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They also can't do organ transplants in Canada or do brain surgery.
They can't? What, is that a law or something?
You need to learn about Dr. Wilder Penfield of Montreal. According to his Wikipedia entry:
Quote:
He expanded brain surgery's methods and techniques, including mapping the functions of various regions of the brain such as the cortical homunculus. His scientific contributions on neural stimulation expand across a variety of topics including hallucinations, illusions, and deja vu.
Seriously, just because I'm curious: where do you come up with this no-transplant, no-brain-surgery stuff?
Really, American medical care is far better than Canadian in a couple of conditions: You have good insurance, or you're extremely poor so that they can't charge you for the medical care you receive.
If you don't fit into those categories, then Canadian medical care is far better than American because you can actually get it without being left destitute.
One problem in the U.S. is that you must provide care to anyone by law. That means you have people who refuse to take care of themselves showing up to the hospital over and over for the same (expensive) procedures, that are paid for by the taxpayer. You have family members bringing them Big Macs two days after having stents put in.
In Canada, that's not the same situation at all. Though the U.S. political class likes to use terms like "death panels" to make it sound terrible, you do have a decision making process that occurs in Canada. In some cases, patients are too old to get a reasonable benefit from a procedure and so will not receive it. It makes much, much more sense.
Moving the U.S. to a single payer system would be a catastrophic failure because the culture is one of greed and entitlement. You'll be spreading a ridiculous amount of waste over the entire tax base while also opening the door for people who won't take care of themselves to demand expensive procedures to keep themselves going long enough for another 42 oz. Coke.
The core issues need to be addressed first; the Government needs to be a referee in the process rather than the main player.
Really, American medical care is far better than Canadian in a couple of conditions: You have good insurance, or you're extremely poor so that they can't charge you for the medical care you receive.
If you don't fit into those categories, then Canadian medical care is far better than American because you can actually get it without being left destitute.
One problem in the U.S. is that you must provide care to anyone by law. That means you have people who refuse to take care of themselves showing up to the hospital over and over for the same (expensive) procedures, that are paid for by the taxpayer. You have family members bringing them Big Macs two days after having stents put in.
In Canada, that's not the same situation at all. Though the U.S. political class likes to use terms like "death panels" to make it sound terrible, you do have a decision making process that occurs in Canada. In some cases, patients are too old to get a reasonable benefit from a procedure and so will not receive it. It makes much, much more sense.
Moving the U.S. to a single payer system would be a catastrophic failure because the culture is one of greed and entitlement. You'll be spreading a ridiculous amount of waste over the entire tax base while also opening the door for people who won't take care of themselves to demand expensive procedures to keep themselves going long enough for another 42 oz. Coke.
The core issues need to be addressed first; the Government needs to be a referee in the process rather than the main player.
Overall agree with your post. Though by any objective spending measure, the U.S. is already wasting and outspending every single country on earth with regards to healthcare per capita - over 16% of our GDP spent on healthcare compared to the next highest (Norway at 12%). Per capita healthcare spending in the U.S. is 2x as high as the expenditure in Canada on any patient - almost $8000 per head per year compared to Canada's $4000. We need change, for sure, but the current system in America is hardly sustainable at the current rate of spending (the GOP likes to talk about fiscal conservatism, but you don't ever hear them explain how we manage to outspend every other country on earth in healthcare and still produce at best mediocre results).
Overall agree with your post. Though by any objective spending measure, the U.S. is already wasting and outspending every single country on earth with regards to healthcare per capita - over 16% of our GDP spent on healthcare compared to the next highest (Norway at 12%). Per capita healthcare spending in the U.S. is 2x as high as the expenditure in Canada on any patient - almost $8000 per head per year compared to Canada's $4000. We need change, for sure, but the current system in America is hardly sustainable at the current rate of spending (the GOP likes to talk about fiscal conservatism, but you don't ever hear them explain how we manage to outspend every other country on earth in healthcare and still produce at best mediocre results).
The US will always spend more on healthcare per person due to R&D expenses. That is just the reality we have to live with. With that said there is alot of work to be done to place price pressure on Health systems and Insurers. I think Global payment systems and bundling is the way to go and has shown great results so far in select states. A fee for service system is not sustainable, especially under the current reform.
