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# Posted: 27 Feb 2020 10:49

Quoting: Houska
Bottom line is I wouldn't exchange the Canadian system for the U.S. one in a million years, but let's not pretend it's perfect.

Thank you for your comments, they pretty much express the thoughts and feelings of virtually all Canadians I have spoken with on this. Some related to me but mostly just ordinary people I have met in all the provinces.

# Posted: 27 Feb 2020 10:56

Quoting: KinAlberta
I’d rather see companies sticking to their knitting and just paying higher salaries and workers compensation for work related injuries.

Agreed. People start companies because they want to provide services or products.

Pay a good wage in real dollars, not benefits.

# Posted: 29 Feb 2020 22:07 - Edited by: bill_bly_ca

Quoting: Houska
Canada as some fake news from south of the border has yelled, it can *feel* like rationing when you're waiting 9 months for a specialist appointment, and some treatment that might work is not available since some bureaucrats have said it's "only

Kinda sorta - Case in point. My Mother worked for a fellow who made some of the best quality kilts in Canada apparently as a part-time seamstress about 15 yrs ago.

In Hamilton, the elderly owner of the shop (over 80) was denied a double bypass as he was told he was too old to justify the procedure and prescribed medication, blood thinners I think.

The fellow's son was having real addiction issues in BC and eventually ended up on life support in a Vancouver hospital. The elderly fellow flew to Vancouver to be with his Son.

After arriving at the hospital in BC, finding his son had passed, he went into attack - The Dr's diagnosed and gave him the bypass. He lived another 7 years afterwards IIRC.

So in the Ontario model, his care was rationed, in BC it was not.

I would assume that there are similar examples the other way around with Ontario.

When there is a finite amount of resources there is rationing - Some subtle, some overt.

# Posted: 1 Mar 2020 12:32

Quoting: bill_bly_ca
So in the Ontario model, his care was rationed, in BC it was not.

Possibly this was unequal rationing, but possibly it is due to the fact that his medical situation changed. Bypass really is a risky operation, especially for old people, because it is open heart surgery. When my elderly grandfather (here in the US) was found to have clogged arteries, the cardiologist recommended he NOT have bypass as long as he was getting by OK. That a "wait and watch" approach was a better bet. Instead put him on blood thinners, cholesterol meds etc. Told him that if anything worsened (i.e. if he got worsening chest pain) to come in immediately, and that at that point they would reassess if the risks of open heart were worth it. Eventually my grandfather DID start getting worsening chest pains to the point he was on the edge of a heart attack, and at that point they offered him a bypass. He knew he might die on the table, but obviously he might also die if he didn't get the bypass. So he took the chance and got the bypass, and he also lived another few years. So he bet right.

# Posted: 5 Mar 2020 15:47

Interesting article:

Coronavirus Exposes the Sickness of Our Shoddy Safety Net

“ For the moment though, these concessions to the reality that (contrary to libertarian dogma) human beings aren’t wholly autonomous individuals — but rather, inescapably interdependent social animals — remain merely hypothetical. ”

# Posted: 5 Mar 2020 15:53 - Edited by: KinAlberta

On rationing. Ageism is everywhere but I don’t think it’s a deliberate process.

For example my wife’s grandmother could have received cataract surgery at 89 or 90 yrs of age but didn’t think she’d live much longer. At 99 years she went and had it done. No problem getting it done. She wished she’d had it done sooner.

So maybe an age based rationing system would actually make sense and cuts costs. Or at least improve the cost-benefit scenario. If it’s recommended but you delay, and the expected benefit is reduced, then you should maybe have to pay a bit more.

And today’s news here in my province - showing the public / private mix we use here and the wait time issue:

$100M to go to moving, merging and upgrading Alberta’s operating rooms to cut wait times | Edmonton Journal

“Private clinics currently perform 15 per cent of Alberta’s surgeries, but the province hopes to increase that to 30 per cent by 2022-23” albertas-operating-rooms-to-cut-wait-times

Province to spend $100M on operating rooms to shorten wait times | CBC News

The government had already announced in last week's budget it intends to double the number of surgeries performed in private clinics. By 2023, 30 per cent of Alberta surgeries would be done outside of hospitals, if the government achieves this goal.

