universal healthcare in the US - an analysis

[2dimes]

Danny went to Mount Sinai in Miami, a specialty heart center. They have just under 1,000 physicians on-faculty.

They have an Insurance search function: http://www.msmc.com/body.cfm?id=316

I did a quick check on different insurance programmes:

Accepts Medicaid (government poverty insurance): 90 physicians
Accepts Medicare (government elderly insurance): 139 physicians
Accepts UnitedHealth (largest U.S. insurance carrier): 153 physicians
Accepts CIGNA (2nd largest U.S. insurance carrier): 130 physicians
Accepts BlueCross/BlueShield (3rd largest U.S. insurance carrier): 154 physicians
Accepts No Insurance: 4 physicians
Accepts No New Patients: 2 physicians

As I have oft-said, "socialized" medicine can only work properly in a socialist state. I absolutely support socialized medicine but only if it is accompanied by the fist of the working class smashing the entire machinery of the democratic-capitalist state in tandem.
Either go all-in or go all-out. You can't start a camp fire in the middle of a swimming pool.

That said, the health programmes operated in Switzerland and Dutchland (as irritating as it is for me to say that) seem (to ol' Saxi) to do a far better job of it than, on the one extreme, the factory-hospitals of Canada and the UK and, on the other, propping high-quality for 90% at the sacrifice of the bottom 10% as in the US and Singapore.

Does that mean he had a choice of 4 of their physicians because they were the only ones that treated "no insurance" patients, becuase I didn't see Newficare on the list?

[saxitoxin]

Danny went to Mount Sinai in Miami, a specialty heart center. They have just under 1,000 physicians on-faculty.

They have an Insurance search function: http://www.msmc.com/body.cfm?id=316

I did a quick check on different insurance programmes:

Accepts Medicaid (government poverty insurance): 90 physicians
Accepts Medicare (government elderly insurance): 139 physicians
Accepts UnitedHealth (largest U.S. insurance carrier): 153 physicians
Accepts CIGNA (2nd largest U.S. insurance carrier): 130 physicians
Accepts BlueCross/BlueShield (3rd largest U.S. insurance carrier): 154 physicians
Accepts No Insurance: 4 physicians
Accepts No New Patients: 2 physicians

As I have oft-said, "socialized" medicine can only work properly in a socialist state. I absolutely support socialized medicine but only if it is accompanied by the fist of the working class smashing the entire machinery of the democratic-capitalist state in tandem.
Either go all-in or go all-out. You can't start a camp fire in the middle of a swimming pool.

That said, the health programmes operated in Switzerland and Dutchland (as irritating as it is for me to say that) seem (to ol' Saxi) to do a far better job of it than, on the one extreme, the factory-hospitals of Canada and the UK and, on the other, propping high-quality for 90% at the sacrifice of the bottom 10% as in the US and Singapore.

Does that mean he had a choice of 4 of their physicians because they were the only ones that treated "no insurance" patients, becuase I didn't see Newficare on the list?

Isn't Newfiecare a six-pack of Labatt and a reach-around in the back of a pick-up truck?

NO! I know it's not really.

"Accepts no insurance" means there are four physicians at Mount Sinai who will only treat you if you hand them a briefcase of $100 bills or a no-limit American Express card.

According to news accounts Danny's physician was Antonio Rosado, who is accepting new patients and will take anyone who has Aetna, Blue Shield, UHC, Cigna, HUMANA, Great West, AVMED, Beech Street or Medicare insurance programmes. That's almost every significant insurance programme in the U.S. In other words, any of the 92% of Americans who have insurance could see Dr. Rosado tomorrow if they wanted (probably not all at once), but the 8% of Americans who don't have insurance couldn't, nor could 99% of Canadians (Danny, of course, is part of that plutocratic 1% who can afford to jet to any hospital on the Earth).

http://www.msmc.com/body.cfm?xyzpdqabc= ... l&ref=3956

[Snorri1234]

I also have grandparents and family members who have been through with heart disease and cancer. They were all pleased by the quality of care.

Compared to what? I think the Thai food I get at restaurants here in Santa Barbara is delish. Then again, I've never been to Thailand.

So you import them prostitutes?

[saxitoxin]

I also have grandparents and family members who have been through with heart disease and cancer. They were all pleased by the quality of care.

Compared to what? I think the Thai food I get at restaurants here in Santa Barbara is delish. Then again, I've never been to Thailand.

So you import them prostitutes?

EXCUSE ME ... Uncle Saxi doesn't need to pay for sex. Just ask Serbia if you don't believe me.

[2dimes]

"Accepts no insurance" means there are four physicians at Mount Sinai who will only treat you if you hand them a briefcase of $100 bills or a no-limit American Express card.

I presume that's basically what he did. Though he would of course have submitted the reciepts upon arrival home.

[heavycola]

I think I know what you're saying but.. they won't have a US&A for Doctors to go to for better pay if it happens.

Post Of The Week

[nietzsche]

universal healthcare in Mexico - an update

IMSS --Mexican Institute for Social Security-- is broke. There is no money to pay next-year pensions. Riots to come. They would find a way to get out of that but it'll surely be a International Bank loan. More debt for our children ha!

And all for fucking lazy motherfuckers that retire at 49.

[mpjh]

Yeah, those 49 year-olds that retire and die 3 years later. Life expectancy in Mexico is not much beyond 50.

[Baron Von PWN]

I also have grandparents and family members who have been through with heart disease and cancer. They were all pleased by the quality of care.

