How would the Tea Party deal with EMS Calls?

[rock_shoes]

Socialized health care, like we have here in Canada would be better than what the US has now.

While I agree with you, If you're going to take the time to comment it's also worth taking the time to defend your position.

I prefer a public not for profit system because I view it as one of those baseline services provided within the context of a first world country. Police, Fire/rescue, basic healthcare needs, public roadways... The only one of these not publically funded in the US are basic healthcare needs. How is it possible that current government practices essentially place "saving basements" ahead of basic primary health care? How is it more cost effective to have private for profit firms running hospitals instead of something entirely not for profit?

[paramedicmike]

Socialized health care, like we have here in Canada would be better than what the US has now.

As was just mentioned, what do you have to support this comment?

I've known several Canadians who do not have a positive image of the socialized health care system found in Canada. I've known several Canadians who've left Canada to seek health care in the US simply because the waits and bureaucracy of the Canadian health care system. Yes, this is anecdotal. But if you've got something to support your position then let's see it.

[zippyRN]

Doc,

You lost me with the "telling 1 million citizens they must now become employees of the state" bit. Where is that from?

Scaremongering from the 'reds under the hospital beds' pundits who believe that single payer must be a monolithic system , when outside of former communist states there are or were no monolithic health systems even if single payer not even the NHS is a monolithic system although the majority of consultant Doctors practicing within the NHS are employees of a Hospital trust or a University medical school.

interestingly enough the salbutamol / albuterol MDI discussed earlier comes into the NHS at a few pounds per unit thanks to centralised purchasing and if if you pay for your prescriptions you'll pay 7.40 gbp for it

Edited September 19, 2011 by zippyRN

[*Lifeguard*]

I am From Canada. We have a great system. Under the terms of the Canada Health Act, all "insured persons" (basically, legal residents of Canada, including permanent residents) are entitled to receive "insured services" without copayment. Such services are defined as medically necessary services if provided in hospital, or by 'practitioners' (usually physicians).^[2] Approximately 70% of Canadian health expenditures come from public sources, with the rest paid privately (both through private insurance, and through out-of-pocket payments). The extent of public financing varies considerably across services. For example, approximately 99% of physician services, and 90% of hospital care, are paid by publicly funded sources, whereas almost all dental care is paid for privately.^[3] Most doctors are self-employed private entities.

[hatelilpeepees]

And how much do you Canadians pay in taxes to receive that care ? And why is it Canadians come to the US for care, if that system is so great. I hear you guys have to wait 6months to a year for a CAT scan, or any "elective" procedures, is that true ?

Nevermind, I found the tax rates:

http://www.cra-arc.gc.ca/tx/ndvdls/fq/txrts-eng.html

Edited September 19, 2011 by hatelilpeepees

[Happiness]

So I am 46 years old and in my life time there has been approx 60k paid for me and my children up to the age of 18. With the exception of approx 10 years of one child I didnt pay as he is a status Indian. So I will list what I can remember in hospital care and maybe some one can tell me approx what that would have cost me in the states.

18 months (3rd degree) burned abds on stove (dont ask) emergency and 3 day hospital stay

20 months drank lemon oil asperated it, 6 months in hospital and 3 months in rehab

8 yrs ears pinned back 5 day hospital stay

14yrs broken ankle x-rays etc,

16 tonsils out 4 days in hospital also treated for pneumonia

19 emergency c-section 6 day hospital stay and child in intensive care for 3 (Spinal that didnt work)

23 natural birth (spinal worked) 10 day hospital stay child with severe jaundice

28 natural birth 2 day hospital stay

34 pheumonia 5 day hospital stay

full prenatal care for all three

tubes tied up

On average 3 trips to dr per year

1st child at 17 surgery for a torn tendon in the knee and probably on average 3 trips to the dr per year

2nd child care for a hole in his heart and on average 3 trips to the dr per year

3rd child tonsiles out, adnoids out, circumcision (medicaly needed) hernia and toung snipping pneumonia 4 day hospital stay and on average 3 trips to the dr per year.

I know that as a child I ate many things and stuck many things up my nose off to the dr, some how my children were not as goofy as i was but I would not have paid any more if they were.

ER Doc I understand where your comming from but if you as a dr feel you need to shove 30 pts in your day to make money then it will be your pts that suffer as you cant give them the same care as you to 20. One thing the states really need to look at is how easy it for people to sue drs for the stupidest crap and once that is done maybe your own insurance will go down and that would make a difference on the bottom line right? (nice picture:)

Yes we have alot of problems in Canada with our healthcare but I have to admit that if you need something that is life and death then you get it (Im sure some have died) if you want to have elective surgery then yep you have to wait and people go to the states because people dont like to wait for anything these days.

