News & Politics - International healthcare systems

cookiely · 06-15-2008, 04:16 PM

I found this documentary on international healthcare systems.
Don`t know if you guys know it already but I saw it for the first time and I thought
it was highly intresting

FRONTLINE:sick around the world | PBS

it shows the different public healthcare models and some of it`s pros and cons.
Something I missed in Sicko, which painted a too perfect picture of public healthcare in my opinion.

It is interesting to see how other countries do it. So far I only knew the beveridge, the bismarckian and the free market system.

**sunnykerr** · 06-15-2008, 05:01 PM

I haven't seen this documentary, and I only really know our system in Canada. I know it's not perfect. But I do think that no system can ever be perfect. So, in the end, I have to say that I'm pretty satisfied with our system here. Even if there's room for improvement.

sm_love_dc · 06-15-2008, 05:20 PM

The Canadian system does has it flaws, but every social system does at some level. I think the worst thing it to give the power of health into the insurance companies, like the States. In Canada Tommy Douglas faught for Universal health care (Kirk Douglas's grandfather by the way) and some day it will either be truely unviersal or it will fall part. The cost of health care is one of the biggest road blocks to ensuring every one has what they need. But I do believe in the fact that when a person walks into a hospitals er they are helped to the best abillities avaliable. Rich or poor every one should have access to the health care system.

**sunnykerr** · 06-15-2008, 05:52 PM

Erm, Tommy Douglas was Kiefer Sutherland's grandfather. Inasmuch has he's Shirley Douglas's father and she's Kiefer's mother.

And the cost of health care is always something that's befuddled me. Because Canada is probably in the group of the world's richest nations... I assume. But we're by no means the richest. And we seem to be doing okay with assuming it.

Of course, we're nowhere near as populous as many countries, so the burden probably isn't as heavy.

But, than again, neither is the pool of people who are taxed to maintain it.

Most of all, though, I consider the human price to be far more important than the financial one.

We're nowhere near perfect. But I do think that the basic principle of universal health care is one with tremendous credence.

**4N6 DNA** · 06-22-2008, 08:34 PM

I agree with the statement that no system is perfect

Thanks for sharing that link cookiely.

I read an astonishing estimate the other day.

Quote:

The Institute of Medicine estimates that 18,000 lives are lost annually [in the US] as a consequence of gaps in coverage. It calculates the annual cost of achieving full coverage at $34bn - $69bn, which is less than the loss in economic productivity from existing coverage ($65bn - $130bn annually).

Source: Problems of the U.S. healthcare system are growing

Being in the Science/Health field, its becoming increasingly obvious the problems we are facing. Employer-based insurance seems to be disappearing steadily and such an uncoordinated health care system the US has is supporting increasingly bigger gaps in coverage. If it wasn't obvious before, it should be now, that something in our health care needs to be changed drastically. One of the only things I agree with Rudy Giuliani is his stand on health care. "The future of America's health care system lies in free-market solutions, not socialist models. We can increase individual choice and decrease costs by increasing competition, encouraging innovation while always compassionately caring for people in need."

I think this should be our approach. Not to switch the entire system to mimic the other major industrialized countries, but atleast shift power to those who can be more fair with the coverage.

With the Canadian coverage, do you guys ever have problems getting a doctor to see you? Or getting the proper attention from your health care professionals?

ceilirose · 06-23-2008, 08:34 AM

Isn't part of the reason that the US healh care system is in such a mess is due to the free market system? Our health care providers (at least most of them) are for profit. When you're for profit then the bottom line is saving money, cutting costs etc. and not the welfare of the patient. The insurance companies have to get on board with reform and I don't see that coming.

I cringe when elected officials warn against "socialist" systems. One it's a catchy sound byte and two - their health costs are being payed by taxpayers and so they are (in a bizarre way) recipients of socialized medicine. To a degree.

A former co-worker of mine who is insured had exploratory surgery a few weeks back. Her tests didn't look good, the doctors saw things they didn't like and recommended immediate surgery. She did have it but first she had to put down $1,500.00 to the hospital. The prognosis isn't that good and this is what irritates me most about the system. Here you are, insured, paying your premiums and when you really need care - someone has their hands out.

Maybe socialized medicine isn't the answer but neither is the free-market system.

**sunnykerr** · 06-23-2008, 06:07 PM

Quote:

Originally Posted by 4N6 DNA (View Post)

With the Canadian coverage, do you guys ever have problems getting a doctor to see you? Or getting the proper attention from your health care professionals?

I'm not gonna lie, it can be very hard to get a first appointment with a GP, depending on where you live. But they've made great strides of late in opening resident positions (under GP supervision) to cater to the need.

I've never, ever had any problems getting the attention of a specialist, though. Nor of health-care professionals, be they nurses, psychologist, physical therapist or what have you.

The wait times can be a little daunting when it's for non-emergency things, but I've never been made to wait even a day for something more urgent (which, in a lot of cases, wasn't really that urgent either).

So, maybe it's because I'm used to it myself, but I don't really understand the big problem with the concept of "socialized medecine." Medecine shouldn't be for profit. And health is a societal value, paid for by society anyway through taxes and benefits... so why not make it a social priority?

