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To Canadian and Former Canadian members
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To Canadian and Former Canadian members


I don’t want this to turn into a political debate. HCV Is a Health Issue that goes hand in hand with Health Care. There would be no logical reason for this thread to be deleted unless it is abused.
I would just like to hear from our Canadian members a truthful opinion about their Health Care System. Please include both Pros and Cons. I would also like to know the truth about how long it takes to see a Dr., get test/results, approval for treatment, time waiting in the lobby for emergency room visits, etc.
I don’t care to hear any conspiracy theories, only reality.
Since I keep hearing about a Health Care System compared to Canada’s, I would love to hear “from the Horses Mouth” about what we may be getting into.
So far we hear about how Great it is going to be from the one’s that are pushing for Reform and Horror Stories from the one’s against it. I would appreciate if only Canadian or former Canadian members respond. If other members use this thread for an opportunity to vent, the chances are, it will be deleted. Thank you for you honesty in advance.

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Put it this way,you dont need money to go the hospital,its all paid for before you even show ip at the doorstep by the Govt system.Altho it is getting a little worse for wait times in certian situations its still pretty damn good.There is a drug progam here called Trillium that will pay for all the TX drugs,if you are working ,the co-pay is based on a % of how much you make a year...it works out to you pay 2% of you net income....for ex:  my co-pay is appox $1500 fot all TX drugs.but i never even needed it because im in a trial,thereare even better places for heath care like the Nertherlands
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Avatar_m_tn
I can't speak for Canada but from what I read on the UK Hepatitis Forum (http://www.hepcukforum.org/phpBB2/viewforum.php?f=7), the national care for Hep C seems as good as we get here in the US on private insurance plans.
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Avatar_f_tn
I'm Canadian so your criteria applies to me.  I just happen to be exhausted so I'll be back tomorrow evening...IF the thread is still here.

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R, you asked pros and cons, I'll do my best to illustrate how things are here in Canada with healthcare.  

The cons are that we have a distinct shortage of family doctors here.  That's partly due to decisions by politicians to limit the amount of spaces in medical schools that they would fund in a certain period of time and now we have a doctor shortage.  

It takes a long time to get in to see a specialist here.  Six months or more.  

Because testing is all paid for by the government, the government decides what treatment is covered, what tests are covered, etc.  The doctors understand that they're working within a governement-funded system and will sometimes support what makes sense from that context.  So you get the care that a government funded healthcare system can sustain.  What you get is the same healthcare for everyone except for those who can afford to pay for their healthcare out of the country.

You have a long wait in an emerg.  It takes 6-8 hours if you go in an early evening after work.  That is not necessarily a bad thing.  It makes people really think if they need to go see a doctor or not. They do move you along on a priority basis and do triage as quickly as possible to determine priorities.  However, things get missed in a busy emerg and there are stories of course.

We have urgent care clinics where you see the doctor oncall.  That helps too.  So on a Saturday, you can hike into the urgent care clinic.  Same kind of waiting times though.  Emerg is for the really tough stuff.

Test results can take a long time to come back.  Results of my first HCV PCR took two months.  There are only the two (maybe three) labs in Canada that do PCR blood results so you have to wait.  For persons with HCV, there is no requesting the kinds of PCR's that you want or the frequency you want them at.  The government funds a set number of PCR's and I recall it's one quant PCR a year.  You can have a certain number of qualitative ones while on treatment but you won't get the quant ones at 4 weeks, etc.  You'll get a quant at beginning of treatment IF you haven't had a quant in the past year.  (That might have changed, that's my understanding.)  And then you get a quant at 12 weeks and 24.  The others are qual and at certain government-decided intervals.

Not exactly true that the Trillium Drug plan funds tx drugs.  And Trillium is only in Ontario, one province - like being in one state in the U.S.  I'm sure the other provinces have similar drug plans.  Anyway, Trillium won't fund tx drugs for anyone who is Stage 1 Grade 1 unless the doctor can make a good case for treatment at this stage.  So if you decide you want treatment at this level, you are on your own.  I applied and was turned down, twice.  My doctor was pretty upset and appealed and they still said no.  I had a conversation with my Hepatologist, very experienced, about two weeks ago after being "discharged" from all treatment and asked him about this.  His opinion was that our healthcare system couldn't sustain treatment for Stage 1, Grade 1 people and that they weren't well informed enough about treatment and that new drugs were coming along.  Well, what if they weren't?  And when I was first looking into treatment, they weren't so close.  And what about choices and where 48 weeks of treatment fit into your life?  None of that matters.  It's what the government decides based on financial and overall considerations.  To change the system, it isn't appealing to your own insurance company, it's changing the government's decision on care for EVERYBODY, not just you.  

The level of care you have is equivalent to what the governement can afford for everyone.  There are long waiting times for *everything*.

People also take this for granted because they never see a bill.  I worked for an answering service for a time and had the dimwits calling after hours to know if coffee was a clear fluid and if it was safe for a guy to have sex with his wife who was 8-1/2 months pregnant.  The system absorbs such ludicrousness because of such idiots. I'm sure there are people going to the doctor who don't need to, simply because they can so they do.

Taxes in Canada are much higher than in the U.S.  Healthcare is always one of the top issues in any election.  Countless dollars have been spent on finding ways to fix the healthcare system and waiting times are one of the key issues.  Not so much getting in to see the family doctor for routine issues (if you have a family doctor), it's getting in to see the specialist for anything else, going for tests and waiting for results.  Those kind of waiting times.  I asked a question here about how long people waited to get results of an MRI as my girlfriend was looking at a two month waiting period.  People here responded they got results within a few days.  Her results would determine when she had surgery.  Everything slows down along the chain.

A friend of mine, his mother needed hip replacement surgery.  She was in alot of pain and discomfort while she waited.  It was almost criminal.  But, there was no choice other than to pay for her to be treated out of the country.  

cont...
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The other side of the coin is this.  The pros.  I just had appendix surgery in December.  I was in to emerg, waited six hours in excruciating pain thinking I had a flu.  I was tested and determined it was appendix and the doc was concerned.  That was midnight.  At 3:30am I was in surgery and they found out it was perforated.  I spent the next three days in hospital recovering.  I never saw a bill, didn't have to even think about it.  All the tests, the surgery, the hospital stay, all covered. I've been a very healthy person all my life but still, I have had cystoscopies, gave birth to three babies, had a tubal ligation, had physicals, various blood and other medical tests, a daughter who caught scarlet fever, the various things that come and go for kids throughout their childhood years.....and not once did I ever see a bill for this, R.  Not once.  I never worried once about how I was going to pay for my kids or myself to see a doctor.  You just go.  What I worried about was how I was going to pay for treatment drugs.  However, there are work related benefits that people have that cover as much as 80% of drug costs and round out some of the things that publicly funded healthcare does not, like a semi private room instead of a ward room.

When I was diagnosed with Hep C, the biopsy and PCR's and doc visits even to the Hepatologists in Toronto where I eventually went for a second opinion and was treated, all covered.  I never saw a bill.  