Compared to what? I think the Thai food I get at restaurants here in Santa Barbara is delish. Then again, I've never been to Thailand.

it might not make economic sense to have such a professional

Yes, as I said, it's unfortunate when central economic efficiencies trump healing and care.

Even in a private system there wouldn't be a similar professional in Newfoundland, it simply isn't big enough to warrant it.

As compared to they would be dead if they didn't receive it? In a private system they would not have been able to afford the care.

[saxitoxin]

I also have grandparents and family members who have been through with heart disease and cancer. They were all pleased by the quality of care.

Compared to what? I think the Thai food I get at restaurants here in Santa Barbara is delish. Then again, I've never been to Thailand.

it might not make economic sense to have such a professional

Yes, as I said, it's unfortunate when central economic efficiencies trump healing and care.

Even in a private system there wouldn't be a similar professional in Newfoundland, it simply isn't big enough to warrant it.

Is the nation of Canada also not big enough to warrant it? I'm pretty sure any location in Canada - save perhaps Alert - is closer than Miami.

As compared to they would be dead if they didn't receive it? In a private system they would not have been able to afford the care.

You're 10% correct.

As noted above, Danny's physician accepts the insurance policies held by (roughly) 90% of the U.S. population. The failing in the U.S. system is the 10% who, as you noted, would not have been able to afford it at all. But giving first-class care to 90% of a population and no care at all to 10%, as in the US, is not ethically superior to giving first-class care to 1% of a population and second-class care in state factory-hospitals to 99%, as in Canada.

When one is part of a population whose leadership caste has chosen to deny that population access to the full spectrum of a physicians skills, while availing it of themselves, it's easiest to imagine Dr. Rosado was an exotic, rich-man's specialist caring for drug dealers and professional golfers in a private floor on the penthouse of the Columbia Records building.

But he wasn't. He was a decent, but ultimately run-of-the-mill, doctor performing a relatively common modern medical procedure at a hospital also treating construction workers, bookkeepers and firefighters. However, it's a procedure not easily available in Canada as it's not quite common enough to be calculable into the economies of scale for which actuaries in a centrally-managed system have to programme.

[Baron Von PWN]

I also have grandparents and family members who have been through with heart disease and cancer. They were all pleased by the quality of care.

Compared to what? I think the Thai food I get at restaurants here in Santa Barbara is delish. Then again, I've never been to Thailand.

it might not make economic sense to have such a professional

Yes, as I said, it's unfortunate when central economic efficiencies trump healing and care.

Even in a private system there wouldn't be a similar professional in Newfoundland, it simply isn't big enough to warrant it.

Is the nation of Canada also not big enough to warrant it? I'm pretty sure any location in Canada - save perhaps Alert - is closer than Miami.

As compared to they would be dead if they didn't receive it? In a private system they would not have been able to afford the care.

You're 10% correct.

As noted above, Danny's physician accepts the insurance policies held by (roughly) 90% of the U.S. population. The failing in the U.S. system is the 10% who, as you noted, would not have been able to afford it at all. But giving first-class care to 90% of a population and no care at all to 10%, as in the US, is not ethically superior to giving first-class care to 1% of a population and second-class care to 99%, as in Canada.

When one is part of a population whose leadership caste has chosen to deny that population access to the full spectrum of a physicians skills, while availing it of themselves, it's easiest to imagine Dr. Rosado was an exotic, rich-man's specialist caring for drug dealers and professional golfers in a private floor on the penthouse of the Columbia Records building.

But he wasn't. He was a decent, but ultimately run-of-the-mill, doctor performing a relatively common modern medical procedure at a hospital also treating construction workers, bookkeepers and firefighters. However, it's a procedure not easily available in Canada as it's not quite common enough to be calculable into the economies of scale for which actuaries in a centrally-managed system have to programme.

You're acting as if Canada has a two tier system, it does not. Within Canada everyone has access to the same doctors (baring geography).I don't know about you but leaving 10% with no support at all sounds worse than any two tier system. Danny Williams for whatever reason chose to leave the country for his health care,even though the procedure is available in Canada to anyone who needs it (in Edmonton, Montreal, Toronto, Ottawa ect). Point in fact my Grandfather received the same procedure last year (I decided to double check to be sure). It isn't available in Newfoundland probably due to the provinces small size (in terms of population) and limited resources. I'm sure there are places in the USA where the same procedure is not available.

The physisicians might accept the insurance but will the insurance companies pay? They might find pre-existing conditions or other nonsense.

[saxitoxin]

You're acting as if Canada has a two tier system, it does not.

When one segment of the population can afford to leave the country to access procedures not available within it, it has a de facto two-tier system, regardless of what is printed in statutes or pamphlets.

Within Canada everyone has access to the same doctors

Not only the same doctors, but the same procedures.

That would be a perfect system if all humans were automotonic clones of each other, or each human had the actuarial average of statistical health concerns.

I don't know about you but leaving 10% with no support at all sounds worse

It doesn't to me. It seems equally as bad as the factory-hospital system.

The way to equality in healthcare is not dragging everyone down to a lower level, it's elevating everyone up to the same level.

I can sympathize with Americans who don't want to be dragged down to the Canadian level to achieve parity.

Danny Williams for whatever reason chose to leave the country for his health care,

"whatever reason" is a cop-out

Given the known political risk he didn't leave the country because he had frequent flier miles he had to use before they expired.

Point in fact my Grandfather received the same procedure last year (I decided to double check to be sure). It isn't available in Newfoundland probably due to the provinces small size (in terms of population) and limited resources.

Surely Quebec is closer than Florida to Newfoundland?

