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 Need a Canadian Perspective 
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Chibi-Czar
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Post Need a Canadian Perspective
[x-post Excelsior]

First read this: Canadian Health Care We So Envy Lies In Ruins, Its Architect Admits

Then, riddle me this:

Are the core claims in the op-ed right or wrong? To what extent are the claims right or wrong and where and how do the claims differ from your experiences? Why or why not?

"Single-payer insurance" (or "government-sponsored healthcare" or "socialized medicine", depending on who's buying your drinks) is already a big issue down here. If we do buy in, I don't want us buying an Edsel...

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Thu Jun 26, 2008 9:39 pm
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Post Re: Need a Canadian Perspective
Right away, I can spot the big point I'd disagree with, and the main thing I would counteract with:

This article is stating there are doctor, nurse and equipment shortages. This I agree with. However, it goes to say that these are the result of universal health-care without considering a number of other factors...the biggest being staffing.

Simply put: Canadian Health Care professionals are going to the US because the money is better there.

Not wildly in some cases, but for some specialists, the pay can be staggeringly different. This is why Alberta and some of the other provinces are kicking around the idea of a private/public mix, and/or the opening of private healthcare systems to coexist along with the famous/infamous Canada Health Care System. It's not that it doesn't work..it's just that when people look at the costs of a Visa and are told they can make an extra 30k a year...well...hell...even I could handle visiting Calgary instead of living here for that much.

Pay the doctors, nurses and specialists more...and they'll stay. Of course...can we do that on the public dime? Capitalism down south of the border might make it impossible to compete, and when people can "sometimes get by" with jetting to the States to get access to the care they need, it may work in the current state for quite some time until the government starts looking at the cost and has to make a choice between ponying up the cash locally...or just cutting off that option for citizens.

My recommendations generally centre around a healthy balance but this is something that could hurt a lot of people and/or piss off a lot of nurses and doctors when you tell them they either have to stay in Canada, and/or cannot make as much money as their peeps down south. With Senie in the healthcare industry, she's told me that throwing more money at the problem likely wouldn't fix it. It's the system itself that is destined to fail in its current decline, and despite my optimism I'd have to agree. I think we may see a continued move to a hybrid system, and depending on how it's implemented, it may actually work.

Not sure what to suggest here, only that the article is over inflating the severity. We've known our system needs tweaking for a long time now. But really, all it's saying is "Canada's system isn't perfect, so why are we trying to emulate it?" without thinking "Why not emulate the parts that work?" It's basically just trying to cash in on the politics for some extra readers.

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Fri Jun 27, 2008 10:39 pm
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Post Re: Need a Canadian Perspective
Posted my thoughts on Excelsior, mostly pointing out that the system's been collapsing for years. But, Fiss made a point I want to address.

Christopher Fiss wrote:
Canadian Health Care professionals are going to the US because the money is better there.


Exactly. Capitalism increases wealth, socialism decreases wealth. Everyone gets the same thing in socialism (except the rulers, who get the best of everything, c.f. Trudeau, Mulroney, and the Mayo Clinic)- but if you can't pay for it, everybody gets nothing. Capitalism is unequal, but it works better than socialism. No, I get it. It's "not fair," it "hurts the poor," I don't care. It works better. That's why they have more doctors than we do, and will continue to do so. And so the unfair, poor-hurting system is able to provide the poor with more doctors than the fair, poor-helping system.

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Tue Jul 01, 2008 9:07 am
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Post Re: Need a Canadian Perspective
Exactly. I like the ideas of socialism because they work well to fill in the gaps of capitalism, but unless it's managed perfectly, the two systems cause pain for each other...and I'd personally rather see 100% capitalism than 100% Socialism.

Of course, no country in North America actually runs with 100% capitalism, anyway, so it's not a matter of trashing the systems...it's a matter of getting them to play nice. (if that's possible) Or, we keep seeing waste in money, organization, and time like we're seeing now...not to mention the lack of quality and health.

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Tue Jul 01, 2008 3:44 pm
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Post Re: Need a Canadian Perspective
Suddenly our 7 hour waits for T3's don't sound so bad...

