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CK 17
11-01-2008, 04:14 PM
I guess it's really a healthcare question but I can't edit the thread title. Obama said the time is right to fix healthcare, so. . . . How do you feel about your healthcare system. I suspect if there is a serious attempt by President Obama to fix healthcare a lot of "experts" from the U.S. will once again be bashing your system.

What do you like about it and what do you dislike about it?

Peter Malcolm Jardine
11-01-2008, 04:31 PM
First, the strengths.

Obviously, the first strength is the universality. Everyone is entitled to the same standard of care. As a result, no one goes bankrupt, or dies as result of not having the money.

Secondly, as a result of universality, the general health of the population is increased. Canada has a longer life expectancy than the USA, and a lower level of child mortality as two examples.

Thirdly, based on our geography, a private system would have trouble, (I suspect) addressing remote areas, since they would not be terribly profitable, or they would be extremely expensive for residents. In this case I am talking about the Canadian North specifically.


Now, the weaknesses

It is difficult to establish enough funding for high level care, particularly in specialties, when you have a large private health care system across the border. It is extremely tempting for specialists, or indeed any doctor, to go south, and make a lot more money.

As a result of funding challenges, services are not equal across the country, since health care is provincially funded. Richer provinces have larger better equipped hospitals, more staff, etc. So where money determines the speed of process in the USA, in Canada, you might wait for non life threatening procedures... such as hip and knee replacements etc.

For the record, waiting lists here are nowhere near what the fearmongers say, and our ranking in the UN study on world health care practices rank Canada at 32nd, the USA at 37th in world standings. I don't think you would find many canadians who would trade our health care system for yours. By vast majority, socialized health care is a sacred cow in our country.

That said... the most successful health care systems in the world are public private partnerships... France would be an excellent example. The USA would be wise to study the top five health care systems in the world, and take the best from them NONE OF THEM ARE PRIVATE SYSTEMS LIKE THE USA CURRENTLY USES.

Good luck with it... The USA spends more money per capita than any country in the world, and ends up with a poorer health care system than almost all of the developed world.

bob winter
11-01-2008, 04:32 PM
Technically, health care is a Provincial jurisdiction so it varies a bit from province to province. Quebec is likely the best place to be in some ways since they have a public drug plan as well as medical. The system isn't perfect but it is a hell of a lot better than nothing, which it appears is precisely what a lot of people in the US are stuck with. I have a few problems with the system. Tests, especially MRI's and other exotic tests, can take a while, hospitals are overcrowded so elective surgery can take a while, and it is very hard in Ontario, at least, to get a family doctor. I have one but a lot of people go to clinics. Seems a lot of doctors headed south so they could make more money.

My main beef is that I can't pay to get a bit of faster or extra service. It is a stupid system in that regard. People keep saying that "two tier" health care will undermine the universal aspect of the system. There already is two tier healthcare in Canada. The ones who are in a rush and that can afford it go the the States. The other thing that pisses me is off is that I can go to Quebec if I have an urgent need for a MRI and get one done at a private clinic but can't do the same thing in Ontario.

In the end, though, the system generally comes through, especially in cases of serious illness. What we need now is public dental and prescription plans but I think that will be a while coming.

My father in law was sick in Florida recently and the wife and I saw a couple of hospitals. One in Titusville and another in Melborne, both made our hospitals in Ottawa look poor by comparison and the parking was free on top of that. The old guy got tests the next day that would have taken much longer in Ottawa. However, he had really good private medical insurance and I think that made a big difference.

S/V Laura Ellen
11-01-2008, 04:35 PM
While there are problems with the Canadian (Ontario) health care system, mostly related to the availability of service, the system does have its good points.

Speaking as someone that required extensive medical treatment to repair my broken ankle, I can say it was nice knowing that I didn't have to worry about the financial aspects of the treatment. In fact, I don't even know how much the treatment costs.

So, what was not covered by the Health Care System?

Upgrade from a basic hospital ward room (typically 4 people per ward room). My company health insurance plan covered the cost of semi-private.

Crutches, braces and physiotherapy. This was covered by my company health insurance plan.

Drugs after release from the hospital. Again this was covered by my company health insurance plan.

Everything else (surgery, drugs while admitted in the hospital, basic hospital stay, ambulatory care after discharge from hospital, doctor's fees, casts, xrays, etc) was covered.

goodbasil
11-01-2008, 04:53 PM
I like it. I get covered through my work. If I was out of work it would cost me $54.- per month for coverage. That doesn't cover everything like cosmetic work, circumcision was dropped a few years ago. (But I was safe cause I had mine done when it was still free. They use a pencil sharpener up here.) Private rooms, extra pretty nurses, those are extra.
Our healthcare is good, but the delivery of it leaves a bit to be desired.
Back in Feb/02, I came down with a pinched nerve. It was 53.5 weeks before I got the operation. This was something that the book says takes 45 minutes, it went so well that it was done in 25.
The problem here is that the population has increased so much that they can't crank out doctors fast enough. There's a real shortage.
And there's the cost, but I'd be okay with a 50% increase in premiums. I know if I ever get realy sick I won't have to win the lottery to repaired.
How bad are doctors needed, last year the Canadian army would pay a $500,000.00 bonus sign-up to a doctor who'd agree to a 2 or 3 year stint.
What do you folks down south pay for insurance.?
I have a cat named, the Gabe. He could sure use it. He's diabetic so he costs a bit. He was born in Washington state.

CK 17
11-01-2008, 07:03 PM
What do you folks down south pay for insurance.?
.

My annual cost is $2300 for very good coverage--medical, dental, vision, mental--for both my wife and myself. In addition, we pay a $10 co-pay during the visit for in network providers.

out of network we are covered 80%

If we were to select my wife's employer's insurance, it would be double that.

We also have to wait for specialists. I was told once a 3 month wait for a colonoscopy by a specialist or i could get one in a month by a general surgeon. This was because of "symptoms" not my age 50 required one.

Often there is a 6 month wait for a annual physical.