It's tenuous to guess based on individual comparisons. We only know that (1) Danny took considerable political risk to have a relatively common medical procedure done outside Canada and (2) he stated he did not want to take shortcuts with his health.

Did he not want to be on a long waiting list at one of the factory-hospitals? Did his age not fit him into an actuarial table of allowed medical procedures? Were the physicians just not skilled enough as they've all gone to higher paying jobs south of the border?

The physisicians might accept the insurance but will the insurance companies pay?

Canada might offer medical treatment but what if a pack of grizzly bears attacked the hospital?

If insurance companies never paid, I feel safe in saying no one would buy insurance.

As hard as one might try, facts don't support the idea that Danny was accessing a rich man's doctor that isn't available to insured Americans. One is certainly allowed to imagine that, but it is not a fact-supported imagining. We do, however, know for a fact that the doctor who treated Danny is not available to the 99% of Canadians who can't afford to jet to the U.S. anytime they need a procedure on a timeframe or for reasons not factored into the centrally programmed actuarial table devised by a civil servant in Edmonton or Victoria or St. John's.

They might find pre-existing conditions or other nonsense.

Do you know the actual percent of claims, annually, that get rejected for pre-existing conditions?

Even though the legal and scientific hurdles for a company to reject a claim on pre-existing grounds are fairly high, it does happen. And even though it does happen at a very low percentage of gross claims, it is a failing of the American system.

But, for the majority of Americans who have never had a 6-month gap in insurance that would potentially put them into a disqualifying category for a pre-existing condition, why would they want their health care dragged down to factory-hospital level when they now have access to levels of care that Canadian politicians jet south to access?

I don't agree with either the U.S. or Canadian systems, but these are questions that need to be answered factually and without resorting to explanations of conspiracies or hyperinflated anecdotes and horror stories schilled by TV news.

[Baron Von PWN]

When one segment of the population can afford to leave the country to access procedures not available within it, it has a de facto two-tier system, regardless of what is printed in statutes or pamphlets.

Short of closing your borders any country will have this occur.

Not only the same doctors, but the same procedures.

That would be a perfect system if all humans were automotonic clones of each other, or each human had the actuarial average of statistical health concerns.

What you are suggesting is impossible. No country on earth(unless they are very small, like say luxemburg) has every single procedure available in every single region. I am sure there are smaller states in the US which do not have the same access to procedures as the larger states.

It doesn't to me. It seems equally as bad as the factory-hospital system.

The way to equality in healthcare is not dragging everyone down to a lower level, it's elevating everyone up to the same level.

I can sympathize with Americans who don't want to be dragged down to the Canadian level to achieve parity.

How are they on the same level at all? Its a highly tiered system those on the bottom receive nothing, then a bit of coverage a little more till you get to the very top where they get the best of everything. All insurance plans are not equal and they differ in coverage and quality. Free market health-care is heavily tiered each tier depends on your wealth. "A janitor? too fucking bad, you shouldof been richer now go die quietly where you won't bother your betters!"

I'm surprised to see you supporting a system which so clearly favors the elites over the commoners.

"whatever reason" is a cop-out

Given the known political risk he didn't leave the country because he had frequent flier miles he had to use before they expired.

Maybe it is. I frankly have no idea why Dany Williams chose to get care in the US. The same procedures were available in Canada. Maybe he wanted some time in the sun?

Surely Quebec is closer than Florida to Newfoundland?

It's tenuous to guess based on individual comparisons. We only know that (1) Danny took considerable political risk to have a relatively common medical procedure done outside Canada and (2) he stated he did not want to take shortcuts with his health.

Did he not want to be on a long waiting list at one of the factory-hospitals? Did his age not fit him into an actuarial table of allowed medical procedures? Were the physicians just not skilled enough as they've all gone to higher paying jobs south of the border?

It is much closer, though both would require a plane to get too so travel time might not be all that different. The waiting list for those procedures is not very long. Depending on the seriousness of the case they can receive care the same day, and usually no more that a couple weeks. The second one is unlikely as some of the Canadian hospitals are leaders in the field.

Canada might offer medical treatment but what if a pack of grizzly bears attacked the hospital?

If insurance companies never paid, I feel safe in saying no one would buy insurance.

As hard as one might try, facts don't support the idea that Danny was accessing a rich man's doctor that isn't available to insured Americans. One is certainly allowed to imagine that, but it is not a fact-supported imagining. We do, however, know for a fact that the doctor who treated Danny is not available to the 99% of Canadians who can't afford to jet to the U.S. anytime they need a procedure on a timeframe or for reasons not factored into the centrally programmed actuarial table devised by a civil servant in Edmonton or Victoria or St. John's.

Don't be silly grizzlies don't travel in packs.

I suspect the percentage of Canadians who could afford American care if they really wanted to Is much higher than 1%. The fact is Canadians trust the Healthcare system. Is it realy such a Hard fact that 99% of americans with insurance could get the same treatment as Danny Williams? I suspect the percentage of Canadians with access to this care is Higher than the percentage of Americans.

Do you know the actual percent of claims, annually, that get rejected for pre-existing conditions?

Even though the legal and scientific hurdles for a company to reject a claim on pre-existing grounds are fairly high, it does happen. And even though it does happen at a very low percentage of gross claims, it is a failing of the American system.

But, for the majority of Americans who have never had a 6-month gap in insurance that would potentially put them into a disqualifying category for a pre-existing condition, why would they want their health care dragged down to factory-hospital level when they now have access to levels of care that Canadian politicians jet south to access?

