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Thread: The high price gays pay for lack of (financial) rights

  1. #16
    Elite Member Grimmlok's Avatar
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    uncle of mine had a heart attack a month ago. was in emerg, no wait, got the cardiogram/barium thing done, next day they cut him open and put a stent in, spent a few days in hospital and then went home.

    out of pocket cost: 40 bucks for an ambulance, which his work health plan picked up.

    Viva Canada.
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  2. #17
    Elite Member MsDark's Avatar
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    There's a good chance he might have died here, even with health insurance. Unless he got really lucky and went to the right place on the right day.
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  3. #18
    Elite Member Grimmlok's Avatar
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    The whole emergency room wait thing in canada is practically a myth. The only people who wait in emerg are people who, amazingly, ARENT IN AN EMERGENCY. People with a deep cut go to emerg. People with a broken leg go to emerg. That's not a fucking emergency.

    If someone shows up in emerg having a heart attack or stab wound, it's triage care. They take whoever is hurt worst if they can't take both.
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  4. #19
    Elite Member MsDark's Avatar
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    Quote Originally Posted by Grimmlok View Post

    Viva Canada.
    But why does it have to be so fucking cold?

    Can I drag Canada down to me?
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  5. #20
    Elite Member Grimmlok's Avatar
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    no no, just wait till global warming catches up. Our winters in the last decade have been pretty tame :/
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    Quote Originally Posted by Grimmlok View Post
    The whole emergency room wait thing in canada is practically a myth. The only people who wait in emerg are people who, amazingly, ARENT IN AN EMERGENCY. People with a deep cut go to emerg. People with a broken leg go to emerg. That's not a fucking emergency.

    If someone shows up in emerg having a heart attack or stab wound, it's triage care. They take whoever is hurt worst if they can't take both.
    I'm an insurance broker in the US but I sell lots of American Health Insurance to Canadians. I'm licensed in 29 states including every state that borders Canada.

    Grimmlok's quote above is true but that's not the end of the story. If a patient is NOT an emergency he/ she MUST go on a wait list for a doctors appointment, then he/she MUST go on a wait list to see a specialist, then he/she MUST go on a wait list for a second opinion, then he/she MUST go on a wait list for diagnostic tests/ inpatient & outpatient procedures/surgery. The average wait times in Canada for all non-emergency medical care is 5 to 20 times what it is in America. Most Canadians who can afford it buy American Health Insurance for quicker access and to recieve America's higher quality medical care. The wait times for care in european countries is even worse than it is in Canada.

    If you'd like to research it yourself this is the place to do it:
    http://www.cma.ca/multimedia/CMA/Con...omicReport.pdf

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    That is what I heard, that you are place on a waiting list in all other countries, and you have to wait, and in some cases, evaluated to see if you deserve further care. So, older folks often die of cancer because they are not deemed cost effective to the system. Have no actual facts for that, just what I have been told by folks who immigrated here.
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  8. #23
    Elite Member Grimmlok's Avatar
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    Quote Originally Posted by Fauvee View Post
    Grimmlok's quote above is true but that's not the end of the story. If a patient is NOT an emergency he/ she MUST go on a wait list for a doctors appointment
    Don't lie. Most (if not all) Canadians have their own family doctor. If not, there are walk-in clinics on every damned city block. You walk in, tell them what's wrong, they give you a cursory exam and send you on your way with a prescrip or a referral to a specialist.


    then he/she MUST go on a wait list to see a specialist

    No, you get a referral. If it's an ear/nose/throat issue, you get sent to an ear/nose/throat specialist. If you're spewing blood out your ear, nose or throat, they will send you to the damn hospital.

    then he/she MUST go on a wait list for a second opinion
    Total fabrication.

    then he/she MUST go on a wait list for diagnostic tests/ inpatient & outpatient procedures/surgery
    really, like MRI's? 3 day wait max. Cardiac diagnostics? Almost no wait at all.

    The average wait times in Canada for all non-emergency medical care is 5 to 20 times what it is in America.
    Total bullshit. I can walk into any hospital with a broken arm and be seen within the hour. Been there, done that.