However.  The care I could get for my HCV was not up to what I considered acceptable.  I started searching out options to get PCR's done out of the country because I couldn't get a PCR done that would tell me my viral load any more definitive than 1.3mil IU/ml.  That was the HIGHEST sensitivity in CANADA at the time, not on a trial.  That upset me alot to not know what my starting viral load would be so was looking for PCR sources in the U.S. at the time I got the clinical trial offered to me.  In Canada, a clinical trial offers you better testing, faster results and paid drugs.  A bit more reason to go on a trial in Canada as the care overall is better.  We lag behind the times here.  I wanted quant tests throughout my treatment, a higher sensitivity VL test and I wanted a beginning of treatment PCR and I wasn't going to get them without going outside the country.

Standard of care here moves slower as it's a whole government decision.  It takes time to move from one standard to the other for a whole country on a whole slew of illnesses and we don't have as many people here in the frozen north as you do in the U.S.  

I'm making it sound like it's terrible here.  It's not.  When I read the stories in this forum about all the stress you all go through fighting with insurance companies and doctors who bill because it makes them more money, I'm immensely grateful for my government funded healthcare even with all it's flaws.  

Somewhere between the two systems is the answer.  People should be able to get the care they need when the government funded system can't provide.  How that happens is a huge debate here.  Some say there should be a second tier of care and others say it will undermine the healthcare system we have.

I hope that helped, R.  I'm by no means an expert on our healthcare system.  Maybe that gives more questions than it answers.  I keep thinking of things to add but I'll just leave it at that for now.

Trish
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I am not Canadian but my son did have his appendix out 18 months ago.  We went into emergency.  We were not sure about whether he was covered by insurance since he was 19 and while he was waiting to be accepted into a school.....he was not currently in school and therefore we were uncertain as to whether we would have coverage.  I was paying $425 per month to blue cross/ blue shield (and presently pay a nice round 500/month).  In spite of the ludicrous amount I pay........ the hours that one can contact BC/BS is 8-5PM Monday through Friday.  As many of you may know, medical emergencies do not always occur during business hours.  (You would think that somewhere in those tallest and most beautiful buildings that the insurance companies own they could afford to have a 24 hour service line, but apparently not)  : (

By way of accommodating us they bypassed the expensive imaging process and mentioned that he had all the classic signs of needing his appendix out.  They recommended that he be admitted immediately into a room but that he wait until morning to have surgery so that he would have a properly refreshed surgeon, not one pulled out of bed in the middle of the night.

I asked, fine..... but when does the billing day start for a bed?  Midnight, was the answer that was finally given.  It is 11:30PM I mentioned.  Can we wait here until after midnight?  NO, was the answer.  As a matter of fact we have already admitted your son into a room.  And what will the cost be to us if it turns out that he is not covered by insurance?  About 700 dollars for what turned out to be about 20 minutes.  (it was at that point 20 till 12 midnight.

You are going to make him wait until 6 AM for his operation.  Can we just show up at 6 AM?  No was the answer.  If you leave you will be doing so against medical advice and therefore the trip to the ER will not be covered.  I asked why are you bothering to ask me anything since there is no option that is being granted?

Long story short, my son had his appendix out.  The operation was a success.  The appendix was not perforated.  There were no complications.  He was in and out as quickly as could be expected.

Cost?   Just under $30 thousand dollars.  

I suppose that I am fortunate that I had insurance and that he was covered.  I was still responsible for 15-20% of the bill.  I don't remember exactly.  So my out of pocket was a mere 2 thousand dollars, give or take.  I continue to pay 500 per month knowing that at some point I will treat.  I cannot let my insurance lapse.....

......for in the United States many of us will not have insurance if they know that we have HCV.

*Pre existing condition* they call it.

best,
Willy
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when I was treating, some of the people in the UK were having trouble getting procrit, which would make the treatment process very difficult if not impossible and downright dangerous for some people. I know quite a few Canadians and the only one I know with a serious chronic illness runs down to Seattle every now and then. I can't recall the specifics of why. He has MS and finally had to get on the interferon treatment for it. You take it once a month. But, this is an arguement that goes nowhere because you can find people in the US with horror stories and want nationalized health care. You can find people in Canada and other places with horror stories and hate nationalized health care.
Not all countries are the same...that's about all I can say. The problem we have in the US is the aging boomers are about to bankrupt the country. We've got big troubles looming. Being a tail end boomer, I fear by the time I need a lot of health care, it won't be good after my older siblings and their peers have devestated it.
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Trish77, you made the comment that taxes are much higher in Canada. That is no longer really true, unless you are a very high income earner. When you add in the different social security taxes, taxes are often higher in the US. So personal taxes are similar, sometimes lower in Canada. With corporations, here in Alberta where I am, by 2012, corporate taxes will be 25%. In the US, it is pushing 38-40% in many States once all the different levels are added in. That's a 15% advantage. As Alberta has no sales tax, we are considerably lower taxed than any US state.

The Canadian health care system is not perfect, in particular it does not allow choice of private health care. But, it offers universal health care. The US is probably the only developed country in the world that does not have universal health care - it really is an embarrassment for a country that is supposed to be the richest in the world
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How do you think they got rich and who has all the money in their back pocket???
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I have been following this thread closely (is that a word like stupidly?)  because I want the truth and I appreciate every post. Let’s keep the opinions bridled. We have debt that someone will have to pay, not money.
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l-horn, my guess would be that this person goes to Seattle for the same reason I was going to go to NY.  For the things that either take too long here or are not available here because the government won't cover them.  Maybe drugs that aren't approved yet in Canada.  Maybe tests where results come back just so much faster.  If you can wait here, great.  If not, then you look for alternatives.

moa, possibly and probably you are right about the taxes having adjusted.  There was an article in Macleans not so long ago - I'll have to dig it out - that indicated Canada was ahead of the U.S. these days in practically every area including quality of life.  I can imagine they compared taxes also.

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Question:  As a stage 4 with cirrhosis, looks like I may have finally cleared after the 3rd tox. Would I have had the opportunity to treat that 3rd time? Or even the 2nd? on the Canadian plan? Thanks.
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gauf: congratulations!! look like third time's a charm.

trish: thanks for taking the time to post a balanced and informative summary. Gauf brings up a good question - how are marginal treatment decisions handled - high cost vs relatively low likelihood of success.  Similar hcv-related questions might be what if one wants to continue with detectable vl at 24w, as some here have chosen to. For cancer it might  be availability of chemo for an aggressive form like small-cell lung. Who sits on the  review boards that make those decisions/appeals and what guidelines do they follow?

Your statement " So you get the care that a government funded healthcare system can sustain." summarizes it well. However is going outside the country the only option? Is it not possible, if you can afford it, to supplement public coverage with a private insurance, paid for by individual or employer? For example, my mother lives in Europe and receives generally very good government-administered health care but also carries an insurance policy to cover additional costs.
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I'll do my best to answer you.

Gauf - two components to treatment, right?  The drugs used and the care delivered.  Drugs are not universal here, healthcare is.  Drug plan is dependent on income and is our 2nd largest healthcare expense.  Both care delivered and drugs approved are government decisions and both are made at provincial levels.  The Government of Canada gives money to the provinces under the criteria that the care delivered will be accessible, universal and non-discriminatory.  The provinces then decide where those dollars go best.  There is some collusion between provinces to make such decisions so that they're in step with each other, mostly for their own sake.  