AK or is it Mike, if pharmaceutical companies can only charge so much in Canada (because of our legislation) why cant the gov of the USA do the same and bring the prices down in your country. I know that yes it cost alot to create and get drugs approved but come on there has to be some sort of line.

A friend of mine said to me once when she was selling one of her horses, "A horse is only worth what someone is willing to pay for it" Our societies have really gone wayward when it comes to econmics for example the IPAD it cost under 50 to make but we are willing to pay 500 for one now thats a big profit line......just saying

[ERDoc]

So I am 46 years old and in my life time there has been approx 60k paid for me and my children up to the age of 18. With the exception of approx 10 years of one child I didnt pay as he is a status Indian. So I will list what I can remember in hospital care and maybe some one can tell me approx what that would have cost me in the states.

18 months (3rd degree) burned abds on stove (dont ask) emergency and 3 day hospital stay

20 months drank lemon oil asperated it, 6 months in hospital and 3 months in rehab

8 yrs ears pinned back 5 day hospital stay

14yrs broken ankle x-rays etc,

16 tonsils out 4 days in hospital also treated for pneumonia

19 emergency c-section 6 day hospital stay and child in intensive care for 3 (Spinal that didnt work)

23 natural birth (spinal worked) 10 day hospital stay child with severe jaundice

28 natural birth 2 day hospital stay

34 pheumonia 5 day hospital stay

full prenatal care for all three

tubes tied up

On average 3 trips to dr per year

1st child at 17 surgery for a torn tendon in the knee and probably on average 3 trips to the dr per year

2nd child care for a hole in his heart and on average 3 trips to the dr per year

3rd child tonsiles out, adnoids out, circumcision (medicaly needed) hernia and toung snipping pneumonia 4 day hospital stay and on average 3 trips to the dr per year.

I don't think anyone can tell you what any of that would have cost. The cost of healthcare in the US is very nebulous. The same procedure/medication will cost a different amount depending on what insurance you have, what part of the country you are in, what day of the week it is, what phase of the moon it is, etc. Hospitals, doctors offices, etc negotiate different rates with different insurance companies so it is never the same. The only guarantee is that that govt (medicare and medicaid) always have the lowest rates of reimbursement.

ER Doc I understand where your comming from but if you as a dr feel you need to shove 30 pts in your day to make money then it will be your pts that suffer as you cant give them the same care as you to 20. One thing the states really need to look at is how easy it for people to sue drs for the stupidest crap and once that is done maybe your own insurance will go down and that would make a difference on the bottom line right? (nice picture:)

Despite the fact that we doctors want to believe we are gods, we are still just normal people (relatively speaking). Just like everyone else, they have bills to pay and have established a certain standard of living. Would anyone be willing to take a 25-50% cut in their paycheck for the benefit of society? The overhead to run a practice will not change (supplies, staff paychecks, rent, utilities, etc) so the cut will come from the physician's take home pay. Why should doctors be the only ones to feel that pain? How do people propose physicians cut back on their cost of living? Sell their houses and buy something smaller? Good luck with that in this economy. Sell the fancy cars? I drive a Nissan, not a Lamborghini. Most of us have a large amount of student loans. The average used to be around $100k-$150k but it is now approaching $200k to almost $300k. This puts student loan payments at over $2200/month over 30 years (more than a mortgage). As for cramming more pts in, I don't have a choice. I have to see whoever comes in the door. We don't have appointments in the ER. In the ER we are judged on our times. It's cram the pts or lose your job. All the talk of doctors ordering tests to pad the bill does not hold in the ER. The more tests we order the longer people stay and the worse our times are. We try to minimize testing without missing anything (including those zebras that you will only see once in your career). Thanks for the compliment on the picture. Apparently you are not the only one that likes it.

AK or is it Mike, if pharmaceutical companies can only charge so much in Canada (because of our legislation) why cant the gov of the USA do the same and bring the prices down in your country. I know that yes it cost alot to create and get drugs approved but come on there has to be some sort of line.

Let's face it. What is the biggest drive for innovation? Profit. It's just human nature. Why are most drugs developed in the US? Because that is where the biggest profits are. Yes, there are successful companies from overseas (Novartis, etc) but the majority of the top pharmaceutical companies are from the US (http://en.wikipedia.org/wiki/List_of_pharmaceutical_companies). The search for profit is what lead to the discovery of the Western Hemisphere by European adventurers. I'm not saying we shouldn't do things to help others, we absolutely should but reality is that profits drive innovation.

