Obamacare in action- company scraps expansion plans over taxes

[FuzzyLumpkins]

"health care spending per capita"

You can post stuff like this, but the spend per capita is less because the amount of care delivered is less. Government WILL curtail care and control access, unlike what we have here. People thought HMO's were bad in the early to mid 90's, well they would be considered a free for all when compared to the typical giovernment run healthcare plans.

WTH are you even talking about? Based on what metric? The amount spent per capita went up. My point is that the increase from 2008 to 2010 was not as much as from 2002 to 2004 for example. IE the rate of change has gone down. Not that the total has gone down.

That is all just nonsense you are pulling out of your ass. And why are you comparing it to HMO's when it's based on existing insurance structures and Medicaid expansion. You literally are just regurgitating shitty propaganda.

About the only sensible thing you have said in this entire discussion is that the labor force is insufficient. Now that same brain thinks that somehow means that doctors and nurses are going to be paid less but the labor shortage is an issue. Thus Hoof's discussion of loosening the hegemony MDs have on medical care.

 

[dbair1967]

WTH are you even talking about? Based on what metric? The amount spent per capita went up. My point is that the increase from 2008 to 2010 was not as much as from 2002 to 2004 for example. IE the rate of change has gone down. Not that the total has gone down.

That is all just nonsense you are pulling out of your ass. And why are you comparing it to HMO's when it's based on existing insurance structures and Medicaid expansion. You literally are just regurgitating shitty propaganda.

About the only sensible thing you have said in this entire discussion is that the labor force is insufficient. Now that same brain thinks that somehow means that doctors and nurses are going to be paid less but the labor shortage is an issue. Thus Hoof's discussion of loosening the hegemony MDs have on medical care.

uh huh

 

[FuzzyLumpkins]

uh huh

Oh I get it. Uh-huh really means 'roll up the white flag.'

I will say that I liked the part about the cost went down "because the amount of care delivered is less." I figured there was no quantification for it and you just pulled it out of your ass. Your response confirms that.

 

[dbair1967]

Oh I get it. Uh-huh really means 'roll up the white flag.'

I will say that I liked the part about the cost went down "because the amount of care delivered is less." I figured there was no quantification for it and you just pulled it out of your ass. Your response confirms that.

Its there because its true. Its the premise of all government run healthcare, and was the premise behind how HMO's would control costs when they were "managing" costs at one point.

I know you dont want to believe it, but the facts are the facts. Go talk to almost anyone with experience within those systems. Access is absolutely restricted to specialty care, advanced imaging and even alot of surgeries and procedures. Here in the USA you can see a specialist usually within a week, you can get an MRI or CT Scan within 1-3 days. You can get results from tests and schedule surgeries a week later. Even with some of the most dire conditions in other countries (like Canada and Grreat Britain) people have to wait months on end to get this same care.

You can argue till you are blue in the face, but this is absolutely 100% true. You are just in denial if you think otherwise.

 

[FuzzyLumpkins]

Its there because its true. Its the premise of all government run healthcare, and was the premise behind how HMO's would control costs when they were "managing" costs at one point.

I know you dont want to believe it, but the facts are the facts. Go talk to almost anyone with experience within those systems. Access is absolutely restricted to specialty care, advanced imaging and even alot of surgeries and procedures. Here in the USA you can see a specialist usually within a week, you can get an MRI or CT Scan within 1-3 days. You can get results from tests and schedule surgeries a week later. Even with some of the most dire conditions in other countries (like Canada and Grreat Britain) people have to wait months on end to get this same care.

You can argue till you are blue in the face, but this is absolutely 100% true. You are just in denial if you think otherwise.

Except the part where medicaid expansions happen and that there is no single payer system. We were talking about the past few years.

And then of course there is the empirical example of every other country in the western world despite all of your unsubstantiated fearmongering. Where is the primary care physician provision in medicaid/care?

Further for acute care your assertion about those countries is full of shit.

