Some patients in Canada are tired of waiting for their MRI. Access to this technology is rationed to a much greater degree than it is in the United States. In Canada, patients who are tired of waiting are stepping out of the government health care system and paying out of pocket for their MRI. How much does a private MRI cost in Canada? According to the article in the link, the cost is several hundred dollars! That's amazing. When I got an MRI of my spine and my shoulder in the last several years, My hospital charged nearly $3,000 and was paid nearly $2,000 for their MRI. Why is that? Why can the Canadians get a cash MRI from a private clinic in their country for several hundred dollars and us Americans have to pay several thousands? Beats me.
Happy,
ReplyDeleteI see you are continuing your assault on the concept of socialized medicine. But you failed to answer my last query after your last post; are Canadians health suffering as a result of delays in testing and treatment? How many Canadians would choose to give up their current health care system? I actually like the idea that if you are in such a rush to have your test or procedure, then you can skip the que and pay out of pocket. The pure capatilistic system you seem to so desire!
Keep in mind that the guy who brought Canadian health care to fruition is considered a national hero!
You seem to prefer your rationing by ability to pay. The weak should simply suffer and die (or is your take that the stupid and lazy should suffer their just fate). Either way, it seems a cruel postion to take for someone in the healing profession.
Maybe doctors and health care execs should all just make less money so we can have a more affordable health care system. After all, I will bet most of us said we were not going into medicine for the money when we applied to medical school.
agree with above
ReplyDeleteLet us examine if any patients may be suffering.....
ReplyDeletehttp://gatewaypundit.blogspot.com/2009/07/more-on-canadas-single-prayer-health.html
http://archives.chicagotribune.com/2009/mar/25/health/chi-oped0325natashamar25
Canadians come to the US all the time for a diagnosis and tests that their "health credit score" etc would not allow them in Canada.
"Maybe doctors and health care execs should all just make less money so we can have a more affordable health care system."
Yes, this is definitely the answer. Just have these people make less money, that will fix everything.
Today's news in Canada: "Patients who have been diagnosed with arthritis in Newfoundland and Labrador are waiting four years to see a specialist, and even then are not receiving the basic support services they need, says a physician who cares for many of them. http://www.cbc.ca/health/story/2009/07/03/arthritis-services-newfoundland-703.html
ReplyDeleteAnd in less than a minute anyone can google results printed by Canadian authorities such as:
"Wait times for colonoscopies vary across LHINs median waits range from 12 weeks in the North West LHIN to 4 weeks in North Simcoe Muskoka, a difference of 8 weeks. Ninetieth percentile waits show a wide range as well, with Erie St. Clair reporting the longest waits (40 weeks), and North Simcoe Muskoka again showing the shortest waits (13 weeks).
Why are Canadians interested in reducing wait times if there is no increased mortality or morbidity associated with increased wait times?
Karen
I recently had a PET/CT (lung, pelvic, abdomen) as a follow-up after cancer treatment. The imaging center charged my ins. co. $23,001.62 for this test. The provider discount brought it down to $2,259.28, which my ins. co. paid. I was told that out-of-pocket people could get a 20% discount off the full amount if they pay within a certain time period. Not many people could afford that. This was in California.
ReplyDeleteKate
Keith,
ReplyDeleteAt least in terms of a cancer diagnosis Canadians do fare worse than those patients in the US. The average 5 year survival is 5% better in the US than in Canada or the UK. The question isn't whether in cancer care specifically who has better outcomes (by far the US), the question is are those outcomes worth the increased price. I think that question is better answered by the individual than by the State.
Interestingly at one of Obama's health care "Town Halls" he profiled a women with metastatic renal cell cancer who was having trouble getting cancer drugs (she got them through the company). What Obama didn't mention was that in the UK if you have renal cell cancer you CANNOT get ANY of the 4 drugs for metastatic renal cell cancer because the NHS has deemed that these drugs are not cost effective. If you as want to pay for these with your own money in the UK you can't because then they will kick you out of the entire NHS system (doctors, hospitals, etc). This is what happens when the State decides your healthcare instead of the individual.
