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Two health care cost headlines
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Two health care cost headlines

Some things to ponder -

My ipad is set up for the daily CNN updates and today's breaking news was "one in three Americans in favor of the Supreme Court  overturning the 2010 health care package."  This headline doesn't speak to the 2 in 3 Americans who favor health care reform.

And then this was in my email this morning and covers a topic we kick around here quite a bit ....the difference in health care costs in the US compared to other countries.  The numbers speak loudly and here is just one example given :

"Daily charges for a hospital stay range from $236 a day in India to average of $3,949 in the United States – and as much as $11,496. Chile is the second-most expensive country, with charges running $1,552."

You can read more at this link:

http://www.medpagetoday.com/GarySchwitzer/31555

The juxtaposition of these two news bits provide quite the look at our health care system in the U.S.



Related Discussions
21 Comments Post a Comment
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This is interesting.  I do have to say though, that $236 in India is probably worth more than $3,949 in the US.  On the other hand, I'm in Italy and my recent week in the hospital didn't cost me a dime.  But, anyone who doesn't want to wait months for tests that they need, etc, has to go "private" and pay out of pocket.  I guess there is no perfect system in the end.  

Another thing that I thought was interesting is that a friend of mine with MS (who is not in favor of the new healthcare package) said that it will cost 4 times more for pwMS and that she won't be able to afford it even if coverage is guaranteed not to be denied.  Is this true?
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This topic is front burner now that the Supreme Court has taken up the constitutionality of the 2010 health care reform law.I saw a statistic this morning that said 51% of Americans are not in favor of the law, specifically the mandate that everyone has to buy health insurance.

I'm not a big fan of government telling me what to do. This includes mandating that I buy health care. If insurers are guaranteed a customer base where is there incentive to provide quality coverage? I am of the opinion that this law smacks of socialized medicine.

I don't want socialized medicine. When you pay nothing for something, you get what you pay for. I had my hip replaced 3 years ago. I got to pic the doctor who replaced it and when it was replaced. On forums like this, related to hip replacement, people in countries with socialized medicine, like Canada or England, were waiting 6-9 months to see a doctor the government picked and another 6 months for the surgery.

The same is true with my MS. I want to pick my doctor. And I want to pick when I see my doctor. I don't want the government dictating any aspect of my medical care!

Just one man's opinion.

Kyle
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2034625_tn?1392646892
Having been on both sides (being an American in Italy) I totally agree.  My father-in-law recently needed a colonoscopy and the waiting time was 13 months (!).  Even if it would have only cost about $40, waiting so long was not an option.  Had he not been able to afford having the exam outside of the national health system, he would not have had any choice.  

There is something to be said for an "open" system and private healthcare.  It should, however, be more accessible/affordable in my opinion.  An overhaul of the american nhs is overdue, but I can't see how making someone with a chronic illness such as MS pay 4 times as much as everyone else can actually be helpful to those who really need it.  (IS this true??)  

Furthermore, I know that when I need a test it drives me nuts to wait more than a  month or so.  :)

Laura
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382218_tn?1341185087
I encourage Americans to be skeptical of what their politicians claim about health care in Canada, particularly those politicians who are opposed to health care reform.  They usually get it wrong.

I have familly members who have had hip and knee replacements who did not wait nearly as long as those timeframes you mention, Kyle, though I appreciate some patients probably do.

In terms of my own situation, I had a MRI within a couple of weeks of my onslaught of symptoms, saw an on-call neuro a week or so after that, had my LP the same day it was ordered, results back the next day, and under the care of a MS specialist a few weeks later.

I had my pick of neuros: one I had seen a year earlier, two different ones I saw in hospital, or the guy I picked at a world class teaching facility.  The "government" does NOT pick our physicians!

My DMDs cost me nothing because the govt plan and my private, employer-benefit  supplemental plans are linked.  If I didn't have employer benefits, the most I'd pay is $30/month co-pay and nominal premiums which off the top of my head I can't recall as I haven't been billed in a while.