 

[FuzzyLumpkins]

AARP Home » Politics » Government & Elections »5 Myths About Canada’s...
5 Myths About Canada’s Health Care System
The truth may surprise you about international health care

by: Aaron E. Carroll, M.D., M.S. | from: AARP | April 16, 2012

Text
Print
Comments
Email1x25_gradient_gray
Recommend
Tweet

Myth #2: Doctors in Canada are flocking to the United States to practice.

Every time I talk about health care policy with physicians, one inevitably tells me of the doctor he or she knows who ran away from Canada to practice in the United States. Evidently, there’s a general perception that practicing medicine in the United States is much more satisfying than in Canada.

Problem is, it’s just not so. Consider this chart:

Source: “2009 International Health Policy Survey of Primary Care Physicians in Eleven Countries,” The Commonwealth Fund, November 2009.

The Canadian Institute for Health Information has been tracking doctors’ destinations since 1992. Since then, 60 percent to 70 percent of the physicians who emigrate have headed south of the border. In the mid-1990s, the number of Canadian doctors leaving for the United States spiked at about 400 to 500 a year. But in recent years this number has declined, with only 169 physicians leaving for the States in 2003, 138 in 2004 and 122 both in 2005 and 2006. These numbers represent less than 0.5 percent of all doctors working in Canada.

So when emigration “spiked,” 400 to 500 doctors were leaving Canada for the United States. There are more than 800,000 physicians in the United States right now, so I’m skeptical that every doctor knows one of those émigrés. But look closely at the tan line in the following chart, which represents the net loss of doctors to Canada.

Source: Canadian Institute for Health Information

In 2004, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out.

Myth #3: Canada rations health care; that’s why hip replacements and cataract surgeries happen faster in the United States.

When people want to demonize Canada’s health care system — and other single-payer systems, for that matter — they always end up going after rationing, and often hip replacements in particular.

Take Republican Rep. Todd Akin of Missouri, for example. A couple of years ago he took to the House floor to tell his colleagues:

“I just hit 62, and I was just reading that in Canada [if] I got a bad hip I wouldn’t be able to get that hip replacement that [Rep. Dan Lungren] got, because I’m too old! I’m an old geezer now and it’s not worth a government bureaucrat to pay me to get my hip fixed.”

Sigh.

This has been debunked so often, it’s tiring. The St. Louis Post-Dispatch, for example, concluded: “At least 63 percent of hip replacements performed in Canada last year [2008] ... were on patients age 65 or older.” And more than 1,500 of those, it turned out, were on patients over 85.

The bottom line: Canada doesn’t deny hip replacements to older people.

But there’s more.

Know who gets most of the hip replacements in the United States? Older people.

Know who pays for care for older people in the United States? Medicare.

Know what Medicare is? A single-payer system

http://www.aarp.org/politics-societ.../info-03-2012/myths-canada-health-care.2.html

 

[dbair1967]

Except the part where medicaid expansions happen and that there is no single payer system. We were talking about the past few years.

And then of course there is the empirical example of every other country in the western world despite all of your unsubstantiated fearmongering. Where is the primary care physician provision in medicaid/care?

Further for acute care your assertion about those countries is full of shit.

No it isnt, its a known fact. Its been widely discussed in numerous reports and documentaries about government run healthcare. I get info on this stuff all the time at work.

Again, you are in freaking denial dude. I dont know what your love of this is, but it seems you are one of yet another of the millions of misguided people who thinks the government has no flaws and can do anything better. When in fact the opposite has been proven true in almost every example you can think of.

If you think this isnt the beginning of an eventual single payer system/national healthcare system, you really are clueless about this.

 

[dbair1967]

http://www.aarp.org/politics-societ.../info-03-2012/myths-canada-health-care.2.html

Thats great, I can probaly finally 100's of similar types of articles that debunk this too.

Care is curtailed in Canada and every other government run system.

 

[FuzzyLumpkins]

The German and Swiss health systems appear particularly well endowed with physicians and acute care hospital beds compared with the United States. The two countries rank much higher than the United States does on hospital admissions per capita, average length-of-stay, and acute care beds per capita. The average cost per hospital admission and per patient day in these countries must be considerably lower than the comparable U.S. number, however, because both countries spend considerably less per capita and as a percentage of GDP on hospital care than the United States does. The average U.S. expenditure per hospital day was $1,850 in 1999—three times the OECD median.19

Fact my ass.

http://content.healthaffairs.org/content/22/3/89.full

 

[FuzzyLumpkins]

I am not in denial I just go by facts and statistics from those countries and ours and do not just make assertions based on nothing except for shit you claim can find.

