Colorado may try a single payer plan

[Peter1469]

It didn't work out for Vermont. Maybe Colorado will have (http://www.washingtontimes.com/news/2015/oct/25/coloradocare-would-replace-obamacare-with-statewid/) better luck.


With Colorado’s shaky Obamacare exchange in peril, some health care advocates are calling for voters to scrap it and replace it with something far more ambitious.

Proponents of a statewide single-payer health care system have submitted 156,107 signatures, far more than the 98,492 required to qualify for the November 2016 ballot, to the Colorado secretary of state’s office for verification.



If the measure qualifies, Colorado would immediately become ground zero for a national debate on the concept of steep tax increases in return for guaranteed health care coverage for all residents, all against the backdrop of a pivotal presidential race.

[Private Pickle]

It didn't work out for Vermont. Maybe Colorado will have (http://www.washingtontimes.com/news/2015/oct/25/coloradocare-would-replace-obamacare-with-statewid/) better luck.

Doubtful. We are a purple State. It wouldnt get past the ballot.

[Peter1469]

Doubtful. We are a purple State. It would get past the ballot.

I was wondering about that.

[Private Pickle]

I was wondering about that.

I fixed my post. I meant wouldn't.

[HoneyBadger]

From the article:


Under the proposal, known as Initiative 20, employers would be on the hook for the lion’s share, 6.67 percent, and employees would be responsible for 3.33 percent of the 10 percent.

If "the people" want single payer, let "the people" pay the full tab. Leave employers out of it entirely. The people who work for them are employees, not children.

[Green Arrow]

Vermont never even really implemented it, so it's a little quick to say it didn't work out.

[Peter1469]

Vermont never even really implemented it, so it's a little quick to say it didn't work out.

I believe that they said it was too expensive.

[Green Arrow]

I believe that they said it was too expensive.

Their model was too expensive and they couldn't find a viable way to fund it, but their model was also flawed in a number of ways. It would have worked if they had parceled it out to municipalities and then just offered funding assistance from the state budget.

[Common]

I read it will cost 25 billion a year.

I also read and im not sure if it was a partisan article or not, that obamacare will have to be written in 2017 because not enough people are buying into the exchanges but opting to take the fine and its driving all the costs up and next year will be worse. I dont know if that has real validity or not. It was not a right wing site and I read it yesterday and ill be damned if I can remember where.

[Common]

This is what I read it was from the Wall Street journal but it was linked to somewhere else so you could read it. Cant read it here unless you are a paid subscriber

The Decline of ObamaCare
Fewer enrollees and rising loss ratios will force a rewrite in 2017.
http://www.wsj.com/articles/the-decline-of-obamacare-1445807092

[Peter1469]

The proposed Colorado plan will cost $25B per year. I don't remember what the Vermont plan was suppose to cost.

I posted a thread about the other article that you mention: not enough young healthy people are buying into Obamacare, so it isn't working.


I read it will cost 25 billion a year.

I also read and im not sure if it was a partisan article or not, that obamacare will have to be written in 2017 because not enough people are buying into the exchanges but opting to take the fine and its driving all the costs up and next year will be worse. I dont know if that has real validity or not. It was not a right wing site and I read it yesterday and ill be damned if I can remember where.

[Professor Peabody]

It didn't work out for Vermont. Maybe Colorado will have (http://www.washingtontimes.com/news/2015/oct/25/coloradocare-would-replace-obamacare-with-statewid/) better luck. I believe Vermont tried that and it died quickly!

[Adelaide]

If a single payer system is going to be implemented it definitely needs to be at the state level... so that's a good start. Taking inspiration from Canada or other places with "universal healthcare" and trying to improve upon it is probably the best thing politicians in Colorado can do if they want to try it out. For example, it would be best to have a mixed private/public system such as Quebec and I believe it is Alberta out west that has the mixed system too; whereas, in Ontario only uncovered areas such as plastic surgery (when elected and not medically necessary) have a private sector.

[Common]

If a single payer system is going to be implemented it definitely needs to be at the state level... so that's a good start. Taking inspiration from Canada or other places with "universal healthcare" and trying to improve upon it is probably the best thing politicians in Colorado can do if they want to try it out. For example, it would be best to have a mixed private/public system such as Quebec and I believe it is Alberta out west that has the mixed system too; whereas, in Ontario only uncovered areas such as plastic surgery (when elected and not medically necessary) have a private sector.

Adelaide, is canadian universal health care, Excellent, Good, Ok or sucks. Is it free? in the sense you dont pay out of pocket or have co pays. Does it include Prescription Medications and Dental.

Im asking because I dont know and I would like to hear the answers from a canadian

[Common Sense]

Adelaide, is canadian universal health care, Excellent, Good, Ok or sucks. Is it free? in the sense you dont pay out of pocket or have co pays. Does it include Prescription Medications and Dental.

Im asking because I dont know and I would like to hear the answers from a canadian

I wont answer for her, but I'll give my take.

Canadians overwhelmingly approve of our system. It's certainly not perfect. I'd call it good.

There are no co pays. Essentially your province acts as insurer and you get a card. In Ontario it's OHIP. It doesn't include prescriptions, dental or glasses. Many Canadians have supplemental insurance that pays for prescriptions, dental, glasses and things like hospital room upgrades. All hospitals are private corporations and there are clinics where you can pay out of pocket for things like MRI's.

[Adelaide]

I wont answer for her, but I'll give my take.

Canadians overwhelmingly approve of our system. It's certainly not perfect. I'd call it good.

There are no co pays. Essentially your province acts as insurer and you get a card. In Ontario it's OHIP. It doesn't include prescriptions, dental or glasses. Many Canadians have supplemental insurance that pays for prescriptions, dental, glasses and things like hospital room upgrades. All hospitals are private corporations and there are clinics where you can pay out of pocket for things like MRI's.

Yeah... Canadians will occasionally complain about it but they wouldn't get rid of it or trade it for what Americans have. Having been through some trouble in the US involving healthcare where I was in a hospital for several weeks with someone I care about, I actually have to say that the standard/quality of care seems better in Canada. I was absolutely infuriated with the care I saw going on at the hospital in the US. Maybe it was just that one hospital/medical centre, but the care was atrocious. I ended up having to be nurse and do things that I'm not trained to do, otherwise they would not have gotten done at all. Remembering to put the stockings back on to prevent clots... having to disconnect and connect an NG tube to suction... having to turn off IVs that were empty and just making noise... advocate for TPN after a week of no food... I was absolutely, uncontrollably angry over the mistreatment/neglect I witnessed.