I don't agree with either the U.S. or Canadian systems, but these are questions that need to be answered factually and without resorting to explanations of conspiracies or hyperinflated anecdotes and horror stories schilled by TV news.

No do you?

Because they would have guaranteed care which isn't dependent on their financial situation, because every single American would have access to care and most important care could never be denied. Not all americans have access to that care. There is at least 10% with no access, then who knows what percentage of those insured would be covered for the procedure. They might find that they aren't covered for reasons not factored into the centrally programmed actuarial table devised by a accountant at corporate headquarters.

[saxitoxin]

Short of closing your borders any country will have this occur.

I'm not aware of wealthy Americans going to Canada for medical treatment.

Not only the same doctors, but the same procedures.

That would be a perfect system if all humans were automotonic clones of each other, or each human had the actuarial average of statistical health concerns.

What you are suggesting is impossible. No country on earth(unless they are very small, like say luxemburg) has every single procedure available in every single region. I am sure there are smaller states in the US which do not have the same access to procedures as the larger states.

And I think people generally then go to other states for those procedures. Not quit the country entirely.

Ergo, the fundamental flaw of the Canadian factory-hospital system. Medicine is targeted to the statistical average human. If you're outside the statistical average you go to the U.S., like Danny and many others.

It doesn't to me. It seems equally as bad as the factory-hospital system.

The way to equality in healthcare is not dragging everyone down to a lower level, it's elevating everyone up to the same level.

I can sympathize with Americans who don't want to be dragged down to the Canadian level to achieve parity.

How are they on the same level at all? Its a highly tiered system those on the bottom receive nothing, then a bit of coverage a little more till you get to the very top where they get the best of everything. All insurance plans are not equal and they differ in coverage and quality. Free market health-care is heavily tiered each tier depends on your wealth. "A janitor? too fucking bad, you shouldof been richer now go die quietly where you won't bother your betters!"

I'm not sure you understand how U.S. insurance works.

I've found the vast majority of U.S. insurance policies to be roughly the same. While deductibles, co-pays, etc. have some variables from policy-to-policy, there tends not to be gross differences due to the statutory minimum coverages required by law. Because of purchasing efficiencies most companies only offer one or two insurance policies to their employees; a janitor at Raytheon is likely to have the same policy as a marketing director.

I'm surprised to see you supporting a system which so clearly favors the elites over the commoners.

1 - I've stated I don't support the U.S. and Singaporean systems; I'm as equally opposed to them as I'm opposed to the Canadian factory-hospital system.

2 - Having used the U.S. system for the last 20 years I can verifiably say the idea it "favors the elites" is laughable at best. It's inefficient and clunky but not really plutocratic.

"whatever reason" is a cop-out

Given the known political risk he didn't leave the country because he had frequent flier miles he had to use before they expired.

Maybe it is. I frankly have no idea why Dany Williams chose to get care in the US. The same procedures were available in Canada. Maybe he wanted some time in the sun?

PWN, you're better than that.

The Premier of Newfoundland took extreme political risk to leave his country for a fairly simple medical procedure. To suggest it's because he wanted a tan is clinging to an intellectual life-preserver.

Surely Quebec is closer than Florida to Newfoundland?

It's tenuous to guess based on individual comparisons. We only know that (1) Danny took considerable political risk to have a relatively common medical procedure done outside Canada and (2) he stated he did not want to take shortcuts with his health.

Did he not want to be on a long waiting list at one of the factory-hospitals? Did his age not fit him into an actuarial table of allowed medical procedures? Were the physicians just not skilled enough as they've all gone to higher paying jobs south of the border?

It is much closer, though both would require a plane to get too so travel time might not be all that different. The waiting list for those procedures is not very long. Depending on the seriousness of the case they can receive care the same day, and usually no more that a couple weeks. The second one is unlikely as some of the Canadian hospitals are leaders in the field.

Apparently the view of what "not a very long waiting list" is to a Canadian may be different than what it is to an American (or a rich Canadian).

Canada might offer medical treatment but what if a pack of grizzly bears attacked the hospital?

If insurance companies never paid, I feel safe in saying no one would buy insurance.

As hard as one might try, facts don't support the idea that Danny was accessing a rich man's doctor that isn't available to insured Americans. One is certainly allowed to imagine that, but it is not a fact-supported imagining. We do, however, know for a fact that the doctor who treated Danny is not available to the 99% of Canadians who can't afford to jet to the U.S. anytime they need a procedure on a timeframe or for reasons not factored into the centrally programmed actuarial table devised by a civil servant in Edmonton or Victoria or St. John's.

Don't be silly grizzlies don't travel in packs.

I suspect the percentage of Canadians who could afford American care if they really wanted to Is much higher than 1%. The fact is Canadians trust the Healthcare system. Is it realy such a Hard fact that 99% of americans with insurance could get the same treatment as Danny Williams? I suspect the percentage of Canadians with access to this care is Higher than the percentage of Americans.

99% is not a hard fact; 90% is a hard fact, as I said

It sounds like you have chosen to believe what supports your worldview and dismiss anything that doesn't as "people wanting a sun tan" or whatever else it takes to protect a cherished institution.

It's important for people to feel they are part of a community that genuinely cares for them. It's important for people to feel that an institution is part of that community and their well-being is being curated, not factored on an actuarial table in a provincial capital. That's fine. We are all entitled to protect our view of an idyllic world and our wish to live in that world.

Do you know the actual percent of claims, annually, that get rejected for pre-existing conditions?

Even though the legal and scientific hurdles for a company to reject a claim on pre-existing grounds are fairly high, it does happen. And even though it does happen at a very low percentage of gross claims, it is a failing of the American system.

