Why We Need a Public Health-Care Plan

[Niels Bohr 72]

I hate Vipers they're ugly.

I like the Phantom.

[Mr. Big Dog 10,747]

Here is an interesting blog post:

Canadian Health Care

In 2007, documentary director Michael Moore released his latest film, entitled "Sicko". The premise of the doc was to compare the American health care industry to other nations, including Canada.

...

Source: Least I can Do

And here's the least I can do - this was posted before in OT:

Debunking Canadian health care myths

By Rhonda Hackett

Posted: 06/07/2009 01:00:00 AM MDT

As a Canadian living in the United States for the past 17 years, I am frequently asked by Americans and Canadians alike to declare one health care system as the better one.

Often I'll avoid answering, regardless of the questioner's nationality. To choose one or the other system usually translates into a heated discussion of each one's merits, pitfalls, and an intense recitation of commonly cited statistical comparisons of the two systems.

Because if the only way we compared the two systems was with statistics, there is a clear victor. It is becoming increasingly more difficult to dispute the fact that Canada spends less money on health care to get better outcomes.

Yet, the debate rages on. Indeed, it has reached a fever pitch since President Barack Obama took office, with Americans either dreading or hoping for the dawn of a single-payer health care system. Opponents of such a system cite Canada as the best example of what not to do, while proponents laud that very same Canadian system as the answer to all of America's health care problems. Frankly, both sides often get things wrong when trotting out Canada to further their respective arguments.

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada's health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada's government decides who gets health care and when they get it.While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.Princeton University health economist Uwe Reinhardt says single-payer systems are not "socialized medicine" but "social insurance" systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren't enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

And these are just some of the myths about the Canadian health care system. While emulating the Canadian system will likely not fix U.S. health care, it probably isn't the big bad "socialist" bogeyman it has been made out to be.

It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty — who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care — will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.

Rhonda Hackett of Castle Rock is a clinical psychologist.

What do we pay for, anyway?

By Ellen Mackey

Posted: 06/07/2009 01:00:00 AM MDT

If you have a little righteous indignation left after hearing about AIG executives and Bernie Madoff, I have a candidate for you: William McGuire, former CEO of the health insurance company United Health Group, Inc.

T.R. Reid — a veteran Washington Post correspondent and host of the "Frontline" documentary "Sick Around the World" — says when McGuire left his company in 2006, he received a "platinum parachute" worth $1.1 billion. That amount dwarfs the compensation of anyone in the financial services or oil industries, Reid says, making McGuire's the largest package ever in corporate America.

America's for-profit health care system is expensive, fragmented, and, by many measures, failing. But as Reid points out, reducing administrative costs is key to a national health care system that works. And other countries are proving it can be done.

According to the World Health Organization, we spend more on health care per capita than any other country, yet we rank 37th in overall health care.

Fox News reported in 2004 that Americans are significantly less satisfied with their health care system than citizens of Australia, Canada, New Zealand, or the U.K. Additionally, we are exposed to more out-of-pocket payments than any of those countries.

Other countries cover the health care needs of their populace, and for less money. How do they do it?

In late March, I went to see Reid at Bemis Public Library in Littleton, where he talked about his new book, "Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care" (Penguin Press, August 2009). Reid pointed out that we already have systems in place that are much like those in other countries that have health care that works. Our veterans are covered in a system much like Britain's. Medicare patients already use a system like Canada's. And it's not all socialized medicine, either. Those whose employers pay for most of the costs use a system much like France's. Germany actually has less government involvement in health care than the U.S. does.

So why are they able to cover anyone at a lower cost? Because they have chosen one system for everyone, Reid says. By avoiding our crazy-quilt of forms, payments and varied systems, they can get their administrative costs between 2.5 percent and 5 percent.

By comparison, costs in the U.S. are between 18 percent and 25 percent. If we could get our administrative costs down, Reid points out, we could save as much as $7 billion, enough to cover America's uninsured.

In the U.S., 20,000 people die each year from preventable diseases. Reid tells of a young woman who had lupus and couldn't afford the medication. She would have lived to 80 in other industrialized countries, he said. Here, she died a young woman.

Additionally, people in other countries don't go bankrupt from medical bills. According to a study by Harvard Medical School, 28.3 percent of the bankruptcies in 2001 resulted from illness or injury. David Himmelstein, an associate professor of medicine and one of the authors of the study, says, "If you're sick enough long enough, you're in deep trouble in our society."

The money that Americans pay for administrative costs goes to three main places:

• Companies pay large sums for marketing costs;

• Companies employ hundreds of underwriters who decide who to cover and how to save money on clients' care.

• Huge salaries.

Which brings us back to William McGuire and his stratospheric "platinum parachute" of $1.1 billion. McGuire, by all evidence, was a good businessman. The shares of his company, UnitedHealth, increased dramatically, pleasing stockholders. Yet his customers weren't quite so happy. According to the American Customer Satisfaction Index, his company scored a middling 68 in 2006, the year he left. The industry average was a 72. Even the U.S. Postal Service scored a 71.