[Common Sense]

Yeah... Canadians will occasionally complain about it but they wouldn't get rid of it or trade it for what Americans have. Having been through some trouble in the US involving healthcare where I was in a hospital for several weeks with someone I care about, I actually have to say that the standard/quality of care seems better in Canada. I was absolutely infuriated with the care I saw going on at the hospital in the US. Maybe it was just that one hospital/medical centre, but the care was atrocious. I ended up having to be nurse and do things that I'm not trained to do, otherwise they would not have gotten done at all. Remembering to put the stockings back on to prevent clots... having to disconnect and connect an NG tube to suction... having to turn off IVs that were empty and just making noise... advocate for TPN after a week of no food... I was absolutely, uncontrollably angry over the mistreatment/neglect I witnessed.


From what I've read, it seems that Americans have a misconception about care outside the US. Anything outside is deemed inferior.

I've been to American hospitals, they really are no different than Canadian ones. In some instances they are worse. It's a shame there is so much hysteria over this issue. A lot of people suffer because of it.

[nic34]

Doubtful. We are a purple State. It wouldnt get past the ballot.

How soon you forget.

http://www.huffingtonpost.com/2012/11/13/hickenlooper-poses-with-c_n_2122465.html

[nic34]

I believe Vermont tried that and it died quickly!

It was never tried there:

http://www.politico.com/story/2014/12/single-payer-vermont-113711

[nic34]

The proposed Colorado plan will cost $25B per year. I don't remember what the Vermont plan was suppose to cost.

I posted a thread about the other article that you mention: not enough young healthy people are buying into Obamacare, so it isn't working.


25 billion? you haven't seen anything yet.....




The Average American Family Pays $4,000 for Medical Fraud and Subsidies


Medical billing fraud is estimated at 10 percent of all health care, or about $270 billion, while patent monopolies raise the price of prescription drugs by another $270 billion a year. Combined, this represents an astonishing annual cost of over $4,000 to an average American household. As The Atlantic puts it, "The people most likely to bilk the system are doctors and medical providers, not 'welfare queens.'"


Intimidation by Outrageous Markups


In a recent analysis of 50 hospitals (49 for-profit) with the highest charge-to-cost ratios in 2012, the average markup was 1,000 percent, which means that a procedure costing a hospital $100 is marked up to $1,000 for us.


Some of the markups test the limits of sanity: an 80-cent needle for $143.25 (a 17,000 percent markup). A 25-cent IUD device for $1,000. A blood test that costs $10 in one hospital and $10,000 in another.


http://www.commondreams.org/views/2015/07/20/private-health-care-act-terrorism

[nic34]

I posted a thread about the other article that you mention: not enough young healthy people are buying into Obamacare, so it isn't working.

About that:

http://thepoliticalforums.com/threads/52579-Obamacare-declining?p=1303974&viewfull=1#post1303974

[Chris]

25 billion? you haven't seen anything yet.....




The Average American Family Pays $4,000 for Medical Fraud and Subsidies


Medical billing fraud is estimated at 10 percent of all health care, or about $270 billion, while patent monopolies raise the price of prescription drugs by another $270 billion a year. Combined, this represents an astonishing annual cost of over $4,000 to an average American household. As The Atlantic puts it, "The people most likely to bilk the system are doctors and medical providers, not 'welfare queens.'"


Intimidation by Outrageous Markups


In a recent analysis of 50 hospitals (49 for-profit) with the highest charge-to-cost ratios in 2012, the average markup was 1,000 percent, which means that a procedure costing a hospital $100 is marked up to $1,000 for us.


Some of the markups test the limits of sanity: an 80-cent needle for $143.25 (a 17,000 percent markup). A 25-cent IUD device for $1,000. A blood test that costs $10 in one hospital and $10,000 in another.


http://www.commondreams.org/views/2015/07/20/private-health-care-act-terrorism


How much of that is Medicare fraud?

[Chris]

Doubtful. We are a purple State. It wouldnt get past the ballot.

Depends on how much you all are smoking. :D

[Private Pickle]

From what I've read, it seems that Americans have a misconception about care outside the US. Anything outside is deemed inferior.

I've been to American hospitals, they really are no different than Canadian ones. In some instances they are worse. It's a shame there is so much hysteria over this issue. A lot of people suffer because of it.

Well nationalizing the healthcare system would have major economic impacts on the U.S.

The fact is that there are very few single-payer systems in the world. Canada being one. Sweden moved from single-payer to private insurers.

We can work on a fully privatized insured health system without the government nationalizing the healthcare. The government would have to be involved and set pricing for things like pharmaceuticals and medical supplies. The fact that this negotiation with the medical suppliers is left to the insurers who despite popular belief are not big profiteers, allows for the boosting of prices which are then transferred to the consumer.

[Private Pickle]

Yeah... Canadians will occasionally complain about it but they wouldn't get rid of it or trade it for what Americans have. Having been through some trouble in the US involving healthcare where I was in a hospital for several weeks with someone I care about, I actually have to say that the standard/quality of care seems better in Canada. I was absolutely infuriated with the care I saw going on at the hospital in the US. Maybe it was just that one hospital/medical centre, but the care was atrocious. I ended up having to be nurse and do things that I'm not trained to do, otherwise they would not have gotten done at all. Remembering to put the stockings back on to prevent clots... having to disconnect and connect an NG tube to suction... having to turn off IVs that were empty and just making noise... advocate for TPN after a week of no food... I was absolutely, uncontrollably angry over the mistreatment/neglect I witnessed.

I think that was a bad hospital. The care I've seen with myself and loved ones has been stellar.

[Private Pickle]

25 billion? you haven't seen anything yet.....




The Average American Family Pays $4,000 for Medical Fraud and Subsidies


Medical billing fraud is estimated at 10 percent of all health care, or about $270 billion, while patent monopolies raise the price of prescription drugs by another $270 billion a year. Combined, this represents an astonishing annual cost of over $4,000 to an average American household. As The Atlantic puts it, "The people most likely to bilk the system are doctors and medical providers, not 'welfare queens.'"


Intimidation by Outrageous Markups


In a recent analysis of 50 hospitals (49 for-profit) with the highest charge-to-cost ratios in 2012, the average markup was 1,000 percent, which means that a procedure costing a hospital $100 is marked up to $1,000 for us.


Some of the markups test the limits of sanity: an 80-cent needle for $143.25 (a 17,000 percent markup). A 25-cent IUD device for $1,000. A blood test that costs $10 in one hospital and $10,000 in another.


http://www.commondreams.org/views/2015/07/20/private-health-care-act-terrorism

All of this would be solved with legislated set prices for medical suppliers.

[Private Pickle]

Depends on how much you all are smoking. :D

Touché fine Sir.

[Common Sense]

Well nationalizing the healthcare system would have major economic impacts on the U.S.

The fact is that there are very few single-payer systems in the world. Canada being one. Sweden moved from single-payer to private insurers.

We can work on a fully privatized insured health system without the government nationalizing the healthcare. The government would have to be involved and set pricing for things like pharmaceuticals and medical supplies. The fact that this negotiation with the medical suppliers is left to the insurers who despite popular belief are not big profiteers, allows for the boosting of prices which are then transferred to the consumer.

