Posted by Jay_Bravest_Face on July 4, 2007, at 14:44:26 [reposted on July 4, 2007, at 14:47:22 | original URL]
In reply to UhOh Canada ? » Jay_Bravest_Face, posted by zazenducke on July 4, 2007, at 10:57:39
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> Canada is the sixth richest country in the world but its health care is rated thirtieth. Wonder why?
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> I'm not sure socialized medicine is the answer to the problem of health care for the poor.
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> I respect John Grohol even when I don't agree with him :)
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> That's the American way.
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> Freedom of speech!
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> Happy Fourth of July!Well, you might want to consider the FACTS before getting caught up in your flag-waving.
Hot-air without facts...that is what Grohol's problem is. BTW...in 2007, Canada ranked 19 places ahead of the U.S. in the infant mortality rate.(See my sources below.)
The WHO study you are referring to still rates Canada ahead of the U.S., and what is missing is the percentage of each "class" (could have been measured using a percentile)
is not just covered, but treated with healthcare. (And quality of healthcare given to ALL patients...lower class vs. upper class) Here are some further facts. Below these, are my comments sent to Grohol, with cited sources.===Canada’s version of national public health insurance is characterized by local control, doctor autonomy and consumer choice. Ironically, with the increasing dominance of HMOs and the increasing complexity of rules covering federal medical payments, the United States health system is quickly becoming characterized by absentee ownership, centralized control, little consumer choice and doctors who must ask bureaucrats permission to dispense medical care and advice.
====The key to the Canadian system is that there is only one insurer -- the government. Doctors generally work on a fee-for-service basis, as they do in the U.S., but instead of sending the bill to one of hundreds of insurance companies, they send it to their provincial government. In both countries there is a continual tug over the dollar between health care providers and insurers. The difference is that in Canada the insurance company is owned not by shareholders, but by the taxpayers -- who, as one analyst explains, must constantly balance "their desire for more and better service against their collective ability to pay for it."====The statistics paint a starkly different picture. In 1971, the year that all ten provinces adopted universal hospital and medical insurance programs, Canadian health care costs consumed 7.4 percent of national income in Canada, compared to 7.6 percent in the United States. In the thirty years since, however, Americans’ health care expenditures as a percentage of Gross Domestic Product (GDP) have nearly double-date 14 percent -- while Canadians’ have remained relatively stable, increasing only to about 9 percent. And despite its high cost, the U.S. system fails to insure more than 44 million of its citizens. Some analysts predict that figure will grow to 60 million by 2008.
====Canada’s system is not only efficient; it is immensely popular. A 1993 Gallup Poll found that 96 percent of Canadians prefer their health care system to that of the United States. As Saskatchewan doctor E.W. Barootes, originally an opponent of universal health care, puts it, "today a politician in Saskatchewan or in Canada is more likely to get away with canceling Christmas than ... with canceling Canada’s health insurance program."
====Comparing the effectiveness and quality of health system across borders is a challenging process. Nevertheless, it is instructive to note that the empirical evidence indicates that Canada’s system is more effective than America’s. The World Health Organization (WHO) has devised an index that measures how efficiently health systems translate expenditures into health. One yardstick they use is known as the average disability adjusted life expectancy (DALE) of a population, which measures a population’s health rather than strict life expectancy. WHO combines this data with figures on the amount of choice patients have, the autonomy of health care providers, the equity of health care distribution and related issues. In 1997, Canada ranked 35th on this index. The U.S. ranked 72nd.
======WHO has developed sophisticated criteria to measure the effectiveness of health care services. These indexes measure a system’s level of responsiveness (which includes autonomy, confidentiality, choice of care providers, quality of basic amenities, etc.); distribution (to all members of society); and fairness of financial contribution (which reflects inequality in household contributions to their health care costs). The U.S. scores better than Canada only on the responsiveness index, where it ranks 1st to Canada’s 7th. When all these criteria are combined with basic health measurements, the WHO ranks Canada 7th, the U.S. 15th.
======Canada has been able to maintain high-quality care at minimum per-capita expense largely because of one of the five criteria mandated by the federal government -- public administration. Single-payer public insurance creates enormous administrative savings compared to a multi-payer managed care system. The difference is due to huge insurance bureaucracies and the duplication of administrative efforts between companies and marketing expenses: in a public program, such duplication would be superfluous.
