The great Health Care debate!
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by iluvcarats » March 17th, 2009, 9:01 am
So let me get this straight. If you were looking to hire a doctor, your ad would read something like this: Wanted Doctor Must attend 4 years of college Followed by 4 years of Medical School. Combined cost approximately $400,000.00 Followed by a residency somewhere between 3-6 years where the match system places you. Followed by a possible fellowship. You must take an oath to treat anyone at anytime. You may never go on strike or you will be put in prison. You may not try to unite with other physicians to change anything that insurance companies implement because that is collusion. You must always be accessible, day and night. (Your pager is your BEST FRIEND) Your patients come before yourself and your family. You are solely responsible for keeping very sick and very injured people alive. People can, and often will sue you if they want. In fact, there is an entire profession dedicated to just this. You will have to pay huge sums of money just to protect yourself from this. Don''t expect much monetary compensation. Oh, and NO WHINING  Um, good luck with that! |
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To many posts to quote but I think that there should be more programs that in exchange for working in poorly served area or at reduced pay in clinics that the student loans should be turned into grants.
Would a doctor starting out be willing to work for $50k(adjusted based on the cost of living in the area) + $50k a year off their student loans? 5 years at $50k in exchange for being debt free? I know there are some programs out there but they don''t cover wide enough areas nor specialists. Something has to be done about the cost of education. I am all for service in exchange for writing the debt down. |
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iluvcarats and vespergirl, every health care system has its horror stories, and the Canadian one is no different. The media loves to report on horror stories. I hope you realise that the links you posted are not balanced unbiased news reports, but in fact sensationalised horror stories and/or editorials.
I actually tried to speak generally about universal health care - keeping the specifics of an individual system out of it, as they are all very different, but, if you really want more detailed information on the problems with the Canadian system here is a sampler: 1. Underfunding of the system The Canadian system has been greatly underfunded for about the past 10 years. Politicians found that it is more popular to give tax cuts than increase funding to health care.  2. Shortage of health care professionals in general Our Univerisites graduate plenty of Doctors and Nurces each year. The main reason for the shortage of doctors and nurses in Canada is that they leave for higher wages in the US (especially specialists). Despite the fact that they graduate with relativley low student debt (compared the the US) we need face the fact that to compete, we have to pay our health care professionals more (see #1). 3. A shortage of "family" doctors. Your first face of contact in our system is your "family doctor", a general practitioner. He or she refers you to specialists, orders tests, tracks your medical history and keeps your medical records. Due to the overall shortage of doctors (see #2), graduates who remain in the country can afford to be picky and family medicine is not the first choice of most of them. There is none of the glamour associated with specailties, and it is hard work. This has created a severe shortage of family doctors, so finding one can be tough if you are a young healthy individual. If you are elderly, have an ongoing health issue, or are pregnant, you won't have a problem finding a doctor. The numbers of people without a family doctor are deceiving as everyone who doesn't have a family doctors isn't actively looking for one. Many simply don't see the need and rely on walk in clinics for their front line service. 4. Waiting times. We aren't talking about the time you sit around your Doctor's office waiting for an appointment, but the time it takes to GET that appointment. How quickly you get to see a specialist or have a special test done depends on how urgently you need it. If you are the "least in need" you can wait many weeks or even months for an appointment. The need for this waiting list is due to the shortage of specialists (see #2), or a lack of equipment (see #1). Since it is your family doctor who determines how urgent your need is, there are times when they underestimate your condition, which can lead to horror stories. . . . 5. Shortage of services in small towns and rural areas Similar to the US, the best doctors generally don't want to work in small towns or at a rural hospital. This makes the above problems that much worse in small places. Most hospital horror stories are found in small places. I personally have heard no stories about line jumping by the "affluent or connected" - it certainly isn't rampant. But I can see that it could happen, all you would have to do is find a crooked doctor who is willing to say that your situation is urgent and your're in. A problem I am more familiar with is fraud. Millions of Canadian tax dollars are spent every year providing health care to uninsured Americans with fake or stolen ID. In recent years things have improved. Funding has increased, and maximum waiting times have been implemented. The government realised that only so much "fat" could be cut out of the system before it was going to be run into the ground. And as I have said in other posts, the general consensus was to fix and improve the public system rather than move towards the alternative - so that is the process we currently undertaking. |
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This is going to be my last post in this ridiculous vein, but give me a break. No, not all professions require the amount of training hours that medicine does. Are you serious? Funny how the attending physicians are pleasant when they''re being paid a wage in accordance with their educational background and responsibility... and not working as slaves. The current residents and fellows are scared to death that we''re not going to be able to pay our loans. But it''s all whining, anyway. |
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I totally disagree with this statement. My article was from the New York Times, one of the most respected newspapers in the world, and it is actually a more liberal-leaning paper according to some, so if that were the case, they would have more of a reason to glamorize socialized medicine. And it did not come from the editorial section. |