Happy,
ReplyDeleteThis is here in this country. What about mammography waits in other countries? And furthermore most mammograms are non urgent anyways. And by the way, I just heard a patient say she couldn't get a mammogram at Northwestern without a 4 month wait.
We can trade examples of the imperfections of both systems all day. I beleive a goverment run (or at least the option of a goverment health plan) woul be better than our current extremely expensive and dysfuntional attempt at the free market system.
Kieth,
ReplyDeleteHere is a little tutorial on statistics. Overall 5 year survival from diagnosis means that 5% more people live 5 years in the US than in Canada after a cancer diagnosis. In most oncologsy studies a 5% increase in 5 year survival means a 5% difference in CURE. In other words 5% more people in the US are CURED of their cancer. It DOES NOT mean that an individual lives an extra 6 months with "toxic chemotherapy." You obviously haven't heard of Gleevec or Herceptin or Rituxan if you are still thinking that chemotherapy is "toxic." As for Avastin, 10 years ago median survival in metstatic colon cancer was 12 months, it is now 24 months.
Please tell my patients who got to live to see weddings and grandchildren and graduations that that 12 months has no value. Also, why should some government stooge decide for me how much 6 months of my life is worth? The main difference in this arguement is that I think that I should decide for myself how much my six months is worth and you think that you (or your government proxies) should decide for me.
In addition you are incorrect about the NHS in the UK. If you are in the NHS system and want to pay for a drug that NICE has not elected to pay for(NICE is NOT the equivilant of the FDA!! NICE has a QALY value placed on what it will pay for - currently about 60,000 pounds. The FDA, thus far ONLY looks at safety and effectiveness - NOT cost) if you buy that drug you are no longer able to use the NHS system.
BTY - nice stands for "National Institute for Comparitive Effectiveness." Hmm... does that sound familiar.
Oh, and Kieth the four drugs for metastatic renal cell cancer are FDA approved and availavle in the US but didn't pass muster by NICE based soley on QALY analysis (ie they cost too much, but were found to be safe and effective).
ReplyDeleteThank you Ohio Oncologist - awesome response.
ReplyDeleteThe idea that a bunch of people in Washington somehow "know" more than practitioners out in the field is offensive.
I became a nurse at 40 after completing three other degrees and working in Washington, D.C. for several years. I will tell you how this is going to work.
Obama and Congress are going to fill hundreds of posts in D.C. with 20 and 30 year olds with fancy degrees who have almost no professional experience and absolutely no experience in the real world. Assured that they truly are the "best and brightest," they will begin to shape programs and policies that have NO BEARING on the reality that we face in health care.
It is NOT up to the government to make the decision whether an additional 6 months of life is
"worth it." But that is what is going to happen.
Ohio Oncologist: YOU are the one who worked so hard to become a physician. YOU are the one who is responsible for helping someone through one of the most difficult times of their life. The decisions is between you and your patients and no one else.
The government has no business meddling in areas where it does not belong.
Keith,
ReplyDeleteYour definition of basic health care INCLUDES Avastin, Erbitux, Gleevec, Sutent, Tarceva, Velcade, Revlimid, and virtually every new advance in oncology care in the last 15 years. They all meet FDA levels of safety AND effectiveness or else they would NOT have been approved by the FDA. The question really is not your definintion of basic health care, but rather what value you would like to place on QALY. Again, you would rather have the goverment set this (and they do - do look into the covert rationing of epo growth factors such as Aranesp). I personally would rather have a high deductible insurance that is relatively low cost and then if I need these drugs pay for them myself.
By the way, if you as a Medicare patient choose to pay for a drug that isn't covered (ie epo - Medicare does not pay for the approved FDA indication - only drug that Medicare doesn't pay when used on label) and your provider takes the payment then you have committed Medicare fraud and you go to jail. So no, you really can't choose to "pay for your drugs yourself." The government puts you in jail for fraud if you do that.