Tuesday, August 21, 2007

Paging Micheal Moore...

Buried lede of an article about the Canadian Quintuplets

The Jepps drove 325 miles to Great Falls for the births because hospitals in Calgary were at capacity, Key said.

That the family had to drive to (population: 56,690) Great Falls, Montana because all of the hospitals in (population: 1,019,942) Calgary, Alberta were full does not make me excited about Canada's much-praised nationalized healthcare.

To me it begs the question, if we were to get nationalized healthcare, where would the Canadians go when they REALLY needed something...



Joel Monka said...

That same question was asked in the short video clip I posted
about trying to get treatment for a brain tumor in Canada.

Chalicechick said...

Yeah, my impression is that nationalized health care is like having Kaiser. It's great on the minor preventative care stuff, but if you get something serious, you better hope that either you're gifted at cutting through red tape or you can afford to go someplace else.

alkali said...

Two points:

1. I understand that the Canadian government paid for the treatment in Great Falls.

2. I understand that new NICU units are being built in Calgary now. Temporary lack of capacity happens in any system.

The upshot of all this is that while the Canadian health care system may be good or bad, the anecdote doesn't prove much.

hafidha sofia said...

One of the strongest points made by Sicko (and I've watched that movie with a religious conservative who is a nurse and she paints an even darker picture of the American health care system) is that the American health care system isn't broken. It's working exactly the way it was designed to work.

Comrade Kevin said...

Baseline coverage is what we need here, in my opinion.

But yes, in my experience with the NHS in the UK--anyone who can afford to get private for-pay coverage does so.

I'll give you an example using Medicaid. Medicaid will only coverage a month's worth of prescription drugs at a time. Many drugs require a Patient Authorization. As a cost-cutting method, Medicaid forces a doctor to go to extra effort to insist that a patient be prescribed a particular medication if there is a lower-cost alternative medicine available.

In addition, it's damn near impossible to find a psychologist who will take Medicaid because it pays at such a low rate. And often times, when finances are in the red, it pays out exceptionally late which is why a lot of therapist have refused to take it.

UUbuntu said...

In response to your last question (I assume it wasn't intended as rhetoric), where would Canadians go when they REALLY needed something: If the US adopted a Canadian-style system (which we will NEVER do), Canadians would create a system that would meet those needs, rather than rely on US hospitals to handle their "overflow" on unusual situations (and quintuplets are certainly unusual). Where Canadians go when they REALLY need something would not be a major factor in my considering ways to improve America's health care system.

I would like to reinforce hafigha sofia's point (which was also Moore's point) in that the US health care system works *exactly* as it's designed to do. It rations health care on the basis of money rather than need, and it views health care as a privilege rather than a right. And for many Americans (and all American libertarians), this *is* the proper priority, and that more of our lives (e.g., education) should be viewed in this manner, and should be handled in a for-profit manner.

That the US won't adopt a Canadian (or French) health care system has nothing to do with efficiency or public good. Rather, Americans prefer to equate morality and deservedness with wealth, and to distribute services accordingly. When Moore makes the point that we don't run fire departments or educational services in this manner, he doesn't point out that many Americans believe that THOSE services are the ones that need privatization, rather than the changing of currently privately-run services like health care.

kimc said...

The system in UK is quite different from the one in Canada. the UK actually has "socialized medicine" -- where the government runs/owns health care (It works fine for our Veterans Administration, which is also this system.). In Canada, the health care is private, only the money part("insurance") is the government.
No one mentions New Zealand's system, but I think it might be a good compromise for Americans who have an excess of individualism: Outpatient medicine is like our current system, but if you need to go into the hospital, the government pays ALL of the bill. They have both private and public hospitals, I believe.
But, just because Canada's system isn't perfect, is not a reason to reject that type of system: 1. It's still a lot better than what we have now-- measurable outcomes show that. And, 2. Why couldn't we do better if you think it's so badly run? Have you no faith in Americans?

Tony said...

The story you relate about the Canadian couple highlights the two components often confused and misunderstood when discussing a U.S. Single-Payer health care system: payment and delivery (no pun intended).

The U.S. has the best health care delivery system in the world, however that care is delivered on a privilege system based on ability to pay.

A national single payer system wouldn't have to change the delivery system, only they payment system and who pays (and how). In a sense it would be a best of both worlds scenario. It would however mean taking on the HMOs and the Drug Companies.

People assume that changing the way we pay for health care means that we would start rationing delivery of health care and that's unfounded.

The bulk of health care costs get eaten up in administrative middle management costs and advertising. Eliminating the competitive advertising and repetitive middle management costs would dramatically lower costs.

Delivery can continue more or less just as it is, what would change is that everyone's insurance carrier would be the government. Remember that our U.S. model would not be exactly like any other existing model.

Chalicechick said...


Do you think that the fact that right now delivery is so profitable has something to do with the current mode of payment?


Tony said...

I'd love to hear from UU physicians n this one. The physicians I know relate that the people making the big money from the current delivery system are the insurance companies. Physicians offices would welcome, so I am led to believe dealing with fewer insurance carriers as it actually cuts into the money their office makes, eating up large administrative costs, which the insurance companies and the doctors pass onto us the patient/consumer and has little to with the actual cost of care. One of the most expensive parts of the current system is "coverage tracking" or keeping track of what is and is not covered by the insurance provider's plan or various plans. The doctors I know hate this as much or more than their patients as it gets in the way not only of providing care, but also of running a smooth office.

You're correct that the current delivery system is profitable, but for the insurance companies and drug companies. For example,

"It is important to note that drug companies’ profits are higher than all other industrial sectors. In fact, drug company profits are four times the average of the Forbes 500 companies, and the salaries of top CEOs averages $19 million, exclusive of unexercised stock options. Drug companies are spending twice as much on marketing, advertising and administration as on research, and in many cases they are profiting from research that was done at taxpayer expense. Intense marketing has been cited as a factor in the overuse of prescriptions that is inflating the costs of health care"
(Dr. Jill Stein's Call for a New Direction for Health Care - campaign position paper 2002).