Sicko (the movie)

Parent Cafe
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<p>A direct e-mail quote from a family friend who lives in Canada (and has raised 6 children there, and is now a grandmother many (many!!) times over):</p>

<p>For us Insurance is different in every province. In Ontario we never paid any health insurance for ourselves, because it was only paid for by employers. We did however pay for our employees. It was paid geared according to income. The employers did not pay, but were covered. In Alberta, we also never paid, because our income was too low. We paid a monthly sum of around $40., but it got refunded at the end of the year. </p>

<p>I know at the last election in your country, someone was promising to bring in the Canadian health system. In Canada people complain about the long waiting list for MRI and hip and knee replacement. We have never had to wait for anything. Except for waiting an hour in the hospital or doctor’s office. </p>

<p>No one is refused help. No income people get the same treatment as high income people. If you do not like waiting periods, you can always pay for private.</p>

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<p>

</p>

<p>Exactly! Also true in Britain, but, then, it is no longer a single payer system. :D</p>

<p>From the WSJ:</p>

<p>"In Canada, dogs can get a hip replacement in under a week. Humans can wait two to three years.</p>

<p>BY DAVID GRATZER</p>

<p>TORONTO–“I haven’t seen ‘Sicko,’ " says Avril Allen about the new Michael Moore documentary, which advocates socialized medicine for the United States. The film, which has been widely viewed on the Internet, and which will officially open in the U.S. and Canada on Friday, has been getting rave reviews. But Ms. Allen, a lawyer, has no plans to watch it. She’s just too busy preparing to file suit against Ontario’s provincial government about its health-care system next month.
Her client, Lindsay McCreith, would have had to wait for four months just to get an MRI, and then months more to see a neurologist for his malignant brain tumor. Instead, frustrated and ill, the retired auto-body shop owner traveled to Buffalo, N.Y., for a lifesaving surgery. Now he’s suing for the right to opt out of Canada’s government-run health care, which he considers dangerous.”</p>

<p>"Consider, for instance, Mr. Moore’s claim that ERs don’t overcrowd in Canada. A Canadian government study recently found that only about half of patients are treated in a timely manner, as defined by local medical and hospital associations. “The research merely confirms anecdotal reports of interminable waits,” reported a national newspaper. While people in rural areas seem to fare better, Toronto patients receive care in four hours on average; one in 10 patients waits more than a dozen hours. </p>

<p>This problem hit close to home last year: A relative, living in Winnipeg, nearly died of a strangulated bowel while lying on a stretcher for five hours, writhing in pain. To get the needed ultrasound, he was sent by ambulance to another hospital."</p>

<p>“In Britain, the Department of Health recently acknowledged that one in eight patients wait more than a year for surgery. Around the time Mr. Moore was putting the finishing touches on his documentary, a hospital in Sutton Coldfield announced its new money-saving linen policy: Housekeeping will no longer change the bed sheets between patients, just turn them over. France’s system failed so spectacularly in the summer heat of 2003 that 13,000 people died, largely of dehydration. Hospitals stopped answering the phones and ambulance attendants told people to fend for themselves.”</p>

<p>Like I said: we either ration by price or by queue.</p>

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<p>bluebayou, </p>

<p>Our experience and that of our friends and family members is not what you’re claiming. Having spent extended periods of time living in both countries and having had to deal with many medical issues, large and small, I’d still take the Canadian system over the one in the U.S. There is undoubtedly room for improvement in the Canadian system, not the least of which is the mindset whereby people abuse the system because they feel that it’s “free”. The issue of wait times to see specialists always seems to be cited when the system comparison is made but, honestly, we have not experienced this. Much of the time, the wait issue is a result of someone living in a small town, far from a city which would be able to provide them with a particular type of specialist. As for seniors or individuals in the endstages of life? I’ve never heard of anyone being given the ‘stock response’ that you’re indicating.</p>

<p>As was stated by someone earlier in the discussion, I don’t see Americans ever approving a system similar to the Canadian one because I don’t see them willing to support it with the increased taxes that are necessary.</p>

