Random facts & questions about health care:

We wintered many years in an RV condominium in CA. Around 25% of our residents were Canadian. A few grumbled about their system but none said they’d exchange it for ours.

We call it “insurance,” but what we’re paying is our doctor bills. We give someone else money in the form of taxes or premiums to pay them.

How much health care do we get for our tax or premium dollar? The Medicare budget suggests we get 98 cents worth of health care for our Medicare tax dollar. Private insurance critics claim we only get 75 cents worth from our insurance premium dollar.

The Council for Affordable Health Insurance, a research and advocacy association sponsored by the insurance industry says these figures are both wrong. You really only get 95 cents worth for your tax dollar, and you actually get 84 cents for your premium dollar. So, according to the best figures the insurance industry can fudge on its behalf, the government still gives you 11 cents more health care for your tax dollar than your insurance company does for your premium dollar.

Reasons for the difference? Advertising & sales expenses the government doesn’t have, and executive salaries, among others. The head of Medicare earns $186,600. The CEO of United Health Group, AARP’s health insurance arm, took home $135.5 million last year.

In the ‘90s, the U.S. spent about 15% of its GDP on health care. Of our major international competitors in the global market then, the Canadians were closest at 10%, Japan & Germany spent less. Our ratio has probablty increased, as medical inflation outpaces other inflation. Lord knows how we suffer in comparison with China today.

In measures of public health, the U.S. ranks lower than most nations with “socialistic” health care systems. In life expectancy, Canadians rank 9th among developed nations, the U.S. 29th

Our local hospital lost $5 million last year in bad debt & uncompensated care for the uninsured.

I don’t have a dog in this fight. As retired military on Social Security I have Tricare for Life, insurance as good as it gets.

My daughter & husband spend $350 a month for a $3600 deductible. I worry about them, and about America’s competitive position in the world.

Anything we pay that doesn’t buy health care is economic waste. Other nations have better public health at lower cost, with less economic waste. Suggests we ought to find a better way. The reasons we haven’t are political, & this is not a political discussion

Thank you for the interesting discussion. Socialized medicine (i.e. Universal covereage) will continue to be a hot topic for years to come.

While you have discussed the price of insurance and procedures, there has been little discussion about time required to get an appointment with a specialist or access to specialized testing equipment. In my opinion, no one really knows the breadth and depth of their health care until someone within the family becomes gravely ill and the policy/ plan is exercised to the fullest extent. Then, you find all of the ups and downs of your system and plan. Of course, that is the precise time that you do not want to find out about your plan.

Since many of the members are traveling, I am assuming that most members are in good health. That’s good. The down side is that you may not know the benefits and heartaches of their coverage.

I am not retired as many of you are. My boss is from Canada and he returns to visit family. CHristmas 2005 he had an accident and required an MRI scan. He was informed that it would be a month before they could scan him. He had his wife drive him to the US and had full treatment, scan included, within hours. I have been told by other Canadians that his experience is similar to theirs.

I have always been skeptical about socialized medicine. It puts government in charge of your care. In my opinion, more government is not always a good thing. Beaucracy takes root. The individual looses control of his/ her own decisions. Also, the government takes away competition. When competition goes away, so does innovation.

BTW, there is something new taking root. People are traveling to modern hospitals in India for complicated medical care at competitive prices. Travel, post procedure stay, and procedures are being completed for less money. This is competition. Competition will drive changes to the system. Now, if the lawyers can just leave it alone for a while…….

A beautiful illustration of the problem, Mike. Doctors & hospitals who provide medical services don't compete with each other in the U.S. Their competition now comes from overseas, which illustrates how disjointed our system is.

There's no free market in health care here. Our government controls prices for Medicare & Medicaid recipients, and your insurance company controls prices by telling your provider to take-it-or-leave-it.

Insurance companies compete with each other, but not to provide us health services. They compete for the privilege of taking our dollars to pay our doctor bills, and they rake off somewhere between 16% & 25% in the process.

The result is a flawed system. Example: January, 2005, I spent 6 days in a Phoenix hospital. The total of all provider bills was $46,000. Insurance paid $13,000, I paid nothing. No doctors or hospitals went broke.

If I were too young for Medicare, too rich for Medicaid, and too poor to afford insurance, I would have been stuck with the whole thing, like any of the 46 million, or so uninsured Americans who don't have the government or an insurance company to run interference for them.

The system's broke. We need to fix it.

From hearing about the high insurance premiums that you pay in the US, it makes me very thankful for our system. Our national TV broadcaster held a poll for the greatest Canadian not long ago, and the winner was Tommy Douglas, a Prime Minister of the country who instituted the system in the '40s. I am only 31 and haven't needed it much, but many loved ones have needed it, and I am thankful that people who need the care can get it. It is the hypocondriacs and street urchins who abuse the system and clog up the ERs, which really annoys me. I wouldn't mind paying a small user fee which would deter abusers from bogging the system down, but all the bleeding hearts up here wouldn't want that.

