Canadian Medical Care Changes on the Horizon?

[Lyion]

Very Interesting

Canadians cherish their publicly funded healthcare system but their supreme court has delivered a ruling that opens the way for a mix of private and public hospitals and clinics of the kind found in Britain and other European countries.

The court's judges decided by a narrow majority, of four to three, that long waiting lists for significant procedures such as hip replacement operations and heart surgery imperilled Canadians' rights.

"The evidence in this case shows that delays in the public healthcare system are widespread and that in some serious cases patients die as a result," the judges said.

The ruling applies specifically to the province of Quebec but many experts say it could lead to radical changes in all parts of the country.

Some observers predict that the decision will destroy Canada's public healthcare system (known as medicare); others say it will force governments to fix serious problems that include long waiting periods for cancer treatment.

Right now, most Canadians don't pay a cent when they visit a doctor, and there are relatively few exclusive private clinics operating entirely outside the public medical system. This is partly because wealthy Canadians who want quicker treatment can always travel to the US, where a hip replacement can cost $22,000, (£12,500).

The Quebec patient and doctor who brought the case argued that this situation was unfair, and that poor and middle-class Canadians should be allowed to purchase medical insurance so they could turn to private clinics if need be. The court agreed, dismissing arguments from the government of Quebec that allowing private medicine would undermine the public system.

Healthcare in Canada is regulated by the federal government but delivered by the provinces. For years, politicians have bickered about where the money to improve the overstretched public system should come from, and the prime minister, Paul Martin, campaigned in the last election on a promise to reduce waiting times for surgical procedures. Few Canadians, however, have noticed any difference.

Mr Martin, who heads a minority government with a tenuous grip on power, has denied that the court ruling will lead to two-tier medicine in Canada - a private system for the wealthy and a public one for everybody else. "Nobody wants that," he said.

The idea of a public healthcare system has become part of the Canadian identity, and for many voters is a sacred notion. Polls suggest that when Canadians need to turn to the health system they are generally satisfied by the care they receive. As a result, few politicians will even risk debating the possibility that private clinics might ease the burden on the public system.

However, there is already a strong private component to the system: x-rays and laboratory tests are done by private companies (though the public system foots the bill for many of the services they provide) and many Canadians pay out of their own pockets for prescription drugs - unless they have insurance. Indeed, according to one study 30% of all healthcare spending comes out of individual Canadians' wallets.

It is unclear what will happen next, but the court decision is strong ammunition for provinces such as Alberta, which want to experiment with a mix of private and public healthcare. It could also help entrepreneurs who wish to establish private clinics. More court challenges look likely, though there is speculation that two new supreme court justices may side with the three who dissented in this case.

Mr Martin says the $33bn the federal government is pumping into healthcare will reduce waiting times, but the country's doctors say far more than that will be required if all Canadians are to have access to quality care when they need it. Albert Schumacher, president of the Canadian Medical Association, said of the money: "It has just kept us from bleeding to death."

[Zanchief]

Two tier health-care will be the death of it all.

[Rust]

Lyion, you utter pinko, quoting the Guardian.

There's hope for you yet!

Quebec was interesting as the law there (healthcare being a provincial matter under the Constitution) forbade private insurance to cover 'medically necessary treatment'.

In Ontario, even if you have private insurance, the law forbids doctors from billing more than what the public health care system allows for a proceedure. So if the government pays $1000 for setting your broken leg, that's the most you can legally bill. Sort of kneecaps 'for-profit' competition. At least that's what I've read.

It's not like doctors are starving, even at government rates.

--R.

[Tikker]

I actualy don't have a problem with people who want to pay extra for faster service


The basic level of service is really pretty good to start with, and if the rich want to spend extra, go for it

[Zanchief]

I actualy don't have a problem with people who want to pay extra for faster service


The basic level of service is really pretty good to start with, and if the rich want to spend extra, go for it

Bad idea Tikker, IMO.

[Lueyen]

I actualy don't have a problem with people who want to pay extra for faster service


The basic level of service is really pretty good to start with, and if the rich want to spend extra, go for it

Bad idea Tikker, IMO.

Why do you think it's a bad idea Zanchief?

[Zanchief]

The service and quality in the lower tier is just gonna become worse.

Better money, better patience on the top tier is gonna force all the good doctors there. IMO, money shouldn't dictate who gets medical attention and who doesn't. The gap between the two will get bigger and eventually could destroy universal healthcare.

[Tikker]

I actualy don't have a problem with people who want to pay extra for faster service


The basic level of service is really pretty good to start with, and if the rich want to spend extra, go for it

Bad idea Tikker, IMO.

It's only bad if it affects basic levels


If the basic lvl of service/treatment remains the same, yet the people who want to pay more get a faster/better level of treatment, I have no issues with it



I'm making the assumption that those paying extra are being shipped to the US or sweden or wherever (ie, not affecting the current canadian public)

[Lyion]

My understanding is this is for 'Canadian' medical professionals, Tikker. People can already head to the U.S. or elsewhere right now.

The question I'd have is are the better doctors going to head for the 'premium' service. Will we see medical professionals splitting their time?

I can see the fears Martin has, since if the service is partially privatized it'll lead to a caste system of medical care with those paying having good, efficient care and those on the public system having less.

I was surprised that even with the public health care system, Canucks pay 30% of their care out of their own pocket. That's more than I pay.

