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View Poll Results: So, what do you think? | |||
Great but not enough, keep on going | 8 | 20.00% | |
Good enough (for now) | 13 | 32.50% | |
Bad (but okay, we lost, let's move on and make the best of it) | 5 | 12.50% | |
Bad as in Armageddon | 12 | 30.00% | |
Trout as in neutral | 2 | 5.00% | |
Voters: 40. You may not vote on this poll |
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07-21-2009, 08:52 AM | #401 |
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A few years ago, Wal-Mart had a dramatic effect on the cost of drugs with its announcement that all generic 30-day drug supplies would be sold for $4. It dumped the industry on its head and was a huge help to people who previously had to choose between needed drugs and life necessities. That was a true change. We need something dramatic and outside the box to implement a true change in health coverage.
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07-21-2009, 08:59 AM | #402 | |
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Quote:
This resonates with me. We keep hearing (rightly or wrongly) that the American people lack the political will to give up what they have. (i.e. "If you like your health plan, you can keep it."). If, however, the whole system is broken on some fundamental level, then simply giving people another choice to the broken system, while making sure that the "choice" operates on a level playing field with the broken system, does not seem to solve the actual problem. It may be that what is being proposed is the best solution possible for an American public unable to sacrifice anything anymore. But it does not seem to solve the real problems at the root of the system. |
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07-21-2009, 09:09 AM | #403 |
College Prospect
Join Date: Oct 2001
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Agreed, you don't see these sort of numbers unless something is wrong, or there is a bubble. (which I have not entirely ruled out, evil short monster always looks for new prey after all!)
You also don't see this much dislike of a product (health insurance) without the realistic probability of a dominant competitor strategy. That is, a WalMart deciding to go its own way and sending a shockwave through the market. I guess we could argue the impact or agenda behind $4 drugs, but I know from my very poor anecdotal market research (the number of times my old lady relatives mention it)... that changing the price expectation can drive a number of market decisions. For instance, the grandma who does her grocery shopping where she can get her pills cheap... or the other major stores in the area matching the price to avoid Walmart getting a competitive advantage. I always think its innovation that drives people's lives getting better, ya health care is crappy right now, but thats just a signal that its time to buckle up and drive some new ideas out there. If its a private company that manages to do it someone will get their billion dollar fortune. If its the government, well yippee for democracy (it does have its successes after all). Last edited by SportsDino : 07-21-2009 at 09:10 AM. Reason: spelun es fur chumphs |
07-21-2009, 09:36 AM | #404 |
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07-21-2009, 09:49 AM | #405 | |
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I've taken some time to digest this, and my feeling is that this is a very rosy assessment. Ironically, this article not only shows how you can lie with statistics, but how you can base a misleading case on statistics. First of all, let's look at the raw numbers, taking the numbers you've given as the truth. Out of the 46 million without insurance, let's assume that 10 million could have it but don't know about it and 9 million make over $75K and could afford it. Taking those numbers as truth, that's still 27 million people without some form of coverage. In the world's richest nation. Now maybe your argument is that we should just target those 27 million people, and "close the hole" as it were. That's fine, a reasonable target and, honestly, probably the most with which we're going to end up, to be honest. But secondly, honesty. The assumptions the article makes about health care coverage paper over more problems with the system. For one, people who make over $75K may not, in fact, be able to afford insurance due to cost-of-living expenses where they live. For two, people who make over $75K may be able to afford insurance, but may only be able to afford insurance that has huge deductibles and considerable riders so that, should they have a serious accident or develop a serious disease, they'll be unable to afford care anyway. Those who qualify for coverage but haven't availed themselves of it? The article assumes they're all lazy. What about those who applied and have been waiting months for the coverage to start? What about those in paperwork hell? What about those who have difficulty with the application due to a (think job-related) itinerant lifestyle? What about those who applied for coverage but whose localities are so cash-strapped that they receive little in the form of benefits anyway? The article also makes some assumptions about those who are covered in that they were "covered within the last four months" or something. As many of us know, a lapse in coverage, even short, can result in a catastrophic financial nightmare should your current insurance company deem something a "pre-existing condition" and decide not to cover it. Anyway, there are a number of ways at looking at such statistics. I think those of us with good insurance who don't run into these problems look at these statistics and assume they mean most people can have coverage like us, obtained just as easily, and so don't understand the urgency of the issue. |
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07-21-2009, 09:59 AM | #406 | ||
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Quote:
If you are that short on money, you need to make a lifestyle change. Move to a cheaper market where you can afford the cost of living. If you can't move out of market, move outside of town and commute, which is relatively cheap in comparison. Also, there are emergency policies for relatively cheap that will cover the bad situations and they have relatively low costs. I just don't buy the 'no alternatives' when you can make $75K. The problem is that people refuse to make the needed changes. Denial is a powerful emotion. Quote:
