Canadian health-care groups vow to fight move towards private system

[struggle4progress]

Lisa Arrowsmith
Canadian Press

August 18, 2005

EDMONTON (CP) - A move by Canada's doctors to support a parallel, private health care system is a wake-up call to Canadians and politicians to move quickly to protect medicare, national health advocacy groups warned Thursday.

Members of the Canadian Medical Association, who say they're frustrated with long wait times for patients, decided in a vote at their annual meeting in Edmonton this week that patients who can't get timely care in the public system should be allowed to use private insurance. <snip>

McBane argued that supporting a parallel, private health system has little to do with cutting wait times and a lot to do with lining doctors' pockets.

"It seems to me they're putting their economic interests ahead of their patients because all the evidence shows that the two-tiered system that they're advocating actually produces longer wait times," he said. <snip>

http://www.canada.com/health/story.html?id=854938a0-80d4-43cc-8f13-b7c5053046d9

[bonito]

1. I have fond memories of Canada

My dad was Born there, don't get snowed.

[area51]

2. "patients who can't get timely care"

Newsflash: in our horrible U.S. for-profit {w}ealthcare system, you don't get timely care. Folks, you don't want to move toward a system like ours.

[Maple]

3. This would be the same as the UK

and France and so on have got.

Only Canada forbids having private insurance.

[iverglas]

7. and ... that's a good thing?

Only Canada forbids having private insurance.

And ... that's a bad thing?

Are we hearing the Liberal line?

Ever spent any time in the NHS?



edited to make it coherent ...

[Maple]

13. Well we had private insurance

until a relatively short time ago. Blue Cross etc. It's not like this is unheard of.

Other countries have it.

I personally don't have a problem with it, and neither do most Canadians.

Health care is only going to get more expensive...it's not only becoming more high tech, but boomers are getting older.

Liberal?? They're opposed to it.

[SidDithers]

18. They're talking about queue-jumping...

not supplemental insurance like Blue Cross.

Sid

[Maple]

19. They're talking

about a lot of things.

[iverglas]

21. ah, the cry of the Liberal is heard in the land

I personally don't have a problem with it, and neither do most Canadians.

Le Canada, c'est moi.


Health care is only going to get more expensive...it's not only becoming more high tech, but boomers are getting older.

Uh huh. So, adding the cost of administrative inefficiency (administrative expenses account for twice as high a proportion of health care costs in the US as in Canada, per capita health care costs in the US being enormously higher than in Canada all round) -- and a healthy profit margin -- to allegedly already high costs is going to ... oh, that's right. Make health care cheaper. And more accessible. Got it.


Other countries have it.

Other countries probably jump off bridges, too.


Liberal?? They're opposed to it.

Uh ... yeah.

[Maple]

24. The Cons want private insurance

The Liberals do not. The NDP can't even discuss it without getting emotional.

According to polls the majority of Canadians have no problem with it.

Health care is a huge budget item, and it's only going to get worse. Eventually, without a change, it will eat up the entire budget, and there will be no money for anything else.

A lot of money could be saved by having the feds and not the provinces, run it. The Feds hand over a great deal of money...the provinces don't account for how they spend it. A lot of hockey rinks were built with dollars meant for healthcare...that buys local votes. Then the provinces run their annual beg-a-thon amidst much fed-bashing.

None of this addresses any problems.

[CHIMO]

27. I Suspect

That there may be some kool aid in that.

Sounds like what I hear from politicians.

Just think about it for a minute.

What if one were to compare it as a percent of say GNP. How fast is it rising.

I say kool aid because what has happened in many cases is that services that used to be provided for free, or at a loss, are now charged for separately on a cost recovery basis. One can see what that does. It reduces the expenditure and every item remaining becomes a bigger percentage. Magic.


Shoot the hippo.

[Maple]

29. We have a problem with the system

and it needs to be fixed.

We can't do that by discussing kool aid or hippos.

[CHIMO]

30. Ok

Enjoy.

[iverglas]

28. Liberal math

Health care is a huge budget item, and it's only going to get worse. Eventually, without a change, it will eat up the entire budget, and there will be no money for anything else.

Whereas ... if we stop paying for it through taxes and minimal geared-to-income premiums and have to start paying (either for insurance or for services) out of our pockets ... the loonies will magically materialize there for the purpose.

I will save, say, the $1000 a year that it costs me in contributions to the public plan in order to have the privilege of paying $2000 to get the same services privately.

Or heck, maybe I'll be lucky (i.e. young, which tends to mean not too flush in ready cash) and be healthy for a while, so I'll use that $2000 for something else instead of buying health insurance, and then boom, a load of snow will fall off the neighbour's roof onto my head and I'll be in hospital for a few weeks, and I won't have the money to pay for it ... and oops! this is Canada, so probably there's going to be some rule about how I can't get turned out onto the icy sidewalk because I can't pay for my post-op care and physiotherapy and rehabilitation services ... so the gummint will pick up the tab ... and bingo! I really will have free health care. It's just that everybody else will be paying my share of my own medical expenses (higher than before as they now are, in the private system) and I won't be paying any.

The Paul Martin school of economics, I suppose. Where you go to get a degree in I'm All Right, Jack, and How to Make People Believe Almost Anything.