The truth is that despite the fact that Canada guarantees access to medically necessary services, in reality we actually do have somewhat of a two tier system.  There are many private practitioners one can see if one wants to speed things up and has the money to pay.  My employer, for example, pays to send employees for private MRIs on a day's notice, if that can expeditite an employee's recovery and ensure a speedier return to work.

In Canada, medical decisions are made by physicians and their patients.  Unlike is the case with many insurers in the U.S., the 'government' does not, I repeat does NOT dictate the physicians we see, the medications we may take, the diagnostic tests that may be run, etc.  

Every single medical decision made in my case was made by me in conjunction with my GP and specialists.  By being an informed patient, I have steered my care in the direction I need it to go with the support of my physicians.

One last anecdote: last week I realized I'd better get a mammogram to check something out.  Called a clinic which specializes in this and could have been seen in a few days, but as it is out of town I booked it for a week later.  Was told because it ismy first visit, I need a GP referra; after that can book directly.  Got in to see my GP the next  day, got the referral.  He authorized the mammogram and ultrasound and any other procedure they may need to do as a result, eg: biopsy.  The clinic told me anything they may need to do subsequent to the mammogram and ultrasound will be done the same day.  All of this will cost me exactly zero dollars.  And the government has nothing to do with it, except to pay the bills.

Canadians are occasionally polled on satisfaction with our health care system and despite it's problems, the majority consistently report that they are satisfied and don't want to lose it.

I'm not saying what works for Canada will work for the U.S.  I am saying that much of what is said about Canadian health care in the US media and by US politicians is at best erroneous and at worst, blatant scare tactics.

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This op-ed in the Denver Post does a good job of clarifying facts.

Debunking Canadian health care myths
06/07/2009  
By Rhonda Hackett

As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one.

Often I'll avoid answering, regardless of the questioner's nationality. To choose one or the other system usually translates into a heated discussion of each one's merits, pitfalls, and an intense recitation of commonly cited statistical comparisons of the two systems.

Because if the only way we compared the two systems was with statistics, there is a clear victor. It is becoming increasingly more difficult to dispute the fact that Canada spends less money on health care to get better outcomes.

Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took office, with Americans either dreading or hoping for the dawn of a single-payer health care system. Opponents of such a system cite Canada as the best example of what not to do, while proponents laud that very same Canadian system as the answer to all of America's health care problems. Frankly, both sides often get things wrong when trotting out Canada to further their respective arguments.

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada's health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada's government decides who gets health care and when they get it.While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost.


Stay tuned for part 2:

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Part 2:


Myth: There are long waits for care, which compromise access to care.There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.Princeton University health economist Uwe Reinhardt says single-payer systems are not "socialized medicine" but "social insurance" systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren't enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

And these are just some of the myths about the Canadian health care system. While emulating the Canadian system will likely not fix U.S. health care, it probably isn't the big bad "socialist" bogeyman it has been made out to be.

It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty — who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care — will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.

Rhonda Hackett of Castle Rock is a clinical psychologist.


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488198_tn?1390241348
Could you please not cut and paste full copyrighted articles?

Because the government in Canada, Italy, wherever pays for whatever level of health care, if you pay taxes or spend money at businesses that pay taxes, you paid for that health care.

“I'm in Italy and my recent week in the hospital didn't cost me a dime.” … “My DMDs cost me nothing.” … “All of this will cost me exactly zero dollars.”  Wrong. There is no free ride.

The U.S. system isn’t perfect, and it may not even be the best, but it gives everybody a chance to live and to live well.
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382218_tn?1341185087
Of course you are correct, I should have clarified that I did not have to pay out of pocket for my medical procedures, DMDs and other services.  I have pointed out several times in previous posts that we do pay for our health care in Canada through our taxes and I and most Canadians accept that, as we benefit from the value of services provided.

Please don't be defensive, as this is not an attack on the US, my intent is to clear up the multitude of ridiculous misconceptions re: Canada's health care system.

Feel free to report to Medhelp my post of the above article, and I'm sure they will remove it for you.
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738075_tn?1330579444
My husband and I have seriously considered moving to Canada or France or even Hungary (where his parents are from) specifically for single payer healthcare.

