Should health care quality be based on your wealth?

[Pinga]

From the living with disability thread:

If someone has worked hard and become upper middle class they should have the freedom to buy the best treatment for themselves and/or for others imho.

That is private enterprise running a rehab physio facility. Like labs and X-ray clinics those are generally privately owned and they bill the government for their services that are billable ones and bill the clients for ones that are not

In return they have paid for all their own équipement. And hire their own staff. If they want to put on a top end product they will pay for a nice environment and lots of staff.
Government run facilities , due to costs, always use the best cheapest thing they can use. That doesn’t mean it’s the best. But the best for the cost.
It is part of the frustration of our medical care. Canadians love to gloat about how great it is not to get a bill from the doctor or hospital. Of course we did get a bill, a big one, it is just from our tax departments

In return we have old, shabby hospitals, medical schools that graduate more students than hospitals have spots for, also using our tax dollars

However the balance is that you can get care at no additional cost. But if you want the Cadillac appliance it costs extra. Even basic air casts and crutches are not given free,

 

[Luce NDs]

Allows the lower chits to be less healthy and thus sooner out of here ... ultimate escapism?

This may be replicated in the non-existent psyche ... and thus mental crap ... thoughtfulness? The powers despise thinking men ... the Romans crucified some 3000 on the Apian Way ... a myth?

Is it critical to say such a thing about the fall of an empire for mysterious rational?

 

[paradox3]

Health care quality already is based on wealth to some extent. Our "universal" health care does not include medications for adults under 65, dental care or even eye examinations for healthy people. Working people often have extended health care plans which cover physiotherapy, massage, psychotherapy & a variety of other services based on fee for service. Without these plans folks either do without or are out of pocket.

Take a look at long term care in this country. Varying quality and long wait lists. On the other hand many who have done well in the real estate market are able to live in luxurious retirement homes & purchase the personal care they need.

Home care services are limited in scope and time. On the other hand, they can be purchased by those who can afford it. Often from the same companies who contract to provide service to government funded agencies.

Also consider some of the determinants of health. . . nutrition, exercise, a reasonable standard of living. All these things rely on a decent income.

So I say we already have a two tiered system. Not to say I am unappreciative of what the public system is able to provide for us.

 

[Lastpointe]

I agree. So n ne hand we have a good system. If you are sick and go to hospital you will get seen


On the other hand, you might not have a family doc
You perhaps won’t get a bed
You perhaps will not have adequate nursing care

If you don’t have benefits, as neither of my kids do, you pay for physio,glasses and exams, all drugs, crutches, dental, braces,......

If you have benefits you are better off but you still might languish on a stretcher in a hall way

Home care is inadequate. A slightly trained PSW, will visit for half an hour, make a grilled cheese sandwich and leave. That isn’t going to help an elderly person not go into a home

Look at the trouble Kimmio has had accessing proper care, support...... if she hadn’t been able to rely on her parents hoe would she have managed

However i also don’t think that. Our tax dollars can afford to provide everything we need.

 

[revsdd]

We have turned our supposedly universal publicly funded health care system into an idol. You can't even discuss options to it or reform of it without some people going apopletic. The reality is that the best health care systems in the world (such as the Scandinavian countries and Australia) are quite a mix of public and private. Those countries don't shy away from private involvement in health care; they don't try to hide it. It's open and above board. It's in partnership with the government system. And they are constantly ranked as having better and more comprehensive health care than Canada. In most rankings, Canada's health care system is middle of the pack among developed countries - not the best in the world as a lot of over-enthusiastic Canadians like to pretend. We compare ourselves to the United States as if there are no other countries in the world, and pretty much everyone (except right-wing Americans) agrees that the US health care system is a disaster. Its public component (Medicare and Medicaid) are tragically underfunded and not especially accessible or comprehensive enough, and its private health care is far, far too expensive and not sufficiently accessible. (My wife's brother and his family live in Georgia. He's retired now - and became a US citizen. Several years ago when still employed he had an employer health care plan. He broke his arm and had to go to the emergency room to have it set and have a cast put on. Even with his health care plan he got a bill for $1000. What would you do if you literally have no money? And Obamacare has not solved all the problems.) Health care results in the US testify to the problems with their system. The US has one of the shorter life spans and higher infant mortality rates in the western world. Compared to the US system, Canada's is paradise. But we could do much, much better. We need to learn from countries that have better health care systems than ours. Instead, we circle the wagons every time anyone tries to open up the conversation as if our health care system is carved in stone by the hand of God and cannot be rethought.

 

[ChemGal]

I'm not opposed to a 2-tier system, as long as the public aspect covers needs adequately. The rare blood disorder clinic where I go is not fancy. There's a typical waiting room but then waiting between seeing all of the team members that are done in the visit I end up in a hallway where a few chairs are shoved into alcoves, and these alcoves are all labeled. Certainly not as nice as a standard waiting room. Compare this to waiting for someone that isn't funded solely by the public system - many dermatologist and dentists. The rare blood disorder clinic still works (now, there was so turnover which fixed many of the issues I did experience).

The basics really do need help currently in particular areas, and I think increasing some 2 tier aspects could help if done correctly.