And this is with 50 million without access. :confused:

dennisbur
11-01-2008, 08:09 PM
I can't speak for other provinces but here in BC>>


1) too much bureaucracry is killing the system. Because it's so political every new government has to restructure how it's delivered. Having been through 5 of these in the last 20 or so years all that has resulted is fewer beds and less staff and 50% more managers.
2) with a public/private system you have to be careful. In BC lab tests are paid for by the Medical Services Plan at a set rate. So the private labs have siphoned off all the automated tests that make them a minimum of 300% profit. Most are in the area of 500% - which is still less than half of what US labs charge. The end result is that all the money losing tests are done in the public system. With none of the profitable tests to offset the costs the hospital labs really scrabble for funds.
this is the big pitfall that could occur with private surgery linics. This would drive costs up - not down like everyone would hope.
3) Several years ago the Canadian and Provincial Medical Associations got together and restructured physician qualifications so that now Family Practise is a specialty. Now med students have to choose their specialty before they leave medical school. The end result has been a severe storage of GP's. This is why some many citizens cannot find a GP. Med students are opting to choose specialities that give them more time for family and of course, money. Prior to this graduates would work as locums (vacation replacements for GP`s) to help pay off debt. They were more likely to find a place to settle down and a practise to buy then to go on to take a specialty.
4) The reality of the US system is that the US government spends more money per capita on health care than Canada does. And yet almost 25% of Americans are without coverage. This is a tragedy. If you really want to appreciate the difference pick any two cities of similar size - one in each country - and take a good look at the overall health of seniors walking down the street. Far fewer in Canada limp, cough, have bad feet, etc. Deaths from pneumonia are much rarer in Canada because people aren't as inclined to wait until it's too late to see a doctor and get antibiotics.

Each system has it`s pluses and minuses. If you have good coverage in the US there is no such thing as a waiting list. But then there is a smaller percentage of the population looking for treatment. US treatment centers also tend to have better equipment because they`re competing for business.

However, I have friends in the US who can`t change jobs or move because they`ll lose their coverage. Most HMO`s won`t insure a pre-existing condition. Talk about an open door prison. Do you really want your life held hostage by whether or not you can get insurance.

Both countries need to upgrade their systems so that people can enjoy life.

Dennis

Peter Malcolm Jardine
11-01-2008, 08:12 PM
We've had lots of discussion about health care on this forum.... but the bottom line is that while Canada has a better system than the USA, it's a long way from being really really good, and I have never figured out why we don't just look at the top five, or hell, even the top ten systems in the world, and adopt what works...

Either way, the USA really needs a serious overhaul of it's health system... it doesn't work unless you have money, and even then it's unbelievably overpriced in comparison to the rest of the world. Best estimate: a decade of serious work.

paladin
11-01-2008, 08:18 PM
Thats the reason I live near Wash. D.C., if I were to leave I would lose my health coverage and my insurance would likely quadruple. My insurance right now is about $150 a month, and co-pays and meds add another $1200 as my meds are covered for the first $3000 and then it's out of my pocket. In Okiehoma I could buy a house 2-3 times as nice as what I have, on a larger acreage, monthly expenses would drop like a rock, but the health insurance etc would empty my coffers in short order. Singapore would be a better place for me to live, financially and medically, but since I no longer have friends or family there it wouldn't be good.

Wayne Jeffers
11-01-2008, 08:51 PM
. . .
What do you folks down south pay for insurance.?
. . .

I'm pretty sure the previous replies were the amounts the individuals contribute to their insurance, not the total cost.

Most insurance is provided through employers, with the employers paying part of the premiums. The amounts of coverage, deductible, copay, etc. will vary considerably. Some plans are relatively cheap for relatively little coverage, others more expensive for better coverage. Some employers contribute little to paying the premiums for group coverage, others contribute more generously, still others do not offer health insurance for their employees.

My employer was pretty generous with health coverage. For the family, the total premium is a little over $1000 per month, with the employee contribution about $250 for a pretty good (not great) plan.

Most folks over 65 are covered by Medicare, some with supplemental insurance to help cover the costs not covered by Medicare.

A large number of folks (47 million?) have no insurance coverage at all.

Wayne

Ron Williamson
11-01-2008, 09:16 PM
FYI
The Ontario government taxes me about $750/year for "Employer Health Tax" due to my income and self-employed status.
R

George Roberts
11-01-2008, 09:17 PM
As I have said before, our insurance is cheap - more or less free if you consider the tax consequences.

But we have $10K deductible.

And the wait for care is reasonable.

Bruce Taylor
11-02-2008, 09:30 AM
The system is under stress, but remains popular.

A couple of points:

Many Canadians believe they have an entirely "public" health care system (what Americans call "socialized" medicine). This is inaccurate. What we have is socialized insurance, paying out to a complicated network of private and public providers.

The vast majority of physicians are self-employed and own their practices. Some choose to own their clinical premises and equipment, as well. Indeed, some entrepreneurial spirits, like my friend Tom, make a profit running large clinics staffed by other self-employed physicians who have no talent for administration or simply don't want the hassle of hiring and firing office staff.

Nearly all doctors receive payment from the public insurance provider (a different one in each province). They are not, in any sense, "employees": they receive no benefits from the government, and submit to very little oversight from it.

And here's an odd fact: they don't have to bill public insurance for their work. Under the terms of the Canada Health Act, doctors are free to opt out of the system. If they wish, they can strike out on their own and receive payment directly from their patients, provided they are not billing the public insurance provider at the same time. Very few physicians take advantage of this option, but it exists.

So: despite all the overheated rhetoric about "privatization" and the threat of "two-tier" health care, we have always had a system that is largely in private hands.

Still, much of the infrastructure is publicly owned, and that can create shortages and delays. My Dad has a bad knee, and is scheduled to have an MRI. Because it's not a progressive or life-threatening ailment, he has to wait three months for the test. He's OK with that, apparently, but if he really wanted to he could buy faster service from a private MRI facility in Montreal.

My wife and I took advantage of a similar private service, a few years ago, to receive some test results more quickly. In our case, we knew that speeding up the process would have no effect at all on treatment & prognosis, but we wanted to relieve our anxieties and it was worth a couple of hundred bucks to get the results in two days instead of two weeks.

One more personal anecdote. We live in an area (the Outaouais) where the medical system is under a huge amount of stress from shortages of specialists & nursing care. Yet, a couple of weeks ago, we had a medical issue that needed quick attention, and we got what we needed promptly. A member of the family had an intermittent sound in her ear (pulsatile tinnitus) and there was some concern about a possible aneurysm. Her MRI was conducted within a couple of days, and the neurologist was immediately available for consultation. All was well, but a follow-up test was scheduled (an EMG to rule out ALS / Lou Gehrig's disease). This could not be considered medically urgent, so we had to wait about two weeks for the appointment. Two weeks is a long time to wait, when you're worried about a terrible prognosis, but I guess that's what Valium is for :) . The test was done, and all is well, and the system, in this case, worked admirably.

Whew. :D

Wayne Jeffers
11-02-2008, 12:25 PM
Bruce, Ill see your anecdote with a recent one of my own.

