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Post by Talron on Mar 14, 2014 11:26:28 GMT -8
What are your thoughts? We have many Americans in TXR and Canadians what are you're guys thoughts on this? I personally have pro's and Cons to both health care systems.
In Canada, health care is free but the wait to see a Doctor like they stated can be so extreme. For me personally I was water skiing a couple summers ago and had a really bad fall. I landed on my right side of my year and hit the water like concrete. I ruptured my ear drum and water poured into my ear honestly the most excruciating pain I have ever been in. I was rushed to the hospital and had to wait for 2-3 hours with my head leaned to my right side draining the water out slowly while I could feel it slowly trickling out of my ear drum... The fucking worst.
Saw a doctor after 3 hours he checked my ear out prescribed me some t3's and gave me a disinfection shot for my ear or whatever. Costed me $0 dollars.
However, when my Dad had cancer he did not want to wait for surgery or on the wait list for 6 months in Canada so he flew to Detroit and had the latest robotic surgery to remove the Cancer that was not available at the time here in Canada. However he had to pay a shit ton of money to get this done but it was a priority for my family for him treatment immediately.
So I'm torn on this discussion. Very insightful though.
What is you're personally take and experience on this matter?
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Post by Swatz on Mar 14, 2014 11:36:42 GMT -8
6:30 made me laugh
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Post by FortySixandTwo on Mar 14, 2014 13:29:23 GMT -8
Political discussions on forums? Nope. Nope. Nope.
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Post by Hans1942 on Mar 14, 2014 14:06:06 GMT -8
If you have money, America is amazing. <---That's if you can afford it.
If you don't have a lot of money, Canadian system is better.
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Post by Hereticus on Mar 14, 2014 14:06:48 GMT -8
C'thulhu help me for giving my political opinion on the internet!
Both Countries I feel need to put a greater emphasis on education - training more medical experts to alleviate the burden of wait times. Regardless of the countries health care program... you shell out the cash and the doctor will see you now instead of later, that's human nature not political reform.
I have family who work at a local hospital in Vallejo California and they have told me horror stories before about people coming in with critical conditions that demand immediate attention or risk death and instead are asked to wait in the lobby with everyone else until a Doctor is able to see them, at worst waiting up to 13 hours.... Worse case is you die in the lobby....
We need more medically trained people instead of business entrepreneurs.
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Post by Atron on Mar 14, 2014 20:08:11 GMT -8
I would say that anyone who has ever been to an ER or even an Urgent Care Center has had to wait far too long for proper care.
Yes; I will agree with Hereticus that we need more MDs, PAs, and NPs but we need to lower education costs before that will happen. With the help of the GI Bill (about $70,000 when everything is counted) I paid a little more than $34,000 of my own savings for my MSN and CSFA education to become a CRNFA and am debating on working towards a DNP.. something that will cost upwards of another 3-4 years of my life and $150k+. (I graduated owing $2400 that I paid off in 3 months.) I cannot imagine how I would have paid for my education without enlisting in the USAF for 5 years.
One of the surgeons I work with on a daily basis just finished his Fellowship a year ago. He's 34 and has over $480,000 in student debt. His wife (one of our PACU RNs) takes home more than he does each month after they pay off his debts.
Half a Million fucking dollars to become an MD. It just isn't worth it (imho) to be a full-blown MD anymore. The ACA seems to be (because lets be honest here; nobody knows WTF it is going to do) changing the system to be far more reliant on PAs and NPs to run clinics and to handle day to day medical care.
The current VA system relies heavily on PAs and appears to be wanting to hire additional NPs to fill in the gaps.
As to the whole Canada vs US or Social vs Private medicine. They both have pros and cons. I certainly don't have an answer to which is better.