    Most Canadians who can afford it buy American Health Insurance for higher quality care and quicker access to America's higher quality medical care.
    Utter bullshit yet again. Most canadians have health plans through their place of employment. The only time Canadians get shipped down to the US is when there might be a backlog AT THAT TIME for one particular diagnostic tool, and then the province or feds pick up the tab anyway. Given that we're only 30 million people, and the US is 10 times that, it stands to reason you have more diagnostic equipment at the ready at any given time.

    That being said, we get lots of Yanks coming up this way for cancer treatment, we're rather something of a pioneer in the field.
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    Elite Member Grimmlok's Avatar
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    Quote Originally Posted by chattykathy View Post
    That is what I heard, that you are place on a waiting list in all other countries, and you have to wait, and in some cases, evaluated to see if you deserve further care. So, older folks often die of cancer because they are not deemed cost effective to the system. Have no actual facts for that, just what I have been told by folks who immigrated here.
    I';m sorry, I live here. Never in my life have I heard of anybody being left in an emerg room to die, nor have i heard of anybody on a wait list except for donor organs. If there IS a ridiculous wait for whatever reason, they will spring for your treatment elsewhere.

    it's amazing what kind of crap you people are fed by your media and politicians. Look, if the US got healthcare like Canada it would DESTROY the republican party. They have fought against it because they recognize that fact. There's a whole thread about memos from 1993 detailing EXACTLY THAT.
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  10. #25
    Hit By Ban Bus! AliceInWonderland's Avatar
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    thats sad, i remember when her partner died

    poor annie

  11. #26
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    Where is that link for the memos? Can you post it?
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    Quote Originally Posted by Grimmlok View Post
    Don't lie. Most (if not all) Canadians have their own family doctor. If not, there are walk-in clinics on every damned city block. You walk in, tell them what's wrong, they give you a cursory exam and send you on your way with a prescrip or a referral to a specialist.





    No, you get a referral. If it's an ear/nose/throat issue, you get sent to an ear/nose/throat specialist. If you're spewing blood out your ear, nose or throat, they will send you to the damn hospital.



    Total fabrication.



    really, like MRI's? 3 day wait max. Cardiac diagnostics? Almost no wait at all.



    Total bullshit.



    Utter bullshit yet again. Most canadians have health plans through their place of employment. The only time Canadians get shipped down to the US is when there might be a backlog AT THAT TIME for one particular diagnostic tool, and then the province or feds pick up the tab anyway. Given that we're only 30 million people, and the US is 10 times that, it stands to reason you have more diagnostic equipment at the ready at any given time.

    That being said, we get lots of Yanks coming up this way for cancer treatment, we're rather something of a pioneer in the field.
    Your rosey picture of Canadian health Care is beyond the pale of reality. I deal in statistical facts. 20% of Canadians who live within 200 miles of the US border/major US city buy some type of US Health Insurance. It is the #1 Insurance product sold to Canadians. Most Canadians buy American Health plans with relatively high deductables ($2000 to $10,000) for approximately $400 per month for a couple - $700 for a family. If they opt for an HMO or PPO with low or no deductable they pay $800 per month per couople or $1200 per family. Grimmlok, I'm a lot of things but I'm not a liar. I can rain stats down on you to prove my ascertions. Wait times for non-emergeny health care using the Canadian Social Medical System are 5 to 20 times slower than the US. That's the truth about Canadian Socialized Medicine.

  13. #28
    Elite Member Grimmlok's Avatar
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    Quote Originally Posted by Fauvee View Post
    Your rosey picture of Canadian health Care is beyond the pale of reality.
    I'm sorry, your post history does not lend you the credence to be belittling anybody elses opinion on 'fact'

    I deal in statistical facts.
    Hah yeah, which is why you've done so well refuting the dismemberment your other arguments have suffered.

    20% of Canadians who live within 200 miles of the US border/major US city buy some type of US Health Insurance. It is the #1 Insurance product sold to Canadians. Most Canadians buy American Health plans with relatively high deductables ($2000 to $10,000) for approximately $400 per month for a couple - $700 for a family. If they opt for an HMO or PPO with low or no deductable they pay $800 per month per couople or $1200 per family.
    Um, 20% of the 85% of canadians who live 200 miles from the border? LOL

    Now it begs the question.. how much time are these people spending in the states themselves. Do they have property there? Are they snowbirds? I would love to see the stats on that.