On Wed., October 1, I woke with a terrible pain in my gut. I managed to get in to see my GP later that day. He diagnosed gallstones as the most likely problem. The earliest I could get in to have an ultrasound of my gallbladder (Im guessing this is the definitive test for gallstones) was Monday, October 6, and the earliest I could get in to see a surgeon was October 13. It took until Thursday, October 30, to get the surgery done. A little over 4 weeks total. My condition was not life threatening, but I was pretty miserable for that 4 weeks.

I doubt I would have waited longer in Canada.

It surely would have cost me much less. I expect it will cost me several thousand dollars out-of-pocket above and beyond what the insurance pays for my diagnosis and treatment. (This was an outpatient surgery.)

Wayne

Tinman
11-02-2008, 11:02 PM
There are as many answers to this question as there are Canadians. From my perspective, while our public system does have admirable goals and advantages, for the most part it falls short of the mark. I could relate many stories of long wait times in hospitals, ambulances tied up for hours with patients that have no one to recieve them when they get to emergency, etc, etc. The other interesting thing, is that while the likes ofr Jack Layton rail against two tier health care, we have had exactly that for years now. We have laser eye clinics, and GP's are actually small buisnessmen that bill the government for their services for just a few examples. I would much prefer having my taxes lowered dramatically, and letting me use the savings to buy private health care. Remember, governments do nothing well and most things poorly. Do you really want a federal employee deciding what services you can and cannot get? I didn't think so.

bob winter
11-03-2008, 07:40 AM
Tinman, I agree with you to an extent, but what if you were unable to obtian private health insurance for either financial or other reasons. Laser eye surgery is, for the most part, cosmetic and I see no reason for it being covered by the public plan.

There are way too many bureaucrats in our system but I imagine that there are likely quite a few in the US system although they likely work for the private insurers rather than the govt. I personally think Canada should take a close look at alternatives to the existing system. Seems that there are some very successful systems in Europe. In the meantime the present system is a lot better than nothing.

Bruce Taylor
11-03-2008, 08:29 AM
Remember, governments do nothing well and most things poorly.

Why have a government, then? If we accept the dogma that private administration is always more efficient (I have doubts about that, but let's allow it, for the sake of argument), then why not privatize policing, roadwork, parks, monuments, the judiciary and the military?

One answer is that we have interests that supercede efficiency. A police force made up of private contractors might be more streamlined (again, I have my doubts), but most of us would like to have our cops directly answerable to the citizenry, and not to the stakeholders in a private concern. A real hardcore libertarian might suggest privatizing, say, the war memorial on Confederation Square (a couple of tasteful billboards would pay for its upkeep) but most of us think that would be a shabby thing to do in the name of "efficiency."

And so it is with health care. When the Canada Health Act was created, it was felt that certain principles (universality, portability and accessibility) were sufficiently important that they needed to be mandated by law. Our old system didn't meet those standards, and the American system isn't meeting them now. Take Chuck's situation, (described above). He's a war veteran with a long and distinguished record of service, but because portability isn't built into their system he is unable to leave the D.C. area.


Do you really want a federal employee deciding what services you can and cannot get? I didn't think so.

As I'm sure you know, it's actually a provincial body (in your case, OHIP) that determines what services you get. Services that are not insured by the province (you mentioned laser eye surgery, much advertised on your own CFRA :) ) can be purchased privately, and extended health insurance can be bought from organizations like Blue Cross to cover services not included in the provincial plan (accidental dental, extra-hospital pharmaceutical, etc.)

As for meddlesome bureaucracies, our provincial insurers interfere far less in medical care than private insurers do down south. In fact, that's one reason why my wife, an American and a physician, chooses to practice here in Wakefield: there's a lot less paperwork and bureaucratic nonsense to deal with. I don't know about Ontario (haven't lived there since the eighties) but here in QC the insurer doesn't second-guess the doctor's decisions, challenge treatment choices, steer the patient toward particular specialists who happen to belong to a particular HMO, or harass sick people with itemized invoices.

Flying Orca
11-03-2008, 11:22 AM
Tinman doesn't need facts, Bruce - not when he has an agenda!

Tinman
11-03-2008, 12:33 PM
To begin with, I agree that it is better than nothing, but I also agree that we need major overhauling of the system and looking at other ways of doing things is always a good idea. Ask any Canadian doctor how much time they spend treating patients compared to how much time the spend doing paperwork. As far as governements doing nothing well and most things poorly, that is an old saying that has a very loud ring of truth to it. Is it true in every case? Nope. look at the revenue agencies that collect taxes as an example. The private sector would kill for a debt recovery rate like that. I am also aware that it is the province by and large that deals with health care, but the point is valid regardless of what level of politician runs it. I admit we need governments to do for us what we cannot do for ourselves. Run the military, negotiate with other countries in trade deals, etc. But I also think where we can do things for ourselves we should. There is another old saying I like. "whenever someone shows up and says Hi I'm from the government, and I'm here to help, be afraid." As far as my airborne killer whale friend is concerned, he's right. I do have an agenda. It's called insisting that things be done accountably, and with integrity. Not by public opinion or popular consensus. It is an agenda I freely admit.

Flying Orca
11-03-2008, 01:10 PM
To begin with, I agree that it is better than nothing, but I also agree that we need major overhauling of the system and looking at other ways of doing things is always a good idea. Ask any Canadian doctor how much time they spend treating patients compared to how much time the spend doing paperwork.

Yes, and while you're at it, ask any American doctor the same thing. Or you could just look at all the studies that have already done that and found that American doctors waste more time on paperwork than Canadian ones.


As far as governements doing nothing well and most things poorly, that is an old saying that has a very loud ring of truth to it. (...) There is another old saying I like. "whenever someone shows up and says Hi I'm from the government, and I'm here to help, be afraid."

I'm not surprised you like those sayings; they fit right in with your preconceived notions. I prefer to base my opinions on facts rather than old sayings.


As far as my airborne killer whale friend is concerned, he's right. I do have an agenda. It's called insisting that things be done accountably, and with integrity. Not by public opinion or popular consensus. It is an agenda I freely admit.

Do you have any facts pertaining to a lack of accountability and integrity in Canada's healthcare system, or just more old sayings?

Dan McCosh
11-03-2008, 01:16 PM
That's simply untrue. Governments do some things exceptionally well. Compare Medicare's 4% adminsitrative burden to the average health insurors' 29% overhead.






Curious about the source of this statement. I've heard it often, but it looks as if the profits of private insurance companies are being lumped in with "administrative costs". ????

Bruce Taylor
11-03-2008, 01:53 PM
Ask any Canadian doctor how much time they spend treating patients compared to how much time the spend doing paperwork.