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Post by PoorRichard (AKA - The Guido) on Mar 14, 2014 20:15:26 GMT -8
Saw a doctor after 3 hours he checked my ear out prescribed me some t3's and gave me a disinfection shot for my ear or whatever. Costed me $0 dollars. However, when my Dad had cancer he did not want to wait for surgery or on the wait list for 6 months in Canada so he flew to Detroit and had the latest robotic surgery to remove the Cancer that was not available at the time here in Canada. However he had to pay a shit ton of money to get this done but it was a priority for my family for him treatment immediately. Firstly, you say you paid "$0 dollars." True in the sense that, in that very moment, you paid nothing. False, becuase you have paid for it through your tax dollars. I don't know how the Canadian tax system works, if it's similar to the American Progressive Tax system or what? I don't know. Bottom line, you paid for it and every Canadian paid for it. Secondly, that waiting list. When it comes to life, limb, or eyesight, the government should have no say, directly or indirectly. The way I see this, is as a sort of "soft" tyranny, if you will. It comes from the rationing of care and lack of reward to become a doctor. Why would you want to become a doctor by putting forth so much time, effort, and money toward becoming something when the reward doesn't match up with the effort put forth? In the states, we have a pilot shortage. Why? Don't pilots get paid well? Yes and no. Right now, a prospective professional pilot is looking at anywhere from $30k to $80k just for training. That training only gets you to around 250 hours of flight time. Prior to 2011 that was all you needed to get hired onto a regional carrier like American Eagle, Delta Express, etc. Some required 500 and others 750, but you get the idea. So, at least, you were looking at getting a job out of training or after doing some flight instruction. In about 2010 or '11, the FAA instituted the 1500 hour rule. This rule states that a pilot has to have 1500 hours in order to fly for a regional carrier. At the same time, all that time and money you have put forth to become a commercial pilot has little reward. Maybe if you get on with a good flight school you can be an instructor till you get the next 750 hours getting maybe $15/hour of flight time. If the weather is bad, you don't fly. You don't fly, you don't get paid. Let's say you get that 1500 hours. Now you can apply for a job with a regional carrier where starting pay is around $20k per year, give or take $2k. Where's the reward? The reward comes after years and years of flying when you finally get hired on with a major carrier like Amercan Airlines, United, Delta, etc. There you get to start out at around $30k-$40k/year and top out around $100k. Bottom line here is, when the government meddles in things like healthcare or aviation, for instance, they screw it up. Sure, treatment may be equal in a single payer system where nobody can get ahead with a few bucks, but that equal treatment means equal destitution in the form of wait times.
Basically, what is needed is cheaper education costs. I pretty much hit on that with the aviation deal. It's a cost vs reward issue. Especially in socialist, single payer systems. Here in the states, I believe we have put a bigger emphasis on education, but it's not entirely reachable by some, depending on what state they live in. Being a soldier, I have experienced how a single payer system can be detrimental. My health issues weren't dire or anything like that. All I needed was to spend 5 minutes with a podiatrist for him to ask me, "do my feet hurt when I run or stand on my feet for hours?" and "are the inserts helping?" and a few other questions of the like. In order to get this done, which I had to do every 3 months until he gave me a diagnosis, I had to make my appointment that same day in order to get that appointment for 3 months from then. Even "sick call" for the podiatry office became appointment only. At one point, I had some weird infection in my throat. Went to the emergency room, they sent me home with some antibiotics after like 6 hours of sitting in the waiting room and a treatment room. I get a call from the Internal Medicine Clinic the next day giving me an appointment for a week later, which by then, the infection or whatever the hell it was, was gone. Never knew what it was and never will. In the Canadian system, I imagine, this would have taken even longer to get seen. Want to lower waiting times? Hire more doctors? Not enough doctors to hire? Offer tuition reimbursement or even scholarship programs to make the profession more attractive and easier to reach. And Tal, you are right. There are pros and cons to both systems. No system created by man will ever be perfect. No matter how many genius "experts", mathematicians, etc. put their minds to it there will never be a perfect system. The communist system of the former USSR made everybody equally poor and gave the people equally poor access to healthcare. The capitalist system creates income inequality, but that inequality is supposed to give an incentive to work, to improve oneself to climb the ladder. At least in a capitalist system there is a ladder to climb. As for healthcare, it should be the individual's decision and not that of the government's. The government has no right to tell someone that they will have to wait for 6 months to get a critical surgery. At that point, there are countries like the US that can get somebody that surgery in an acceptable amount of time. In the UK, dentists have a cap on how much they can make or how many patients they can treat per year (government mandated). In turn, the people of the UK go to countries like Belgium for dental care when they can't get it in their own country because their dentist is on vacation because he/she has met their goverment mandated limit. How would you like to spend your vacation going to get your teeth cleaned, having braces put on your child, getting a cavity filled, a cap replaced or put on, etc? Going back to my Army supplied healthcare. This single payer system was focused on getting somebody in and out as quickly as possible and with as little cost as possible. "Here's some 800mg Ibuprofen, get out." Thanks for letting me rant Tal.