It's true, nationalizing the healthcare system would have an impact. Probably a positive one. But that's not really what the Canadian system is. Healthcare is provided by private corporations and the provinces act as insurer. So they get to negotiate with healthcare providers etc...

Sweden's system may have changed, but they are still mainly tax funded. They have not moved to a private insurer system.

[Private Pickle]

It's true, nationalizing the healthcare system would have an impact. Probably a positive one. But that's not really what the Canadian system is. Healthcare is provided by private corporations and the provinces act as insurer. So they get to negotiate with healthcare providers etc...

Sweden's system may have changed, but they are still mainly tax funded. They have not moved to a private insurer system.

Well if the provinces are the insurer then its single-payer. The citizens pay the government and the government doles out the money to the providers.

[Common Sense]

Well if the provinces are the insurer then its single-payer. The citizens pay the government and the government doles out the money to the providers.

It is single payer. I just wanted to be clear. Sometimes people hear nationalized healthcare and they think of things like the VA where the govt not only is insurer, but healthcare provider.

[Private Pickle]

It is single payer. I just wanted to be clear. Sometimes people hear nationalized healthcare and they think of things like the VA where the govt not only is insurer, but healthcare provider.

Right. I said single payer.

The truth about the Canadian healthcare system is that it does have a lot of holes. The biggest of which is the wait times for things like surgeries and MRIs. I had an MRI done on my knee a day after I saw my general practitioner. That and the "brain-drain" that occurs when Canadian doctors come to the U.S. for better paying jobs.

My suggestion however; does take a portion of the Canadian healthcare system, the pharmaceutical side as it's basis. Correct me if I'm wrong but pharmaceutical healthcare is provided through employment-based insurance. Given that, the government keeps prices low by negotiating the costs of medicines and as such gives the insurers a set price to the consumers (employers). I say the U.S. government should do something similar in that we should take the negotiation of medical supplies out of the hands of the insurers and into the hands of the U.S. Government. That will drastically reduce the cost of healthcare in the U.S. and would more closely resemble the healthcare systems of places like England, France, Switzerland and even Canada. However; the private sector would remain intact.

[Common Sense]

Right. I said single payer.

I understand that, but you also said "nationalizing healthcare"


The truth about the Canadian healthcare system is that it does have a lot of holes. The biggest of which is the wait times for things like surgeries and MRIs. I had an MRI done on my knee a day after I saw my general practitioner. That and the "brain-drain" that occurs when Canadian doctors come to the U.S. for better paying jobs.

If I want, I can pay out of pocket and get an MRI at a clinic. It's not a perfect system. There are wait times, but there are wait times in the US as well, not to mention flat out refusals by insurers. There is some brain drain but actually the wage gap has closed a fair bit. Canadian doctors are paid very well here. We've also done a good job recruiting doctors from other countries.


My suggestion however; does take a portion of the Canadian healthcare system, the pharmaceutical side as it's basis. Correct me if I'm wrong but pharmaceutical healthcare is provided through employment-based insurance. Given that, the government keeps prices low by negotiating the costs of medicines and as such gives the insurers a set price to the consumers (employers). I say the U.S. government should do something similar in that we should take the negotiation of medical supplies out of the hands of the insurers and into the hands of the U.S. Government. That will drastically reduce the cost of healthcare in the U.S. and would more closely resemble the healthcare systems of places like England, France, Switzerland and even Canada. However; the private sector would remain intact.

That's a great idea. Again here, the private sector are the ones delivering healthcare. Creating a single payer system does not change the private sector outside of the insurance sector.

[Private Pickle]

I understand that, but you also said "nationalizing healthcare"



If I want, I can pay out of pocket and get an MRI at a clinic. It's not a perfect system. There are wait times, but there are wait times in the US as well, not to mention flat out refusals by insurers. There is some brain drain but actually the wage gap has closed a fair bit. Canadian doctors are paid very well here. We've also done a good job recruiting doctors from other countries.



That's a great idea. Again here, the private sector are the ones delivering healthcare. Creating a single payer system does not change the private sector outside of the insurance sector.

Let's not go point to point. It's tedious. We agree that in Canada single-payer is a nationalized funding mechanism that pays private medical providers. The difference is that the government negotiates the cost of what it's buying thereby dramatically reducing the cost of general healthcare. Now while it removes the insurance sector it certainly changes the private sector as I've mentioned below. The wait times for me for just about any medical necessity are almost zero while the median wait time for a surgery in Canada is 4 weeks. That is just simple facts.

The idea that insurers are bad is simply flawed. Insurers have a distinct interest in trying to keep the claims of the insured down. While there is shady shit that needs to be rounded out like the fraudulent denial of claims, insurance companies do a lot in the interest of the health of their customers. Examples include innovations such as digital medicine. The government simply is the funding mechanism in a single-payer environment.

[Common Sense]

Let's not go point to point. It's tedious. We agree that in Canada single-payer is a nationalized funding mechanism that pays private medical providers. The difference is that the government negotiates the cost of what it's buying thereby dramatically reducing the cost of general healthcare. Now while it removes the insurance sector it certainly changes the private sector as I've mentioned below. The wait times for me for just about any medical necessity are almost zero while the median wait time for a surgery in Canada is 4 weeks. That is just simple facts.

The idea that insurers are bad is simply flawed. Insurers have a distinct interest in trying to keep the claims of the insured down. While there is shady shit that needs to be rounded out like the fraudulent denial of claims, insurance companies do a lot in the interest of the health of their customers. Examples include innovations such as digital medicine. The government simply is the funding mechanism in a single-payer environment.

Much of that is accurate. However wait times are typically for non life threatening things. There are also wait times in the US that are often comparable.

Insurers aren't bad, however they are only motivated by profit. I that means a healthier customer great. If it means denying a claim or raising premiums, then it's not so great.

The government in Canada and the US invest in medial research and new technology.

[Private Pickle]

Much of that is accurate. However wait times are typically for non life threatening things. There are also wait times in the US that are often comparable.

Insurers aren't bad, however they are only motivated by profit. I that means a healthier customer great. If it means denying a claim or raising premiums, then it's not so great.

The government in Canada and the US invest in medial research and new technology.

The wait times are not comparable Common. Insurers in the U.S. don't get a lot of profit. That's a myth. While both governments invest in medical research only one country has insurers doing the same.

[Common Sense]

The wait times are not comparable Common. Insurers in the U.S. don't get a lot of profit. That's a myth. While both governments invest in medical research only one country has insurers doing the same.

Insurance is a very profitable industry. They are publicly traded corporations. Wellpoint alone made $2.7 net in 2012 and is worth $23 billion....and they're not even the biggest.

I don't doubt you, but I haven't seen anything about insurers contributing to medial research. If they do, I'm sure they get a nice tax break.

[Private Pickle]

Insurance is a very profitable industry. They are publicly traded corporations. Wellpoint alone made $2.7 net in 2012 and is worth $23 billion....and they're not even the biggest.