Well, I have a doctor on hand here, and I just asked her that question. As I mentioned above, SWMBO is a physician (American, but practicing here). She tells me that she and her colleagues have less paperwork to do than their counterparts in the U.S. This is hardly surprising, since they are dealing with only one insurer, and that insurer does not question her medical choices.

She and about twenty of her colleagues share the services of a single secretary for billing. Having done her billing, a few years ago, I can vouch for the fact that it's not a hard job.

Of course, doctors everywhere have a lot of charting to do, but that has nothing to do with our provincial insurance provider.

Mind you, there are other aspects of the system she finds quite frustrating, and I can tell you about those if you're interested.

TomF
11-03-2008, 01:59 PM
I'll second what Bruce just said, from the perspective of one within a Provincial health department. The amount of time spent by physicians' practices doing billing is insignificant in Canada, compared with the US.

Physicians who've sat on some policiy committees with me have remarked that the most time they spend on billing is inevitably for patients who were visiting Canada at the time they needed care. For Canadian patients, it's a snap.

Kaa
11-03-2008, 02:00 PM
Governments do some things exceptionally well. Compare Medicare's 4% adminsitrative burden to the average health insurors' 29% overhead.

So, Norman, are you saying Medicare is a prime example of a government doing something exceptionally well?

Kaa

TomF
11-03-2008, 02:05 PM
Be sure that you're not switching subjects, Kaa.

Norman's not made claims about whether patients get better or worse for receiving Medicare. He's saying that Medicare's administrative costs are about 7 times lower than the private sector average for health insurance.

If your firm achieved 7X efficiency in some aspect of the service you deliver, wouldn't that aspect of the business be "exceptional" compared with your competitors?

Bruce Taylor
11-03-2008, 02:11 PM
A timely article from the current issue of the Canadian Medical Association Journal, comparing our system to the American one:

http://www.cmaj.ca/cgi/content/full/179/9/916

Kaa
11-03-2008, 02:13 PM
In a least one respect, absolutely.

There are other deficiencies of Medicare, but in terms of delivering health care per dollar expended, they're fantastic.

Medicare, of course, doesn't deliver health care. It only pays for it, right?

But in any case, we were not talking about the amount of overhead. The topic was things that a government does exceptionally well -- and you brought up Medicare.

So, let me repeat the question -- is Medicare a program that's run exceptionally well?

Kaa

Kaa
11-03-2008, 02:15 PM
Be sure that you're not switching subjects, Kaa.

Well, kinda. I'm interested in the subject of governments doing things "exceptionally well". Or maybe not :-)

And, of course, if Medicare is that great, why, there's no need for the debate on which form should national healthcare take, right? Just reduce the required age for Medicare to zero and we're good to go.

Kaa

TomF
11-03-2008, 02:19 PM
Doubtless some aspects of your Medicare health insurance scheme would need to be adapted to cover the full population, yes? But it fulfills at least some aspects of its current mandate exceptionally efficiently, compared with its competitors?

I love Joel White's Shearwater; IMO it's an exceptional small rowing boat. Would need to tweak the lines a bit though, for it to become a 60' cargo-carrying galley.

Kaa
11-03-2008, 02:25 PM
But it fulfills at least some aspects of its current mandate exceptionally efficiently, compared with its competitors?

I'd like to look at the source for the numbers. I rather suspect there is some apples-and-oranges comparison going on.

Kaa

TomF
11-03-2008, 02:28 PM
Have at it, then. The article Bruce linked in the CMA Journal is peer reviewed, fully footnoted, and written by a Boston researcher.

George Roberts
11-03-2008, 02:30 PM
"Medicare, of course, doesn't deliver health care. It only pays for it, right?"

Medicare does a bit more than that. It sets prices.

The prices are most certainly wrong. In fact, there are businesses that review bills before they are sent to medicare. The review recodes the procedures to get higher payments.

While the office overhead is 2%, there is perhaps much more overhead hiding in mis-pricing.

TomF
11-03-2008, 02:37 PM
Prices set too high, or too low, George?

Prices in Canada's medicare system are set through negotiations between provinces and the provincial Medical Association. Lower than average prices in your country, but we seem to have many physicians willing to pauper themselves and practice here.

Kaa
11-03-2008, 02:37 PM
You'd have to define 'exceptionally well' for me.

Well, you, unprovoked, jumped in and offered Medicare as an example of something a government does exceptionally well. So it's your definition we're talking about.


According to the article cited by Bruce, Medicare's administrative overhead is just 2% (less than the 4% I had been assuming)... so in terms of accomplishing it's job, I'd say that yes, Medicare does exceptionally well at it.

I think you're a bit confused. Bruce's link leads to http://content.nejm.org/cgi/content/full/349/8/768?ijkey=9e601495aeb2083931977d298a43c41e6b52588a #T1
which says:
In 1999 U.S. private insurers retained $46.9 billion of the $401.2 billion they collected in premiums. Their average overhead (11.7 percent) exceeded that of Medicare (3.6 percent) and Medicaid (6.8 percent).It seems the article defines overhead as gross revenue -- the difference between money taken in and money paid out. That's not really a good basis to compare a private company and a government department.

Besides, what about things such as fraud, for example? There are estimates that at least 10% of all Medicaid costs go to fraud. If we're talking about "efficiency", shouldn't we take this into account as well?


It should be noted that private health insurors also don't deliver medical care...

Unless the insurer is an HMO. I don't know how these statistics treat HMOs.

Kaa

Kaa
11-03-2008, 02:42 PM
It would be no different than for a private insuror. Both Medicare and private insurors negotiate with health care service providers on reimbursement rates, and both try to contain costs as much as practicable.

There is a difference. Private insurers negotiate with health care providers. Medicare tells them what the price will be.

Kaa

Tinman
11-03-2008, 02:47 PM
Yes, and while you're at it, ask any American doctor the same thing. Or you could just look at all the studies that have already done that and found that American doctors waste more time on paperwork than Canadian ones.
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I will not argue with the other poster who is married to adoctor. I am in no positon to offer crique on her personal experinces. However the doctors I know have a different song to sing. So we'll chalk it up to each having a set of different experiences within the same system.
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I'm not surprised you like those sayings; they fit right in with your preconceived notions. I prefer to base my opinions on facts rather than old sayings.

The reason old sayings are old is because they are based mostly in fact. They stand the test of time. My notions as you call tehm are hardly pre concieved, but rather borne out of life experience and observation, not just studies or reports written by those who have a vested interest in perpetrating ever larger agencies for them to secure either a job at or funding from.
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Do you have any facts pertaining to a lack of accountability and integrity in Canada's healthcare system, or just more old sayings?