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Post by kieladar on Mar 14, 2014 20:50:39 GMT -8
I'm currently writing a paper on the Canadian health care system and it's good to read some of this stuff and know my research isn't just newspaper biased, so to speak.
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Post by PoorRichard (AKA - The Guido) on Mar 14, 2014 21:25:06 GMT -8
I'm currently writing a paper on the Canadian health care system and it's good to read some of this stuff and know my research isn't just newspaper biased, so to speak. When you're done with it, would you mind if I could get a copy? Might be educational.
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Post by Swatz on Mar 14, 2014 22:04:18 GMT -8
"Canadians are nice people" - Square headed lady with several chins.
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Post by dacommando on Mar 15, 2014 7:58:07 GMT -8
At the end of the day, the risk/reward of being a Doctor in the US doesn't make it worth it.
There's extremely high costs in educating doctors, which turns to extremely high tuition costs for doctors, and let's not even go into how expensive R&D gets taken out on new medicines, or how medicine is so expensive because of the very complex chemicals and regulatory compliances required. One single slip-up could lead to a multi-million dollar lawsuit that doesn't even remotely fit the error in many (but not all) cases.
So right now, virtually all the risk is on the doctor in the US (I admit ignorance on Canada's educating of doctors) so, by sheer law of economics, virtually all the reward goes with doctors to make the risks worthwhile.
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Post by dclxvi on Mar 15, 2014 10:51:50 GMT -8
Health care coverage is different here because we fund the world's research with the profits. Plain and simple. Insurers and pharmaceutical companies are given crazy leeway and have learned how to milk those dollars. Shitty system but no one else is pumping billions into developing cures and vaccines. If you want the numbers, we spend 50% more on research & development than all of Europe combined (120 billion v. 80 billion). Industrial profits alone account for almost 2/3 of that.
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Post by dacommando on Mar 15, 2014 15:04:04 GMT -8
There's the fear that cracking down on these companies will bring an end to the research, but in all honesty, I'd rather the people doing this research NOT be in it for the money. It's a conundrum to be sure.
Pumping money into something doesn't produce results either, just look at the US education/political structure.
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Post by trcommissar1 on Mar 15, 2014 15:17:27 GMT -8
Obamacare is changing the U.S. medical system as we speak. Currently you can technically be fined for the IRS for not having health insurance and the fines are doubling every year. Frankly, I believe the free market in the end either makes one side expensive and the other side a long ass wait. No matter what system you implement supply and demand always come into play and with the U.S. system supply and demand is regulated by insurance costs, whereas in the Canadian system it's more of a sheer numbers thing. In the end there are only so many trained human resources and facilities that can withstand the ever growing populations. It's quite obvious that the Canadian systems are much much less taxed due to the massively smaller populations. Despite GDP Per Capita being the nearly identical in both countries; the U.S. just has a huge population and a government that is titanic in size and on the edge of bankruptcy printing more and more money and spending more and more money on more and more programs growing larger and larger which just adds to the complications.
