[DerbyX]

OnTheIce OnTheIce:

So how do we fix things Derby?

Since many have said our current system is unsustainable, I'd like to hear your solutions.

How much stock do you personally put into doom and gloom people talking about AGW and its impact? I guessing very little.

I don't put a lot of stock into the health care crisis people or unsustainability.

You want a quick answer? It lies in eliminating the deficit, paying down the debt and putting those savings directly into health care.

You talked about how quicker service was in the US. (although your scenario describes exactly what I go through. Within 2 hours I see a doctor, get a prescription, have it filled in that building and be on my way).

Care to guess how much more per capita they spend towards health care? It is about double ours.

Imagine how many more service providers and MRIs and things we could get if we doubled our health care spending over night.

[BartSimpson]

DerbyX DerbyX:

I don't put a lot of stock into the health care crisis people or unsustainability.

Anymore, the word 'crisis' is so overused that when I hear it my skepticism jumps into high gear and I find the credibility of the person using the word as immediately suspect.

[Dragon-Dancer]

There is a great deal to be said for finding cost savings or order to help make things run smoother and in a more sustainable way.

First off is the issue of money for health care ending up in general revenue instead. Money earmarked for health care should absolutely never be used for anything but health care, no if and or buts.

The next thing is we have to get people into stable on salary jobs. I know far too many nurses here in Edmonton and not a single one of them has a full time contract. I'm not sure why that is, I hear all sorts of reasons from a hiring freeze onwards but it all seems to be connected to some democrat or government official deciding that hiring nurses as contractors on an 'as needed' basis instead of giving them a regular full time shift with benefits is going to cost the public less money. This is patently ridiculous, what you do get out of this is nurses working crazy numbers of hours with very little sleep between shifts (sometimes at more than one facility) and having to pay them overtime at double or triple wage.

If this is a sign of how poorly our system is being managed then i shudder to think of how much money is being wasted in other areas. I also very much agree that federally we should have some sort of pharmacare plan to leverage bulk purchases to help keep drug costs down.

There certainly needs to be some sort of incentive to keep doctors who train here in the country, at least for a time after they complete their training. Also incentive for doctors to start practices in rural areas who are currently most in need of these services.

[Caelon]

BartSimpson BartSimpson:

PublicAnimalNo9 PublicAnimalNo9:

What do you guys think and do you have any ideas as to how a two tiered system could work in Canada?

Sure it can mostly for the fact that you folks have always had two-tier health care:

There's been Canadians who use Canadian socialised health care and Canadians who can afford US health care for years now.

Your tongue in cheek response has more fact behind it. We have had a a two tier system since public health care was developed.

Anyone injured in the workplace has medical coverage through WCB, who pays for worker health care not the public system. For example if you have knee problems that are preventing you from working a normal shift that can be cured with surgery it is the WCB that approves the operation and funds the required surgery. You do not go on the public waiting list, but will have your surgery within a few days at WCB expense. WCB is reimbursed through employer premiums.

Also the Canadian military has private health care and to a certain degree so does your member of parliament. It is the general public that must use the public health system and enjoy the varying levels of service.

[Regina]

A two tier healthcare system cannot work within the borders of this country. The need for it is rather pointless since we already have a “pay as you go” healthcare network that works great just south of our border. The only people, who would push hard for a two tier system in here is the greedy, well established physicians in Canada.

[commanderkai]

Regina Regina:

A two tier healthcare system cannot work within the borders of this country. The need for it is rather pointless since we already have a “pay as you go” healthcare network that works great just south of our border. The only people, who would push hard for a two tier system in here is the greedy, well established physicians in Canada.

The best way for it to work is this:

Let American health insurers operate in Canada. Right now, only extremely wealthy Canadians, or Canadians who are living/working in the United States have access to American health insurance.

If we allow Canadian families the option to buy American health insurance to actually get faster care in the United States, then we wouldn't need to open up private insurers here. The burden basically stems from the idea that moderately wealthy Canadians can probably afford decent health care insurance, while paying for the actual care out of pocket will probably be a difficult burden. If you allow Canadian citizens (not those who live in the USA) the ability to buy health insurance to use in the United States, we can have a proper two tier system.

Right now, only Canadians with a MASSIVE amount of disposal income can go to the United States, and pay out of pocket for medical care. In this system, Canadians with relatively high wealth, without being multi-millionaires can get affordable access to the American health care system.

[Proculation]

Remove the administration of the hospitals from the government hands. The government can fund the public system but it should be no where near the administration. In Quebec, there is one administrator job for one medical job (nurses, doctors, etc). That's money thrown in out of the windows.

[Regina]

commanderkai commanderkai:

Regina Regina:

A two tier healthcare system cannot work within the borders of this country. The need for it is rather pointless since we already have a “pay as you go” healthcare network that works great just south of our border. The only people, who would push hard for a two tier system in here is the greedy, well established physicians in Canada.

The best way for it to work is this:

Let American health insurers operate in Canada. Right now, only extremely wealthy Canadians, or Canadians who are living/working in the United States have access to American health insurance.

If we allow Canadian families the option to buy American health insurance to actually get faster care in the United States, then we wouldn't need to open up private insurers here. The burden basically stems from the idea that moderately wealthy Canadians can probably afford decent health care insurance, while paying for the actual care out of pocket will probably be a difficult burden. If you allow Canadian citizens (not those who live in the USA) the ability to buy health insurance to use in the United States, we can have a proper two tier system.