For these billions of dollars we give to for-profit insurance companies to spend on marketing, underwriting and executive salaries, we are not getting actual health care services. We are essentially paying people to sell us insurance and then fight us on paying claims while they give high-ranking execs large salaries.

When the health care debate heats up, take a look at what is done in other countries. They have better overall outcomes and lower costs. In the U.S., we need to talk about out how to cut administrative costs, not hide behind a misguided notion that what we have is the best possible.

The alternative is to keep paying executives millions of dollars to keep us in 37th place in the world in health care.

Ellen Mackey (emackey61@yahoo.com) is a librarian in Littleton. She was a member of the 2007 Colorado Voices panel.

[Down With PMP 0]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

[Mr. Big Dog 10,747]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

Says who?

[Down With PMP 0]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

Says who?

Says the Senate.

You starry-eyed liberals with your sunny optimism make me sick. You can everything you need, but no - you can't settle for that. You want it all, even the stuff you don't need but just want.

[Mr. Big Dog 10,747]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

Says who?

Says the Senate.

You starry-eyed liberals with your sunny optimism make me sick. You can everything you need, but no - you can't settle for that. You want it all, even the stuff you don't need but just want.

Starry-eyed liberals with sunny optimism? Way to make a point - not!

A patch as you suggest is not going to halt - or even slow - the health care expenditures of this nation. We'll then revisit the issue when our health care system is the absolute laughing stock of the world and third world countries get better public health grades than the US. We're ranking 37 in the world today - in terms of public health. Of course, we're number 1 in spending. How anyone can tolerate this obvious rip-off is beyond me.

I'm realistic in regards to the prospects of real reform - ain't going to happen. Folks in D.C. just fail to grow a pair and get the people's business done.

[My Name Is Nobody 3]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

Says who?

Says the Senate.

You starry-eyed liberals with your sunny optimism make me sick. You can everything you need, but no - you can't settle for that. You want it all, even the stuff you don't need but just want.

Starry-eyed liberals with sunny optimism? Way to make a point - not!

A patch as you suggest is not going to halt - or even slow - the health care expenditures of this nation. We'll then revisit the issue when our health care system is the absolute laughing stock of the world and third world countries get better public health grades than the US. We're ranking 37 in the world today - in terms of public health. Of course, we're number 1 in spending. How anyone can tolerate this obvious rip-off is beyond me.

I'm realistic in regards to the prospects of real reform - ain't going to happen. Folks in D.C. just fail to grow a pair and get the people's business done.

Which people? Not me

[Ban Hammer 13,657]

What is PMP?

Pseudomyxoma Peritonei?

pimp my #######?

[Hilarious Clinton 452]

like sheep to the slaughterhouse.

They blindly follow the Messiah.

[Mr. Big Dog 10,747]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

Says who?

Says the Senate.

You starry-eyed liberals with your sunny optimism make me sick. You can everything you need, but no - you can't settle for that. You want it all, even the stuff you don't need but just want.

Starry-eyed liberals with sunny optimism? Way to make a point - not!

A patch as you suggest is not going to halt - or even slow - the health care expenditures of this nation. We'll then revisit the issue when our health care system is the absolute laughing stock of the world and third world countries get better public health grades than the US. We're ranking 37 in the world today - in terms of public health. Of course, we're number 1 in spending. How anyone can tolerate this obvious rip-off is beyond me.

I'm realistic in regards to the prospects of real reform - ain't going to happen. Folks in D.C. just fail to grow a pair and get the people's business done.

Which people? Not me

You're a member of Congress?

like sheep to the slaughterhouse.

They blindly follow the Messiah.

I always value these enlightened contributions to a debate. Very helpful.

[Peikko 1,575]

I, for one, don't give a rats ####### about the profits of private health insurance firms.

You can either have a plan that gives health care to the uninsured and uninsurable or you can have nothing.

Says who?

Says the Senate.

You starry-eyed liberals with your sunny optimism make me sick. You can everything you need, but no - you can't settle for that. You want it all, even the stuff you don't need but just want.

Starry-eyed liberals with sunny optimism? Way to make a point - not!

A patch as you suggest is not going to halt - or even slow - the health care expenditures of this nation. We'll then revisit the issue when our health care system is the absolute laughing stock of the world and third world countries get better public health grades than the US. We're ranking 37 in the world today - in terms of public health. Of course, we're number 1 in spending. How anyone can tolerate this obvious rip-off is beyond me.

I'm realistic in regards to the prospects of real reform - ain't going to happen. Folks in D.C. just fail to grow a pair and get the people's business done.

Which people? Not me

You're a member of Congress?

like sheep to the slaughterhouse.

They blindly follow the Messiah.

I always value these enlightened contributions to a debate. Very helpful.

Aren't they just too cute? It always surprises me that they are not printed in pink with lots of sparkles

[Empress of Groovy 373]

I only follow messianic pink sparkly sheep w/ a "baaa!" that sounds like a harp. Anything else--forget it.

[rooster 1]

like sheep to the slaughterhouse.

They blindly follow the Messiah.

Actually I think Obama fvckin sucks!! This is one of the very few things I kinda agree with.

[Peikko 1,575]

[Niels Bohr 72]

Why do people hate sheep?