Canada does NOT have 'socialized medicine'

[spaslam]

Socialized medicine is when doctors are employees of the government. In Canada, the healthcare system is publicly funded and PRIVATELY delivered. They have one billing system, which is much simpler than the huge bureaucracy for the hundreds, if not thousands of different forms, deductibles, policies, etc. in the USA.

Some of the best healthcare is delivered like it is in Canada: Medicare and Medicaid are the two largest health insurers in the USA, both government programs. If only more docs accepted Medicaid. Medicare recipients and the VA system get some of the best marks on quality values and from their patients.

We need to take what works with the Canadien system and stop paying corporate execs to cut costs to doc and deny claims from patients.

[scoobz1981]

Well... what works with the Candian system???

If you mean that there are NO Family Practice docs in the surrounding area that I live in that take New Patients, then I guess the Canadian system works. If you mean that it takes at least 3 months to get an MRI, then I guess the Canadian system works. I guess if I go to my family practice doc and spend 3 hours waiting to get into my scheduled appointment (appt. for 3:00pm, I get into his office at 6:00pm after waiting my butt off) then i guess the Canadian system works. So, I guess the system does work?

Now, on the plus side, I have never paid a dime which i am greatful for. Not for my surgery, not for my drugs (thanks in part to my dads work), not for a single appointment, not even for my twice a year HIV test. BUT if you are insinuating that we have GREAT healthcare, then I personally think that you are SADLY MISTAKEN!!! It isn't perfect but it's FREE. Now, would I rather pay and have a better system... yes. That's just my opinion.

Val

[ValuelessMD]

..............................

[teratos]

If only more docs accepted Medicaid. Medicare recipients and the VA system get some of the best marks on quality values and from their patients.

We need to take what works with the Canadien system and stop paying corporate execs to cut costs to doc and deny claims from patients.

You are insane? The VA is a nightmare. I have several patients who came to me after being frustrated with the VA system. I saw a patient who served 3 tours in Vietnam, and was combat wounded. He made a big sacrifice for his country, wouldn't you think the VA would want to give him the best care?? He is in his early 50's, and has some of the worst hip disease I have ever seen. you can feel bone scrape bone when his hips move if you put your hand over the joint. He can hardly walk. He had been trying to get a hip replacement for 3 years. Within 2 weeks of his first visit to me, he had his second visit, a pre-op physical. One week later....two new hips. He is not an isolated story, almost all of my VA transfers have stories like that. The VA is a joke.

I do agree with the part about the corporate execs. They make way too much for denying good care. G

[rdecastro]

Socialized medicine is when doctors are employees of the government. In Canada, the healthcare system is publicly funded and PRIVATELY delivered. They have one billing system, which is much simpler than the huge bureaucracy for the hundreds, if not thousands of different forms, deductibles, policies, etc. in the USA.

Some of the best healthcare is delivered like it is in Canada: Medicare and Medicaid are the two largest health insurers in the USA, both government programs. If only more docs accepted Medicaid. Medicare recipients and the VA system get some of the best marks on quality values and from their patients.

We need to take what works with the Canadien system and stop paying corporate execs to cut costs to doc and deny claims from patients.

You might learn what socialism means, and what the effects of controlling the money side of any transaction mean.

That being said, the billing system in the US is terrible, mainly thanks to Medicare. The customer (patient) has no idea what health care costs, and so demands everything. Hence the current problems with Cox-2 inhibitors like Vioxx and Celebrex, they never helped pain any better than the OTCs they replaced, a very small number of patients needed the added gastric protection but by-damned, they're free and they're better! Oh, yeah - the patient would actually have to pay for his OTC ibuprofen (750 tablets at Costco, $8.00, probably less than the patients co-pay).

The patient doesn't realize how much his "free" health care costs, unless he actually pays for it. Even if he pays a portion of the costs through an employer, the true cost is hidden in the US because that cost is tax free to the employer (and may be to the patient). Again, the cost appears to be zero so patients cannot make cost/value judgements.

Imagine if you would a mandated requirement that car dealers provide you with a new car, and free maintenance. How many people, with cars that don't cost them anything, would actually make an effort to maintain their car? And, when the car needed maintenance, would they get the car fixed, or demand a completely new car? Dealers and cars are metaphores for health care and people, of course.

The other problem with the billing system is that since the insurance companies (including medicare) haven't received any benefit from the care they don't really care too much about paying the bill. They too are isolated from the transaction between patient and doctor. So, they make it as difficult as possible to get paid, and off-load as much of the cost of their transaction to the physician as possible. So, the physician (group, hospital, whatever) has to employ large numbers of non-care givers to process insurance forms, and the physician has to spend time directly arguing with the insurance company - time that he could be making money by seeing more patients, or giving patients more time and attention.

Medicare is the worst in this regard, claiming to have very low overheads while the physician is required to spend 25% or more of the reimbursement he receives (which is defined by medicare, and is far less than a reasonable cost for the services) on medicare related paperwork.

