Quebec healthcare legalizes "private care?"

it's not just quebec- under canada's socialized medicine policy, all private health care is illegal. there are increasing number of private clinics opening up, and the government generally looks the other way, but under current canadian law, they are technically illegal clinics.

 

I get a kick out of the term “socialized medicine.” lol! That so 1950’s of you basso.

Langal, what basso is telling isn’t exactly true and it’s spun with an ideological agenda, neither of which will surprise you I’m sure. There are private clinics in Canada and they cover elective procedures and certain other exceptions. Basic health care issues are covered by our single tier progressive health care system which is based on the same general model that I believe all first world countries have used for decades, all except 1 that is. Although clearly vastly superior to the American model by all objective assessments our system is not without its problems. One is that the government starved it for money during the deficit years of the 90’s and wait lists grew. Now that we are running surplus budgets we are putting more money back in and wait lists are shrinking, but that problem hasn’t been completely solved yet.

 

To be fair to Basso, he probably doesn't realize that he is just repeating conservative spin .

So with increased revenues, the Canadian system is getting better, while ours of course is getting worse (40 million plus with no insurance) and more expensive even for those of us who have insurance.

Grizzled, I don't know if you are famiiliar with Medicare in the US for the disabled and those over 65? If so, how does the Canadian system differ from essentially a "Medicare for All" system? Under Medicare doctors are free not to accept it and patients are free to spend their own money on doctors who don't accept it if they want.



I'm in favor of a "Medicare for All System". Let the rich buy their own expensive insurance or pay out of their pockets if they want.

It would also be good to not lose your health insurance when you get laid off, be subjected to "pre-existing " conditions rules, and all the rest of the bs we face here.

 

That would be a little alarming, but it may be true. Do conservatives there talk about socialized police enforcement and socialized sewage collection too? How about socialized tax collection? Socialized fire protection is certainly an outrage too, wouldn’t you say?

I’m not sure I understand the question and I’m really only generally familiar with the US system. In the Canadian doctors can accept or reject patients for certain reasons, but whether or not they are insured isn’t one of them because every Canadian citizen is insured. Ours is essentially a single payer system and if you’re a Canadian citizen you are covered by that insurer, the provincial and federal governments (they share funding).

The problem we see with the “let the rich pay for their own” system is that it creates a two tier system, and that’s something we don’t want. Going back to the 60’s when our program was first established there was a feeling that there would be a tendency for top doctors to be hired away by the private system creating a level of better care for those who could pay and for the public system to become a level of lesser care for those who couldn’t afford the to top tier. As we consider basic health care to be a human rights issue we considered the two tier system to be morally offensive and unacceptable. In recent years there has been more debate on this, however. Our system is about 40 years old now and it does need to be updated to address and align it with current issues and the question of two tier care in certain areas is coming up again, and then there is the question of wait lists I mentioned before.

I should add that for practical purposes the very wealthy here have always had a second tier of care available to them and they have often used it, and that tier is the top private facilities in the US. You doctors accept our money too.

 

Here’s an article that contains part of the current debate.
http://www.canada.com/montreal/mont....html?id=77d38652-cbda-44d4-8880-5b9445eb4267

Not necessarily, and that question is part of the current debate.

We believe that certain things are human rights issues where all must be treated equally. The legal system, issues of freedom of speech and expression, basic heath care, the right to basic food and shelter, are all principles and things that we believe all citizens of our country are entitled to and must be treated equally under.

Medical costs are going up everywhere but the Canadian system costs about 30% less as a percentage of GDP than the American system and it covers 100% of our citizens. The savings come from getting rid of the cost of administering the multi-insurer system. More of our dollars go to the actual health care and less to bureaucracy and duplication. The savings are huge and the coverage is complete and there really is no argument for the American system from our standpoint. Nothing is perfect and the down side is that our system can get caught up in politics a bit, but the public and the courts are very attentive to this issue so no government can get away with playing too many games or they would get turfed. The current government is trying to win brownie points by boosting funding to health care, which is what the people now want. During the 90’s when deficits were high people accepted some cut backs in health care spending.