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salty- I had no idea this was going on! It''s really unfortunate, because it''s taking away from care for actual Canadians. Physician shortage is a big problem up north, it seems. I know Canada is on the verge of utopia and all (just teasing, I love Canada), but they cannot keep up with the demand for care. I grew up near Buffalo (just across the border), and our friends from the Ontario are currently advertising in attempt to attract American doctors to work up there! After I saw the ads, I did a bit of searching and apparently Canada is actually claiming a net gain of physicians moving in/out of Canada for quite a while, so it does not seem that the problem is that doctors are leaving for greener pastures in the States. I don''t think there will ever be a way to keep the connected folks from getting faster care when they want it. As a doctor, I have friends in all fields. If something came up within my family, I would not hesitate to give them a call to get things done more efficiently
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So what is the answer more weight based discrimination? Frankly it should be legal to shoot anyone with a tazer who comments about another person weight.  It was fun when someone would comment about my weight when I was working patrol and walking about 30miles in a shift. If you wanted at a regular pace you were walking for 12 hours strait but if you walked fast you could sit down for 10min an hour. An hour in and they were dieing on their feet it was fun to ask them if they wanted to sit down and take a breather, then say to bad don''t have time and take off at a fast walk and leave them behind in the middle of a chemical plant. After one scrawny guy guy in his 20s had a heart attack they put 4 people per shift so it was only 18 miles, 1.5 hours walking and then 1.5 hours in the office. That was gravy until I got a blood clot and PE and had to quit. |
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Vespergirl, I appologise - you article wasn't sensationalised, and was a factual news article (although I still question the widespread line-jumping comment  ). I unfairly grouped it with iluvcarats links as I read them all at once. I was also a bit taken aback at all the sudden posting of articles on the problems with the Canadian system as I had never claimed that our system was perfect.What I should have said is that one article doesn't provide the whole story, and you need more information to really get an understanding of the strengths and weaknesses of a system. It was an article about the problems in the system (and a fair thing to report on). But to see all sides of an issue, you would also have to read the "good news" as well. A single story about the problems with the US system wouldn't provide a fair overview of your system either. |
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universal coverage could sure go a long way towards health education and preventative care... My mother''s weight was up. She went to the doctor, he/she ran the numbers, and he painted a not so pretty picture for my mom. She went home, changed her diet, and lost 20lbs before her next doctors appointment. Her numbers were perfect, and she went off of some meds. If she had not gone to the doctor, or had been unable to, who knows if/when she would have addressed the problem. Access to doctors IS important for health outcomes, even things like weight management and diet! |
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icekid, A net "gain" of doctors is great news, but we still have such a shortage that there is along way to go. We definitely do still loose a lot of "home grown and educated" doctors to the high salarys in the US (they call it the "brain-drain"). Where we are ''gaining'' our Doctors from is immigrants from other countries. The government has made the visa process easier for doctors in an attempt to attract them. |
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Absolutely! Preventative medicine is a huge cost saver. I myself visited a nutritionist recently due to some poor test results, and learned a huge amount. My mother''s breast cancer was found during a standard annual mammogram, she only had to have a short round of radiation treatment, and has been healthy the 15 years since. My father''s bipass surgery didn''t stem from a heart attack, but from tests ordered at his annual physical. I haven''t seen SICKO, but did see a "real" documentary on doctors in Cuba. It was very interesting. A main part of their health care program is that every citizen sees a doctor twice a year (no choice in the matter - it is Cuba!). Doctors travel all over making sure that everyone gets their twice yearly appointment. It is obviously expensive, but they catch so many things early this way that they are able to eliminate a lot of costly hospital stays. |
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And wait until it comes here. The throngs of illegals who''ve made an art form of bilking the welfare system for 40 years will surely have a field day when they realize they no longer have to wait in the ER all night for a stuffy nose. Now they''ll be able to sit in a nice cushy office, read a few magazines, see a GP and keep someone else waiting who actually contributes to the system. |
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The funny thing is, our current system is so inefficient that this would SAVE us money! 
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Hi saltymuffin, no worries. I also agree with your "myths" - especially about Dr's not being under the thumb of govt - I have never heard of any anectdotal evidence of this, and I work in H.C every day (and trust me, people will complain about anything!, lol).  I also believe Dr's are under more pressure from private Co's than they would be with a mixed system. I am not here to criticize, as I understand this is a sensitive issue - but I am quite surprised at alot of the attitudes in this thread - where folks are admitting," yes our system is very broken, but we still don't want to make it like yours. "  Honestly, patients having to go the ER for a cold?! In find that quite unbelievable 
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Well, I am going by the parts of medicine in our country that are in a public system. The military and VA, and doctors are micromanaged by administrators. If those 2 systems would change in our own country, than I would be open to more government involvement. But I am afraid here, it would be more of the same.
