International Canada spends less tax dollars on healthcare than the USA

[cincymma79]

Larger scale should make prices come down more.

If this were driven by markets it would, this is not

 

[Andy Capp]

I wonder if we could harness both.
I live in Japan and the drug companies say the prices are so low that they stifle innovation. Which is probably true as drugs here are far behind and medical techniques are also lagging

Japan has some very deeply systemic issues. Sadly, it looks like nothing less that total collapse of the entire thing will lead to much in the way of reform, however.

 

[Andy Capp]

My own anecdotal evidence as a healthcare worker, I've met a lot of Canadian clinicians that come to the states to practice since the pay in Canada is abysmal in that particular field. I mean, it isn't great here in the states but it's far worse on the other side of the boarder.

Do you consider well over $200K/yr to be abysmal?

 

[Rek Rekington]

Good job @Sketch, proud of you guys!

 

[Andy Capp]

Yeah I have a hard time taking that comment at face value too. I went to the hospital ER for a bloated stomach; no pain no signs of anything serious. Yeah I waited about 4 hours before being seen. They did a ultrasound and found a fuck ton of liquid. They kept me overnight for a scan in the morning. Did the scan: cancer. Within an hour I saw one gastrointestinal specialst, one oncologist and an oncology resident. That evening I did a colonoscopy and stayed a week for all required testing including biopsy and they were draining my stomach every other day because it was super uncomfortable. I eventually got my chemo and knock on wood I’ll be fine.
My point is if the situation was as the guy described, that we’re good at taking care of just minor issues, then we wouldn’t have the life expectancy rate that we have. Our system isn’t perfect but I thank my lucky stars I didn’t get cancer in the U.S

Acute problems get taken care of pretty well, I think. In fairness to the lowered quality of care argument, I feel I must point out the "triage everything" philosophy according to which our system operates results in a certain fraction of people deemed to have non-urgent conditions who turn out to have much more serious illnesses. The correspondingly contrary situation in the states, of course, seems to be throwing the kitchen sink at minor things "just in case". Whether this cost-saving trade-off is justified is debatable but I think the average Canadian would agree with it and that's the main thing as far as I am concerned when it comes to the cost argument.

 

[Ultra O’Dia]

War Canada.

i remember a time, not long ago, where Sweden would have been at or near the top of all of those lists.

 

[Andy Capp]

I wonder what the taxes would be like here (Canada) if they had enough doctor nurses to not wait for health care.

For example from what I've read. The avg wait time in emergency is like 5 hours where it's more like 30 mins in the US

And how many of those are non-emergency visits by people who for whatever reason didn't go to a clinic or family doctor?

 

[luckyshot]

I think this applies pretty well here:

 

[Jack V Savage]

You pay more in $ and % in GDP for less coverage and arguably less effective outcomes. Drugs are a big piece of it, lack of preventative care, use of emergency rooms, the lack of monopsonistic buying power and coordination, and the perverted incentives of insurance actors, all have a role. But I think it’s fair to raise the point that any system that increases participation will see some, if not many of the benefits that Medicare has. Where I might state it differently is that with Medicare Canadian system you will reduce costs but there are ways to get there in the USA that don’t abandon the entire system.

I think you probably need a microscope to see our substantive disagreement here, but can you elaborate on the perverted incentives? Seems to me that the incentives that insurers have is to hold prices down.

I think fans of single payer see insurers as the enemy (and they are when it comes specifically to single payer), and thus want to blame them for everything, but when it comes to keeping costs down, the enemy (that is, the party that benefits from higher costs and fights to increase costs) is providers, with insurers being on the side of buyers (i.e., sick people).

 

[Andy Capp]

I think you probably need a microscope to see our substantive disagreement here, but can you elaborate on the perverted incentives? Seems to me that the incentives that insurers have is to hold prices down.

I think fans of single payer see insurers as the enemy (and they are when it comes specifically to single payer), and thus want to blame them for everything, but when it comes to keeping costs down, the enemy (that is, the party that benefits from higher costs and fights to increase costs) is providers, with insurers being on the side of buyers (i.e., sick people).

Indeed, I see over and over again the bump prices receive when a cost is expected to be borne in whole or in part by an insurer. A method to defeat that gaming of the system is where the most cost saving would be realized in any health care system ("with for-profit insurance" may be a key qualifier here--I haven't given it enough thought to be sure it's required).

