1. It's all socialized out there!
August 26, 2009 3:17 PM   Subscribe

5 Myths About Health Care Around the World by T.R. Reid (Washington Post)
posted by blue_beetle (138 comments total) 25 users marked this as a favorite
 
Yes, but what about their death panels? No, he doesn't even mention them...
posted by Mental Wimp at 3:23 PM on August 26, 2009 [3 favorites]


Japan's Socialized Ninja Death Panels: Kick Ass or Awesomely Wicked?
posted by Blazecock Pileon at 3:25 PM on August 26, 2009


Cripes, there's at least one mistake there: Canada doesn't have wait lists for non-urgent care to keep costs down per se. Canada has limited capital budgets for hospitals (though they're certainly getting built) and there is a real shortage of doctors and surgeons. So there are only so many hip replacements that can get done in a week, fewer than people who want them. But we're not holding people up directly.
posted by GuyZero at 3:28 PM on August 26, 2009 [2 favorites]


Great article! One of the best summaries of health care outside of the US I've read in ages.

I only have one minor nitpick concerning a point about France:
"In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry."
In France, you DO get a choice of supplemental insurance provider (not just "insurance" provider, the "supplemental" is key since national health care covers 100% of emergency care and 30-70% of basics [unless any basics are required for a chronic condition in which case they're covered 100% too]. The percentage of non-essential basics not covered can be taken care of by a private supplemental health insurance plan). You do not have to take the supplemental health plan offered by your employer, although it is usually cheaper, with better coverage, and so no one really bothers to look elsewhere. I can understand the article's oversight since indeed, due to that, even some French people I know don't realize they could take a different plan than their employer's.
posted by fraula at 3:31 PM on August 26, 2009 [2 favorites]


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...
posted by Alexandra Kitty at 3:44 PM on August 26, 2009


And the reason for Canada's shortage of doctors and nurses is that so many of them are lured south by the promise of vastly over-inflated salaries: this (supposed) problem with Canada's system that the anti-health care people in the States like to crow about is, at least in part, caused by America's stupid system.
posted by Flashman at 3:46 PM on August 26, 2009 [14 favorites]


So there are only so many hip replacements that can get done in a week, fewer than people who want them.

Back when I was a medical device industry droid, I worked with investigators in Canada who were electrophysiologists. As I recall, they were limited in the number of defibrillators they could implant per year in each region, because there was a limited amount of money allocated for purchasing them. This made them very selective in choosing patients.
posted by Mental Wimp at 3:47 PM on August 26, 2009


And the reason for Canada's shortage of doctors and nurses is that so many of them are lured south by the promise of vastly over-inflated salaries: this (supposed) problem with Canada's system that the anti-health care people in the States like to crow about is, at least in part, caused by America's stupid system.

Actually, it's because the Canadian government actually pushed doctors south.

Yes, our country is run by bozos too!
posted by Sys Rq at 3:49 PM on August 26, 2009


Has anyone linked this graphic here yet? Who's Paying to Kill Health Care Reform
posted by mediareport at 3:55 PM on August 26, 2009 [9 favorites]


It's really just a matter of simple math. If we're paying twice as much, not covering 1/6th of our population, have a very uncompetitive life expectancy and a higher child mortality rate, then we're failing this class. Maybe Canada only gets a C+, but we get an F. There, you wait a while for elective or non-vital procedures. Here, you're denied coverage for VITAL procedures and then you die. (At which point you stop complaining, which is a plus for the insurance companies.)

I really think the government needs to be heavily involved in health care, as it is in all the other countries that surpass us in just about every aspect of human health. The government has more at stake in your survival than anyone else except you yourself, for the obvious reason: the longer you live, and the more productive you are, the more tax receipts you will generate over your lifetime. Insurance companies only look at short-term gains: can you pay your policy this year and next, or is it going to cost more to treat you than your payments will bring in? If the latter, then they don't mind if you die. The government is involved with you, and has a stake in your survival, from basically day one. All that public school education doesn't come free, and letting insurance companies kill you off by denying coverage throws all that investment right in the toilet. The insurance companies don't care about that, because that's not THEIR investment that's lost when you die.

Our system probably is the best in the world, if you're rich. For everyone else (that is, 99% of us) our system is rapidly approaching laughable joke status compared to the other developed nations on this planet. AND we pay buttloads more for the shoddy 'service' we do receive.

It's kinda funny (and sad too) to see fiscally poor people attacking health care and, in effect, defending the bloodsucking insurance companies and their bloated paychecks. ($750 million for the CEO of Cigna -- makes the big bank CEO paychecks look like peanuts.) Poor people defending rich peoples' raping of all people -- that's just crazy.
posted by jamstigator at 4:02 PM on August 26, 2009 [25 favorites]


Canada doesn't have wait lists for non-urgent care to keep costs down per se

It's almost worse if spending more money wouldn't help, though.
posted by smackfu at 4:05 PM on August 26, 2009


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...

Um...yeah....you must live in a whole different Canada then I do. Due to a variety of reasons (health complications, childbirth, etc.) I've made rather copious use of the Canadian medical system over the past few years and it has been timely, well-run and organized, compassionate, personalized, and 100% free. Sounds to me like you need to move to another country.
posted by Go Banana at 4:08 PM on August 26, 2009 [14 favorites]


It's almost worse if spending more money wouldn't help, though.

There are lots of places where money alone will not solve problems.

For example, have their been any new medical school opened in the last 20 years in Canada? Have provinces created fast-track systems for certification of foreign-trained physicians? Sure, these things need money, but they need more than just money.

Yes, our country is run by bozos too!

Unfortunately.
posted by GuyZero at 4:11 PM on August 26, 2009


Um...yeah....you must live in a whole different Canada then I do.

According to her profile, she lives in Ohio.
posted by Pope Guilty at 4:12 PM on August 26, 2009 [25 favorites]


Grrr.

Why do so many articles on "socialised health care" omit the information that there is also a user pays option for having elective procedures performed in the private health care system?

For those who aren't aware that "socialised medicine" is often multi-tiered, this is a significant omission. The waiting lists for having those procedures performed free of charge within the public health system might be long, but many of those procedures are ones which could be performed as day surgery within the private system and the government would still rebate part of the cost - the option of covering the "gap" out of one's own pocket exists for people who do not have supplementary private health insurance but is rarely discussed and that creates a false impression that those without private health insurance must depend entirely on the public system and cannot get faster care without paying the entire cost themselves.
posted by Lolie at 4:12 PM on August 26, 2009 [4 favorites]


Ah. Thanks, Pope Guilty!
posted by Go Banana at 4:15 PM on August 26, 2009


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...

Oh look, Shona Holmes got a Metafilter account.
posted by sevenyearlurk at 4:15 PM on August 26, 2009 [9 favorites]


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...
posted by Alexandra Kitty at 5:44 PM on August 26 [+] [!]


Speaking as an employee of the Canadian Healthcare system, allow me to say this: You have no fucking clue what you are talking about.
posted by WinnipegDragon at 4:15 PM on August 26, 2009 [35 favorites]


To expand on Guy Zero's point, yes, in Canada one *can* end up waiting for non-emergency care, but it's not done on purpose as a cost-saving measure. For example, growing up I lived in a small rural town. It had one ENT doctor, and he was doing all the ENT surgeries, including for really critical stuff like throat cancer. I waited 6 months for a tonsillectomy. When my younger sister had to get her tonsils out, my mom didn't want to wait. So she called up a doctor in a nearby town with more than one ENT doctor and got her an appointment in a very reasonable amount of time.

Now I live in a larger centre, with a bit of a shortage of family doctors but a fair number of specialists for the demand. Both my partner and I have had to have non-emergency surgeries in the past 5 years. Both of us were in a lot of pain but not a lot of danger. In my partner's case, his degree of pain got him priority on the waiting list. In my case, I told my doctor that I would be willing to come in at a moment's notice if a surgery slot came up. I went from first symptom to surgery in 7 months, for a condition that takes an average of 7 years to diagnose in America. From the time the doctor determined I needed surgery to the actual surgery was less than 2 months. My partner also had his surgery in less than two months.

When I recently came back from a year and a half in Africa, I felt, well, off. I went to my doctor and she ran every test she could think of, including x-rays and ultrasounds. Non of it cost me anything, including any worry about whether feeling "off" was enough of reason to go to the doctor. I found I had a minor parasite, treatable but that it's not a good idea to leave untreated. When chatting with a friend in the peace corps, he was worried about coming home because chances are high of coming home with problems that might need treatment over the coming year, but his insurance through the Peace Corps would expire in 6 months. I can't even imagine having to deal with that. Give me 5 hours waiting in an emergency room for some minor ailment over that kind of worry any day of the week.
posted by carmen at 4:16 PM on August 26, 2009 [7 favorites]


Oh, and also, Japan's health care sounds awesome!
posted by carmen at 4:16 PM on August 26, 2009


Reid was also very compelling on Fresh Air on Monday. I believe he's flogging a book.
posted by jeoc at 4:17 PM on August 26, 2009


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed.

This likely does not reflect the views or experience of many, many Canadians. Certainly some people do wait for certain types of treatment and funding is always an issue, but does making such a broad mis-characterization really push forward the debate in an argument about health care myths?
posted by Adam_S at 4:18 PM on August 26, 2009


So she called up a doctor in a nearby town with more than one ENT doctor and got her an appointment in a very reasonable amount of time.

Exactly. I don't know anything about pacemakers and they could very well be literally rationed, but when my dad had hernia surgery he ended up going to an all-hernia clinic that does nothing but hernias (man would I love to do their marketing) that was out of town because it was a lot faster. And my mom often goes to the next town over (~100km) to get stuff done as there either isn't a specialist or a room available or whatever. (I can't quite figure why people have so much surgery as they get old, but apparently it's pretty popular for the retired crowd)

So yeah, it's not perfect, but it's always there regardless of age or preexisting conditions. I never worry that some day my parents may get cut off from medical care.
posted by GuyZero at 4:26 PM on August 26, 2009


Pope Guilty: "Um...yeah....you must live in a whole different Canada then I do.

According to her profile, she lives in Ohio.
"

Did she just change it, then? Because now it says Canada.
posted by pineapple at 4:28 PM on August 26, 2009 [4 favorites]


Hamilton is Ontario's Ohio.
posted by GuyZero at 4:30 PM on August 26, 2009 [7 favorites]


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...

You're a loon. Seriously, you've got to be crazy. There's no other explanation.
posted by You Should See the Other Guy at 4:31 PM on August 26, 2009


You Should See the Other Guy: "You're a loon. Seriously, you've got to be crazy. There's no other explanation."

Of course there is. Starts with T? Rhymes with "rolling"?
posted by pineapple at 4:34 PM on August 26, 2009 [1 favorite]


Five items spread across three pages?