I never claimed that there was a lack of integrity or accountablility within the Canadian health care system per se. What I did say, was that my "agenda" was one that demanded those things of not only government at every level, but of myself and those I am responsible for. I do not present some false intellectual facade masquerading as objectivity, I lay my bias and "agenda" out openly. I would only wish more people [ are you paying attention CBC? ] would do the same.

TomF
11-03-2008, 02:52 PM
There is a difference. Private insurers negotiate with health care providers. Medicare tells them what the price will be.

KaaTruly?

It would be a considerable surprise to my colleagues across the hall in the Medicare division to find that their negotiations with the Medical Association aren't actually negotiations. Would surprise the Association too.

Popeye
11-03-2008, 02:54 PM
i think there's new legislation in canada to treat hmo's fairly

TomF
11-03-2008, 02:55 PM
i think there's new legislation in canada to treat hmo's fairlyCouple of friends got married, come to think of it.

Keith Wilson
11-03-2008, 02:57 PM
Some data - figures for 2006, US$:
Per-capita spending for health care : US- $6,714; Canada, - $3,678.
And as a percent of GDP: US - 15.3%; Canada - 10.0%.

Kaa
11-03-2008, 03:01 PM
The link Bruce Taylor referred to, and that I referenced, was http://www.cmaj.ca/cgi/content/full/179/9/916 (http://www.cmaj.ca/cgi/content/full/179/9/916)

It references a paper written for the Kaiser Foundation which says "The costs of administering the Medicare program have remained low over the years about 2 percent of program expenditures" but does not provide any references or sources for that number.

I still want to see a verifiable source.


We should, but we'd have to also figure out what sort of 'fraud' we're talking about. Since private insurors also contract with third parties for services, they're no less exposed to fraud than Meidcare is...

Sure, private insurers also have to deal with fraud. The important difference is that they have strong incentives to fight it. I would argue that government bureaucracy does not.

Kaa

Kaa
11-03-2008, 03:13 PM
Let me clarify my position before this gets really messy. I am no big fan of the current US system -- it's clusterf*ck of byzantine bureaucratic rules, unfunded mandates, Kafkaesque regulations, private greed, and just plain old stupidity.

But to say that just replacing everything with a big government department will make things magically efficient and effective seems to me... optimistic :D

Medicare and Medicaid are government-run health programs and, Norman nonwithstanding, I don't think there is a general perception that they are run well.

By they way, let me reiterate again that if you're poor (and don't live somewhere way in the boonies) there is no problem receiving free medical care in the US.

Kaa

Flying Orca
11-03-2008, 03:19 PM
Sure, private insurers also have to deal with fraud. The important difference is that they have strong incentives to fight it. I would argue that government bureaucracy does not.

The bureaucracy with which I conduct business on a daily basis certainly does.

Keith Wilson
11-03-2008, 03:21 PM
let me reiterate again that if you're poor (and don't live somewhere way in the boonies) there is no problem receiving free medical care in the US.If you qualify for Medicaid. If you don't, you can get emergency medical care. That's not at all the same thing.
Medicare and Medicaid are government-run health programs and, Norman notwithstanding, I don't think there is a general perception that they are run well."General perceptions" may or may not be accurate. One thing is indisputable, they are run with a much lower level of administrative overhead than private insurance. And the idea that the government has no incentive to try and prevent fraudulent use of its programs is just silly.

Flying Orca
11-03-2008, 03:35 PM
The reason old sayings are old is because they are based mostly in fact. They stand the test of time.

The "I'm from the government, I'm here to help" line has been making the rounds of right-wing blogs, radio shows, and newspaper columns since Hurricane Katrina. You know, a little over three years ago.

As for your "old saying" about government doing "nothing well" and "most things poorly", a quick google turns up exactly two instances... and one of them is your own. Doesn't sound like an old, fact-based saying.

Folk "wisdom" is frequently pithy, concise, and catchy. Unfortunately that doesn't make it right.


My notions as you call tehm are hardly pre concieved, but rather borne out of life experience and observation, not just studies or reports written by those who have a vested interest in perpetrating ever larger agencies for them to secure either a job at or funding from.

So you consider your own vast experience and range of observation to be more reliable than that of people who actually, you know, study something for a living? That explains quite a bit, actually. Your addendum about "vested interests" is also quite telling - nice how it allows you to ignore any data you don't like or agree with. This must have something to do with your blanket pronunciations on integrity and accountability... Oh wait, that's next:


I never claimed that there was a lack of integrity or accountablility within the Canadian health care system per se.

How silly of me to think you were talking about healthcare when that's the topic of this discussion.


What I did say, was that my "agenda" was one that demanded those things of not only government at every level, but of myself and those I am responsible for.

Well, that's an excellent way for you to distinguish yourself from all those people clamouring for less integrity and accountability in government. You're a, what's the word, yes, you must be a maverick!

Or maybe, since pretty much everyone agrees that integrity and accountability are good things, that's not "your" agenda at all. Judging by your posts, I'd say that spreading right-wing talking points is your agenda.


I do not present some false intellectual facade masquerading as objectivity

I'll say.

Kaa
11-03-2008, 03:39 PM
If you qualify for Medicaid. If you don't, you can get emergency medical care. That's not at all the same thing."

I disagree. You can get free non-emergency medical care without being on Medicaid.

And, of course, you can get on Medicaid.

Kaa

Kaa
11-03-2008, 03:42 PM
health care in the U.S. is largely 'free market'

It's nothing of that sort.

Not everything not run by a government is a free market.

Kaa

Keith Wilson
11-03-2008, 03:43 PM
The "I'm from the government, I'm here to help" line has been making the rounds of right-wing blogs, radio shows, and newspaper columns since Hurricane Katrina. You know, a little over three years ago.
I think Ronald Reagan first used that line in the early '80s. The ides that if government does something it will inevitably be done worse than if it were done by someone else is a primary article of faith of modern conservatism. While the government consists of human beings and can certainly screw things up very badly, there are certain things which are best done by government. I would argue that the experience of almost every civilized country shows us that heath care is one of them.


You can get free non-emergency medical care without being on Medicaid.
How?

Kaa
11-03-2008, 03:45 PM
Where? How?

For example, there are things called Public Health Centers. They are free or charge a nominal fee.

For another example, medical schools often have clinics where students practice -- they are free.

Kaa

Flying Orca
11-03-2008, 03:48 PM
I think Ronald Reagan first used that line in the early '80s. The ides that if government does something it will inevitably be done worse than if it were done by someone else is a primary article of faith of modern conservatism.