In its 2019 election platform, the United Conservative Party pledged to reduce surgery wait times to no more than four months within four years of taking office. Its goal was to reduce the number of people waiting more than three months by 75 per cent by the end of government's first term.“ ...

According to the Canadian Institute for Health Information, wait times for non-emergency coronary bypass surgery, hip replacements, knee replacements and cataract repair all rose between 2014 and 2018. For cataract repair, in 2014, 71 per cent of Alberta patients had surgery within 112 days of referral. By 2018, only 49 per cent were in the operating room within that 112-day goal.

Alberta did improve access to urgent hip fracture repair surgeries during that time. In 2018, 94 per cent of patients were under the knife within 48 hours.

Critics question privatization plan

...” 1.5485367

And a few days ago:

UCP government shifts focus of Alberta’s addictions treatment to recovery - The Globe and Mail

Despite demand and Alberta’s growing addictions crisis, about 50 of Thorpe’s 72 beds have been sitting empty, said Ms. Krueckl, the non-profit’s chief executive officer. Chunks of the accredited facility are essentially shuttered; Thorpe turned down the heat and shut off the lights in dead zones.

“We do have a whole wing that we don’t utilize,” Ms. Krueckl said. “The beds are there, ready to be made."

“ There are 1,396 treatment beds in Alberta, according to Marshall Smith, the chief of staff for the Associate Minister of Mental Health and Addictions. Of those, Alberta Health Services directly funds 228 beds. Another 500 beds are funded under AHS contracts, 309 are supported through other government programs, 114 are on reserves and an additional 245 are not financed by the government. The government does not know how many treatment spaces all of those beds amount to.

In the unfunded beds, the costs are covered by patients, insurance companies or non-profit organizations. The government, however, says ...” -albertas-addictions-treatment-to/

# Posted: 15 Mar 2020 20:22 - Edited by: KinAlberta

I’m curious how the US and Canadian systems will handle the coronavirus (Covid-19). Similarities and differences.

Any thoughts?

# Posted: 17 Mar 2020 13:33 - Edited by: bill_bly_ca

Well one observation was on company policy causing a visit.

Context - I was in Cuba Feb 22 to 29 and a cold in Jan to which I still have a niggling cough.

As per COVID-19 company policy, I was flagged to work from home on Friday the 13th.

To come back to work I needed to be cleared.

Dr.'s office I have posted by email that they would not be seeing persons who have cough, fever or shortness of breath

We do have a phone in service in Ontario called Telehealth which has been in place for the past 10 or 12 years. It was unreachable for the 50+ hours I tried to call.

I did a walk-in clinic at 2PM on Sunday - I was seen by 3:30 and given a clean bill of health by 3:44

My all-in cost is 1) almost 2 hrs in a clinic and 2) a couple of hours frustration in trying to call in 3) Gas to drive to clinic.

Mind you my tax rate (From income, to sales, to gas to etc etc) is about 45%

# Posted: 21 Mar 2020 05:55

‘The bills were more stressful than the cancer’: US versus UK healthcare – a personal story
March 20, 2020 1.56pm GMT k-healthcare-a-personal-story-133131

The NHS in the UK and the Canadian System are very similar. Within Provinces there are variations but not super huge.

# Posted: 21 Mar 2020 07:52 - Edited by: silverwaterlady

Yes, the billing in this story is true.
In 2002 I almost died. I had a 10K deductible until everything was coved 100%.
I am the one that deals with all the bills.
I was so sick, it took me two years to recover fully.
I told my husband to just pay whatever medical bill we get. I did not have the energy to deal with it. I was trying to get well. Dealing with all the bills coming in, I’m not kidding could have set my healing back months.
Fortunately, all my medical expenses occurred in one year. Far exceeding my 10K deductible. We didn’t go bankrupt because I already had planned ahead of time and had the deductible saved. Having that money already saved helped with my healing too.
I suffer today with scar tissue. If I do to much I have a lot of pain.