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<p>My experience:
I practice in what might be called a mix of Medicaid, HMO and PPO. It is similar to Private practice. One of our biggest problems is access to our specialty clinic. Patients have trouble getting in. This is largely due to the fact that Medicaid in California pays less than the cost of giving the care, so many doctors opt out. Across the street at the Veterans Hospital they had an access problem as well, getting patients into their specialty clinic. With the arrival of a new medical director the problem was solved in their clinic. I was totally intimidated by their success relative to ours until I learned that what had happened was that the 6 - 12 month wait to get into clinic was reduced to a matter of weeks but that the wait to go to surgery after being seen in clinic was now 12 months. They could now say that they had access without actually giving any more “care”.
Government Medicine will become an entitlement like any other. It should be free. People also hate paying taxes. There will be rationing of care. At any one time there are more tax payers than there are sick people. The drive to save money will always be stronger than the urge to provide care to people you don’t even know.</p>

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<p>

You’ve hit it exactly, Bluebayou. Both are options, in any case. </p>

<p>Alwaysamom, just because you didn’t have problems in the Canadian health care system doesn’t mean that they don’t exist. Maybe you were lucky. Maybe you were in a good area. That doesn’t change the fact that the Canadian government itself, in Bluebayou’s statistic, says that only half of patients are treated in a timely manner. I didn’t know that, but the statistic should be alarming. </p>

<p>I live in a rural area, and I’m glad that I can see the doctors I need to see this summer on my own time while I’m home from college. I went in to the doctor’s office yesterday not expecting much, and I left with the knowledge that I’m having blood work done in two days, another doctor’s appointment in a week, two minimally invasive surgical procedures in the next few weeks, and three appointments with different specialists, including in-demand specialties such as neurology and hematology. I’m also going to have my eyes checked and get my non-infected wisdom teeth (a purely elective procedure) removed this summer. If I were in a UHC system (especially one run by the United States government), who knows when these things would happen?</p>

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<p>mardad:</p>

<p>I’m glad you mentioned the VA, since many want the Medicare prescription Rx program to follow the VA pricing structure. But, those folks need to be careful what they wish for since the VA has a strict drug formulary. The latest and greatest high tech drugs (and also expensive) are NOT on the VA list and therefore cannot be used to treat our veterans.</p>

<p>alwaysamom: It was a Canadian govt report that stated that wait times are not where they should be.</p>

<p>"Canadian doctors, once quiet on the issue of private health care, elected Brian Day as president of their national association. Dr. Day is a leading critic of Canadian medicare; he opened a private surgery hospital and then challenged the government to shut it down. “This is a country,” Dr. Day said by way of explanation, “in which dogs can get a hip replacement in under a week and in which humans can wait two to three years.”</p>

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<p>"In that case, Opie of Maybery2, it would not be true that
Quote:
claims will still need to be processed, forms filled out… I mean come on, look at the tax code…My tax return is a half inch thick. It’s going to be simpler? </p>

<p>It would be simpler because pateints, doctors, claims payers would all know what’s covered. There’d be only one claims payer for each claim, not two or three if you also have Medicare or coverage through a spouse. It’d be “one and done.”"</p>

<p>Very you don’t think their’s paperwork involved in medicare and other government run programs? :slight_smile: :slight_smile: </p>

<p>While you are no doubt quite experienced for your company’s position in the health care system, you are mistaken about paperwork and government.
Does your company self insure and use a stop loss carrier for risk? </p>

<p>One of my clients is a home health care agency… do you know who the #1 slowest to pay provider is??? Our government. Do you know how much paperwork they require now, when they are the payor? This company had a special claims person just to work on the government side of billing. You don’t think the government didn’t question procedures? Sure it’s a covered procedure, but you used it in situation “A”, when our manual clearly states to only use this procedure in situation “B”. </p>

<p>The owner finally had enough not being paid for months for basic claims that she sold her license for medicare to someone else. It wasn’t so much the discounted dollars that medicare pays, it was the fact that in many cases it was taking 12 months or more. </p>

<p>Again, because we don’t like the current system we push almost mythical effiecency on a government that really isn’t there. We through hopefulness make the government as a carrier a paperless, unquestioning, quick efficient deliverier of services at the same time refusing to see how they do now. They are extremely slow to pay, require gobs of paperwork, respond slowly to error inquirys. </p>

<p>Nothing below the top layer and sales department would change, you would still have claims, claims questions and the sheer volume of claims to deal with. In fact, I would be willing to bet the cost would go up, unless high deductibles and copays were used.</p>