    Grimmlok, I'm a lot of things but I'm a liar.
    Patently false, but I digress.

    I can rain stats down on you to prove my ascertions. Wait times for non-emergeny health care using the Canadian Social Medical System are 5 to 20 times slower than the US. That's the truth about socialized medicine.
    Yes, i can quote stats from unknown sources too, and pretend they're valid. Your argument has an 95% chance of making me laugh my socialist head off.

    There. That was easy.

    Wait, let me try something else. Actual information!

    Myth #1: Costs are out of control.

    Reality: Health care costs are actually being quite tightly controlled, to the point where spending on publicly funded health care services is not even keeping pace with population growth. As a percentage of GNP, health care spending has levelled off at about 9%.

    In the 24 years since 1971, when medicare became a national program, the proportion of Canada's GNP spent on health care increased from 7 1/2% to 9%. The increasing share going to health care by the 1980s was due, not to "spiralling costs", but to a shrinking economy caused by two major recessions in the 1980s and by the introduction of the Free Trade Agreements. Were it not for the resulting declines in GNP, Canada would still be spending about the same share (7 1/2%) on health care as it did in 1971.

    When discussing health care costs, it is important to remember the public sector accounts for only 72% of total health care spending in Canada: well below the 80% average in OECD countries. The costs which are growing most rapidly are not those in the public sector, but those in the private sector: for example, drugs and dental services.



    Myth #2: We can't afford our current "free" system. We have to institute user fees.

    Reality: It is logically absurd, on the face of it, to suggest that if costs are too high, the solution is to raise them even higher. User fees don't reduce costs, they increase them.Taxes, user fees, or insurance premiums: the money still comes out of the same pockets.

    However, the real advantage of user fees, from the point of view of those who advocate them, is that they deter the poor from seeking medical care. If the poor can be denied medical care, then those who are not poor can avoid helping to pay for their care.

    When Saskatchewan introduced user fees under the Liberals in the 1970s, physician visits by low-income people decreased by 18%.

    Despite this, overall costs rose, because of changes in "utilization patterns" and the "mix of services." In plain English, doctors maintained their incomes by calling back higher-income patients for more frequent visits and more tests.

    In the end, more money was being spent to provide care to fewer people.



    Myth #3: A major cause of rising health care costs is people abusing the system.

    Reality: Patients don't write their own prescriptions, book their own tests, schedule themselves for a series of follow-up appointments, or admit themselves to hospital for surgery.People normally go to the doctor because they think something is wrong, not because their idea of fun is sitting in a waiting room for a couple of hours.



    Myth #4: Government-run health care programs are bureaucratic and inefficient. Introducing private health insurance and competition would make the system more efficient.

    Reality: The evidence from all OECD countries shows that the private sector is far more bureaucratic and much less efficient than the public sector when it comes to providing health care.

    The United States, which has the most privatized health care system of any OECD country, spends 14% of its GNP on health care, compared to 9% for Canada.

    The U.S. pays $911 per person per year in administrative costs. Canada by contrast pays $270 per person.

    The disproportion in insurance overhead costs is even more marked: insurance overhead per capita comes to $212 in the U.S., $34 in Canada. Blue Cross/Blue Shield of Massachusetts, a typical major insurer, employs 6680 people to administer insurance for 2 1/2 million customers, more than are employed to administer public health insurance for all 28 million Canadians.

    When Germany recently shifted dental services from the public system to private insurance, administrative costs tripled from 5% to 15%.



    Myth #5: Americans may pay more for health care, but they get better health care as a result.

    Reality: Studies show that on average, Canadians are more likely to receive needed care quickly than Americans. Canadians get more physicians visits per capita than Americans, more immunizations, more hospital admissions, and more surgical procedures. A survey of 10 OECD countries showed that Canadians were the most satisfied with the care they received, while Americans were the least satisfied. In fact, Canadians are more than five times as likely to be satisfied with the health care they receive than Americans.

    Infant mortality, maternal mortality, and life expectancy were worse in Canada than in the U.S. before the introduction of medicare. Canada's infant mortality rate is now only 70% of that in the U.S., while American women are almost twice as likely to die during childbirth as their Canadian counterparts. The average Canadian now lives two years longer than the average American.