Single-page version.
posted by Eideteker at 4:38 PM on August 26, 2009


Pope Guilty: According to her profile, she lives in Ohio.

Her profile (now, at least) says Canada.
posted by Dysk at 4:39 PM on August 26, 2009


...does making such a broad mis-characterization really push forward the debate in an argument about health care myths?

I don't think that's part of that comment's motivation.
posted by Kirth Gerson at 4:39 PM on August 26, 2009


"According to her profile, she lives in Ohio."

Did she just change it, then? Because now it says Canada
ush was.

Don't worry, she'll change it back to America when it comes time to talk about how great George Bush was.
posted by happyroach at 4:41 PM on August 26, 2009 [1 favorite]


If only Americans were having a reasoned debate over health care and weren't actually worried about lazyscummypromiscuousimmigrantsandpeoplewhosecolorwedon'tlike getting coverage if we offer health care to all, I'd think this piece would save the day.

Sadly, those who oppose national health care oppose it because they see it as welfare-- and if they can keep just one lazyscummypromiscuousimmigrantorpersonwhosecolorwedon'tlike

from getting free health care, they don't mind if they themselves have coverage which might suddenly bankrupt them if they got unlucky because, of course, they won't be unlucky, because they deserve riches and blessings and those who don't have them sinned and deserve to die for it. Even their children do.

No matter that Medicaid already covers such people and emergency rooms subsidize the care they must by law give to anyone who shows up by making everyone else pay more-- the facts aren't the issue.

The problem is a fundamentalist morality which sees helping people as "enabling" them to be dependent-- and dependence as a state of weakness and disease. It's not a coincidence that we call addiction dependence and hate addicts-- we think we're independent and it makes everyone miserable so we want to spread that misery around.
posted by Maias at 4:41 PM on August 26, 2009 [6 favorites]


You're a loon. Seriously, you've got to be crazy. There's no other explanation.

Just for a moment, let me expand on my earlier response to this.

I'm not just an employee of the system, I am also, as you would expect, a consumer. My recent experience with the system was as follows:

My wife and I just welcomed our second child about seven weeks ago. It was a fairly complicated pregnancy, with several worrisome moments.

Over the course of the eight months and one week of it, she had no less than seven ultrasounds, a few dozen appointments with both our family doctor, her OB/GYN and one specialist. She had an emergency C-Section one afternoon out of the blue, and the entire duration of time from her admission to the surgery was under six hours, and most of the delay was just time spent monitoring and evaluating the position and health of our son.

The surgery went flawlessly, with no complications, no infection, and no post-surgical issues at all. Within a day of our bringing our son home, the Public Health Nurse arrived to check on our son and my wife. She did so several times over the next month.

The total amount of paperwork we had to complete for this amounted to three pages, and that was simply to register his birth and request his birth certificate. Our cost out of pocket amounted to about $50 and all of that was parking fees at the hospital and the two dinners I had at the cafeteria.

Now my wife is on a one-year maternity leave paid for buy our Employment Insurance program. It won't pay her full salary, of course, but it's enough that we don't need to panic.

I will put this experience up against any, and I mean any, Healthcare system in the world. It may not be perfect, but I suspect that there are far more people in the USA who would envy this scenario than not.
posted by WinnipegDragon at 4:42 PM on August 26, 2009 [23 favorites]


Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...

Oh behalf of the many millions of Canadians who are both proud of, and grateful for, our health care system: Fuck off, and take your talking points with you.
posted by jokeefe at 4:44 PM on August 26, 2009 [16 favorites]


I saw another sweeping, dismissive, bullshit statement about Canadian health care from Alexandra Kitty some time back, checked her profile then, and it said Hamilton, Ontario at that time, too. I think Pope Guilty saw Hamilton and something starting with "O" and filled in the rest incorrectly. So bullshit claims aside, can we stop with the breathless, "Oh, NOW it says she's in Canada, but she's really an American troll playing profile games."?

GuyZero, was the all-hernia clinic in Shouldice? I was just reading Atul Gawande's Complications today and he described the amazing work they do there.
posted by maudlin at 4:44 PM on August 26, 2009


Germany's health care is a mess — you have to wait months and months for a death panel, the camps are filthy, and chronically ill are ground up to feed the troops.

Oh, wait? You meant in this timeline? No, no, here they're fine.
posted by klangklangston at 4:44 PM on August 26, 2009 [7 favorites]


Pope Guilty: According to her profile, she lives in Ohio.

Her profile (now, at least) says Canada.


If only amateur astroturfers were smarter.
posted by Blazecock Pileon at 4:47 PM on August 26, 2009



You're a loon. Seriously, you've got to be crazy. There's no other explanation.


No, to be fair there are a lot of Canadians who think the US system is better. If you compare new, clean hospitals in expensive areas (say, the hospital at Stanford in Palo Alto) to older, urban hospitals (Hamilton General, anything in downtown Toronto) the US system is going to look like it's a million times better. You get really fast referrals and appointments in the US. Heck, if you're on a PPO you skip your GP and just go straight to whoever the heck you want to see. Think you have thyroid condition? Push a few buttons and you're seeing an endocrinologist on Thursday!

I know plenty of Canadians who think their system is slow, inflexible and annoying. Coincidentally, they're all older, white, well-off people. But demographics aside, there are certainly lots of Canadians who don't like what they've got. Let's not misrepresent Canada as a one big happy Kumbaya-singing hippie-land.
posted by GuyZero at 4:47 PM on August 26, 2009 [1 favorite]


can we stop with the breathless, "Oh, NOW it says she's in Canada, but she's really an American troll playing profile games."?

I think it's a testament to the veracity of her claims that every Canadian who entered the thread seems to have thought her so off the mark they checked her profile. I mean seriously, if she was halfways accurate, no one would have.
posted by You Should See the Other Guy at 4:49 PM on August 26, 2009 [2 favorites]


Yeah, it was Shouldice, though my memory is fuzzy and he may only have evaluated going there and he may have had it done locally instead. Apparently Shouldice does an older type of operation so their risk rate is next to zero but the recovery time is longer. He may have opted for the newer procedure with a generalist surgeon to save the drive to Toronto and with the expectation of a better recovery. It was years ago now so I forget the details.
posted by GuyZero at 4:50 PM on August 26, 2009


"I will put this experience up against any, and I mean any, Healthcare system in the world. It may not be perfect, but I suspect that there are far more people in the USA who would envy this scenario than not."

Yes, but ultimately the true cost of the Canadian health care system was paid: the child was born Canadian.

USA! USA! USA!
posted by klangklangston at 4:55 PM on August 26, 2009 [9 favorites]


Japan's health care is awesome. Anecdotally anyway. Very long involved story aside - I got hurt. I was in a Japanese hospital. Really, really, really great.
Only thing threw me off, I felt like I was missing a step, the nurses. They were kind of flirty, the younger ones, and yet there was this sort of "Hey, pal, suck it up" regarding pain. Lot of attention, but not a lot of care, at least for me. Which may have been sort of a respect deal (martial artists get a lot of respect), as in, I can take it and they're letting me know they know I'm tough, but too a lot of checking with the doctors. I don't know if that was a female issue or a style in their hospitals. Not a lot of autonomy, seems. But then hospital styles vary from city to city in the U.S. too.
Still, I would have liked more drugs. Although I've been in hospitals where they really overdo it. I remember watching belogrivye loshadki thinking it was in English and being left alone for vast swaths of time.
So yeah, Japan good.
posted by Smedleyman at 4:58 PM on August 26, 2009


Yes, but ultimately the true cost of the Canadian health care system was paid: the child was born Canadian.

Obama's plan will make any child born under the plan automatically Kenyan, Muslim and socialist. Check it out, it's in there!
posted by qvantamon at 5:01 PM on August 26, 2009 [7 favorites]


Well yeah, we'd all like more drugs. Now we have to go to Mexico for that.
posted by jamstigator at 5:05 PM on August 26, 2009


You get really fast referrals and appointments in the US.

Not always. My wife can't see her PCP without making an appointment at least a month in advance. Referrals are even slower. My own doctor is more like your description. Why doesn't she switch? Beats the hell out of me.
posted by Kirth Gerson at 5:08 PM on August 26, 2009


Yes, but ultimately the true cost of the Canadian health care system was paid: the child was born Canadian.


Holy crap! He's *BLACK*?!
posted by WinnipegDragon at 5:08 PM on August 26, 2009 [4 favorites]


No, to be fair there are a lot of Canadians who think the US system is better.

I've never met a single one. Most Canadians I know will not even take a 3 day trip to America without getting insurance first they're so terrified of being caught in it.

I know plenty of Canadians who think their system is slow, inflexible and annoying.

Again, I don't know any. My mother has a pacemaker, my father has Parkinson's, a friend of mine got hit by a car a month ago, a coworker just had knee surgery, my neighbor just had hip surgery... never heard a single complaint from any of these people about their healthcare. The co-worker got his knee surgery a month earlier than was initially forecast.

anything in downtown Toronto

I guess that depends on your definition of DT. I was in the emergency room with the car-struck friend and there were 3 other people there, one guy with a broken pinkie and the other two I can't say as it wasn't obvious. My friend was in the worst shape and got quick treatment. This was at St. Joseph's around Queen and Roncy about 2 in the morning on a Friday night.

Seriously, when I see these anti-gov't-healthcare Americans on TV I am at a loss for words. They are so ridiculously misinformed it's laughable.

Absolutely there are times when something will go wrong in healthcare. That'll happen at some point anywhere that humans are involved. But these examples are in the steep and extreme minority.

When I read AskMe and see people say, "I woke up this morning and my left testicle was green... what should I do?" My first thought is always always always, "Must be an American." Why? Because a Canadian with a green testicle goes to the doctor. He doesn't seek advice from anonymous strangers on the internet.
posted by You Should See the Other Guy at 5:09 PM on August 26, 2009 [38 favorites]


One thing I never see mentioned in articles regarding US heathcare is the reliance of insurance companies on brokers.

I was tangentially associated with one for a number of years, and I've never seen such a money hole. At one point, the president of the brokerage actually held an insurance company's feet to the fire in order to get a one-week, all-expense trip to Hawaii for himself and his sales staff. The level of entitlement this man had was astounding, and he barely even a regional player.

The broker's incentives are another hidden cost in the health insurance business, and I'd be willing to bet, not an insignificant one.
posted by lekvar at 5:09 PM on August 26, 2009 [2 favorites]


You get really fast referrals and appointments in the US. Heck, if you're on a PPO you skip your GP and just go straight to whoever the heck you want to see.

And yet I often see Americans posting that they can't get a same day appointment to see a GP who is approved by their health insurance provider.