 

Read the bold. If it is so great then why do Canadians come to the US for treatment rather than the other way around? US system is far from perfect but I think Id rather have it this way.

I also have a cousin from Mexico getting treatment here in Houston's MD Anderson Center, because that is the best place in the world to go.


http://www.cbsnews.com/stories/2005/06/09/health/main700681_page2.shtml
(AP) Canada's Supreme Court on Thursday struck down a Quebec law that banned private insurance for services covered under Medicare, a landmark decision that could affect the country's universal health-care system.

The justices took a year to rule on a case that began in 1997, when George Zeliotis, an elderly Montreal man, tried to pay for hip replacement surgery rather than wait nearly a year for treatment at a public hospital.

Zeliotis told the high court that he suffered pain and became addicted to painkillers during the yearlong wait for surgery, and he should have been allowed to pay for faster service with private insurance.

"It is indeed a historical ruling that could substantially change the very foundations of Medicare as we know it," said Dr. Albert J. Schumacher, president of the Canadian Medical Association.

Although the ruling was made on the Quebec law, it likely will affect other Canadian provinces that forbid residents from buying private health care insurance for treatment under the country's Medicare system.

Opponents of changes to Medicare claimed it could force Canada into a two-tiered health care system in which those who have deeper pockets get faster, better service from doctors who opt out of the public health-care program.

Zeliotis' doctor, Jacques Chaoulli, argued that his patient's constitutional rights were violated because Quebec could not provide the care he needed and did not offer him the option of getting it privately.

Chaoulli also argued that doctors should be allowed to open private hospitals if patients are willing to pay.

The 1984 Canada Health Act affirmed the federal government's commitment to provide mostly free health care to all, including the more than 200,000 immigrants arriving each year, under a system called Medicare.

But the universal health-care system — while considered one of the fairest in the world — has been plagued by long waiting lists and a lack of doctors, nurses and new equipment. Some patients wait years for surgery, MRI machines are scarce and many Canadians travel to the United States for medical treatment.

In most Canadian provinces, it is illegal to seek faster treatment and jump to the head of the line by paying out of pocket for public care. Private health clinics have sprouted up even though they are technically illegal, though the provincial governments tend to look the other way.

If Zeliotis had been from outside Canada, he could have bought treatment in a private Quebec clinic. That is one way the system discourages the spread of private medicine — by limiting it to nonresidents.

Most polls indicate Canadians support Medicare, despite the high taxes needed to fund the service, seeing it as a marker of egalitarianism and independent identity that sets their country apart from the United States, where some 45 million Americans lack health insurance.

 

Mr. Clutch:
You’re not reading what I wrote. I’ve already mentioned that wealthy Canadians sometimes go to the US to “jump the cue”. Mr. Zeliotis could have done this as well, if he had the money that is. Let me say here that a year long wait for a senior citizen to get a hip replacement is outrageous. I have to think that this was an unusual situation, but I don’t deny that wait lists have grown to the point where they are a problem. But I’ve also already discussed the reason for this and the fact that the government is now putting more money into health care, i.e. buying more equipment and hiring more doctors. Please go back and read my posts so I don’t have to repeat myself.


Langal:

They aren’t free by any means. It takes money, effort and resolve to enforce them.

Back in the early 20th century when the push first started for universal health care one of the key points raised by the proponents was that these were no longer scarce resources. We have the ability to provide them for all now. The early proponents in Canada were Christians and were motivated by the Christian principles of compassion for your fellow man, but the also pointed out that from a purely economic perspective it makes sense. The Canadian health care system costs far less per capita and it covers all Canadians, so even from a cold financial perspective it’s the way to go.

