6 ms·

Let us not delude ourselves into thinking any healthcare system is self-contained and self-sustaining, equipped to deal with all the needs of its citizenry. Mo

Let us not delude ourselves into thinking any healthcare system is self-contained and self-sustaining, equipped to deal with all the needs of its citizenry. Most European nations ( and Canada, Australia & New Zealand ) are great at dispensing - what can be termed as - "subsistence medicine." Most ailments, procedures and surgeries are handled quite well, although - it has to be said - a tad frugally. ( It is not uncommon for the doctor to under-prescribe medications or opt for a less cost-prohibitive option over another even when the situation could be better dealt with, with a more exhaustive course of prophylaxis) Plenty of Canadians including the Premier of New Foundland have opted and continue to opt for minimally invasive procedures ( as well as convoluted surgeries ) to be done in the United States, simply because the U.S. is better equipped with the resources and the doctors to deal with such cases. "This is my heart, it's my health, it's my choice." With these words, Newfoundland Premier Danny Williams defended his decision to hop the border and go under the knife for heart surgery in Florida. The minimally invasive mitral valve surgery he needed is not available in Newfoundland, he told his province's NTV News channel in the first part of an interview aired last night.[1] For instance, some Canadian patients who are tired of waiting for procedures in their country's national health system come to Michigan hospitals. [2] Even the richest of the rich pick the United States over say European destinations for their medical treatments. The king (Abdullah of Saudi Arabia), who is 86 years old, was in town for surgery at New York Presbyterian Hospital on Nov. 24.[3] [1] http://www.theglobeandmail.com/news/politics/its-my-health-its-my-choice-danny-williams-says/article4311853/ http://www.theglobeandmail.com/news/politics/its-my-health-i... [2] http://www.cbsnews.com/news/reverse-medical-tourism-points-up-pluses-and-minuses-of-us-healthcare/ http://www.cbsnews.com/news/reverse-medical-tourism-points-u... [3] http://www.nytimes.com/2010/12/14/business/14road.html?_r=0 http://www.nytimes.com/2010/12/14/business/14road.html?_r=0