 

[Gundarmyx]

Someone just said average wait time in the ER in US is 30 minutes? I call bs on that one. I've been few times myself and with families and the average is at least 4 hours or more of wait time.

Healthcare needs an overhaul asap and i don't see any of the elected officials doing anything to help the issue. Just block and criticize any ideas like medicare for all.

 

[Deleted member 159002]

Someone just said average wait time in the ER in US is 30 minutes? I call bs on that one. I've been few times myself and with families and the average is at least 4 hours or more of wait time.

Yeah, that half hour stat has to be bullshit. The numbers in this link are much longer. https://projects.propublica.org/emergency/

 

[wufabufa]

Do you consider well over $200K/yr to be abysmal?

You're assuming I'm talking about physicians. I'm not.

 

[MikeMcMann]

I'll say again. Canada is not the HealthCare Model to template off of.

Our mistake is that every doctor, nurse, janitor, etc in the industry is an 'EMPLOYEE' of the gov't. Every MRI machine, stethoscope, etc, is bought by gov't. And the Insurance for every citizen is supplied by gov't.

Only the last one should be done via gov't as the one who controls the Insurance pool can drive costs down on both Pharma and Service providers.

When gov't makes everyone an employee it leads to bloated bureaucracies and exorbitant wages. When gov't owns all the equipment its gets rationed and you don't have the latest and greatest as they have budgets to live to. It is a big mistake to go those two roads.

As France and the UK and others ranked much higher than Canada do, just stick to single payer Insurance only. That is the key.

But even with all the bloat and inefficiencies in the Canadian system it still beats the US in many ways for average citizens. That is how badly the industry profits are harming the US citizens.

 

[ryan3434]

And how many of those are non-emergency visits by people who for whatever reason didn't go to a clinic or family doctor?

Probably not just a Canadian phenomenon so point still stands Canadian ER's are under staffed

 

[Gandhi]

I think you probably need a microscope to see our substantive disagreement here, but can you elaborate on the perverted incentives? Seems to me that the incentives that insurers have is to hold prices down.

I think fans of single payer see insurers as the enemy (and they are when it comes specifically to single payer), and thus want to blame them for everything, but when it comes to keeping costs down, the enemy (that is, the party that benefits from higher costs and fights to increase costs) is providers, with insurers being on the side of buyers (i.e., sick people).

Well my disagreement was bigger when the post started but as I was thinking it through / writing it down I have to agree it became pretty minor.

Glad you picked up on the insurance thing though. I would say insurance and employer specific insurance specifically brings a lot of additional problems.

I think we can all agree that costs and benefits of health care are opaque, wildly fluctuating on an individual bases, and have very long time horizons. That and a very small subset of uses result in a majority of the cost occurrence. I think in that situation insurance companies have a lot of incentive to reduce costs by denying and restricting service.

Insurance companies need to worry about a small section of people they can fuck over to save a ton of cost going somewhere else if those people have enough agency with the their employers. They also can worry about being sued by these people. There is a lot of grey zone for abuse I see potential for market forces to keep costs down in ways that are patient beneficial and non beneficial.

That’s not to say insurance companies don’t have some great plans or that it MUST be eliminated. M4A would get rid of the conflict but maybe a simple public option would be enough to keep them honest as well.

 

[panamaican]

I've come to accept that universal healthcare is probably cheaper/more efficient than our current model if done properly.

The arguments about quality are harder to quantify.

 

[AndroidRage]

It is important to be honest about the challenges of gov't 'anything' when you make this argument.

Sure there is no 'profit' in gov't delivered service but there is always 'waste', 'bloat' and 'exorbitance'. That will happen in a gov't run insurance program. Once you create a sole provider of anything with no competition the things I said inevitably creep in. Sometimes that can be more costly to citizens then the 'profit' a private entity would make.

The issue is that 'in this case' that 'waste, bloat and exorbitance' will be much less than the profit made by all the parties you identified rightly getting rich off the profits.

Except that has not been the case with medicare for many years now.

 

[D3thr0n3d K1ng]

Who could have guessed that a mountebank run healthcare system would result in increased costs and people being denied care????

 

[SammyPops]

Nationalizing it would decrease not only the quality, but most importantly, the innovation in the progress of medicinal science. The prime motivation for finding cures, just like with everything else, is to make money.

Does anyone know which country in the world comes up with the most advancements in medicine?

Too tru, and all us who benefit from the US system but do not pay into it or live with it- thanks!