Debate Canada's Healthcare System

[Hilldog]

Go on now let's have a discussion.

[NeverAgain]

ff, gud. i lik it, maks u tink.

[angus]

Weird.  I was driving eastbound on QEW once, in about 1998, and I saw a big billboard advertising a major hospital in Toronto and it said, "MRI coming in 1999!"

1999?  MRI coming in 1999?!  To a major-city hospital?  Sounds about right.  My guess at the time was that I probably don't want to get sick or injured in Canada.  On the other hand, if you're poor, then a canadian-style system will probably be a better system for you than a US-style system.  Then again, if you're poor, life sucks no matter what.  

At least they don't get fined for electing not to buy medical insurance, which is more than I can say for us.  Thanks, Obama.

I really don't have any first-hand knowledge.  I've only used the medical facilities in the USA, Peru, China, and Mexico.  If I were to rate my experiences, I'd go with USA≈China>Mexico>Peru.  If I ever get sick or injured in Canada, I'll figure out where to put canada in that list.

[politicallefty]

Debate it? I would take their single-payer system in a heartbeat over what we currently have in the US. If we wanted to go the route, it would not be that hard to explain to the American people. Just take Medicare and give it to everyone with some expanded benefits and no premiums. Yes, that does mean higher taxes, but it also means no health insurance premiums. For most, the costs would be roughly a net zero, though some would end up paying more and some paying less.

I don't know what's so hard for some to understand about how single-payer health insurance works. Like I said, for most, the insurance premium is paid in the form of a payroll tax. The biggest lie I cannot stand has to do with those on the right that say you can't pick your own doctor if we adopt a single-payer system. That's an outright lie. To our Canadian posters, are you limited in any way as to the choice of your GP or specialists? As an American that has employer-based health insurance, my choice of doctor is limited to those pre-approved by the insurance company. Somehow, everything is perfectly right with the world if the insurance company dictates your choice of doctors, according to those on the right.

[OSR stands with Israel]

I like the current US system better. Private>Gov Owned(Not a socialist)

[Murica!]

I like the current US system better. Private>Gov Owned(Not a socialist)

>Implying that state ownership is inherently socialistic

Dude, no.

[parochial boy]

I like the current US system better. Private>Gov Owned(Not a socialist)

Private is better than publically owned regardless of how well it actually works in practice?

That's bizarre.

[DC Al Fine]

The biggest lie I cannot stand has to do with those on the right that say you can't pick your own doctor if we adopt a single-payer system. That's an outright lie. To our Canadian posters, are you limited in any way as to the choice of your GP or specialists?

We can pick our family doctor but since there is a doctor shortage, my options are my current doctor or nobody. Virtually every doctor in my city only accepts newborn babies as patients. No one I know chooses their specialist.

[DC Al Fine]

While I'm ok with the Canadian system, it has some serious flaws that I think American progressives dismiss too easily.

Single payer systems have to control costs. How do they do that? Some of it comes from bargaining power, but most of the savings come from rationing care. This takes the form of very long wait times, fewer specialists and difficulty finding a family doctor. Rationing is disproportionately felt by chronic patients.

In practical terms it means having to book doctor's appointments 6-8 weeks in advance, waiting in the emergency room for over eight hours, or waiting two years for a hip replacement. Canada's healthcare system is excellent if you are healthy or need acute care, but it doesn't serve chronic patients well. If I broke my leg or had cancer, I'd rather be in Canada. If I needed a hip replaced, I'd choose the States in a heartbeat.

[DC Al Fine]

While I'm ok with the Canadian system, it has some serious flaws that I think American progressives dismiss too easily.

Single payer systems have to control costs. How do they do that? Some of it comes from bargaining power, but most of the savings come from rationing care. This takes the form of very long wait times, fewer specialists and difficulty finding a family doctor. Rationing is disproportionately felt by chronic patients.

In practical terms it means having to book doctor's appointments 6-8 weeks in advance, waiting in the emergency room for over eight hours, or waiting two years for a hip replacement. Canada's healthcare system is excellent if you are healthy or need acute care, but it doesn't serve chronic patients well. If I broke my leg or had cancer, I'd rather be in Canada. If I needed a hip replaced, I'd choose the States in a heartbeat.

Eight hours is identical to the average wait time in the ED for my local hospital. And, like roughly a third of the people living in my county, I don't even have a primary care physician. I tried to find one when I moved here and no one could see me within three months. With wait times like that, why bother? I'm young and I have no chronic conditions. I can always go to urgent care if I need to.

Hmm. That's strange. Canada's long had a reputation for the worst emergency rooms among countries with 'socialized medicine', much less the USA. The chart below suggests much, much better wait times. Perhaps you live an extreme outlier? This is just anecdata, but I've been/taken people to emergency about half a dozen times and the two times it happened in the USA (Orlando and middle of nowhere in Maine) were hours less wait time than my Canadian visits, and the American situations weren't very serious.



Interestingly enough, the study behind the chart indicated that wait times were generally less in rural areas.

[I’m not Stu]

I personally oppose single-payer.

[politicallefty]

The biggest lie I cannot stand has to do with those on the right that say you can't pick your own doctor if we adopt a single-payer system. That's an outright lie. To our Canadian posters, are you limited in any way as to the choice of your GP or specialists?