Yes, I get to see the MDs I want, and get quick referrals, but at what cost?  My premiums are $672/month!!!  That's right - you read that right!!  And the older I get, the more expensive it gets.

Oh, and thanks for that article, DV.  That was great, and I'll refer my friends to the link!

Some folks might say, "Mind the door-@ss interface", when I talk about this, but I'm serious!
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2034625_tn?1392646892
Woah.. Maybe I was misunderstood, but saying my stay in the hospital didn't cost me a dime thanks to nhs was followed by the was followed by the statement that to get non emergency tests done there is a very long wait or to pay out of pocket for which I don't believe you can even buy private health insurance. I was in no way intending to criticize the US, just stating that I dont think national healthcare is as good as it sounds, having actually been on BOTH sides.

Another thing that no one has answered is the cost of the new plan. The way I understand it, the care will not be as good as priate insurance and it will still come at a substantial monthly cost to those with a chronic illness. How is this better? In this way, I don't think it can be compared to the plan in Italy/Canada, etc which are paid for by -yes- taxes.  Even here in Italy though, non emergency healthcare does have a "copay" of sorts.
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As a Canadian, I agree with Doublevision.

I remember when my son was born at 31 weeks.  He was in the NICU for 5 weeks.  For the first week he was on 1 : 1 care from a nurse.  For the remainder of his time in the hospital it was 2 : 1 (2 babies per nurse).  I remember reading on the internet of other women in my situation with premature babies but, some of these women were not only praying their babies would live but also wondering how they would pay for their babies stay in the NICU.  I can't imagine that stress.

I think the Canadian healthcare system is amazing.  It has some "bugs" but overall I feel very, very lucky to have this system to support my family and I (regardless of the taxes my husband pays).  But I suppose we are all patriotic and will support the healthcare system in the country in which we live and I don't mean any disrespect to any healthcare system.
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The link to that opinion piece is below. Note the comments following the piece, many of which strongly take issue with the author.

From 10/8 at 11:49 a.m., about the fifth comment as they appear to me, “As a U.S. citizen living in Canada for the past year and a half, this person is full of it.”

From 10/7 at 6:16 p.m., “This might be the most worthless article I have ever read. A Canadian living in the U.S. for 17 years talking about Canandian wonders. If it is all that great move back and stop taking my doctors time.”

http://www.denverpost.com/recommended/ci_12523427

My perceived defensiveness is more for the rights of writers (such as myself) and publishers, and just irritation by the ill-conceived thread. I’m not worried about an “attack on the US” or its healthcare system from Canadians. And yes, I may have misunderstood something dogmum wrote. That said, I would love to see this health care “reform” shot down by the Supreme Court.
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This topic is front center all over America this week and I have to take exception that this is an ill-conceived thread. As with every other thread here, if it is found to be one that someone doesn't feel good about joining in on, then maybe it should just be passed over without commenting.

I hope that this is a bigger idea that can be discussed here without causing hard feelings or anyone feeling they have to draw sides.  There is enough polarization in this debate going on in our political, judicial and news arenas.

We often get questions about the costs of procedures and the referenced article has the link to the report prepared by the International Federation of Health Providers in clearly displayed graph form.

http://www.ifhp.com/documents/2011iFHPPriceReportGraphs_version3.pdf

The experiences with insurance, health care and associated costs born by the people who are here and live in the US are all over the spectrum, from excellent private care to those people who are barely getting attention through the insurance offered with government assistance.

I do have excellent insurance and get the care I need and want, but I also worry if that were to change would I be able to find and then afford a health care policy for myself with two chronic diseases and my husband who also has his own list. I don't kid myself that if I found myself unemployed, I realize I could also be left uninsured, which would quickly deplete all of our retirement savings. There are people here who already experience this lack of coverage, and often do without other necessities to get medical care or their meds.

The article referenced  by DoubleVision appears to give credit to the writer, the date of publication and the source. I also included the attributions in my quotes. I am not sure what the problem is with that but anyone can always push the report button and the moderators will take a closer look.