NYC - Patient already in hospital dies after 1 hour of neglect

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Tue Jul 01, 2008 9:21 pm
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Post Re: Need a Canadian Perspective
Albeit a bit late, the scary part is that Kings County Hospital is a public hospital - i.e., run by government.

Now, I am not such a fool as to automatically assume that anybody would've given more of a rusty f-word at a privately funded charity hospital... But I am not at all sure that the neglect at such an institution would be any worse - And, if there's one thing that twenty years of Civil Service has taught me, it's that excellence is ignored, incompetence is salvaged, and mediocrity is the key to success (which is why I've never been promoted beyond "Lead" to a Supervisory position... Reverse snobbery in action, I wear my glass ceiling as a badge of honor :P )

But, since we seem hellbent on ignoring our century's worth of collective empirical experiences with Civil Service bureaucracy, what does anybody suggest as a safeguard?

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Mon Jul 07, 2008 9:52 pm
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Post Re: Need a Canadian Perspective
Michael J Doyle wrote:
what does anybody suggest as a safeguard?


GUNS EVERYWHERE.
What was the question? *reads*
Oh. Uh... yep! GUNS EVERYWHERE.

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Tue Jul 08, 2008 4:27 pm
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Post Re: Need a Canadian Perspective
Alrhough I will admit to a certain personal fondness for the concept of a battle rifle in every closet, in the matter at hand, I'd like a few safeguards that do not entail armed revolution as our first response - that's "Plan Aw, Fukkit!" Got a Plan A, B, or C that we can try using before we get to Aw, Fukkit?

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"Charlie was a policeman, Nick-san. If you steal, you disgrace him. And me. And yourself..."

"Tough times don't last. Tough people do."

"You have the rest of your life to solve your problems. How long you live depends on how well you do it."

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Thu Jul 10, 2008 12:36 am
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Post Re: Need a Canadian Perspective
Plan A) Tax private healthcare services and use the funds to assist with the bare-bones critical universal healthcare system. Negitives: Companies bitch about high taxes, may move elsewhere. However, companies are not as mobile as people, and keeping people turns into a company problem, not the governments.

Plan B) Treat Private Healthcare as a Government Contract style deal. Make healthcare systems fight for the dollars. Less government spending on administration, and in theory, we use the capitalist system to the advantage of everyone's health. Possible downfalls include what happens with any long-term contract...laziness and monopoly. Also depending on the region/company, you may get grossly disproportionate service depending on where you are.

Plan C) Abolish private healthcare. Drastic but it would work. The problem is then we put all our eggs in the government's basket, and neither the US or Canada have proven their governments are ready for that kind of responsibility. Also, you'd have to then sponsor doctors and health care professionals in such a way that they'd WANT to stay. Maybe...free training in exchange for X number of years?


Thoughts?

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Thu Jul 10, 2008 4:12 pm
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Post Re: Need a Canadian Perspective
All three of those are "Mister Government, do something!" solutions. I prefer free-market ones that don't involve me paying for bureaucrats to do something.

Let's see.

1) Let the market decide.

In America, you can offer state-funded health care are you like! If your state votes for it, go for it. But there's a difference between that and nationalized health care, which is what the Clinton/Obama crowd are aiming for as carefully and quietly as they can.

Canada has laws, depending on the area, making it illegal to accept payments directly from patients. There are definitely laws against charging what the market will bear. Why? Because for some reason Canadians are absolutely sure that if doctors are allowed to charge what they're worth, the poor will immediately drop dead of plague and all medicines will cost 1 BAJILLIION dollars.

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Fri Jul 11, 2008 2:54 pm
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Post Re: Need a Canadian Perspective
Doctors wouldn't charge a BRAZILLION DOLLARS but Companies would. Direct payments to doctors would be fine...except that the payments EASILY jump past the point of "I have a few bucks left in my chequing account" to "oh shit, unless I have insurance I can't pay for this".

I have nothing against doctors making an honest living...they SHOULD be paid well and most of them go above and beyond what most people need to do in their daily lines of work just to stay current. Many props, and that's why my plans mention the danger of pissing them off...we're already doing that enough and they're leaving, not just to the USA, but all over the world wherever they're apreciated more, or given freedom to make the money they want.

