Profit is already in the system. Do you think that physicians, nurses and other staff work for free? Do you think that the contractors who built the hospitals worked for free? Do you think that suppliers of medical equipment - everything from CT scan machines to rubber gloves - work for free?Poonhound said:
Two tier health care?
- Thread starter Quest4Less
- Start date
First the U.S. is not really a two-tier system, as the first tier it not universal. If it were universal, that would not happen. Also, I don't know why you are comparing the Canadian system to one of the only countries in the world without a universal first tier. Do you really believe that it is the only possibly alternative to the current Canadian system and that there is nothing that we can learn from the other developed countries of the world? I'm curious as to why you seem to believe that the Canadian and American systems are the only alternatives.Poonhound said:Another thing too. In the states which is a two tier system something like 50-75% of people that go bankrupt do so from paying medical bills. Do we really want to create a situation like that in Canada.
Given that the provincial medical associations limit the number of doctors licensed to practice in the province and the SC only allowed for private health care in settings where those centres operated wholely outside of the public system. This, if doctors opt out wholely, will limit the number of doctors able to see those patients who are unwilling or unable to pay. So there will be an impact.red said:two tier or three tier or one tier- whatever happens won't impact the delivery of services to the average person who can't afford to pay fees to jump the line
Probably because it's the one quoted by the reform as the system we should be practicing. Cynic aside, it's the one we see daily and as a result the one we can easily compare what we have to what want.someone said:First the U.S. is not really a two-tier system, as the first tier it not universal. If it were universal, that would not happen. Also, I don't know why you are comparing the Canadian system to one of the only countries in the world without a universal first tier. Do you really believe that it is the only possibly alternative to the current Canadian system and that there is nothing that we can learn from the other developed countries of the world? I'm curious as to why you seem to believe that the Canadian and American systems are the only alternatives.
Can't. The Canada Health Act (And the SC) won't allow it. This decision was only for private insurance for services operating outside of the public system.George OTJ said:...I'd like to see the 2nd tier help reduce the cost of those who don't have a choice. Either something like
a) 30-50% of the fees paid by the 2nd tier should be refunded to provincial health plans to help fund the 1st tier, or
b) requiring doctors/clinics/hospitals to maintain a minimum ratio of reduced fee treatments for the 1st tier for every $50,000 collected from the 2nd tier.
Given that the Canada Health Act is an act of the federal parliament and can be changed, I don't see that as a real problem.superquad1968 said:Can't. The Canada Health Act (And the SC) won't allow it. This decision was only for private insurance for services operating outside of the public system.
BTW, how would people feel about taxing the second teir to support the first teir? Sort of like part (b) of George OTJ proposal.
Yes, obviously the Act can be changed but I don't see the political landscape allowing for it. The only party who advocate modifications are the Reform and you can bet that the NDP will fillibuster until the end of time before they allow the dismantling of universality to happen.someone said:Given that the Canada Health Act is an act of the federal parliament and can be changed, I don't see that as a real problem.
BTW, how would people feel about taxing the second teir to support the first teir? Sort of like part (b) of George OTJ proposal.
As for the second proposal, sounds a little like double taxation. Which I believe is illegal
here's a quick lesson
in the state of nature...MIGHT IS RIGHT...i.e. the strongest will survive sometimes at the expense of the weak.
since, man, has made his own fake representation of that in the world that we know and has set it up that we no longer have to compete through physical means for limited resources, but, we compete through the acquistion of wealth...we can now say that BEING WEALTHY is equal to MIGHT.
i.e. The wealthy will survive sometimes at the expense of the poor...I hate to say this...but, poor people do not wield any power over someone with more wealth. Let's face it...big fish eats little fish, I didn't make that rule, but, I am subject to it. So...why are we so surprised that this has happened?
doesn't the saying go.."the rich get richer and the poor get poorer"
well now it's " the rich get healthier and the poor get sicker" it's the same thing..
In the study of the philosophy of logic I believe it would look like this
if A then B...
A therefore B.
in the state of nature...MIGHT IS RIGHT...i.e. the strongest will survive sometimes at the expense of the weak.
since, man, has made his own fake representation of that in the world that we know and has set it up that we no longer have to compete through physical means for limited resources, but, we compete through the acquistion of wealth...we can now say that BEING WEALTHY is equal to MIGHT.
i.e. The wealthy will survive sometimes at the expense of the poor...I hate to say this...but, poor people do not wield any power over someone with more wealth. Let's face it...big fish eats little fish, I didn't make that rule, but, I am subject to it. So...why are we so surprised that this has happened?
doesn't the saying go.."the rich get richer and the poor get poorer"
well now it's " the rich get healthier and the poor get sicker" it's the same thing..