I hope and trust  the Supreme Court will take all the arguments into consideration, put the politics and corporate interests aside, and come to a well  reasoned decision.  As with so many other disputes within our system, the Supreme  Court will make the ultimate decision and then the legislators on the losing side will go back to looking to enact changes in different ways that might meet the Court's approval.  It happens all the time, and surely that will be the same scenario this time, regardless of how the court rules.

Lulu


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900662_tn?1380159390
this is an outstanding thread.


We should always take  care  of those that truly need our help.


One way or another our  healthcare will change,  for better or worse ?
The G.A.O.  has now revised the cost of Obama care upwards by $700 billion and that with a $500 Billion in Medicare.
   The  Federal Government wants another tax, they have given it a cute  name V.A.T.  its a Value Added Tax,  really just nation sales tax.   It will start out small 2%maybe, just like income tax started out small..


Here's my take on few items as relates to the healthcare debate.

To our friends up North,  is  your the legal system abusing the medical system with frivolous lawsuits?  
Have you ever made a mistake at work?
All I'm saying get the lawyers the heck out of healthcare..


A lot of cost of medical in   our healthcare system is because of lawsuits,  there should be some sort of  legal reform with the healthcare.
  Let insurance companies provide insurance across state lines.


I'm sorry If you abused drugs and have  other abusive life styles don't expect me to help foot the bill for you,  when a truly needy persons are more deserving of the care..


To further illustrate my point about the legal system,  take a look at your step ladder,  look at how many warning labels are attached to the ladder,   and yet the ladder manufacturers  still gets sued.


Its not all that  Great up North,   the former Prime Minister of Canada Brian Mulroney's mother needed  heart surgery and was on awaiting list for six months in Canada ,  He brought his mother to the America and was seen & treated in less than five days.


They are cutting back on NHS in the UK, why?  the cost.....
I think a few limbo-ers could tell what its like to get a DX over there & the difficulties in obtaining DMD'S..

I'm not for Obama care, I do understand we need some changes to improve our system.



This is my two cents worth.   I hope we are all still friends....


take care
JB....

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2078115_tn?1333930165
I too feel extremely fortunate to live in Canada in light of my relatively recent, and very expensive health care concerns. Prior to my diagnosis, I realize now that I had taken our health care system for granted (as most healthy people do)

And thank you for posting that article, DV. I remember some time ago, I watched a 20/20 John Stossel "special" on Canadian health care... and lets just say that as my mother and I were watching it, we kept asking ourselves "what country's health care system is he talking about?" The blatant misrepresentations and exaggerations were laughable. It may not be perfect, but it's good enough for me. And I'd like to think I have high standards when it comes to my health!
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I agree with Dianna.  I did not appreciate the level of our health care services until I needed them.  

I am curious though, in Canada, no matter what your income level you receive the same health care and even without insurance, you will still receive drug coverage but what happens in the US if you need a DMD and don't have insurance?  I mean for the people that have reasonable jobs but no insurance?  Does anyone help pay for the drugs (or MRI or whatever) or is it a matter of choosing DMDs or rent type of situation?
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I think this is a very timely post.  Whatever our views may be, it's something that anyone who will be effected by this in the future should be interested in and concerned about.  Thanks, Lulu!
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What I have heard others say here is that when they can't afford DMDs the drug companies supply them free or at nominal charge.  I don't know what the process is, maybe someone who has been through it could explain.  

As for MRI, those that have spoken about their insurer denying MRIs or approving brain but not c-spine, etc, or approving the MRI but not with contrast, is that people pay out of pocket or go without.  I have a friend who has insurance which covered part of the cost but she still had to pay a few thousand dollars.  So she hasn't had one in a few years.

It was actually surprising to me that my DMD is covered by the province even though I have supplemental employer insurance and can afford what would have been the monthly co-pay of $160.  But as you know, MS drugs are included in the special program of govt covered drugs, not just in Alberta but in all provinces.  So coverage is universal and not based on ability to pay which is not true for most prescription meds.  I do wonder about the future of such programs in Canada and if they are feasible and sustainable in the long run.  I hope so, at the very least for those who could not otherwise afford them.