So if you live in the USA, you should have your deductible saved for however many people in your family, designate someone to handle all medical bills. Hope that your illness doesn’t go into the following year.
If you don’t have that money saved and you get really sick you are going to have a more difficult time healing worrying about going bankrupt.

# Posted: 22 Mar 2020 09:53 - Edited by: KinAlberta

One thing I’ve long thought about (since the early 1990s) is how INEFFICIENCY can be a great thing.

Efficiency optimizes and reduces redundancy and waste. This is all fine and dandy until you need extra capacity. If the bean-counters have been put in charge and have wrung all the waste out of the system for current needs you can rest assured that you will be unprepared for surges in demand.

In light of the latest viral outbreak (Covid-19) here’s an 11 year old post of mine from a local forum. In the US I would guess that the system is inefficient as it offers more choice (aka waste and inefficiency) which means that in a pandemic it may have more capacity than the Canadian system.

Health Care Crisis

Join Date: Mar 2006 Posts: 19879

07-11-2009, 08:59 AM

Funny how we always whine about the lack of planning - after the fact. Read on...

Jeremy Grantham, who manages over $100 billion, wrote this about the financial crisis but I think it speaks to a lot of the problems we seem to have these days... Blame it on HR departments I guess

"Why is it that several dozen people saw this crisis coming for years? I described it as being like watching a train wreck in very slow motion. It seemed so inevitable and so merciless, and yet the bosses..., none of them seemed to see it coming."

Our government and banking leaders are "management types who focus on what they are doing this quarter or this annual budget are somewhat impatient." However, "seeing these things requires more people with a historical perspective who are more thoughtful and more right-brained, but we end up with an army of left-brained immediate doers. So it's more or less guaranteed that every time we get an outlying, obscure event," a Black Swan, "that has never happened before in history, they are always going to miss it. And the three or four dozen odd characters screaming about it are always going to be ignored."

- GMO Quarterly Letter Fall 2008 Part I

What's also fascinating to note is how few people participated in the thread discussion below (started before anyone had even heard of the Mexican swine flu). Compare that to all those participating in this thread... Successful planning involves thinking about specific threats and senarios not traditional fuzzy policy level stuff that can never be translated into real action and all this capitalism vs socialism dogma and mumbo jumbo where the "system" solves all problems.

Also, about 10 yrs ago - before SARS - on another forum I suggested "wash stations" to be installed at hospital and care facility entries and exits to prevent anyone from entering or leaving without washing their hands. That thread too died a miserable lonely death like these 'planning' threads... (I've got lots more too.)

Pandemic Planning - Jan 2009

Strategy for next Recession/Depression - June 2006
Last edited by KC; 07-11-2009, 09:08 AM.

Health Care Crisis 16-health-care-crisis/page2

Pandemic Planning idea /11081-pandemic-planning

# Posted: 22 Mar 2020 10:12 - Edited by: KinAlberta

I’ll add a couple more of my now very old posts from that other forum.

So the point is, that universal health care insurance systems, like Canada uses, are excellent most of the time. They serve core needs well. They are efficient.

However it’s like the separation of the RCMP and the local police forces vs the Canadian Forces or in the state’s case, the separation of the FBI and local police forces vs the US Military.

Core regular everyday needs are met by the health care systems. However, I’ve come to the conclusion that the focus on the short term will always prevail and lead to the equivalent of electrical grid blackouts when demand peaks.

What’s lacking is a supplemental system equivalent to the military (which is often tasked with health crisis issues but not dedicated to them). A dedicated emergency response / care system for wars against bugs and other natural non-human threats is needed. Like the US’s FEMA or the US medical ships times 100 or 1000.

The issues I highlighted years ago (see below) will never change in either the Canadian or US health care insurance schemes because of their focus on routine daily issues not on the unusual, rare devastating issues coming down the pike:

That is a comment on how it went from story du jour to a non event.

I wouldn't be surprised if this sentiment may soon apply to this ebola outbreak. Still, note my first posting on ebola in this thread. Each outbreak has done more and more damage over the past 40 or so years. That just doesn't seem very encouraging.

