House Democrat Health Plan

[Smoke]

The rich have taken a beating in the last year.

So true. I stay up at night over it, walking the floor, unable to sleep and weeping over the desperate plight of the wealthy.

 

[Alceste]

In the US nobody knows what prices will be charged, not ever the Dr, as they're all negotiated with the insurance provider. Ten lanced boils, ten appendectomies = ten completely different prices, depending on your individual insurance plan and provider, plus how much time and effort you &/or your Dr want to take arguing with the insurance carrier.

Provincial fees schedules are posted on the internet. They're in Dr. language, of course - not very stimulating reading. Nevertheless, utterly transparent.

SOMB – Health Professional Fees – Alberta Health and Wellness

 

[Jackytar]

"A physician cannot charge a fee for a service that is higher than the negotiated rate — even to patients who are not covered by the publicly funded system — unless the physican opts out of billing the publicly funded system altogether."

Yeh, don't know how it is you don't see the logic in that. What would be the point of a single-payer health insurance system if the government just coughed up any amount of money? The provincial governments set the fee schedule, but doctors work for themselves. If they don't like the fee schedule, they don't have to be part of the public system. Sounds private to me.

Right, so that provider must get all of thier business from self payers. Which makes it prohibitively difficult. And this is only in a few provinces and only for certain specified overlapping services. In Alberta, one such provice that everybody's watching, the premier and health minister went through great pains to convince voters that this would not evolve into a two-teir system. Do you support a two teir system like your boyfriend has in England?

And, Alceste, really... if you want to shoot down the evidence for long waiting periods in Canada as anecdotal, it would help if you didn't provide a personal anecdote to accomplish this. What of the Canadian Supreme Court findings? Was that based on American special interest propaganda?

I supported your response to Rev Rick that the very capitalism he cherishes here in America may actually be diminished by employer based health care. As for Canada, I was merely making the point that although countries with socialized medicine may enjoy a more active capitalistic climate, especially when it comes to small business start-ups, this would not be the case for the business of health care in Canada. I have a health care business. I think Rick does too.

Jacytar

 

[Alceste]

Right, so that provider must get all of thier business from self payers. Which makes it prohibitively difficult. And this is only in a few provinces and only for certain specified overlapping services. In Alberta, one such provice that everybody's watching, the premier and health minister went through great pains to convince voters that this would not evolve into a two-teir system. Do you support a two teir system like your boyfriend has in England?

Yes, the whole point is to make it prohibitively difficult. I think public health care is better in the UK because more services are covered, and my experience there was the same. (Strolled in, got a wound treated immediately, and strolled out). What exactly are you referring to when you say "two-tier"?

And, Alceste, really... if you want to shoot down the evidence for long waiting periods in Canada as anecdotal, it would help if you didn't provide a personal anecdote to accomplish this. What of the Canadian Supreme Court findings? Was that based on American special interest propaganda?

I assume you mean the Quebec supreme court finding, which applies only to Quebec, and addresses a problem that only exists in elective (non-urgent) surgeries? Not nearly as significant as you are trying to make it sound, and entirely concerned with the issue of duplication of coverage. It's a niggly legislative detail handled differently in every province and country, not the Achilles Heel of Universal Health Care Coverage that you (and American special interest propagandists) are trying to make it out to be.

FYI, Canada performs better than the UK on elective surgery wait times, and is in line with New Zealand and Australia. 73% of patients receive treatment within 4 months. In the UK, it's 62%. source

I supported your response to Rev Rick that the very capitalism he cherishes here in America may actually be diminished by employer based health care. As for Canada, I was merely making the point that although countries with socialized medicine may enjoy a more active capitalistic climate, especially when it comes to small business start-ups, this would not be the case for the business of health care in Canada. I have a health care business. I think Rick does too.

I wish you well in your business ventures, really I do, but you honestly can't expect me to value your personal financial success over people's lives, can you? I mean if I had a magic wand I could wave only once, I'd heal jamaesi so she doesn't have to spend every waking moment of her life in agonizing pain - not make you wealthier.

BTW, as I understand it, Rick is in construction. He is not eligible for insurance (I think) on account of the fact he actually needs health care services (cancer). He pays all his medical expenses out of pocket, which presumably puts quite a sizeable dent in his little capitalist bundle.

