[Register123]

^^^^100% correct, you've hit the nail on the head.

 

[Riverdale Rink Rat]

If this is your idea of solid concrete evidence great, I don't feel the need to post such, since I have first hand experience and have seen reality. Not trying to convince you of anything.

Register123 -- My apologies for a (very) intemperate post. I did go over the top.

However, my point stands: you cannot put a baldfaced, unsupported opinion onto a forum such as this without any evidence, because no one knows you, and you could be the King of Siam or a 16 year old Orkney Islander. If you're going to slam Canadian health care, you need to provide evidence.

Your second point about the US social safety net is sort of a divergence -- we were talking about health care specifically. But, and this is from two years in Washington, DC from '89-'91 when the place was basically bankrupt, the US social safety net is nowhere near as strong as ours. Whether that's a good thing or not, I don't think it can be argued that it is on par with the Canadian experience.

 

[nfitz]

This is what he is looking at that the rest of you seem to pretend not to see. I cannot believe when i saw that post. These posts on these various forums seems to have gotton way out of which with the language being used to insult people who have opinions

Oh my ... how did I not see that? Sorry kkgg7 ... you were quite right!

 

[Eug]

Interesting they don't tell you how they arrive at the "cost" though - I mean, just look at the use of medical technologies like MRI in the US and one can understand how these "costs" can be artificially inflated - and it often provides minimal benefit clinically speaking. Not to mention the additional issues with fee-for-service for physicians in what should have been integrated care (like, seriously, does everything needs to go to the doctor?). Plus the US system is by default structured towards cherry picking by having varying rates for reimbursement.

Indeed, but that is in my view one the main issues with the system. With differing rates of compensation (with medicaid usually the lowest), and insurance types based on class (medicaid for the poor), this means that there is an incentive not to see a class of patient.

Also, whether this is ethical or not is a different question. Ethical or not, it happens all the time. Some physicians refuse to see medicaid patients because medicaid patients generate less income. And unfortunately, social class does come into it. Uppity physicians don't want to be seen as catering to the low end, since their higher income patients then go elsewhere. Furthermore there is a higher rate of missed appointments for medicaid patients - and there is no income at all from a missed appointment.

For the Canadian experience, one common scenario is that Canadian physicians in English Canada will sometimes refuse to accept Quebec health cards. Go to an Ontario walk-in clinic with a BC health card, and you'll get seen and probably won't get charged anything. Go to an Ontario walk-in clinic with a Quebec health card, and they may demand cash. First of all Quebec often pays less, although a bigger issue may be that physicians sometimes have problems getting paid at all. I have several friends who say they've had to fight with the Quebec plan and resubmit bills multiple times to get paid, and then they get paid less. So some of their colleagues just said screw it and refuse to accept Quebec health cards at all. Now if payment were say only 15% less, most probably wouldn't have a problem with it since these patients are infrequent. However, if this were potentially say 25% of their practice, and the payment was 25% less, then there would be a strong incentive to charge them up front.