I don't doubt you, but I haven't seen anything about insurers contributing to medial research. If they do, I'm sure they get a nice tax break.

Forbes has insurers at #35 on profit return. They average 2.2% which is terrible.

http://fortune.com/fortune500/2009/

[Bob]

If a single payer system is going to be implemented it definitely needs to be at the state level... so that's a good start. Taking inspiration from Canada or other places with "universal healthcare" and trying to improve upon it is probably the best thing politicians in Colorado can do if they want to try it out. For example, it would be best to have a mixed private/public system such as Quebec and I believe it is Alberta out west that has the mixed system too; whereas, in Ontario only uncovered areas such as plastic surgery (when elected and not medically necessary) have a private sector.

A study was made of the world's best single payer systems and Canada nor England came close. I am not sure of the winning country but recall how well Taiwan scored and also Japan though the complaint over Japans was doctors rushed you in and out in 5 minutes.

[Captain Obvious]

Forbes has insurers at #35 on profit return. They average 2.2% which is terrible.

http://fortune.com/fortune500/2009/

If you pay attention to advertising which I casually do, insurance companies are very aggressive advertisers. The market must be fairly competitive.

[Bob]

Insurance is a very profitable industry. They are publicly traded corporations. Wellpoint alone made $2.7 net in 2012 and is worth $23 billion....and they're not even the biggest.

I don't doubt you, but I haven't seen anything about insurers contributing to medial research. If they do, I'm sure they get a nice tax break.

Insurance companies must set aside profits to make sure they can cover the worst disaster. I believe were all companies also setting aside profits, a lot of hell would be raised.

[Private Pickle]

If you pay attention to advertising which I casually do, insurance companies are very aggressive advertisers. The market must be fairly competitive.

On the flip side of that coin they spend a ton in advertising which drives the cost up.

[Captain Obvious]

On the flip side of that coin they spend a ton in advertising which drives the cost up.

Well... depends. I'd have to see financials to make that determination.

Running a radio ad isn't really all that much.

[Dr. Who]

I understand that, but you also said "nationalizing healthcare"If I want, I can pay out of pocket and get an MRI at a clinic. It's not a perfect system. There are wait times, but there are wait times in the US as well, not to mention flat out refusals by insurers. There is some brain drain but actually the wage gap has closed a fair bit. Canadian doctors are paid very well here. We've also done a good job recruiting doctors from other countries. That's a great idea. Again here, the private sector are the ones delivering healthcare. Creating a single payer system does not change the private sector outside of the insurance sector.I believe the majority of Canadian hospitals are private, but not for profit entities (http://mapleleafweb.com/features/canada-s-health-care-system-overview-public-and-private-participation):

"Nevertheless, it would be incorrect to characterize hospitals as being completely private in nature, as provincial governments have considerable authority over their operation. While the nature of this authority can differ from one province to another, it is generally the case that a provincial government sets and provides overall hospital budgets, in addition to reviewing large financial decisions made by a hospital’s board. Provincial governments also have the power to set the scope of the services offered by a hospital and even close facilities they deem unnecessary.In examining this idea of provincial government control of health care, it is useful to examine the administrative structure of hospitals in a particular jurisdiction. Ontario has 211 hospitals, most of which are private, non-profit entities (Government of Ontario, 2010). While each hospital is free to establish its own internal governance structure, most have a board of directors and are incorporated under the provincial Corporations Act. These boards have legal and management responsibility for the hospital and administer its day-to-day activities, such as finance, planning, in-patient and outpatient care, imaging and laboratory services, and administration services.The Government of Ontario, however, exerts considerable authority over these hospitals and their boards. Funding for hospital services is provided by the provincial government through annual budget allotments. This funding is based on a number of different factors, such as past financial needs. However, the provincial government has complete discretion to raise or lower hospital funding. Hospitals must also operate according to provincial regulations, including Ontario’s Public Hospitals Act. The Ministry of Health and Long-Term Care also develops and enforces operational policies for hospitals regarding the services they provide and their financial decision-making. Hospital boards must further submit annual operating plans to the government and must gain ministry approval before making any changes to the services they offer."

The fact that they are primarily not for profit and the price of procedures, doctor fees, nurse fees and the costs of all manner of supplies are fixed, keeps prices down and avoids the issues noted by nic whereby the hospital nickel and dimes patients for trivial line items because the insurance companies often won't cover the actual costs of procedures.

[Peter1469]

Eliminate the profit margin from most industries and quality drops like a rock.....

[Dr. Who]

Eliminate the profit margin from most industries and quality drops like a rock.....
It really depends on the industry and the expectations of profit. If a hospital has a non-profit model, it doesn't have to be poor quality. It is simply not being run for profit. It doesn't have shareholders that have to be paid. In this case, it simply has to meet Provincial regulatory standards for operation. I don't think that America has a comparable model for major hospitals. They are either for profit or state or federally funded. Those directly run by government entities do seem to suffer the problems that you mention, but that may also be because they are overwhelmed with uninsured patients and they are not funded appropriately.

[Captain Obvious]

Eliminate the profit margin from most industries and quality drops like a rock.....

It's the advantage the private sector has over the public.

The public sector operates as if revenues are a bottomless well.

[Private Pickle]

Well... depends. I'd have to see financials to make that determination.

Running a radio ad isn't really all that much.

In any case it isn't the insurers who are making out like bandits, its the healthcare and medical providers. If they were government were to set prices their positions would be strengthened not weakened. In so much that currently U.S. insurers typically have to pay at least a point above the Medicare standards that are negotiated by the government.


In the United States, insurers negotiate with hospitals and drug companies on their own -- and they pay more as a result. In fact, because of their weak negotiating position they frequently use whatever price Medicare is paying as a baseline and then, because they lack the power to strike a similar deal, add a percentage on top. Joshua Gottlieb, an economist at the University of British Columbia, found (http://www.washingtonpost.com/business/economy/medicare-pricing-drives-high-health-care-costs/2013/12/31/24befa46-7248-11e3-8b3f-b1666705ca3b_print.html) that when Medicare increases what it pays for a service by $1, private insurers increase their payments by $1.30.
That leaves the United States with the worst of both approaches: Prices aren’t set by the market, but they also aren’t set by the government. Consequently, Medicare’s negotiating power is weakened by the threat that drug companies or hospitals will opt to do business only with higher-paying private insurers. We simultaneously miss out on the efficiency of a purely private system and on the savings of a purely public one.


http://www.washingtonpost.com/news/wonkblog/wp/2014/01/13/what-liberals-get-wrong-about-single-payer/

[Private Pickle]

Eliminate the profit margin from most industries and quality drops like a rock.....

The insurers profit margins are terrible...

[Peter1469]

The insurers profit margins are terrible...

2-5% I think?

[Private Pickle]

2-5% I think?