While those of us living in countries with universal health insurance greatly appreciate that catastrophic care is available to us free of charge, it is the more mundane health issues and preventative health care which means we don't have to worry about whether we can afford to look after our health. Even out of hours, we can still get a home visit from our GP's locum service if we'd rather wait a few hours at home to see a doctor than a few hours at an emergency room - and if it's an urgent issue we aren't going to think twice about calling an ambulance.

FWIW, in Australia you can actually see a specialist without a referral from a GP, but neither government nor private health insurers will pay a rebate on the cost unless there's a GP referral and in practise few specialists will take unreferred patients.

I think what stuns many of us is that Americans seem to pay more in out of pocket expenses for many things despite their mind-bogglingly expensive medical insurance than we would pay with no insurance at all. Part of that is that high end high cost medical interventions are the domain of public hospitals here, but even private care seems to be considerably cheaper here for the uninsured that it is for the insured in the US. So private care is a realistic option for the uninsured here in a way that it doesn't seem to be in the US (I've "gone private" for several day surgeries myself and my total out of pocket expenses have been well under $500 all up - hospital, anaesthetist and surgeon's fees combined).
posted by Lolie at 5:10 PM on August 26, 2009


I love the NHS - I hate twitter, so I won't put it there, but I will put it here. I also love the Canada Health Act, and have had nothing but the best care in both countries. (Slightly better coverage under the NHS though - prescription and eye coverage, and free birth control - Canada, you have some shaping up to do). When I lived in the US, I had health insurance courtesy of a very good university and their teaching hospital; it was the same as was standard where I've been in Canada and Britain.
posted by jb at 5:15 PM on August 26, 2009


In his NPR interview, he talked about a nagging problem (soreness) he's been having with his shoulder. In Canada, he was told it would take about 8 months to see a specialist for a consultation, and if surgery was approved, that would take another 6 months. In some countries (Japan was one, I think) they were ready to give him an awesome metal shoulder right away, and in some, he was told he just needed physical therapy or massages.
posted by Stylus Happenstance at 5:17 PM on August 26, 2009


I've never met a single one.

Hey, I've never met someone who voted for the Bloc, but that doesn't mean they don't exist. Heck, I don't even know any Conservatives and I'm pretty sure they exist.

Don't get me wrong, I think the Canadian system is great. But there will always be plenty of America-worshipers north of the border who think that everything American is automatically better. I don't agree with them, but they exist.

This was at St. Joseph's around Queen and Roncy about 2 in the morning on a Friday night.

My old local hospital. Thewy treated my pneumonia there once. Perhaps you noticed the emerg treatment area was full of homeless people of unstable mental health that had not showered in a long time? Glad I was put into isolation due to my mysterious respiratory illness.

I don't have an issue with it, but there are plenty of prissy Canadians, even in NDP-Orange Roncesvalles that don't like seeing the emerg full of smelly crazy people. Most have the sense to live in Markham so not many complain about it, but there are people who would rather die than get treated in St Mikes or St Josephs. America has no monopoly on stupid people.
posted by GuyZero at 5:19 PM on August 26, 2009


Why do so many articles on "socialised health care" omit the information that there is also a user pays option for having elective procedures performed in the private health care system?...

Well in Canada, that would probably end up with the user (and the doctor!) in court. And when I say probably, I mean that it's done so in the past.

Now, admittedly in that opinion, the law banning the use of private health was ruled as opposed to the Quebec Charter, but it was an UGLY case, 3 separate opinions, it was only limited to Quebec (with some speculation that the reason the 3rd opinion was limited to Quebec is specifically because the Court wanted a way out of throwing open the floodgates in Canada), and this is in the situation that the long wait times could negatively impact health.

So it's definitely not a given that one can pay for private. Moreover, it could be considered immoral on a broad scale - that is exactly how the dismantling of a single-tier of health care would happen. The rich migrate towards a private system for some things, then agitate towards being out of the public option altogether, then only the poor and unhealthy are on the public option.

Also: nthing the love of the Canadian system - I've been walked into the hospital unsure of who/where I was with no ID (bike ride, hit by a car). Got taken care of, overnight for observation, then the next day I popped back to give 'em my (out of province) health card. Had a weird leg thing, in a town that I didn't have a GP, went to the clinic, waited an hour, saw a doctor. Gallbladder out in about 2 weeks after it was determined that the stones wasn't going away by themselves, at 15. Double hernia at 8 months. All things to laugh at, since I don't have to worry about paying for them.

Hey WinnepegDragon, congrats on the kid!
posted by Lemurrhea at 5:19 PM on August 26, 2009


PBS Frontline- Sick Around the World, Five Capitalist Democracies And How They Do It, as seen previously.

Personally, I'm doing career training in hopes of applying to a company in Toronto and getting the Canadian citizenship ball rolling.
posted by paisley henosis at 5:20 PM on August 26, 2009 [3 favorites]


And yet I often see Americans posting that they can't get a same day appointment to see a GP who is approved by their health insurance provider.

This is because Canadians who fantasize about the US healthcare system always have the best insurance in the universe in their fantasies. Or they have no real idea exactly how US healthcare really works. But it must be great because, woo-hoo look at that hospital we drove by on vacation in Orlando.

No one closes their eyes and imagines having sex with an ugly person.
posted by GuyZero at 5:22 PM on August 26, 2009 [10 favorites]


Dear Encyclopedia Browns,

Congratulations coming off like idiots in your haste to run for the pitchforks.

DO MOAR RESEARCH.
posted by absalom at 5:34 PM on August 26, 2009


Dear Encyclopedia Browns,

Congratulations coming off like idiots in your haste to run for the pitchforks.

DO MOAR RESEARCH.
posted by absalom at 7:34 PM on August 26 [+] [!]


She wrote some books on completely unrelated topics. Good for her.

She is still completely wrong on this subject.

DO MOAR THINKING.
posted by WinnipegDragon at 5:37 PM on August 26, 2009 [1 favorite]


Well, her publisher is the Disinformation Company.
posted by Flashman at 5:42 PM on August 26, 2009


Or they have no real idea exactly how US healthcare really works.

I think this is true all around. Not a Canadian, but I do find it hard to wrap my head around how the US healthcare system works in practise - especially for routine, mundane stuff which those of us who've never had to pay a cent for a GP visit, vaccinations, or routine screening tests take for granted. Likewise, those in the US find it hard to wrap their heads around how "socialised" medicine can possibly work in the real world.

My own country and Canada are both physically large nations with relatively small populations - the challenges of delivering a relatively consistent level of health care in our countries are very different to the challenges of delivering health care to the much larger US population. In many ways, delivering health care in the US is probably more equivalent to trying to deliver standardised health care across the EU than it is to trying to deliver it in any other single nation.

As an outsider looking in, I guess I see the US health care industry as a reminder that free market competition doesn't always result in lower prices or more efficiency - sometimes it results in prices being driven up in order for the industry to be profitable for smaller players with little or no benefit to the consumer (which is what has happened here as other infrastructure functions of government have been transferred to the private sector).
posted by Lolie at 5:46 PM on August 26, 2009


She is still completely wrong on this subject.

I dunno, Hamilton is a shit-hole. (sorry Hamilton. Keep trying for that NHL team! Go TiCats!) I wouldn't be surprised if there are no doctors there and the hospitals are indeed filthy. This whole "American run by the Swiss" thing is a bit of a myth. And being right on the border, Hamilton probably has lots of people going over to Buffalo to get medical treatment. I mean, doctors and hospitals in Buffalo are probably pretty happy to see anyone with enough money to pay for medical services considering how economically gutted Buffalo is.

People really need to stop telling this one poster that her opinions are wrong. There is more than one Canadian opinion. although we all love Feist and Arcade Fire.
posted by GuyZero at 5:46 PM on August 26, 2009


Don't Believe It!: How Smart People Can Be Wrong About Topics They're Not Experts In (and even then it's not a given)
posted by Lemurrhea at 5:46 PM on August 26, 2009


coming off like idiots

She wrote a book about mainstream trolling and how effective it is. In fact, we passed her test because MeFi universally rejected her comment and is now embracing her with our love.
posted by niccolo at 5:47 PM on August 26, 2009


Canadian here. I've spent a night in the emergency room, have a sister who had 4 babies in Canadian hospitals, and has a father with a recurring blood clotting issue. None of us have had "insurance". None of us have had to wait, ever. None of us have had to pay a dime in healthcare costs. None of us have ANY complaints about Canadian healthcare. It's cheap, efficient, clean, and friendly.

Is our system perfect? Nope, but I'll take it over the american system any day of the week.
posted by blue_beetle at 5:55 PM on August 26, 2009 [2 favorites]


People really need to stop telling this one poster that her opinions are wrong. There is more than one Canadian opinion.

Not according to her post there isn't.
posted by You Should See the Other Guy at 5:57 PM on August 26, 2009 [3 favorites]


DO MOAR RESEARCH.

Yes, I had already noted the irony of the summary of the book in that first link versus her hit and run, bullshit, scare-mongering, unsourced assertions here about the state of Canadian health care. As some guy may have once said, everyone is entitled to his own opinion, but not his own facts.

But if she's not going to return and back up her claims, meh, let it go.
posted by maudlin at 5:57 PM on August 26, 2009


GuyZero: For example, have their been any new medical school opened in the last 20 years in Canada?

Actually, yes!. Not to mention the various satellite campuses that have been opened at schools around the country.

Mental Wimp: As I recall, they were limited in the number of defibrillators they could implant per year in each region, because there was a limited amount of money allocated for purchasing them. This made them very selective in choosing patients.

I'm not defending rationing of care, but there is a silver lining to the cloud of limited money for defibrillators: physicians actually looking to the evidence to see which patients the devices help the most, as opposed to just giving it to everyone who potentially fits the criteria (cf. the saga of Swan-Ganz catheters).
posted by greatgefilte at 6:04 PM on August 26, 2009


Not a Canadian, but I do find it hard to wrap my head around how the US healthcare system works in practise

At least in part that's because people have a wide variety of coverage. Some people are paying a lot for crummy care, especially contractors and small business owners and part-time workers. Others get great care included in their corporate job benefits. (This latter group doesn't especially care about reforms, but really doesn't want to be taxed on their benefits.)
posted by smackfu at 6:05 PM on August 26, 2009


As a Canadian who has lived for a significant amount of time in the US, let me say this:

I have had bad insurance, good insurance and no insurance. Even with good insurance in the 'States, there is always a level of uncertainty with any treatment. Is this really covered? How does my deductible come into play? Is there a co-pay? Will I wind up with a bill in three months, regardless? The answers to these questions are not always immediately apparent, even when consulting providers or HR reps, etc. Yes, you can often see a specialist right away, but there were times when I had to wait to see my GP, and that was with the good insurance. With bad or no insurance, I didn't have a GP.