In the study of the philosophy of logic I believe it would look like this
if A then B...
A therefore B.
The only thing that I can see that MIGHT be illegal is the fact that the federal government would be taxing an area of provincial responsibility. Even, then I don’t think that would much of a problem as they would be taxing private suppliers which is different than, for example, resources which are actually owned by provinces. Otherwise, I don’t think that there is anything in the constitution to prevent it. Generally, differing tax rates are allowed. When you by prepared food, you pay GST/PST or HST. When you buy unprepared food you don’t pay such these taxes.superquad1968 said:Yes, obviously the Act can be changed but I don't see the political landscape allowing for it. The only party who advocate modifications are the Reform and you can bet that the NDP will fillibuster until the end of time before they allow the dismantling of universality to happen.
As for the second proposal, sounds a little like double taxation. Which I believe is illegal
Poonhound said:Evidently, you've never been ill...someone said:Why change a good thing?
The rich will get better treatment regardless if Canada allows a two tier system or not. They hop on th eplane and fly south to an US clinic, which will gladly take there money.
A single payer, single tier sytem is doomed to fail, but don't take my word for it, take a look to Europe.
For years the Europeans have promnoted and maintained a single system. They foung out the hard way that this type of system is not sustainable in the long run.
Like in Canada the intial reaction was to throw more money at it, hoping it will fix itself.Where does the goverment get more money from? From us the taxpayer, but there is only so many times you can go to the piggy bank, before the taxes get so high that it has other adverse effects on the economy.
Britain i believe was the first to "officially" introduce a two tier system. It is far from pefect, but it has resolved some fiscal issues. Now other Europeans have followed, or are in the process of following the model.
Some NDP talking head has cited Sweden as the model for Canada. He is correct by saying that the swedish model works. What he failed to add is, that Sweden has the highest tax rate in Europe.
Is Canada willing to follow Sweden?
Why are US and Canadian politicians so pig headed? Why aren't they willing to study and learn from Europe?
A single payer, single tier sytem is doomed to fail, but don't take my word for it, take a look to Europe.
For years the Europeans have promnoted and maintained a single system. They foung out the hard way that this type of system is not sustainable in the long run.
Like in Canada the intial reaction was to throw more money at it, hoping it will fix itself.Where does the goverment get more money from? From us the taxpayer, but there is only so many times you can go to the piggy bank, before the taxes get so high that it has other adverse effects on the economy.
Britain i believe was the first to "officially" introduce a two tier system. It is far from pefect, but it has resolved some fiscal issues. Now other Europeans have followed, or are in the process of following the model.
Some NDP talking head has cited Sweden as the model for Canada. He is correct by saying that the swedish model works. What he failed to add is, that Sweden has the highest tax rate in Europe.
Is Canada willing to follow Sweden?
Why are US and Canadian politicians so pig headed? Why aren't they willing to study and learn from Europe?
Naive
So by allowing (or even increasing) a two tier system then the level of care a poor person receives will improve?????
Doubt it - instead human nature will intervene and soon the first question asked by a doctor will be "how rich are you", instead of "how can I help".
As for the examples of sports people and such that were given - I think it's just plain wrong for ANYONE to get care "first" just by being connected or rich.
Care should be based on NEED.
So by allowing (or even increasing) a two tier system then the level of care a poor person receives will improve?????
Doubt it - instead human nature will intervene and soon the first question asked by a doctor will be "how rich are you", instead of "how can I help".
As for the examples of sports people and such that were given - I think it's just plain wrong for ANYONE to get care "first" just by being connected or rich.
Care should be based on NEED.
100 people need an MRI. Johnny Six-pack has no money, no private insurance, and is 100th on the list.Quest4Less said:So by allowing (or even increasing) a two tier system then the level of care a poor person receives will improve?????
Podunktown has 1 MRI machine and only does one test per day. Johnny will get his MRI in 100 days.
Shakey MRI Inc. opens an office in Podunktown that has a modern machine, flexible hours, and conducts 4 tests per day.
10 people on the waiting list are rich pricks and immediately pay for their tests with their pocket change.
40 people are normal, middle-class folk who have paid for private insurance. The private insurance firm pays for them to get the private test.
Johnny quickly moves from 100th on the list to 50th, and gets his MRI in half the time.
Why are we afraid of this?
Human nature...
1) Clinics would all want to go "private" so they could make money.
2) Doctors would want to see ONLY rich clients - again so they could make money.
Therefore: Less clinics, less doctors, LESS CARE for the average joe.
Because in reality it would not work that way:The Shake said:100 people need an MRI. Johnny Six-pack has no money, no private insurance, and is 100th on the list.
Podunktown has 1 MRI machine and only does one test per day. Johnny will get his MRI in 100 days.