The point is to determine what rational steps should be taken well in advance for various pandemic scenarios where a pesky bug gets out of hand and then have criteria that automatically kick in and not have a lot of high level confusion and emotion driving the response. (Basically, we need 'an equipment and supplies are at the ready' provisioning scenario - even if the equipment leaves a lot to be desired. As things are now, hospitals alone would seize up with any significant problem. eg. Speading ebola geographically as a result of an airplane ride might be a luckier happenstance than spreading it in a tight geographic location with only say one hospital, possibly very ill equipped to handle more than one case at a time.)

Ebola is a really slow moving threat (time wise) but think back to SARS, H1N1, etc. where the threat spread much faster. In some future scenario people will be wasting time debating, protesting, witch hunting and appointing weirdly qualified czars rather than trying to anticipate needs and responses? /11081-pandemic-planning

Yes, we should take the Katrina response as our cue (for rare but predictable events). Anyway, since the risk of a spreading flu is in the news again with the Mexican deaths and risk posed by what's possibly swine flu, I'm wondering if people are thinking about what courses of action things might take.

Just as when I started this thread, my worry is that a pandemic might create unnecessary shortages and supply bottlenecks of key products because of a sudden, but of course very predictable demand with coincident supply chain failures. 'Naturally', the rich countries get the goods (food, fuel, vaccines, masks, cleaning supplies, bleach, oxygen, etc.) and the poor countries perish.

Actually, maybe I spoke to broadly. Say with surgical masks - these days I wouldn't be surprised if they are all made in China or somewhere so if the proper filter material starts to run short I could see them stopping or limiting exports to supply their own people first. We could also expect to receive substandard, fake and ineffective product.

My thinking may be flawed but wouldn't creating artificial demand and small stockpiles before a crisis, lessen the demand and at the time of an actual crisis. I can't see how production systems will have the capacity or supplies to ramp up fast enough to meet the peaks in demand.
Last edited by KC; 25-04-2009 /11081-pandemic-planning

# Posted: 24 Mar 2020 08:30

Stay in place order in MI.
My daughters best friend is supposed to be getting married in a outdoor civil ceremony this weekend.
Her regular wedding canceled.
She was having just a few people there. Now all outdoor gatherings of any kind are illegal.

How does this have anything to do with this topic?
Her long time boyfriends mother is very ill. She’s on dialysis. She needs a kidney or she’s going to die. He can give her a kidney but his medical insurance coverage is awful. Won’t cover as much of the procedure. His fiancée has much better medical insurance. Better coverage.
So now I’m not sure what they are going to do. I’ll find out later today.

The choices that have to be made by citizens of the United States every single day due to our totally messed up medical system are staggering.

# Posted: 24 Mar 2020 17:52 - Edited by: KinAlberta

Hope everything works out.

Canadians Increasingly Come to U.S. For Health Care | Best Countries | US News

“...Universal health care is a source of collective pride in Canada, which boasts one of the highest life expectancies and lowest infant mortality rates in the world.

However, the Canadian health-care system is far from perfect, and its shortcomings are a hot-button topic north of the 49th parallel.

Contrary to popular belief among Americans, health care is not entirely free for Canadians. Dental, ambulance and many other services as well as prescription medications must be paid for out of pocket or they're covered through a combination of public programs and private health insurance. About two-thirds of Canadians have such insurance.




All for the future after this crisis when people don’t want to talk about it, but should. New viruses will keep coming and people and governments need to actually prepare in advance. Next time it could be something really deadly.

Canada’s Health Officials Are The Heroes We Need During This Coronavirus Pandemic | HuffPost Canada 65c5b6f5b7c5444f71

Coronavirus and health care: Why the U.S. should follow Canada’s example - The Washington Post irus-follow-canadas-example/

Without universal health care, coronavirus puts us all at risk | Opinion all-at-risk-opinion.html


# Posted: 4 May 2020 16:44 - Edited by: KinAlberta

Interesting article:

Canada succeeded on coronavirus where America failed. Why?

May 4, 2020

Third, and finally, every expert I spoke emphasized the value of Canada’s single-payer health care system at this crucial moment, especially when compared to America’s extremely expensive and low-capacity system.