**4N6 DNA** · 06-24-2008, 08:23 AM

Quote:

Originally Posted by ceilirose (View Post)

Isn't part of the reason that the US healh care system is in such a mess is due to the free market system?

I feel that the US is not entirely under a free market system. The past half a century the government has been intervening in our heath care market (Medicare, HIPPA, COBRA, Medicaid and others). We get a tax break for getting health insurance through an employer and you can't get insurance out of state among other things. This isn't a free market. I think that the role of the government should be lessened if we want our "free-market" health care to work as a free market system should.

Not to say that free-markets are perfect either. In this market, companies only make money by denying care to certain customers. I guess it safe to conclude that no health care system is perfect, and it would be near impossible to perfect them. Perhaps some other alternatives? I have heard a few ideas that seem like they could improve the situation and I would love to hear your comments on them:

Ending the medical savings accounts cap so that everyone can participate regardless of their employment status
Develop a pool for the more risky people so that even they can get insurance

SunnyKerr,
Thank you for your opinion on the Canadian Health care system.

How do you feel about the government covering things like sex change and such? Do you feel that takes away from the people who need life-saving surgeries?

ceilirose · 06-24-2008, 08:48 AM

Quote:

Originally Posted by 4N6 DNA (View Post)

I feel that the US is not entirely under a free market system. The past half a century the government has been intervening in our heath care market (Medicare, HIPPA, COBRA, Medicaid and others). We get a tax break for getting health insurance through an employer and you can't get insurance out of state among other things. This isn't a free market. I think that the role of the government should be lessened if we want our "free-market" health care to work as a free market system should.

Not to say that free-markets are perfect either. In this market, companies only make money by denying care to certain customers. I guess it safe to conclude that no healthcare system is perfect, and it would be near impossible to perfect them.

It may not be a free market system in whole but a lot of it is and it's not working. Most of us can agree on that or at least I would hope so.

I don't really consider COBRA government intervention per se. Also I don't know that some government intervention isn't a bad thing. I shudder if health insurance is turned over to profit making organizations in it's enitirety. It would be chaos. The bottom line would be making a profit instead of helping people.

McCain's plan basically throws it back in it's entirety to the free market system - we're all on our own to get insurance.

It will never be perfect but I'm not going to be scared by sound bytes that scream "socialism" and all that implies. We need a sound, reasoned discussion on this subject because it's literally life or death for some. I'm tired of it being a poltical football between political ideologies.

**4N6 DNA** · 06-24-2008, 09:33 AM

Quote:

Originally Posted by ceilirose (View Post)

I don't really consider COBRA government intervention per se.

But the Departments of Treasury and labor have jurisdiction over private sector group health plans and the Department of health affect the public sector health plans. IRS and the department of Treasury issue regulations on who is eligible and how much they are covered.

Quote:

Originally Posted by ceilirose (View Post)

Also I don't know that some government intervention isn't a bad thing. I shudder if health insurance is turned over to profit making organizations in it's enitirety. It would be chaos.

I agree with the chaos part. ,but the reason I don't think healthcare should be monitored by the gov is because it would be more costly and seemingly inefficient. It would lead to more taxes, longer waits and denials of coverage. Even though the system has worked for sunnykerr, I imagine she is paying more than 15% more in taxes. I work in a cancer lab and at our clinic just yesterday a woman from Canada came to get chemotherapy and surgery because she said it would be months before she could have it at home.

Also, hospitals are supposed to be non-profit. Charging patients with insurance less than without isn't non profit. But on the other hand, a standard health care plan would end up costing some people a lot more. I think the plans should be left up the the individual families. If your child has asthma or something reoccurring and are in the hospital more often than normal, then they should be able to pick a plan that covers that

ceilirose · 06-24-2008, 10:29 AM

Quote:

Originally Posted by 4N6 DNA (View Post)

But the Departments of Treasury and labor have jurisdiction over private sector group health plans and the Department of health affect the public sector health plans. IRS and the department of Treasury issue regulations on who is eligible and how much they are covered.

Can you link me to site that explain those jurisdictions? I'm not an expert on health care but COBRA was passed by Congress in the 1980's and helps (at least in one instance) people who are transitioning between jobs and need to cover their health care needs. For me personally it was a Godsend. If it's a law passed by Congress then yes - the government will oversee it. I don't see anything necessarily wrong with that unless you can provide information otherwise.

Quote:

I agree with the chaos part. ,but the reason I don't think healthcare should be monitored by the gov is because it would be more costly and seemingly inefficient.

LOL.. I don't know where you live but health insurance by private companies is anything but cost efficient and organized. I broke my leg last year in an accident and I have pretty good insurance. For five hours I waited in a gurney in a hallway by a men's room until someone could come and tell me what my diagnosis was. They were short staffed that day and I had to get myself from a wheelchair to an x-ray table on a broken leg - let me tell you it was not a pretty sight.