I'm pretty sure that 10M of those 27M are illegal immigrants. So you can toss them out as needing coverage. If you aren't a citizen, you're not getting the benefits if I had my choice. |
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07-21-2009, 10:04 AM | #407 |
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Kind of a threadjack but I was wondering if this is really true, and by how do you measure such a thing. Obviously the US has the highest GDP (by far). But we rank lower in fancier numbers like GDP per capita (#15), and the Human Development Index (#15) And it's pretty well assumed that we have a lower standard of living, on the whole, than many European countries. Maybe just something to balance the perspective that we're entitled to whatever we want, no matter the cost. Though, I'm for any health plan that gives more people access to better care, more cheaply, that as Obama promised, "doesn't add to our deficits". I mean, I don't know how anyone could be against that. Unfortunately, it just seems obnoxiously disingenuous to contend that this is possible. |
07-21-2009, 10:15 AM | #408 | ||
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It's often not quite that simple. And yes I know we can castigate, to the nth degree, those who make decisions which land themselves in this kind of situation, but all that shows is that the systemic cause for this state of affairs is our lack of compassion, not the chronic mistakes of others. Quote:
OK, so in the best possible scenario, assuming the best of all the statistics, there's only 17 million people without some form (no matter how useless) of health care coverage. |
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07-21-2009, 10:27 AM | #409 | ||
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I couldn't disagree more with your last statement, but I doubt any amount of discussion will change your or my opinion, so we'll leave it at that. Quote:
Well, there's also a large portion of kids in that number that could be covered by the government at a cheap rate if done correctly (as opposed to the way Hawaii did it when they and their citizens managed to bankrupt a state plan to cover all children). That would cut that remaining number by 40-50%. Still not covering everyone, but an improvement for sure. Last edited by Mizzou B-ball fan : 07-21-2009 at 10:28 AM. |
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07-21-2009, 10:37 AM | #410 | |
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Quote:
That's not how I read the article. How I read the article already lumped this population in with the people who could have coverage but didn't know about it. |
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07-21-2009, 12:31 PM | #411 | ||||
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IMO, reducing the uninsured through new programs (public or otherwise) has always been a red herring in health care debates. To get true health care improvements, these need to be the focus: 1. Find a way to get people who qualify for existing coverage registered. 2. Extend unemployment coverage 3. Find a way to increase the number of primary care doctors (a prerequisite for any public plan - also needed if more people register for existing programs). 4. Ensure proper funding structure for ER/safety net clinics. Right now, this process is a mess and if a large number of people were added to the covered group - they wouldn't have the manpower or funding to take on the increased load. 5. Look at better ways to bill and define covered services (esp on these existing publicly sponsored plans). We have existing plans per state and federal government to cover uninsured (esp poor and kids). Let's clean up the billing process for these existing programs before starting a whole new program. In order for us even to consider a public health care option or think about improving the cost for the current private system, we have to take these above steps (if only to have the infrastructure to support it). Take an example of running an after school care business where you are paid by a billing process. Right now, you have 10 kids each day and it takes you around a month to get paid for this week's care for each kid. Imagine if tomorrow you had 25 kids dumped in your class and it was going to take 2-3 months for the billing process to flush out for the first year of transition? You would be immediately forced to more than double your staff while getting paid at a much later time than you are used to. Without proper planning and infrastructure, you would be out of business in a few months. This is what some of these public-based plans are proposing for our health care system and it's amazing to me that people are so gung ho about leaping in the water with both feet knowing it's full of sharks and crocodiles. It's probably worth our time to check the water first Everyone wants to "do something" to improve health care, but we shouldn't just jump at the first attempt without first defining what problem we want specifically solved and how this attempt gives us a reasonable chance of providing that solution - not mention how this system will sustain over time. In many ways, this is like the initial Iraq war plan where we make a run on Bagdad, get Saddam and then go "Um, what now?". I don't think we want to be in that "What now?" situation in 2 years with a clusterf*ck health care program simply because a bunch of people want to do something (anything) ASAP. Last edited by Arles : 07-21-2009 at 12:37 PM. |
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07-21-2009, 01:09 PM | #412 |
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Good points, Arles, and I appreciate the post. I don't think we agree 100%, but I think we may be closer to agreement on a number of points than not. Thanks.
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07-21-2009, 01:10 PM | #413 |
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07-21-2009, 03:06 PM | #414 |
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Arles: But the most difficult problem is cost containment. If you add a bunch of people at the same cost structure things just get monumentally worse. From what I've read that's the heart of the problem in MA. They added the uninsured, but punted on cost containment and now they can't sustain the program.