It is a basic human right because we consider it a basic human right. Freedom of speech and the other are the same. They haven’t always been considered rights, but in our enlightened society we have come to value them as such. Your comments about “enslavement of medical and agricultural workers” are utter nonsense. I can’t even figure out what you’re trying to say here.

Not true. Poor countries typically cannot guarantee freedom of speech and fair legal systems. It’s true that the resources a country has to work with limit what it can do, but with respect to healthcare and basic food and shelter all first world countries have far far more resources than they need to ensure these for all of their citizens. The only question is, are the enlightened enough to do so? With 1 exception they are.

Again your comments are simply bizarre. “The best brain surgeon in the world can only work a limited amount of hours per year. He or she should have the right to operate on who he or she chooses to. And he or she should have the freedom to not work.” !?!? I can’t even figure out what you’re trying to suggest here.

Your final comments are scary. Any surgeon who works primarily for money is not one I want working on me or anybody else. Money is part of the equation and surgeons are very well paid, but it should never be a primary motivator in a person who carries human lives in their hands, IMO. What has happened historically is that we have had doctors who have gone to the US for the money and we’ve had many who’ve come back because of the working conditions and medial environment in the US. They found it morally offensive to deny people treatment they needed simply because they couldn’t pay for it. We also have doctors who come to Canada from all over the world to practice here, so there are instances of each. There are some who go to the US for the money and there are some who leave the US and who come here because they are morally offended by the US system.

 

I am not so sure that it is just the wealthy Canadians doing this, if it has gotten to the point where more private clinics are opening up. Even the Supreme Court, which I assume is pretty liberal, has decided to look the other way.

There's positives and negatives to both. I don't think its obvious that Canada's is better. Yes, it's fairer and cheaper over there. But we don't have waiting lists and there is more incentive for innovation over here.

To fix the US system, I'd take a look at the employer based insurance. They just pass on the cost to employees anyways. I'd rather get that money in my paycheck. I wonder what would happen if it was more like car insurance, then the incentive for people would be to keep themselves healthy and try to avoid the doctor unless it was necessary. Right now, I could go to the doctor as much as I want and my premiums would not go up. There is no incentive to control costs. Of course, there would have to be rules of some sort where insurance companies can't drop people just because they have health problems.

 

Well, you do the math. Any Canadian who heads south to have an insured procedure done sooner is paying for it out of his or her own pocket. His or her insurance, which is paid for from their taxes, will only pay for a procedure to be done in the US if it can’t be done in Canada. So the people who are heading south are those who can afford to pay for it out of their pocket and who are willing to do so in order to have a procedure done some months sooner.

And the Supreme Court doesn’t “look the way.” lol! What they’re doing, however, is saying that if the government won’t provide a reasonable level of care then people must be allowed to seek it some other way. And clearly their judgement was not “liberal” in any way. The effect of this is to light a torch under the government to make it get its *poop* together and reduce those waiting lists.

The waiting lists are a temporary problem caused by factors already discussed. They are not a systemic problem. I’m not sure there is more incentive for innovation in the American system. What evidence do you have that that is the case?

The fatal flaw in the American system is the multi-payer system. The bureaucracy and the duplication and waste of that system eats up over 30 cents on every dollar. Think about the prospect of having competing sewage collection companies for example. Think about the cost of having 3 sets of sewer lines running down every street and into every home. The overhead these companies would have to absorb would be exorbitant and the end cost to the consumers would end up being much higher. The same general principle applies to heath care. It’s much much cheaper and you can get universal coverage by going to a single payer system. This is why I believe all first world countries have been using this system for close to half a century, all except 1 that is.

PS- As a bit of trivia, in 3 Canadian provinces the automobile insurance system is run on a single payer system as well, with the government being the single payer of course. Here’s one example. SGI stands for Saskatchewan Government Insurance, btw.