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<p>corranged, I didn’t say that there weren’t any problems with the Canadian system. The problem with relying on any particular study or statistical report on things as subjective as being “treated in a timely manner” is that you’re not likely to get a good sense of what is actually happening ‘on the ground’. The article she posted which quoted the claim about a dog getting a hip replacement in a week is ridiculous. Well, of course, a dog can get a hip replacement in a week, because the owner is paying for it! That has absolutely nothing to do with the healthcare debate for humans. As I said before, I know many people who have had hip replacements and not one of them had to wait anything remotely close to two years. It has nothing to do with me being in a ‘good area’, or being lucky.</p>

<p>Looking at the issue cannot be narrowed down to one study of how long it took people to be seen at emergency rooms. The totality of the system must be examined and I don’t see any comments about the positives of the Canadian system being made by those of you who are so quick to point out what you see as such huge negatives. Is it not a positive that everyone has access to care? That no one has to fight with insurance companies, or even worse, to bankrupt themselves to get the care they need? That no one has to refrain from seeking care because they don’t have the insurance or the money to pay for it? </p>

<p>I’ll state again that, no, I don’t think the Canadian system is perfect but it sure beats a system which allows millions of people to be uninsured, and which also makes it as difficult as possible for millions more who ARE insured to get adequate care. Brian Day’s opinions on Canada’s healthcare system should not, and cannot, be limited to the quote by bluebayou. For those of you who are actually interested in looking further than soundbites into what he thinks, you might want to read his website, where he unequivocally states that he is not in favor of privatizing healthcare, but rather in a system which balances each in the delivery of care. As I said before, a balanced approach is probably ideal but, in the meantime, I don’t see any way in which the current approach in the U.S. is favorable, when considering the general population as a whole.</p>

<p><a href=“http://www.brianday.ca/[/url]”>http://www.brianday.ca/&lt;/a&gt;&lt;/p&gt;

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<p>Mardad hit an excellent example of government run health care… The VA hospital. We all seem to have short memmories. Didn’t we just fire the General of the DC VA hospital for the condition they were in? We have a government that basically REFUSES to fund healthcare for the people who put their lives on the line and didn’t come back whole. Now we “think” they’re going to care for all of us with hugs and kisses? </p>

<p>I’d agree with the concept more if the little piece that they currently have wasn’t so screwed up. </p>

<p>Another side tibit about the Canadian system. Equipment is rationed by the government there. While vacationing in Victoria and reading the newspaper a big article on a hospital hoping for BC government approval of an MRI machine. The government was concerned because there already was a machine within 20 miles of this hospital. A simple way to control cost is to limit access.</p>

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<p>Actually, I’m currious to see how the mandated requirement of health insurance is going to work in MA. Of all those millions of uninsured, roughly half can buy health ins, but choose not to. They don’t feel the need for coverage at any price. I’m in the business and I run into them all the time. They have the money, the just don’t see the need.</p>

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<p>“I have a friend with relatives who live in Canada. My friend told me that there were long waits to see a specialist, but I don’t know if this still occurs, b/c I was told about this many years ago.”</p>

<p>We live next to Canada. We send busloads of seniors in the prescription drug "donut hole: (or usually family members) up to Canada to get their meds. We have excellent health insurance, and it took my d. almost 9 months (including a change in health insurance) to get the proper operation for her knee (which then healed in two weeks. Don’t assume that the U.S. system works so well for those with insurance either. </p>

<p>All that is anecdote, of course.</p>

<p>Anyhow, there are regular surveys among both Canadians living in BC and Washington state residents regarding which system each of us would prefer. We are the folks most attuned and knowledgeable about our respective systems. 86% of Canadians, given the choice, prefer their system. 70% of Washington residents (including a majority of Republicans), and despite all the capitalist press decrying the horrors of socialized medicine, prefer their system.</p>

<p>I would imagine that docs would prefer our system (given profit potential). Yet, they are leaving their practices where I live (a state capital) in droves. Canadian doctors could easily move here and set up practices. They don’t.</p>

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<p>mini:</p>

<p>Presrcriptions are definitely cheaper practically anywhere but in the US. However, I would guess that the busloads of seniors aren’t going to Vancouver to see a physician.</p>

<p>"The total waiting time for patients between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, increased slightly this year; rising to 17.9 weeks in 2004 (from 17.7 weeks in 2003). </p>