From the above link:

Some in the United States believe that Canada is rationing health care by placing tight constraints on capacity and waiting lists. That impression is reinforced annually by the annual waiting list survey of Canada’s Fraser Institute.23 Exhibit 5⇑ shows that hospital admissions per capita, indeed, were lower in Canada than in the United States in 2000. Remarkably, however, Canada actually had a higher acute care bed density than did the United States and also reported a greater number of acute care hospital days per capita. The explanation for this seeming paradox could be the much longer average length of hospital stay in Canada. In both 1990 and 1999 the Canadian length-of-stay exceeded the comparable U.S. numbers by about 20 percent. To the extent that bed capacity is a binding constraint in Canada, further reductions in average lengths-of-stay could help to relax that constraint.

 

[dbair1967]

Financial Post
Homemore
Sick health care system made Canadians lose more than $3-billion in economic activity in 2011: Fraser Institute
Dan Ovsey Jun 20, 2012 – 2:13 PM ET | Last Updated: Jun 21, 2012 8:46 AM ET


THE CANADIAN PRESS/ Paul Chiasson
“Rationing health care in Canada doesn't just deprive patients of timely access to necessary medical treatment... it also causes them to lose out on wages, productivity and enjoyment in life while they wait,” says Nadeem Esmail

Comments Email Twitter inShare15The key to boosting productivity in Canada may come from an often overlooked but seemingly logical source – health care.

So says a study released this morning by the Fraser Institute, which estimated that last year Canada lost $1.08-billion in business-day economic activity due to excessive wait times at hospitals and time gaps between visits to specialists and receipt of treatment.

Long waits in emergency rooms and forcing Canadians to take time out their work days to visit multiple doctors has a cumulative effect not only on the quality of their care but on the overall productivity of the workforce, says the report.

The study estimates that when factoring non-work time, the Canadian economy loses out on an about $3.29-billion in productivity – a number that does not take into account the residual productivity losses associated with the energy and time family members may need to provide to loved ones who are not receiving efficient care.

Nadeem Esmail, senior fellow at the Fraser Institute, says the purpose of the study was to examine the efficacy of the healthcare system beyond the quality-of-care debate, which tends to overwhelm most discussion about health care.

“Rationing health care in Canada doesn’t just deprive patients of timely access to necessary medical treatment… it also causes them to lose out on wages, productivity and enjoyment in life while they wait,” he says.

The study estimates each patient loses about $3,490 each year as a result of having to wait 9.5 weeks between the time they see a specialist and the time they are able to receive care.

While Canada’s healthcare system isn’t nearly as costly as that of the U.S., spending on health care has been rising at a much faster rate than most other industrialized nations. Much of the spending has been due to a fluid transfer of healthcare-dedicated funds from Ottawa to provincial coffers, but how each province spends those resources and how effectively it cuts costs is still a bone of contention.

With more and more attention being placed on Canada’s poor productivity relative to other industrialized nations, Mr. Esmail says it’s high time Canada’s leaders begin examining more efficient means of providing health care through a socialized healthcare model that operates parallel to a private care model that is open to competition (similar to the model used in Japan and numerous European nations).

“They all have a private parallel medical sector,” says Mr. Esmail. “That is, patients aren’t shackled to the public healthcare system with no alternatives. They are able to buy their health care if they choose to do so. Finally and critically, all of these nations have a social-insurance funded healthcare system. It’s not a system run by government, it’s run by an independent group or, in some instances, private insurance companies, with the government taking a more appropriate regulatory role.”

The problem is likely to get worse as the population ages and more Canadians require higher levels of care over longer periods of time. The Canadian Caregiver Coalition estimates there are already more than 4-million Canadians today who are taking care of ailing family members and collectively losing out on $5-billion in earnings as a result. Couple that data with the fact that those same caregivers are spending more than $80-million a year on caregiving expenses and the economic consequences suddenly become severe.