You would have had the opportunity to treat all three times, I believe.  What you would not have had is approval for the drugs for treatment beyond the first time and you might have had to wait until you were stage 2 to get approval to begin with.  Having said that, if you were willing and able to pay for your own drugs, you would have been able to proceed for the most part.  

What you would NOT have had is the flexibility you would potentially have in the U.S. when it comes to frequency of testing and type of testing, length of time to wait for test results and possibly the treatment regimen you wanted to follow. I do not know if you would have been able to treat at the intervals that YOU wanted. The standard treatment regimen is decided by a body of health professionals.  It's as current as they are in making those decisions and making changes to the protocols.  I find them lagging.   Case in point again is the fact that the highest sensitivity PCR in Canada when I entered treatment in 2007 (after waiting a full year to get in to see the specialist and then get results of a quantitative PCR) was 1.3mil IU/ml.  Gauf, that was in 2007.  Can you imagine that being the highest sensitivity PCR available IN CANADA at that point in time, considering what was available in the U.S.???  I think a year (or less) after that, they have now added a new higher sensitivity test.  There are only two labs in Canada that process PCR's and they are both publicly funded.  Any private labs would not be able to provide their services privately, they'd be contracted by the government and paid by them to provide their services privately but in accordance with the guidelines of our healthcare system.

Test results are everything going through treatment, mais oui?  You would have gotten mostly qual PCR's and quants at beginning (maybe, depending when your most recent one was) 12 weeks and 24 weeks and at 48 weeks.  I don't think you would have gotten 4, 12 and 24 post EOT tests.  I was on a trial so things were different for me.  I know it's been excruciating waiting for the results of my fellow heppers who are not on trials and wait months for results instead of the week or less I had to wait.

If I wanted procrit or neupogen and I had to count on the provincial drug care plan to pay for it, it would take weeks to approve at minimum.  If my first treatment had failed and I had to do it again, I think I would get the doc to submit approval for procrit and neupogen (eprex and neupogen here) upfront so that we were ready to go on a moment's notice if required but I don't know if that is possible.  I don't see why not, I just don't know.  Now I'll have to find out.

Having said that, my biopsy was covered, my doc visits were all covered, from the family physician, local GI, Toronto hepatologists, all the tests ran by each along the way....all of it.  I never saw a bill.  We did have to fight for approval for treatment drugs and got denied twice.  Then I went for the second opinion because my GI wanted to treat based on viral load and without a biopsy.  I wanted more expertise than that.  My first Toronto doc was willing to fight yet again for drugs for me at Stage 1 because I was *mentally ready* to do treatment.  Then I got into the trial.

Does that help at all?  If it gives more questions than it answers, I'll be happy to check with my fellow heppers around here.  What my overall impression is...is that we lag behind and the treatment is not what I would like it to be.  You would have more flexibility and superior care in the U.S. IF you had the right combination of doctor and insurance company.

Here...my care would be adequate for the most part and again, according to what a publicly funded healthcare system can sustain.

Trish
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"when I entered treatment in 2007" - that should not read when I entered treatment...it should read when I entered into care for my HCV.  I went into treatment on the last day of Feb in a leapyear in 2008.  SVR April 2009 after 34 weeks on the cancelled R1626 PhaseIIb trial as a G1 treatment naive Stage 1 Grade 1.

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Will try to answer YOUR questions as best I can.

Bear with me for some preliminary explanation on how care is delivered here:

First, understand that the Government of Canada gives money to the provinces, as long as they follow the overall philosophy and policy of the universal health care system - available regardless where you are in Canada when you require treatment, universal and non-discriminatory based on who you are and how much money you have and no extra user fees to be charged for things that the government covers. There are fees for things like a doctor's letter, etc. The provinces administer health care and make decisions.  You get some differences from province to province on what is funded and what is not.  Essentially, it's similar but then there is Quebec which is the ONLY province in Canada to allow private health care and that is only because a patient and a doctor took it all the way to the Supreme Court of Canada and the patient won the right to receive private health care and the doctor won the right to offer it, thereby making it available in all of Quebec..  (Qu'el surprise, Quebec is "a nation within a nation".)

"Gauf brings up a good question - how are marginal treatment decisions handled - high cost vs relatively low likelihood of success.  Similar hcv-related questions might be what if one wants to continue with detectable vl at 24w, as some here have chosen to. For cancer it might  be availability of chemo for an aggressive form like small-cell lung. Who sits on the  review boards that make those decisions/appeals and what guidelines do they follow? "

Any decisions here are made with keeping the cost in mind.  Having said that, if the doc feels it's worthwhile, he / she will proceed.  They may be hampered by tests or procedures that the government will not cover.  The doctor themself may have an opinion that, in a publicly funded healthcare system, the approach is not responsible.  If someone wanted to go beyond 24 weeks, that would likely not happen here.  It's happened for the one woman I know but not because it was a knowledgeable decision between her and her doctor.  It was a lack of knowledge on his part that had her extending treatment longer than she needed when she was still detectable at 24 weeks and he continued.  For the most part, protocol would be followed here.  That protocol is decided by committees of doctors and advisors.  Decisions are made based on what is good medical practice and what the system can afford.  So, yes - there is a certain amount of decision-making that takes into account the balance of risk vs. the cost to determine the standard of care for a country full of people on a broad range of health issues.  

Having said that, the impression I get is that where we lack is flexibility, waiting times and keeping up with current trends.  Waiting times are absolutely terrible.  If you want to see funding for a specific health issue in specific ways, you need to lobby the government to change it for everyone.  There is no individual appeal to the insurance company you're with, the government IS the insurance company so to speak.  

cont....
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cont..

Willing:  "Your statement " So you get the care that a government funded healthcare system can sustain." summarizes it well. However is going outside the country the only option? Is it not possible, if you can afford it, to supplement public coverage with a private insurance, paid for by individual or employer? For example, my mother lives in Europe and receives generally very good government-administered health care but also carries an insurance policy to cover additional costs."

In the U.S., if you can pay for it, you can have it.  In Canada, you cannot pay for it.  Private health care here is against the law.  Going out of the country is pretty much the only option.  You get benefits that cover extras like a private or semi-private room, a percentage of your drug costs, in Ontario perhaps your optometrist visit will be covered by your benefits as Ontario removed coverage for an optometrist assessment for glasses - things like that.  But if you want to pay for or have the care that the government does not provide, there is no mechanism for that and, as I said, it is against the law for anyone to provide provide health care here in this country.  The only exception is Quebec - I'm going to include a link for you that contains a story about the lawsuit brought in Quebec by a man who had to wait interminably long for hip replacement surgery and the doctor who fought for the right to provide private care.  The Supreme Court of Canada sided with the patient and the doctor so Quebec is the only province where private health care is available.  I don't actually know if this is true as the government there planned to appeal of course and I don't know the status (maybe a Quebecer or  more knowledgeable Canadian can kick in here.)

In this story is a good link that explains the difference between private and public health care in Canada.  In a nutshell however, as private as it gets is that you may get your ambulance paid for, a semi-private room, your optometrist appointment paid for..peripheral things like that.  Actual care and treatment, no.  It has to be the same for everyone and we do not currently allow what is referred to as a two-tiered system here - where those that have the money to pay for better care can get it here.  If you have the money, you're going out of the country and private clinics that provide treatment outside of the publicly funded healthcare system are against the law.  