But, for the majority of Americans who have never had a 6-month gap in insurance that would potentially put them into a disqualifying category for a pre-existing condition, why would they want their health care dragged down to factory-hospital level when they now have access to levels of care that Canadian politicians jet south to access?

I don't agree with either the U.S. or Canadian systems, but these are questions that need to be answered factually and without resorting to explanations of conspiracies or hyperinflated anecdotes and horror stories schilled by TV news.

No do you?

Because they would have guaranteed care which isn't dependent on their financial situation, because every single American would have access to care and most important care could never be denied. Not all americans have access to that care. There is at least 10% with no access, then who knows what percentage of those insured would be covered for the procedure. They might find that they aren't covered for reasons not factored into the centrally programmed actuarial table devised by a accountant at corporate headquarters.

It sounds like the core of your belief is that actuarial tables calculated by a government institution can express love and concern for well-being, and a corporate institution can not.

I don't believe either can.

I dislike the Canadian system that provides 100% of the population with second-class care.

I dislike the US system that provides 80% of the population with first-class care (those with insurance), 10% with second-class [Canadian style] care (those with Medicaid) and 10% with no care at all (those with nothing but access to emergency rooms and charity clinics).

As I've said, the Swiss and Dutchland systems are really model. (that of the DDR, of course, was even better)

[Baron Von PWN]

Short of closing your borders any country will have this occur.

I'm not aware of wealthy Americans going to Canada for medical treatment.

Because the Canadian system isn't a free market one. It doesn't sell health-care it provides it. Middle class Americans do go to poor countries for health care though. Evidence insurance policies are not so Iron clad as you think?

I think people generally then go to other states for those procedures. Not quit the country entirely.

Ergo, the fundamental flaw of the Canadian factory-hospital system. Medicine is targeted to the statistical average human. If you're outside the statistical average you go to the U.S., like Danny and many others.

Normally Canadians simply go to the other region as well. As I've said I have no idea why Dany went to the US when the same treatment was available in Canada. I think he might not have thoroughly pursued the options available to him and Canada. By the way you mentioned "political risks" associated with the matter. It was a near total non issue in Canada.

I'm not sure you understand how U.S. insurance works.

I've found the vast majority of U.S. insurance policies to be roughly the same. While deductibles, co-pays, etc. have some variables from policy-to-policy, there tends not to be gross differences due to the statutory minimum coverages required by law. Because of purchasing efficiencies most companies only offer one or two insurance policies to their employees; a janitor at Raytheon is likely to have the same policy as a marketing director.

If the company chooses to cover their janitors. How many companies actually provide full coverage all the way to their lowliest employees?

PWN, you're better than that.

The Premier of Newfoundland took extreme political risk to leave his country for a fairly simple medical procedure. To suggest it's because he wanted a tan is clinging to an intellectual life-preserver.

Hardly . Nobody looked at it positively but there was no serious backlash against Danny Williams and the Canadian media barely bothered to mention it. The only reason it came up at all was because Americans were spouting nonsense about the Health care system. So of course some politicians took the opportunity to be staunch defenders of health care. The whole thing went away in less than a week.

Apparently the view of what "not a very long waiting list" is to a Canadian may be different than what it is to an American (or a rich Canadian).

Perhaps.

It sounds like the core of your belief is that actuarial tables calculated by a government institution can express love and concern for well-being, and a corporate institution can not.

I don't believe either can.

I dislike the Canadian system that provides 100% of the population with second-class care.

I dislike the US system that provides 80% of the population with first-class care (those with insurance), 10% with second-class [Canadian style] care (those with Medicaid) and 10% with no care at all (those with nothing but access to emergency rooms and charity clinics).

As I've said, the Swiss and Dutchland systems are really model. (that of the DDR, of course, was even better)

I'm curious what evidence do you have that American care is better than Canadian. You keep saying the Canadian system provides "2nd rate" care but haven't really provided anything to support this, other than rhetoric about "actuarial tables". Anything like recovery times being lower? Life expectancy? solid facts which would indicate a disparity in quality between the systems.

[saxitoxin]

Short of closing your borders any country will have this occur.

I'm not aware of wealthy Americans going to Canada for medical treatment.

Because the Canadian system isn't a free market one. It doesn't sell health-care it provides it. Middle class Americans do go to poor countries for health care though. Evidence insurance policies are not so Iron clad as you think?

I'm not aware of that occurring in any measurable quantity outside of cosmetic procedures, which Canadians also pursue overseas.

I think people generally then go to other states for those procedures. Not quit the country entirely.

Ergo, the fundamental flaw of the Canadian factory-hospital system. Medicine is targeted to the statistical average human. If you're outside the statistical average you go to the U.S., like Danny and many others.

Normally Canadians simply go to the other region as well. As I've said I have no idea why Dany went to the US when the same treatment was available in Canada. I think he might not have thoroughly pursued the options available to him and Canada.

If you want to protect your worldview that's understandable. You've been grown into it. It's a natural reaction. But it would, sometimes, be better to simply say nothing than say that the Premier of Newfoundland simply wasn't aware of the healthcare options in Canada and - concerning an operation on his heart - just randomly ambled down to Miami without doing much research in the matter.

I'm not sure you understand how U.S. insurance works.

I've found the vast majority of U.S. insurance policies to be roughly the same. While deductibles, co-pays, etc. have some variables from policy-to-policy, there tends not to be gross differences due to the statutory minimum coverages required by law. Because of purchasing efficiencies most companies only offer one or two insurance policies to their employees; a janitor at Raytheon is likely to have the same policy as a marketing director.