Hi all
I'm in British Columbia on the west coast above Washington S.tate.My wife and I are both self employed and pay our provincial gov't $96.00 per month for our medical insurance- which covers everything...... mind you we do have waiting lists! Emergencies such as heart or any LIFE threatening surgeries are taken as PRIORITY over non threatening. The government keeps putting money in to the system but LACK of doctors,nurses and supporting staff creates the long waits...or at least that is what we are TOLD!!WE can also go to a private clinic for such operations such as Knees,hip, feet and other non threatening injuries but a full fee has to be paid and is done by those that can afford to.When we travel out of country we purchase travel insurance so that we will be re-imbursed once back in country but we do have to pay in advance unless it is a dire emergency and then the gov't can step in and cover ahead of time. We also can deduct medical expenses from our income taxes after a pre determined amount of deductible.Private corporate health care plans add such things as cosmetic,dental etc as added perks

Wait time priority surgeries increased significantly in 2005-2006 (Canada)

Copyright 2007 CNW Group Canada NewsWire
February 05, 2007 OTTAWA Feb. 5
Nearly 42,000 additional procedures in wait time priority areas were performed in Canada outside Quebec in 2005-2006 compared to the previous year, according to a new study by the Canadian Institute for Health Information (CIHI). This represents an annual increase of 7%, after adjusting for population growth and aging, in the combined total number of procedures in all four surgical wait time priority areas (hip and knee replacements, cataracts, cardiac revascularization and cancer). The increase is largely due to a surge in the number of hip and knee replacements and cataract surgeries. Surgical rates for cardiac revascularization and cancer also saw modest growth between 2004-2005 and 2005-2006. By comparison, the rate of surgeries outside priority areas increased by 2% over the same period, after taking population growth and aging into account.
The CIHI study, Surgical Volume Trends Within and Beyond Wait Time Priority Areas, tracks the rates of inpatient and day surgery procedures performed in Canada outside of Quebec between 2001-2002 and 2005-2006. The priority areas for wait time reductions were identified by Canada's first ministers in the fall of 2004.
"Increasing the number of surgeries is one strategy being used to reduce wait times. But some have questioned whether the focus on priority areas has come at the expense of other types of surgery," says CIHI President and CEO, Glenda Yeates. "Our study shows that even with last year's significant growth in priority area procedures, the number of patients receiving other types of surgeries has remained relatively stable overall."
While thousands of patients receive priority area procedures every year, they account for less than one-fifth of all surgeries performed annually. In 2005-2006, more than two million Canadians outside of Quebec had procedures for conditions (other than pregnancy or trauma) that were outside the wait time priority areas.
Provincial Variations
CIHI's analysis shows that while all provinces saw growth in the overall numbers of wait time priority area procedures in 2005-2006, there were significant differences between jurisdictions, both in the size of the increase and in trends by type of surgery.
For example, while Manitoba and Ontario had similar growth rates for priority procedures overall, numbers of specific types of surgery grew at different rates. Almost two-thirds (63%) of Ontario's increase comes from increased rates of cataract surgery, while in Manitoba over half (56%) of the change is from growth in joint replacements.
"Outside of wait time priority areas, the overall number of procedures either stayed the same or increased last year in all provinces in our study," says Jennifer Zelmer, CIHI's Vice-President, Research and Analysis. "That said, when drilling down, trends may vary for specific regions, facilities or types of procedures."
Comparing Trends Over Five Years
Last year's growth rate in priority area surgeries was higher than the average in recent years. The average increase in rates of surgery within wait time priority areas was 1% per year from 2001-2002 to 2004-2005, compared with 7% in 2005-2006. All percentage changes are adjusted for population growth and aging.
Other key findings include:
- Hip replacement rates rose by 12% in 2005-2006 over the previous year,
while knee replacement rates grew almost twice as fast, increasing by
20% over the same period. Although surgical rates for both types of
joint replacement have increased every year since 2001-2002, over 40%
of the growth occurred in 2005-2006.
- Cataract surgery increased by 10% in 2005-2006. More than 23,000
additional surgeries were performed in 2005-2006 than in the previous
year.
- Cardiac revascularization procedure rates grew in each of the past five
years, increasing by 12% overall. However, trends for specific
procedures vary within this category. For example, cardiac bypass rates
are down while angioplasty rates are growing. This reflects
international trends in cardiac care.
- Cancer surgery rates rose slightly in 2005-2006 (up 2%) after falling
in the four previous years (between 2001-2002 and 2004-2005). There are
a number of possible explanations for this trend (for example, changes
in the location of care, the use of alternatives to surgery and flat
trends in the number of new cancer cases), although their relative
importance is not well understood.
"Across the country, it's clear that overall, the number of surgeries in priority areas has grown in recent years," says Zelmer. "However, it's not clear what impact this is having on actual wait times for Canadians, because we do not yet have comparable data to track trends in how long patients across the country waited for surgery."
About this Analysis
The focus of this study was on surgeries for which there is more likely to be a wait, so results exclude surgeries related to trauma and pregnancy, as well as procedures performed on newborns. All percentage changes are adjusted for population growth and aging. To enhance comparability, adjustments were also applied to address variations in day surgery reporting. Data from Quebec for 2005-2006 were not available to CIHI at the time this analysis was prepared, so data on patients treated in that province were not included.
About CIHI
The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada's federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI's goal: to provide timely, accurate and comparable information. CIHI's data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.
The report and the following figures are available from CIHI's website, at http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_05feb2007_e