    Myth #6: Private clinics will improve access to services by taking pressure off the public system.

    Reality: Private clinics suck resources out of the public system. Private clinics give the well-to-do preferential access to health care, while the public picks up most of the tab.

    Because they have access to additional sources of revenue in the form of fees from well-off patients, while still being able to fully bill the public system for the procedures they perform, physicians are able to make significantly more money working at a private clinic. Physicians therefore seek to maximize the number of patients they see in their (publicly-subsidized) private clinics, while minimizing the number of patients they see in a public facility. As physicians withdraw their services, waiting lists at public facilities grow longer and the motivation to seek services in the private sector is increased for those who can afford to do so.

    As long as well-off patients receive their health care through the same system as everyone else, they continue to demand the health care system provide excellent care. In a two-tier system, well-off patients are no longer dependent on public facilities for their health care and lose their vested interest in ensuring the excellence of the public system. They demand instead that the taxes they pay to support the public system be reduced, thereby ensuring a further erosion of access and services.



    Myth #7: We can save money by relying more on community care and less on hospital care.

    Reality: "Community care" has usually been a code word for ceasing to provide care. When Ontario closed psychiatric institutions in the 1980s in order to institute "communitycare" for psychiatric patients, it simply dumped people onto the street with no provision for proper housing or support services.

    Applied to frail seniors and those with physical and mental disabilities, "community care" is a polite way of saying that families (especially women, of course) will be expected to provide care for free because the health care system won't.

    Real community care is not cheap. It may often be better for people to receive care in their own homes or in a community setting, but there is no convincing evidence that it's any cheaper if the care is provided by qualified professionals. It may even be more expensive. For example, a doctor can see a lot more patients if they come to her than if she makes house calls to see them.



    Myth #8: Instead of our current system of "illness care" we should be moving to a system that emphasizes prevention and "wellness."

    Reality: People tend to go to the doctor when they're sick, not because they're feeling in the mood for a lecture about how they should eat better, exercise more, and stop smoking.

    Prevention is a fine idea, but aside from a few standard procedures like pre-natal examinations, immunizations, eye exams, and pap smears, most of the things that contribute to long-term good health can't be obtained in a doctor's office.

    The primary determinants of ill-health have been established by any number of epidemiological studies. They include poor nutrition, especially maternal nutrition, unemployment, poverty, powerlessness, inadequate housing, and family stress. Social and economics policies can certainly contribute to making these problems better or worse, but it's hard to see how the health care system can do much about them, even if it is re-labelled "the wellness system".



    Myth #9: The money isn't there. Governments can no longer afford to provide high-quality medical care to all Canadians.

    Reality: Money is being drained from the system, not by a force of nature, but by deliberate government decisions. Large-scale reductions in federal transfer payments are indeed undermining medicare and other social programs. Federal contributions have been systematically cut back since the early 1980s. The cash portion of federal transfer payments for all social programs is due to disappear entirely by around 2005. The result is increasing financial pressure on the provincial health care plans, leading various provincial governments to move in the direction of dismantling universal medicare coverage and instituting a two-tier system. If these funding cuts continue as planned, medicare will not survive.



    Myth #10: Government deficits make funding cuts inevitable.

    Reality: Government deficits are the result of conscious policy decisions. The tax reforms of the Trudeau and Mulroney governments set in motion a dramatic reduction in the amount of taxes paid by wealthy Canadians and by corporations. With the public treasury deprived of billions of dollars in revenue, governments have made up the shortfall by borrowing from the beneficiaries of the tax holiday, at high rates of interest. If governments were serious about eliminating deficits, they would reverse the tax giveaways of the 1970s and 1980s.



    References

    1. Evans, Robert G., Barer, Morris L., Stoddart, Greg L., Bhatia, Vandna. Who Are the Zombie Masters, and What Do They Want? The Premier's Council on Health, Well-being and Social Justice. June 1994.

    2. Himmelstein, David U., Woolhandler, Steffie. The National Health Program Book: A Source Guide for Advocates. Common Courage Press. 1994.