======During the debate over Clinton’s national health care proposal, the New England Journal of Medicine calculated that the U.S. could save as much as $67 billion in administrative costs (easily enough to cover every uninsured American) by cutting out the 1,500 private insurers and going to a single government insurer in each state. HMOs consume anywhere from 9 to 30 percent of their revenue on overhead. That doesn’t include the significant cost to physicians and hospitals of dealing with the paperwork required under the American system. Administrative costs are sucking up an ever-greater portion of the health care spending pie. Between 1968 and 1993 the number of U.S. physicians rose 77 percent, while the number of administrators rose 288 percent. According to federal government figures, U.S. health care spending (excluding administrative costs) rose 196 percent between 1980 and 1991. Over that same period administrative costs rose 350 percent. Nor do these figures include the most important, albeit unquantifiable cost of all: the psychological and emotional burden that comes with patients having to answer the dreaded question, "Do you have insurance?"
===="Canada rations by queuing," explains Morton Lowe, M.D., coordinator of health sciences at the University of British Columbia. "You have to wait your turn for a hip transplant even if there are three poorer people in front of you. Which I think is damn fine. In the U.S., if you’re rich, you get it fast, and if you’re poor, you don’t get it at all. That’s how they ration."
=====Interestingly, access to specialty care is also limited in the American system. Obviously the 44 million Americans without any insurance experience grave difficulties in accessing health care. But so do Americans in managed care plans–40 percent reported difficulties similar to Canadians in obtaining specialty care.
====Canada’s system is trying to cope with the same problems the U.S. has -- an aging population and increased cost of drugs and technologies. But because of the pioneering work of Tommy Douglass(The brain behind Canada's universal healthcare), the strategies Canada is embracing are founded on equity, public administration and decentralized control. The U.S., on the other hand, is struggling to find solutions within a structure based on a paper-hungry, profit-motivated private insurance bureaucracy. In trying to fix the health care system, we would do well to learn from Canada -- and in fact, Massachusetts Representative John Tierney made the first move in that direction last year with a proposal to fund the research and development of state health care plans.
(Sources are at bottom of post)
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It seems that Mr. Grohol, along with Mr. Freking and Ms. Johnson, have not done their homework and checked the facts. Mr. Grohol, as employed in the healthcare business, is likely getting some nice kick-backs from private insurance and drug companies in the U.S. None of these people have a vested interest in helping the poor have equal access to healthcare. Their interest is money, and keeping their big slice of the pie.First off, I am a Canadian, and a hospital social worker at one of the biggest hospitals, a teaching hospital, and leading research centers in the world. (McMaster, in Hamilton, ON) I have about 17 years experience in this position.
A very quick and simple look-up of infant mortality rates, based on 2007 figures, NOT 1997 figures, put Canada at #199, the U.S. at #180, and Cuba at #182.(The lower being the better, of course.)
(CIA "The World Factbook" https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html ) Looking at these numbers, it even shows that Cuban females have a longer life expectancy then U.S. females.So, there is really little difference in numbers between Cuba and the U.S., and what also has to be taken into account is
the terrible effects of the U.S. blockade of Cuba, as evidenced in this next paragraph:(from http://www.cubanow.net/global/loader.php?&secc=3&cont=show.php&item=681 )
"This (American) policy, implemented and added to by ten US administrations also amounts to an act of genocide under the provisions of paragraph (c) of article II of the Geneva Convention for the Prevention and Punishment of the Crime of Genocide of 9 December 1948 and therefore constitutes a violation of International Law. This Convention defines this as ‘(…) acts perpetrated with the intention to totally or partially destroy a national, ethnic, racial or religious group’, and in these cases provides for ‘the intentional subjugation of the group to conditions that result in their total or partial physical destruction’..... The blockade on Cuba is an act of economic war. There is no regulation of International Law which justifies a blockade in times of peace. Since 1909, in the London Naval Conference, as a principle of International Law, it was defined that ‘blockade is an act of war’, and based on this, its use is only possible between countries at war."
Further, from zmag.org,
(http://www.zmag.org/content/print_article.cfm?itemID=4325§ionID=54)The U.S. embargo against Cuba is condemned by an ever larger and by now overwhelming majority of states members of the United Nations General Assembly. However, it continues to be imposed by the U.S. government’s isolated but stubborn will, in spite of the United Nations repeated injunctions, notably its resolution 56/9 of the 27th of November 2001. The purpose of this expose is to denounce this embargo in the strongest terms for the violation of law it represents, and for its total lack of legitimacy. These measures of arbitrary constraint are tantamount to a U.S. undeclared act of war against Cuba; their devastating economic and social effects deny the people to exercise their basic human rights, and are unbearable for them. They directly subject the people to the maximum of suffering and infringe upon the physical and moral integrity of the whole population, and in the first place of the children, of the elderly and of women. In this respect, they can be seen as a crime against humanity[1].