A better system is the one that I follow: I have relatively inexpensive catastrophic care insurance that will take care of me if I really need it, and I pay for everything else out of pocket - visits, drugs, etc. And you know what? It costs me far less than full coverage insurance would, even factoring in the out of pocket costs. Even when I had to get an MRI last summer. And boy, let me tell you - when you're paying cash you get great service! It means that I don't go to the doctor when I have a cold (news flash: All you'll do then is spread the cold to the doctors patients and staff), I deal with it with OTC potions, I pay my $40 twice a year for a dentist to confirm that my teeth are OK, and I get my eyes checked once a year and get new glasses.

We're just starting to see the effects of "free" health care and health care rationing in Europe - where "physicians" (so called, in the model of Mengele) are deciding to take active measures to kill children, without the parents input, and without legal authority to do so. After all, they feel that it's their right to decide how best to allocate health care resources, and disabled children don't deserve any consideration. This is not passivly letting children die, this is causing their death with the same leathal cocktail used to execute murderers. There's a historical model for this, a world war was fought to stop the perpetrators. In Germany they started out with the defectives, then the infirm, then the undesireables, and the result was more than 20 million dead.

[wolfvgang22]

Can you move this to the relaxing lounge, George? I don't think it has much to do with Saba, though lots of Canadians go to the school.

[teratos]

Can you move this to the relaxing lounge, George? I don't think it has much to do with Saba, though lots of Canadians go to the school.

I'm not a mod on the Saba forum. I can't do it. G

[wolfvgang22]

so much for you being an "ultimate" moderator, then....:lol:

[spaslam]

I guess I am insane--along with the people at Annals of Internal Medicine and all th VA patients who rated there care as being so great.

http://www.medscape.com/viewarticle/496454

VA Hospitals Beat National Average in Overall Quality of Care
By Will Boggs, MD

NEW YORK (Reuters Health) Dec 21 - Veterans Health Administration hospitals score better than national averages in overall quality of care, chronic disease care, and preventive care, according to a report in the December 21st Annals of Internal Medicine.

"This study showed that in major areas of care, the VA did better than the country's general health care system at providing recommended care," Dr. Steven M. Asch from West Los Angeles Veterans Affairs Medical Center, Los Angeles, California told Reuters Health. "In fact, there was no area in which the VA did worse than the general health care delivery system."

Dr. Asch and colleagues compared the overall quality of care delivered in the VHA system and in the United States, as well as the quality of acute, chronic, and preventive care across 26 conditions.

VHA patients overall were more likely than patients in the national sample to receive the recommended care for their condition (67% versus 51%, respectively), the authors report.

Performance was better in the VHA than in the national sample for chronic care (72% versus 59%, respectively) and preventive care (64% versus 44%), but not for acute care (53% versus 55%), the report indicates.

Differences were even more substantial in the areas targeted by the VHA for improved quality, the researchers note.

"We found that what gets measured gets done," Dr. Asch explained. "In other words, the VA advantage over the rest of the country was greatest for care covered by the VA quality tracking system."

The study findings persisted after adjustments for age, number of acute and chronic conditions, number of outpatient visits, and when the comparison included only processes supported by randomized, controlled trials.

"These findings are so important because they show us that it is possible to improve the care that patients receive," Dr. Asch said. "We also found that there was a spillover effect, so that important parts of care that were not part of the VA quality tracking system, but were closely related, still got done more often. This is a strong argument for the continued spread of quality measurement systems throughout the healthcare system."

"Physicians were central to the development of the indicators of quality that we used," Dr. Asch added. "Participation of physicians in these sorts of efforts ensures that they will be as clinically relevant as possible and thus help our patients the most."

Ann Intern Med 2004;141:938-945.

[teratos]

Maybe our VA sucks, or maybe my group just provides great care. :D

[rdecastro]

Maybe our VA sucks, or maybe my group just provides great care. :D

I'm sure your group is administering great care :)

The VA is having their problems with technology. However, my brief exposure recently to the system (when a friend developed cancer and died) was suprisingly good - a great improvement from years ago. The VA Medical Center in West LA is affiliated with UCLA Med Center so most of the attendings and residents are UCLA docs, the staff appeared to be both very competent and very caring, and the facilities were excellent.

Looks like they screwed the pooch on this system, though:


Feds Investigate Collapse Of Pilot IT System At Florida VA Hospital Dec. 22, 2004
Networking



Veterans Affairs shut down the financial and logistics system, intended for use by VA hospitals nationwide, after it failed a nine-month trial this summer. Taxpayers paid about $278 million for the system.
By The Associated Press



Civil and criminal investigations by two federal agencies will look into the collapse of a $472 million prototype computer system at Bay Pines VA Medical Center in St. Petersburg, Fla., officials say.

The Core Financial and Logistics System failed a nine-month trial this summer and was shut down by the Veterans Affairs Department. Taxpayers paid about $278 million for the system, which was intended for use by VA hospitals nationwide.


http://informationweek.com/story/showArticle.jhtml?articleID=56200025

[classic]

teretosMaybe our VA sucks, or maybe my group just provides great care

Not likely. Here in TN, one of the surgical residents drove a VA patient in his car to the nearest affiliated hospital to get an X-ray and CT done of this guy's gut. The VA healthcare system should be revamped since the people who need it love this country enough to willingly sacrafice their lives for it. It always makes me a bit sad to have the EMS come pick them up and take them back to the VA.

[scoobz1981]

Just sad... nothing I say can even come close to how hearing stories like that make me feel (and I am not even American).

Val