I give up. If we stop paying for health care out of the common purse by collecting the money to do that on an equitable basis, where is the money that will have to be paid out of private pockets for the same thing going to come from?

Is this what they called Voodoo Economics? Abracadabra, you can now afford to pay for stuff all by your lonesome that we can't afford to pay for all together.

According to polls the majority of Canadians have no problem with it.

Apparently Liberals have special polling systems, too.

Well, actually, all they need is a few well-placed "opinion leaders" on their side ...

So yes, let's govern by opinion poll. Let's make the welfare and security and prosperity of our population a matter to be decided based on what somebody had for breakfast and how many public finance courses s/he didn't take at school and how many media outlets in his/her locality are controlled by friends of big insurance companies. By all means.

A lot of money could be saved by having the feds and not the provinces, run it. The Feds hand over a great deal of money...the provinces don't account for how they spend it. A lot of hockey rinks were built with dollars meant for healthcare...that buys local votes. Then the provinces run their annual beg-a-thon amidst much fed-bashing.

None of this addresses any problems.

Of course, that kinda assuuuuuuuumes that there are "problems".

I'd be perfectly happy to have public health insurance run federally, just as I'd be perfectly happy to have a lot of other things run federally ... except for the little problem that I don't trust the Liberals to do anything in my interests, and as long as things are being run provincially, we may have to deal with Alberta, but we can rely on a few others at one time or another to set the bar slightly higher and provide some counterweight. Federally, at the moment, there's just as likely to be none.

[Maple]

31. The public system would remain in place

and since it would look after fewer people, it would have more money to do so. Private insurance allows people who can afford to pay, to do so.

Why you wish to subsidize the well-off when there is no need to, I don't know.

We have a problem with the current system. Your insistance on blaming Liberals...who oppose private insurance...isn't going to fix it.

I personally don't have a problem with either system...but it has to be run properly.

[iverglas]

35. I find it hard to believe, but you must be serious

The public system would remain in place
and since it would look after fewer people, it would have more money to do so.

Ah yasss. The gummint would just keep on collecting the same amount of money from everybody for services (insurance) that only some people would be using, while others paid directly for their own services (insurance).

The gummint would have the same amount of money ... and the rich folks who wanted to buy their own insurance would just have to cut back on the foie gras.

Yes, that's a vision of a sustainable future, indeed.

Have you thought of all the problems this voodoo would solve?

Why, just imagine all the money the public schools would have if the rich took their children out and put them somewhere else.

Oh, that's right! A bunch of people do want to do just that! And oh look! They want their tax dollars back to do it with!

Private insurance allows people who can afford to pay, to do so.

A public system that mandates public insurance and allows private insurance MAKES people who can afford to and choose to pay for their own insurance CONTINUE TO PAY for the public insurance EVEN IF they never use it.

Oddly enough, we might expect those people to vote, and perhaps even in higher proportions than the less well off.

Gee. I wonder what might happen next.

People who can afford to pay for their own health insurance are going to find that pot o' loonies at the bottom of their pockets for the purpose, AND keep smiling while they pay for everybody else who chooses not to spend that money.

Yup. Right around when pigs are flying.

Why you wish to subsidize the well-off when there is no need to, I don't know.

Why you would sit there with your bald face hanging out and call our present sytem "subsidizing the well-off" when it is no such fucking thing is beyond me.

The health care system is funded mainly out of general revenues -- which are raised, in terms of the costs to individuals, mainly through progressive income taxes -- income taxes that are paid at higher rates by the well-off than by the less well-off.

How in dog's name could you characterize this as "subsidizing the well-off"?

If the well-off were being subsidized, why on earth would they be so anxious to start pulling loonies out of their pockets (and OBVIOUSLY planning to voice a little objection to continuing to pay the costs of the public plan -- isn't the whole idea to make those costs go down??) to get what they're getting at such generous rates now?

We have a problem with the current system. Your insistance on blaming Liberals...who oppose private insurance...isn't going to fix it.

What the FUCK are you talking about??

I mean, actually, sure, I DO blame the Liberals, and specifically Paul Martin who did his damn'dest while he was running the show the first time to shred the social safety net in general and health care in particular.

But I haven't said a word to that effect in this thread, and that fact isn't relevant to anything I've said in this thread, or anything anyone else has said, as far as I can tell.

And your bottish insistence on the "Liberals oppose private insurance" mantra is just laughable. Do you really think that there's a big market for this propaganda hereabouts? Many, many people here are going to read what spews out of party HQ through your keyboard, and say why yes! that's right! the Liberal Party is all things to all people, but mostly it's for standing up for the little guy against big business! that's our Paul! Go, Liberals!

See Paul Martin
Lying there in the sun
All things to everyone
Run, run away

Maybe you've got a little social credit up your sleeve to solve these awful pie-slicing dilemmas? Need more money for health care? Spend the same amount only on fewer people, let the other people pay for their own ... and mint a few billion loonies for them to do it with.

Make that pie higher!

[Maple]

37. This isn't really the place

to discuss the Canadian healthcare system, as it's reserved for breaking news, and a genuine debate on the healthcare system could easily generate several hundred posts.

Healthcare however has several problems and they need to be solved.

The entire system should be overhauled, top to bottom, and then looked at again, every 7 years. 5 years is too often, 10 years is too seldom.