I also wanted to point out that the training of doctors in other countries is not a rigorous as it is here, you don''t have as many years of school, and we are the only country to have an 80 hour work week. They are thinking of making work hours more strict, but all the program directors say the same thing. If that happens, we are extending the length of training. Great, 4+ years of below minimum wage (if you work out our salary by the hour) to be a generalist who has to see a patient every 15 minutes, 20-30 patients a day to even make a profit? And than get multiple complaints for the wait that patients have? Oh yeah, and a nurse practitioner''s can do that without going to residency??? Why am I even doing all of this??? As Icekid said, if you want to pay doctor''s less, than fine. But expect the best and brightest to go into another field (it is already happening), and expect those that do go into to not accept the kind of training we have. I am open to more ideas, but I am for reform, not a completely government run system. |
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That is already happening (in the ED), I live in SD, and are only 20 miles from the border. A long wait in an ER is worth it for proper medical care for these people. In fact, they are some of the most grateful and appreciative parents I see. They know how much worse it can be. |
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I think the anecdotes about people crossing the border to get care just highlights two things: 1.) Health care is a basic need 2.) It is human nature to do anything you can to take care of your family |
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Are you suggesting that this country would be well-served by becoming the free clinic to the world? |
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I fail to see how you derive your logic. I suggested that the US would be well-served as a free clinic to the world about as much as I suggested that Canada would... which is to say, not at all. I stated two things, very clearly. No need to read between the lines. |
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We are constrained primarily by our lack of imagination... Free med school anyone? http://www.kevinmd.com/blog/2008/12/free-medical-school-for-students-who.html of course, we could always just bring in more students from China and India to populate our med schools, since they will happily take the training and compensation without complaint... "Oh, and NO WHINING Um, good luck with that!" see... there are LOTS of alternatives! 
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You have obviously only been on the receiving end of medical care. I suppose we could import "more students from China and India to populate our med schools, since they will happily take the training and compensation without complaint." After all, we have already outsourced all of our manufacturing there because it is cheaper, and lost thousands of American jobs. We might as well hire them to give us less expensive healthcare. I mean, as long as it''s cheaper. Very "creative" and dare I say Capitalistc! Let''s socialize medicine by bringing in cheaper labor from other countries! And we already owe China 2 trillion dollars anyway. Of course, if someone was to suggest importing students from other countries to work at Walmart or General Motors because it was cheaper, and well, "they''d at least be appreciative to have a job", I have a feeling it would meet with some resistance. Sort of like the Mexicans who cross the border every day illegally, and are willing to work for wages that Americans won''t. (That is not ok) So when you are rushed into the ER having a heart attack and everyone around you speaks English as a second language - Good luck with that But on a positive note, the malpractice lawyers will be thriving. Unless of course the government makes a new rule that you can''t sue government doctors. Because when they are in charge rules can be made and broken and changed and broken and made and broken..... This might just work in this new and fair society that you are planning.
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I think she was referring to the Dr''s and not the patients |
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Thank you for clarifying TLH, that is what I meant. |
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Wow Vespergirl, your sense of entitlement (and immortality!) is astonishing. You are aware that people that do 5 days of cardio a week, who don't smoke, and who eat healthily still get serious illnesses, but I suppose you just don't care, because your husband's job provides your family with good health insurance. When I was a kid, my father taught me that not everyone has had the same advantages that I had starting out in life, and that is why it is important to share and be charitable. My mother is one of those people--she grew up begging for food, and she also instilled the same concept of charity in me. In this thread, I am talking about Single Payer. Single Payer gives everyone the same access to healthcare. Perhaps, you Vesper feel that you deserve better, because your husband, as you so delicately put, "makes money hand over fist."
I'm sure the non union workers and gov't contracts help him out a great deal. Put yourself in someone else's shoes--and not those of your immigrant parents fleeing a totalitarian regime. Put yourself in the shoes of, let's see, a family of four with an injured mother and a laid off father who lost all health benefits. Say one of the children is diagnosed with a serious illness like leukemia. Would you have a problem accepting assistance from the government? I seriously doubt it. Or, don't. Just keep on posting your dubious statistics and whistle on your way to the doctor. I hope you don't have to wait too long in the waiting area--hope they have some good magazines this time. |
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Here it is the doctors and nurses. Being fluent in a 2nd language is a hiring plus for an ER nurse so there is a lot of nurses who English is not their first language. A lot of the ER Doctors are from Pakistan as are a lot of doctors in my area. Good docs for the most part but some are hard to understand sometimes. The last time my sis-in-law was in the ER I noticed there were fewer than there used to be so some have moved on but the 2 trauma docs on duty were from Pakistan or at least had the accent. I know one of them nice guy, great doc and speaks 7 languages and was born in Pakistan. I had him for a doc when I was in there about 6-7 years ago. |
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Thank you Coati for expressing what some of us are not eloquent enough to type.
Karl, Yes, it is the same here. The best teaching hospitals seem to have more foreign born students than native. Then again, we should all remember that the US will be a minority majority country by 2050. link |
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Coati I''m all for criticizing "ideas" around here, and I''ve done plenty of it myself, but you really are crossing the line by calling a particular individual "immoral" and "entitled". Really out of line. (And weren''t you so incensed that you took leave of this thread a few days ago?) |