Shakey MRI Inc. opens an office in Podunktown that has a modern machine, flexible hours, and conducts 4 tests per day.
10 people on the waiting list are rich pricks and immediately pay for their tests with their pocket change.
40 people are normal, middle-class folk who have paid for private insurance. The private insurance firm pays for them to get the private test.
Johnny quickly moves from 100th on the list to 50th, and gets his MRI in half the time.
Why are we afraid of this?
1) Clinics would all want to go "private" so they could make money.
2) Doctors would want to see ONLY rich clients - again so they could make money.
Therefore: Less clinics, less doctors, LESS CARE for the average joe.
Really?Quest4Less said:Because in reality it would not work that way:
1) Clinics would all want to go "private" so they could make money.
2) Doctors would want to see ONLY rich clients - again so they could make money.
Therefore: Less clinics, less doctors, LESS CARE for the average joe.
Because that's not the case in every other Western democracy (other than the US, of course).
I would actually prefer that system if we have go down that path. I think it is how we allocate the resources we have. If person x wants to go down south pay for their hip replacement and leave those resources for those who can't. That would be a benefit.langeweile said:The rich will get better treatment regardless if Canada allows a two tier system or not. They hop on th eplane and fly south to an US clinic, which will gladly take there money.
Not the ideal path
Problem with this theory is that the public MRIs are being run as much as they can. Not as efficient as 4 to 1 maybe 4 to 3. So Johnny's benefit to the private system may not be as great as half the time. But Shake I do see where you're going. Just guarantee me that no doctor can leave public practice or you're proposed benefits for Johnny are lost.The Shake said:100 people need an MRI. Johnny Six-pack has no money, no private insurance, and is 100th on the list.
Podunktown has 1 MRI machine and only does one test per day. Johnny will get his MRI in 100 days.
Shakey MRI Inc. opens an office in Podunktown that has a modern machine, flexible hours, and conducts 4 tests per day.
10 people on the waiting list are rich pricks and immediately pay for their tests with their pocket change.
40 people are normal, middle-class folk who have paid for private insurance. The private insurance firm pays for them to get the private test.
Johnny quickly moves from 100th on the list to 50th, and gets his MRI in half the time.
Why are we afraid of this?
No I don't think that these are the only two systems available but I do believe if we open up to a two tier system that our government would go the way of the American system and we'd be fucked.someone said:First the U.S. is not really a two-tier system, as the first tier it not universal. If it were universal, that would not happen. Also, I don't know why you are comparing the Canadian system to one of the only countries in the world without a universal first tier. Do you really believe that it is the only possibly alternative to the current Canadian system and that there is nothing that we can learn from the other developed countries of the world? I'm curious as to why you seem to believe that the Canadian and American systems are the only alternatives.
Last time I went to Hamilton General they were humming. Also at McMaster. Also a hospital with MAJOR budget problems. I'm not saying that other centres have a problem but my experience tells me otherwise.Winston said:no, they are not. because of budget limitations the machines often sit idle because there is no money to pay an operator.
In the US, many HMOs now take the scans, send them to India via the net and have an Indian doctor do the diagnois because it is cost effective.
Do we really want to send them to India to be diagnosed? Why not use the hundreds of Indian trained doctors wholive here in Canada. I DO NOT want my health to be determined by someone who has never seen me. Surely my health and yours is worth more than the bottom line. Let's leave the HMOs down south. Need I mention HealthSouth?
in an ideal world, but that's not human nature. If I had a sick child and I had $100,000 available to jump him/her to the top of the cue with the best available, damn right I'd spend it.Quest4Less said:Care should be based on NEED.
In my earlier suggestions, I wasn't proposing another level of taxes.
I was thinking of "tier 1" as being a universal health care available to all Canadians regardless of income (i.e. OHIP for us Ontarians) and would include basic health care as well as any neccesssities for maintaining a decent quality of life.
The "2nd tier" is strictly pay-as-you-go, charge what ever the market will bear service. The 2nd tier could still offer the same range of services as tier 1 but in a more 'refined' setting plus any additional non-essential services their patients were willing to pay for - whether it be cosmetic surgery or gourmet hospital meals, fresh flowers daily, and a big screen TV in their private room.
My earlier suggestion were more in creatiing a link between these two tiers - so as the rich & powerful demand better services, their is some pay-off for the universal system.
In other words, for example, as private clinics install more MRI equipement to respond to the demands of the rich & powerful, the movement of the rich & powerful to the private clinics will reduce the wait time for tier 1 clients - not reduce the number of MRI equipment available to tier 1.
In short, I'm in favour of a two tier systems which promotes the expansion of resources, not just a shift of resources.