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07-21-2009, 03:51 PM | #415 | |
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This is what worries me so much about the current debate. It usually ends up morphing into a "how can we setup a plan to cover all the uninsured" instead of "how can we get the country to a point to where we could handle an increased load of new patients and help control the increased cost". I think if we answer the second question, the first almost becomes irrelevant. If we setup the infrastructure and cost certainty needed to cover more people, then we can easily find ways to increase the number of people covered. Starting with the idea of increasing the number covered and then going "Oh, crap" once doctors are slammed, costs are up and wait times are through the roof is extremely dangerous. That seems to be the current plan many in congress are in favor of. Last edited by Arles : 07-21-2009 at 03:52 PM. |
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07-21-2009, 04:14 PM | #416 |
College Prospect
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Yep, I think attacking the heart of the cost problem is necessary to solve the insured numbers problem. Going the other direction first can actually be counter productive. Stress an already stressed system and maybe we'll see the health business version of the credit crunch margin call... more short term obligations than real world supply is highly destructive to long term growth (which is what we need, we are currently in a shortage situation).
I think you have hit right on the point, with your list of focus steps (although I'd push in the 4,5,3,2,1 order) and example of running a business (arguably deferred revenues against current expenses can be dealt with, but the scale and timing are just too far off in this problem). |
07-21-2009, 04:18 PM | #417 | |
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Interesting numbers from Gallup:
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07-21-2009, 09:23 PM | #418 |
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07-21-2009, 09:26 PM | #419 |
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07-21-2009, 10:07 PM | #420 |
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07-21-2009, 10:09 PM | #421 | |
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Quote:
RASMUSSEN!
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07-22-2009, 01:47 AM | #422 | |||
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Quote:
http://www.cmaj.ca/cgi/content/full/173/11/1343#R2-19 Quote:
You also have this report: Fraser: Canadian patients worse off than uninsured Americans | Physicians for a National Health Program Quote:
Just because people have coverage on paper, doesn't mean they are better off. If you are on a waiting list for major surgery in Canada (can take years in some instances) or are stuck with a $1400 bill for needed prescription drugs, I doubt you would consider yourself "covered" when it comes to health insurance. We need a system that not only reduces the number of uninsured, but actually functions well for the numerous people currently well-insured. And that's not Canada. Last edited by Arles : 07-22-2009 at 01:48 AM. |
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07-22-2009, 07:57 AM | #423 | |
Head Coach
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Canadian's view of their healthcare (note it admits its not a scientific poll)
Poll: Canadians like their health care despite grumbles - Yahoo! News Quote:
Interesting, not sure if I am reading this right. It does seem that US gets faster access to doctors but Canadians are more happy? This is attributed to because they do not need to pay (and I guess, think they are getting a good deal?). Last edited by Edward64 : 07-22-2009 at 08:04 AM. |
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07-22-2009, 08:03 AM | #424 | |
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Sure, there are imperfections and I don't think anyone is saying that the Canadian system is perfect. The comment still stands though, other countries are able to do it (okay, maybe not 100% precisely), we should be able to also. The quote said $15K procedure was free but that there was disparity in the medication. Still a pretty good deal to me. I wonder how Canadian's handle the last x months of life which I've read is where the disproportionate $ are going to. I'll research. |
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07-22-2009, 08:51 AM | #425 | |
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I think this is the problem with comparisons to other countries...they are highly relative to what they believe is a "good doctor" or a "long wait". They also have differing cultural values and habits that may (or may not) lend themselves to more reasonable costs. US consumers are also notoriously more demanding of "service when I want it" than, dare I say, "any" other county. We have to find ways to make health care work, within the confines of our society and budget variables...not anybody else's. So where country X can do Y, it doesnt mean country X also does ABCDEF, etc. US consumers expect all (or most) of it...and for the same relative price. And if the U-HC advocators say that's tough, and we all need to get over it in order to help the rest...fine, then at least sell it that way. |
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07-22-2009, 11:23 AM | #426 | |||
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What do you consider "better off"? You've already said that the overall health of the country is not a good gauge of whether health care in the country works. So what is your way of judging? Like I said, I lived there and never had an issue. I never heard of people complaining about it or having to wait all these horrible times. Sometimes you'd have to drive a ways to get a faster appointment with a specialist or to get a test done. But I never remember hearing of people dying in the streets because they had to wait years for major medical procedures. The waits were almost always for non life threatening issues that you were able to get privately done faster if you wanted to. Last edited by RainMaker : 07-22-2009 at 11:23 AM. |
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07-22-2009, 11:50 AM | #427 | |
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Bingo. We can't have it "all". With the trillions of dollars in debt we already have, it makes it even tougher. Not to mention we need to provide an incentive to make people want to become doctors. Last edited by Galaxy : 07-22-2009 at 11:51 AM. |
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07-22-2009, 11:58 AM | #428 | |
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And I've visited my grandfather in the hospital in Charleston, SC recovering from a bypass surgery where his roommate was from Canada. That guy needed coverage right away, not "univeral coverage" later that year. |
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07-22-2009, 12:01 PM | #429 |
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There is private care in Canada that you can use at any time.