Ah, yes - address to the Future Farmers of America, 1988. Twenty years ago, and out of the mouth of a conservative politician - no long history as a folk saying. Tinman will be so disappointed.

Kaa
11-03-2008, 03:50 PM
The "I'm from the government, I'm here to help" line has been making the rounds of right-wing blogs, radio shows, and newspaper columns since Hurricane Katrina. You know, a little over three years ago.

Three years? That's a Ronald Reagan quote ("The nine most terrifying words in the English language are: 'I'm from the government and I'm here to help.'") and I'm pretty sure he didn't invent this phrase.

Kaa

Kaa
11-03-2008, 03:53 PM
Will they repair a torn ACL, like I did? Do a hip replacement? How about a heart bypass? Chemotherapy for cancer? Fix an aneurism in your brain? (that last one cost my insuror $58,000...) How about a colonoscopy, especially if there's a family history?

I rather suspect that they will. What, you think poor people don't get hip replacements? Don't get chemo?


Sorry, Kaa, but saying that you could get a checkup or stitch a bad cut for free isn't the same thing as saying you can get free health care. This is another 'let them eat cake' sort of statement.

I think this is the third time we are going over this.

I've been there and did it. You haven't and your "knowledge" comes out of newspapers.

I am saying it's possible to get free medical care because I, personally, got it.

Kaa

Kaa
11-03-2008, 04:11 PM
Just what did you get, and where? and how do you know that anything/everything can be gotten that way?

That was in Philly and included preventive and non-emergency treatment.

I also never claimed everything can be gotten this way. You can't get everything if you're insured either. But you can get get a reasonable level of medical health care for free.


If this is true, why are over half of bankruptcies due to costs of catastrophic medical care?

Because you forgot about the first part of my statement: "If you're poor".

There is no point in charging or billing you if you have no money and no assets.

Kaa

Kaa
11-03-2008, 04:23 PM
I submit that this talk about 'free medical care' is irrelevant to the discussion.

ROTFLMAO...

Kaa

P.S. That's such a nice case of "Don't confuse me with facts, I've already made up my mind" :D

Flying Orca
11-03-2008, 04:48 PM
Three years? That's a Ronald Reagan quote ("The nine most terrifying words in the English language are: 'I'm from the government and I'm here to help.'") and I'm pretty sure he didn't invent this phrase.

Yeah, I found it with Keith's help - I think you and I cross-posted. Haven't found an older usage, though. My point - that it's a conservative politician's talking point, not "an old folk saying" - remains.

Kaa
11-03-2008, 04:54 PM
Yeah, I found it with Keith's help - I think you and I cross-posted. Haven't found an older usage, though. My point - that it's a conservative politician's talking point, not "an old folk saying" - remains.

Your google-fu is weak :-)


Yale Book of Quotations
By Fred R. Shapiro
New Haven, CT: Yale University Press
2006
Pg. 825:
George F. Will
U.S. journalist, 1941-
The American condition can be summed up in three sentences were hearing these days:
Your chek is in the mail.
I will respect you as much in the morning.
I am from the government and I am here to help you.
Quoted in Frederick (Md.) News, 19 July 1976 (http://www.barrypopik.com/index.php/new_york_city/entry/im_from_the_government_and_im_here_to_help_you/)

Kaa

Flying Orca
11-03-2008, 05:15 PM
Your google-fu is weak :-)

"I have not yet begun to google." ;) (I was at work, only had time for a quick visit to Reagan's Wikiquote page.)

Bruce Taylor
11-03-2008, 05:24 PM
So we'll chalk it up to each having a set of different experiences within the same system.

We could.

Or we could skip the anecdotes and the slogans and check out the research.

The article by Dr. Marcia Angell I linked to earlier addresses the subject of how private insurance generates paperwork (http://www.cmaj.ca/cgi/content/full/179/9/916).

And here's a short article from Harvard Science:


Study shows U.S. health care paperwork cost $294.3 billion in 1999

More than $1,000 per person; far more than in Canada

August 19, 2003

Researchers at Harvard Medical School and the Canadian Institute for Health Information, Canada's quasi-official health statistics agency, analyzed the administrative costs of health insurers, employers' health benefit programs, hospitals, nursing homes, home care agencies, physicians and other practitioners in the U.S. and Canada. They used data from regulatory agencies and surveys of doctors, and analyzed Census data and detailed cost reports filed by tens of thousands of health institutions in both nations. They found that health care bureaucracy cost Americans $294.3 billion in 1999. The $1,059 per capita spent on health care administration was more than three times the $307 per capita in paperwork costs under Canada's national health insurance system. The authors found that bureaucracy accounted for at least 31 percent of total U.S. health spending in 1999 vs. 16.7 percent in Canada. Cutting U.S. health bureaucracy costs to the Canadian level would have saved $209 billion in 1999. This study was conducted with grant support from The Robert Wood Johnson Foundation. The foundation does not endorse the analyses or findings of this report or those of any other independent research projects for which it provides financial support.

http://harvardscience.harvard.edu/medicine-health/articles/study-shows-us-health-care-paperwork-cost-2943-billion-1999

Here's one from PNHP:


A Canadian hospital negotiates its annual budget with the provincial health plan and receives a single check each month to cover virtually all of its expenses,& Himmelstein said. It need not fight with hundreds of insurance plans about whether each day in the hospital was necessary, and each pill justified. The result is massive savings on hospital billing and bureaucracy.

Doctors in Canada face a similarly simple billing system. Every patient has the same insurance. There is one simple billing form with a few boxes on it. Doctors check the box indicating what kind of visit they provided to the patient (i.e., how long and whether any special procedures were performed) and send all bills to one agency.

Himmelstein returned to Boston and visited Massachusetts General Hospital, which was similar to Toronto General in size and in the range of services provided. Himmelstein was told that Massachusetts Generals billing department employed 352 full-time personnel, not because the hospital was inefficient, but because this department needed to document in detail every item used for each patient and fight with hundreds of insurance plans about payment.

U.S. doctors face a similar billing nightmare, Himmelstein said.” They deal with hundreds of plans, each with different rules and regulations, each allowing physicians to prescribe a different group of medications, each dictating that doctors refer patients to different specialists.”

The U.S. system is a paperwork nightmare for doctors and patients, and wastes hundreds of billions of dollars.

http://www.pnhp.org/news/2004/january/national_health_insu.php


A "paperwork nightmare." Strong language.