The Canadian system does have limitations and shortfalls, but the kind of uncertainty I experienced in the US simply does not exist here. That alone was almost worth moving back. Otherwise, I have found the level and quality of care to be relatively equivalent, with similar degrees of variance based on location, institution and type of procedure.
posted by TheWhiteSkull at 6:20 PM on August 26, 2009 [4 favorites]


Japan's system is, on a global basis, perfectly adequate. I do wish they covered vision for adults (they do for children), it's sometimes a bit confusing as to what is covered, and they are quite slow on approving new medicines and techniques, but on the whole it works, and does so at a very good price. That being said, insurance premiums keep rising and the system as a whole faces some fundamental problems as the population ages.

Still, I wouldn't choose US health care if I could possibly avoid it.
posted by armage at 6:20 PM on August 26, 2009 [1 favorite]


Another thing that really bugs me about the Republicans fighting health care reform is that virtually all of these people identify themselves as Christians. And yet, who really thinks that Jesus would have agreed with health-care-only-for-profit? Capitalism is all fine and good for some things, even most things, but letting your citizens die so that insurance companies can make a profit, that's about the most UN-Christian thing I can possibly imagine. The very things that Jesus taught -- helping the poor, the weak, the aged, the sick -- these are the VERY THINGS that the Christians don't seem to want to do AT ALL, whereas most of us atheist/agnostic folks, that IS what we want: let's work together and help make everyone healthier, make our planet a better place for everyone. When the atheists are more Christian in their actions and beliefs than the actual Christians, well, I can't help but find that rather ironic.

I'm not in the slightest religious, but if Jesus *was* the son of God and all that stuff, I really think he'd be rather appalled at how his followers are acting toward their fellow man. The fact that these Republicans, most of them poor or middle-class, keep falling for insurance company shilling indicates to me that we're also failing in our public school system, because really, these folks are just so mind-numbingly stupid that it hurts my brain to hear them rant.

We need more Rachel Maddows and waaaay fewer Glenn Becks. I'll throw out a hearty ,,|,, for Rush Limbaugh and Lou Dobbs too.
posted by jamstigator at 6:38 PM on August 26, 2009 [6 favorites]


jamstigator: Another thing that really bugs me about the Republicans fighting health care reform is that virtually all of these people identify themselves as Christians. And yet, who really thinks that Jesus would have agreed with health-care-only-for-profit? Capitalism is all fine and good for some things, even most things, but letting your citizens die so that insurance companies can make a profit, that's about the most UN-Christian thing I can possibly imagine. The very things that Jesus taught -- helping the poor, the weak, the aged, the sick -- these are the VERY THINGS that the Christians don't seem to want to do AT ALL

...but if the poor, weak, and sick stop being poor, weak, and sick, at whom will we direct all our feelgood charity? These socialists want to deny us our fasttrack to heaven!
posted by Dysk at 6:41 PM on August 26, 2009 [2 favorites]


Mental Wimp: Yes, but what about their death panels? No, he doesn't even mention them...

Mental Wimp: (five posts later) As I recall, they were limited in the number of defibrillators they could implant per year in each region, because there was a limited amount of money allocated for purchasing them. This made them very selective in choosing patients.

MW, you're looking at a death panel right now, right here, it's staring you right in the eyes, with the gaze of the basilisk. Your lips are speaking its name. Can you see it?
posted by Slithy_Tove at 6:42 PM on August 26, 2009 [1 favorite]


Here's what I thought was a nice writeup on one of the town hall meetings: 'Slavery' talk at health care session?
posted by marxchivist at 6:52 PM on August 26, 2009 [1 favorite]


That being said, insurance premiums keep rising and the system as a whole faces some fundamental problems as the population ages.

I think this is a problem in most first world nations irrespective of whether their health care system is private or public - expectations of what constitutes "basic, routine health care" have changed beyond what could ever have been imagined when these systems were established and the expectation of high end, expensive end of life care is as established in my generation as the expectation of high end, high risk, expensive reproductive and neo-natal medicine is in the generation which followed my own.

That's not a public/private health care issue, it's an indication that medicine has developed capabilities which were never imagined and that the public has developed a sense of entitlement to those capabilities. Whatever the failings of our respective health care systems, whether private or public they are routinely delivering outcomes our parents and grandparents could never have imagined - and we take that for granted.
posted by Lolie at 6:53 PM on August 26, 2009 [1 favorite]


When the atheists are more Christian in their actions and beliefs than the actual Christians, well, I can't help but find that rather ironic.

The average Christian is only slightly more religious than the average atheist.
posted by smackfu at 6:59 PM on August 26, 2009


marxchivist, that link was absolutely fucking astoundingly mindblowing. I wouldn't expect that sort of stupidity, ignorance and sheer stubborn unwillingness to learn anywhere in the world, nevermind an industrialised country. If people like this make up any significant part of the voting base or population, then America as a nation is pretty much fucked, at least until the education system is heavily reformed and a generation or two have passed...
posted by Dysk at 7:00 PM on August 26, 2009


Another thing that really bugs me about the Republicans fighting health care reform is that virtually all of these people identify themselves as Christians.

Funny, ain't it? But the one thing to keep in mind about many (not most, and certainly not all) American conservative christians* is that their interpretation of What God Wants Them To DoTM is pretty freaking far from anything in, say, the Beatitudes, or sermon on the mount, or what-have-you. The kind that believe "The Lord helps those who help themselves" is actually a quote from the Bible. The kind that believe if you have less in life that it's because you are in an essential sense morally lacking or well on your way there. And the way they interpret things is that you clean up the mess YOU made, don't drag me into it, and definitely don't ever ask me to pay for it. It's a pretty ugly mindset IMO but there you have it - the shoutingest voice in our electorate belongs to these cretins.

* deliberate lower case c, not a typo
posted by contessa at 7:09 PM on August 26, 2009


Yeah, what the hell, here's a choice quote from it:

And then another woman asked me where slavery was started. Without waiting for a response she said “Africa! They started it themselves.”

Slavery? “They”?

The small crowd around me nodded.

I was stunned and dismayed. Who are these people? They look like my neighbors. They are people I see at the store.

What has happened to them?

Somehow, to some people, health care reform looks like reparations.

Somehow it has become a symbol of the passing of the old order. Somehow it has tapped into deep fears about the uncertainty of the future, and fears lingering from a history that remains unresolved. And then I realized why I cannot forgive McHenry and his colleagues in the right wing of the Republican Party. Not only are they distorting what is proposed for health care reform, and in some cases promulgating outright lies, they are deliberately igniting racist fears and stoking racist anger – the Southern strategy, repackaged.

This is un-American.

This is unforgivable.

posted by marxchivist at 7:10 PM on August 26, 2009 [3 favorites]


I'm American; my husband is Canadian. Last year, his 78-year-old mother was diagnosed with breast cancer. Again. I had always been in favor of a single payer system; in addition to being the best practical solution, I find it a moral one as well. Watching my mother in law's breast cancer treatment has turned me outspoken.

My in-laws live in a smallish town about two hours from Ottawa. The treatment process was handled with all haste. Mere days passed between "this is a suspicious lump" and biopsy and surgery. The town where she lives doesn't have a cancer center, so OHIP (Ontario Health Insurance Plan) pays her mileage to drive to the cancer center in Ottawa for checkups, or if she prefers will provide a car and driver for her. Every penny of her tests, treatment and followup are paid. She's elderly (I think the cutoff is 65?) so all her drugs, including post-op pain meds and continuing chemo treatments, are free. If she were my age, the prescriptions would be something like $8.50 apiece no matter what's in the bottle. OHIP would have paid for reconstructive surgery but she decided against it because implants can make further cancer detection more difficult.

In Canada, everyone has this coverage. Independent of their work status. Independent of their wealth. I want this for myself and for everyone I know. Why can't we have it?
posted by workerant at 7:16 PM on August 26, 2009 [14 favorites]


You get really fast referrals and appointments in the US. Heck, if you're on a PPO you skip your GP and just go straight to whoever the heck you want to see.
Not necessarily. I have an old post on our very own AskMetafilter to the effect of "I called my insurance company and they told me I was covered and to just make an appointment, but nobody on the list can see me in less than two months, and most of them won't even take my call. How can I find someone who will see me?" The answer, as it happens was, "you can't." Two years later, I'm still limping along on my own.
posted by Karmakaze at 7:28 PM on August 26, 2009


People who live in other countries have a hard time imagining how US health care works because it mostly doesn't. For the majority of people, if you get sick enough you go to the emergency room where they have to treat you. Then, if you recover, you have the fight with your insurance company over who owes how much for what. If you have an insurance company. If it sounds insane and unworkable, that's just because it is.
posted by rusty at 7:38 PM on August 26, 2009


If she were my age, the prescriptions would be something like $8.50 apiece no matter what's in the bottle.

Sadly, no. As I said above, I love the Canada Health Act and the OHIP it mandates (since I live in Ontario), but there is no coverage for prescriptions for under-65s in Ontario. Those who are over-65 have their prescriptions covered, except for a $2 filling fee (waived by some pharmacies), as do those on welfare/family benefits.

But for everyone else without private coverage, we pay full price, out of pocket. Now, this can be much less than in the US for a variety of confusing reasons, but my mom's prescriptions still cost her a couple hundred dollars a month. There is a program for people with really expensive prescriptions - like HIV patients - but you have to be spending thousands a month before you qualify, and have exhausted all savings. It does nothing for someone with rheumatoid arthritis, for example, who spends $700 on live-saving prescriptions.

Prescription and dental - and now eye exams - are two major holes in the Canadian universal healthcare system. As in the US, many middle-class people have coverage through their work, and so don't notice, but working class and self-employed don't, and just do without if they can't afford it. (I haven't had a teeth-cleaning in 15 or 20 years, and only one check up in that time - fortunately I seem to have teeth of steel since I still have no cavities. I thank the extra heavy flouride pumped into the water in the 1970s.)
posted by jb at 8:04 PM on August 26, 2009


Yeah, prescriptions and dental are not covered by OHIP, but there is a little more leeway for people who are under 65, not poor enough to get covered by the province and not covered by a group plan at work or via a professional association.

If you are currently working and covered by a group plan, but expect to lose it soon, or have lost it within the past 60 days, companies like Manulife Financial offer plans that cover various combinations of dental, drug, vision and paramedical services. No medical exams, no pre-existing conditions excluded. It's kind of like COBRA, but not time-limited.