You may find this interesting reading:

The battle in Quebec for private health care:

http://www.cbc.ca/canada/story/2005/06/09/newscoc-health050609.html

The link within the article that explains Public vs. Private healthcare in Canada:

http://www.cbc.ca/news/background/healthcare/public_vs_private.html

I must say here though ... while it's *important* to have your eyes open and know what you're not getting with universal healthcare, it's also important to know what you DO get and I hope the U.S. finds a good balance between the two.

I happen to have been particularly blessed to have raised three children who seem to have inherited their mother's healthy constitution.  There wasn't really anything serious that my kids had growing up - there was a tonsilectomy my daughter had at age 4 and then the regular childhood ailments along the way.  Not even a broken bone, I don't think.  Partway through their childhood I became a single parent working two jobs to support them.  I didn't fit into the criteria of being covered by the social assistance program.  Money was really really tight.  I cannot even begin to imagine how I would have paid for their doctor visits and prescriptions for even routine things if I had no insurance.  I almost always worked a job where I had benefits that covered most of their drugs and dental.  If I was a family where there were health issues to manage...I shudder to think how I would have managed to pay for that.  I guess I would have ended up with what is social care in the U.S.  In Canada, the care is the same quality for everyone regardless of income.  And I have to say, I really like that.  We get very frustrated with the inefficiencies in the system but there is no having to settle for the care your income will provide you here (except for those that can afford to go out of the country and the world will always have such things.)  You get to see the very best doctor you can manage to get an appointment with regardless of income.  We do have good care here.  It's just not perfect.  

The kind of healthcare we have here may not appeal as much to those who can afford to provide for themselves differently.  But life isn't all about ourselves, right?  We're a global village.  Just take from our system what you can learn and make yours a good one.  

Hope that helps somewhat??

(*always* nice to see your name up there, Willing...hope you are well. :)

Trish
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I don't want it, no way
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Trish, thank you so much for your time. Please (along with others) continue to share the truth as you see it, concerning Health Care in Canada. You guys (notice I didn’t say ya’ll. LOL) are about all we have to go on. So far we haven’t seen an actual plan.
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"I don't want it, no way "

NO way?  Not even in SOME way?  In what ways do you think your system needs to be improved?  I'm curious, because as I've been going through treatment and reading all the battles the people here go through with doctors and insurance companies, despite the inefficiencies in my own system, I'm grateful I don't have to battle with that.  Your co-pay amounts are significant and would cause me serious financial issues.  Willy mentioned he pays $500 a month???  I can't even conceive of having a $500/month bill for anything other than mortgage, let alone my healthcare just in case I get sick.  I know it comes out of our taxes here and is an invisible bill in some ways but certainly it's not something I have to worry about every month if I can pay it or not.

In the U.S. it seems the level of health care you get is dependent on the employer you have and how much you're able to pay per month.  Some insurance companies are better than others, it seems, in your system.  In Canada, your health care is guaranteed regardless of your employer and everyone has equal access.  What happens if you lose your job?  

I'm not sure I'd want to live with that constant uncertainty and pressure when it comes to something as fundamental as healthcare, particularly as a parent and when we're now the sandwich generation, taking care of children and taking care of aging parents, etc.

So again, I ask you...in what ways do you think your system needs to be improved?  Because if it was a direct swap between yours and mine as they are, I'd take mine in a heartbeat.

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My main concern is quality, who will really be paying the tab, and jumping into this thing with so many unanswered questions.
You would think by now we would learn from our mistakes. Jumping into things prematurely has done little more than pour salt in wounds. Whether it is Bush with Iraq or Obama’s Stimulus that resulted in little more than Bonuses and Vacations.
I see this like a Parent that promised his children a Pony for Christmas. At Christmas Eve the parent realizes, I have to get a Pony. He goes out to buys a pony with the attitude a pony is a pony and I promised them I would get them one. Christmas morning arrives and a raggedy, barely rideable pony is presented.
Later the question is asked, where will the pony be kept, who is going to pay for the stable, who is going to pay for the feed, who is going to pay for the Vet. Bills? The parent answers, there are several people all over the country that can afford pastures, stables, feed, and have veterinarians to care for their horses. When they can no longer afford to take care of everyone’s ponies, we will think of something else. Until that day comes rejoice that I followed through with my promise and got you the pony I promised, even though it was not the pony you expected.
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Since this thread has crossed the Medhelp line anyway...  I think that the pony analogy is just a little bit off.  Over the years we have discussed the female inflatable 'aid'.  You know who I'm talkin about out there.  You hear wonderful things about her (it).  Shapely, dosen't ask for much, puts up with bad jokes and bad gas. But in the end, you just get screwed and are left with a limp deflated pile of useless carcass that you are embarassed about and it still shows up on your credit card bill the following month.  Time to take matters in to your own hands.
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Oh man, The Health Care and The Female Inflatable Aid Analogy.
Sorry FLguy  but I am trying to block that one out of my mind. The more I think about it the worse it gets.
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whoa!  your ability to write in depth always amazes me, Many thanks for the interesting replies and links. The concept that private health care should be illegal in a capitalist society takes some getting used to. In my non-existent free-time I'd like to read more about what led to the adoption of that view.

A couple more questions if you have the time. Is there a generally accepted explanation for the long lead times for specialist appointments (eg relative to the US do fewer doctors specialize or do more people, who might otherwise not have access, see specialists?).  The link you provided indicated fees for say private hospital rooms or botox injections are standard - but apparently that's not the case for MRIs or patient-ordered PCRs. Is there a move towards widening or narrowing the fee-based part of the system?

Since Flguy's inflatable aid analogy has probably already pushed this thread  over the edge I'll risk more censorship - I agree completely:  notwithstanding  the considerable problems you list, it looks like a very good system.

"Lawyers for the federal government argued the court should not interfere with the health-care system, considered "one of Canada's finest achievements and a powerful symbol of the national identity.""
I wonder who would consider the current US system one of our finest achievements, etc. Still the interesting about a democracy is people get to choose what they want - we should find out before too long...
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This was a fascinating thread.  However, I don't think we're going to replicate the Canadian system, nor the British, nor anybody else's. Ideally we'll take the best from each, including our present one, and come up with something newer and better.  I've been told that Kaiser Permanente's system may be a model for us.  If so (I'm on Kaiser), it's pretty good, especially if you're proactive or have somebody to fight for you. I also have read that France, which has a hybrid state and private system, affords the best medical care in the world.
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“However, I don't think we're going to replicate the Canadian system, nor the British, nor anybody else's. Ideally we'll take the best from each, including our present one, and come up with something newer and better.”

The only way I can see that happening is taking the time to make it happen. I don’t see a plan yet that offers a “newer and better plan’. If we are going to take the best from each, how come they do not do this before it is voted on?
I don’t trust our government enough to work out the kinks as we go. It would be like having a car that needs work and having an incompetent mechanic work on it. The car seems to constantly be back in the shop, costing more money each time.
Another concern of mine is, it going to regulated like our Welfare System and SSI? If it is, I am totally against it.  I am 100% for helping the needy but until our government can figure out the difference between the Needy and Human Parasites, it will just be another free lunch for the free loaders.
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willing - quick answer to your question is that it was largely governments along the way that made decisions that caused severe doctor shortages.  The decision to outlaw private health care had docs running for the U.S. in droves apparently, then amazingly stupid decisions to limit the number of spaces available to train doctors  based on some report that indicated we'd have a surplus (wrong!) so governments decided to save money and cut back on the number of funded spaces in medical schools and now we have a shortage so severe it's going to take some bold decision-making and creative action to fix it.  Couple that with the severe requirements for immigrant doctors to certify and you have a bit of a mess.  I'll send you links again for your reading pleasure and flesh this out a bit more when I have a bit more time.