 

[Jackytar]

Yes, the whole point is to make it prohibitively difficult. I think public health care is better in the UK because more services are covered, and my experience there was the same. (Strolled in, got a wound treated immediately, and strolled out). What exactly are you referring to when you say "two-tier"?

"Two-tier" allows for a private health-care industry to exist alongside the public one. A very important part of the debate in Canada. Of course, to join the debate, you first have to concede that Canada actually has a public health system. Something I've never really seen challanged (until now).

I assume you mean the Quebec supreme court finding, which applies only to Quebec, and addresses a problem that only exists in elective (non-urgent) surgeries? Not nearly as significant as you are trying to make it sound, and entirely concerned with the issue of duplication of coverage. It's a niggly legislative detail handled differently in every province and country, not the Achilles Heel of Universal Health Care Coverage that you (and American special interest propagandists) are trying to make it out to be.

You are wrong. I am referencing the Canadian supreme court and it does have implications for all of the provinces. There is no such thing as the "Quebec supreme court". And it's hardly a niggly matter. This decision forced the governments of many provinces to step up their spending to reduce wait times.

I wish you well in your business ventures, really I do, but you honestly can't expect me to value your personal financial success over people's lives, can you? I mean if I had a magic wand I could wave only once, I'd heal jamaesi so she doesn't have to spend every waking moment of her life in agonizing pain - not make you wealthier.

I don't know how to respond to this politely.

BTW, as I understand it, Rick is in construction. He is not eligible for insurance (I think) on account of the fact he actually needs health care services (cancer). He pays all his medical expenses out of pocket, which presumably puts quite a sizeable dent in his little capitalist bundle.

Okay. I thought I remembered he installed MRIs or something.

Jackytar

 

[Reverend Rick]

Yes, I do install the electrical portion of the MRI machines. Running wiring and conduit around a big magnet presents certain challenges. When machines are first set up, they need a Ginnie pig. I sometimes get a freebe. I still have to pay to have the test read though.

 

[Alceste]

"Two-tier" allows for a private health-care industry to exist alongside the public one. A very important part of the debate in Canada. Of course, to join the debate, you first have to concede that Canada actually has a public health system. Something I've never really seen challanged (until now).

I don't think we can continue until you acknowledge the fact that the vast majority of Canadian health service providers are private businesses, and that the government acts as a universal insurer.

If you don't believe that's the case, there's really no point continuing.

Back in a bit for the Supreme Court dealie - got to take care of business.

 

[Alceste]

"Two-tier" allows for a private health-care industry to exist alongside the public one. A very important part of the debate in Canada. Of course, to join the debate, you first have to concede that Canada actually has a public health system. Something I've never really seen challanged (until now).

If you mean am I opposed to a private health care industry in Canada, of course not. We have one of those already - it provides almost all of our health care services, then sends the government the bill.

If you mean am I opposed to a parallel private health insurance scheme which duplicates coverage already provided through the public insurance system, I'm not opposed on the condition that facilities operating outside the public health insurance scheme are not entitled to any public funds (I don't pay my taxes so the rich can have tea and cakes in their hospital lobby).

Also, my lack of opposition is conditional on careful study of the impact of private insurance options for services covered by Medicare on the quality and timeliness of publicly insured universal health care. It's a complicated issue - countries with universal health insurance all handle it in different ways. (Increased funding, tax incentives, wait times guarantees, etc). Some countries are more successful than others, and I would expect policy-makers to model their proposals on the successes in other countries with similar systems dealing with the same problem. I do NOT expect them to consider which solution is most profitable for the private sector, although they do. THAT is why the private insurance issue is the focus of the public debate.

But, that's capitalism for you.

To join the debate, Jacky, all you need is a passing familiarity with how Canadian health care actually works. I think on this basis, I'd be fine but you'd have a bit of a struggle.

You are wrong. I am referencing the Canadian supreme court and it does have implications for all of the provinces. There is no such thing as the "Quebec supreme court". And it's hardly a niggly matter. This decision forced the governments of many provinces to step up their spending to reduce wait times.

Sorry, I mis-spoke. What I mean is, the Supreme Court decision applies only to Quebec. Yes, it's relevant to any other province that has BOTH a prohibition on duplication of coverage (not the case in every problem) AND a problem with unreasonable wait times for elective surgery, but only Quebec was obliged to immediately take administrative action to rectify the problem.

