New York Times: Canada's publicly financed health insurance system is gradually breaking down

[w¡n9Nµ7 §£@¥€r 123]

The country's publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — is gradually breaking down. Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine.

[...]

Canada remains the only industrialized country that outlaws privately financed purchases of core medical services.

[...]

But a Supreme Court ruling last June — it found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists — appears to have become a turning point for the entire country.

"The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services," the court ruled.

[...]

"Why are we so afraid to look at mixed health care delivery models when other states in Europe and around the world have used them to produce better results for patients at a lower cost to taxpayers?" the premier of British Columbia, Gordon Campbell, asked in a speech two weeks ago.

[...]

... most Canadians agree that current wait times are not acceptable.

The median wait time between a referral by a family doctor and an appointment with a specialist has increased to 8.3 weeks last year from 3.7 weeks in 1993, according to a recent study by The Fraser Institute, a conservative research group. Meanwhile the median wait between an appointment with a specialist and treatment has increased to 9.4 weeks from 5.6 weeks over the same period.

Average wait times between referral by a family doctor and treatment range from 5.5 weeks for oncology to 40 weeks for orthopedic surgery, according to the study.

http://www.nytimes.com/2006/02/28/internat...s/28canada.html

[Saddle Bronc 124]

That the system was breaking down was not even "news" 12 years ago (as the provincial health systems were overtaxing and overregulating doctors). The response of many doctors then was to flee south on TN-1 visas (some of these may have adjusted to GC or US citizenship by now).

The oncology wait hit a chord. My mum had made a trip to India in early 1999. After finding swelling in her leg, she had seen a doctor in Bangalore who made a preliminary (no biopsy) diagnosis of "possible lymphoma"; she went back to Calgary to get diagnosis and treatment--and had to wait over six weeks for a diagnostic appointment (and ANOTHER six weeks to start treatment).

As a whole, it is like attempting to plug levee AFTER substantail flooding has already occured (which Canada also did with pharmaceuticals in the late 1980's--it had not changed the laws on these since WW1!).

[ace13 0]

I am not sure if this relates, but my mother-in-law had to wait 6 months in Italy for surgery for kidney stones. She passed a few while waiting, poor thing She wishes she had more options, too.

[mikeize 0]

I think a mixed system is best. Those who can afford it will certainly pay for the advantages of private care, while decreasing the burden on the public system. Of course they won't want to continue to pay taxes for public health care... but no one is saying they can't use it if they want to... they just won't if they don't have to.

-mike

[w¡n9Nµ7 §£@¥€r 123]

Those who can afford it will certainly pay for the advantages of private care, while decreasing the burden on the public system. Of course they won't want to continue to pay taxes for public health care... but no one is saying they can't use it if they want to... they just won't if they don't have to.

This is a very good point. If I paid taxes towards a universal healthcare system, I'd use it except in case of emergencies. A routine check up can wait a few weeks but essential surgery can not. Well maybe that can too (I'm not a doctor, what do I know) but I think I'd be willing to spend a certain amount of money to get that sorta thing expedited. For peace of mind, if nothing else. And besides, who would trust a government doctor? It would be like letting the clowns who work the DMV fix your expensive car.

Edited February 28, 2006 by Agent Smith

[Mr. Big Dog 10,747]

Those who can afford it will certainly pay for the advantages of private care, while decreasing the burden on the public system. Of course they won't want to continue to pay taxes for public health care... but no one is saying they can't use it if they want to... they just won't if they don't have to.

This is a very good point. If I paid taxes towards a universal healthcare system, I'd use it except in case of emergencies. A routine check up can wait a few weeks but essential surgery can not. Well maybe that can too (I'm not a doctor, what do I know) but I think I'd be willing to spend a certain amount of money to get that sorta thing expedited. For peace of mind, if nothing else. And besides, who would trust a government doctor? It would be like letting the clowns who work the DMV fix your expensive car.

Problem with some of the "mixed" systems is that those that can "afford" private insurance usually fall into either (mostly both) of these categories: high income, good health. See, private insurance gets to pick and choose who they accept allowing them to reject those that will cost and accept those that will contribute. Leaves those whose care is expensive to the rest. Of course, there you have moistly your median -low income folks shouldering the burden.

And if that ain't bad enough, they will also shoulder the burden of those that have saved out the wazoo when young and healthy once the private carrier makes coverage unaffordable to them (they get old or pick-up a condition that's not covered). When their care gets expensive, they get dumped by the private carriers on what's left of the public system. Gives the public system an unavoidable disadvantage which the private insurance industry a ) helps create and b ) uses to "sell" the advantage of the private system (more cost-effective - on the surface). It's a lose-lose for the publicly funded system. Just look around the state and county health systems in the US and you know what I mean...

[cmartyn 0]

Yikes.. I think Ill just keep my money and die when Im suposed to. Float me out on an ice sheet when I turn 50. More logical than paying the president of Aetna 50 mil a year I think. Screw him.

[daisy16 0]

The Canadian health care system worked for me for 40 years. And the US system is brutal, where if you can't pay you just get sicker.

However, there are problems that I see in Canada, like people running to the "free" doctor every time they get a sniffle. That doesn't seem to happen here. I'd like to see a token user fee system to cut out some of the abuses. Also, my mom needed to have a bone density scan done, which took more than 9 MONTHS! Hubby said that here it would take a week - if one can pay that is. So the system is great but it does need work.

[Satisfaction 1]

I am not familiar with the Canadian healthcare system, although I have heard that it was usually pretty good, except for the province of Quebec. I am not sure why? There seems to be poor access and/or lack of healthcare facilities and insufficient trained and motivated staff. I heard that doctors would rather conduct their "business" in other provinces instead, and that immigrant doctors have a very hard time getting a license...

In the meantime, the American healthcare system, which is mostly run by private insurance companies, is too costly for many people. In an industrialized country with such economic power, how can it be that so many citizens are uninsured? What is the option for those, whose employers don't provide them with medical insurance, and who can't afford to pay for it on their own? (I read a percentage close to 40%?? TBC). Are we supposed to turn a blind eye and let the poor or "poor working class" get sick and die?

[cmartyn 0]

Well, this is the age old question isn't it. I like the private system. Its the runaway corporate greed and corruption that screws it up. I think Canada's issues are somewhat overblown and appear out of context in the media down here. My parents seem to get on allright, 2 knee replacements, bypass and all.. still ticking at 80. The US allready has a mixed system with 50% of healthcare costs allready coming out of tax revenue. The combination of private insurance and government regulation will get you every time.

[chocolaterie 0]

hmm, it's a highly debated topic. The healthcare system was kind to me during my 19 years in Canada. But I agree, there are too many people who run to the doctor at every sniffle or cough. I admired my mom, she never goes to the doctor unless it's an absolute necessity, or I make her. She thinks going to the doctor is a wasteful use of money unless truly needed (hah, maybe she got this from communist china). I also stress that I hate the way insurance is in the states. Everytime before I go for anything, I have to re read my policy and verify that what I'm going for is covered (if I don't see it in my paperwork). I also hate it when the docs/dentists etc send you an invoice when they're too impatient to wait for the ins check. Maybe they should give out health cards where people can only go 3 times a year and anytime after that, they would have to pay? It might give them an incentive to stay healthy and mind their bodies? But then again this can't apply to someone who has cancer etc. I guess there will always be a problem with the system.