R Glass, you might not get it right the first time but maybe you can start with what's most important and build on it.  An implementation plan of sorts.  What you have now is horrendous.  Your government has the right idea at least to make healthcare a priority and to make it more equitable.

As for this - "Another concern of mine is, it going to regulated like our Welfare System and SSI? If it is, I am totally against it.  I am 100% for helping the needy but until our government can figure out the difference between the Needy and Human Parasites, it will just be another free lunch for the free loaders. "

Healthcare is a whole other issue than whether someone is freeloading.   People don't ask to get sick.  Kids certainly don't, the aged don't, and they need healthcare.  It has nothing to do with being a freeloader when it comes to healthcare.  If your system goes on a principal that everyone deserves equal access to decent care and doesn't go in the direction of one kind of care for those that have and another kind of care for those that have not, then you have nothing to worry about.  Again, one of the things I appreciate most about my system in my country is that healthcare is a basic human RIGHT here and equal access regardless of income.  To me, that is fundamentally humane. I'm not interested in a system such as your current one that forces people without money to accept substandard care when they didn't ask to get sick.  That's different than people who don't bother to go to school or work hard living off the backs of those who do.  Just a thought.

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Thanks, Trish. That is a great in-depth comment. Your candor and intelligence are appreciated.

I am not sure what is going to be appropriate for a U.S. health care system, but rushing to get "something" passed is not the way to go (I must agree with R Glass). Only a fool would trust politicians who have not even read the bill themselves to get it right. But I agree that we should start somewhere. It is not right to deny people necessary health care because they are poor, or even stupid. Likewise is seems unfair to make some people pay for healthcare while others get it free. Canada seems to have solved these problems, but at the cost of of sluggish and outdated care.

I tell my bosses all the time, "do you want it done right or do you want it done fast?" The answer is always "Yes."  
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"I am not sure what is going to be appropriate for a U.S. health care system, but rushing to get "something" passed is not the way to go (I must agree with R Glass)."

I can understand this as well and do also agree with R Glass on that.  I really do wish you all well at putting something into place that will make life better for most people.  This is not going to be an easy task at all.  

"I tell my bosses all the time, "do you want it done right or do you want it done fast?" The answer is always "Yes."   "

And there's the rub, eh?   I'll be watching it unfold with great interest and hoping it turns out well - that they choose the right pony to start with and continue to groom it so that it turns out to be a fine horse that rides well.  I'll stay away from analogizing with the inflatable doll example. :)

Hope you are feeling well these days and enjoying your summer.

Trish



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I think it definately needs some sort of reform. A ceiling on frivolous lawsuits and also letting states buy healthcare outside state lines would help alot I think. Neither one of these are even a part ofthe current bill here. We all know the Government will ration it and turn it into a burueacratic nightmare.
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Oh boy
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"I think it definately needs some sort of reform. A ceiling on frivolous lawsuits and also letting states buy healthcare outside state lines would help alot I think. Neither one of these are even a part ofthe current bill here. We all know the Government will ration it and turn it into a burueacratic nightmare."

I'm not sure what exactly you're referring to when you say "buy healthcare outside state lines" - what would you mean by buying healthcare and why would one state buy from another state?  You mean a trade of services?  That might work if one State has labs, lets say and another State doesn't want to have to build them when they already exist in another State and it doesn't compromise service to have the labwork done there.  My PCR's during my clinical trial were done down in Georgia?  Texas?  Something like that.  It would be interesting if my government contracted that out - it might be cheaper and quicker.

If you're referring to simply shopping around for better care in another state, something to think about.  Here in Canada (yes again...) you can go to other provinces (like going to another State) and get healthcare there but ONLY if it's because you're there for work or pleasure.  You can't simply jump a queue in someone else's province or go because you like it better there.  And that makes sense to me.  We pay our taxes to our province and they provide our healthcare.  If I'm going to another province, I'm doing so on other people's dimes when my own province is supposed to be covering me.  It's hard for provinces to manage the needs of their own people if there's "cross border shopping" going on.  So there has to be some element of control.

Healthcare IS bought here from private interests by the government within a province, however it has to be PROVIDED inside of government guidelines.  So basically, the private interests are on contract to the government, not that people can go there and buy extra healthcare services.

Government should ration healthcare, it's simply good management.  They have to contain costs.  I've already seen it here that when it's free, it's abused.  Sometimes I think the government should send us all an annual bill that shows what the services we used in the past year actually cost.  It might open some eyes.
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all: it might be interesting to extend this thread with summaries from those in the US covered by government-funded health care : medicare and Vet. Admin. My impression is that there are fewer complaints there than from those fighting ins cos but perhaps not..

gauf: I don't see how 'rationing' can be avoided insofar as no matter whether payment comes from government/taxes or for-profit ins. cos/premiums there will never be enough to provide 'optimal' care for all (particularly as aging  boomers push up demand).  Biotech keeps advancing at a furious clip, and the advantages to the  wealthy, are/will-be  substantial. but until new technologies become mainstream they will remain too expensive for unrationed access.

For example, there's  a recent story about a Stanford prof who sequenced his genome for under $50K
http://med.stanford.edu/ism/2009/august/genome.html
(see also accompanying story about predicting cirrhosis progression)
All great stuff, but can you see either government or ins. co providing access anytime soon? A good test case will be availability of the new PIs  - which health program UK NIH, Helalth Canada, VA, Medicare, HMOs, PPOs will provide access/when?
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"If your system goes on a principal that everyone deserves equal access to decent care and doesn't go in the direction of one kind of care for those that have and another kind of care for those that have not, then you have nothing to worry about.  Again, one of the things I appreciate most about my system in my country is that healthcare is a basic human RIGHT here and equal access regardless of income.  To me, that is fundamentally humane. I'm not interested in a system such as your current one that forces people without money to accept substandard care when they didn't ask to get sick.  That's different than people who don't bother to go to school or work hard living off the backs of those who do."

I believe a single payer system makes the most economic sense, but it won't fly in the US.  Americans want their freedom of choice and don't like being told what they can get and not get.  We will continue to have a multi-tiered health care system, and we will pay more for it, comparative to other industrialized countries.