And preferably by people outside the system, perhaps by a European team, so the ideology and emotion is kept out, and some objectivity can be brought into play.

[Spazito]

39. Ideology is what our healthcare is built upon and is essential

in any discussion of our system. Here are the CORE VALUES that are the essence of our healthcare system:

Core Values - Our Values in Action
The Dialogue on Values and Ethics resulted in the identification and description of the following core values for Health Canada . In pursuing and fulfilling our vision and mission, we achieve personal, organizational and public good by:

Taking Pride in What We Do
We are motivated and guided by our personal integrity.

A We recognize our potential
B We take the initiative to improve ourselves and the way we do things
C We act with sound judgment

Building a Workplace Community
We respect each other and work together in a healthy environment.

A We embrace diversity and nurture empowering relationships
B We communicate honestly and effectively
C We create an environment that promotes learning and innovation

Caring for the People of Canada
We advance the public good with purpose and passion while honouring democratic values.

A We provide credible information, reliable advice and quality services
B We establish and maintain good working relationships with our stakeholders
C We responsibly and wisely manage resources entrusted to us

By being accountable for our values and their integration in our work, we lay the foundation for excellence at Health Canada.

Link: http://www.hc-sc.gc.ca/ahc-asc/activit/about-apropos/index_e.html

To say ideology and emotion should be kept out is ludicrous and is code for 'profits above all', imo. Corporations believe that, citizens do not.

Edited to add the 5 criteria that govern our Canada Health Act:

The five criteria of the Canada Health Act are:

public administration: the administration of the health care insurance plan of a province or territory must be carried out on a non-profit basis by a public authority;
comprehensiveness: all medically necessary services provided by hospitals and doctors must be insured;
universality: all insured persons in the province or territory must be entitled to public health insurance coverage on uniform terms and conditions;
portability: coverage for insured services must be maintained when an insured person moves or travels within Canada or travels outside the country; and
accessibility: reasonable access by insured persons to medically necessary hospital and physician services must be unimpeded by financial or other barriers.

[Maple]

40. Healthcare should be built on healthcare

Not ideology or emotion.

That is not a 'code' for anything, just common sense.

Mission statements are a dime a dozen.

Outcomes are what matter.

[iverglas]

42. there's a Liberal office missing a red book somewhere ...

jeez, ya write a post that has no content, and ya can't even get that right ... there's *a* Liberal office ...

No sleep for the wicked, here.

[Spazito]

44. ROFL, I know, outcomes aka profits are key to SOME

The right to adequate healthcare for all is a VALUE, values are what determine the direction a country takes with regard to the care of it's citizens. Values are based on ideology and emotion.

[iverglas]

41. well, I guess you fixed my little red wagon

Maybe we should get you to "fix" the health care system.

If things can be fixed by spewing propaganda and slogans at 'em, you should have it done in no time.

[Maple]

43. I specifically stated

that we need an objective look at the healthcare system in order to prevent just such reasoning.

Ideology doesn't solve problems.

It just makes the problems impossible to discuss.

So I will leave you now, and you can all debate the finer points of dipper philosophy on your own. Bye.

[iverglas]

45. wait! you can't leave!

we already kicked yer ass all over and out the door.

[Maple]

46. Sorry....can and did

Ciao.

[Spazito]

47. ROFL!

:thumbsup:

[not fooled]

4. Why do I suspect...

...that this has maybe something to do with boosting MD's incomes? Canucks, could this be a motive??

[nine23]

5. That's a big part of it. Good call on recognizing it as you did.

Prior to a major career change, I was an Trauma/ER RN at a big downtown hospital in Vancouver for 15 years. (That's 15 years of slow/boring night shifts shooting the breeze with doctors from all specialties...)

They were all frustrated to no end that the Mercedes 500 class would have to be put off for a couple of years after graduating from med school.

[iverglas]

8. first thing I thought when I read of the doctors' communiqué

... foxes ... henhouses ...

[SoCalDem]

6. There already IS a parallel system.. It's for the rich, and it's

called The USofA.. These are the people that our politicians love to talk about.. Ther ones who "have to wait months to see a doctor or schedule surgery".These are the rich Candians who can (and always have) hooked up with "celeb" doctors in the US..They do it for convenience and because they CAN ..and perhaps they tie it all into a "business trip" south, and claim the whole thing as a business expense anyway.

[I concur]

38. Exactly, if they don't like waiting and...

...if they don't like a free universal health care system, tough! No one can help getting sick and have to pay through the nose when they do become ill! There also should be an age triage practice where these elderly rich farts on their last legs go to the back of the line for service (especially for organ donations), and younger poorer sick people (who can STILL contribute to society) have the more premium and faster care!

[ret5hd]

9. wife and i made a trip to the calgary area two weeks ago...

(actually going to glacier national park in montana)]

during our 3 days in canada, we asked countless working people (cashiers, shopowners, waiters, etc) if they would like to participate in our informal poll.

everyone asked said yes.

we asked: would you trade your healthcare system for the healthcare system in the u.s.?

our answers ranged from: 'not in a million years' to 'hell no' to simply 'no' to 'never' to ...

in fact there was only ONE person that felt differently: a bartender in a casino bar in calgary...and it turned out he was a u.s. citizen.

[Spazito]

10. The most recent poll has Canadians happy with their healthcare

system and that won't change regardless of what greedy doctors and private corporations would like to try and say otherwise.

