Overeaters, smokers and drinkers: the doctor won't see you now

Macleans ^ | April 18, 2006 | NICHOLAS KOHLER AND BARBARA RIGHTON

[USFRIENDINVICTORIA]

You seem satisfied with the present system, and that's fine. However, you originally asked about choice & that's what's lacking.

If you're not aware about waiting lists -- or if you think that waiting lists for knee replacement surgeries are only two months long -- you haven't been paying attention.

There is no "no cost" health care in Canada. Part of the problem is that Canadians don't even know how much their care is costing -- or how well those costs compare with alternatives.

Those private clinics in Quebec aren't being allowed elsewhere. Why should we have to go to a foreign country to get health care. BTW -- you wouldn't need to use your credit card to get that care, if you were allowed to buy supplementary insurance (for items that purport to be covered by the public system). It's rather disingenuous of the supporters of the public monopoly to prevent us from buying competing insurance -- then to pretend that only the very rich could afford health care (because, it would not be covered by insurance).

[CaptainCanada]

I'm with you on this all the way..
On one hand I keep hearing that the U.S. health care system is the best
in the World - and also the the most expensive.
The old chestnut of the U.S. having almost 2X the MRIs vis-a-vis Canada
is always dragged out as prima facie evidence.
But......... Japan has 4X the MRIs per capita compared to to the
U.S. - does that mean that the Japanese health care system is superior
to USA?

[CaptainCanada]

We lack the choice

I think the choice Canadians lack that Americans have is that no
Canadian will ever have to choose between medical care and something to eat.

[USFRIENDINVICTORIA]

No Canadian has ever had to chose between being put on a waiting list and eating either.*

No system is perfect. Every organization or service can be improved. Rather than becoming defensive, and trying to deflect criticism through fatuous comparisons with the U.S.; we should be practicing kaizen (Japanese word for continuous improvement).

* "Access to a waiting list is not access to health care." Chief Justice Beverly McLachlin, Supreme Court of Canada, in reference to health care in Quebec.

[Snowyman]

Apparently I'm more aware than you. I know too many people with new hips , knees and eyes to buy into the notion that there are huge long waiting lists. I know two people, one got a new knee in 10 weeks, another a new hip , first appointment Dec 16, operation Feb 22 . You do the math.

I never said there is no "cost "insurance I pay taxes and the so called Ontario health premium. I said a no cost knee . I already paid for the insurance.

"if you were allowed to buy supplementary insurance (for items that purport to be covered by the public system)"

WHY would you want to ? You're already covered.

btw, Most Canadans going to the US use private insurance, but if I was desperate , which I'm not , I can go to States and get a MRI and pay out of my pocket.
Just like in Quebec or Alberta, or Nova Scotia.

[Boris99]

Ahh more passive aggressive posts from CaptainCanada "eh?" I guess even a fellow Canadian can't even express any dissatisfaction with anything in Canada. How dare they "eh!!!" Well I guess if it makes you feel all tingly inside to believe that everything is peaches and cream in Canada have at it "eh."

[Snowyman]

think the choice Canadians lack that Americans have is that no Canadian will ever have to choose between medical care and something to eat.

Well I know no American will be turned away from having proper care. I guess who pays for those who can't pay is basically the same thing as we do anyway .The taxpayer pays. Worrying about paying just isn't part of the Canadian hospital experience and I think that's a positive thing .

[USFRIENDINVICTORIA]

And I know someone who spent 18 months in total agony, waiting for knee replacement surgery. (A recent case, BTW) The average wait for surgery is 17.9 weeks.
http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=705

Most proponents of the health care monopoly -- including our previous Liberal Health Minister, want to close those private clinics down.

The insurance I'm referring to would actually pay for a treatment you need, when you need it. If it were no different than what we have now -- why would it be prohibited on the basis of "creating a two-tiered health care system"?

If you can pay out of pocket for a service in the U.S. -- why are you not allowed to do so in Canada?

If the public health care monopoly is so great -- why are proponents so afraid of allowing any competition?

In the absence of any competition, how do you know that our system is the best possible system?

The possibility that competitors would skim the youngest and healthiest people, and leave the public system to treat the oldest and sickest; has long been one of the main rationales for maintaining a monopoly. Now, we see signs that the public monopoly is moving toward skimming -- and leaving the oldest and sickest without treatment. Rationing through waiting lists was tried (and still exists) -- now, it seems there is a movement toward rationing by targeting specific client types. These people are first demonized -- not worthy of treatment, because of poor behaviour. Even though I'm not fat, nor a smoker, nor a boozer -- I'm still concerned about this trend. Partly, because I don't think it's ethical; partly because I don't know where it'll end (who's going to be added to the list next); and partly because of self-interest (I want to be able to access treatment when I get old).

[LibertarianInExile]

ROFLMAO!

So in Canada, "doctors" are turning away people who might be likely to GET SICK.

In the US, doctors call those people PATIENTS.

[CaptainCanada]

Even though I'm not fat, nor a smoker, nor a boozer -- I'm still concerned about this trend...

I'm a little confused. You're initial beef had to do with the
apparent trend of doctors cherry-picking the healthier lifestyle
folks and giving them preference over the fat slobs, smokers and boozers.
Then you claim that you are a victim of this trend even though
you aren't a fat slob, smoker or boozer...
Are you an exception to the rule, or are you in denial about your weight
and alcohol problem???

[USFRIENDINVICTORIA]

You got me -- I'm actually 450 pounds of lard, connected intravenously to an alcohol drip, and breathing in a tent filled with concentrated cigar smoke.

If you read my postings carefully; you would see that my self-interest in this is the fact that I'm an aging baby boomer. Our health care system is already straining to keep up -- what will happen in a few years, when multitudes of elderly patients are banging at the doors -- and fewer young taxpayers are out there to pay the tab.

There is a lot to be admired about Canada's health care system -- thousands of very smart people have worked many years to make it work as well as they can. However, it is simply not sustainable in its present form. Rather than getting defensive about it; we should try to dispassionately look for solutions.

Whenever a valuable service is being given away for free, it is inevitable that some sort of rationing occurs. We have overt rationing; in the form of lists of ailments that are covered, or not covered. We also have prescribed and proscribed treatments (sometimes the second-best treatment, in the interest of economy). We have had limits on the number of places in medical and nursing schools. Now -- I see signs of refusing services to whole categories of people. This is disturbing; because, as budgets get tighter and tighter, more and more services will have to be denied, to more and more people.

Like most people, I could not afford to pay by credit card for major treatment in the U.S. I am entirely dependent on our health care system working for me when I need it. I could have afforded to pay for private insurance -- which is an option most other countries allow. If a private insurer suddenly announced that it wasn't going to honour it's policies -- there would be criminal charges, and civil suits galore. Governments can weasel out of any implied contract -- but, they shouldn't be allowed to get away with it.