In 2009, Forbes ranked (http://money.cnn.com/magazines/fortune/fortune500/2009/performers/industries/profits/) health insurance as the 35th most profitable industry, with an anemic 2.2 percent return on revenue.

Brutal.

However;


To understand why the U.S. health-care system is so expensive, you need to travel higher up the Forbes list. The pharmaceutical industry was in third place, with a 19.9 percent return, and the medical products and equipment industry was right behind it, with a 16.3 percent return. Meanwhile, doctors are more likely than members of any other profession to have incomes in the top 1 percent.

[Dr. Who]

In any case it isn't the insurers who are making out like bandits, its the healthcare and medical providers. If they were government were to set prices their positions would be strengthened not weakened. In so much that currently U.S. insurers typically have to pay at least a point above the Medicare standards that are negotiated by the government.



http://www.washingtonpost.com/news/wonkblog/wp/2014/01/13/what-liberals-get-wrong-about-single-payer/
Crony capitalism strikes again. The government supports overcharging by the likes of pharmaceutical companies. They have potentially the greatest bargaining power, but the least inclination to do so. As the article notes, the worst of all possible worlds and the losers are the patients that end up paying out of pocket for ridiculous things that should cost very little, but desperate hospitals and equally desperate insurers are squeezing every penny in order to try to provide some return on investment, while the likes of Merck laugh all the way to the bank.

[Private Pickle]

Crony capitalism strikes again. The government supports overcharging by the likes of pharmaceutical companies. They have potentially the greatest bargaining power, but the least inclination to do so. As the article notes, the worst of all possible worlds and the losers are the patients that end up paying out of pocket for ridiculous things that should cost very little, but desperate hospitals and equally deperate insurers are squeezing every penny in order to try to provide some return on investment, while the likes of Merck laugh all the way to the bank.

Boom!

[Adelaide]

From what I've read, it seems that Americans have a misconception about care outside the US. Anything outside is deemed inferior.

I've been to American hospitals, they really are no different than Canadian ones. In some instances they are worse. It's a shame there is so much hysteria over this issue. A lot of people suffer because of it.

Well, and to be fair, it was the only hospital I have ever had to deal with in the United States. It could have been an exception but it was supposed to be a good hospital and the person I was with had very good coverage so I assumed the care would be good... I was wrong.

[Adelaide]

Well nationalizing the healthcare system would have major economic impacts on the U.S.

The fact is that there are very few single-payer systems in the world. Canada being one. Sweden moved from single-payer to private insurers.

We can work on a fully privatized insured health system without the government nationalizing the healthcare. The government would have to be involved and set pricing for things like pharmaceuticals and medical supplies. The fact that this negotiation with the medical suppliers is left to the insurers who despite popular belief are not big profiteers, allows for the boosting of prices which are then transferred to the consumer.

If the US were to adapt some form of universal healthcare they would have to do it the way Canada did, or at least in a similar way. The federal government came up with an Act of parliament that says what the provinces must provide but the Canada Health Act is interpreted differently by each province, (examples being what is considered essential such as dental not being covered by most provinces, and also that some provinces have a mixed private/public system). The five "pillars" that must be met by the provinces are public administration, comprehensiveness, universality, portability and accessibility - it's up to each province to decide how best to implement the system. Failure to adhere to those five pillars means the province will be fined by not receiving transfer payments/federal funding from the federal government. But literally every provincial insurance program is different.

It leaves most of the responsibility to the provinces to create their programs and run them. Every province does it differently depending on what they're able to do. If the US mimicked this it would mean the States each have majority of the power to determine what their programs are and it's definitely more sensible then trying to create a program for 300+ million people. The less people the better, which is why state-level or province-level control is preferable. It also means that states could opt out and if it mimicked our system, the punishment would be no transfer payments from the federal government that would have gone towards a universal system (so no loss to states that have no desire to have a universal insurance program like OHIP).

[Adelaide]

I think that was a bad hospital. The care I've seen with myself and loved ones has been stellar.

Entirely possible. It was supposed to be a really good hospital but I was absolutely shocked with the quality of care.

[Adelaide]

Right. I said single payer.

The truth about the Canadian healthcare system is that it does have a lot of holes. The biggest of which is the wait times for things like surgeries and MRIs. I had an MRI done on my knee a day after I saw my general practitioner. That and the "brain-drain" that occurs when Canadian doctors come to the U.S. for better paying jobs.

My suggestion however; does take a portion of the Canadian healthcare system, the pharmaceutical side as it's basis. Correct me if I'm wrong but pharmaceutical healthcare is provided through employment-based insurance. Given that, the government keeps prices low by negotiating the costs of medicines and as such gives the insurers a set price to the consumers (employers). I say the U.S. government should do something similar in that we should take the negotiation of medical supplies out of the hands of the insurers and into the hands of the U.S. Government. That will drastically reduce the cost of healthcare in the U.S. and would more closely resemble the healthcare systems of places like England, France, Switzerland and even Canada. However; the private sector would remain intact.

I've never had to wait long for an MRI because I have a neurological condition. It isn't something that could kill me, however, so technically I'm not top of the list.

There are wait times for surgeries and specialists but it takes into account priority - I had to have my heart tested using a holter monitor to see if I could take a medication and it took 2 weeks to see a cardiologist, or thereabouts. My mother has a rare heart defect and she was seen within a day by a specialist, had surgery within the month, (it wasn't an urgent surgery).

The real problem(s) seems to be a lack of family physicians and ER wait times, although provincially our wait times are going down slowly but surely.

[Common Sense]

I've never had to wait long for an MRI because I have a neurological condition. It isn't something that could kill me, however, so technically I'm not top of the list.

There are wait times for surgeries and specialists but it takes into account priority - I had to have my heart tested using a holter monitor to see if I could take a medication and it took 2 weeks to see a cardiologist, or thereabouts. My mother has a rare heart defect and she was seen within a day by a specialist, had surgery within the month, (it wasn't an urgent surgery).

The real problem(s) seems to be a lack of family physicians and ER wait times, although provincially our wait times are going down slowly but surely.

I think what dramatically alters our wait times averages is our extreme rural communities. I don't know anyone who has had to wait for long periods near an urban center.

[PolWatch]

The Canadians I have talked to are happy (mostly) with their health care. I can't say the same thing about the Americans. When people talk about the delays for procedures in Canada, they don't mention the delays we have here too. I have family in Houston and they tell me that a 45+ day delay for appointments for tests like mammograms is not unusual. Visits of short duration are the norm now for most doctors....patients are run through like cattle.

I have been very fortunate to find a good internist but she had to refer me to a pain management specialist. The laws concerning pain medication have been changed....only specialists can prescribe pain medication for more than 60 days. The p/m doctor told me I needed another MRI.....a week later I received a call from their office to schedule me for a spinal epidural....no discussion of the procedure during the visit. Since I know I have at least 5 areas of spinal stenosis, I have no idea where they think they need to inject the spine. I now have to visit the office again to find out what is going on. This is quality American health care? BTW: I have Medicare and the best BC/BS supplemental insurance you can buy.