The question is: Is anyone paying attention?

 

[dbair1967]

http://news.bbc.co.uk/2/hi/health/7071660.stm

'Serious flaws' in UK health care

UK health care has been changing in recent years
People in the UK face longer waits for non-emergency surgery and struggle to see GPs out-of-hours compared with other western countries, a survey says.
But they are the least likely to have problems with medical bills and insurance, the poll of over 12,000 patients in seven countries showed.

Experts said the study, carried out by the Commonwealth Fund, a US think tank, presented clear challenges to the UK.

The government said care was improving, but it was aiming to be the best.

Some 55% of UK patients said they had had difficulty getting access to GP care on weekends and nights. Delivering the highest quality of care for all, as good or better than any country in the world, must be a fundamental goal of the NHS

Department of Health spokeswoman

This was worse than Germany, the Netherlands and New Zealand and comes amid mounting criticism of the arrangements within the NHS.

A new GP contract, which started in 2004, allowed family doctors to opt out of providing out-of-hours care.

But the changes, which has seen private firms take on the role in many places, have been accompanied by a rise in complaints.

The UK also has the worst record for waiting times with 15% having to wait for more than six months for elective treatment.

Canada was the next worst on 14% and the Netherlands the best with 2%.

It is not the first time waiting times in the UK have been compared unfavourably with those in other countries.

When Labour came to power in 1997, it made hospital waits a major priority and by next year ministers have promised that no-one will wait longer than 18 weeks for treatment.

Waiting

Over half of those quizzed also said "fundamental changes" needed to be made to the system, with 15% saying it should be completely rebuilt.

These were similar figures to the other countries with the exception of the US which was much higher and the Netherlands which was lower.

However, UK patients were the least likely to have problems paying medical bills. Just 1% said they had had difficulties, compared to 19% in the US and 8% in both Australia and New Zealand.

A Department of Health spokeswoman said: "Over the last 10 years there has been record investment in the NHS.

"That money is paying for more staff and better pay, 1m more operations a year, over 100 new hospitals and improved access to healthcare."

But she added: "Delivering the highest quality of care for all, as good or better than any country in the world, must be a fundamental goal of the NHS."

Patients from Australia, Canada, Germany, the Netherlands, New Zealand, the UK and the US were questioned.

 

[dbair1967]

By the way Fuzzy, why do you think it is that virtually every country that has a government run/national healthcare plan also has for-profit companies in business that are there solely to arrange care to be obtained in the US?

 

[FuzzyLumpkins]

By the way Fuzzy, why do you think it is that virtually every country that has a government run/national healthcare plan also has for-profit companies in business that are there solely to arrange care to be obtained in the US?

Because they have extremely wealthy people that do not want to wait for non-acute care.

http://content.healthaffairs.org/content/21/3/19.full

Results from Canada.

Several sources of evidence from Canada reinforce the notion that Canadians seeking care in the United States were relatively rare during the study period. Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received health care in the United States during the previous twelve months, and only twenty indicated that they had gone to the United States expressly for the purpose of getting that care.13

20 out of 18,000 came here for the purpose of getting health care. .1%

So what we have learned today is that those countries have universal coverage, spend about half of what we do per capita/%GDP, have better acute care service but they have to wait longer for nonacute, elective care.

Hmmmm....

Now of course there is no single payer system here nor HMO structures or anything else you have claimed so far. And you base your opinion because of those you work with from the single biggest profiteer in the health care game, the insurers.

 

[dbair1967]

http://blog.heritage.org/2010/02/09/the-canadian-patients’-remedy-for-health-care-go-to-america/

The Canadian Patients’ Remedy for Health Care: Go to America!


Vivek Rajasekhar

One common assertion among the left is that other industrialized nations, such as Canada, achieved great success in health care within their collectivist framework. This, then, begs the question: why is the head of an east coast Canadian province coming to the United States for medical treatment?