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07-22-2009, 12:02 PM | #430 |
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There's also a problem of scope. The average wait for orthopedic surgery in Canada is 3-4 months. This is for a country of 30 million people with an infrastructure that's been in the works since 1985 for national health care.
We have 300 million people and no infrastructure. It's borderline lunacy to think the US could do even the same as Canada (let alone better) when it comes to wait and quality of service. I just don't see a need to change our system when some very simple steps can reduce the number of uninsured, especially when we lack the infrastructure to even consider a national plan. |
07-22-2009, 12:10 PM | #431 |
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Far be it for me to defend Canada's poor system, but I never thought I'd see the day when conservatives were arguing that the US could never be as good as Canada.
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07-22-2009, 12:13 PM | #432 |
"Dutch"
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07-22-2009, 12:16 PM | #433 | |
"Dutch"
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Quote:
The argument has never been about the USA vs Canada. It's that private health care is generally better than public health care. EDIT: Ah, I see you responded to Arles. Makes more sense that you said that, but it's still a poor way to look at the basic argument. Last edited by Dutch : 07-22-2009 at 12:19 PM. |
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07-22-2009, 12:19 PM | #434 | |
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Quote:
It's borderline lunacy to think the US could do even the same as Canada (let alone better) when it comes to wait and quality of service.
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07-22-2009, 12:24 PM | #435 |
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07-22-2009, 12:25 PM | #436 |
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07-22-2009, 12:47 PM | #437 | |
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The Three Things Obama Should Say About Health Care - The Atlantic Business Channel
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Last edited by albionmoonlight : 07-22-2009 at 12:47 PM. |
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07-22-2009, 01:14 PM | #438 |
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Brutal stuff here. Wonder who tried to stick this in the bill.
Inside The Health Care Bill - Forbes.com |
07-22-2009, 01:30 PM | #439 | |
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07-22-2009, 02:39 PM | #440 |
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07-22-2009, 02:41 PM | #441 | |
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If doctors don't want it and say "f--- it", who's going to treat us? Why would a doctor be a public provider and earn less, when he can be private and not have any government influence? Last edited by Galaxy : 07-22-2009 at 02:44 PM. |
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07-22-2009, 02:50 PM | #442 |
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07-22-2009, 02:51 PM | #443 |
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07-22-2009, 03:30 PM | #444 | |
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Of course, the elephant in the room is that no public system will never provide the quality of care and lack of wait time that currently working people get with most private plans in the US. |
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07-22-2009, 03:39 PM | #445 | |
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Surely you mean "no public system that will be set up in the United States", right? Because there are public systems around the world that outperform the United States' private system. Data for that is a relatively easy google. |
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07-22-2009, 03:44 PM | #446 |
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07-22-2009, 03:45 PM | #447 | |
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It's pretty complex (as the provinces have a great amount of control over it's health care). |
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07-22-2009, 03:46 PM | #448 |
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I sure hope Obama gives us more info about how what he promises is possible then the "OTHER COUNTRIES CAN DO IT" horse that's been beaten to death in this thread.
I do look forward to his anecdotal stories about individual people across the US with health care issues. That's a staple. Last edited by molson : 07-22-2009 at 03:53 PM. |
07-22-2009, 03:52 PM | #449 |
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I would start with having access to orthopedic surgery in days, not months. I would then move on to advanced equipment and techniques that cause people in Canada to come down to the US (ie, the Mayo Clinic) to have procedures done. Rarely do you see someone leave the US to go to Canada for life-saving surgeries/procedures.
On day-to-day type doctor visits, it is comparable but the US has much less of a wait time (which I think would again impact the quality of care). In fact, I'm struggling to find an instance where a US worker covered by a normal PPO would be better off in Canada than they are in the US. They get quicker doctor appointments, much faster surgeries, access to better top-end hospitals and when you factor the increased tax burden in Canada compared to most out-of-pocket limits, the cost ends up a wash (even for major surgeries). |
07-22-2009, 03:55 PM | #450 | |
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So it's about speed. Couldn't we just loosen the requirements for becoming a doctor so that we get more doctors and thus more speed? I mean if it's all about speed, who cares how good they are? |
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