[Adelaide]

The Canadians I have talked to are happy (mostly) with their health care. I can't say the same thing about the Americans. When people talk about the delays for procedures in Canada, they don't mention the delays we have here too. I have family in Houston and they tell me that a 45+ day delay for appointments for tests like mammograms is not unusual. Visits of short duration are the norm now for most doctors....patients are run through like cattle.

I have been very fortunate to find a good internist but she had to refer me to a pain management specialist. The laws concerning pain medication have been changed....only specialists can prescribe pain medication for more than 60 days. The p/m doctor told me I needed another MRI.....a week later I received a call from their office to schedule me for a spinal epidural....no discussion of the procedure during the visit. Since I know I have at least 5 areas of spinal stenosis, I have no idea where they think they need to inject the spine. I now have to visit the office again to find out what is going on. This is quality American health care? BTW: I have Medicare and the best BC/BS supplemental insurance you can buy.

Are they maybe trying to measure your ICP for some reason? That's how mine is measured and lowered/controlled.

[Private Pickle]

If the US were to adapt some form of universal healthcare they would have to do it the way Canada did, or at least in a similar way. The federal government came up with an Act of parliament that says what the provinces must provide but the Canada Health Act is interpreted differently by each province, (examples being what is considered essential such as dental not being covered by most provinces, and also that some provinces have a mixed private/public system). The five "pillars" that must be met by the provinces are public administration, comprehensiveness, universality, portability and accessibility - it's up to each province to decide how best to implement the system. Failure to adhere to those five pillars means the province will be fined by not receiving transfer payments/federal funding from the federal government. But literally every provincial insurance program is different.

It leaves most of the responsibility to the provinces to create their programs and run them. Every province does it differently depending on what they're able to do. If the US mimicked this it would mean the States each have majority of the power to determine what their programs are and it's definitely more sensible then trying to create a program for 300+ million people. The less people the better, which is why state-level or province-level control is preferable. It also means that states could opt out and if it mimicked our system, the punishment would be no transfer payments from the federal government that would have gone towards a universal system (so no loss to states that have no desire to have a universal insurance program like OHIP).

Very few countries operate like Canada. A handful. I will pass given the negatives I've already mentioned. While the concept you're laying out sounds good it would result in horendous issues in larger States that already have entitlement issues. But regardless the Provinces only act as a paying mechanism and they have different way for their populace to pay. That's about it.

Again I don't want to trade the effectiveness of a privatized system for the paying mechanism efficiency of a single payer.

[Adelaide]

Very few countries operate like Canada. A handful. I will pass given the negatives I've already mentioned. While the concept you're laying out sounds good it would result in horendous issues in larger States that already have entitlement issues. But regardless the Provinces only act as a paying mechanism and they have different way for their populace to pay. That's about it.

Again I don't want to trade the effectiveness of a privatized system for the paying mechanism efficiency of a single payer.

Fair enough - but most Canadians wouldn't trade our system even with some of the problems that exist.

[Common]

I wont answer for her, but I'll give my take.

Canadians overwhelmingly approve of our system. It's certainly not perfect. I'd call it good.

There are no co pays. Essentially your province acts as insurer and you get a card. In Ontario it's OHIP. It doesn't include prescriptions, dental or glasses. Many Canadians have supplemental insurance that pays for prescriptions, dental, glasses and things like hospital room upgrades. All hospitals are private corporations and there are clinics where you can pay out of pocket for things like MRI's.

NO disprespect intended but that doesnt sound good to me at all. From what you wrote, you dont get dental or prescriptions, you pay tax for the health care then you have to pay for mris? which here cost over 2,000

[Common Sense]

NO disprespect intended but that doesnt sound good to me at all. From what you wrote, you dont get dental or prescriptions, you pay tax for the health care then you have to pay for mris? which here cost over 2,000

You only have to pay for MRI's if you don't want to wait. Waiting periods vary by necessity and area. All I'm saying is that people do have a choice.

Dental and prescriptions aren't covered. It's something I disagree about, but coverage for it is affordable compared to full medical coverage.

[Private Pickle]

I think what dramatically alters our wait times averages is our extreme rural communities. I don't know anyone who has had to wait for long periods near an urban center.

The fact is the average wait times for surgery in Canada is 4 weeks. It's a matter of losing efficiency in health care providing to make a semi-effective payment mechanism.

[Private Pickle]

I've never had to wait long for an MRI because I have a neurological condition. It isn't something that could kill me, however, so technically I'm not top of the list.

There are wait times for surgeries and specialists but it takes into account priority - I had to have my heart tested using a holter monitor to see if I could take a medication and it took 2 weeks to see a cardiologist, or thereabouts. My mother has a rare heart defect and she was seen within a day by a specialist, had surgery within the month, (it wasn't an urgent surgery).

The real problem(s) seems to be a lack of family physicians and ER wait times, although provincially our wait times are going down slowly but surely.

For specialists in 2005 the average wait in Canada was 57 days. 2008, 60 days. 2010, 59 days.

In the U.S. The numbers are 23, 26 and 20 respectively.

[Private Pickle]

Fair enough - but most Canadians wouldn't trade our system even with some of the problems that exist.

I never asked them to. As a matter of fact my plan takes a note from Canada's way of handling meds

[Common Sense]

The fact is the average wait times for surgery in Canada is 4 weeks. It's a matter of losing efficiency in health care providing to make a semi-effective payment mechanism.

My point is that many rural areas are served by small hospitals. Their wait times are far worse than urban centers.

There are differing wait times for different procedures. There has been a concerted effort to bring wait times down and it has worked.

I've had minor surgery and I waited a day for it. The fact is, there are states and hospitals in the US with very long wait times for specific surgeries as well.

[Common Sense]

For specialists in 2005 the average wait in Canada was 57 days. 2008, 60 days. 2010, 59 days.

In the U.S. The numbers are 23, 26 and 20 respectively.

There has been an effort over the last few years to reduce those. 2010 was nearly 6 years ago.

I can go to this site...

http://www.ontariowaittimes.com/Surgerydi/en/PublicMain.aspx

...to see average wait times. It will show me what hospitals have what wait times. I plugged in MRI. I could get one in 29 days. However if your doctor recommends that you need one asap, you can be bumped ahead.

[Adelaide]

My point is that many rural areas are served by small hospitals. Their wait times are far worse than urban centers.

There are differing wait times for different procedures. There has been a concerted effort to bring wait times down and it has worked.

I've had minor surgery and I waited a day for it. The fact is, there are states and hospitals in the US with very long wait times for specific surgeries as well.