Tinman
11-03-2008, 09:10 PM
[quote=Flying Orca;1998493]The "I'm from the government, I'm here to help" line has been making the rounds of right-wing blogs, radio shows, and newspaper columns since Hurricane Katrina. You know, a little over three years ago.

Are you telling me that you had never ever heard that saying before Katrina? Surely you jest.
--------------------------------------------------

As for your "old saying" about government doing "nothing well" and "most things poorly", a quick google turns up exactly two instances... and one of them is your own. Doesn't sound like an old, fact-based saying.

Perhaps you would care to share your definition of a "well run government program"? I have a feeling that your definition of said successful program and mine are mildly different.

-------------------------------------------

Folk "wisdom" is frequently pithy, concise, and catchy. Unfortunately that doesn't make it right.

No it dosn't, but that "old wisdom" seems to carrried us for a very long time before the internet got here.

-------------------------------------------


So you consider your own vast experience and range of observation to be more reliable than that of people who actually, you know, study something for a living? That explains quite a bit, actually. Your addendum about "vested interests" is also quite telling - nice how it allows you to ignore any data you don't like or agree with. This must have something to do with your blanket pronunciations on integrity and accountability... Oh wait, that's next:

While it is always a good idea to listen to those who, you know, study things, that doesn't mean I'm going to believe it just cause the guy telling me that the sky is falling is wearing a lab coat. Being a little skeptical has stood me in good stead thus far, and I haven't met a search engine yet that has changed my mind on that point. As far as accountability and integrity are concerned, I fear it is not nearly as widespread as you would believe. Paying it lip service is easy, living that way? Well now, that is a different matter.

---------------------------------------------



How silly of me to think you were talking about healthcare when that's the topic of this discussion.

It does seem silly to actually let a conversation evolve. I mean who would want to just talk about one narrow subject and not the things that surround it as well? Right, silly me.

---------------------------------------------------



Well, that's an excellent way for you to distinguish yourself from all those people clamouring for less integrity and accountability in government. You're a, what's the word, yes, you must be a maverick!

Or maybe, since pretty much everyone agrees that integrity and accountability are good things, that's not "your" agenda at all. Judging by your posts, I'd say that spreading right-wing talking points is your agenda.

A maverick? If you define Maverick as a guy who raises his 8 kids to believe in the value of your word, hard work, and only promising what you can deliver, and delivering on your promises, then ya I suppose I am.

Tinman
11-03-2008, 09:34 PM
Yours seems to be pretty good at starting wars.


Ummm.. would you care to point out exactly what "war" Canada started? I will blushingly admit though, that we are damn good at finishing them.

Flying Orca
11-03-2008, 09:36 PM
Are you telling me that you had never ever heard that saying before Katrina? Surely you jest.

I don't, and don't call me Shirley. ;) All kidding aside, I don't think I'd heard it before then. It might be a well-known saying in conservative circles, but those aren't circles in which I tend to move.


Perhaps you would care to share your definition of a "well run government program"? I have a feeling that your definition of said successful program and mine are mildly different.

What does my definition of a well-run government program have to do with the topic? You disputed the efficiency of Canadian health care; you have ignored posted studies that contradict your point of view and have offered nothing but platitudes to bolster your position. Let's deal with those points before we move on.


No it dosn't, but that "old wisdom" seems to carrried us for a very long time before the internet got here.

Oh, I think the divide between catchy one-liners and fact-based analysis existed long before the Internet.


While it is always a good idea to listen to those who, you know, study things, that doesn't mean I'm going to believe it just cause the guy telling me that the sky is falling is wearing a lab coat. Being a little skeptical has stood me in good stead thus far, and I haven't met a search engine yet that has changed my mind on that point.

Given that I don't recall seeing you admit you were wrong around here - ignoring facts that contradict what you're saying seems to be more your style - I'm not surprised if you don't change your mind much. It's worth remembering that opinions aren't created equal; informed, expert opinions are more likely to be correct than uninformed, inexpert opinions. Automatically rejecting something because it comes from someone who knows what they are talking about is a good way to ensure that you don't learn anything.


As far as accountability and integrity are concerned, I fear it is not nearly as widespread as you would believe. Paying it lip service is easy, living that way? Well now, that is a different matter.

I didn't say they were widespread, although I think that if you look at research on honesty and integrity in social transactions you'd be surprised at how basically decent the vast majority of people are. What I said was that claiming a desire for accountability and integrity as your agenda does little to differentiate it from anyone else's, unless you can point to someone who is advocating less accountability and integrity in government. I stand by my assessment that your agenda seems to be the repetition of right-wing talking points.

stevebaby
11-03-2008, 09:38 PM
Ummm.. would you care to point out exactly what "war" Canada started? I will blushingly admit though, that we are damn good at finishing them.Ummm...should have looked at the top right of the page before I hit "submit".
Der.
I apologise for offering the ultimate insult to a Canadian...mistaking them for an American.

Tinman
11-03-2008, 09:54 PM
No need to apologize. I wish we had a little more of that American style patriotism around here.

Bruce Taylor
11-04-2008, 06:45 AM
No it dosn't, but that "old wisdom" seems to carrried us for a very long time before the internet got here.

Bromides, slogans, proverbs and catchphrases are easy to memorize and fun to repeat.

It would be nice, though, if the old wisdom agreed with itself. ;)

Ol' Gramps used to tell, me "All good things come to those who wait." Of course Granny was always there to assure me that "Time and tide wait for no man."

Everyone knows that "Birds of a feather flock together." But everyone also knows that "Opposites attract."

"Out of sight, out of mind," as they say. On the other hand, ahh...."absence makes the heart grow fonder."

"Look before you leap," but "strike while the iron is hot."

Here's a real oldie: "A rolling stone gathers no moss." This one's even older: "A setting hen never lays."

And finally, "Hold fast to the words of your ancestors." But on second thought..."Wise men make proverbs and fools repeat them." :D

Keith Wilson
11-04-2008, 12:18 PM
Imagine, fellow Canuckians, what our health care system would be like if we allocated another 5% of our GDP to health care! Wait times? What wait times?Why, they'd be grabbing anyone who looks even slightly unwell off the street and fixing him up in seconds! :D

George Roberts
11-04-2008, 12:44 PM
"Study shows U.S. health care paperwork cost $294.3 billion in 1999

More than $1,000 per person; far more than in Canada

August 19, 2003"

My health care has almost no paperwork. Yet it provides me with very good coverage.

I suspect that the paperwork costs are in part the choice of the people buying policies.

Bruce Taylor
11-04-2008, 01:15 PM
My health care has almost no paperwork. Yet it provides me with very good coverage.

I suspect that the paperwork costs are in part the choice of the people buying policies.