<p>“This stalling of waiting times is not a good-news story. It is important to remember that these waiting times are the longest that Canadians have ever experienced and that they exist despite record levels of health spending,” said Nadeem Esmail, senior health policy analyst at The Fraser Institute and co-author of the survey. “Canadians should not expect to see any dramatic improvement in waiting times as a result of the latest federal-provincial agreement on health care funding. The long waiting times for medically necessary services are a symptom of a much greater problem: a poorly designed health care system,” Esmail continued.</p>

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<p>In February, my younger d. went to the emergency room for an asthma-related condition. This is a town of mostly middle-income folks, very, very few undocumented immigrants, few language difficulties, etc. She waited for 5 hours. They didn’t test for influenza (figuring that since she had been vaccinated, it couldn’t be that.) She was back in the emergency room the next night, a slightly shorter wait, and this time they bothered to test her. Sure enough. </p>

<p>Hers was far from the first case of vaccine-resistant influenza in our town. But poor medical practice not only meant pain on her part, fear on ours, a couple of thousand dollars in medical bills mostly paid for by our insurance company, but an unnecessary clogging up of the emergency room - it was indeed an emergency, but an unnecessary one.</p>

<p>The docs were well paid. Obviously none of them (the first night) had bothered to read the public health advisories on vaccine-resistant influenza. I’m sure they meant well. But they get paid either way.</p>

<p>As noted, we had to wait almost nine months to see the right specialist here. Anecdotal of course, but lowering wait time to see less than qualified specialists (which happened to us because of insurance company practice) is hardly a response worth having. We would have been extremely grateful for a 17.9 week wait for the result finally achieved after fighting with, and ultimately leaving, a very highly ranked HMO.</p>

<p>The poor design of the U.S. health system is so well-documented it is hardly worth talking about. Again, we and our Canadian neighbors are those who know both systems best. We both vote overwhelmingly, and regardless of political persuasion, for theirs, wait times and all.</p>

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<p>One thing that should be mentioned about healthcare in Canada vs the US is that Canada actually spends about half as much per capita than the US (and a smaller portion of its GDP, in fact, few nations spend as much or more than the US per capita on healthcare). To claim that a Canadian-style healthcare would be more costly is therefore dubious*. Also, if Canada were to spend as much as the US on healthcare, many of its current problems would be reduced or disappear altogether. Federal and provincial governments drastically reduced funding years ago to reduce their deficits, creating many of the problems seen in the Canadian system today. Even now that at least the federal government has surpluses, fixing those issues cannot be done in a short amount of time.</p>

<p>*That is not to say changing from one system to another is easy and cheap. Obviously, trying to change a sprawling byzantine bureaucracy into a streamlined system is going to take a lot of effort, time and money. But the idea is not to dismiss other systems because they have their own problems; it’s to look at the problems of one’s healthcare system, and consider solutions offered by other systems, to see whether they can be adapted to work on one’s home turf.</p>

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<p>mini, but what “vote” has taken place? where? If a vote took place in Wash State, what happened to the will of the people?</p>

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<p>Ah, this is stuff I know about, because I worked for the State Board of Health at the time. In 1992, after two years of study (and having concluded that the Canadian system was both cheaper and more efficient, delivered better care to more people, as well as dealing with the problem of the uninsured),the Washington Health Care Commission voted to implement a “single payer system”. However, to do so required an “ERISA” waiver (waiver of law that basically exempted large, self-ensured employers like Boeing) from state regulation/control. In the 1970s, Hawaii had received such a waiver. No state had received one since. At the same time Washington’s Guv directed the state’s lobbyist to petition for a waiver, Minnesota and Vermont (two other states bordering Canada, where the people, based on experience, also favored a Canadian-style system) also did the same. But the Clinton Administration was in the throes of its own health care debacle, and decided to grant no waivers, the thinking being that they need Washington, Minnesota, and Vermont if they were ever going to pass something.</p>

<p>So, instead, we ended up with a managed-care nightmare from which we have yet to recover, 793,000 people without any insurance whatsoever, doctors leaving their practices, overfull emergency rooms, wait times for specialist care, seniors going to Canada for prescriptions, and 70% of Washington residents favoring the health system of our BC neighbors (as well as 85% of Canadians favoring their system as well.) The people would still overwhelmingly support a Canadian-style system in Washington, but there is no ERISA waiver on the horizon.</p>