If the company chooses to cover their janitors. How many companies actually provide full coverage all the way to their lowliest employees?

It's the law in California.

So, I suppose the answer to your question - as regards my only frame of reference - are all non-criminal enterprises.

PWN, you're better than that.

The Premier of Newfoundland took extreme political risk to leave his country for a fairly simple medical procedure. To suggest it's because he wanted a tan is clinging to an intellectual life-preserver.

Hardly . Nobody looked at it positively but there was no serious backlash against Danny Williams and the Canadian media barely bothered to mention it. The only reason it came up at all was because Americans were spouting nonsense about the Health care system. So of course some politicians took the opportunity to be staunch defenders of health care. The whole thing went away in less than a week.

That's incorrect. I was in Toronto when the Globe & Mail and National Post splashed his decision on their front pages. It was raised in debate in the Newfie parliament.

It did, however, get back-of-newscast treatment in official state media CBC.

Apparently the view of what "not a very long waiting list" is to a Canadian may be different than what it is to an American (or a rich Canadian).

Perhaps.

.

It sounds like the core of your belief is that actuarial tables calculated by a government institution can express love and concern for well-being, and a corporate institution can not.

I don't believe either can.

I dislike the Canadian system that provides 100% of the population with second-class care.

I dislike the US system that provides 80% of the population with first-class care (those with insurance), 10% with second-class [Canadian style] care (those with Medicaid) and 10% with no care at all (those with nothing but access to emergency rooms and charity clinics).

As I've said, the Swiss and Dutchland systems are really model. (that of the DDR, of course, was even better)

I'm curious what evidence do you have that American care is better than Canadian. You keep saying the Canadian system provides "2nd rate" care but haven't really provided anything to support this, other than rhetoric about "actuarial tables". Anything like recovery times being lower? Life expectancy? solid facts which would indicate a disparity in quality between the systems.

My frame-of-reference is mostly experiential; seeing the inside of many American hospitals and seeing the inside of many Canadian. One type are, generally, hygenic and modern with the best of all equipment. The other type (Canadian) are clean, but not quite as clean. Modern, but not quite as modern. More expensive equipment is often disbursed to the largest hospitals that serve as medical combines, allowing maximum efficiencies of scale in lieu of community-based treatment.

Again, I'm not defending the U.S./Singaporean health care system as I'm opposed to it as much I am to the Canadian factory-hospital system.

But, your question did prompt me to spend a few minutes on Google.



P.S. - It bears noting that the reason Germany has such high-ranks in Access and Patient-Centered Care is due to the Polyclinic system that was innovated in the DDR and retained and expanded throughout Germany following the anschluss.

[Baron Von PWN]

I think people generally then go to other states for those procedures. Not quit the country entirely.

Ergo, the fundamental flaw of the Canadian factory-hospital system. Medicine is targeted to the statistical average human. If you're outside the statistical average you go to the U.S., like Danny and many others.

Normally Canadians simply go to the other region as well. As I've said I have no idea why Dany went to the US when the same treatment was available in Canada. I think he might not have thoroughly pursued the options available to him and Canada.

If you want to protect your worldview that's understandable. You've been grown into it. It's a natural reaction. But it would, sometimes, be better to simply say nothing than say that the Premier of Newfoundland simply wasn't aware of the healthcare options in Canada and - concerning an operation on his heart - just randomly ambled down to Miami without doing much research in the matter.

Well he said he couldn't get the procedure in Canada, which isn't true. The procedure is and was available to him in Canada.

That's incorrect. I was in Toronto when the Globe & Mail and National Post splashed his decision on their front pages. It was raised in debate in the Newfie parliament.

It did, however, get back-of-newscast treatment in official state media CBC.

Yes but it all blew over quite quickly, and has had no serious effect on Danny Williams popularity.

Apparently the view of what "not a very long waiting list" is to a Canadian may be different than what it is to an American (or a rich Canadian).

Perhaps.

.

My frame-of-reference is mostly experiential; seeing the inside of many American hospitals and seeing the inside of many Canadian. One type are, generally, hygenic and modern with the best of all equipment. The other type (Canadian) are clean, but not quite as clean. Modern, but not quite as modern. More expensive equipment is often disbursed to the largest hospitals that serve as medical combines, allowing maximum efficiencies of scale in lieu of community-based treatment.

Again, I'm not defending the U.S./Singaporean health care system as I'm opposed to it as much I am to the Canadian factory-hospital system.

But, your question did prompt me to spend a few minutes on Google.



P.S. - It bears noting that the reason Germany has such high-ranks in Access and Patient-Centered Care is due to the Polyclinic system that was innovated in the DDR and retained and expanded throughout Germany following the anschluss.

I suppose I should take this opportunity to say that I don't think our system is perfect, it has its problems and it is due for serious review and reform (something which I think our politicians lack the will to do). Its interesting that the chart places Canada and the US effectively on par.

How does the polyclinic system work? I think the Soviets might have used something similar as I've heard that word in Russian in reference to the health care system.

[saxitoxin]

I think people generally then go to other states for those procedures. Not quit the country entirely.

Ergo, the fundamental flaw of the Canadian factory-hospital system. Medicine is targeted to the statistical average human. If you're outside the statistical average you go to the U.S., like Danny and many others.

Normally Canadians simply go to the other region as well. As I've said I have no idea why Dany went to the US when the same treatment was available in Canada. I think he might not have thoroughly pursued the options available to him and Canada.

