It depends on how you define "socialized" medicine. The system here is government funded, but not directly government run. Those are very different things. You should also know there are several parts of the Canadian system that are privatized (including surgical centers, MRIs, etc).

As far as our system, go to any thread on universal health care and you'll get an email. I would not trade our system for an American style system, and over 90% of Canadians agree with me. The system here has problems with wait times, improper use of resources and drug approval times in particular, but so does the US. I like the system here. I never have to worry about going broke if I happen to get sick, I can pick my own doctor (despite what people think), I can seek treatment anywhere in the country without worry and I have never been refused treatment or had to wait a long time for anything. My dad even had knee surgery the year before last and only had to wait about 6 weeks. Considering the fact that it was completely elective and that they supposedly have the longest waiting time for ortho surgeries and I don't think that's bad at all...

Universal systems in some countries are government run, in others they are simply government funded and monitored. In Canada, the provincial governments divide their provinces up into health authorities which are managed by docs and beaurocrats, same as in the US. The provincial government decides how to fund each area according to need, but it isn't the government micromanaging. There are universal systems, like in the UK I believe, which have both public facilities and private facilities. Standards are still monitored by the government (like they are in the US), but there are private facilities for people who have the supplemental insurance, which compete with public ones in a way.

As far as ingenuity... Canada has a long history of that (as do many other countries)! Where do you think scientists discovered insulin and changed the lives of millions of diabetics? My hospital raises litterally hundreds of millions of dollars for research (I think it was 170 million over three years of fundraising). Drug and technology companies still have a motive to develop new products because we still purchase the drugs and technologies we use (our unit is looking at buying over 60 $40 000 isolettes for the NICU). Drug companies' patents here still allow them to make a handsome profit.

As far as pay scales.... Doctors and nurses in universal systems are not paid less than bus drivers. This is another common misconception in the US. Nurses in some parts of the US make more than in Canada and in other parts make less. Average doctor salaries in Canada are lower than in the US, but that's because we have fewer specialists and more GPs, and GPs always make less money. Specialists here are compensated less outright, but the fact that their overhead is so much less means that a lot of docs actually do just as well or better here. Malpractice insurance is MUCH less, we have a single payer system so there is less paperwork to spend on and doctors and hospitals here never have to worry about getting stiffed by patients who can't pay. I know a lot of Americans are scared of the term universal because they think it means they will have to pay for the people who can't, but really, you do now anyways. The costs for you to get medical care are so expensive partly because it has to absord the cost of non-payors who declare bankruptcy.

As far as lawsuits... there seem to be a lot less here, and I don't know why. Doctors and nurses still have their own malpractice insurance (mine is covered by the hospital and the union, like it was when I worked in the US).

As far as elective surgeries: they are just that. A mastectomy is classified as urgent, not elective. We have elective, urgent and emergency. An urgent surgery is one that will cause health problems if not treated fairly quickly, like a mastectomy. An emergency is obviously one that would cause injury or death if not treated immediately. That's why people aren't questionning that aspect. Again, studies have shown that people may wait longer here for certain procedures, but it doesn't have a negative effect on their long term health. And for all the talk about waitlists, I have never known anyone who has had trouble getting treatment when it was needed. Are there horror stories about indivdual cases where things have gone wrong in Canada? Of course, just like in the US. But you have to look at the big picture. Is it the norm? No. There has even been research showing that women in Canada from low socioeconomic groups do better when they get ovarian cancer compared to women in the US and the reason was access to care. I would rather have to wait a week or two as opposed to not getting a surgery I needed cause I didn't have the money. I promise I will find the name of the book that references all the studies you seem interested in.

As far as patient choice, trust me, it is MUCH more limited in the US unless you have signifigantly more money that I did. Having lived and worked in both countries, I know that Americans think Canadians have no control over their care or who they choose as a care provider, but that just isn't true. I think it's because Americans think the government manages healthcare, when in reality they fund and monitor it, but the system is run by the people who work in it (administrators, doctors, etc). I chose my doctor and when he wants me to get certain tests, I get them done. When I have had health issues, we have discussed the options and then made a decision together. The government does not determine my care, my doctor and I do. When I lived in the US, I had to have a doctor that was a part of the HMO list, and it was a struggle to get the HMO to approve things the doctor wanted done. I wound up paying out of pocket more than once. And the most ridiculous part was, I was only covered in a certain geographical area! If I went on vacation to Florida, I wasn't covered at all!