In the current political environment here, talking about what is humane doesn't get you anywhere.

smaug
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I have an idea, take away health care benefits from everyone in this country including the politicians until we can figure a way to cover every body.  
"Health Care" I believe is a human right.  Now I also think people should be educated as to what healthy is.  Is is Mctriple burgers slathered w/ bacon, mayonnaise and a coca cola healthy?  Is it smoking 4 packs of cigarettes a day.  Face it we are fodder, and until we can stand up for ourselves see ourselves and others as precious human beings all we do is provide $$$ for someone else, corporations to be exact.  
Ahem....... why do we always have enough money to go to war to destroy other cultures, but not enough money to take care of each other?  Besides all money really is is a $symbol, its paper at this point.  Is it worth a human life?  My philosophy, if the proverbial poop hits the fan, that paper will only be good to wipe yourself with.  I learned that from being in a flood.
A good example was Schindlers List it broke my heart when he looked at a gold pin and thought of the lives he could save in exchange.  
I know we have to work with what we have, so lets try to change our priorities and take care of each other.
How about the 17 yr. old girl who had insurance and was denied a liver transplant because it was too experimental and she died 3 days later.  I'll guarantee you if she was the daughter of some insurance co. CEO she would have gotten it.
Something is better than nothing.  I know, I have nothing and hope to get into a study, otherwise forget it.
whew I can rant.
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Mary: "I have an idea, take away health care benefits from everyone in this country including the politicians until we can figure a way to cover every body".

Good point, Mary, Why won't our representatives settle for the same health care and retirement benefits that they insist are best for everyone else? Doesn't this itself create a two-tiered system?

Trish: Your comment about not poaching on other states/provinces: "We pay our taxes to our province and they provide our healthcare.  If I'm going to another province, I'm doing so on other people's dimes when my own province is supposed to be covering me."

I extrapolate from that comment, that a citizen from another country would not be eligible for benefits in a province of Canada. I am assuming that Canada has at least some illegal residents in the country. How does Canada deal with that?

Brent
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We kind of accept it as axiomatic that the U.S. health care is "broken" and compares poorly to European and Candian care systems. I was surprised to see the data that appeared on the website for the National Center for Policy Analysis on March 24, 2009.

Here is the info/link for what it is worth.

http://www.ncpa.org/pub/ba649
or  http://www.hoover.org/publications/digest/49525427.html
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I sincerely hope this is not an abuse of this thread. I don't want to see a debate or any deletions, either.
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"I extrapolate from that comment, that a citizen from another country would not be eligible for benefits in a province of Canada. I am assuming that Canada has at least some illegal residents in the country. How does Canada deal with that?"

Everybody has a health card with your own unique health card # on it.  You have to show it every time you go somewhere for service unless they have your # on file because you've become a regular, such as at my family physician's office.  They have a sign up that says you have to show your health card every time you come but they never ask me for it because they know me.  

When I went to see my endocrinologist this past week for example, he sent me for a blood test and his office already had my healthcard # on file so they were able to simply pull it from their computer and put it on the form which I then take to the lab and they have my healthcard #.  If I was fresh, I'd have to show it.  I don't actually know what happens if you don't have a healthcard.  You really do have to show it everywhere or provide the # and they have ways of checking the number to see if it matches to you.  

If you were an illegal immigrant, maybe you might not be picked up by the system and you might be able to get a healthcard under false pretenses.  If you don't have one at all, I'm thinking that's a real problem here but I don't know how that works.  I just know it's a big deal if I don't have my healthcard.  

On top of that, the hospitals I go to, the bigger ones, they also have their own carding system and you have to show THEIR card when you go there.  That means not only do you have a healthcard on file with them but YOU are on file with them and they have all your information.  

It's not like you can just walk in off the street any old time and just present yourself and get treated.  

Does that answer your question at all?  
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iatw: thanks for the link, but I couldn't find the March 24,09 paper you referenced on their site. Is there a direct link?

all: for those interested in comparisons with the Canadian system, here's a couple of recent npr news stories:

"Report: U.S. Health Care Costs Double Canada's"
http://www.npr.org/templates/story/story.php?storyId=1404971

and

"Does Canada's Health Care System Need Fixing?"
http://www.npr.org/templates/story/story.php?storyId=111721651
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Yes, the link in my comments above is the direct link to the NCPA website archive:

http://www.ncpa.org/pub/ba649

The NPR report was interesting. But I must conclude that Canada's system is a little more than just socialized insurance. The idea of making one large pool to absorb individual risk is a good one in my opinion.

Brent
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“I am assuming that Canada has at least some illegal residents in the country. How does Canada deal with that?”

Great question.


“Again, one of the things I appreciate most about my system in my country is that healthcare is a basic human RIGHT here and equal access regardless of income.”

In The USA most all us Tax Payers have to submit to Drug Testing to keep our jobs. But it is discrimination for Welfare Recipients to be forced to submit to Drug Testing. Keep in mind; it is our Tax Dollars that pays for their Welfare.

In Canada, is everyone subject (Welfare and Free Healthcare) to Drug Testing? As I said before, I am all for helping the needy but many others and me are sick and tired of supporting Human Parasites and I have little compassion for them.

I agree that it should be a basic human right and equal access regardless of income. But there has to be a line drawn somewhere.

Thanks again for your time and input to this Thread, R. Glass
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http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw
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Link was to long..........

http://tinyurl.com/lhfkyp
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I have never been subjected to a drug test in all of my 48 years.  Not on any job.  I was on welfare top-up for a short period of time after my marriage ended and the child support quit coming in suddenly - feel compelled to say I replaced that with a couple of jobs from there forward and never went back even though I could have - and was never, I repeat, ever in my life subjected to drug testing.  In fact, I'm thinking that would be incredibly controversial here.  

They do draw the line here.  There are regulations around what procedures are covered, we have a doctor shortage and private health care is not allowed.  

Drawing the line at a drug addict not allowed to get healthcare?  Or an alcoholic?  While those people are contributing to the costs, where do you draw the line?  Obesity?  People who don't exercise enough?  People who exercise too much?  Ask people to undergo a diet test before you allow them access to healthcare?  

Think for a minute about all the ways you might have contributed to your own healthcare needs.  Would you want to be denied healthcare based on that?  The government promotes healthy living and all that and society demands it but to deny healthcare is an extreme measure.  Some things you hold your nose and do.  To deny welfare to able-bodied people who could work, that's something else but denying healthcare.   That one is a hard one for me to swallow.  Big topic.
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Willing - I think the article you quote on if Canada's healthcare system needs fixing is reasonably accurate but a little rosy and Can-Do, the one you quote comes across as more dire than it is.  Both quote doctors as their resources.

The system is certainly in need of fixing but we would also never give it up.  There have been mistakes along the way that need to be corrected and it's an ongoing source of frustration for ME to see millions of dollars poured into trying to figure out how to fix the things that are broke and see very little change.  Perhaps that's the downside of a government-run healthcare system.  Change happens slowly and inefficiently.  Government decisions were made here that created this situation and I keep waiting for someone with guts and vision to correct the situation and it just ain't happening yet.

In the meantime, when I went to Sunnybrook Hospital in Toronto to see my thyroid specialist, I had a conversation with the nurse who took my blood.  I had been reading the paper and didn't hear her call me, so she joked and asked me if there was anything interesting and coincidentally, I'd been reading an article about Obamacare.  (If that is a derogatory term, my apologies - it's just easier to say and something I read - if it's derogatory, please let me know and I'll stop using it)  So I mentioned that to her and we got in to a discussion.  She has relatives down in the U.S. and she talked about what trouble they have compared to us and we both agreed that while our system needs fixing, we'd both take this any day.  Witness the waiting room just in the blood clinic in that hospital.  Didn't matter who those people were or what walk of life.  We were all equal and none of us saw a bill.  We all had health issues and we were all being treated and none of us had to worry about how we were going to make that happen.