stcredzero 13y ago
So let's charge these rich people coming over here for premium care a bit extra and redistribute subsistence care to those traditionally not covered.
- sans-serif 13y ago
  This is so appalling. If your wife is in labor and needs to rush to the hospital, the cab driver ought to charge you outrageously because you're richer than him?
  - deleted 13y ago
    [deleted]
  - boomlinde 13y ago
    The cab driver is a really bad example because the cab driver isn't providing a service that people argue is a human right. In terms of healthcare I think that it's reasonable that those who can should pay more to cover for those who can only afford to be grateful. That is usually how the cost of public services is distributed using taxes.
    - growupkids 13y ago
      Ok, so make the example "your wife is bleeding out". Should the can driver charge you outrageously because you are richer than he is?
      - boomlinde 13y ago
        If you read my post again I am sure that you will understand that the predicament of my wife is irrelevant to my argument. Economically rationally the taxi driver will charge according to the perceived value of his service, which in terms of money means more to a rich person. Of course other factors weigh into this equation, especially competition and the fact that people aren't economically rational.
      - stcredzero 13y ago
        Should the can driver charge you outrageously because you are richer than he is? Only if you are outrageously rich and the driver did an excellent job of emergency transportation and only by billing you after the fact. The first priority should be on saving lives, then sort the logistics out later.
sanswork 13y ago
Having the best hospitals in the world doesn't matter if only a tiny subset of your population can actually use them. The wait times for life threatening issues in Canada really isn't that bad as someone who spent last year with my mother going through Cancer treatments and has a few friends here going through the same at the moment. Less urgent procedures due tend to take a long time though. So while Canadians may wait up to 6 weeks for non-essential/urgent surgeries, 45,000 americans die each year because they lack the insurance to pay for their medical treatments.
TheLegace 13y ago
I think you need to see what Dr. Danielle Martin[1] a Canadian doctor had to say when she testified to the U.S. Senate defending the Canadian system. The reference was to Newfoundland Premier Danny Williams’ controversial 2010 decision to undergo heart surgery at a Miami hospital. “It’s actually interesting,” replied Dr. Martin, “because in fact the people who are the pioneers of that particular surgery … are in Toronto, at the Peter Munk Cardiac Center, just down the street from where I work.” She then hinted that Mr. Williams was of the mistaken belief that simply paying more for something “necessarily makes it better.”[2] [1] http://youtu.be/iYOf6hXGx6M?t=1m22s http://youtu.be/iYOf6hXGx6M?t=1m22s [2] http://news.nationalpost.com/2014/03/12/toronto-doctor-smacks-down-u-s-senate-question-on-canadian-waitlist-deaths/ http://news.nationalpost.com/2014/03/12/toronto-doctor-smack...
- haldujai 13y ago
  As a Canadian in the healthcare field perhaps I can chime in as well. When you talk about Canadian healthcare, it is a provincially run program (not federal) so let's talk about it at the provincial level. As I am an Ontario resident I'll be discussing this from an Ontario perspective, talking about all of the provinces and their differences would entail several posts. Ontaio is currently going to institute (or plans to at least) pay freezes on physicians due to the rising cost of healthcare in a non-booming economy. However it is currently one of the best provinces in wait times. The provincial median is 6.7 weeks to see a specialist after being referred and another 7.1 weeks to being treated. This has increased 3 years compared to last year and about doubled from 20 years ago. For some specialties like orthopaedics the total duration is ~40 weeks. This is in contrast to the US where ~90% see the specialist within 4 weeks. Internationally we are considered to be amongst the worst nations when it comes to wait times. Another big problem with the Ontario system is unemployment. 1/3 specialists, especially surgeons, are unemployed due to a lack of operating rooms and jobs available - even in rural areas. There is a definite need but with the single payer system we have, the aging population pyramid, and increasing healthcare costs we have there is no money left to pay physicians - who make less on average (at least in the surgical specialties) than the US physicians. So we're graduating surgeons who can't work and are forced to go the US to find jobs. To address one of Dr. Martin's comments btw, someone jwo develops a surgery/technique/game isn't always the best person at solving it. Developing a mitral valve replacement survey using MIS techniques doesn't mean you're the best person to technically achieve it (you could be, but it's not a given as she phrases it). The US has a system that rewards exceptionalism and excellence, the Canadian system generally rewards mediocrity (this is even evidence in other fields such as law and even academia). The US is famous for having premier surgeons and state of the art equipment. A prominent example I know is in the field of limb lengthening, where until very recently there was not a single surgeon in Canada who could do internal limb lengthening, they all used the external fixator pioneered in the USSR. Even in medical education you are seeing prominent US schools teaching the use of hand held ultrasound devices which are supposed to one day replace stethoscopes. The US also has far more specialized medical fellowships focused on advanced techniques and tools such as using tne da Vinci robot system. I can provide references if necessary (I typed this up on my phone) but most of these facts are readily google-able. TLDR: Our system isn't as perfect as you might think and is actually teetering on financial instability at the moment with up to 1/3 new physicians unable to find a job in the country due to funding issues.

stcredzero 13y ago

So let's charge these rich people coming over here for premium care a bit extra and redistribute subsistence care to those traditionally not covered.

sans-serif 13y ago
This is so appalling. If your wife is in labor and needs to rush to the hospital, the cab driver ought to charge you outrageously because you're richer than him?
- deleted 13y ago
  [deleted]
- boomlinde 13y ago
  The cab driver is a really bad example because the cab driver isn't providing a service that people argue is a human right. In terms of healthcare I think that it's reasonable that those who can should pay more to cover for those who can only afford to be grateful. That is usually how the cost of public services is distributed using taxes.
  - growupkids 13y ago
    Ok, so make the example "your wife is bleeding out". Should the can driver charge you outrageously because you are richer than he is?
    - boomlinde 13y ago
      If you read my post again I am sure that you will understand that the predicament of my wife is irrelevant to my argument. Economically rationally the taxi driver will charge according to the perceived value of his service, which in terms of money means more to a rich person. Of course other factors weigh into this equation, especially competition and the fact that people aren't economically rational.
    - stcredzero 13y ago
      Should the can driver charge you outrageously because you are richer than he is? Only if you are outrageously rich and the driver did an excellent job of emergency transportation and only by billing you after the fact. The first priority should be on saving lives, then sort the logistics out later.