We can pick our family doctor but since there is a doctor shortage, my options are my current doctor or nobody. Virtually every doctor in my city only accepts newborn babies as patients. No one I know chooses their specialist.

I'm sorry I just noticed your reply. I'll try to respond to the one after as well.

I don't know of any private insurer that just lets you pick your doctor in this country. The for-profit private insurer has a list of pre-approved doctors. If you want to see someone else, it's going to cost you a lot more money. As for specialists, it's the same here. My parents have good employer-based health insurance and recently my mom still had to wait about three months to see a specialist for a non-life threatening condition. Literally, every complaint I've heard people say about government-run health insurance are things the private insurance companies are already doing. The choice is essentially between big business and government.

I never said the Canadian system is perfect, but it seems to be one of the better ones that could be implemented here. Costs are wildly out of hand in this country and with outcomes that are less than similar industrialized nations. We pay a lot more for a worse outcome overall. I don't think there is a perfect option, but I categorically reject the idea of for-profit health insurance. While I do prefer something like the Canadian system, I'd gladly accept the Bismarck Model over what we have now.

I personally oppose single-payer.

Why?

[Person Man]

I don't really see the reason to totally ban private money from a healthcare system or to eliminate profit. At the same time, healthcare, though a stretch to call it a right, is a basic public utility and not a consumer good/service like donuts, massages, XBoxes, or invisible cola.

[politicallefty]

I don't really see the reason to totally ban private money from a healthcare system or to eliminate profit. At the same time, healthcare, though a stretch to call it a right, is a basic public utility and not a consumer good/service like donuts, massages, XBoxes, or invisible cola.

I disagree with you in that I do think healthcare is a right. You are right that you cannot totally remove money from healthcare. However, I think one of the biggest issues is the cost barrier to accessing healthcare at all. Everyone should be entitled to a certain level of healthcare. Current federal law only guarantees access in emergency situations. I'd prefer a scheme where one's life isn't weighed against the sharedholders' dividends.

In terms of reducing private for-profit influence, in exchange for taking over the insurance aspect of healthcare, I think government should work in strong public-private partnerships to produce new drugs. I also think the government should pay for medical school based on MCATs and college GPA and income. For those with high scores and low income, I think a free ride for med school would be a great idea. If we look at education in terms of healthcare, I think we can prevent a brain drain. One of the biggest barriers to becoming a doctor is the cost of med school. If some of our best and brightest were able to get in for free, I think we could limit a shortage. We have to be proactive in keeping the best here.

[DC Al Fine]

The biggest lie I cannot stand has to do with those on the right that say you can't pick your own doctor if we adopt a single-payer system. That's an outright lie. To our Canadian posters, are you limited in any way as to the choice of your GP or specialists?

We can pick our family doctor but since there is a doctor shortage, my options are my current doctor or nobody. Virtually every doctor in my city only accepts newborn babies as patients. No one I know chooses their specialist.

I'm sorry I just noticed your reply. I'll try to respond to the one after as well.

I don't know of any private insurer that just lets you pick your doctor in this country. The for-profit private insurer has a list of pre-approved doctors. If you want to see someone else, it's going to cost you a lot more money.

I want to clarify here. I'm not upset about lack of choice. I'm upset about having no choice.

Roughly 1/5 Canadians doesn't have a family doctor and in many areas, none are taking new patients.* This can be very distressing if you have an issue with your current doctor, since your options are often your current doctor or nobody. This is quite different from having to pick from a pre-approved list.

*Typically an exception is made for pregnant women and babies, but otherwise you are out of luck.

[politicallefty]

I want to clarify here. I'm not upset about lack of choice. I'm upset about having no choice.

Roughly 1/5 Canadians doesn't have a family doctor and in many areas, none are taking new patients.* This can be very distressing if you have an issue with your current doctor, since your options are often your current doctor or nobody. This is quite different from having to pick from a pre-approved list.

*Typically an exception is made for pregnant women and babies, but otherwise you are out of luck.

I've tried to keep myself knowledgeable about other countries, including Canada, but that's a new complaint I've never heard before. The main argument I've heard has to do with waiting lists. But, like I said, people here in the States wait a long time as well. As I've said, the main argument against single-payer in this country is that we'll have waiting lists and you won't be able to choose your own doctor. Neither of those are new to the average American.

You can attack your own system as you see fit, but the Canadian system does ultimately result in overall better outcomes at a far lesser cost.

[Hatman 🍁]

All of my experience is anecdotal of course, and I'm not an expert on our health care system. I do shudder at the thought of the US system and all the horror stories I hear about it. Canadians are generally very proud of our health care system, especially considering our exposure to all of those horror stories. Perhaps this fact is preventing us from improving the system?

Anyways here is my experience:
- Free doctor visits. If it weren't free, I'd probably never go! (As it is, I rarely go to the dentist, because it does cost money.)
- When my partner gave birth, it was free. What does it cost in the US to give birth? $10,000? That would've bankrupted us. Not nice!
- When I was diagnosed with type 1 diabetes last year, I was in and out of the hospital in 24 hours. Sure, I had to wait in the ER for a bit, but who am I to complain? Also again, everything was free. Also now I have to see the doctor a lot more, whether I like it or not.

Of course one big issue I have is that prescriptions are not free. They are cheaper than in the US, but still. Luckily for me, my insurance covers it. But not everyone is so lucky.