I don't know how to respond to this politely.

It's a valid ethical question. Whose problems should we be more concerned about: the very ill and uninsured - like Jamaesi - who are not receiving any care, or the American Capitalist - like yourself - who might see a dent in his profits if care is provided to the uninsured?

I wouldn't have brought it up if you hadn't insinuated that universal health insurance coverage is unfair to the owners of health-care related businesses.

 

[yossarian22]

It's a valid ethical question.

Not in the way you are framing it.

 

[Alceste]

Not in the way you are framing it.

How should it be framed, in your opinion?

 

[yossarian22]

How should it be framed, in your opinion?

preferably in a way that does not turn his point about [starting a health business] into a ridiculous strawman.

 

[Alceste]

preferably in a way that does not turn his point about [starting a health business] into a ridiculous strawman.

Well what do you think he was saying?

"... although countries with socialized medicine may enjoy a more active capitalistic climate... this would not be the case for the business of health care in Canada."

I mean, to begin with it's a bit incomprehensible due to the use of the phrase "socialized medicine". What we have is "Universal health insurance coverage", funded by taxes and administered by the government. But if you substitute "socialized medicine" with the correct term for what Canada actually has (universal health insurance coverage), it looks to me like he's saying that the BAD thing about everybody having health insurance is that it makes the business of health care less profitable.

And that's bad why? I don't get it. Should I care about profits in the health care business more than I care about universal access to life-saving health services? It's not as if health care in Canada is NOT profitable. It is LESS profitable than in the US, but still very profitable.

IMO, it's not a straw man. Maybe, if you don't actually know how the Canadian system works and aren't aware that the private, discretionary health insurance system in the US is actually killing people, it might seem to be one, but from my point of view it's a valid point.

 

[yossarian22]

Well what do you think he was saying?

"... although countries with socialized medicine may enjoy a more active capitalistic climate... this would not be the case for the business of health care in Canada."

I mean, to begin with it's a bit incomprehensible due to the use of the phrase "socialized medicine". What we have is "Universal health insurance coverage", funded by taxes and administered by the government. But if you substitute "socialized medicine" with the correct term for what Canada actually has (universal health insurance coverage), it looks to me like he's saying that the BAD thing about everybody having health insurance is that it makes the business of health care less profitable.

And that's bad why? I don't get it. Should I care about profits in the health care business more than I care about universal access to life-saving health services? It's not as if health care in Canada is NOT profitable. It is LESS profitable than in the US, but still very profitable.

IMO, it's not a straw man. Maybe, if you don't actually know how the Canadian system works and aren't aware that the private, discretionary health insurance system in the US is actually killing people, it might seem to be one, but from my point of view it's a valid point.

I wasn't clear perhaps.

The claim he is making (hopefully I don't butcher your point Jackytar) is that while UHC might make creating small businesses easier, this does not extend through every industry, most notably health services industry, where it diminishes competition (as the industry is harder to get into).

This statement (presumably) is really about whether or not the decrease in health company performance (whether or not this would happen is debatable) is ultimately beneficial or not (also debatable).

Personally, I think he is wrong but to frame his statement as profits over life is a massive strawman.

 

[jamaesi]

Yes, I do install the electrical portion of the MRI machines. Running wiring and conduit around a big magnet presents certain challenges. When machines are first set up, they need a Ginnie pig. I sometimes get a freebe. I still have to pay to have the test read though.

I was not expressing disbelief that you have not MRIs and have a company that builds, installs, and maintains them.

I was expressing disbelief that because you have had MRIs and have a company that builds, installs, and maintains them, that you would not know they are a part of radiology, use radio waves, and that an radiologist reads MRIs.

 

[Alceste]

Personally, I think he is wrong but to frame his statement as profits over life is a massive strawman.

Fair enough - it could very well be he was just making some subtle point about differences in the viability of health care start-up businesses on either side of the border. I suppose I'd need to see some data, since it's an issue I know nothing about. I haven't heard of any problem in Canada with health care being unprofitable before now. We do have a lot of defectors in the health industry to the US because it is more profitable there - after all, you pay twice as much as we do.