The votes of the U.N. General Assembly on the “necessity to lift the blockade against Cuba"= Countries against the embargo lifting
1992 59 2 USA, Israel
1993 88 4 USA, Israel, Albania, Paraguay
1994 101 2 USA, Israel
1995 117 3 USA, Israel, Uzbekistan
1996 138 3 USA, Israel, Uzbekistan
1997 143 3 USA, Israel, Uzbekistan
1998 157 2 USA, Israel
1999 155 2 USA, Israel
2000 167 3 USA, Israel, Marshall Islands
2001 167 3 USA, Israel, Marshall Islands
2002 173 3 USA, Israel, Marshall IslandsNext, is the issue of medical "wait times". ( http://www.wicleanelections.org/SinglePayerMyths.pdf ) Even though the U.S. far from covers healthcare for all citizens, the wait times in Canada are about the same as in the U.S. The *only* difference is when it comes to some "elective surgery" (This is mostly some "Cosmetic" forms of surgery ). Furthermore, Canadians can pick *any* physician they wish to. (The "lack of choice" myth is big in the U.S. anti-universal healthcare movement...lead of course by rich HMO's, insurance companies, and politicians, doctors and medical CEO's and administrators who recieve big kickbacks from "Big Pharma") Also, there are currently more physicians that are returning to Canada then going to the U.S. The "poor" Canadian physicians have their salaries capped at......$400,000. Also, interesting to note, surveys show that American physicians would actually *prefer* universal healthcare.
Over 90 percent of Canadians prefer the universal system rather then a for-profit "free market" system. Studies also show that Canadians are NOT (very, very far from) going to the U.S. for healthcare. The big myth of "Canadians traveling to the U.S. for healthcare needs" is pushed by for-profit interests in the U.S.
So, why are politicians in the U.S. so strongly against universal healthcare? Well, it comes down to money, that is, money being contributed to politicians from pharmaceutical companies, insurance companies, healthcare CEO's...the amount used to lobby U.S. politicians is over 100 million dollars a year. (Sources are listed below)
So, if Mr. Grohol is so BIG on helping people with mental illness, he has got a good financial interest in doing so. That is, to those who can pay him enough! I am a consumer of mental health systems here in Canada as well, and I have 95 percent of my drug costs covered, can go to any doctor I want, any day of the week, simply present my government health card, and see a doctor in anywhere between 30-45 minutes. Of course, in the event of an emergency, I dial 911, and an ambulance will be at my house in a matter of minutes, and I will get taken and admitted to, no questions asked, a local hospital, and get top-notch treatment.
I will also say from personal experience, beyond even seeing your own doctor, Canadians can walk into any of the vast "med clinics" (not-hospitals) that are spread in large numbers in all of Canada's towns/cities, and get free urgent care for whatever the problem is.On a even more personal note, my Dad was diagnosed with fatal heart disease early last December. He needed a quadruple bypass, which would cost many hundreds of thousands of dollars. On January 3, less then a month after he was diagnosed, he was taken to one of the best medical and research hospitals in the world. That same day, Jan. 3, he had his operation for his bypass, which they used 4 top surgeons and many assistants, and which also took about the average time (anywhere) for this type of operation, about 5 hours. They had to remove a few arteries from his legs, and moved them into his clogged heart ones, basically replacing them. The amazing procedure was explained to us (his family waiting) by one of the surgeons, telling us about it in complete detail, with confidence and making the complexity sound very simple and routine. If my Dad hadn't have had that operation, he would have been dead within the next 6-7 months. If this was taking place in the U.S., my Dad is on a basic pension, he would not have been able to afford the insurance costs, and likely (if he still could afford it) have gone bankrupt.
America, you are NOT the center of the universe. Taking care of the poor, the needy, and even your middle-class citizens, is something you refuse to do. You and your politicians should be ashamed.
Sources:
"The New Rules", Spring 2001.published by the Institute for Local Self-Reliance.
http://www.pnhp.org/facts/quality.pdf
http://pnhp.org/facts/myths_memes.pdf
http://www.savemedicare.com/
http://www.sfgate.com/cgi-bin/article.cgi?file=/n/a/2006/04/23/financial/f152633D51.DTL&type=printable
http://www.sfgate.com/cgi-bin/article.cgi?file=/n/a/2006/04/23/financial/f152633D51.DTL&type=printable
http://healthcouncilcanada.ca/docs/papers/2005/BkgrdWaitTimesENG.pdf
http://www.latimes.com/features/health/la-he-global18jun18,1,1444274.story?coll=la-headlines-health
poster:Jay_Bravest_Face
thread:767620
URL: http://www.dr-bob.org/babble/poli/20070312/msgs/767624.html