[crotchitymedic1986]

The question is happiness, how much did it cost you ? How much of your paycheck goes to federal and provential taxes ? It would depend on your insurance here, but in the end it probably all equals out. I think I paid around $200-300/paycheck for family health insurance, and then you would usually only have a co-pay of $50-100 for each visit to an ER/Hospital, no fee for Doctor's office.

[Just Plain Ruff]

My health insurance is free to me if I took the high deductible and I did but even with free premiums I'm still nailed in the end if I have medical issues.

I have 25.00 copays for the doctor

I have 100 dollar copays for the ER

250 copays for outpatient procedures

my individual deductible is 2500, and that 2500 per family member not just one of us.

My maximum out of pocket costs are 9500.00

So with my wifes pregnancy she has met her individual deductible and we have met our out of pocket max so everything from here on out is paid for at 100% for her but I still have to meet my deductible and my children have to meet theirs. We are only about 25% of the way for me and 10% each for the kids.

So total amounts I have to spend is 19500 total for all of us to be fully 100% covered not including any co-pays for meds and doctors offices or ER visits.

That total amounts to 2/3 of my total yearly salary not counting my bonus structure so my insurance overall is not cheap or free, maybe if it was I'd be singing a different toon.

[systemet]

Another perspective from a someone who's lived and worked in Canada. When I was there, I got:

- basic health insurance from the province (think: state) I lived in. Currently this is free (Well, free in that there's no separate tax for it, it just comes out of general revenues). This covered medical treatment with the exception of (i) dentistry / orthodontics, (ii) prescription costs, (iii) ambulance, fixed-wing / rotary wing transport *unless admitted to a given facility [so not ER->ER], (iv) things like crutches, peak flow meters, ambulatory aids, etc. (v) private hospital rooms. Maximum prescription costs are also limited by the province, (vi) driver's medicals, (vii) immigration paperwork / sick notes for work, etc.

- additional private insurance through work, covering (i) - (iii) and (v), some of which were capped.

So, living in Canada, I never really had to worry about the cost of healthcare. Granted, if I didn't have the private insurance, if my doctor wrote me a script for a $100 antibiotic treatment, I'd be a little out of pocket. Or if I ended up requiring ambulance transport, I'd get a few hundred dollars as a bill. But I'm basically never opening my wallet to pay for healthcare.

The tax rate probably is higher than the US. I paid 5% sales tax to the federal government. 0% to the provincial government. The income tax rates might be a little higher. I had to pay city taxes on my house that went towards fire, police, ems, school, public works, etc. But I doubt the quality of life is much different. I'm sure many of you guys have visited Canada. Did you see a big burden being placed on people because of taxation? I never saw it.

What are the negatives to the system?

- if I need an MRI or a CT or something, especially for a minor joint injury, I'm going to wait. It's going to take a while. If I tear my ACL, it's not getting fixed quickly. As a young person this is inconvenient, and obviously runs the risk of turning a minor injury into some degree of permanent disability. For an elderly person needing a joint replacement, this is disastrous. My understanding is that it's many of these patients that are going to the US for treatment.

- experimental drugs often aren't approved by the medical system. So if I develop a rare kind of cancer, and someone develops a new therapy that doesn't have a lot of evidence supporting it, that might reduce morbidity, might reduce mortality a little, it may not be approved. Some of the patients going to the US are going for this sort of treatment, obviously at their own expense.

- Dental care can still be quite expensive if you don't have private insurance. I have a relative with bad peridontitis, who has been paying to fly to Mexico and get dental work done. He can pay here, but it's expensive. The insurance company has told him they'll pay to have some teeth removed and get dentures. He wants to get a series of implants instead. They're cheaper in Mexico. I doubt anyone is going to the states for cheaper dental treatment (usually treatment costs are capped -- but obviously as my example illustrates, can be quite expensive).

----------------

The thing with health care is no matter what system you choose for delivery, you have to pay for it. Almost all of the industrialised nations have socialised systems. With the exception of the US. That's a choice you guys have made, and it's not my right to tell you how to design your economy, and run your nation. What I can say, is if you get hurt in Canada, you're still paying for medical care through taxation. You're just not having to worry about getting huge lump sums to pay. You're not worrying about qualifying for medical insurance, and family coverage, etc.

Either way you pay. Either through direct taxation and universal coverage, or through partial coverage and direct pay.

I couldn't imagine living somewhere where I could get run over by a car, and end up selling my house to pay for it. I wouldn't choose to do that. I'd rather pay the higher taxes.