If you don't apply soon enough after group benefits end, or were never covered, that's where your options are more limited. You can still get decent coverage fairly cheaply, but expect pre-existing conditions to be excluded. It can get a little weird. The company I applied to initially tried to exclude my entire right leg because of a stress fracture I had earlier that year. When I protested and said that my doctor said I was healed, they just asked me to annotate the offer of coverage with that statement and withdrew that clause. But yeah, if you already have arthritis and apply for private coverage, expect arthritis drugs not to be covered.
posted by maudlin at 8:38 PM on August 26, 2009


A Canadian here, who's very happy with our healthcare system (I have two young children, and get to see it in action more frequently than I would like).

Reading Metafilter has brought home to me how much more time Americans devote to thinking about their coverage than Canadians do (by which I mean: worrying about whether or not they'll be covered, wondering what doctor they can go to, planning how to get coverage, questioning what will happen if they switch jobs, asking how to get insurers to actually pay, looking for advice on how to get bills lowered, trying to decide if it's a good idea to go to the doctor or not).

I'm pretty much a constant worrier and this whole area: just not something I've ever had to worry about or devote much thought to at all. Seeing a list of myths was interesting, as I haven't understood what Americans need to be convinced about (and still don't really understand why people believe these things).
posted by Badmichelle at 8:43 PM on August 26, 2009 [1 favorite]


7 or 8 year lurker, first time commenter, Hamilton, Ontario resident spurred to splurge the $5 and join the blue by Alexandra Kitty's comment.

To be fair to her, areas around Hamilton General Hospital and Henderson General Hospital ARE a bit filthy and there are some areas of those hospitals recently closed. But that's because both of them have expansion construction going on.

http://www.infrastructureontario.ca/en/projects/health/hamiltonhs/profile.asp

I guess she saw all the mud all over the roads and sidewalks, fenced off areas and signs saying "This area closed" but completely failed to see a local construction company's signs, backhoes, dump trucks, cement trucks, cranes, and electrical and plumbing service trucks?

Inside each of those hospitals there are older sections from the 50's and 60's that look a little frumpy because they don't have that annoying bright white wall paint and floor tiles, high intensity fluorescent lighting with stainless steel polished reflectors, and polished stainless steel handles and bars everywhere giving that "clinical" look that the newer sections have. Taupe wall paint, older fluorescent lights housings with white reflectors, satin finish stainless steel handles and bars, and old-school Terrazo flooring can look filthy if you're used to the newer stuff. But as someone who has nearly gone ass over tea-kettle in leather soled shoes in the General, those floors are kept cleaned and polished.

As for our system being a mess, I have no complaints whatsover. In fact, as someone has mentioned above about Canadians taking out travel insurance when traveling to the US, I must admit I'm one of them, and even with that insurance taken out and if something were to happen I would still do everything in my power to get myself back over the border to seek care here.
posted by Randwulf at 9:02 PM on August 26, 2009 [14 favorites]


maudlin: But yeah, if you already have arthritis and apply for private coverage, expect arthritis drugs not to be covered.

This is exactly what confuses me about private (and semi-private) healthcare systems - surely that represents their complete and utter failure to actually provide healthcare coverage. If you have arthritis, the whole point of applying for healthcare coverage is so that it'll, you know, cover your healthcare.
posted by Dysk at 9:06 PM on August 26, 2009 [2 favorites]


Another Canadian here. I'm reading this during a break from helping care for and make plans with a close relative who's dealing with some pretty major health issues.

And it occurred to me all of a sudden, about two thirds of the way through the comments, that we've been in the middle of this crisis for two and a half weeks, and the issue of cost of treatment has never crossed my, or my relative's, mind once, because there won't be one.

That's what universal health care is, and will give Americans. The day you (or your child, sibling or parent) need looking after, you get looked after, without financial fear or bureacracy. You get the most appropriate care for your situation, and you don't see a bill. For this, we pay a whole lot less as a society than you pay for your curent system.

I don't think I know a single Canadian, of any political view, who would argue against this or give it up. I don't think I know anyone who's ever been denied any necessary form of care. I do know people who've needed to wait a bit for things that are non-essential.

I hope, a generation from now, that every American is as used to this as we are.
posted by namasaya at 9:38 PM on August 26, 2009 [4 favorites]


[Paying for private care in Canada] could be considered immoral on a broad scale - that is exactly how the dismantling of a single-tier of health care would happen. The rich migrate towards a private system for some things, then agitate towards being out of the public option altogether, then only the poor and unhealthy are on the public option.

Unfortunately, two tiers are a reality in Canada for some, including women needing an abortion or individuals suffering from drug and/or alcohol addiction.

Women who cannot afford care at a private clinic (often operated by Canadian hero Henry Morgentaler) must take their chances in the public system. Twenty-one years after the law criminalising abortions was struck down, coverage is spotty: There's a shortage of doctors who can or want to do the procedure; many hospitals (like the one where I work, run by a Catholic charity) forbid the procedure; in many places (PEI and the north) women must travel long distances for publicly-funded care.

It's the same with addiction treatment. Those with funds can access a huge range of detox, rehab, or long-term therapy delivered in a residential setting or through clinics. The poor, especially those with comorbidities, often homeless, must joust for a limited number of treatment slots in in-patient or out-patient settings.

As a Canadian -- even one who once voted for the Bloc and dislikes Feist ('tho The Band, the Hip and my man Shakey are supreme) -- I will defend our publicly-funded healthcare system against all comers. But let's not pretend it's perfect.
posted by docgonzo at 9:41 PM on August 26, 2009


Another thing that really bugs me about the Republicans fighting health care reform is that virtually all of these people identify themselves as Christians. And yet, who really thinks that Jesus would have agreed with health-care-only-for-profit?
For I was hungry, and you gave me food to eat. I was thirsty, and you gave me drink. I was a stranger, and you took me in. I was naked, and you clothed me. I was sick, and you visited me. I was in prison, and you came to me.

Then the righteous will answer him, saying, "Lord, when did we see you hungry, and feed you; or thirsty, and give you a drink? When did we see you as a stranger, and take you in; or naked, and clothe you? When did we see you sick, or in prison, and come to you?"

The King will answer them, "Most certainly I tell you, inasmuch as you did it to one of the least of these my brothers, you did it to me."
posted by kirkaracha at 11:09 PM on August 26, 2009 [9 favorites]


I like the fact that here in Japan I can just wander into the hospital, sit down, and get checked up on without an appointment. Sure, you have to get there bright and early in the morning to not have to wait forever. I like that the payment is done immediately and that I don't have to wait months for the bills to show up (with the late-notice immediately following). I like that the last checkup I had at the dentist cost me ¥120.

I don't like that I don't know where to go for emergency treatment and urgent care on Sunday. But I guess that's what the emergency telephone number is for.
posted by that girl at 11:37 PM on August 26, 2009


During my wife's first pregnancy she suffered from severe hyperemesis which required a lot of medial care, including hospitalisation, dietary supplements, ultrasounds, specialists, medications and in the end the induction of delivery early.

With the exception of some perscriptions all the treatment was free. We thought nothing of it, because it's what we expect of New Zealand's health system. But a while later my wife joined some online hyperemesis groups, where she heard many horror stories from American's with the same condition (in many cases not as severe) who ended up with bills in excess of $50,000, in some cases bankruptcy, and horrifically in a couple of cases with termination of the pregnancy. In one case, related by a third-party, the woman in question actually died of complications. Many of these horror cases had insurance, but it simply didn't provide enough coverage.

Watching from a distance the American 'debate' over this issue is absolutely unfathomable. It's completely insane. There is no shortage at all of evidence that the system as it stands is seriously broken, but there is some insane idealistic opposition to the idea of universal coverage that stems from weird capitalist ideals and the lingering fear of 'commies'.

I would never have believed that a dialogue on a national level could be so completely messed up, on an internet forum sure, but nationally?
posted by sycophant at 12:00 AM on August 27, 2009 [4 favorites]


Others get great care included in their corporate job benefits. (This latter group doesn't especially care about reforms, but really doesn't want to be taxed on their benefits.)

Like most generalizations, this one is overstated. I have very good insurance through my employer. I really wish we had single-payer. Why? I've been with this company almost five years. If they fold up, or get sold to some larger competitor, or decide they can't afford that insurance any more, or I get laid off, my great insurance will be history. Odds are whatever I get next won't be nearly as good and will cost me more.

That's my self-interested reason for wanting single-payer.

There are also the general arguments: A nation that has a lot of people not taking care of their health has a lot of unhealthy workers. That can't be good for its economy. Those unhealthy workers are less productive and use up a lot of resources when their health problems finally force them to get medical attention. People worried about paying for doctors for themselves and their families are tied to whatever job they have that provides insurance, however crappy it is. That's an unfair advantage for corporations in the labor market. Don't get me started on the flat-out wrongness of insurance executives getting rich by denying treatment and coverage to sick people. That those practices are not criminal acts punishable by jail time is a huge failure of our society.

So no, not everyone with good insurance "doesn't especially care about reforms" - just the ones who are both selfish and short-sighted.
posted by Kirth Gerson at 4:39 AM on August 27, 2009 [5 favorites]


docgonzo, I completely agree with you. As far as I know, PEI doesn't even have a clinic at all, and women come to (I guess it'd be) Moncton. I grew up on the west coast of Newfoundland, with a family member as an addictions counselor (non-hospital, in the community health sector, doing mainly outpatient but the facility can handle both) - addiction treatment where I've seen it is quite bad, at best.

That being said, I was only talking about the possibility of going external to the public system in my comment. I prefer the fact that it's somewhat illegal to do so for non-essential situations, I think that concept is perfect. We've got a few different sets of two tiers: Rural v. Urban is the big set. Rich v. Poor is true only in certain circumstances. It should never be true, or at least close to that, since there will always be a bit of divide.

The rural problem is bigger, and a lot harder to manage. The cost-per-treatment for tools in any hard to access area is going to be higher. Doctors will have quite a bit more difficulty travelling to remote areas - even in Newfoundland, there are hundreds of communities only reachable by boat. Labrador & the North are worse. What we need, beyond the obvious investment in doctors (which is needed, but still would require incentives to get doctors to remote areas, but which is tricky on funding and equal pay grounds), are mobile hospitals. I would love to see an airplane that could easily be converted to a sterile OR, even a small one. Or, a few years down the road, small dotted undoctored ORs with high-quality telesurgical links to the major teaching hospitals, each with a medivac water-landing capable plane. Tie that in with an surge in travelling nurse-practitioners, and a great deal of the remote problem will be fixed (not all, never all).

We're definitely not perfect, and currently I'm not sure we're trending better. But I still think that in general our policies are set up correctly to do things very well - they just need a swift kick in the ass.