Right now, only Canadians with a MASSIVE amount of disposal income can go to the United States, and pay out of pocket for medical care. In this system, Canadians with relatively high wealth, without being multi-millionaires can get affordable access to the American health care system.

Nope never happen. We are too afraid of their system and they are too afraid of ours.............and never will the twain shall meet.

[commanderkai]

Regina Regina:

Nope never happen. We are too afraid of their system and they are too afraid of ours.............and never will the twain shall meet.

No doubt. Even so, instead of demonizing the American system, we might as well take advantage of it, instead of trying to compete with it. Americans might not like our system, but I don't think many Americans would mind money going into their economy.

More importantly, letting private health insurers from the US (and, of course, Canadian startups and expansions) cover Canadians going to the United States for health care will remove a burden to the overstretched Canadian health system, without having taxpayer money being diverted away from Canadian medical facilities and coverage.

Hell, the taxes and cross-border trade that can be made might make the government a decent dollar or two.

[andyt]

What stops a Canadian from getting US insurance right now? I doubt there's any legislation against it. The Canadian govt wouldn't even know. Unless you mean you want to let that Canadian write off the insurance costs on his Canadian taxes, in which case you'd be bleeding dollars away from our system again. Then there's the problem that the US company might insist he use his Canadian coverage before he can access theirs.

And I can see the howling of Canadians who took out US insurance, at huge cost, but still had to pay Medicare premiums here. When I live in the US 20 years ago, it would have cost me $1200 a month to get premium coverage.

[commanderkai]

andyt andyt:

What stops a Canadian from getting US insurance right now? I doubt there's any legislation against it. The Canadian govt wouldn't even know. Unless you mean you want to let that Canadian write off the insurance costs on his Canadian taxes, in which case you'd be bleeding dollars away from our system again. Then there's the problem that the US company might insist he use his Canadian coverage before he can access theirs.

And I can see the howling of Canadians who took out US insurance, at huge cost, but still had to pay Medicare premiums here. When I live in the US 20 years ago, it would have cost me $1200 a month to get premium coverage.

Right now, the Canadian government is the only legal health insurer in Canada, excluding prescription/dental. Usually, health insurance in the United States is dependent on where you live, thus why health insurance rates might differ from state to state.

Canadians with residences in the United States can purchase American health insurance (including my family), however, I do not believe that Canadians living in Canada can legally purchase American health care, specifically due to not having a legal residence in the United States. Probably some legal bullshit, but eh. Snowbirds also probably are good examples of Canadians with legal American residences having American health insurance, in order to cover any medical issues when they're enjoying their retirement home in Florida.

Although I do think Canadians who purchase American health insurance can get some tax incentive to do so, in order to lessen the burden upon the demand of family doctors, specialists, and what have you, they shouldn't be completely exempted. More importantly, the most likely individuals who would go for this are those with enough disposable income to purchase it, and/or possibly getting a good deal from the company they work with.

[andyt]

I really doubt if there's any law against a Canadian resident buying American insurance - look at buying travel insurance. I don't know what restrictions an American insurer would put in place for a non-resident, but if they were smart, they would jump at the deal, since the Canadian is likely to access the Canadian system for routine things. And if the Canadian is injured in a car crash or other accident, a huge part of medical system, he's going to a Canadian hospital first.

But if you allow the Canadian to deduct that coverage from taxes, you're robbing the Canadian system of funds, which will reduce the available healthcare resources in Canada. So you remove this person from sometimes accessing our system, but you also rob our system of some tax monies. Doesn't make sense.

[Proculation]

You need to live in the US to get an american insurance. Imagine the pressure on the demand of specialized healthcare that would do on their system. Like you say andyt, Canadians would use healthcare in Canada for minor things while if they need a costly surgery, they would go to the US. If that was available tho, just imagine the premium cost since you would only use expensive healthcare in US.

[commanderkai]

andyt andyt:

But if you allow the Canadian to deduct that coverage from taxes, you're robbing the Canadian system of funds, which will reduce the available healthcare resources in Canada. So you remove this person from sometimes accessing our system, but you also rob our system of some tax monies. Doesn't make sense.

I'd like the tax reduction, but I know in all likelyhood, it wouldn't happen. I never said a FULL reduction either, but some, considering a large part of the demand is specialists/family doctors. I can't blame anybody who would rush to the nearest hospital in an emergency, but options for out-patient care, specialists, and what have you can probably be transferred to the United States.

I wouldn't worry about the American system as much, they can withstand the shock of a few million more patients coming once in a while. It's not like they're all going to the Henry Ford Medical Center in Detroit all at once, or something.

So, andy, if they didn't get the tax reduction for getting American health insurance, would you find this reasonable?

[andyt]

Of course. What you do with your own money is your affair. I'm not sure how reasonable it will seem to most families, since the extra costs will be huge and the chance of using it pretty minimal. As I pointed out, all sorts of healthcare will still be accessed by that family in Canada. So it probably only makes financial sense if an American insurer were willing to write some sort of special product for Canadians.

Remember, you already can deduct medical expenses over a certain amount. I don't think those expenses are limited to having been spent in Canada, tho I'm not sure. But I'm saying you shouldn't be able to deduct the cost of the US insurance.