My discussion with Tinman was about the paperwork doctors and other medical professionals have to complete in order to get paid by insurers. We weren't discussing the patient's paperwork, for the simple reason that in Ontario & Quebec (as in your plan, evidently) there's none to speak of (beyond the form you have to fill out when applying for a health insurance card).

The comparative studies I've looked at show that administrative overhead is much higher in the American system than in ours. This is not to say you'd be better off with a Canadian-style system, or even that your administrative costs would drop if you had one. For all I know, there may be factors that would make a system like ours impractical in your country.

George Roberts
11-04-2008, 03:05 PM
Bruce Taylor ---

"My discussion with Tinman was about the paperwork doctors and other medical professionals have to complete in order to get paid by insurers."

My doctor simply prints of a standard bill/receipt. I don't argue.

With my insurance there is no paperwork for the insurer. I simply send them my paid bills, they send me a check.

I guess there is some paperwork on their end. They keep track of what they have sent me and they stop at some amount. It used to be $3 million. I am told they stop at a much higher number now. I never asked how high.

Tinman
11-08-2008, 12:16 PM
My assertion about the heavy burden of paperwork, comes from conversations I've had with people witha fomrer head of the Canadian medical association, [ who's name escapes at the moment ] Dr Barry Dwarken hwo does a syndicated radio talk show acros sthe country and is a personal friend, My own family Dr., and a friend of the family who is herself a GP and left the practice for a number of years due in large part to the amount of paperwork she was required to deal with, as well as look after her patients. So while some may not think it a problem, the medical professionals I know have a different point of view. Is it the only problem? far from it. But it is a big one.
-------------------------------------------
More concerning than this though is the decision of the colledge of Physicians and Surgeons that their members must now begin applying the human rights code in their practices. It forces medical professionals to leave their conciences out of the practice of medicine. Dr Dwarken's analogy was that if he had a patient that was on some powerful pain killers, and feared his patient ws becoming addicted, he would face the real possibility of persecution at the hands of the HRC if the patient refused to change medication citing an infringement of his rights to medicl care. there are other sinsiter areas in this ruling as well concerning Catholic Dr's being forced to prescribe birth control, and not allowed to refuse to do abortions, or refer their patients to someone who will. Say what you will about socialized medicine, bu the day a Dr cannot invoke his concience during his or her daily practice, is the day, you effectively kill the health care system.

Bruce Taylor
11-08-2008, 12:51 PM
OK, Nick, I just interviewed SWMBO about her paperwork.

When she sees a patient she writes up a "medical note," which goes into the patient's file. Doctors everywhere do this, and it has nothing to do with the government.

Then, she take a small piece of paper, about the size of an index card, with a number of billing options written on it (complete examination, minor exam, procedure, etc.). She circles one of these options, and writes in a one-word diagnosis.

And that's the end of her paperwork.

This information gets sent electronically to the Regie de l'assurance maladie du Quebec, which deposits money directly into our bank account.

The only other paperwork she has to do consists of insurance claims -- mainly workman's compensation -- where she has to document the nature of the patient's claim and justify it to a suspicious insurer. This comes up quite rarely (maybe once a week). The forms she dreads most come from private disability insurers like Sunwest. She complains of having to fill out 3-page forms, explaining & documenting everything she has done.

I listen to Dr. Dworkin's show, and enjoy it (btw, caught your act on the Lowell Green show, yesterday, while I was tearing up a bathroom floor :) ). I don't know what type of paperwork he's talking about. I'm pretty sure he can't be talking about his billing, because that just isn't a cumbersome process.

Bruce Taylor
11-08-2008, 01:06 PM
More concerning than this though is the decision of the colledge of Physicians and Surgeons . . . Say what you will about socialized medicine, bu the day a Dr cannot invoke his concience during his or her daily practice, is the day, you effectively kill the health care system.

The Ontario College of Physicians & Surgeons is an independent, self-regulating body exactly like the professional associations that monitor the conduct of doctors everywhere (including the United States).

Its positions are not dictated by the government, and have nothing to do with publicly administered health insurance, or what you call "socialized medicine."

Tinman
11-09-2008, 11:51 AM
OK, Nick, I just interviewed SWMBO about her paperwork.

When she sees a patient she writes up a "medical note," which goes into the patient's file. Doctors everywhere do this, and it has nothing to do with the government.

Then, she take a small piece of paper, about the size of an index card, with a number of billing options written on it (complete examination, minor exam, procedure, etc.). She circles one of these options, and writes in a one-word diagnosis.

And that's the end of her paperwork.

This information gets sent electronically to the Regie de l'assurance maladie du Quebec, which deposits money directly into our bank account.

The only other paperwork she has to do consists of insurance claims -- mainly workman's compensation -- where she has to document the nature of the patient's claim and justify it to a suspicious insurer. This comes up quite rarely (maybe once a week). The forms she dreads most come from private disability insurers like Sunwest. She complains of having to fill out 3-page forms, explaining & documenting everything she has done.

I listen to Dr. Dworkin's show, and enjoy it (btw, caught your act on the Lowell Green show, yesterday, while I was tearing up a bathroom floor :) ). I don't know what type of paperwork he's talking about. I'm pretty sure he can't be talking about his billing, because that just isn't a cumbersome process.


Dr. Dwarken was referring to the overall level of time spent filling out forms, he didn't elaborate on how much on what klind of form. Ditto my Dr. friend. [ Barry is a really cool guy btw if you ever get a chance to meet him in person. ]

JimD
11-09-2008, 12:06 PM
...Dr's being ... not allowed to refuse to do abortions,...

One of the crazier notions I've heard in a while.

Bruce Taylor
11-09-2008, 12:09 PM
Dr. Dwarken was referring to the overall level of time spent filling out forms, he didn't elaborate on how much on what klind of form. Ditto my Dr. friend. [ Barry is a really cool guy btw if you ever get a chance to meet him in person. ]

Heard a bit of your Sunnyside Nick show while doing errands this morning. You seem to be a pretty personable fella yourself. :)

SWMBO adds that she has lab results to process, and doesn't bill for the time she spends on them. American doctors would have pretty much the same stuff on their desks, but perhaps they bill insurers or patients for the time spent. Dunno. Maybe George Jung will chime in, if he's interested.

Oh, and evidently I was wrong to lump workman's comp in with "suspicious insurers." They don't second-guess her decisions.

Tinman
11-09-2008, 12:11 PM
Thank you Bruce, I do try to be. The only thing that really pisses me off is when people do things that are not grounded in common sense. I'm not arguing with your Dr friend btw, just relating what I have heard form the ones I know.