Actually one of the worst hospitals in Canada (I think it's ranked second last) for ER wait times is the ER I use frequently. I never wait longer than 2 hours, although the average is about 6 hours. The problem is that we have 2 hospitals for like 500,000 people. Part of the problem is that the two universities in the city don't have medical schools... most major cities do, and hospitals benefit from it and regions benefit from it by tending to have more hospitals. It's kind of a unique situation. I get through so quickly because physicians see my history and assume my brain is going to blow up or something. Plus I'm a frequent flier that has legit issues (meaning I don't show up with a cold or seeking drugs) so when I do go, they look at my history and put me in the critical care portion of the ER quickly to start treatment even when it's not related to my brain problem. It probably helps that I get runs of tachycardia when I'm stressed out so when I get triaged my resting heart rate is like 150+bpm.

But that hospital has an average 6 hour wait time for the reasons I listed, as well as the fact that my region is terrible for not having enough family physicians (another side-effect of not having a medical school) and so people do show up with minor issues too frequently like colds, the flu, etc. - things that should and would normally be dealt with by a general physician.

I've been to many ERs and to many medical centres in my life for a variety of reasons. Vancouver, Hamilton, Toronto and London all have great hospitals where the wait is low and I've gotten in to specialists or for ER treatment quickly. My region just really sucks... a lot. I have to go to Hamilton or London for majority of the specialists because I have some pretty rare problems that can't be treated in my region. My region is great for adult cancer, geriatrics, cardiology, acute mental health, and some other areas... but really sucks for chronic mental health, neurology, specific areas of general surgery, bariatric surgery, so on.

The two universities really need to get a medical school but they specialize in engineering/mathematics and business. Really great universities, but just no medical schools.

[Common Sense]

Actually one of the worst hospitals in Canada (I think it's ranked second last) for ER wait times is the ER I use frequently. I never wait longer than 2 hours, although the average is about 6 hours. The problem is that we have 2 hospitals for like 500,000 people. Part of the problem is that the two universities in the city don't have medical schools... most major cities do, and hospitals benefit from it and regions benefit from it by tending to have more hospitals. It's kind of a unique situation. I get through so quickly because physicians see my history and assume my brain is going to blow up or something. Plus I'm a frequent flier that has legit issues (meaning I don't show up with a cold or seeking drugs) so when I do go, they look at my history and put me in the critical care portion of the ER quickly to start treatment even when it's not related to my brain problem. It probably helps that I get runs of tachycardia when I'm stressed out so when I get triaged my resting heart rate is like 150+bpm.

But that hospital has an average 6 hour wait time for the reasons I listed, as well as the fact that my region is terrible for not having enough family physicians (another side-effect of not having a medical school) and so people do show up with minor issues too frequently like colds, the flu, etc. - things that should and would normally be dealt with by a general physician.

I've been to many ERs and to many medical centres in my life for a variety of reasons. Vancouver, Hamilton, Toronto and London all have great hospitals where the wait is low and I've gotten in to specialists or for ER treatment quickly. My region just really sucks... a lot. I have to go to Hamilton or London for majority of the specialists because I have some pretty rare problems that can't be treated in my region. My region is great for adult cancer, geriatrics, cardiology, acute mental health, and some other areas... but really sucks for chronic mental health, neurology, specific areas of general surgery, bariatric surgery, so on.

The two universities really need to get a medical school but they specialize in engineering/mathematics and business. Really great universities, but just no medical schools.

They should have a medical school. I know where you're talking about.

I've never really waited very long. The last time I was at St. Michael's in downtown Toronto, I waited about 20 mins. When I was younger I fell through a window and severed an artery, I waited for almost 4 hours, but that was because it was the middle of the night and I was waiting for a plastic surgeon to show up.

[Adelaide]

They should have a medical school. I know where you're talking about.

I've never really waited very long. The last time I was at St. Michael's in downtown Toronto, I waited about 20 mins. When I was younger I fell through a window and severed an artery, I waited for almost 4 hours, but that was because it was the middle of the night and I was waiting for a plastic surgeon to show up.

I've only dealt with Sick Kids in Toronto. After I did a tissue donation they sent me home within 8 hours and we were staying at the Ronald McDonald house. About an hour after getting back I started to vomit and become somewhat unresponsive. They had taken about 750ml of bone marrow and because of an accident in paperwork (boy, were my parents pissed!) I was put into the day surgery recovery room instead of being admitted overnight. When we went back and went to the ER at Sick Kids I was rushed through and stayed overnight there, hooked up to an IV for fluids and my parents got an apology. But I did two other tissue donations there and never had that problem. Sick kids was truly amazing when I look back at it. Spent most of my childhood there. I hear really good things about CHEO, too.

In terms of the universities here, they have tried to link up with McMaster to basically get medical students to intern but the program is kind of new and not really what is needed. A full-blown medical school is what is needed... but nanotechnology and other areas of technology are what is being funded because that's simply what they're good at. The other university is great for business students, but not for much else. Most people say people go to that second university to continue high school because it's not really known for academics and most students seem to pass through based on their ability to perform stunts like keg stands. :undecided:

Anyways... my region is an exception because of the lack of medical schools. It's not going to change anytime soon.

[Private Pickle]

My point is that many rural areas are served by small hospitals. Their wait times are far worse than urban centers.

There are differing wait times for different procedures. There has been a concerted effort to bring wait times down and it has worked.

I've had minor surgery and I waited a day for it. The fact is, there are states and hospitals in the US with very long wait times for specific surgeries as well.

Sure you can point to sub-par hospitals in the U.S. and compare that with Canada's average but the fact remains the average for procedures is more than double or even tripple in Canada.

[Private Pickle]

There has been an effort over the last few years to reduce those. 2010 was nearly 6 years ago.

I can go to this site...

http://www.ontariowaittimes.com/Surgerydi/en/PublicMain.aspx

...to see average wait times. It will show me what hospitals have what wait times. I plugged in MRI. I could get one in 29 days. However if your doctor recommends that you need one asap, you can be bumped ahead.

I understand but it's a real problem. One I don't think should be an issue. If you're fine with longer wait times and a litany of other problems because you have universal healthcare than I'm happy for you. Again I do not want to impact the effectiveness for healthcare in order to obtain efficiency in the payment mechanism.

[Common Sense]

I understand but it's a real problem. One I don't think should be an issue. If you're fine with longer wait times and a litany of other problems because you have universal healthcare than I'm happy for you. Again I do not want to impact the effectiveness for healthcare in order to obtain efficiency in the payment mechanism.

One thing that impacts overall health in Canada is preventative medicine. I have never had an issue with accessing a family doctor. One reason why many Americans wait until a problem become unmanageable is that they have to pay to see a family doctor. That adds to the overall cost of healthcare.

If you want to look at effectiveness, you could look at our lifespans, cancer survival rates and infant mortality rates which are superior or on par with the US.

[Private Pickle]

One thing that impacts overall health in Canada is preventative medicine. I have never had an issue with accessing a family doctor. One reason why many Americans wait until a problem become unmanageable is that they have to pay to see a family doctor. That adds to the overall cost of healthcare.