[iverglas]

11. I wish I were that certain

I'm pretty optimistic ... or lazy ... when it comes to a lot of things. It'll all be all right on the day, and all that.

This one, I'm starting to be not so sure of. There's a reason why the simple obvious good-ness of public health care has never been grasped by a majority of USAmericans, and it pretty much comes down to money: the money spent to prevent them from knowing the truth, and to persuade them to believe lies.

A whole very big lot of money is going to be spent to persuade us that we here don't already know the truth, and the truth is something else altogether from what we've been living.

I'm worried. Not just about the immediate effects on health care if things go wrong, but on the effects on "Canada", the essence of the thing. And on the world.

We've been among the world leaders in the economic democratization of society (not that we've caught up to much of Europe in many ways yet -- and that's part of my point), and we've held out pretty well against some pretty bad recent right-wingery abroad in the world. There appears to be opportunity at hand these days, in terms of a slight loosening of the grip the right-wingery has had on the course of events, but I'm not seeing advantage being taken of this. To not only lose that opportunity but also put up our hands and give away what we've got would be unforgivable.

If we let our system slip through our hands, if we even start letting rats in through the cracks, we're going to have a very long rough road to walk back. We'll be fighting some very rich and very powerful and very motivated corporations, with the full force of NAFTA behind them, and it will be a lot different from what it was when Tommy Douglas only had to worry about the doctors.

[Spazito]

14. I agree, I am far from complacent for sure

Once the private HMOs from the US get even a crack in the door, we are in deep shit, imo. The pressure has to be put on both the Liberals and the NDP while we have a minority government. The NDP has clout it can use and I have confidence it will on the specific issue of universal healthcare.

On the larger issue of right-wingery, bush has done a great deal to make many in the world take a second look at how destructive it is and how it serves only the very rich at the expense of everyone else. What will happen next is hard to say given we have NAFTA, there is CAFTA, the IMF, etc, fighting hard to maintain control of the agenda.

[Bassic]

12. They will fight, and we will fight with them

Execpt of course for rich people and a few of the yuppies.

Selfish, near-sighted people all.

[CHIMO]

15. Kinda Hard

To fight something when it appears from some of the posts here that there is a combination of ignorance and kool aid poisoning by a lot of people.

If you want to keep the system you have to make sure that the provincial politicians support it.

They recent ruling on private insurance was only for the provence of Quebec. It was not against the federal government for the simple reason the federal government doesn't have that rule.

Quebec already has doctors that have withdrawn from the system and are charging for their services. So how are you going to stop that. It is already there.

I am sure that the doctors don't expect everyone to pay three to four thousand dollars per person per year for health insurance. No. You can bet your bottom dollar, that they expect the basic coverage to come from the public insurance as now and the private insurance would cover the wine and cheese part.
So if we have two systems and a shortage of doctors, how many doctors do you think wouldn't want the extra money from the private part.

If it is too expensive now, how in the hell do you expect that it will be cheaper with private insurance. Do they have their own printing presses?

As I said a lot of people don't know what the hell they are talking about. They only have themselves to blame.

[Spazito]

16. Under the Canadian Health Act, the federal government can have

the control by way of withholding funds from the Provinces if they go to private insurance, etc. It is relatively simple to protect our universal healthcare from these latest hits by strengthening the Act with additional legislation on the conditions for withholding federal funds. The big question is: Do our politicians have the mettle to do that? We need to keep on them to do exactly that, imo.

[CHIMO]

20. You

Are looking at how the funds are managed to the provence. If a group of doctors decide to get together and open a hospital with no funding from the government there is nothing to my knowledge in the Canadian Health Act to prevent that, nor to reduce the funding to the provincial government. As long as the provincial system is there to provide the service they have met the requirement. There may be provincial requirements from the medical association to approve things.

So where does the present system prevent this?

If it not outlawed at present then why aren't those doctors doing it now?

[Spazito]

33. Doctors want to 'double dip', imo, they want to receive government

payments PLUS additional monies through their 'private' practices. Canadians can currently go 'south' and pay for services if they want, most don't, even if they can afford it.

I do think Parliament needs to look at the Canada Health Act and strengthen it in order to make it even more difficult and less profitable for those who wish to opt out. Tax the hell out of them and put those taxes back into the public system. You can bet those pushing the 'private' insurance, etc, won't like that.

[CHIMO]

36. Agree

When the plan was first brought in there was resistance from the doctors. It was communist, takes people's freedom away etc. etc. When it was finally working there wasn't too much of a problem. In fact I believe that the doctors even thought that it was OK, as they didn't have to wait a week for the chicken or turkey and hope that it didn't die before they got their payment in some cases.
It seems that the whole thing at present can be traced back to the budget cuts that Martin made in the nineties. He cut funding and gave tax points to the provinces. Well the provinces got into a fight to see who had the lowest taxes. Then when the fiscal system got better they didn't bring back funding for health fast enough.

One thing that I find funny in the present discussions between politicians and doctors is the absence of industry. They are not stepping up to keep the plan in order to keep costs down. It almost seems like they think that a private system will come only from the individuals pocket.(I can just see them in that scenario, "We can't afford more or our competitors will put us out of business) Yet we are supposed to allow industry set the rules for NAFTA.