If you want to protect your worldview that's understandable. You've been grown into it. It's a natural reaction. But it would, sometimes, be better to simply say nothing than say that the Premier of Newfoundland simply wasn't aware of the healthcare options in Canada and - concerning an operation on his heart - just randomly ambled down to Miami without doing much research in the matter.

Well he said he couldn't get the procedure in Canada, which isn't true. The procedure is and was available to him in Canada.

I think we're going back and forth.

Once again, there is obviously a reason he chose to quite the country and it's not reasonable to assume the Premier of Newfoundland was such a dullard that he wasn't aware if there were domestic options. Once again, was the waiting list too long, did he not qualify based on his demographics, were the physicians not skilled enough?

With all due respect, there's a reason and I don't think it's because Danny Williams didn't bother spending 2 minutes on a message board where he could have found out from you, before having someone cut into his heart.

That's incorrect. I was in Toronto when the Globe & Mail and National Post splashed his decision on their front pages. It was raised in debate in the Newfie parliament.

It did, however, get back-of-newscast treatment in official state media CBC.

Yes but it all blew over quite quickly, and has had no serious effect on Danny Williams popularity.

That's kind of irrelevant to the point. He took a political risk.

Apparently the view of what "not a very long waiting list" is to a Canadian may be different than what it is to an American (or a rich Canadian).

Perhaps.

.

My frame-of-reference is mostly experiential; seeing the inside of many American hospitals and seeing the inside of many Canadian. One type are, generally, hygenic and modern with the best of all equipment. The other type (Canadian) are clean, but not quite as clean. Modern, but not quite as modern. More expensive equipment is often disbursed to the largest hospitals that serve as medical combines, allowing maximum efficiencies of scale in lieu of community-based treatment.

Again, I'm not defending the U.S./Singaporean health care system as I'm opposed to it as much I am to the Canadian factory-hospital system.

But, your question did prompt me to spend a few minutes on Google.



P.S. - It bears noting that the reason Germany has such high-ranks in Access and Patient-Centered Care is due to the Polyclinic system that was innovated in the DDR and retained and expanded throughout Germany following the anschluss.

I suppose I should take this opportunity to say that I don't think our system is perfect, it has its problems and it is due for serious review and reform (something which I think our politicians lack the will to do). Its interesting that the chart places Canada and the US effectively on par.

How does the polyclinic system work? I think the Soviets might have used something similar as I've heard that word in Russian in reference to the health care system.

I think you're right. I'm not sure how it worked there, though.

In short, Polyclinics are a cross between a clinic and a hospital; basically a non-stay hospital. It puts all the medical specialties (no surgical specialties) at the community level where they're community managed. I believe some health co-ops (non-profit insurance companies owned by their members) in the U.S. and Switzerland have started to experiment with them but even that's fairly odd. I think they're not widespread outside of Germany, and there only since they were introduced from the east. They do have places called polyclinics in England, I think, but it's just the name, they don't follow the model entirely.

[2dimes]

We opened one of those http://www.albertahealthservices.ca/fac ... id=1018406 most people are pretty exited about it.

The only real issues I have with it and I know this is how it's going to be due to economics.

First, there's many procedures only available there. Why don't I like that? Because it means a person that is in a hospital has to get loaded in an ambulance type shuttle and go there for that procedure then return the same way because there's no long term stay facility there. Some procedures are daily. In theory that's going to raise that patients carbon foot print riding that shuttle around.

Second, there's no trauma facilities. The problem with this is someone gets stabbed near it being downtown. They figure I'll just walk over, bad idea to begin with. By the time they get there they need to be taken somewhere else to get access to triage.

Other than that it's much better than the gap left when they imploded the inner city hospital a decade or so before starting demo on an other inner city hospital that was no longer being used as a hospital to build the center.

I know I'm old fasioned but when you only have 3 hospitals in a city of just over a million people I think all of them should be equally equipt. I don't know maybe that's totally unrealistic.

Why do I say Only 3? Mostly because we used to have 7 or so in the 1970s when there was under 250 000 people. Population grows by four times, cut back the hospitals to less than half, uh, ok. Yes I realise the 3 hospitals are much larger than any of the 7 but two of them were part of the 7, only one was built in the 1980s. They are now building another one. It's nearly funny to see when you go to existing hospitals here, due to lack of space they have beds in what used to be patient visiting lounges, storage rooms and I have even seen a bed in coves in the hall with a curtain to make it a room.

[2dimes]

Having said that, I still would complain but in the big picture don't mind when we had to pay $90 a month so that anyone could access the same care available to all. Yes including some lamo pot smoker that dodges his taxes and lives in his parents basement or whatever scummy criminal. You still deserve to be taken care of if you have health problems.

There are a few thing here they do really well also. I have heard of Americans coming here for hip joints. I don't know it to be fact but I do know for certain people come from other provinces.

[saxitoxin]

We opened one of those http://www.albertahealthservices.ca/fac ... id=1018406 most people are pretty exited about it.

The only real issues I have with it and I know this is how it's going to be due to economics.

First, there's many procedures only available there. Why don't I like that? Because it means a person that is in a hospital has to get loaded in an ambulance type shuttle and go there for that procedure then return the same way because there's no long term stay facility there. Some procedures are daily. In theory that's going to raise that patients carbon foot print riding that shuttle around.

Second, there's no trauma facilities. The problem with this is someone gets stabbed near it being downtown. They figure I'll just walk over, bad idea to begin with. By the time they get there they need to be taken somewhere else to get access to triage.

Other than that it's much better than the gap left when they imploded the inner city hospital a decade or so before starting demo on an other inner city hospital that was no longer being used as a hospital to build the center.