[Rust]

My understanding is this is for 'Canadian' medical professionals, Tikker. People can already head to the U.S. or elsewhere right now.

The question I'd have is are the better doctors going to head for the 'premium' service. Will we see medical professionals splitting their time?

I can see the fears Martin has, since if the service is partially privatized it'll lead to a caste system of medical care with those paying having good, efficient care and those on the public system having less.

I was surprised that even with the public health care system, Canucks pay 30% of their care out of their own pocket. That's more than I pay.

Some of that will be for drugs, dental expenses, and other stuff OHIP doesn't cover. The Economist had a graph in last week's issue, Canada's percent of private costs is higher than a few countries, lower than a lot.
I might still have the Economist issue in the car, I'll look...

--R.

[Wrath Child]

Two tier health-care will be the death of it all.

You already have a "two tier health-care" system. It's just not an official one.

Canadian health care is far from the utopian system so many have been led to believe it is. If I'm not mistaken, Canada is second only to the US in the amount of money it spends on its health-care system, but it quite poorly spends that money when compared to countries in Europe with similiar systems. Advances in medicine - which has allowed people to live far longer than ever before - and new, expensive medical treatments have drained the system of most of its resources. It's the main reason for the long queues which have negatively effect people's health.

Canada either needs to massively infuse its system with cash(new taxes) or it needs to change. And change seems to be in the air.

[Ironfang]

About time that we went for a two-tier system.

If you can pay for an MRI and get it done tomorrow go for it. If you cannot, back of the eight month line for you.

Sadly, with the huge increases in costs in all types of healthcare no country can afford a totally public healthcare system. The "requirement" that a system immediately provide all the latest drugs and testing 100% of the time will inherently burn off far too much cash as the population of the Western World ages. More costs = worse service.

The European countries that offer a more efficient version of costs than Canada have a couple of huge advantages. One is size, Canada is spread out over thousands of miles. When you compare to say Belgium where you can concentrate the doctors and hospitals in a smaller area you spend less. Overall you can have the same number of doctors per capita but the overhead costs go way down. Also Europe has a much simpler attitude that Canada does regarding certain procedures. If you are too old you don't get it, end of story. In Canada we still spend money to give hip replacements to 90 year olds.

There will be a day soon that the government will mostly just regulate how much can be charged for procedures and just let private companies do the work. Getting rid of the artificial billing caps and other crap that the current Canadian system has will help clean up part of the mess that the redtape is causing to choke the healthcare system.

[Markarado]

Survival of the fittest. People should get what they pay for. If you can't afford what someone else can - well then to hell with you. That's not the rich guy's problem nor should it be.

[mofish]

I will pray to my lord jesus christ tonight that you end up homeless, with an expensive disease.

[Rust]

Survival of the fittest. People should get what they pay for. If you can't afford what someone else can - well then to hell with you. That's not the rich guy's problem nor should it be.

That's a real Christian attitude right there, now.

--R.

[Ciladan]

Survival of the fittest. People should get what they pay for. If you can't afford what someone else can - well then to hell with you. That's not the rich guy's problem nor should it be.

I hope that was satirical

[Zanchief]

Sadly, I don't think it is.

[alezrik]

Health and wellness should be a basic human right to any/everyone regardless of money.

Dentists are the worst imo, try to go see a dentist without insurrance in the US and if you dont have a good pocket of cash you'll end up with a college student doing your root canal.

[Wrath Child]

Survival of the fittest. People should get what they pay for. If you can't afford what someone else can - well then to hell with you. That's not the rich guy's problem nor should it be.

I hope that was satirical

Maybe he's converted to Darwinism!

[Tossica]

Maybe he's converted to Darwinism!

I didn't realize Darwinism was a religion or a moral standing? I think he is more likely a retardist.

[Lyion]

Health and wellness should be a basic human right to any/everyone regardless of money.
.

Health and wellness is also a responsibility of the person. The problem here is doctors, medicine, and hospitals in their current incarnation are very expensive. The insurance middle men are wanting their big cut of the pie, too.

Well, something that people who do not live in the US do not understand is if someone without medical insurance has an emergecny, the Hospital will still take care of them. Generally, the county/state will eat the bill when the person doesn't pay.

This is different than in Canada where many people cannot have emergency procedures due to the nature of the socialized system.

There has to be a happy medium between where the U.S. is and where Canada is that provides basic coverage but allows for competition and good private practice so the better doctors are rewarded.

[Goose_Man]

Health and wellness should be a basic human right to any/everyone regardless of money.

Dentists are the worst imo, try to go see a dentist without insurrance in the US and if you dont have a good pocket of cash you'll end up with a college student doing your root canal.

For some reason I've never gotten around to getting dental insurance yet. However, I still get top notch service. If you go get your teeth cleaned every 6 months like your supposed to and actually take care of your toofs then its really not an issue. I spend maybe $150 a year on dental bills... I think having insurance would cost more.

But thats a healthy single guy's point of view.

[Rust]

Maybe he's converted to Darwinism!

I didn't realize Darwinism was a religion or a moral standing? I think he is more likely a retardist.

I suspect W.C. means 'Social Darwinism'. Which was a Victorian creation to allow the rich to still consider themselves 'good people' while denying a decent living to the 'underclasses' who clearly deserved what they got.

--R.