But no one seems to mind.

I think more funding has to come from the feds and then they have to carry a big stick.

Unfortunately some people seem to think that a parallel system would be better. Perhaps they can't concentrate long enough to think it through or it is a belief.

But we have allowed our premiers to eat away at the system without holding them accountable as well.

[Maple]

17. Some of us

have also lived through all 3 systems.

[CHIMO]

22. Great

So have I. And my parents were saddled with a huge bill that took over ten years to pay off. Believe me it wasn't universal. The only universal part was the money.

[iverglas]

23. mine were lucky

When I spent 3 months in hospital in 1960, my dad had workplace insurance. Apparently they had a $100 bill to pay at the end of it. Had it not been for the insurance, I don't imagine they would have had a house at the end of it.

In 1958, the house cost something like $9,000 brand new. It's probably worth about $150,000 today (they're long gone from it, of course) -- not an upper middle class house, not a place where people with kids who have money in the bank choose to live. A place where people working all the hours they can get, to get a foot on the property ladder and a back yard in a relatively quiet neighbourhood, start out. And that's without losing a few hundred bucks a month to cover private health insurance, as people do in the US. I don't imagine there'd be much of the house left at the end of a three-month hospital stay if their health care were privatized and they didn't have that insurance, though.

I'm with you. Anybody who doesn't see the rats waiting to chew the structure down, one way or another, once they get in a crack just isn't looking.

After all, health care is only going to get more expensive as demand from an aging population rises; read: the market is only going to get more attractive to profiteers.

[Megahurtz]

25. Is Canada following the lead of it's neighbors down South?

You don't want to do that, that's a disaster waiting to happen!:hurts:

[Maple]

26. No, there is

no wish to do that. The Canadian public would never accept it.

[Megahurtz]

34. Good.

I don't want to see Canada ruined!

[CHIMO]

32. Bang Head On Table

It feels nice when you stop.

[JMDEM]

48. Our experience has been a nightmare

I have not posted to DU in quite some time, but I saw this thread today and had to respond.

My family and I are in Calgary, as I attend the University of Calgary PhD program. When we came up a year ago from the US, my wife had a spinal condition known as a spinal syrinx, which is a bubble of fluid in the center of the spinal column. It was caused by an automobile accident. At the time we came up here, the syrinx was stable, and our US doctor told us that she might be able to just live with it for quite some time -- she might need an operation in 10 or 20 years.

About 8 months ago, my wife started experiencing severe pain from the syrinx. This is significant, because these things can kill you. She needed to see a neurosurgeon.

Well, we found out that in Calgary, you need to first get into a waiting list to get pre-screening. Once you get pre-screened, you need to get into a waiting list for treatment. So -- it took us 6 months to get pre-screened. They took MRIs at the time (which is a miracle -- there's only one MRI machine in all of Calgary) and found that the syrinx had shifted significantly up towards the brain. It's been 3 months since the MRIs, and they are just now getting around to discussing her case. She still hasn't actually seen a neurosurgeon yet. We've been informed that if she is approved for an operation, it will be 8 months before she can get treated. So -- we are looking at 6 months + 3 months + 8 months -- 17 months, since we've tried to get help to the point where we might get help. My wife may be dead by then.

My daughter caught pneumonia last March. Waiting time at the hospital? 7 hours. At the time, there was an 80+ year old woman who had been waiting 10 hours -- her family was taking 2 hour shifts staying with her.

In one of our excrutiatingly long waits at hospitals, we talked with a nurse whose mother had died of cancer. The nurse told us that her mother began having peculiar symptoms, but it was four months before they took tests and began treating her. If they would have begun treating her immediately, she would have made it. She died, due to the delay.

Despite being in agonizing pain all of the time, my wife cannot get to see a pain specialist. Her general practicioner doctor prefers to insinuate that she has a drug problem, and meter out small doses of pain medication. My wife has now been completely incapacitated with pain for the last several months. The doctor refused to refer her to a pain specialist. We finally did an end-run around the doctor and had the spinal pre-screening clinic refer us to a pain specialist, and have found out that the average waiting time to see a pain specialist is 1 year. So we may get to see one in one year. In the meantime, my wife is in sheer hell -- sheer agony 24 hours a day.

This is not propoganda. I'm a liberal demorcrat who fought ferociously for John Kerry, and have had nightmare experiences with the US health care system too. This is my direct experience of the Canadian health care system. Things are seriously wrong up here.

[Spazito]

49. I don't understand, are you and your wife now Canadian

citizens or holding dual citizenships? This is not a criticism, just trying to understand how you are getting coverage from Medicare.

I have quite the opposite experience. My brother-in-law, who passed away three weeks ago, received excellent, timely care throughout the whole difficult time. He died of cancer.

Re your wife's doctor, if she is unhappy with him, within the Canadian system, she is free to find another.

[JMDEM]

51. We are eligible because I am a PhD student

Canadian laws allow PhD students to enroll themselves and their families into Medicare. We also carry the school's supplementary insurance ($900 a year) as well as Blue Cross supplementary insurance ($1000 a year).

Well, I don't know how to explain your experience versus ours, but ours has been a horrendous nightmare.

Your suggestion about switching doctors is a good one, except that there is a severe shortage of GPs in Calgary. We were told that we were lucky to find any GP willing to take us on.

