I Love Canadians, I Really Do...

**vidcc** · 07-31-2004, 03:31 PM

All this is true to a degree rat and well known.

We do get poor value for money. Yes the drug companies overcharge and every time a bill has attempted to "negotiate on price" it has failed due to our politicians bowing to the drug company lobby ( one of the most powerful we have). Medicare pays more for drugs than the private insurance companies do because of this.

I would like to make a case on some things though as even though it is overpriced there are some valid reasons.

the irony is that the US Government already pays more % of GDP on health care than most of Europe (a lot more than the UK).... so they wouldnt have to pay more Tax for a Universal Health Service thats free at point of contact.

The USA is vast and the populus is spread out, not huddled together as in europe so the "GDP" spending would have to be greater due to the cost of dispersion. Hospitals need equiptment for all treatments and we can't have the efficiency of specialist hospitals "down the road" That said we are overcharged.

I think they spend a fortune stopping people going to Canada to get the same drugs at a vastly reduced rate, as this is their closest neighbour.

Yes this is true. The FDA says it's to protect us because they haven't approved the drugs or the factories they are produced in, but it seems more like they are protecting the drug companies as the're the same drugs. some drug companies have threatened to stop supplying companies in Canada if they sell to Americans. So we can't legally buy drugs produced by our own companies cheaper.

**hobbes** · 07-31-2004, 03:57 PM

I have a question for those of you who live outside the US.

What is the medico-legal climate.

In the US, we have hordes of attorneys who advertise on TV, encouraging people to sue for just about anything.

The trick is that even if the doctor is 100% in the right, he may lose the case because his malpractice insurance provider will lose less money than successfully fighting and winning the case.

So the doctor is stuck with a "malpractice suit" against his name, his medical license becomes in jeopardy, and his malpractice insurance goes through the roof. In South Texas, 50% of doctors in the "Valley"- (Southern tip that borders Mexico) have been sued or are currently being sued.

This tends to drive doctors to practice "defensive" medicine, instead of acting on their training and instincts. A simple car wreck can cost 10's of thousands in diagnostic tests, even if you are completely without injury, because doctors are afraid to let you walk out the door without crossing every "t" and dotting every "i".

In many countries, doctors cannot be sued. Some balance between that system and what is going on now would squeeze out so many wasted health care dollars.

I watched my father suffer through 2 years of litigation before the insurance company decided to settle. He did nothing wrong, but he had to deal with the stress of being unfairly accused for 2 years, he was punished for doing nothing.

Kind of hard to go to work everyday with a good attitude when the system we have in place makes the patient someone you fear, rather than someone you want to help.

**Biggles** · 07-31-2004, 04:50 PM

Hobbes

There have been some attempts recently with the "Where there is blame there claim" style adverts. However, these companies received some criticism (their fees took a fair percentage of the "claim") consequently they don't appear as often as they did.

I think, as a rule of thumb in the UK, they pretty much have to cut the wrong leg off before a judge will even countenance a claim. Some of the crustier judges get quite irritated by frivilous suits and often end up awarding fairly small (tiny) damages.

We have yet to truly embark on the litigacious road the US has gone down. However, where there has been clear negligence such an option has always been there. Hopefully it will be a while yet before we see lawyers trying to sue restaurants for making people fat.

Actually my favourite (and this may not be true) is the story that a US vacuum company has a warning not to use the device as a sex aid after a suit filed by some maniac who had all but had his dick sucked off by one of their vacuums. As I said, this may not be true.

**vidcc** · 07-31-2004, 05:03 PM

It's a very good point hobbes, and yet another reason for the consumer getting a raw deal, but in this case it's caused by the consumer.
In other countries the lawsuit culture isn't so common but in recent years tv ads such as ours are pushing things.
We do need common sense in our society but the $ signs bring out the worst in some people.
The malpractice suits have made it hard for some areas to get medical facilities, but i wouldn't outlaw them as some suits are just. What we need is some sort of control to weed out frivilous suits

**Monkster** · 07-31-2004, 09:02 PM

u wouldn't be dead j2k4, u see the secret is not to get injured

**Rat Faced** · 07-31-2004, 09:41 PM

There are fixed damage awards I believe for the most common things, so that they very rarely have to go to court.

If a Judge see's something as Frivilous, then he will give only Token damages... If they decide to go to court because the compensation scheme "Isnt enough", then the Judges will look at that...