OK, I am getting long winded, but I'll keep going.....

Patient ratios in the US and Canada are similar, but I generally get a better deal in Canada which could be because I work in larger urban settings. In L&D it was rare for me to get 2 women in active labor, something that was routine when I was in washinton. In the NICU I look after 2 or 3 babies (only look after 3 if none are vented). Med surg in my hospital only uses RNs and they have 4-5 patients on days. I have worked with LPNs on med surg and generally the RN-LPN team would have 8 or 9 patients, though I have seen up to 12 in one hospital. Just like in the US, it does vary between hospitals depending on their size (a hospital in NYC may have more resources than one out in the boonies). I do not have to float, ever. I get an hourly wage and am paid OT (time and a half) for anything extra as are all nurses (we get a pretty good benefit package as well). We have no mandatory OT like some places in the US because it is against our labor laws. Wage scales vary by province. In Ontario, a new grad starts around $23 an hour + shift diffs (so figure $18 American). The top of the payscale for staff nurses is reached at 9 years and is about 32-34+ diffs (though agency nurses make much more). In BC the range is from 25-33 or something. Each province has a nursing union which negotiates wages. If you go to a provincial union website you will get links to the payscale. In ontario, it's the ontario nurses association. In BC it is the British Columbia Nurses' Union (www.bcnu.org I think). You'll have to google a bit It's hard to give a real comparison because cost of living is a big factor and Canada is a BIG country. Nurses in San Fransisco will make a large hourly wage, but it's so expensive that a nurse in Arkansas making a much lower wage may live better.

As far as people all paying for health choices of others.... This is actually a good thing. It means that EVERYONE has to pay into the healthcare system through their taxes. In the US, you do it indirectly (that article was American right?). Someone can go without insurance, then show up with an MI and the hospital has to treat him, even though he will never pay for any of it. Then those of us who do carry insurance wonder why it is so expensive! It's cause we have to pay for that MI guy's care one way or another!

In Canada, people who make bad lifestyle choices are not free to avoid contributing to their healthcare. The other thing is, insurance companies in the US can refuse to cover people with certain conditions, so even if they want to pay for insurance, they can't. The best way to run a system is to have low and high risk people in your pool. One of the reasons the medicaid system is so shabby is because it only takes the high risk, no paying people. We pay more in taxes in Canada, but I actually take home about the same percentage of my pay here, because in Washington I had to pay for my insurance.

I think it's a little ironic you would say that people are brainwashed into thinking that universal healthcare is good. It has been my experience that people in the US are brainwashed into thinking it's bad, based on misconceptions. Canada's system may be completely wrong for the US, but there are a lot of universal systems to look at for ideas. The Canadian system certainly is far from perfect, and we can also look to other countries for inspiration.

Answer: Health insurance and the "agency" sale of such is immoral. Via the medical cartel, it passes along the cost of medical care for the uninsured and indigent to it's "clients" that it supposedly represents and even charges a percentage on it (profiteering on indigent medical care). If the Health Insurance industry failed to be complicit in this arrangement, the hospitals would surely HAVE TO refuse to treat EVERYONE. The ensuing outrage would cause government to have to step in and pay for it. Any governement involvement is perceived as BAD for business because Government would then likely, eventually and finally KILL the golden goose...the health insurance racket.

In conclusion, health insurance has really become privatized socialized medicine. My health insurance premiums contain a tax which covers the cost of medical care for the uninsured. This is, in essence, taxation and worse yet, it's taxation without representation. It's immoral and UN-American. Surely, a single payor system will have problems but, at least, I'll be voting for the people in charge AND nobody will be left in the cold if and when they actually NEED medical services.

Mr. Wondering

If you cannot afford to go to the hospital, you should not get to go. You should have to go to a free clinic and not burden those who can pay. I wish the insurance companies would just close their doors and stop insuring everyone. Eventually, hospitals would require income verification to save you when you had a heart attack to make sure you could pay. Sound cruel, sounds crude. But think about it. The most productive members of society (those who worked and saved) would live longer and those who were not would die off. I guarantee people would save money sitting around in case of emergency b/c their life would depend on it.

Public care is the only way to go. This is because health care is not a commodity.

Here's why.