To be honest, I believe the debate actually is over whether the US values profits over lives. It's just that a lot of Americans don't know that's what the debate is, since the media portrays it as something else altogether. The real battle here is between legislators in both parties who want to save lives, and lobbyists in the for-profit health care industry who want to maintain increase profits. I don't know, maybe you see that as a straw man. I see it as cutting through all the lies, propaganda and rhetorical nonsense to the actual heart of the matter. Lives or profits? Which does America value more?

 

[tumbleweed41]

I was expressing disbelief that because you have had MRIs and have a company that builds, installs, and maintains them, that you would not know they are a part of radiology, use radio waves, and that an radiologist reads MRIs.

Gotta admit, does sound a little strange.

 

[Jackytar]

Sorry, I mis-spoke.

Oh. You weren't completely oblivious about a recent landmark Canadian supreme court decision that penetrated to the heart of Canadian health care system, and went so far as to invent a new tier to Quebec's DOJ and a completely made-up and erroneous detailed analysis of it's implications to support your position. You misspoke.

To join the debate, Jacky, all you need is a passing familiarity with how Canadian health care actually works. I think on this basis, I'd be fine but you'd have a bit of a struggle.

Hmmm...

If you mean am I opposed to a private health care industry in Canada, of course not. We have one of those already - it provides almost all of our health care services, then sends the government the bill.

Almost all services, eh? You mean like... hospitals? Medical laboratories? Home health? Surgery centers? Diagnostics? Physical therapy? Dialysis? Rehab? Behavioral health? Did I already mention... hospitals?

Perhaps you misspoke.

Think about it. Alceste. How is it that long waiting lists are blamed on provincial governments when all they do is "pay the bill" to private providers. How is it that provincial governments set the budget for health care in advance and expects the providers to stick to it if all they do is "pay the bills".

Or maybe you can tell me this. How many loonies does your provincial government pay your private provider for an MRI of the head? Can you retrieve this information for me?

Jackytar

 

[twinmama]

Just reminding that there are many many other countries with public healthcare where waiting times or other issues are no problem.

 

[Valjean]

Every system has problems. When they're recognized, administrators make changes to fix them. New problems will come up, and the system will be tweaked again and again.

Some systems, though, are wolves in sheep's clothing. They're not what they appear to be. Much of American "healthcare" is like this. Parasitical companies feeding off society while pretending to be mutualistic symbionts. A system like this could do with a complete overhaul.

 

[Alceste]

Oh. You weren't completely oblivious about a recent landmark Canadian supreme court decision that penetrated to the heart of Canadian health care system, and went so far as to invent a new tier to Quebec's DOJ and a completely made-up and erroneous detailed analysis of it's implications to support your position. You misspoke.

That's just rhetoric, Jacky. Meaningless. And apart from sticking "Quebec" in front of "SUpreme Court" by mistake, which I've acknowledged, you haven't demonstrated that my analysis is erroneous, or any more "made-up" than yours.

Almost all services, eh? You mean like... hospitals? Medical laboratories? Home health? Surgery centers? Diagnostics? Physical therapy? Dialysis? Rehab? Behavioral health? Did I already mention... hospitals?

Well, 3/4ths of services in Canada are privately delivered and publicly funded according to a former director of the Canadian Medical Associstion, as I've said before. That would leave 1/4 remaining, divided between services that are both privately delivered and funded, services that are both publicly delivered and funded, and services that are publicly delivered and privately funded. There are many different approaches to running hospitals, I'm not aware of any that are administered directly by the government.

Think about it. Alceste. How is it that long waiting lists are blamed on provincial governments when all they do is "pay the bill" to private providers. How is it that provincial governments set the budget for health care in advance and expects the providers to stick to it if all they do is "pay the bills".

Why are they blamed? lol. Hmmmm... let me think. Maybe because longer wait times for non-critical procedures is the only area where public health insurance systems in some countries perform worse than the US, so it's like crack to health industry propagandists.

Not saying it's not a problem, mind you, but it's a problem that is totally manageable within the existing system with a bit of administrative tweaking.

Or maybe you can tell me this. How many loonies does your provincial government pay your private provider for an MRI of the head? Can you retrieve this information for me?

Jackytar

I posted a link to the fees schedule, you can look it up yourself.