 

[BetteTheRed]

I wonder what Jesus would think of a system where rich people got better health care than poor people? OTOH, I don't think the fanciness of where you sit has anything to do with the quality of care you get...

 

[Mendalla]

If we had a health problem and felt we were getting hung up in the Canadian system for too long, Detroit is less than three hours away. In fact, I would argue that we are already two tier to the extent that anyone close to the border with money can always say "eff you Medicare" and go South for treatment. In my family's case, there's also China, where some of the best hospitals have clinics catering to foreigners and are even run by European and North American doctors.

So it isn't a question of two-tier or not. We are a two tier system unless we are going to start arresting people who leave the country for treatment.

The question is whether to leverage the private sector in a managed, effective way to improve the system as a whole because the current version of two-tier is inherently biased to those blessed by geography and their bank account and does nothing to fix our system's problems.

I wonder what Jesus would think of a system where rich people got better health care than poor people? OTOH, I don't think the fanciness of where you sit has anything to do with the quality of care you get...

Based on personal experience, we have remedied this equality problem the same way the Mao-era CCP solved equality problems: lowering everyone to the same level instead of raising everyone to the same level. And, as Steven pointed out, the "socialist" countries in Europe are mostly mixed public-private systems and rank above us on various healthcare system metrics. So clearly a fully government funded system may not be the best way to deliver effective health care. Our banning of any private alternative to Medicare is unique in the Western world. Even the Chinese system is user-pay and they are nominally socialists.

 

[paradox3]

Surgery for cataracts is another good example of our two tiered system. Those who can afford it go to private facilities and receive premium lenses.

 

[paradox3]

I wonder what Jesus would think of a system where rich people got better health care than poor people? OTOH, I don't think the fanciness of where you sit has anything to do with the quality of care you get...

I would settle for safe and uncrowded. Was at a fracture clinic recently with my dad and I am sure the waiting area would not have passed fire safety codes.

 

[Lastpointe]

Nor would hospital corridors lined with stretchers

 

[paradox3]

Nor would hospital corridors lined with stretchers

True. With or without patients on those stretchers.

 

[Mrs.Anteater]

Treatment in the public health system is also not equal. Race, education, social background still influences how you are being treated. But, compared to some developing countries, we do not need to bribe people to get even the basic health care.

 

[Delightful Life]

From the living with disability thread:

when i first read yer title i imagined R Bucky Fuller's usage of the term Wealth, which made me think of interesting things (like the quality of one's health care based on how well one does in helping thy fellow human being...which would still cause its own problems lol)

 

[Delightful Life]

I would settle for safe and uncrowded. Was at a fracture clinic recently with my dad and I am sure the waiting area would not have passed fire safety codes.

wow
i've only had 1 xperience in Canada that made me cringe and wonder what country i was in
it was at a drop in clinic and the examination room i was in was gross

 

[Kimmio Laughterlove]

It's not so much that I think the care is bad, it's just inadequate. Half assed, rushed, full of red tape, as opposed to beligerent or cruel or blatantly negligent. I mean, after this experience. I broke a bone. It needs to be treated properly. I need to be able to rest and look after it, too, and not be too stressed with basic tasks - it should be temporary, not ongoing. It seems to me that more money spent in the initial stages would avoid accumulating costs down the road. However, I think at the "root" of this mechanism (not consciously, or deliberate on the part of any staff), the system is set up for marginalized folks to want to give up and die, or get so sick they die anyway. They always cut from the bottom.

 

[Lastpointe]

One thing I notice is that you need to be a good advocate for yourself , more now than ever.

That means that people who are educated, speak good English, understand rights...... they get better care

The homeless person brought in will be seen but not as quickly as english speaking white, middle aged guy with chest pain

 

[Mrs.Anteater]

The question is also: would privatizing healthcare improve the performance of the healthcare staff?
Or would it just increase the pressure?
Could the performance be improved through other regulations? They had on the radio this morning the case of a physicians couple which immigrated here from (? south Africa- don’t quite remember) , got a provisional licence to practice and failed the exam 5 times ( both of them) in 5 or six years. That scares me. They have been practicing that long without enough knowledge. There are other physicians that have been investigated and it had no consequences whatsoever. Like the one that wrote prescriptions for a patient which she picked up herself to feed her own addiction.

 

[Mrs.Anteater]

One thing I notice is that you need to be a good advocate for yourself , more now than ever.

That means that people who are educated, speak good English, understand rights...... they get better care

The homeless person brought in will be seen but not as quickly as english speaking white, middle aged guy with chest pain

Oh yes. I wish we had patient navigators on 24/7 duty.

 

[Delightful Life]

The question is also: would privatizing healthcare improve the performance of the healthcare staff?
Or would it just increase the pressure?
Could the performance be improved through other regulations? They had on the radio this morning the case of a physicians couple which immigrated here from (? south Africa- don’t quite remember) , got a provisional licence to practice and failed the exam 5 times ( both of them) in 5 or six years. That scares me. They have been practicing that long without enough knowledge. There are other physicians that have been investigated and it had no consequences whatsoever. Like the one that wrote prescriptions for a patient which she picked up herself to feed her own addiction.

i remember lissening 2 that story
the man made a load of moolah
and they had something like 1000 patients between them? that now have to find, waaay out there in that small community, a Doc?