going to post it anyway. There is a very, very good reason why most fire departments, etc. are mostly volunteer...is because of the downtime involved in the job.
Every fire department, ambulance service, etc that I have been to...usually has some type of recreation room, kitchen, pool tables, you name it. I've had to stop by these places from time to time and usually alot of guys sitting around and playing cards or board games.
I am NOT saying, that they don't work...but this is what they do in between calls...and I'm ok with that...after all, most of them only get paid for the hours that they are out on a call.
I also have 5 paramedics in my Anatomy and Physiology class right now. Every single one of them "down" the nursing program, talk about how paramedic's job is more skilled, more challenging, how nursing is pretty much an "office job with healthcare aspects" to it.
Anytime anyone brings up any subject during class breaks...one of them always relays it back to being a paramedic...one person mentioned he liked to ride sidewalks, the paramedic commented, "It's fun until you call me to scrape your brains off the sidewalk," another girl talked about how her and her husband liked to go hunting, and another paramedic said, "Yeah, we have alot of people that think they know how to use guns until they get into trouble and call us."
Can you imagine having a conversation with a nurse or a doctor with that kind of "elitest" attitude?
These folks are not popular members of our class...they are constantly trying to correct our instructor, and so far haven't won any arguments, and they always talk about how doctors and nurses don't know anything.
We have several LPN's in our class that have worked in hospitals for years, and they actually contribute to the discussion...not find something negative or tell "war stories" about what goes on in the hospital.
Nurses don't downgrade their profession, who why do they downgrade nurses?
DarrenWright
173 Posts
I didn't cherry-pick data, and noone has shown conflicting data.
I never said that. IT IS PART of the consideration, and I've included it! You have to keep it in context, though. You can't just use one benchmark (i.e. life expectancy), and say that the system is better. You see, preventative care starts at home, and there is no wait time for this in either country. Americans have by-in-large simply refused to take advantage of it.I agree, and I thought I'd point out that the US has a better survival rate than Canada for breast cancer; it's one area where we've gotten a grip on preventative care.
First, it's not a myth that Canadians cross the border for healthcare, and it's very meaningful, because it reflects a problem with obtaining that care in their supposedly paid-for system.
I'm very sure you do, and I'm not surprised. Something I think it's important to consider is the access that Canadians have to the US system. I sincerely believe that acute-care and surgical outcomes would change in Canada if access to US healthcare was suddenly shut off. And it's meaninful to note that privatization is growing in Canada out of the necessity to expand services.