The reasons varied. Some pointed out that, in a single-payer system, the universality of care meant that everyone would go to a doctor if they needed a test or treatment. If care is affordable, poor and marginalized communities — like, say, undocumented migrants — are less likely to become hot spots than they are in the American system, where out-of-pocket costs can be prohibitive.

Others argued that a single-payer system gives Canadian authorities coordinating powers that their American counterparts lack.

When the government controls the system of payment for health care services, rather than leaving decisions up to hospitals and insurance companies, they have a huge amount of power to commandeer the health system for national goods. If a Canadian hospital is having a spike in cases and needs an emergency shipment of PPE, the government can work to get it shipped over from a less-needy hospital. If an American hospital is having the same problem, they’re going to have a tough time getting it from a competitor (absent a level of aggressive police intervention we haven’t seen here).

It’s a little tricky to say how much of the difference between these countries can be explained by the specific nature of Canada’s health care system. If you look across the world,...”

That’s as true on the coronavirus as it is on anything else. The Canadian experts I spoke to had no shortage of complaints about their country’s response.

The most striking such failure ...“It is profoundly troubling and deeply disturbing to me how broken this part of our health care system is,” Susan Bartlett, a professor of medicine at McGill University, told the New York Times’s Dan Bilefsky.

Canada’s indigenous population is another important problem area. These communities, some of which are so isolated that they can only typically be reached by aircraft, are chronically under-resourced and underprivileged.

Bolding mine

# Posted: 4 May 2020 17:07 - Edited by: KinAlberta

More on differences:

Why is the Canadian healthcare system faring better than its counterpart in the US? | openDemocracy

The Canadian single-payer system contributes an average of 2% of its spending to administrative costs, while the average American private insurance company will spendapproximately 18% of revenue generated on billing and administration. Limitations in the single-payer system, as well as savings on administrative costs, exist however, as only 70% of Canadian healthcare is funded publicly. The majority of the remaining 30% of healthcare costs is consolidated in the spheres of pharmacare, dentalcare and eyecare. All three are not covered by centralised provincial health insurance plans and require Canadians to obtain private insurance to supplement their coverage. ter-its-counterpart-us/

# Posted: 5 May 2020 01:01

Quoting: KinAlberta
The Canadian single-payer system contributes an average of 2% of its spending to administrative costs, while the average American private insurance company will spendapproximately 18% of revenue generated on billing and administration.

Not to mention that in 2018, "62 CEOs of health-care companies made a combined total of $1.1 billion in compensation." which is just a little bit more than what the directors of the Canadian not-for-profit system are paid.

# Posted: 5 May 2020 13:29

Cost is always a factor for free market insurance and the money that CEOs make can seem obscene. It is not hard to imagine that with the variety of insurance choices, in plan, out of plan, and hospitals that 18% is spent on billing and admin.

I think it is really difficult to compare admin costs between the U.S and Canada. It is like apples and oranges. Canada GDP is 1.7 trillion and spends about 11% of GDP on healthcare. That spending is second only to Switzerland for universal healthcare.

Spending that much on healthcare should mean that Canada should rank very high among universal healthcare nations. That is not true. Canada ranks at the bottom for the number of doctors, number of hospital beds, number of MRI machines, number of CT scanners, highest percentage of patients who waited 2 months to see a specialist, and highest percentage of patients who waited 4 months for elective surgery.

Inefficiencies seem to exist in the Canadian system to.


# Posted: 5 May 2020 14:29 - Edited by: ICC

Many factors are at play; many metrics to use.

One being the life expectancy... Different placings in different studies, but Canadians always have a longer expected life than Americans. They may be many other factors affecting results.

My state, NM ranks below that Canadian average.

# Posted: 7 May 2020 02:42

I guess we should start by finding the top 10 or 15 healthiest populations in the world (by various measures) to see what systems they use.

# Posted: 7 May 2020 08:56

Quoting: KinAlberta
I guess we should start by finding the top 10 or 15 healthiest populations in the world (by various measures) to see what systems they use.

I'd bet it has a lot more to do with diet than anything.

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