Also just an observation - not to start a controversy! - about contraception coverage.  We're aware of the debate happening in the US re: a govt mandate for insurers to provide birth control pills to all, free of charge.  This discussion is a little surprising to me, given that the Canada Health Act has no such mandate.  Canadian patients pay out of pocket, or may have (non-mandated) supplemental coverage through an employer or other group plan, or do what I did, get them free from their physician.  My GP gave them to me for years.  They were samples she got from the drug companies.  Given the controversy about health care reform in the U.S. I do wonder what the dialogue would be had this mandate on contraception coverage be excluded from the program.  I would say that it might be an easier pill to swallow, but that would be a terribly bad pun. :)
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I'm all for healthcare reform. I'm a Brit living in the states. I'll admit the US is more plush when it comes to healthcare. You get your own room in the hospital!! I have had several MRIs done and within a few days. I've never had a MRI done in the UK but can't imagine it would be that long a wait.

Interestingly everyone is saying that they would have to wait in canada or the UK but my symptoms started in Dec and I had to wait a shocking 5 weeks to see a neuro at the end of Jan, LP not till march and my next meeting not till the middle of April. So even though I know its 99% MS no Dx for me yet. I would like to point out that Mummy76 and I started this Journey around the same time. Mummy76 is already Dx and just waiting to start a DMD, Mummy76 is living in Canada and me the states. Seems canada is not slower to me. I think there is a girl from the UK here too that got ON around the same time I got my numbness and shes Dx too. I'm still waiting and I have pretty good healthcare here.

I fear getting Dx with MS, having a pre existing condition and losing my job and insurance. To ease my mind I always say to my husband..... its ok, we can run back to the UK. :)

People need healthcare and the US system stops some people from getting the help they need because of cost. I support health care reform.  
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To respond to johnniebear's question, no, frivolous lawsuits are not a major issue in Canada, and generally the non-frivolous ones that go forward do not garner the huge awards that one hears about in the US.  I don't know all the ins and outs of it but this issue of malpractice coverage for physicians driving up costs does seem to be a concern....is this accounted for in the current health care reform legislation?  Not hearing much about it lately.

With respect to the comment about our former PMs mother, I don't know the details of that case, but if true, two things come to my mind: first, whatever this surgery was, it must not have been deemed urgent or she wouldn't be waiting at six months; and second, it is very nice to know our system does not let those with influence, money and power jump the queue ahead of low-and middle-income Canadians.  

Personally though, I have not heard of six month waits for heart surgery in Canada.  The current wait time for scheduled (non-urgent) coronory bypass surgery in Calgary is 6 weeks; for urgent, 1.1 weeks.  Also 1 week for urgent surgical intervention of brain and spinal cord conditions.  My mother had double bypass surgery in Vancouver within a couple of weeks of the initial referral, came through it with flying colours, and has had excellent follow up care.  She's on a fixed income and could never have afforded the surgery, or premiums on private insurance.




As I've already stated, I'm not saying that what works for Canada is right for the US.  But it isn't helpful for lies in the form of scare tactics to be perpetuated to support a particular political agenda.  

If readers wish to take away anything from this discussion about the Canadian system, please understand this:

1. The government  does not 'run' our single-payer health care system; it sets basic parameters as per the Canada Health Act (eg: universality, portability, accessibility, etc) and pays for it from taxes levied on citizens.

2. Universal health care in Canada is not 'socialized' medicine; Canada's system is not the same as the NHS or other European countries.  Doctors do NOT work for the government; most are self-employed.

3. The government does NOT NOT NOT pick our doctors.

4. The government does NOT dictate any aspect of one's medical care.

5. Medical decisions are made solely between doctors and patients.


Anything said to the contrary is simply not true.  

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Hi everyone -

We just wanted to clarify our rules for posting articles, etc. As long as proper credit is given, we allow it. We would, however, suggest checking the other site's Copyright policies. Several sites allow for readers to reference their material as long as credit is given, but many don't.

We typically don't allow political posts, but since this is an important time for healthcare, and it pertains to MS treatments, even indirectly, we will allow it.  Just make sure it doesn't get into a debate about candidates, political parties, and the like.

Thanks!

Emily
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