[Spazito]

54. Thanks for your response, it is much appreciated

I was unaware of the allowance for enrollment of PhD students into Medicare, a wise decision on the part of government, imo.

I am very sorry about your wife's experiences. I hope things improve for her very soon.

I can honestly say, among my family and myself, including my adult children and grandchildren who reside in Alberta, our experiences have been much more positive than negative.

Don't listen to everything you are told, especially in Alberta where there are those who WANT universal healthcare to disappear for their own monetary purposes. Double check everything before assuming it is fact would be my advice.

[JMDEM]

60. I will keep you informed on my progress

the person who posted the link to the web site about the average wait time for neurosurgery really provided me with some powerful arguments to bring to the table. 4 weeks! Not 8 months. I'm gonna really raise some hell now, and find out just what is going one.

[Spazito]

61. Great, I would appreciate knowing what happens for sure

No one should have to go through what your wife is, I am glad CHIMO was able to help you.

[JMDEM]

67. Newest news -- received today

As I answered to a different post:

A neurosurgeon reviewed my wife's MRIs (taken 3 months ago) and stated in the record that it was his opinion that she did not need surgery, therefore we will not be put in the waiting list at all.

My wife has never been seen in person by any type of doctor except a general practicioner. No neurosurgeon has ever seen her in person.

We have it officially on file that my wife:

1. Is experiencing excruciating, unbearable pain that not even morphine will control.

2. Is rapidly losing sensation in the right side of her body.

3. Cannot feel heat/cold at all any more on the right side of her body.

4. Has had her entire right side become paralyzed for brief periods on several occasions over the last 8 months.

These are all classic symptoms of syrinxes. CLASSIC. Yet the neurosurgeon spends 5 minutes looking at MRIs and says "no surgery". He did not meet with her. He did not test her pain sensitivity or reflexes. He did not do the standard pinprick tests on her body. (This is where the doctor pokes you with pins on your backside, and you can't see when he pokes you, and you have to report what you feel.)

Only surgery will relieve the symptoms.

We have been told that we can now get in line to see a neurologist (which I guess is different from a neurosurgeon) but that the waiting list is 6 months or longer.

[iverglas]

68. two separate problems ...

One is that you're dealing with a professional, a member of a self-governing professional body (the College of Physicians and Surgeons), who has made a decision that it is within his professional purview to make.

The health insurance plan specifically does *not* interfere in those decisions. That's actually one of the big good things about the Canadian system -- it is doctors, not insurance administrators, who make medical decisions. If the doctor in your wife's case had decided that she did need surgery, the health insurance plan would not have been able to step in and say "no she doesn't".

So as far as the actual standard of care she is receiving goes, your recourse is a complaint to the College of Physicians and Surgeons of Alberta:
http://www.cpsa.ab.ca/home/home.asp

And of course that isn't exciting news. But it's possible that if you did make a complaint, it could lead to the neurosurgeon, or another neurosurgeon, reviewing her case, as part of an effort to settle the complaint.


The other problem is not knowing what role scarce resources is playing in the scenario. In a private-insurance system, you would be just as much in the dark, unless the physician you were dealing with chose to tell you that s/he recommended surgery but the insurer refused to authorize it. (Many physicians might be reluctant to tell a patient this, for fear of being dropped from the insurer's roster.)

While physicians in the public-insurance system do play a role as gatekeepers for access to resources, they are primarily professionals and not resource-allocators, and that should not (and really does not appear to) play a role in their diagnoses and treatment plans.


It doesn't appear that it is the health care system that is the source of whatever problem there might now be in your wife's care, at least in terms of the refusal of surgery.

If her primary care physician is prepared to act as her advocate, which s/he definitely should do, there is no reason why a second opinion could not be requested, from another neurosurgeon.


If your wife had a previous valid diagnosis of a syrinx, which she seems to have had, and if surgery really is the only option for correcting it, then you're entitled to know *why* the neurosurgeon is recommending against surgery. A second opinion -- either on referral from her primary care physician or as a step in the course of a complaint to the College -- could result in a different recommendation, or could result in the same thing. Unless you know the *reasons* for the recommendation, you don't know how to proceed.

You're entitled to see the letter from her physician requesting the neurosurgeon's opinion, and you're entitled to see the neurosurgeon's opinion. (These are straightforward -- for example, I have copies of the letter from my doctor referring me to a surgeon for consultation about an abnormality in a mammogram, and of the letter to her from the surgeon reporting on his findings.)

The letters will tell you what findings were reported to the neurosurgeon, in addition to the MRIs -- e.g., the results of any "pinprick" tests done by her own doctor, descriptions of her pain, etc. If this information was *not* included in the referral information, you need to ask why, and perhaps insist that it be submitted to the neurosurgeon for reconsideration; or, if the information submitted doesn't reflect her current situation, that it be updated as a follow-up to the neurosurgeon.

The primary care physician *does* have a responsibility to advocate for the patient, and to ensure that specialists have all of the relevant information ... and is also subject to the College complaint procedure. You're entitled to know why s/he accepts the neurosurgeon's recommendation and isn't seeking a second opinion, which is what appears to be the case.