    3. Stoddart, Greg L., Barer, Morris L., Evans, Robert G., Bhatia, Vandna. Why Not User Charges? The Real Issues. The Premier's Council on Health, Well-being and Social Justice.
    or


    1. Canada's health care system is "socialized medicine."

    False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

    The proper term for this is "single-payer insurance." In talking to Americans about it, the better phrase is "Medicare for all."

    2. Doctors are hurt financially by single-payer health care.
    True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

    First, as noted, they don't have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

    Second, they don't have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid -- quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren't interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

    One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don't realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don't operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

    Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor's debt is roughly half that.

    Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family's major expenses, expectations tend to run very high. A doctor's mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it's no wonder people are quick to rush to court for redress.

    Canadians are far less likely to sue in the first place, since they're not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don't have to include coverage for future medical costs, which reduces the insurance company's liability.

    3. Wait times in Canada are horrendous.

    False again -- it depends on which province you live in, and what's wrong with you. Canada's health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don't plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that's just as true in any rural county in the U.S.

    You can hear the bitching about it no matter where you live, though. The percentage of Canadians who'd consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country's health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland's grandfather.). In spite of that, though, grousing about health care is still unofficially Canada's third national sport after curling and hockey.

    And for the country's newspapers, it's a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it's on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it's certainly one of the things that keeps the quality high. But it also makes people think it's far worse than it is.

    Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I'm finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It's the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

    4. You have to wait forever to get a family doctor.

    False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don't have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

    It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that's just as true in the U.S. -- and in America, the government won't cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.

    5. You don't get to choose your own doctor.

    Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don't get a choice. Be afraid! Be very afraid!

    For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country's top specialists that rich ones do.

    6. Canada's care plan only covers the basics. You're still on your own for any extras, including prescription drugs. And you still have to pay for it.

    True -- but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees' premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

    "The basics" covered by this plan include 100% of all doctor's fees, ambulance fares, tests, and everything that happens in a hospital -- in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn't include "extras" like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you'd pay for a room in a middling hotel). That other stuff does add up; but it's far easier to afford if you're not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren't nearly as expensive here, either.

    Filling the gap between the basics and the extras is the job of the country's remaining private health insurers. Since they're off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month -- about $300 for a family of four -- if you're stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America's largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

    7. Canadian drugs are not the same.

    More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they're actually likely to be safer.

    Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It's amazing.

    8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.

    False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.

    One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they're getting a constant level of care that ensures small things get treated before they become big problems.

    The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren't working 60-hour weeks trying to hold onto a job that gives them insurance.

    9. People won't be responsible for their own health if they're not being forced to pay for the consequences.

    False. The philosophical basis of America's privatized health care system might best be characterized as medical Calvinism. It's fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one's own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One's Own Health.

    They'll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you'll never get sick. (Like all good theologies, there's even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it's a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can't complain. It was their own damned fault; and it's not our responsibility to pay for their sins. In fact, it's recently been suggested that they be shunned, lest they lead the virtuous into sin.

    Of course, this is bad theology whether you're applying it to the state of one's soul or one's arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us -- even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it's built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.

    This difference is expressed in a few different ways. First: Canadians tend to think of tending to one's health as one of your duties as a citizen. You do what's right because you don't want to take up space in the system, or put that burden on your fellow taxpayers. Second, "taking care of yourself" has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you're contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they're still small and cheap to fix.

    Third, there's a somewhat larger awareness that stress leads to big-ticket illnesses -- and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there's a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.

    The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.

    10. This all sounds great -- but the taxes to cover it are just unaffordable. And besides, isn't the system in bad financial shape?

    False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we're not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we're actually money ahead. When you factor in the greatly increased social stability that follows when everybody's getting their necessary health care, the impact on our quality of life becomes even more signficant.

    And True -- but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There's always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.

    But, as many of us know all too well, there's also constant tension between what patients want and what private insurers are willing to pay. At least when it's in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.

    It is true that Canada's system is not the same as the U.S. system. It's designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It'll be a good day when when Americans can hold their heads high and proudly make that same declaration.

    Mythbusting Canadian Health Care -- Part I | OurFuture.org
    etc etc etc
    I am from the American CIA and I have a radio in my head. I am going to kill you.

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