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<p>Opie: If you re-read my posts, I never said that having the government be the single payer was the solution; I just said we need a single payer. I don’t know who should manage the single payer health care plan. </p>

<p>That said, I do believe it’s the responsibility of the government to make sure its citizens have decent health care, just as it’s the government’s responsibility to make sure its citizens are well-educated. That’s why we have public schools, and laws requiring children to attend school</p>

<p>And Yes, my company is self-insured; and Yes, we do have stoploss insurance. I’m not sure how that’s relevant, but you did ask.</p>

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<p>then, back to my original premise: disconnect health insurance from employment (which then eliminates the ERISA issue), AND allow people to buy individual/group policies across state lines (which is essentially forbidden by your – and my – local legislators), unless self-funded.</p>

<p>Another thing to remember about the “cost” of insurance: each state rakes in 3-5% of premiums as a tax. Eliminate the tax and the price would drop by that amount.</p>

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<p>Bluebayou - What are your credentials? I think much of what you are posting is just plain inaccurate. Perhaps I am wrong or misinterpreting what you are saying, however, I am curious.</p>

<p>People who are veterans may know that the VA is gradually cutting back benefits to veterans. There is a very tiered system now. However, a friend of mine who is a nurse practitioner with the VA says if you are a Veteran who doesn’t qualify according to the Bushie cut offs, you should apply anyway, as people who are being told they don’t qualify, frequently get coverage anyway.</p>

<p>Does the idea of univeral health care make anyone else think of Monopolies? It sure does me. I remember the days when they were illegal. I suppose they are still, though aren’t all the industries gradually being bought by the largest player? I can imagine this being the result of universal health care in the US. It would be a disaster, in my opinion.</p>

<p>Mini, how could that be that it is taking your daughter nine months to see a specialist. Who is your insurance carrier? An ER wouldn’t make somebody in respiratory distress wait 5 hours, especially a child, if the parent is in their face. You can demand a test be given your child. Don’t be nice to Drs. Threaten to sue if they won’t do what you want. It is very effective. Of course, argue and reason extensively before threatening.
When you threaten, send an email to the Dr. and copy it to multiple people. You can tell the Dr you are copying and blind copy, so he doesn’t know to whom he is being reported, or let him know. It always works. If you do not have time to email, follow up the threat with the emails.</p>

<p>I had an incident with my son at his school. I didn’t agree with the health care he was getting for a knee injury. Somehow, by shmoozing with the receptionist, I got put through directly to the Dr. He actually answered the phone. I wanted my son to get an MRI for a knee injury which the Dr refused to order. Finally I said,“Please, I’m begging you.” Still he refused. I told him I intended to pursue it beyond him, called the hospital director and sent multiple emails to the Dr. and the Director. Within less than 5 mins of my emails, I was called and my son got extensive treatment. This is how people have to deal with the medical ego maniacs.</p>

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<p>Jamie,</p>

<p>Not so, that letters “always work”. We have had two very serious incidents, where doctors or nurses completely misdiagnosed a condition (once was a serious allergic reaction, which ended up as an emergency, and the other was a pneumonia, which was undiagnosed with both an office and ER visit (neither did a blood test or chest xray, and wasn’t discovered until D had a fever of 105).</p>

<p>My H and I wrote letters, and in the case of the near death allergic reaction, we quit the practice and wrote to the president of the HMO, and got a response that basically absolved themselves of any wrong doing. It was outrageous.</p>

<p>Unfortunately, we gave the ER in the hospital (which did not pick up on the pneumonia) another try when my S broke his ankle. After waiting three hours, he was left by himself in an exam room while the xray techinician went to have dinner. It was 6:00 afterall. When S didn’t come out after five minutes, I rapped and rapped on the door. Can you imagine leaving a kid in there while you went to get a hamburger? Apparently, someone thought this was no big deal. Dinner couldn’t wait till AFTER the xray. Nope. Had to go, right on the stroke of 6.</p>

<p>Needless to say, we will never again go to that hospital EVER, for any reason, but despite writing letters in all the above cases, absolutely nothing happened, except denial of any sort of culpability on the part of the docs, nurses and hospital staff.</p>

<p>Outrageous.</p>