Musings in the life of an internist, cardiologist and cardiac electrophysiologist.
All of my experiences (and that's a lot, considering I've had rheumatoid arthritis for 24 years and have spent the last 3 years in and out of cardiologists' offices) have been really positive, and I've never had to wait for necessary procedures. I have great EPs, an excellent HCM specialist, a fantastic rheumatologist. I get what I need when I need it. Danny Williams, who is premier of Newfoundland and Labrador, can make his own decisions, as we all can. If there's an expert he wants to see, that's his right. But, speaking as a frequent and long-term Medicare consumer, I have never been anything less than satisfied and completely confident in the care I've received.
Wes,It is clear we have some outstanding hospitals that deliver top notch care. On th eother side of the coin, we have hospitals surviving on a shoe string that don't and frankly can't deliver that same care. Mr. Williams, as mentioned "has made millions in the cable televion buisiness" and we don't even know what he ventured to the US to have done. Some experimental procedure or what?! For all we know he is getting high colonics at some spa/clinic!All this seems to prove is that the wealthy can opt to get their care anywhere they want, and certainly our hospitals (at least some of them) have the concierge services/waterfalls and flat screen TV's that I doubt Canadian hospitals have, because they have made the choice to provide health care to all their citizens, unlike our system that caters to the well to do, while letting the have nots (those lazy, shiftless folks who would choose to live on the public dole if we gave them anything subsidized; even health care)receive less than stellar access and care.My guess is that from your perspective as a specialist, we provide for these folks since we likely put pacemakers in when they present at the ER for complete heart block. But we in primary care are frustrated by the waste of inadeqaute treatment of hypertension/diabetes/high cholesterol that is not availible to these individuals who don't posess Mr. Williams bank account. Maybe we wouldn't need so many pacemakers if we first took care of some of the underlying issues of heart disease.Bottom line; poor anecdotal example of any deficiency of Canadian health care to suggest that a rich guy traveling to some other country for a medical procedure represents any fault with the entire health system, but nice try.
Keith-I wonder why he picked the health care system that's 37th in the world, according to the WHO? Damn, one would think he had 36 other choices...
Dr. Wes,I won't argue that our health system is VERY good if money is no object. It's not so good if you have lost your job and lost your insurance. Further, perhaps the WHO statistics are shaky, but just how shaky? Are we 30th? 20th? 15th? Would you insist that we are #1? And let's reverse the story... just how many Canadians who make $60K/yr. are knocking down our doors for our health care? And how many Americans are becoming medical tourists or going to Mexico for their care?
Helen-Thanks for the counterpoint. I know of other Canadians who are very happy with their system, too. But like America, they're financially strained, and, like France, there is a push to privatize some of the health care system due to long wait times. It seems clear to me that a "one size fits all" system is not where most of the world is migrating toward. Anony 10:34-You ask excellent questions. My retort was an attempt to discredit the widely held belief that our health care system is 37th in the world. For others who expect government to be responsible for all health care in America would argue those statistics are accurate. I am not one of those people, obviously. I agree that those who are less fortunate than others need a safety net health care system, but while Medicare has worked for over 40 years, our government has not proven itself to be a good steward of the fiscal house of our current entitlement programs, in large part due to special interest influence. Developing a financially-responsible and sustainable health care system that balances quantity of care with quality remains our country's most pressing challenge. Certainly, basing decisions upon the experience of others that have gone before us with data would make more sense than with special interests agendas, hyperbole and sound bites.
Wes,I think the choice of location might relate more to proximity and possibly use of frequent flyer miles. Also, I don't think the rest of the medical world has such an entrepenurial spirit as we do of selling high tech procedures and such to wealthy sheiks, with the exception of Great Britain. Why travel accross the pond when you can get your marble mausoleum lobby and flat screen tv much closer to home!
Helen - I am glad to hear of your positive experiences with your health care system. I have heard from a few people who have opposing opinions, but, overall it seems that your citizens like your health care system, like the majority in America do.But there are some very striking differences between our countries that impact the economics of our health care systems.For example, according to the World Health Organization in 2008, America is the largest consumer of cocaine, heroin, alcohol and tobacco. Moreover, according to the only international statistics resource I could find (nationmaster.com), we also lead in other things such as total crimes, gun violence, car accidents, rapes, child maltreatment, obesity, teen pregnancy, teen on teen violence (we have a lot of violent "gangs" here), plastic surgery consumption, etc.Unfortunately, when violence happens, health care gets consumed. When people ingest toxins, or otherwise treat their bodies badly, health care gets consumed. When accidents happen, or there are high rates of risky behaviors leading to accidents, health care gets consumed.All of these things trend up our overall health care spending, and trend down our ability to increase longevity despite that consumption.So, while our consumption needs of health care are much higher than your country, it seems worth pondering how well a system like yours would work here. How high would our taxes have to rise in order to meet our staggering health care needs, compared to yours?In America, we have seen a little taste of what government run health care would look like. We also have "Medicare", though it is not the same as yours, as you likely know, and is essentially tax money used to pay for our elderly to have health care. The tax money collected for that system, a system less than 50 years old, have been repeatedly borrowed by our government and used elsewhere, rather than being used for the purposes of elderly health care needs. As such, we are facing a $37 trillion dollar shortage in that system, while being on the brink of the baby boomer generation retiring and looking to collect those benefits. And, our governments lack of ability to adequately check claims has led us to taxpayer losses from Medicare fraud and waste to the tune of $60 to $90 billion dollars a year.Furthermore, I am interested to know about your tort system and how that works. How hard is it for you to sue a provider? I am also interested to know how much your doctors and nurses must pay for their education - and how long is their training. Do you know? Also, do you happen to know what your country's costs are for treating illegal immigrants?Also, compared to the US, do you know how much your country sends overseas, either via your military spending or foreign aid spending? I know our spending on both of those things is quite high.Do you know, also, about your country's innovation statistics (drug research, medical advancements, etc.)?I am also curious to know how your country's GDP, productivity, and employment rates are, or are not, affected by your tax rates.So many questions!!- Jodi
Helen - A few more questions.I understand that your country has a history of physician strikes. Can you elaborate on that? Do you know why? Do you have a problematic doctor shortage in Canada?
The World Health Organizations assessment of health care systems was based on 5 indicators:1) Overall level of population health;2) Health inequalities (or disparities) within the population;3) Overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts);4) Distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system);5) The distribution of the health system’s financial burden within the population (who pays the costs).The US was ranked number one on Responsiveness (#3).WHO link:http://www.who.int/whr/2000/media_centre/press_release/en/index.htmlAccording to the same WHO website, Responsiveness includes these two things:1. Respect for persons which includes:- Respect for the dignity of the person.- Confidentiality, or the right to determine who has access to one's personal health information.- Autonomy to participate in choices about one's own health. This includes helping choose what treatment to receive or not to receive.2. Client orientation includes:- Prompt attention: Immediate attention in emergencies, and reasonable waiting times for non-emergencies.- Amenities of adequate quality, such as cleanliness, space, and hospital food.- Access to social networks - family and friends - for people receiving care.- Choice for provider, or freedom to select which individual delivers one's care.According to WHO and their #3 above, the US has a very high satisfaction rate, etc.Also - I wonder of the validity of this CBS news story from 2005 about the Canadian health care system in crisis. Is Canada's health care system sustainable?It claims that families pay "48 percent of its income in taxes each year, partly to fund the health care system." If it's that high there, think of how high it would have to be here!!CBS news link:https://www.blogger.com/comment.g?blogID=18943510&postID=5485665777448105285(note to Wes, how do I post links like this and have them show up in blue like other people? Am I doing something wrong?)
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