Where the Canadian medical care system shines.

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It's a simple mechanic. You can vote to get more out of the system than what you contribute. It's due to people voting in their self interest instead of the good of society. Those without much skin in the game do it as much as those paying into the system.

If someone is getting more out of the system than they contribute, someone is getting less out of the system than they contribute.

This system runs on people who produce a lot and receive less than they produce.

ruveyn

But you have a group of interests who now have a very strong interest in the population making healthy choices.

The insurance industry is going to be stuck with a revenue squeeze: with a universal insurance requirement, there will be no room for the market to expand its base. With non-discrimination bars on pre-existing conditions, etc., there will be very little room to move on discretionary pricing. With government subsidizing the price differential, there will be very little room to move on bloc pricing. With regulations limiting deductibles, coverage caps and the like, there will be very little room to move on quantum of expenditures.

And that means that the way for insurers to maintain their profits is to do two things: 1) push back against pharmaceutical costs by promoting generics; and 2) reducing the number of claims.

Insurance companies have some very powerful tools in their arsenals. After pension funds and mutual funds, they are the third largest participants in the investment market--they can starve many companies of access to capital if those companies don't play in their sandbox. By promoting healthier choices and by undercutting the pharmaceutical industry, the insurers can start to keep their costs under control.

I have heard good things. About the Netherlands Healthcare system. But in Canada I bet the wait at the doctors office. Is longer then it is in Amercia.

Insurance companies are limited on what discounts they can offer for healthy life style choices. Perhaps we should remove that legal limit to allow them to offer more incentives for healthy life styles.

Absolutely. People who control their weight, exercise regularly and are careful of their diet should be rewarded economically.

ruveyn

Yes, it's terrible. I called my doctor for an apppointment and he couldn't see me until the next day! [/sarcasm]

We have a few issues up here:

1) Too few family doctors--precisely the same problem that you have in the United States. Despite universal insurance, many people do not have a family doctor, and must rely on walk-in clinics for primary care.

2) Wait times in certain specialties. Generally speaking, wait times are well under control here. There are no wait times for critical care in any discipline--hospital care is comprehensive and immediate (subject to medical decision making, of course. Sometimes waiting is a good thing.) The biggest issue is for outpatients getting the first examination with a specialist. Typically, over half of referrals are seen within a month and 90% within 3 months. Some displines, such as neurology, have very significant wait times--largely because critical care cases keep bumping outpatients for priority.

3) Wait times for facilities. There are only a finite number of operating rooms, recovery beds and MRIs in the country, and each can only serve one patient at a time. The other major factor is geography. Operating rooms and diagnostic equipment are not portable, and we have only 35 million people spread out over an area of 10 million square km. Even if 90% live in the thin strip along the border, that still leaves a lot of Candians living in remote communities. Wait times for diagnostics are generally in the two week range, though the 90% benchmark still takes about 3 months. The priority for critical care will often create longer wait times for non-critical procedures--particularly ones like joint replacements that have extensive facility requirements.

But it is also important to remember that sometimes waiting is a good thing. Many patients are first seen when they are in distress or when they have been significantly weakened by the onset of symptoms that they could no longer ignore. It is often beneficial, in non-emergency situations, to wait until a patient is stronger and more stable before starting aggressive surgical or medical therapies--which patients don't always like to hear in this "I-want-to-feel-better-right-now!" world.

Good point but your not taking into the fact of a waiting list for a organ transplant.

That is more a matter of how many organs are available for transplant and the demand. No medical system can make organs out of thin air. They have to be there to be transplanted.

ruveyn

Yes which is why just because you have Universal Healthcare doesn't mean it is a prefer system. The Taxpayers should not be forced to pay for everyones elses health. Only pay for their own.

What about contagious diseases? It makes sense to fund vaccines out of a general revenue source since the health of the entire community is at stake.

ruveyn

It signed into law constitutionally then yes I am all for it.

if you're yank working class then chances are very good that your wait will be far longer than the worst case scenario up north.

that assumes the system is zero sum, it isnt it can generate value through its citizens, not enough variables accounted for for the mechanic to be viable as is.

I think some of the culture here has many causes. In some ways when people do manage to get a job they are overworked as well as being receiving low compensation for their labor. Maybe people just feel short on both time and money and on top of that stressed.

Also for a variety of reasons people are adopting a Multitasking lifestyle. They're juggling their smart phone and social networking with work and family and they cut corners on personal time. Often they probably make up time by getting food to go. Some of it is McDonalds but much of it is probably sugary Starbucks Lattes or Monster Energy Drinks and RedBulls.

Some Americans need to slow down and really deserve more true vacation time. Others need to seriously unplug from Facebook.

I also sometimes wonder about American food in general. I mean what if someone decides to be healthier and chooses a Breakfast Cereal. Many choices branded as healthy have plenty of sugar in them. Or other foods are "Fortified" by basically injecting vitamins into what was otherwise BS food.

In the South' "where I am from' the wait is even longer.