If they dont agree with you, then you'll get that amount anyway and have to pay your legal costs and that of the defendant.

As the amount awarded in these schemes are looked at regularly, then its very rare that a Judge would revise them on the back of one court case (Im not sure that they could anyway, however there decision would probably be taken into account at the next review)

If its serious then Damages to fit are awarded:

eg:

If it was something that stopped you working again, then you would receive damages that would make it unlikely you'd need to work again.

If a Dr made a minor error and you got the runs for a few weeks, then you certainly wouldnt receive 1000's in punitive damages.

No-one wants to follow the American Route of suing everyone for everything, however legitimate cases are allowed and acted upon.

I do recall that I have to sign a waver before any operation, which also helps.

Basically, do i want them to help me, and not hold them liable for something that goes wrong that is beyond their control. Its not negligence if i have a reaction to the anesthetic...thats a risk I chose to take, it is negligence if they remove the wrong Kidney.. that type of thing.

**j2k4** · 08-01-2004, 02:04 PM

I just felt compelled here to search out an old post of mine that is relevant to the health care issue:

Quote:

....This very point is what is responsible for all the political squabbling here in the U.S.; if the politicians (all of them; in both parties) didn't owe their livelihoods as politicians to the distribution of tax revenue (how much they drag back to their districts), things could be more easily accorded proper funding.

An example: Medical Care is the eternal political football; the libs (if they had their way) would nationalize it, effectively dulling the "cutting edge" of medical research (no competition=no profit opportunity=no money for research=no breakthroughs) and we'd have to also pay the exhorbitant costs of the attendent bureaucracy The conservative side opposes this for the same reasons.

The irony is, if this issue were ever resolved, ALL of the politicians lose their raison d`etre, a fact which is not lost on them.

The fact is, there is enough money wasted in government bureaucracy to pay off our debt, provide free medical care and prescription drugs. etc., etc.,.... but the pols won't spend responsibly.

We are beset by incredible greed, and a system which accomodates and winks at this behavior.

THAT is the bottom line.

-UNQUOTE

I don't feel any differently about it these days; the grandiose endeavor to push the envelope of medical technology would be blunted to some extent; the question of malpractice, and it's effect of pushing doctors out of certain disciplines, or, indeed, pushing students into the legal profession instead, would have to be addressed.

Prescription drugs would take a hit or develop their own discipline, one or the other; research would be reined in.

Perhaps some developing African country would emerge as a the world-leader in pharmaceutical development.

As I said, though-I'm sure it could be done; the money is there, but only if our legislature is responsible with our cash, and if P. Diddy's rush to bring uninformed newbie voters to the polls succeeds and becomes the new norm, I doubt we will see any sort of spending discipline in our grandchildrens lifetimes, because boring facts such as those I've recounted would not engage a new voter who is most intent on exercising his new "right".

**vidcc** · 08-01-2004, 06:21 PM

J2

i am getting a deja vue feeling on that post

I agree totally that our enemy with this is the people we vote for.
however one thinks, we do have a problem that needs to be addressed and that is the fact that healthcare is pricing itself out of the reach of millions of Americans and that number is rising. If we don't address the financial aspect soon we may find that we have social healthcare by default of the amount of people needing the safety net making it the norm....and that would really cost.

The problems with total social systems is the size....they own everything and don't run efficiently because of the typical state run "gravey train" aspect. America has the ability to show the world how to do things properly, still keeping healthcare in the private sector but coupled with social funding.

In answer to the costly red tape issues and to give you some indication of how i believe we could make a system that works and is still free at point of service.

we already have a system that works but for the cost so i wouldn't touch the actual frontline providers. They give excellent service.
we don't need to set up a costly bureaucratic dept. to run the financing, we already have insurance companies that can do that on government contract.
We would however need co-operation and the will to police it so we get value for money. Government contracts are like the goose that lays golden eggs because they charge top dollar and we pay it. We need to start negotiating on prices for drugs as well and the insurance companies could do that for us as they do now for themselves...take the politicians out of it as they are the ones that have been the "berlin wall" to affordable healthcare.

This is just a rough idea and i do appreciate that it is simplified, but it would give us the efficiency and service of private medicine thereby avoiding the problems with a social system that owns and runs everything, coupled with social financing which give EVERYONE full access . Obviously it would be nearly impossible to bring about in the USA as no doubt the medical lobbyist would resist and our politicians would support them over the people that voted for them.

Just an idea