Mainly, you really do need to know *why* the neurosurgeon has recommended against surgery, in as much detail as you need, and with as much explanation and opinion from the primary care physician as you need, in order to make your own decision as to whether you believe the standard of care she is receiving is adequate. It might actually be that surgery is not the best plan of action, although in that case there should of course be some better plan than to wait 6 months to initiate action on it.

There just doesn't seem to be any way of having the professional decisions of a physician reviewed by the health care plan authorities (as there really shouldn't be), and the no-surgery decision really does seem to be a matter of professional practice, rather than a matter of resource allocation. If you get the answers you need in order to evaluate that decision, which you're entitled to get, you can pursue the options that are open to you in that respect (request second opinion, complain to the College).

Not fun, but about the only thing to do. Good luck and best wishes still.

[CHIMO]

50. MRI's

The following site is just one in Calgary. I am sure that there are more. This one site appears t0o list three locations for MRI.

Seems funny one MRI for a population of nearly one million.
http://www.mayfairdiagnostics.com/patients_index.php

[JMDEM]

52. This is what we were told -- perhaps we were told wrong.

Maybe they just don't like Americans very much, and we are getting the runaround and bad information.

[rman]

53. ok, but is fixing it = privitization?

i don't think so

[JMDEM]

56. you are reading me wrong

I have had nightmare experiences in the US too. When my wife and I got married, I immediately called to put her on my health insurance. Eight weeks went by, and they said that they had lost the paper work and had to start over. By that time my wife was pregnant, and the insurance company refused to cover her, even though it was their fault for losing the paperwork. In fact, I found out that NO INSURANCE COMPANY in the US would pick up a pregnant woman. Her pregnancy cost us $20,000. (C-section, gestational diabetes).

No, I am not preaching for privatization. I don't know what the answers are. The US system is severely damaged -- in fact deranged. But our experience has been that the Canadian system has severe problems too. I don't know what the answers would be.

[rman]

64. Sorry about your troubles,

I wasn't really reading you, just probing a bit.

The answer begins with fixing democracy. Without true representation no system will work for the people.


ps
I like your sig.

[CHIMO]

55. Don't Know

If you are familiar with this site but it lists the expected wait times for different services and operations. I have paged through as far as I could to the description that you provided. Perhaps you can search around. If there is any further info you require then just continue posting here and I will check back.

I would definitely go to your insurer and find out what isn't working properly. If all else fails I would contact the local MLA and let him know what is going on.

As a last resort I would go to the media. As you probably are aware King Ralph doesn't want to be caught with his pants down for not meeting the published wait times. Especially when it becomes something critical.

http://www.health.gov.ab.ca/waitlist/CategorySummary.jsp?rcatID=12&levelOfCare=All

[JMDEM]

57. Holy Shit!!!

Thank you so much for posting this! This chart shows an average 4 week wait for neurosurgery. They are telling us 8 months!

Thanks thanks thanks thanks thanks!!!!

This might be powerful ammunition in my fight for my wife.

[CHIMO]

62. Hope That

It helps out.
If I might suggest something, I would try to find someone you work with or associate with that knows a doctor socially and try to meet him/her. It might help so that you would know the ropes a little more. Such as is someone giving me the run around or is this really the way it is.

I know that some schools have their own clinics and if that exists at your location it might help by utilizing a visit to pump information from the person on alternate means to get where you should be going.

One thing, which you are probably aware of but just in case, most insurance policies don't insure for pre-existing conditions and if that were the case they might just be trying to delay things until you return to the US.

It is not my area of expertise but what we see as one provider is broken up internally for billing purpose such as perhaps your case.

Anyway good luck.

[iverglas]

58. you're in Alberta ... surely you've figured a few things out

This is my direct experience of the Canadian health care system.

That is your experience of the ALBERTA health care system.

You do understand how a right-wing government that wants to undermine social security benefits (in the broad sense of that expression) that its cronies don't want to pay for will try its damnedest to make sure nobody's happy with them ... right? You know ... like the Bush Administration and the US Social Security scheme?


I'm not suggesting that my anecdotes are better than yours, but they're certainly different.

My recently widowed mother lives north of Toronto, in the burgeoning bedroom area that is currently experiencing a chronic doctor shortage.

A few months ago she had some pain in her knee. Within a month, she had had two rounds of xrays and a bone scan, with consults with her family physician and an ortho in between. The initial tentative diagnosis (a somewhat rare but almost always benign congenital malformation of the head of the tibia that occurs in adolescence and just sits there unless something happens -- in 1% of cases, a tumour grows, and in others, it's irritated by something ... like my mother taking up step exercising at the local gym) couldn't quite be confirmed. The results were all basically inconclusive. Because my dad died of metastacized melanoma which initially manifested as bone cancer (a whole nother set of anecdotes I've given in great detail at DU) and my mum has had various skin cancers, she was anxious, and so the ortho decided to have an MRI done. The following Monday, she called and asked my mum whether she could come in for the MRI that afternoon. My claustrophobic mum had wanted some time to prepare and get the right drugs in a row first. She said noooo ... so the ortho said how about tomorrow morning ... and my mum said noooo ... and they agreed on Wednesday. It got done, it was as suspected, she's fine. She really didn't need an MRI at all, except to meet a rather high standard of care. But she got it on less than a week's notice.