I'd like to also address the need for "Doctors". I don't think that's entirely correct. In the end is the question does the person who all these government taxing resources are funneled into able to pay for this stuff? If not can the government take the loss and still operate without inevitable degradation and the answer is usually no. Getting a surgeon and Doctor and treatment and facilities all costs resources that just aren't infinite in this world unless someone makes and infinitely renewable energy resource. So, a short term workaround in the meantime to me would be to lower the costs in places where they are the highest and right now the highest costs are in equipment, drugs, and training. If you streamline those processes and lower the resource costs then you can more easily spread healthcare around. The problem is there is a lot of corruption and profiteering in those areas and large corporations and government funded bloated institutions behind them that would make that very difficult.
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Post by Hereticus on Mar 15, 2014 16:02:05 GMT -8
LOOK AT WHAT YOU STARTED TALRON, REAP WHAT YOU HAVE SOWED!
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Post by PoorRichard (AKA - The Guido) on Mar 15, 2014 16:03:00 GMT -8
Obamacare is changing the U.S. medical system as we speak. Currently you can technically be fined for the IRS for not having health insurance and the fines are doubling every year. Frankly, I believe the free market in the end either makes one side expensive and the other side a long ass wait. No matter what system you implement supply and demand always come into play and with the U.S. system supply and demand is regulated by insurance costs, whereas in the Canadian system it's more of a sheer numbers thing. In the end there are only so many trained human resources and facilities that can withstand the ever growing populations. It's quite obvious that the Canadian systems are much much less taxed due to the massively smaller populations. Despite GDP Per Capita being the nearly identical in both countries; the U.S. just has a huge population and a government that is titanic in size and on the edge of bankruptcy printing more and more money and spending more and more money on more and more programs growing larger and larger which just adds to the complications. I'd like to also address the need for "Doctors". I don't think that's entirely correct. In the end is the question does the person who all these government taxing resources are funneled into able to pay for this stuff? If not can the government take the loss and still operate without inevitable degradation and the answer is usually no. Getting a surgeon and Doctor and treatment and facilities all costs resources that just aren't infinite in this world unless someone makes and infinitely renewable energy resource. So, a short term workaround in the meantime to me would be to lower the costs in places where they are the highest and right now the highest costs are in equipment, drugs, and training. If you streamline those processes and lower the resource costs then you can more easily spread healthcare around. The problem is there is a lot of corruption and profiteering in those areas and large corporations and government funded bloated institutions behind them that would make that very difficult. Spot on with the costs being in equipment, drugs, and training. The Affordable Care and Patient Protection Act has placed a tax on medical devices from the smallest scalpel to MRI machines and what not. The only thing Obamacare will be credited with is giving health insurance to all but at the cost of what? Well, already there are instances where somebody may use Hospital X for their emergency needs and Primary Care Physician or Specialist under the old way that now have to make a choice. These people have to make a choice to go with a plan that keeps their Primary Care Physician or Specialist OR Hospital X. If Obamacare has done and will do anything is to take the healthcare decision out of the hands of doctors and individuals and put it in the hands of the government. For an American, it should be a no brainer that the government leviathan cannot rightly control or regulate the medical needs of the people. After all, we're facing $17 Trillion in debt with no end to the massive spending in sight. All that we've seen in the last 8-10 years is the ever expansion of government and even more intrusions into the privacy and right to choose for the individual. We've seen the government expand welfare programs to the point that, for some, it's better to stay on welfare than it is to get a job. There are some on welfare who make $30k/yr. I make 2/3 of that and work 40hrs/wk. With that, where's the incentive to work? Where's the incentive to better oneself? I was on unemployment for a year before I moved to DFW, began school, and got a job after getting out of the Army. I made more on unemployment than I make now. So why did I get a job? Quite simply, pride, a sense selflessness to give something to society. I could have easily applied for and received food stamps, but I didn't. I rely on myself for my needs and wants and ask of nobody to help me. The government isn't responsible for me, I am. This country has a proud history of independence and all Americans should strive to keep that history alive for generations to come.