Yeah Feist, no thanks. Give me Lightfoot, Cockburn, and Cohen.
posted by Lemurrhea at 4:50 AM on August 27, 2009 [1 favorite]


Brother Dysk: "This is exactly what confuses me about private (and semi-private) healthcare systems - surely that represents their complete and utter failure to actually provide healthcare coverage. If you have arthritis, the whole point of applying for healthcare coverage is so that it'll, you know, cover your healthcare."

You're overlooking the #1, glaring, honking, pink-elephant problem with the US system. When you put [The health of one human being] up against [Dollar], the dollar will always win. Sadly, whether or not an insurance company actually provides the benefits is not its measure of success, in any way. They care first and foremost about their profits, ergo they make far more money when they deny claims and refuse care.

That we as a nation can turn blindly away and ignore what can only be called an inhumane and unscrupulous way of doing business makes me very sad.
posted by pineapple at 5:39 AM on August 27, 2009 [1 favorite]


Quick anecdote on waiting lines in the states. I live in the Boston area and have an excellent PPO plan through my employer. I recently was told by my doctor to have some moles looked at by a dermatologist. I called multiple dermatologists and discovered that the soonest appointment I could get is 6 months away.
posted by batou_ at 6:04 AM on August 27, 2009


I really am beginning to become annoyed by the countless stupid people that buy into corporate greed's BS fearmongering. Honestly if you look at other countries that have this type of health care system, they spend less than us, are healthier than us, and in some cases receive better care than us. I swear one of these days I'm going to start pointing at conservative lobbyists and start calling them fear mongering names. Or I can just make up something that sounds scary. Off the top of my head: Agenda pushing capitalistic passive aggressive domestic terrorists. Big words scare stupid people :)

There I'm done with my rant.
posted by Mastercheddaar at 7:12 AM on August 27, 2009 [1 favorite]


The reason that pre-existing conditions are excluded from private insurance, in Canada, the US or anywhere else, is perfectly understandable when you abstract what private insurance is: it's a bet you make with the company that something will happen to you (they, of course, bet that it won't). They aren't going to bet against a sure thing.

As to the Canadian system being perfect: I completely agree that it isn't. I think there's two basic reasons why Canadians get so zealous about Canadian health care in the face of American debate.

First, we're proud. It's a pretty good system, if not perfect, and clearly better for us than the American one is for Americans. When that contingent of completely insane people stand up and start telling lies and shifting the debate away from useful questions (like, for example, could a Canadian model scale to the American population?), it rankles.

Second, at least for me, I love a lot of Americans. I was born in America (my mom moved here to work for the Canadian health care system, actually), and my entire extended family lives in America, including a cousin who is a struggling single mom and my ageing grandparents. Although arguably American health care does not affect me directly, it is a highly personal debate to me and to many other Canadians. It seems not just unfair, but also profoundly worrying to me to see the people I love struggling with a system that isn't working and a debate that's gone completely, well, batshitinsane. It sort of inspires the most fanatical praise of the Canadian system, and a fear of acknowledging what doesn't work in case that acknowledgement feeds the worst of this debate.
posted by carmen at 8:00 AM on August 27, 2009 [1 favorite]


marxchivist, keep in mind that 66% of this country is composed of uneducated rubes who don't set foot on a college campus.

I found it really funny that part of the article you omitted was about an old conservacretin whanging off at the author because she thought the author was making fun of her for being uneducated (which even if she wasn't being made fun of, people such as these morons rightly deserve).
posted by kldickson at 8:09 AM on August 27, 2009


kirkaracha - thank you for reminding me of one of the most profound bits of a pretty profound book.

That said, I had forgotten the next bit entirely:
Then he will say also to those on the left hand, 'Depart from me, you cursed, into the eternal fire which is prepared for the devil and his angels; for I was hungry, and you didn't give me food to eat; I was thirsty, and you gave me no drink; I was a stranger, and you didn't take me in; naked, and you didn't clothe me; sick, and in prison, and you didn't visit me.'
Then they will also answer, saying, 'Lord, when did we see you hungry, or thirsty, or a stranger, or naked, or sick, or in prison, and didn't help you?'
Then he will answer them, saying, 'Most certainly I tell you, inasmuch as you didn't do it to one of the least of these, you didn't do it to me.' These will go away into eternal punishment, but the righteous into eternal life.
I may be agnostic, but it makes me want to go out and donate to charity and do a bit of volunteering. You know, just in case.

I think I read somewhere that devout Christians of whatever political hue donate more to charity of time and money than non-religious people. But as someone raised devoutly Christian, I still don't understand why some don't see support of a state-based social safety net also as a religious imperative. Charity is very important as well - charities are better at catching the people who fall through the cracks of a more universal system. But you need the state-organised system to get the right coverage to start with, and the paying of taxes to support this should be seen as an essential tithe to one's society.

(Yeah, I know we pay more than 10%, but we also make a lot more money and thus don't need to have 50% of our income just for food.)
posted by jb at 8:09 AM on August 27, 2009


If you want to sell healthcare/insurance reform in the states, here's what you need to do:

Buy commercial time at the end of every episode of House MD.

In each commercial, list the cost of the emergency care provided by House and his team.

Then break down the cost by:
[A] how much the patient would have to pay
[B] how much Standard American Insurance (SAI) would most likely pay
[C] how much SAI may or may not pay, thus leaving the rest to the patient to pay.

Then show the total range of how much the patient would be on the hook for [A] + [C]. Also, how much the follow-up and recovery would cost (a lifetime of dialysis ain't cheap)

Then show how much the patient would be on the hook for if they had the same emergency care in Canada, England, Japan, and, let's say, France.

Follow it up with a reminder that you never know when you'll be near a collapsing building where you'll inhale dust spores that just happen to interact with a breath spray you just took before a date thus exacerbating a previously unknown medical condition. At anytime, you the viewer could suddenly find yourself liable for thousands and thousands of dollars in medical bills through no fault of your own.

Soon enough, watercooler talk wouldn't just be, "Did you see that guy's eyeball explode on House? Jesus." but "Did you see that guy's eyeball explode on House and how much money it cost? Jesus."
posted by robocop is bleeding at 8:29 AM on August 27, 2009 [11 favorites]


Has anyone linked this graphic here yet? Who's Paying to Kill Health Care Reform
posted by mediareport at 3:55 PM on August 26 [9 favorites +] [!]


The link seems to be dead to me. Has it been updated?
posted by Mental Wimp at 9:30 AM on August 27, 2009


kirkaracha above links to a wikipedia article about the sheep and the goats parable. I went to the article and it mentions an alternative interpretation that might explain how some christians don't see support for things like singer payer health care as supporting this parable.
An alternative interpretation, one found by Calvinist theologian John Gill, is that the disadvantaged men spoken of are actually fellow Christians. And so instead of the division between blessed and cursed being on good works it is based on ones response to the people and message of Christ's Church.
And so, according to this interpretation, charity to others has nothing to do with your judgement.
posted by Librarygeek at 9:30 AM on August 27, 2009


Try this: Who's Paying to Kill Health Care Reform?
posted by Karmakaze at 9:42 AM on August 27, 2009 [1 favorite]


Mental Wimp: (five posts later) As I recall, they were limited in the number of defibrillators they could implant per year in each region, because there was a limited amount of money allocated for purchasing them. This made them very selective in choosing patients.

MW, you're looking at a death panel right now, right here, it's staring you right in the eyes, with the gaze of the basilisk. Your lips are speaking its name. Can you see it?
posted by Slithy_Tove at 6:42 PM on August 26 [+] [!]


Oh, you think defibrillators are underutilized, eh? Well, here, buy one from me. Only US$35K. I can have someone install it for about US$20K more.
posted by Mental Wimp at 9:43 AM on August 27, 2009


I don't understand why americans are dissing the UK NHS system.

If there are like 60 Million People in america who can't get healthcare there is no queue for them.

Here in the UK, at least there is a queue, you might have to wait a bit to get an operation, but at least THERE IS A QUEUE YOU CAN JOIN !!!

I don't understand how people with Insurance can deny there fellow man in their own country the right to health care.

Forgot about politics for a moment.


Americans should be embarrassed that people are queuing up for days at a stadium waiting to a see a doctor for free from a charity designed to give doctors to THIRD WORLD COUNTRIES by a BRITISH charity. The irony abounds.

I think people in america are nuts. Should have more respect for your fellow man, it's supposed to be a rich wealthy country !
posted by flexiverse at 10:06 AM on August 27, 2009 [4 favorites]


flexiverse: Forgot about politics for a moment.

But, but... your entire post is about nothing but political issues and politics...
posted by Dysk at 10:45 AM on August 27, 2009




Just learned something which helps explain the chaos that is the US health system if the information I came across is accurate - that private health insurance in the US is not sold across state lines. Is that the truth? If so, then a lot of things which didn't previously make sense to those of us outside the US given the size of your population start falling into place.
posted by Lolie at 2:36 PM on August 27, 2009


that private health insurance in the US is not sold across state lines. Is that the truth?

Yep. Just like Canada, there's a lot of stuff that's regulated on the state level instead of federally. It's also why banks are more concentrated in Canada (at least in part) - in Canada banks are bound primarily by Federal regs where in the US they're primarily bound by state regulations. Until fairly recently there were few banks that covered more than a handful of states for this reason.

At any rate, there's not much competition among the hundreds of US insurance companies for that reason. They're quite geographically separated.
posted by GuyZero at 2:46 PM on August 27, 2009


At any rate, there's not much competition among the hundreds of US insurance companies for that reason. They're quite geographically separated.

I can't imagine what the administrative burden of that kind of system is. Even here, where we have only about 30 health private health insurers the administrative burden of billing patients differently according to who provides their health insurance is large enough that many small clinics won't participate in "special rate for members of health insurer X" plans - the extra business doesn't offset the extra administrative costs.
posted by Lolie at 3:32 PM on August 27, 2009


The administrative burden is 20 percent. They spend one fifth of the money on administrative-type stuff (like hiring lawyers to devise clever fine print that allows them to deny you care if you should actually get ill with something expensive). That's more than TEN TIMES the administrative costs in Japan, and about three times the administrative costs of any other developed country. I guess those healthcare-denying lawyers don't come cheap. Oh yeah, the CEOs eat up a lot in compensation packages too -- the CEO of Cigna had a $750 million package, just that one guy. I wonder how many people he forced into slow, miserable deaths to be able to cash that check (and still make the shareholders some profit too, of course).
posted by jamstigator at 7:30 PM on August 27, 2009



Canada's health care is a mess -- you have to wait for months for basic service, hospitals are filthy, and they are being closed. There are many people without a family physician and a lot of people in Canada go to the States to get treatment they need because they can't wait. And more and more services are no longer free -- this article is a myth itself...
posted by Alexandra Kitty at 5:44 PM on August 26 [+] [!]