I could also go on and on about all the diabetic care my co-vivant has had this month (the community clinic where he goes for primary care called yesterday to reschedule his foot-care specialist appointment to September), all the lab tests I had last winter, my brother's skin cancer treatment last fall, my best friend's currently underway prostate cancer treatment (him being lucky he's got civil service early-retiree supplemental private insurance, because otherwise the chemo costs would be killing him, that being a definite shortcoming of most of our public plans -- although there is a provincial plan in Ontario that would probably provide him with some reimbursement, free of premium charges) ... and on, and on.

Things are *not* what they were 15 years ago. Fifteen years ago, I could pick up the phone and schedule an appointment at my community clinic (the non-profit that is my choice for primary care) for one of my refugee claimants who needed medical care, for the following week. This year, they go on a two-year waiting list.

Surely this tells us something.

Surely its obvious that as affluent as we are -- and very few people would say that they are worse off financially themselves than they were 15 years ago, that they can't afford what they could afford 15 years ago when it comes to food and housing and household expenses and the same level of non-essential spending (unless they are the marginally poor whose incomes have been eaten away by utility price increases, for example) -- we can afford the standard of care we had 15 years ago.

What's wrong with the system at present isn't a matter of ability to sustain the system, it's a matter of will to sustain the system.

And that's one thing that the Alberta government doesn't have, in spades.


Things are seriously wrong up here.

Yeah ... there is apparently something in the water in Alberta, for starters, that turns normal people into cretinous beasts who vote for cretinous beasts like Ralph Klein.

The continental divide must have gone haywire a few years ago, because we Ontarians (I use the generic "we" of course!) voted for our own cretinous beasts for a couple of elections in a row, and we're still suffering from the devastation that they wrought in our health care system here.

In a short period of time, Canadian provinces lost through cutbacks (when it should have been increasing production to keep up with population growth) doctors, nurses, technicians ... and those chickens have come home to roost.

But the fact that a bunch of ordinary people went loony and voted for right-wing cretins who did this to them does *not* mean that they should be doubly punished by making them pay for it all, all over again and twice over, by imposing a parallel private system that will drive quality in the public system down even farther and raise costs even higher.

I'm curious. A Cdn student in the US for extended periods (like my brother was recently, in Chicago) needs to buy supplemental health insurance because costs in the US are far higher than the fees paid by the Cdn public plans. But they are still resident in their Cdn province, and still covered by their Cdn plan, and could still choose to receive treatment in their province under that plan, as I understand it.

Does your wife not have the option of seeking treatment in the US? Or are you without any health coverage at all in the US while you are in Canada? And if so, might I point out that it's kind of a damned good thing that you have any Cdn coverage at all?

[JMDEM]

59. You are right -- I shouldn't mistake Canada for Alberta

Due to my PhD work, I haven't been in tune with the politics up here.

[iverglas]

63. and you have to excuse me

I'm actually much more useful most of the time, but I've been up all night and all today not doing the work I was supposed to do for today, and I get to blathering.

CHIMO gave you exactly the right thing -- I hadn't had the lightbulb gon on about that wait-time business.

Technically you don't have an MLA, but you could for pretty sure find a Conservative one to adopt, who might be quite eager to avoid a smelly bit of publicity about how one of our USA'n cousins was being mis-treated. Perhaps a cabinet minister.

Not that any of them want the system to work, but they don't likely want it to be quite so obvious that they're the reason it isn't working.

One teeny remote-possibility suggestion: U of Calgary has a faculty of medicine, and therefore must be involved in a teaching hospital. Any chance of an "in" through the academic connection? I'm not proposing queue-jumping; I can't believe that the waiting times you're being told are being organized entirely by genuine assessed priority, and it strikes me that it's a bit of that prioritizing that might be needed -- or that there might be some mutual benefit for your wife and the med students/residents to get together sooner than later, if hers is at all an academically interesting case.

I gather you don't have coverage in the US, so you're in the system for better or for worse. Very best of luck.

[JMDEM]

66. Thanks for the advice, but it looks like we are screwed

A neurosurgeon reviewed my wife's MRIs (taken 3 months ago) and stated in the record that it was his opinion that she did not need surgery, therefore we will not be put in the waiting list at all.

My wife has never been seen in person by any type of doctor except a general practicioner. No neurosurgeon has ever seen her in person.

We have it officially on file that my wife:

1. Is experiencing excruciating, unbearable pain that not even morphine will control.

2. Is rapidly losing sensation in the right side of her body.

3. Cannot feel heat/cold at all any more on the right side of her body.

4. Has had her entire right side become paralyzed for brief periods on several occasions over the last 8 months.

These are all classic symptoms of syrinxes. CLASSIC. Yet the neurosurgeon spends 5 minutes looking at MRIs and says "no surgery". He did not meet with her. He did not test her pain sensitivity or reflexes. He did not do the standard pinprick tests on her body. (This is where the doctor pokes you with pins on your backside, and you can't see when he pokes you, and you have to report what you feel.)

Only surgery will relieve the symptoms.

We have been told that we can now get in line to see a neurologist (which I guess is different from a neurosurgeon) but that the waiting list is 6 months or longer.

[Orsino]

65. I knew Big Money couldn't stand it much longer...

...looking north and seeing all that stuff it doesn't own.

[William Bloode]

69. What it would come down to is this>

Wealthy people who could afford private care would do so, and get better faster care those who cannot afford it.