If you want to look at effectiveness, you could look at our lifespans, cancer survival rates and infant mortality rates which are superior or on par with the US.

I pay a co-pay just like you to see my doctor. Preventative medicine however; is completely free for me both medically and dentally.

[Common Sense]

I pay a co-pay just like you to see my doctor. Preventative medicine however; is completely free for me both medically and dentally.

I don't pay a co pay to see my doctor.

How is preventative medicine like colonoscopy free to you?

[Private Pickle]

I don't pay a co pay to see my doctor.

How is preventative medicine like colonoscopy free to you?

Colonoscopy would cost me a co-pay. My current copay for a specialist is $45.

Aren't there provinces that have copays like Quebec? Only the government collects it as part of the tax process so it isn't considered a "copay". A nice end around to the 1984 CHC Act.

[Common Sense]

Colonoscopy would cost me a co-pay. My current copay for a specialist is $45.

Aren't there provinces that have copays like Quebec? Only the government collects it as part of the tax process so it isn't considered a "copay". A nice end around to the 1984 CHC Act.

There are no copays that I'm aware of.

When you pay a copay, that's on top of your monthly insurance bill is it not?

[Private Pickle]

There are no copays that I'm aware of.

When you pay a copay, that's on top of your monthly insurance bill is it not?


I looked into Quebec and I was right however; I'm not sure if the Canadian Government did anything about it:

http://healthbusinessblog.com/2010/04/01/co-pay-canadian-style/


One of the real nightmares of the US health care system is the paperwork involved in processing small transactions. A solo practitioner friend gave me an example of an office visit where he is paid $43 by a private insurance company. After collecting the $25 co-pay from the patient he’s left with trying to get the remaining $18 from the insurer. It’s not a simple matter to collect from the insurer, so he employs a biller. If the patient doesn’t pay the $25 at the time of service, there’s effort and expense involved in billing and collecting for that. All of this is not exactly a great use of time and resources. One of the advantages of a single payer system –like Canada’s– is that it greatly reduces these hassles and frictions.
I’m in Montreal today, where the Gazette leads off with a story (Feds mum on fee to visit MD (http://www.montrealgazette.com/health/Feds+visit/2750716/story.html)) on how Quebec may begin to impose a $25 co-pay for each office visit or other service. Payment at the “point of contact” is forbidden by the Canada Health Act, which would seem to rule out co-pay’s. However, the plan is for the government itself to collect the fee as part of the personal income tax filing process. Twenty visits to the doctor? That will be an extra $500. It’s yet to be determined whether the federal government will allow this circumvention of the intent of the Health Act.

[Private Pickle]

There are no copays that I'm aware of.

When you pay a copay, that's on top of your monthly insurance bill is it not?

And yes. It is. But insurance companies are not the ones driving up the prices. The providers are.

[Common Sense]

I looked into Quebec and I was right however; I'm not sure if the Canadian Government did anything about it:

http://healthbusinessblog.com/2010/04/01/co-pay-canadian-style/

I don't believe a copay was ever implemented in Quebec. I could be wrong, but I don't think it has.

[Private Pickle]

I don't believe a copay was ever implemented in Quebec. I could be wrong, but I don't think it has.

Roger.

[texan]

It didn't work out for Vermont. Maybe Colorado will have (http://www.washingtontimes.com/news/2015/oct/25/coloradocare-would-replace-obamacare-with-statewid/) better luck.

I thought Obamacare was working really well?

[Private Pickle]

I thought Obamacare was working really well?

You did?

Huh.

[Dr. Who]

The Canadians I have talked to are happy (mostly) with their health care. I can't say the same thing about the Americans. When people talk about the delays for procedures in Canada, they don't mention the delays we have here too. I have family in Houston and they tell me that a 45+ day delay for appointments for tests like mammograms is not unusual. Visits of short duration are the norm now for most doctors....patients are run through like cattle.

I have been very fortunate to find a good internist but she had to refer me to a pain management specialist. The laws concerning pain medication have been changed....only specialists can prescribe pain medication for more than 60 days. The p/m doctor told me I needed another MRI.....a week later I received a call from their office to schedule me for a spinal epidural....no discussion of the procedure during the visit. Since I know I have at least 5 areas of spinal stenosis, I have no idea where they think they need to inject the spine. I now have to visit the office again to find out what is going on. This is quality American health care? BTW: I have Medicare and the best BC/BS supplemental insurance you can buy.
Spinal needles of any kind give me the willies and epidurals of any kind run the risk of causing paralysis.

[Peter1469]

If the US were to adapt some form of universal healthcare they would have to do it the way Canada did, or at least in a similar way. The federal government came up with an Act of parliament that says what the provinces must provide but the Canada Health Act is interpreted differently by each province, (examples being what is considered essential such as dental not being covered by most provinces, and also that some provinces have a mixed private/public system). The five "pillars" that must be met by the provinces are public administration, comprehensiveness, universality, portability and accessibility - it's up to each province to decide how best to implement the system. Failure to adhere to those five pillars means the province will be fined by not receiving transfer payments/federal funding from the federal government. But literally every provincial insurance program is different.

It leaves most of the responsibility to the provinces to create their programs and run them. Every province does it differently depending on what they're able to do. If the US mimicked this it would mean the States each have majority of the power to determine what their programs are and it's definitely more sensible then trying to create a program for 300+ million people. The less people the better, which is why state-level or province-level control is preferable. It also means that states could opt out and if it mimicked our system, the punishment would be no transfer payments from the federal government that would have gone towards a universal system (so no loss to states that have no desire to have a universal insurance program like OHIP).

Bravo. Most Americans don't understand the concept of federalism these days.

[Matty]

Bravo. Most Americans don't understand the concept of federalism these days.




Republicans have long advocated for block grants for Medicaid funds. Which is basically the same thing Adelaide is talking about.

[Dr. Who]

Sure you can point to sub-par hospitals in the U.S. and compare that with Canada's average but the fact remains the average for procedures is more than double or even tripple in Canada.
Part of the problem appears to be a lack of a: national system that analyzes demographics and other data to project future health personnel needs, then adjusts the training pipeline as closely as possible to those projections. (http://news.nationalpost.com/health/untrained-and-unemployed-medical-schools-churning-out-doctors-who-cant-find-residencies-and-full-time-positions) Canadian medical schools are graduating too many doctors in specialties that are not required, and not enough in those that are.

[Private Pickle]

Part of the problem appears to be a lack of a: national system that analyzes demographics and other data to project future health personnel needs, then adjusts the training pipeline as closely as possible to those projections. (http://news.nationalpost.com/health/untrained-and-unemployed-medical-schools-churning-out-doctors-who-cant-find-residencies-and-full-time-positions) Canadian medical schools are graduating too many doctors in specialties that are not required, and not enough in those that are.

Because they can get jobs in the States.