Your current healthcare discussion is big news in my papers here.
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" The link you provided indicated fees for say private hospital rooms or botox injections are standard - but apparently that's not the case for MRIs or patient-ordered PCRs. Is there a move towards widening or narrowing the fee-based part of the system? "

Think about it - botox and private hospital rooms are perks.  No government funded coverage for that, nor for non-essential surgery.  Facelifts and cosmetic surgery are not covered, for example. It has to be essential.  

You can't get an MRI without a doc's order.  You can't get a private MRI to speed things up.  You also can't get a patient-ordered PCR that the healthcare system doesn't cover or that would have been easy for me.  I could be wrong on that, however.  The Toronto hospital I went to when I was getting ready to enter regular SOC treatment indicated that their hands were tied on the types and number of tests they could order and that the ones at 4, 8, 12 and 24 were the best they could do and they were quals except for the 12 and perhaps the 24.  My family doc gave me a script for a PCR once a month though and I was about to test that theory.  I was talking to a fellow hepper on the weekend and he got his first PCR at 12 weeks.  He indicated that was standard in the treatment centre he goes to.  And this is a Geno 2 who has had a liver transplant.  Now that upsets me, particularly because he's being treated out of a hospital that does liver transplants.  I have to tell you, that would not have happened in the Toronto hospital I went to.  But I think I'm getting offtrack here (I have plans to do something about all this and I'm putting my steps in place - again, another topic.)

Anyway, my usual long answer to your short question is no, they aren't planning on adding essential services to the list of things we can pay for.  Some things we pay for aren't so non-essential such as an optometrist visit.  I pay $89 for that and not all of our work insurance plans cover that.  Mine happens to, my previous one didn't.  For the life of me, I don't understand why that's not covered.  You can't get glasses without it.  But it's not.  So maybe there's a move more in the other direction, to start being more discriminating about what is considered essential.  And that I see more of, because there are things that I think should be covered, such as treatment drugs for Geno 1's (within certain parameters of course) and they're not.  So again, I would say more of a move to cover less than to cover more.  

An interesting situation - an organization representing persons with autism lobbied the government hard for coverage for a particular kind of treatment or extra services for children with autism.  They were unsuccessful.  They would have to hope that their insurance saw that differently.  That's not necessarily a bad thing.  Just that if you want something covered by the government plan that's not, you will have alot of work on your hands.    So it becomes a big question on private care being against the law and how you fit private care into a public health care system.  A question I hope your country has answered better than we have.

Trish
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But how does Canada's system handle people from other countries while they are in Canada? The treatment of illegal residents in the U.S. seems to be a relevant and controversial issue. If care is a human right, then do we restrict the definition of human to just our citizens? How do Canada and other countries handle this issue? If I am in Canada and I am in urgent need of medical care, would I receive it?

I don't know if we should be idealistic about providing health care as a human right or if we need to be more practical. If we take the practical route, should we ration care, and if so based on what criteria?

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He does bring up a good point. If Health Care is a Human Right and Illegal Immigrants are human, the answer to our health care problem could be to flood Canada’s border.
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"But how does Canada's system handle people from other countries while they are in Canada? The treatment of illegal residents in the U.S. seems to be a relevant and controversial issue."

Well, you're mentioning two things in one sentence here. People visiting from other countries?  I don't know.  I've had no exposure to that.  I can imagine there must be some sort of provision for that but I can imagine it has to be restricted or we'd be flooded with people visiting relatives and then going for healthcare services.  We're a humane country but we're not stupid.  So I don't know where that sits, Brent.  Because we're humane doesn't mean we don't approach this practically as well.

As for illegal immigrants, if it's known they're illegal they get shipped out. If we don't know and we think they're citizens or legally here, they get the same care as anyone else who's legally here so I don't understand your question.  The controversial issue with regards to illegal immigrants in this country is that our controls are not strict enough to prevent illegal immigrants from getting in.  It has nothing to do with healthcare.  As I said, there's that whole carding system.  If you are an illegal immigrant and you have a healthcare card, you've gotten it through illegal means and you'll end up getting free healthcare until you get caught, not because our healthcare system allows it.


"I don't know if we should be idealistic about providing health care as a human right or if we need to be more practical. If we take the practical route, should we ration care, and if so based on what criteria?"

Care is rationed here so it seems we're taking some sort of practical approach to providing healthcare even though we've decided that it's something that should be extended to everyone who is in this country legally.  Just because we have decided that healthcare is to be extended to everyone legally here doesn't mean we're being idiots about it.  As I said to you, everyone has to have a healthcard, there are specific things that are covered and beyond that, if it's not considered a necessity, it's not covered.  So it's like the government is the one insurance company in this country.  There isn't anything about it that indicates that we just blindly hand out healthcare like candy.  

We've decided, in this country, what basic entitlements everyone should have.  For some people, that's precious little.  If you're not working, you're entitled to welfare if you have no other  means of income and yet, you can be denied welfare if you abuse the system.  Then the social network kicks in - the homeless shelters, the food distribution groups, etc.  We have homeless people like everyone else.  But healthcare - well, if you're legally here and you're homeless and you have your health card, you can be treated by a doctor here.  If some idiot like the guy I used to work with decides that kicking a homeless guy around and throwing pennies at him qualifies as entertainment, that homeless fellow is still entitled to see a doctor for his injuries and the same doctor as the rich guy's son who kicked him around. I'm really not sure how they'd work that out at the hospital if some homeless guy arrived there with no ID and injured.  I'm sure we have some kind of provision for that rather than simply allowing someone to die.  I just don't know what it is.  I don't have all the answers to that. I think the police here make some effort to get to know the regulars and get some sense of who they are. But I really don't know how that works.  Now I'll have to find a nurse or something and figure that out or ask the next time I end up in emerg or at my family doctor's office.  

The current big debate here and among the medical community as well is whether we allow private care into the system and in what ways.  The healthcare system has gone on the principle of equal access to all legal citizens and the question will be how to introduce private care and maintain that equal access.  There are those who think that's not possible, that it will immediately create a two-tiered system where those who can afford it will get better care.  Well, we already have that system as those who can afford it go outside the country and pay for it and maintaining the system as it is means to continue with the inefficiencies in the system that bring with it the long waiting times, etc.  If it can be demonstrated that private care can be introduced in such a way as to maintain the foundational philosophy of equal access to all, but it hasn't been done yet.  Under current debate though for sure.

"He does bring up a good point. If Health Care is a Human Right and Illegal Immigrants are human, the answer to our health care problem could be to flood Canada’s border."

If you think we're that idiotic, give it a shot and see how far you get. We've decided, overall, that to be entitled to ANYTHING in Canada, you need to be here legally.

If you think some people are not entitled to health care, you have a right to that opinion.  In my country, we've decided that everyone who is here legally has the right to equal access to healthcare.  If you want something different for your country, then you have the right to that opinion.  I have the right to mine.  

Good luck to your country with sorting this all out.

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“If you think we're that idiotic, give it a shot and see how far you get. We've decided, overall, that to be entitled to ANYTHING in Canada, you need to be here legally.”