Speaking as an employee of the Canadian Healthcare system, allow me to say this: You have no fucking clue what you are talking about.


Oh, of course I don't -- I just lived here my entire life and have had relatives (and myself) have to go through it multiple times where we had to wait twenty plus hours in the emergency room and never got the treatment needed -- or supposedly have a family doctor who does not ever answer the phone so you can't make an appointment when you are sick. I have had doctors push medication on me that I didn't need who did not so much as conduct a single, solitary test on me. I just had to wait months for specialists and when I did get into see a specialist or had ot take a relative, the doctor wasted the entire visit talking about politics of health care.

And if you really are a Canadian health care provider, hang your head in shame -- I am sick and tired of walking into filthy hospitals where garbage isn't being picked up from the floors for weeks, where the staff sit at their desks talking themselves into believing how busy they are without actually doing any work, and getting misdiagnosed because someone was too lazy to read the results properly.

You can lie to yourself, you can lie to naive Americans who think our medical system is some sort of salvation, but you can't lie to people who actually had to go through it time and again and can back up what they say with evidence or can walk into a hospital with a video camera and capture what really goes down here. Maybe your inner circle doesn't have the morals or courage to tell you to your face that you are failing your own people, but I have no problem with it...
posted by Alexandra Kitty at 8:48 PM on August 27, 2009


Alexandra Kitty: Maybe your inner circle doesn't have the morals or courage to tell you to your face that you are failing your own people, but I have no problem with it...

Or maybe some people have had very different experiences to you?

It's quite possible for a healthcare system to be inconsistent in quality. In fact, it's pretty much inevitable (though degrees vary) regardless of whether you have private or socialised healthcare (or anything in between).
posted by Dysk at 8:57 PM on August 27, 2009


I saw another sweeping, dismissive, bullshit statement about Canadian health care from Alexandra Kitty some time back, checked her profile then, and it said Hamilton, Ontario at that time, too. I think Pope Guilty saw Hamilton and something starting with "O" and filled in the rest incorrectly. So bullshit claims aside, can we stop with the breathless, "Oh, NOW it says she's in Canada, but she's really an American troll playing profile games."?


It's not bullshit and I am Canadian with no American roots -- I just am not going to play cheerleader for something that is obviously not working here. Our system is one where patients have too little control and too little respect -- it wasn't always this bad -- once upon a time my doctor made house calls and the local hospital was run by nuns and was spotless -- but now, you have people without a family doctor, the provincial government here are closing hospitals and people are dying, and you have people who went to their doctors with serious complaints who were patronizingly dismissed only to find out later on that, yeah, they had something terminal. And when you do go to the hospitals, you end up catching something that is far worse than what you went in for.

Speaking the truth does not make a person a troll -- pretending that something is working when it is clearly not does.

But Americans should not merely take my word for it -- I encourage them to come here to see for themselves what they can expect if they adopt a system similar to ours...
posted by Alexandra Kitty at 9:19 PM on August 27, 2009


But Americans should not merely take my word for it -- I encourage them to come here to see for themselves what they can expect if they adopt a system similar to ours...

That's quite misleading. The fact that one particular implementation of a socialised healthcare system isn't working well doesn't mean that every implementation of socialised healthcare needs to suffer in the same way, or to the same extent. "We tried it and failed" (which seems to be your position, but not the position of most Canadians here on the blue) is not the same as "it is not possible".
posted by Dysk at 9:27 PM on August 27, 2009


@ Alexandra Kitty - who provides what in Canada?

For instance, under my nation's socialised medicine system the Federal Government is the primary health insurer and purchaser of drugs, but the public hospital system is administrated at state level through a combination of federal and state funding (which is why there are currently howls from the larger states for the Federal Government to take over the administration of hospitals - under the current arrangements it's those states where things aren't working so well). GPs are private practitioners here, medical specialists often practise both privately and as consultants in public hospitals, and our private hospitals can provide most forms of non-catastrophic care. Optical and dental entitlements are a state issue here (although the Federal Government looks set to include dental care in Medicare in the future). Non-medical mental health was previously left to the states but the Federal Government is slowly taking on some responsibility for it by adding psychological services to the list of things for which Medicare will pay (within limits).

So, far from a perfect system, but better I suspect than that which is faced by Americans without health insurance and always working towards better practise. We, too, have our fair share of older hospitals awaiting capital improvement programmes, but the physical appearance of the facility doesn't reflect the level of care provided.

I think that most people here have definite ideas about how our health system could be improved and I suspect the same is true of Canada. I can't for the life of me work out though how you could make socialised medicine work effectively for 200 million Americans across 50 different state frameworks, though. It's only as the health care debate has gathered momentum in the US that I'm beginning to see why solutions which seemed simple to those of us outside the US might be extremely difficult to implement in reality.
posted by Lolie at 10:24 PM on August 27, 2009


Our system is one where patients have too little control and too little respect -- it wasn't always this bad -- once upon a time my doctor made house calls and the local hospital was run by nuns and was spotless -- but now, you have people without a family doctor, the provincial government here are closing hospitals and people are dying, and you have people who went to their doctors with serious complaints who were patronizingly dismissed only to find out later on that, yeah, they had something terminal. And when you do go to the hospitals, you end up catching something that is far worse than what you went in for.

So, basically, the Canadian system is like the American system, except you don't go bankrupt in the process.
posted by dirigibleman at 11:05 PM on August 27, 2009 [1 favorite]


The only glaringly obvious reason Canada's system isn't so great is that there aren't enough doctors and hospitals.

That should not be anywhere near as much of a problem for the US. If it was going to be, it already would be.

And, frankly, the Canadian waitlist problem isn't nearly as bad as it's being played up. It's not like livers are first come, first served; there is such a thing as triage. I've honestly never heard of anyone dying because the waiting list was too long. If the situation gets dire, there's always that release valve we call the USA. Not an ideal solution, but exorbitance aside, they've got doctors and hospitals, which are all that's missing.

Rural emergencies are kind of a bitch, though. A lot of ERs, especially the smaller ones that are the only medical anything for hundreds of kilometres, have very limited hours. Figure that one out. But again, it's all about the quantity of hospitals and doctors. There just ain't enough of 'em.
posted by Sys Rq at 11:45 PM on August 27, 2009


"You can lie to yourself, you can lie to naive Americans who think our medical system is some sort of salvation, but you can't lie to people who actually had to go through it time and again and can back up what they say with evidence or can walk into a hospital with a video camera and capture what really goes down here. Maybe your inner circle doesn't have the morals or courage to tell you to your face that you are failing your own people, but I have no problem with it..."

Well… Let's see that video, then.

Because growing up in Michigan, and having Canadian friends and colleagues (and even family) end up in Canadian hospitals—Ontario hospitals—I have to say that your experience is so far outside the norm that I find it hard to believe.

Sure, everyone I've ever met who dealt with the Canadian health care system could have been lying to me, but, especially given what I saw when a friend was getting his MD at Wayne State, I think it's more likely that you're full of shit than all of them are.

In fact, I just met some folks who were glowing about the treatment they received in Hamilton regarding a weird bacterial infection in a hernia—they were the parents of a girl I met in Korea, and were able to visit her because they didn't have to worry about their son's health in a Canadian hospital. It was rather an elaborite lie, to hear you tell it, though I got them well drunk enough that they should have given me the truth.
posted by klangklangston at 12:12 AM on August 28, 2009


Accusing her of lying, even about what country she is from, isn't a very good debating strategy.
posted by smackfu at 5:37 AM on August 28, 2009


smackfu, accusing people of lying is terrible debating strategy, but seems to be applied by both sides here, unfortunatly.

Is it so hard to imagine that Alexandra Kitty had a horrible experience (or sequence of many horrible experiences) with the Canadian healthcare system? I've never been to Canada, but it doesn't seem impossible to me that things might go wrong sometimes, or be less impressive in some areas (geographical and medical) than others.

Given that there seem to be more people with good experiences, it'd seem likely (though not certain) that on the whole, it's more good than bad. Regardless, it certainly doesn't make sense to say that a socialised healthcare system will fail in the US because it failed in Canada (whether or not it did).
posted by Dysk at 6:01 AM on August 28, 2009


She's basically the first Canadian I've heard this sort of thing from. The Canadians I know are generally terrified of getting sick in the US and very positive about Canadian healthcare, so I have no reason whatsoever to believe that she's telling the truth about anything.
posted by Pope Guilty at 6:48 AM on August 28, 2009


Okay, old thread, but this needs to be addressed:

Oh, of course I don't -- I just lived here my entire life and have had relatives (and myself) have to go through it multiple times where we had to wait twenty plus hours in the emergency room and never got the treatment needed

I'm going to let you in on a secret here. If you are waiting 24 hours in the emergency room, you *shouldn't be at the emergency room*. We triage and prioritize based on need, not first-come-first-serve. If you go to ER for a sore throat or upset tummy, be prepared to wait while actual sick people are taken care of first. While there can always failures and mistakes that can happen in triage, that has nothing to do with single payer insurance.

-- or supposedly have a family doctor who does not ever answer the phone so you can't make an appointment when you are sick.

Your doctor sucks. Find a new one. Mine calls back with test results as soon as she sees them, takes phone calls all day, and also runs a walk-in in the same clinic if she is out of the office.

I have had doctors push medication on me that I didn't need who did not so much as conduct a single, solitary test on me.

I'm curious about this statement and would love to know what drug you were prescribed and what symptoms you presented with. If you are not a medical professional, I'm curious as to how you have determined what you did and didn't need?

I just had to wait months for specialists and when I did get into see a specialist or had ot take a relative, the doctor wasted the entire visit talking about politics of health care.


Some waits for specialist do take time. Orthopedics can be tricky, for instance, given the aging population. That's why the IT segments are working hard on wait-list management and utilization management. I have worked on both of these projects and have seen dramatic results from them. We continue to work hard on it, but there are absolutes on the amount of work that a single doctor can perform.

If your specialist wasted your visit, ask for a referral to another, and talk to your medical college about this doctor. You have rights as a patient.

And if you really are a Canadian health care provider, hang your head in shame

Again I invite you to fuck yourself. I work very hard at my job.

I am sick and tired of walking into filthy hospitals where garbage isn't being picked up from the floors for weeks

I have never, ever, in my entire career seen garbage on the floor of a hospital that is not quickly removed.

where the staff sit at their desks talking themselves into believing how busy they are without actually doing any work

Healthcare is like police work: Hours of boredom punctuated by moments of insanity. When a patient goes into arrest, those same staff that you think 'don't do any work' work their ass off. You have absolutely no idea how hard this work can be.

and getting misdiagnosed because someone was too lazy to read the results properly.

What does this have to do with single-payer insurance?