After they told me I didn't need surgery I asked for some water and the nurse looked at me like I had asked for her newborn. I didn't get any water until a friend came to pick me up. And a painkiller? Forget it - I was given a prescription and had to fill it myself later. And then while I was waiting for my friend to come pick me up the head nurse kept on telling me I had to leave because they needed that spot on the wall for another patient. I was ready to leave, believe me, but with my right leg immobilized it would have been difficult for me to drive. I understand that hospitals are terribly short staffed and their staff are overworked but this is with a free market system.

I was just one story that day - there were others waiting to be seen waiting in that hallway. All of us with legitimate emergencies. The tally for me that day without insurance was about $5,500.00. All told it was about $9,000.00.

Quote:

It would lead to more taxes, longer waits and denials of coverage. Even though the system has worked for sunnykerr, I imagine she is paying more than 15% more in taxes. I work in a cancer lab and at our clinic just yesterday a woman from Canada came to get chemotherapy and surgery because she said it would be months before she could have it at home.

Again - I don't know where you live but I can wait months to see a dermatologist and I schedule my ob/gyn appointments at least 6 months out. I wait now for regular appointments for weeks anyway so that doesn't scare me off.

Someone can correct me if I'm wrong but with single payer health insurance I don't know that taxes will increase that much. WIth Obama's plan the intent is to not have coverage denied because of pre-exisiting conditions.

Frankly I'd rather pay higher taxes for heath care, schools, roads than seeing my tax money squandered overseas.

**sunnykerr** · 06-24-2008, 06:42 PM

Jessie - I think the question becomes whether that woman paid for her own treatment. Like I said, our system isn't perfect, but they're trying to find ways to work it out. My mother has a few friends who were sent to the States to get surgery, too. Because the wait would have been too long up here. But the government still paid for their care.

And I don't know how much I pay in taxes, but it's not in any way crippling, I have to say. And I'm not even a middle-class earner.

I have absolutely no objections to government paying for sex-change operations as I don't consider those an elective surgery. Not when there's such a profound psychological aspect to them.

I don't feel it takes away from people requiring life-saving surgeries as those are two different fields of medecine and, thus, surgery.

I also don't feel it would be right tp expect a parent whose child had asthma to handle the financial costs of medical care for their child. Health is not something anyone can anticipate or predict. I feel that expecting parents (or anyone) to have any given health coverage because their child has a certain condition is unfair pure and simple. It puts an unfair burden on the poor or the middle class. Not to mention that it leaves the care of the person in need of it up to some third party who, by definition, is approaching the whole situation from a business perspective. I feel that, whenever someone is sick or injured, they should be given care. No middle man health-insurance company, no hospital bills. Just care.

sm_love_dc · 06-24-2008, 10:56 PM

I believe that getting medical attention is for everyone, not just for those who can afford it. Yes the wait times would be longer. But I guess that is the price you pay. Knowing that if I could afford it and I could go anywhere is not a convinence that everyone has. We ( Canadians) may get a 2 tierd system that is more structured in the future; I hope that it does not come at a cost to those who can afford medical.

**sunnykerr** · 06-26-2008, 07:07 PM

In theory, I have no opposition to a 2-tiered system. From what I read, it seems we already have one. We just don't like to know it. So, hey, as long as it stays this thing that rich people know about and the rest of us don't suffer for, I think it's all good.

My big worry is when it becomes more mainstream. Because, then, you start in on the whole thing where doctors may go where they can get a better profit for their services. And it's already not the greatest situation for nurses.

I don't know. It seems to be so obvious that business and medecine should be two entirely separate entities.

ceilirose · 06-26-2008, 07:25 PM

Medical care's state of denial

This link is to a story about cancer patients in California and the battles they have when their doctors order tests which their insurance companies then don't approve. It's a long one so I'm only showing some of it.

My question is - do other countries that have universal health care run into these same issues?

Quote:

06-22) 17:38 PDT -- Doctors are supposed to prescribe tests and treatments that are medically necessary for their patients. Health insurers are expected to cover that care, while keeping inappropriate expenses in check.

But what happens when that process breaks down and sick patients are left to fight for medical care?

Each year, thousands of Californians find themselves at odds with their health insurers over whether they, as patients, should get the treatment their doctors prescribed.

Peter Isgro of Santa Cruz is among them. His insurer, Anthem Blue Cross, stopped paying for certain chemotherapy drugs after his cancer progressed, a decision that has been upheld in two appeals.

Isgro said he feels like the insurance company is second-guessing his doctor. "If your doctor wants to give you something and they can deny it, that's wrong," he said.

Anthem Blue Cross said it follows strict protocols, relying on medical evidence in determining what is necessary and appropriate to cover.

"Even in a dire situation, it is ethically appropriate to withhold treatment if it's not effective," said Dr. Michael Belman, medical director of Anthem Blue Cross, who was not speaking specifically about Isgro's case. Belman said doctors do not always recommend the best treatments, and cost is never a primary consideration.

Consumer advocates, however, see the situation differently.

Health insurers "are going back to the old strategies of the '90s, when they interrupted care on the front end by denying or delaying treatment offered by a doctor," said Jerry Flanagan, health advocate for Consumer Watchdog, a Santa Monica group. According to him, insurers hope patients will give up or settle for less, either way saving them money, a contention the companies dispute.