Saskatchewan Auto Fund

• is the province’s compulsory auto insurance program

• operates on a break-even basis over time

• is financially self-sustaining

• does not receive money from, nor pay annual dividends to, the government
http://www.sgi.sk.ca/sgi_internet/sgi_pub/about_sgi/corporate_structure.htm

 

As far as the people who head south all being "rich," isn't it possible that middle income people saved up money to go south? After all, if there are months of waiting they have plenty of time to save up. Again, if private clinics are popping up I doubt it's just the "rich" going there. You are going to have to back that up better.

It's not a systemic problem? I am not convinced either. Seems to me that shortages and long lines are always systemic in "socialized" systems. Doesn't mean you shouldn't do it your way, but it is an expected problem.

There is more incentive in the American system because of the competition and the rewards for innovation. While in Canada they are paying to stop waiting lists, here we are paying for the latest innovations, people all over the world will come and pay for the latest stuff.

I don't think you even saw my point in the last paragraph. You are right, though that bureaucratic costs are killing us down here. But my point had to do with reforming the multi payer system. Car insurance is not an inefficient system down here.

 

Because there are people in the US who don’t have coverage? Maybe I’m not understanding your question properly.

Would you consider freedom an inalienable right? In many places in the USA in the 1800’s slavery was legal. Should women be allowed to vote? Is the death penalty just? All these things have changed over time. The point is that our idea of what constitutes a human right has always evolved over time as our ideas of what is fair and just evolve. A human right is what a people come to understand it as through progressive stages of enlightenment. And part of this equation involves what is practically possible. In 1st world countries basic health care is not a scarce resource, so given that we can provide basic health care to all our citizens, should we not do so? All these countries but 1 said yes to this question roughly half a century ago.

It’s an essential service and they are not allowed to strike in such a way that would put people’s lives at stake, but they wouldn’t want to do that anyway. I’m sure that similar laws exist in the US.

I’ll give you a mulligan on this one.

This is a pretty silly question. It’s not an issue. Enough people want to be health care workers. What would you do in the US if no one wanted to be a health care worker?

Huh?

 

Sure it’s possible, but practically speaking the cost benefit analysis doesn't make sense unless you have a lot of spare cash around. In practice, with few exceptions, it’s only the rich that do this.

These clinics are typically for fairly simple and relatively inexpensive procedures like MRIs. Some people would travel to the US for an MRI but when you add travel and accommodation expenses, and the time off work, it’s gets a lot more expensive. If you travel to the US for surgery of some sort then it gets very expensive. The private clinics they’re talking about in Quebec won’t be doing any kind of major surgery either I’m sure.

And which systems are you familiar with? None I suspect. You’re just regurgitating rhetoric that you’ve been fed somewhere along the line. No, shortages and long lines are not always systemic in progressive systems, nor is there any reason why they should be.

Research goes on here as well.
http://www.cbc.ca/story/canada/national/2005/06/05/monkey-vaccines050605.html

The multi-payer system for healthcare, and sometimes for auto insurance, is inherently wasteful. I don’t know of any system that has been able to reform it to make it anywhere near as efficient as the single payer system. There are lots of tweaks and reforms that can be made to the single payer system, but as a general system, in this case, I don’t think it can be beaten.

 

People from the U.S. do travel to Canada for healthcare. My brother (who lives in Montana) went to Canada for lasik surgery because of cost and quality of care.

 

I understand the terms you’re using. I just don’t think they apply to this situation, and I don’t think they apply the way you think they apply. Let me make this simple. The United Nations Universal Declaration of Human Rights includes the right to an education as a basic human right. Education is clearly a scarce recourse, and yet it is something that isn’t scarce in first world countries. All countries can provide it and all, even the US, would say that it’s a basic human right. And there are many other rights here that rely on “scarce resources” too.
http://www.un.org/Overview/rights.html

As I have shown above, a “scarce resource” can be a human right. Your conclusion is wrong because you are basing it on a faulty premise.

I don’t believe for a second that the US doesn’t have back to work legislation. In fact I remember George Bush himself using back to work legislation to order longshoremen back to work a few years back, never mind doctors and police officers.