One: Need, Not Choice
Patients are in a position of need, not choice. Their survival can be dependent upon regular visits to a clinic or to a doctor. Unlike other products in the marketplace, if you need medical services to make you well or function normally you can't shop around for the best deal, nor can you compare makes and models, nor withdraw your consumer choice because the product is over-priced with the hope that if enough patients do the same the price will drop as supply exceeds demand. If you need medical care, you need it now. You've got to pay the price, whatever it is. Patients are at the mercy of the provider and they are unable to influence the competition and costs of services as in a free-market model. In fact, the reverse is more likely: the market manipulates patients to pay whatever cost is set by a private provider.

Two: Insufficient Information
Patients do not have the information necessary to make an informed consumer choice. Imagine Consumer Reports on dialysis units or magnetic resonance imaging devices (MRIs). Only specialists have the knowledge required to make such choices and patients are dependent upon their expertise for a referral. Patients trust that their doctor will make the best choices for treatment on their behalf. It's wrong to burden sick people with these decisions and unreasonable to expect them to do the research necessary to be informed about illnesses and their treatments. How many senior citizens even use the Internet?

Three: Profit Motive Inappropriate
Patients trust their health-care providers. The profit motive is inappropriate for health-care providers because it can interfere with the quality of care within a relationship of trust. Patients assume this relationship is based on the doctor's commitment to health, not to profit. The profit motive could encourage a practitioner to make unwise decisions like prescribing more drugs and recommending costly surgery since these represent opportunities to increase profits. Health-care providers motivated by profits may be tempted to select patients who require these interventions. But we expect our health-care workers to want to help us because they're interested in our well-being, not because we pay them to take care of us or because we pay more than someone else who will receive inferior care as a result.

Four: Maintaining Standards
Patients depend on the public regulation of standards in care. Like other concessions to companies in the private sector, private firms delivering health-care services may win exemptions from standards in technology, safety and licensing of technicians. How would quality be regulated? How could consumers as patients have an influence upon standards, given their circumstances? Given the narrow margin for error, a patient would be too sick to register an official complaint if something goes wrong during a procedure. Their family could do so on their behalf, but in terrible circumstances.

Five: Lower Cost
Private health care can't compete with the lower costs of public health care. In the U. S., where a private health-care system parallels a public one, health care takes up 14 per cent of the GDP, highest in the world. Canada spends about 9.5 per cent of its GDP on health care, less than Germany, France and other European countries respected for their vibrant social programs. Why is private health care more expensive? Like any other profit-making venture, private health care must create a 10-to-15 per cent return for shareholders. It also must cover costs that are non-existent in public organizations like marketing, advertising, taxes, compensation packages for senior executives and higher administrative costs. In March, 2000, the Toronto Star reported that the Australian government has to subsidize its private hospitals by $2.2 billion in operating costs. These hospitals are not a viable business without this assistance. Many studies show private health care is more costly than a fully public system. A 1999 article in New England Journal of Medicine states that No peer-reviewed study has found that for-profit hospitals are less expensive.

Six: Superior Quality
Private health care can't compete with the superior quality of public health care. Public health care saves lives. The Canadian Medical Association Journal just published a report on 15 studies on for-profit and not-for-profit U. S. hospitals. They found that patients treated in for-profit centres were 2 per cent more likely to die. While this may sound like a small number, given that the sample was 38 million patients between 1982 and 1995, this means that 760,000 people died in private facilities who might have lived had they been treated in public hospitals. More funds are diverted away from patient care toward other expenditures like marketing and executive salaries. The profit motive obscures the priority of saving lives.

Source = Health Care not a commodity

"If you cannot afford to go to the hospital, you should not get to go. You should have to go to a free clinic and not burden those who can pay. I wish the insurance companies would just close their doors and stop insuring everyone. Eventually, hospitals would require income verification to save you when you had a heart attack to make sure you could pay. Sound cruel, sounds crude. But think about it. The most productive members of society (those who worked and saved) would live longer and those who were not would die off."

My God!!!! You CAN'T be serious. I am praying this is tongue-in-cheek because it is one of the cruelest things I have ever read.