I know I'm old fasioned but when you only have 3 hospitals in a city of just over a million people I think all of them should be equally equipt. I don't know maybe that's totally unrealistic.

Why do I say Only 3? Mostly because we used to have 7 or so in the 1970s when there was under 250 000 people. Population grows by four times, cut back the hospitals to less than half, uh, ok. Yes I realise the 3 hospitals are much larger than any of the 7 but two of them were part of the 7, only one was built in the 1980s. They are now building another one. It's nearly funny to see when you go to existing hospitals here, due to lack of space they have beds in what used to be patient visiting lounges, storage rooms and I have even seen a bed in coves in the hall with a curtain to make it a room.

This is a great post. The centralization of hospitals to capitalize on bureaucratic efficiency is one of the critical failings I have, as enunciated above, with the factory-ization of health care.

I'm very interested to learn about a polyclinic opening in Alberta. I've set my Google alerts to this! Uncle's going to take 2Dimes out for an ice cream!

I visited one in Seattle last spring on my way up to Osoyoos. They have 300 physicians in practice there, and they're all co-owners. It really followed the DDR model to a tee. If your GP refers you to a dermatologist you just walk down the hall; if you need a cardiologist you just take an elevator to the next floor. There are no appointments and no waiting, you walk-in and see anyone you like within 30 minutes. There's intentionally no emergency room and no surgeries, 100% out-patient. Nostalgia!

[Trephining]

Yo Saxi, is there any decent reference I could look at to see what the DDR model was? Thanks in advance.

[saxitoxin]

Yo Saxi, is there any decent reference I could look at to see what the DDR model was? Thanks in advance.

I don't know that there are, online, or at least in popular reading ... inferences that practices or programmes of the democratic-sector of Germany were, at any level, superior to those of the fascist-sector are verboten topics of discussion.

You may want to bing-dot-com the word Poliklinik, versus the English spelling.

[2dimes]

There's intentionally no emergency room and no surgeries, 100% out-patient. Nostalgia!

My understanding (admitedly vague) is any day surgury they can manage to schedule gets done there so the patient doesn't get the wrong idea and figure they'll have a sleep over and get breakfast. "This isn't a hospital, there's no place for you to sleep, go home or back to the shelter or wherever you usually sleep dude."

All food preperation for hospitals has been moved to capital city. The patient chow is cooked there and trucked down in bulk. Then they take the items and build those wonderfull tray meals for each patient according to what they checked off in the "build-a-meal" charts from the day before.

So yeah there's certain things that are excellent. My issue is it morphed from health"care" to budgetary responsible health"repair".

They used to go by Calgary regional health authourity. CRHA but changed to Calgary Health Region because things started being tagged Can't Really Help Anyone by the bad people that didn't love them.

It's not that the system sucks here, it's just depressing that it could be so much better. I think a public system in the US&A could easily be the best in the world but won't because of all the fighting about it. Too many people will not make an effort to make it the best because they disagree with the concept.

[saxitoxin]

There's intentionally no emergency room and no surgeries, 100% out-patient. Nostalgia!

My understanding (admitedly vague) is any day surgury they can manage to schedule gets done there so the patient doesn't get the wrong idea and figure they'll have a sleep over and get breakfast. "This isn't a hospital, there's no place for you to sleep, go home or back to the shelter or wherever you usually sleep dude."

All food preperation for hospitals has been moved to capital city. The patient chow is cooked there and trucked down in bulk. Then they take the items and build those wonderfull tray meals for each patient according to what they checked off in the "build-a-meal" charts from the day before.

So yeah there's certain things that are excellent. My issue is it morphed from health"care" to budgetary responsible health"repair".

They used to go by Calgary regional health authourity. CRHA but changed to Calgary Health Region because things started being tagged Can't Really Help Anyone by the bad people that didn't love them.

It's not that the system sucks here, it's just depressing that it could be so much better. I think a public system in the US&A could easily be the best in the world but won't because of all the fighting about it. Too many people will not make an effort to make it the best because they disagree with the concept.

Well, in addition to the service menu, one of the fundamental things that makes the Polyclinic workable is that it is locally managed. In the former country I was from, each Polyclinic was budgeted, staffed, built, managed, etc. by a local council composed of practicing physicians and members of the neighborhood formation of the Combat Groups of the Working Class. The Ministry of Health did not manage Polyclinics.

This made them most responsive, unlike a system where mid-level civil servants in some faraway national or state/provincial capital make decisions based on statistical averages.

This is why I firmly believe socialized medicine can never work in a capitalist country. Socialized medicine in a socialist country has been seized by the workers in an agitated fervor of armed revolution. Socialized medicine in capitalist countries is a gift from the leadership caste to the workers and they'll manage it in a way that's just good enough to stop the riff-raff from complaining but not much else. Meanwhile, they'll jet to foreign destinations for their own care, like Williams and many other Canadian politicians.

A market system requires market forces. I saw that in Alberta the wheels of bureaucracy in the Health Ministry are mulling whether they should raise the quota of authorized eye surgery or not to speed-up the atrocious factory-hospital waiting lists. In a private-market system there would never be a wait because market forces react faster than people can organize, protest, petition and so forth for their health care. In a socialist nation (obviously the one I prefer) there would never be a wait because health is decentralized and your neighbors react instantly to your needs. Hybrid systems do not work. You can't start a bonfire in a swimming pool.

(However, as I noted, I do admire Switzerland and Dutchland for doing the best possible job of managing an impossible equation. The Swiss system is essentially the American system with the addition of their minor reforms that are supposed to take effect in 5 years.)