Regardless, mistakes do happen, there is still a certain amount of 'art' to the medical science, but to attribute mistakes to laziness is incredibly insulting to the vast number of hard working, well educated, and concerned Healthcare providers in this country.

You can lie to yourself, you can lie to naive Americans who think our medical system is some sort of salvation, but you can't lie to people who actually had to go through it time and again and can back up what they say with evidence or can walk into a hospital with a video camera and capture what really goes down here.

Anecdotes do not equal evidence. The fact is that the vast majority of Canadians (between 80-88% depending on the study you cite) are satisfied with their Healthcare. No one is denying that problems to arise, but 'what really goes down here', time and time again, is efficient and effective Healthcare.

Maybe your inner circle doesn't have the morals or courage to tell you to your face that you are failing your own people, but I have no problem with it...

My 'inner circle'? Please. There is no giant conspiracy of people lying to me to convince me that my co-workers and I do a good job. We have successes, we have failures, but we make sure that each and every person that walks into a hospital get the same level of care, regardless of their bank balance. How can anyone defend a system that determines your access to Healthcare based on what's in your wallet?
posted by WinnipegDragon at 6:49 AM on August 28, 2009 [6 favorites]


So Alexandra Kitty you come in at the top of the thread and leave what to practically every other Canadian poster on here is a pack of nonsense as a post. Then, you wait until the thread is pretty much dead two days later and come in with more of the same while choosing to ignore the reams of people who refute your "facts" and speak to their own experiences that are 100% the opposite of your own... seriously, you're a journalist?

Not one other Canadian has backed up anything that you've said yet you insist that over the course of your entire life Canadian hospitals and doctors have treated you poorly repeatedly.

You know, I eat out a lot. Generally, it's a pleasant experience. Every time I talk to my mother and she mentions dining out she complains about how horrible she's treated. Doesn't matter which restaurant. Doesn't matter what she orders. The experience is always awful. Our entire family and friends have noted this oddity. So I took my mother to my favorite restaurant--where I generally eat once a week and I always love the food and service. The evening was a nightmare. "See," my mother told me.

Guess what the common denominator was?

You can't get your doctor on the phone? Well, I've never gotten my doctor on the phone either. Then again, I've never tried. His secretary answers the phone. His secretary calls me back. His secretary books my appointments. But when I go to the doctor--having called usually the same day to book an appointment--his secretary waits in the outer office and he treats me. He takes a unbelievable amount of time explaining what's wrong with me. He is ridiculously thorough. And patient. He often offers me sample drugs for my condition because he knows I don't have a drug plan. The experience could not be more professional.

When I went to the emergency room with a friend who'd been hit by a car, we were treated very professionally. The hospital was clean, the staff were helpful, and from what my friend told me the doctor was good. Again, they provided him with samples of pain killers as well as a prescription. He's fully mended now and didn't have to return to the doctor due to "improper diagnosis or medication," as you've had in your own experience.

When my father was diagnosed with Parkinon's, it was a very trying time. But the care he got, the time that the doctors took with us to explain what it was and what would happen, etc., was not just good, it was thoughtful. It was polite and considerate. There was never a time when I was angry at the healthcare system for the way the problem was dealt with.

I'm sorry that you seem to keep getting poor healthcare. I assume that you've switched doctors and hospitals, right? I mean, you haven't been going to the same unprofessional person your whole life, have you? Assuming you have, I'd say it's baffling how it can keep happening again and again to the same person but then, I've dined out with my mother. I hate to play blame the victim but seriously, your experiences are so absolutely beyond my comprehension, given my own 40+ years in the country and the thousands of years of my combined friends and family (my older still goes to the same doctor she's had since she was three!), that I honestly can't come to any other conclusion.
posted by You Should See the Other Guy at 6:50 AM on August 28, 2009 [3 favorites]


Does Canada have enough hospitals / doctors that it's easy to switch to another one? Hospitals in particular seem to a bit scarce according to the prior comments. Obviously big cities give more choices, but does a rural patient have options?
posted by smackfu at 7:07 AM on August 28, 2009


smackfu,

As you said, it depends on where you are. In the cities, it's fairly easy, in the country not so much. There is no point in putting two hospitals in an area where there are only 5,000 people in the surrounding 300 miles. Don't forget, Canada is a *big* country, with a lot of small, scattered pockets of population.

Rural patients often only have on hospital in their region, but if the care they need is not available they will be transferred to one of the cities.

No charge of course.
posted by WinnipegDragon at 7:10 AM on August 28, 2009


As you said, it depends on where you are. In the cities, it's fairly easy, in the country not so much. There is no point in putting two hospitals in an area where there are only 5,000 people in the surrounding 300 miles.

This is, of course, not a situation that is particular to Canada.
posted by Pope Guilty at 7:15 AM on August 28, 2009


As you said, it depends on where you are. In the cities, it's fairly easy, in the country not so much. There is no point in putting two hospitals in an area where there are only 5,000 people in the surrounding 300 miles.

This is, of course, not a situation that is particular to Canada.


...and not is it particular to socialised healthcare.
posted by Dysk at 7:30 AM on August 28, 2009


Of course it isn't, yet it is still a talking point that I see used by the anti-single payer interweb militia.
posted by WinnipegDragon at 7:37 AM on August 28, 2009


Just chiming in, yet again, to wonder exactly where Alexandra has been going for her healthcare or treatment, as her experience, as she tells it, is utterly opposed to mine and to those of my friends and family. Every story I could tell you about times I was sick, or my friends/family were sick, ends not with complaints about the system (though there might be the odd bitching about the food in hospital) but with gratitude.

But you know who I have known in the past who complained about health care? A hypochondriac former friend, who was in and out of doctor's offices constantly, who demanded surgery for vague and undiagnosed problems, who spent more money than she should have on psychics and various kinds of quackery. She complained a lot, but the problem wasn't with the system, which dealt with her very well, mostly be refusing to enable her addiction to codeine and her belief that she was suffering from things like "petrochemical poisoning" (this diagnosed by a chiropractor through having her hold crystals). The problem was with her. I'm not saying that this is Alexandra's issue-- that would be unfair, I don't know her--but the only person I've ever known who spoke of our medical system with the same level of whining and complaint was somebody who was looking in the wrong place for a fix for what was tormenting her.
posted by jokeefe at 7:51 AM on August 28, 2009 [2 favorites]


I've been working at a Canadian hospital recently - and sure, it's a bit scruffy on the research floors where there is no one but researchers and computers. Clean, but scruffy.

But I would eat off the floors in the patient areas. Without a plate even.
posted by jb at 9:29 AM on August 28, 2009


But I would eat off the floors in the patient areas. Without a plate even.

We have C Difficile in Canada, FYI. Not that that has anything to do with who pays the bills.

And to Alexandra Kitty's many-times-rebutted points, I am a Canadian living in the US. And the only thing that's different between Canada and the US is that rich people here can pay for much better care. But every single complaint you make is as true in the USA as it is in Canada. The USA is hardly utopia.
posted by GuyZero at 9:37 AM on August 28, 2009


alexandra kitty: a family doctor who does not ever answer the phone so you can't make an appointment when you are sick

These absurd posts don't necessarily need further debunking, but this point shouldn't be ignored. Your family doctor is not a government employee; she or he operates a private practice and bills a public insurer for services rendered. If you have a doctor that's providing poor service, this is an indication you should switch doctors and not a condemnation of single-payer insurance. These are the very myths that need debunking.

Anecdotally, I've worked in three different GTA hospitals and visited 4 other southern Ontario hospitals in the past few years. Ignoring your "hang your head in shame comment', all of these facilities were perfectly clean. In fact, the only mess was generated by the ongoing construction from the massive government infusions of cash to expand and improve facilities.
posted by Adam_S at 10:48 AM on August 28, 2009


If you have a doctor that's providing poor service, this is an indication you should switch doctors and not a condemnation of single-payer insurance. These are the very myths that need debunking.

Yes, but are existing physician pay scales sufficient to motivate more doctors to stay in or move to Canada, especially rural Canada? You can't switch doctors if there are no doctors accepting new patients in your area.

Certainly it's a separate issue from the overall structure of the system, but it's so intertwined that it's hard to discuss one without the other. How can Canadians get more family doctors without raising health care costs in the current system? If you have an answer please stop by Queen's Park and let everyone know.
posted by GuyZero at 10:57 AM on August 28, 2009


Oh and "hand your head in shame" - not at Sick Kids in Toronto. No way. Every single person there from the director to the janitors should be in the Order of Canada. That place is so far beyond incredible that it was honestly one of the things I miss most about Toronto. When my daughter has juvenile colon polyps they gave her the best treatment I could have hoped for. Incredible work. Incredible.
posted by GuyZero at 11:01 AM on August 28, 2009


As you said, it depends on where you are. In the cities, it's fairly easy, in the country not so much. There is no point in putting two hospitals in an area where there are only 5,000 people in the surrounding 300 miles.

There's absolutely nothing stopping private entities from building tertiary care medical facilities in remote areas of Australia. They don't do so for the same reason that the government doesn't - economics. Whether privately insured, covered only by Medicare, or filthy rich, if you need and organ transplant or are going to deliver conjoined twins here you're going to be transported to one of the major city hospitals - at the expense of your private or public insurer. This isn't a function of how many payers are involved.

Yes, those living in remote areas often have limited access to medical care - many small country towns don't have a full-time doctor at all or a hospital - it's one of the trade-offs you make and plan for when you choose to live in an isolated location and those who make that choice are well aware that there's no hope of an intensive care ambulance with a defibrillator on board arriving within 7 minutes.

One of the things which discourages doctors from setting up practising in sparsely populated areas is the cost of professional insurance coverage. If you're in a high-risk speciality like obstetrics and you're in a location where you don't have access to cutting edge medical facilities, you're unlikely to see enough patients to cover the cost of your insurance premiums, let alone make a living.

Another thing which probably adds to the cost of the US system is seeing specialists for routine things like pap smears, birth control and childhood vaccinations. Those things would be done by a GP here and a GP visit is one third to half the cost of a specialist visit.
posted by Lolie at 11:03 AM on August 28, 2009


Yes, but are existing physician pay scales sufficient to motivate more doctors to stay in or move to Canada, especially rural Canada? You can't switch doctors if there are no doctors accepting new patients in your area.

There are extra bonuses paid for those doctors who move up North and practice there. I'm not sure of the exact numbers, but they certainly exist, and for the purpose of encouraging new doctors to move to rural areas.
posted by jokeefe at 2:12 PM on August 28, 2009


especially rural Canada? You can't switch doctors if there are no doctors accepting new patients in your area.

An ENORMOUS problem in the US, BTW.
posted by Mental Wimp at 2:21 PM on August 28, 2009 [1 favorite]


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