Here is the truth about Canadian medicine.
You may think all is well in Canada. A land where FREE=MORE has been granted a birth right. It has been said many times before: You have three endpoints for which to strive for. Cheap, Quality or Quick. Pick any two. You can not have all three. It seems that Canada has decided to sacrifice Quick. You can always guarantee cheap health care. You simply stop paying for it. That's called rationing. Getting in line and waiting is a classic form of rationing used by governments all across this land of ours.
In fact, as a resident in training at a VA facility, I saw first hand how rationing of care occurred using waiting as the tool of choice. Schedules blocked at 5-8 patients. Leaving when the clock struck 4. Scheduling dead patients. Yes folks, that actually happened. As an inpatient, technologists would finish their day on their terms. Getting studies after hours was impossible. Patients would wait for days to get an echo or a doppler. I once had an xray technologist refuse to come in, from home, in the middle of the night to take a chest xray on a crashing ventilator patient. The fact that the VA would not staff an overnight xray technologist was simply ridiculous. Try to get anything done on a holiday. Not only impossible but the hoops one had to travel through to attempt it would make Obama cry if he had any idea what the government run care was doing to his Vets.
Wait times is rationing, no matter how you look at it. You can find the link to the Fraser Institute on Canada's Wait times here at Dr Hal Dall's blog. I want to thank him for pointing it out. It is a fascinating look into the discrepancies in Canada's health care, in spite of the equality for all mantra of social solidarity.
Happy,
ReplyDeleteI am suprised you succumb to the propaganda that has swirled around Canadian Health Care. I would challenge you to explain a few things after your diatribe.
Why are Canadians able to run their health care system at a much lower cost than ours?
Why are Canadians considered much healthier by most measures and live longer than folks in the US.
Why can I not find a Canadian (and believe me, I ask every one that I meet) who would willingly give up their current system, even with some waiting times for treatment, and trade it for our dysfunctional system.
You prefer rationing by the survival of the fittest. If you can't afford insurance, then you shouldn't have access to care. This Darwinian system will, I guess, make us the superior country after a few mellenium.
Hey Happy,
ReplyDeleteAs a Canadian RN and with an MSc in Epidemiology, I can attribute that much of what you say is correct- to some extent. The Frasier Institute is highly regarded, but it is also known for right-wing conservative views. They are known to support private for-profit health care, and it shows in their studies and reviews of health care.
Wait times are decreasing considerably in many areas. Now you can get an MRI in a decent time- however it may be at 3:30am.
As a front lines ED RN I see the "Free=more" mentality in some patients, but the majority of patients who need quick care get it. Have a STEMI? Bypass the ED and go right to the cath lab. In areas that don't have a cath lab (Canada is a small population- large land area country) then get TNK'd and sent to the nearest PCI center via helicopter.
Just like in the U.S. where things are varied by State and income, it is the same here. A lot of times it is the socio-economic status of individuals that determines one's health, not necessarily the medical care one receives. Remember, medical care is only one piece of the puzzle called 'health'. Education, Income, Lifestyle, Environment- they all play a part.
Elaine
http://miss-elaine-ious.blogspot.com/
Keith,
ReplyDeleteRead the report, see what it says and also what it does not.
The Canadians have lower cost for many reasons including a different culture and overt rationing.
The mindset in the US is very much oriented to high-tech/aggressive/invasive/best-advertised/newest/right-now-or-i'll-sue-your-pants-off and to free=more. From the information I've had, I'd hazard a guess that Canadians are not so far in that direction.
If the US gets a national system(there is no actual system now) open rationing will be unavoidable. China does not have enough money to pay for everything/foreverybody/allthetime/nomatterwhat healthcare in the US. We have increasing covert rationing now, but it cannot contain costs.
My expectation is that scarce access to primary care(think Massachusetts) coupled with rules/paperwork required for a referral will be the initial attempt of new covert rationing after Obama's plan passes. The crucial statistic will be #weeks delay to see the internist.
Rationing is necessary with socialized medicine but the form varies among nations. Canada chose the queue as a major component as seen in the report. Other nations have diverse methods. All have positives and negatives, just as the hodge-podge in the US has pluses and minuses.
The US WILL have rationing. We can democratically decide the methodology or rather let the medicrats on high allocate our care, but it WILL happen.
Elaine, Quick query.
ReplyDeleteAre medical needs of alien nationals covered by the Canadian system (not landed immigrants)? How about Yanks who snuck acreoss the border?
Hal,
ReplyDeleteTo preface the reply I should first say that I'm not an expert on hospital accounts payable, nor do I register the patients when they come in (we have registration clerks for that).
From what I see is in my own ED is that we stabilize the patient as need be, and the patient gets billed for their care. Most often, as in other countries, they get stabilized and then shipped to their home country for continued treatment.
Surprisingly I've also seen some people discharged and request to know where the accounts payable office is.
I'm not sure if there is a co-payment required at discharge.
In my short career as an RN I have yet to see an illegal immigrant come to the ED. But to be fair I don't live in one of the major Canadian cities where immigration is most of the populace.
Elaine
Dr. Dall (You're a shrink aren't you?)
ReplyDelete"The US WILL have rationing. We can democratically decide the methodology or rather let the medicrats on high allocate our care, but it WILL happen."
We already do have rationing. It is by ability to pay, for the most part, but it is still there. The debate is over whether we want to change from that to rationing by queue or other means.
"Wait times are decreasing considerably in many areas. Now you can get an MRI in a decent time- however it may be at 3:30am."
ReplyDeleteWait times, in the past in Canada have proven to be balloonish. In other words, you push wait times in one area toward the center, and wait times in another area pooch out. Be interesting to see if that happens this time or if there is really a handle on this one.
For example, in the 90s there were some problems with CABG to the point where you were 3x more likely to die on the queue waiting for a "non-emergent" CABG than you were to die on the operating table. The excrement hit the wind circulation device, much hand wringing ensued, the concerns dropped away. Other similar ups and downs were seen in other areas over the years.