I was being fecisous (I still can’t spell that damned word). The Illegal Immigrant situation is one of our main concerns when it comes to Health Care Reform. We basically have no borders and our government puts forth little to no effort to do anything about it. They put no money into our system but our government seems more than happy to look the other way as they drain it. People are getting fed up with it. Until it is made clear, Free Health Care is for Legal Americans only; I don’t think it is going to pass. There are several other issues with “the plan” that should get worked out before it is voted on but this is one of the big one’s. My take is, patch them up enough to them back across the border. Wife and kids here, no problem, pack them up to. Our country is broke and we can no longer afford to try to take care of everybody else.
I see a lot of Pros & Cons with Canada’s system. I don’t understand why we have to jump into this so quickly. Many others and I would like a complete plan. We have a very corrupt and sometimes incompetent government. I don’t think we are asking for much. Slow down, put together a plan that the Pros and Cons have been worked through, and we will probably go for it. With the past history, only a fool would just trust them.
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Why wouldn't health care simply continue to be available to legal Americans only?  I don't see an issue with that.  Is something other than that on the table?  If you carded legal citizens for healthcare the way we do here, wouldn't that take care of it for the MOST part?

Do you have a link to what's being proposed for your system?  I'd be intrigued to read it.

(And I'm not being facetious. :)

I'd like to see you go slow too and be careful.  I can't for the life of me imagine rushing into something that's going to be as difficult to administer and as costly to support as a national healthcare plan with the size of your population, the number of States you have and the current state of your economy.  This is far too important to be a political feather in someone's cap.  Would be nice if partisan politics could be set aside and people work together on this but that would be WAY too optimistic, I suppose, eh?
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Do i see that 4 letter word again..govt?...dont you all see its again about greed and money,there is enff cash to help every person on the blue chunk of rock floating in space,but its just a few hoarding all the mulla....greed is evils brother
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Trish, Good Luck. If you can find a legitimate copy of “The Plan” please let me know. As I see it, there is no “Plan” and they just want us to trust them.


http://www.ehow.com/how_5306796_copy-health-care-reform-bill.html

“A Senate version of the bill was passed out of the Health, Education, Labor, & Pension Committee in July, but as of mid-August, the bill has not been assigned a number or its text published. The Senate website's active legislation list currently links those searching for the health care reform bill to the House of Representatives ' HR 3200. This will be updated when the Senate information is available.”



“(And I'm not being facetious. :)”
I know you rejoice in the fact you are a better speller than me. Admit it.
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Health care for everyone in the USA like in Canada will not make the big insurance compaies very happy,there make more cash on the 2 tier systems.
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iatw: thanks for the link. Scott Atlas makes valid, well-documented points (and what is the UK not/doing to achieve a frightening  604 % higher prostrate cancer mortality rate !?).

However, the flip side to those rosy stats about the current state of US health care is evident in the  recent stories about physician charity groups tending to the uninsured in LA and elsewhere eg
http://www.dailybreeze.com/news/ci_13038443

I'm personally pretty far out on the left edge of the spectrum but commentary like Atlas' seems very informative/helpful (here's another recent piece he wrote against the public option:

http://www.forbes.com/2009/08/19/public-option-health-insurance-opinions-contributors-health-care.html
)
These decisions involve difficult tradeoffs without obvious solutions. Though I don't agree with Atlas he seems to be genuinely interested in a solution, unlike the Palin/McCaughey "the Dems are out to get your granny" comedy routine. What I'm not even close to understanding is (1) the  the incredibly deeply rooted suspicion of gov. (isn't gov. no more or less than the  us in US) and (2) the trust in for-profit marketplace as a distributor of care.

trish: thanks for the additional information. It would seem that even with Canada's entirely public system there remain  opportunities for supplementing the gov. -provided baseline with insurance. All this has been on my mind lately as I recently had an experience not unlike Willy's above. I was driving my daughter cross-country; she has a few weeks between completing grad school and starting training as a vet. A couple of weeks ago she was badly bitten by a dog, probably valuable on-the-job training for her chosen field (HCV patients get pretty cranky but at least we don't bite). Though she explicitly told the Dr she was penicillin intolerant he prescribed a  strong amoxycillin-based antibiotic and a few hours later she was in the ER. Another Dr. prescribed a different antibiotic and all was well. However, while driving cross-country the symptoms returned, violently, leading to another ER visit in the middle of the night. Fortunately she figured out that with the packing confusion she had mistakenly taken  one of the amoxycillin antibiotics. These were promptly tossed and again she recovered. However the 2nd ER intervention occurred during the brief  window she is uninsured. Though we don't have the bill yet, I expect something between 1500/2000..another small caution of what happens when you slip through the gaps in our current insurance-based system.
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You are amazing, thanks for all  the time and detail you've given this thread. Thanks to everyone for not turning it into a heated name-calling debate that gets deleted.

Rglass: Have you thought about healthcare in Europe and Japan compared to our system? I know that Canada is our only neighbor to compare too, obviously, but I'd love to hear from some one other than Canada who is in a not-for-profit healthcare system.

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I would love to hear from them to.
The only reasons  that I specifically asked for Canadian’s is because Canada is what “The Plan” has been mostly compared to and I was trying to keep the heated political debate down to a minimum .
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Ladybug...not so amazing.  I'm pretty opinionated and when someone says "what do you think about .... " my response is alot like "how much time do you have?" :)  I'd like to hear about other systems also - don't we have some members from Britain and isn't Marcia from a publicly-funded system in Denmark and Zazza / Comeagain in Sweden?

R Glass - no rejoicing in the fact that I'm a better speller than you, it is what it is. ;->  A story - my grandmother I grew up with thought she'd give me a comeuppance and for some bewildering reason one evening, decided to have a spelling bee pitting my aunt and me against each other, my aunt being 4 years older than me.  I clearly won, bringing the spelling bee to an abrupt end.  Suppose it didn't occur to my grandmother that me hiding out in the basement reading books all the time to avoid getting whacked around would leave me with a helluvalot of words swimming around in my head....anyway....thanks for the link to your Plan.  I haven't explored it too far just yet however it's a tab in my browser just waiting for me to find a window of time for it.

willing:  "It would seem that even with Canada's entirely public system there remain  opportunities for supplementing the gov. -provided baseline with insurance."   I'm not sure I'd call it opportunities here - no opportunity whatsoever until they figure out how to do it without compromising the holy grail of equal access for all.  I support that premise to a great degree - sure wish all the money that's been poured into studying a solution would actually come up with one.



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I knew I was stirring the pot with my comment, but I wasn't being facetious (I'll trust your spelling, because I don't know!) and I was certainly not implying that Canadians are stupid. Au contraire! I just wanted to get your thoughts on the subject as a respected intellect and as a real Canadian.

This is a very difficult issue dealing with our humane desires and our practical limitations. RGlass is correct about the lack of control of our borders. I wonder what would happen with govt funded healthcare system and its limitations. In Canada you say that people who are in the country illegally are deported. In the US, it is official policy not to even try to do this other than when illegals are apprehended in serious criminal activity. There is an official "don't ask, don't tell" policy for the most part concerning residency status.

I have noticed that many countries with active government support of helathcare, etc. also have strictly enforced immigration policies, as seems sensible. Just try to live in Switzerland, or most any european country, without documentaton. I get the feeling it just doesn't happen.

It seems that people in the US want it both ways. They want the government to be the nanny providing for all needs, but they don't want the sensible discipline that needs to come with that.

I just hope the politicians quit playing this issue as a political football and get serious about what is best for the US.
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