sanswork 13y ago

Having the best hospitals in the world doesn't matter if only a tiny subset of your population can actually use them. The wait times for life threatening issues in Canada really isn't that bad as someone who spent last year with my mother going through Cancer treatments and has a few friends here going through the same at the moment. Less urgent procedures due tend to take a long time though. So while Canadians may wait up to 6 weeks for non-essential/urgent surgeries, 45,000 americans die each year because they lack the insurance to pay for their medical treatments.

TheLegace 13y ago

I think you need to see what Dr. Danielle Martin[1] a Canadian doctor had to say when she testified to the U.S. Senate defending the Canadian system. The reference was to Newfoundland Premier Danny Williams’ controversial 2010 decision to undergo heart surgery at a Miami hospital. “It’s actually interesting,” replied Dr. Martin, “because in fact the people who are the pioneers of that particular surgery … are in Toronto, at the Peter Munk Cardiac Center, just down the street from where I work.” She then hinted that Mr. Williams was of the mistaken belief that simply paying more for something “necessarily makes it better.”[2] [1] http://youtu.be/iYOf6hXGx6M?t=1m22s http://youtu.be/iYOf6hXGx6M?t=1m22s [2] http://news.nationalpost.com/2014/03/12/toronto-doctor-smacks-down-u-s-senate-question-on-canadian-waitlist-deaths/ http://news.nationalpost.com/2014/03/12/toronto-doctor-smack...

haldujai 13y ago
As a Canadian in the healthcare field perhaps I can chime in as well. When you talk about Canadian healthcare, it is a provincially run program (not federal) so let's talk about it at the provincial level. As I am an Ontario resident I'll be discussing this from an Ontario perspective, talking about all of the provinces and their differences would entail several posts. Ontaio is currently going to institute (or plans to at least) pay freezes on physicians due to the rising cost of healthcare in a non-booming economy. However it is currently one of the best provinces in wait times. The provincial median is 6.7 weeks to see a specialist after being referred and another 7.1 weeks to being treated. This has increased 3 years compared to last year and about doubled from 20 years ago. For some specialties like orthopaedics the total duration is ~40 weeks. This is in contrast to the US where ~90% see the specialist within 4 weeks. Internationally we are considered to be amongst the worst nations when it comes to wait times. Another big problem with the Ontario system is unemployment. 1/3 specialists, especially surgeons, are unemployed due to a lack of operating rooms and jobs available - even in rural areas. There is a definite need but with the single payer system we have, the aging population pyramid, and increasing healthcare costs we have there is no money left to pay physicians - who make less on average (at least in the surgical specialties) than the US physicians. So we're graduating surgeons who can't work and are forced to go the US to find jobs. To address one of Dr. Martin's comments btw, someone jwo develops a surgery/technique/game isn't always the best person at solving it. Developing a mitral valve replacement survey using MIS techniques doesn't mean you're the best person to technically achieve it (you could be, but it's not a given as she phrases it). The US has a system that rewards exceptionalism and excellence, the Canadian system generally rewards mediocrity (this is even evidence in other fields such as law and even academia). The US is famous for having premier surgeons and state of the art equipment. A prominent example I know is in the field of limb lengthening, where until very recently there was not a single surgeon in Canada who could do internal limb lengthening, they all used the external fixator pioneered in the USSR. Even in medical education you are seeing prominent US schools teaching the use of hand held ultrasound devices which are supposed to one day replace stethoscopes. The US also has far more specialized medical fellowships focused on advanced techniques and tools such as using tne da Vinci robot system. I can provide references if necessary (I typed this up on my phone) but most of these facts are readily google-able. TLDR: Our system isn't as perfect as you might think and is actually teetering on financial instability at the moment with up to 1/3 new physicians unable to find a job in the country due to funding issues.