I think the sweet spot would be around the $5-6k/PP level, which would place the US in the company of Switzerland, Norway and The Netherlands. All countries that employ a strong regimented global payment system along with robust R&D investment.
The US will always spend more on healthcare per person due to R&D expenses. That is just the reality we have to live with. With that said there is alot of work to be done to place price pressure on Health systems and Insurers. I think Global payment systems and bundling is the way to go and has shown great results so far in select states. A fee for service system is not sustainable, especially under the current reform.
I think the sweet spot would be around the $5-6k/PP level, which would place the US in the company of Switzerland, Norway and The Netherlands. All countries that employ a strong regimented global payment system along with robust R&D investment.
Wondering if you could enlighten us on what the global payment system is? Sounds intriguing but most posters on here are probably not healthcare professionals
Wondering if you could enlighten us on what the global payment system is? Sounds intriguing but most posters on here are probably not healthcare professionals
Sure. The quick definition is basically a dollar value is attached to each patient, that varies based on age, sex, ailment, etc...That dollar value follows the patient around from start to completion rather than hospital/physicians billing for each individual procedure like the do now. What that does is cap the payment amount and forces physicians to order tests/procedures that are based on medical outcomes rather than defensive medical practices.
Doctors are backed into a corner due to the threat of litigation and order unnecessary tests just to protect themselves from future actions from the patient if something goes wrong. With a global payment system the number stays the same regardless and there is also a bonus payment in place for positive outcomes, so rationing of care is a concern that people should not have.
The NEMJ and Harvard School of public health followed the global payment system in Massachusetts (The law is called the AQC) and found that the participating insurers (BCBS MA) reported a 10% accelerated medical savings over the first 4 years. This was combined with a rise in health outcomes and patient satisfaction.
The structure of the global payment system varies by country/state but the principles are the same. Paying for outcomes and care rather than over testing, which has blown a hole in the US System price wise.
Really, American medical care is far better than Canadian in a couple of conditions: You have good insurance, or you're extremely poor so that they can't charge you for the medical care you receive.
If you don't fit into those categories, then Canadian medical care is far better than American because you can actually get it without being left destitute.
One problem in the U.S. is that you must provide care to anyone by law. That means you have people who refuse to take care of themselves showing up to the hospital over and over for the same (expensive) procedures, that are paid for by the taxpayer. You have family members bringing them Big Macs two days after having stents put in.
In Canada, that's not the same situation at all. Though the U.S. political class likes to use terms like "death panels" to make it sound terrible, you do have a decision making process that occurs in Canada. In some cases, patients are too old to get a reasonable benefit from a procedure and so will not receive it. It makes much, much more sense.
Moving the U.S. to a single payer system would be a catastrophic failure because the culture is one of greed and entitlement. You'll be spreading a ridiculous amount of waste over the entire tax base while also opening the door for people who won't take care of themselves to demand expensive procedures to keep themselves going long enough for another 42 oz. Coke.
The core issues need to be addressed first; the Government needs to be a referee in the process rather than the main player.
I'd take a few issues with this quote:
While some of those who are poor in the U.S. receive good care, the program that covers the poorest (Medicaid) is not taken by many doctors. As for free care being required, this is only emergency care at a hospital. In Canada, the poor also get "free" care - since our system is paid for by tax money, those who earn little pay little, but still have access to our health care system as anyone else does.
I've never heard of Canada making decisions on what procedures are appropriate by any other than a doctor. I'm sure doctors and hospitals have protocols they follow, as they do in the U.S. - are the two so different? I'm curious, and what info are you basing this on?
As for "a culture of greed and entitlement," you sound like the type who like to stereotype, or else who watches too much Fox News. I've lived in both countries and have not seen some big difference. A year of reading my local Canadian newspaper proves as much. A comparison of health measurements shows that while Canada may come out ahead overall, we each have regions with similar lifestyle-realted health issues (e.g. Ontario or Quebec is similar to New York or most northern or west coast states in the U.S.; BC to Colorado; and some of the maritimes and prairies to the U.S. south).
While some of those who are poor in the U.S. receive good care, the program that covers the poorest (Medicaid) is not taken by many doctors.
Just wanted to chime in on this part of your post. According to a study conducted by Wolters Kluwer Health, new Medicaid patients were accepted by about 72 percent of office-based and 90 percent of facility-based physicians. So Medicaid access is very strong under the new ACA expansion.
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