However, if you give that kind of freedom to the medical companies... my God... have you thought this one through? When was the last time you'd trust your wallet with Faceless-Pharma-Corp? Governments answer to the voters, as flawed and slow as that process is...it's better than Corporations answering to only their stock-holders. There are plenty of companies that would follow the market and not shiv people in the kidneys for their wallets. But there are always a few that will take every. single. penny they can get. That's why the government has to step in to pretty much every modern capitalist system.

One of the suposed tennants of Government is to provide health and safety resources to The People, so I don't consider Plan A or B needlessly mired in government...it's doing what it's supposed to do and placing the bulk of the logistics on the private sector. I assume plan C is more what you're attacking...and I agree it would be hopelessly bloated without an overhaul to our governments first. But that's why it was Plan C, wasn't it?

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Wed Jul 16, 2008 8:47 am
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Post Re: Need a Canadian Perspective
Yeah, I'm going to go ahead and quote Chesterton here;

"Big business and socialism are very much alike... especially big business."

So you're saying that instead of leaving the decision to the free market, ruled by faceless corporations who care only about money, we should leave the decision to government, ruled by faceless bureaucrats who care only about power. Best improvement ever. PROTIP: My sister is a doctor considering setting up a private clinic in Alberta. If the laws were totally fscked regarding billing, she wouldn't hesitate- as it is, she has to weigh a lot of financial questions. I know whereof I speak.

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Wed Jul 16, 2008 3:59 pm
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Post Re: Need a Canadian Perspective
You're going to get the "big ol faceless bad guy" anyway you roll the dice. It really comes down to accountability. When the system breaks: who's going to fix it? Who...and this is important...has to fix it?

"Mr CEO, Mr CEO! Our customers are complaining!"
"Oh? Well, what are our earnings like this quarter?"
"Uhm...they're record breaking, sir."
"Golly gee, then I guess we're doing something right. People vote with their money, right?"

Good thing all those companies listen to the plight of the common man, woman and child, or they would still be dumping plainly toxic and human-killing chemicals into our water supply, forcing their workers to work in dangerous and sub-standard conditions, and benefit from cheap international labour where governments are lax about working and environmental laws.

Oh...wait! They AREN'T listening to the plight of the common person, and if it wasn't for the fact they lose money via fines (and even then, sometimes they take that calculation into consideration) they keep doing all that!

<grins> Here's an idea...next time you dial 9-1-1...and get some dude in an Indian Call Centre asking if you've rebooted your heart when you're calling in for a stroke-in-progress...you can thank the Almighty Dollar for running things so efficiently and smoothly. </chuckles>

I vote for Plan B. Make it a Contract to Provide Services to the Public. I DO agree the "crown corps" lose money and suck ass, so we NEED the capitalist edge of a good, solid, reputable company. GOOD companies are more than possible, driven to innovate, and have done amazing things EVEN WHEN WORKING FOR AND WITH THE GOVERNMENT. (shock! gasp!) However, to leave it unchecked means you have a ticking time-bomb in place of the slowly dying hamster running on the wheel powering your health care system. The bomb is shiny, and it will work for a while, but unless it has checks and balances not based in money, the people will suffer needlessly. Not only that, but Plan B still lets the market have a say.

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Wed Jul 16, 2008 10:36 pm
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Post Re: Need a Canadian Perspective
Christopher Fiss wrote:
They AREN'T listening to the plight of the common person


And the government is famous for that. Right.

Well, I'm done. Have fun.

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Thu Jul 17, 2008 1:13 pm
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Post Re: Need a Canadian Perspective
<shrugs> Just saying choose the lesser of evils.

-The Almighty Dollar

VS

-Politics

The alternative to both is everyone has to learn how to take care of their own bodies. :/ That's working even worse so far.

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Fri Jul 18, 2008 12:40 am
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Post Re: Need a Canadian Perspective
Digging up an old thread here just to say that the Canadian problem basically applies to us here in the UK as well.

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Tue Aug 05, 2008 7:53 pm
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Post Re: Need a Canadian Perspective
Any good hints/suggestions from the powers that be in the UK?

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Wed Aug 06, 2008 12:30 am
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