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Post by meliande on Mar 15, 2014 16:52:13 GMT -8
I like the Canadian system, but then I'm biased. Yes, there are longer wait times for elective surgery, but where you live can have a huge effect on wait times. I have longer wait times for my dentist than I have ever had to see a doctor or get into emergency, and dental is not covered by our provincial health care. I think the government is in the best place to provide most basic services and needs as they already have an infrastructure in place so can do it with the most cost effectiveness. I don't think population size has much to do with the smaller amount spent per person on health care. Since Canada's population is also spread out further than the US, I would think that the Canadian system more often pays for travel and lodgings and hospital stays. I know where I live is an extreme case, but when my friend had an irregular heart beat the government paid not only for the emergency room visit but the medivac out, flight back and hostel stays for two days for him and his escort. What I suspect lowers the cost is the middle/working/poor classes know that they can go to the doctor with a small problem, they don't wait until it progresses to a harder and more expensive to treat stage. I think the early detection also has a part to play in the longer wait times for elective surgery. Furthermore, because the government foots the bill for health care, the government has a vested interest in preventative and educational programs such as vaccinations and screening. I'd rather not be sick/ill in the first place, and I enjoy knowing that I don't have to worry about cancer treatment bankrupting myself and/or family.
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Post by kieladar on Mar 15, 2014 18:29:24 GMT -8
It's hard to say what's best or worse, especially since Canadian health care tried to take after both the European and American systems.
Either way, for the laymen, I would say they both have a lot of work to do.
Canadian health care is good for the cost effectiveness. You may not get the best of treatment in many cases, but in many cases, you just need a patch or drug, etc. You also have the possibility of going to a private doctor in Canada. Some subsidiaries may apply to help with costs, but you have the ability to get what you pay for.
In the American system, you have insurance or you don't (You pay or you can't). You go into the emergency room with insurance, you're going to get care. If you don't have insurance, you're not going to get helped. Or, very minimally.
Canadians will help you no matter what (Unless your insurance you applied for doesn't cover you in that province). Whether it's good care or not is by opinion and it's hard to discuss opinions based on how you 'feel'.
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Post by PoorRichard (AKA - The Guido) on Mar 15, 2014 19:15:20 GMT -8
It's hard to say what's best or worse, especially since Canadian health care tried to take after both the European and American systems. Either way, for the laymen, I would say they both have a lot of work to do. Canadian health care is good for the cost effectiveness. You may not get the best of treatment in many cases, but in many cases, you just need a patch or drug, etc. You also have the possibility of going to a private doctor in Canada. Some subsidiaries may apply to help with costs, but you have the ability to get what you pay for. In the American system, you have insurance or you don't (You pay or you can't). You go into the emergency room with insurance, you're going to get care. If you don't have insurance, you're not going to get helped. Or, very minimally. Canadians will help you no matter what (Unless your insurance you applied for doesn't cover you in that province). Whether it's good care or not is by opinion and it's hard to discuss opinions based on how you 'feel'. There's a third option when it comes to insurance. It's not just pay or can't pay. There is also the don't pay. Yes, many don't because they can't but some don't simply by choice, like me. Hospitals are required by law to treat you. If you don't have insurance they have to stabilize your condition, in the very least. I want to go back to what Tal said regarding his father. A 6 month wait for a surgery in regard to cancer. That wait can mean the difference between life and death. It could mean the difference of a cancer metastasizing or being removed, treated, etc. A lot can happen to cancer in 6 months. I'm sure Tal and his father realized this and that's why they came to the states. Probably not just for the latest robotic surgery, but for the surgery period. Hell, my former boss is Canadian. He needed a heart surgery and he was looking at a year. He came to the states, not only for the surgery, but to live here. He was sick of the Canadian healthcare system. I simply hope to god that when and if I get cancer or have a heart attack, I'm not sitting on some 6 month waiting list. As for good care or not and it being by opinion. Check the facts. Waiting lists for critical surgeries that are long enough that the waiting list could be a death sentence. Does that sound like "good" care?
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