WH2LE

If you cannot afford to go to the hospital, you should not get to go. You should have to go to a free clinic and not burden those who can pay. I wish the insurance companies would just close their doors and stop insuring everyone. Eventually, hospitals would require income verification to save you when you had a heart attack to make sure you could pay. Sound cruel, sounds crude. But think about it. The most productive members of society (those who worked and saved) would live longer and those who were not would die off. I guarantee people would save money sitting around in case of emergency b/c their life would depend on it.

hospitals would require income verification to save you when you had a heart attack to make sure you could pay. Sound cruel, sounds crude. But think about it. The most productive members of society (those who worked and saved) would live longer and those who were not would die off.

If you cannot afford to go to the hospital, you should not get to go. You should have to go to a free clinic and not burden those who can pay. I wish the insurance companies would just close their doors and stop insuring everyone. Eventually, hospitals would require income verification to save you when you had a heart attack to make sure you could pay. Sound cruel, sounds crude. But think about it. The most productive members of society (those who worked and saved) would live longer and those who were not would die off. I guarantee people would save money sitting around in case of emergency b/c their life would depend on it.

“The health insurance model is closest to the parasitic relationship imposed by the Mafia and the like. Insurance companies provide nothing other than an ambiguous, shifty notion of "protection."

The solution is for physicians and patients to abandon the traditional healthcare insurance grip.

Government (local,state or national) or employer associations (third party payers) set up their own healthcare insurance companies. They set rules in favor of the patient with the patient having control over their first six thousand dollars. The patient does not contribute the first 6,000 dollars. One of the third party payers contributes the insurance premium. Self employed people would contribute their own money with pre-tax dollars. If they could not afford the premium, they would be subsidized by the government. This is not an entitlement. This is pure insurance with motivation to save money.

I wonder how many politicians would be willing to past legislation to permit this to happen. It could easily be done on a state level. Consumer would then be able to control the system. We would be able to get rid of what Dr. Kellerman calls the Healthcare Insurance Mafia.

So HURTandSHOCKED:

I wonder what would happen if we all felt as you do and believed and supported the "Survival of the Fittest" and "Everyone Only Looking Out for Ones Self" mindset.

For example, people here on MB. The vets and longtimers etc., we're here because AS HUMANS we care. Our human-ness, unlike animals, compells us to want to help and support our fellow hurting human beings. Instead of turning our backs and allowing YOU to struggle thru infidelity all on your own.

Otherwise, using your "survival of the fittest" mindset, infidelity without support would look something like this:

"Sound cruel, sounds crude. But think about it. The emotionally stronger members of society (those who became bitter, cold and unfeeling) would live longer and those who were not would die off."

Sound familiar?

Posted by: Pearl Chen | October 21, 2008 at 01:00 PM

After being covered contunously for more than 25 years by individual and the employer based ins. I was diagnosed with cancer. Made it through that but then 2 yaers later my husband gets high blood pressure . He makes the changes needed to bring it down but it still takes three drugs to keep it under control. We lost our insurance due to employment change 3 years ago. Since we had always been covered we checked 1st into a portibilty policy and for the polcy we had , it would run $2,000 a month. If we raised the deductible the premium to $10,000 a yr. if would have dropped to $1700 a month. The only policy we could get was a major medical with a $20,000 yr deductible and no drug coverage at all. Price was $850 but when you added back in the scripts we both need it came back up to $1400 a month.Not possible to pay on $50,000 a year! After checking with the company's underwritting staff, we applied for a new policy after being told since it had been 6 years that I had been cancer free we could be underwritten,. Not! They did as it states in this article. They turned my husband down due to two conditions, the high BP and heartburn he had f or a few weeks from one of the first drugs they tried him on, a sideaffect. They turned me down stating I too had two conditions, the cancer and back pain which I was treated for before my cancer diagnosis. The back pain had been an early symptom of the cancer and went away after the chemo and radiation. We are both in our mid 50's and are now praying that our health holds till we qualify for medicare. What is really sad is that insurance companies are also treating their own employees almost just as badly. Our yougest daughter works for Cigna in claims resolutions and her company policy is almost as bad as not having coverage at all!

Single-Payer National Health Insurance

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 47 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, long-term care, mental health, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The first article you posted amused me right off the bat when it indicated that physicians AND THE INSURERS were interested in finding "value" in the health care system.

I took one of the links from your 2nd article above to the website Physicians for National Healthcare.

They confirmed the number I had read earlier which was the Health Insurance industry tacks on over 30% to the cost of actual healthcare in this country... Didn't you say this was wrong??