Newfoundland Premier Danny Williams is seeking heart surgery in the United States, drawing criticism from “local bloggers and people calling in to the province’s immensely popular open-line radio shows.” Yet his actions are hardly unusual for world leaders. Saudi Arabian King Abdullah bin Abdulaziz is known to have his checkups at the prestigious Mayo Clinic in Rochester, Minn. Italian Prime Minister Silvio Berlusconi had heart surgery at the Cleveland Clinic in 2006 . Even middle-class Canadians are utilizing their proximity to the United States to seek treatment here.

A study by Steven Katz, Diana Verilli, and Morris Barer in Health Affairs examining the Ontario Health Insurance Plan from 1987 to 1995 found “evidence of cross-border care seeking for cardiovascular and orthopedic procedures, mental health services, and cancer treatments,” although not widespread. Examples include the governments of British Columbia and Quebec sending patients to the United States for coronary artery surgery and cancer treatment. Shona Holmes, a Kingston, Ontario resident in need of an endocrinologist and neurologist, crossed the border when she was told to wait “four months for one specialist and six months for the other.” Karen Jepp delivered identical quadruplets in Montana “because of a shortage of neonatal beds in Canada,” with the Calgary health system picking up the tab.

Perhaps Canadians’ health care migration patterns are a result of their own centralized system of government health care planning and “free care” crashing into the government’s budget constraints. The annual study “Paying More: Getting Less“ produced by the Fraser Institute, a Canadian think tank, found that government-run monopolies established in each province of Canada (simultaneously barring private operators from competing for the delivery of public health services) produce rates of growth in government health care spending that are “not financially sustainable through public means alone.” Each province’s policy of insulating consumers from price signals, such as premiums, co-payments and deductibles, has naturally led to over-consumption of medical treatment. Thus provincial governments, encountering fiscal restraints, must resort to long queues and the rationing of care.

And wait patients must. A hospital survey of five countries (United States, Canada, New Zealand, United Kingdom and Australia), conducted by Robert Blendon and colleagues in Health Affairs found that “waits of six months or more for elective surgeries were reported to occur ‘very often’ or ‘often’ by 26–57 percent of executives in the four non-U.S. countries; only 1 percent of U.S. hospitals reported this. Half of all Canadian hospitals reported an average waiting time of over six months for a 65-year-old male requiring a routine hip replacement; no American hospital administrators reported waits this long.

Perhaps if Canadian provinces adopted a free-market approach to health care, more of their citizens (and politicians) would seek treatment within their borders. This leaves just one question: if the United States adopts government-run health care system, even remotely like that of Canada, with government control of benefits and financing, plus reams of rules specifying what we can and cannot get, which border are we going to cross to get the care we need?

 

[dbair1967]

[video=youtube;cahvnCBVXXU]http://www.youtube.com/watch?v=cahvnCBVXXU[/video]

 

[dbair1967]

[video=youtube;QPh85FsOkpc]http://www.youtube.com/watch?v=QPh85FsOkpc[/video]

 

[FuzzyLumpkins]

.1%. You can give all your individual anecdotes that you want 20 out of 18,000 is what it is.

As for wait times in the ER. While certain places in urban areas of Canada are bad there is the average US wait time across the country of 4 hours. Then of course for all the people waiting to see a specialist in Canada there are the millions of people that will never see a specialist for lack of coverage here in the states.

http://www.upi.com/Health_News/2010/07/26/Average-US-ER-wait-time-4-plus-hours/UPI-76891280122494/

On a final note elective non-acute care wait times are longer in Canada. Acute care is better and more accessible there. So if you need a hip replacement you may have to wait a month but if you need treatment for meningitis you will be treated better and not be booted out as quickly as possible. Oh and you only pay half.

 

[FuzzyLumpkins]

And that last video I stopped watching after I saw the bitch from PRI. I am not down with ALEC nor the Kochs.

 

[superpunk]

I guess it comes down to what you think is more important.

Are longer wait times for non critical care acceptable so that everyone has access to medical care?

Or would you prefer shorter times so that only those with the means to pay for care receive it?

Personally my coverage is excellent cuz I can afford it and Kaiser seems pretty great so far, but I'd much prefer a system where I have to deal with more delays and annoyances that are ultimately meaningless but provide coverage for all Americans. Even if that means I have to pay even more taxes.

Just how I was raised.