Friday, March 26, 2010

For the Canadians...

I was going to repost a comment from a Canadian reader, but decided not to. Rather, I want to clarify a few things that seem to have been mis-perceived.

1) I do not like what I have heard and seen with Canadian health care for the very sick. If a patient is healthy, there appears to be no problem in getting to see a physician. There is no waiting period, no review, the person just goes to see the doc.

My experiences with Canadian health care have been with the very ill, or very old. That experience has not been stellar. What my friend who died said was, that she preferred US health care over Canadian because she could get the medications she needed here whereas in Canada they are not prescribed because the government doesn't allow it. In the US she could have been on experimental treatments whereas in Canada she could not. The last time I spoke to her, she said that she was praying for a miracle that would allow her to get to Mayo as that would surely give her life some promise.

She never made it.

That bothers me still.

2) There are hundreds of thousands of health care horror stories in the US, of that there is no doubt. Doctors messing up in the surgical suite, labs running the right analysis on the wrong patient and accidentally switching up lab reports.

However, if a choice can be made by the wealthiest in the world about where they want to be treated... they come here, to the US... not Russia, not Germany, and not Canada.

Why is that? I do not know. I believe whole heartedly that physicians educated and trained in Canada are just as capable as those in the US. I know a few myself. So, then what is the difference?

As it stands now, I would believe technology and less governmental interference in advancement of drug therapies and diagnostic tools are the difference. For if the people are taken out of the equation, there is nothing else to look at.

3) And to Elizabeth, you do not upset me. I do not know you. The Canadians I have met... well, were very rude... arrogant, and selfish EXCEPT for the ones related to my friend. Those Canadians were the most giving, gracious, and unselfish that I have met - from any country.

But I liken it to this:

Americans say the French are rude. Americans generalize and say Parisians are the worst of the French and to avoid speaking to the locals while there because of the rudeness.

On the other hand, I found the Parisians I met to be very nice, polite, helpful... mind you, THIN! :D

So... the few Canadians that I have met have been rude and the one whom lived with me for almost 2 years, was the epitome of evil. My son still bears the emotional scars of what that man did to him and to me. I tried to look beyond that and met the two at the Olympics a few years ago.

I would also say this:

How many people judged Americans when President Bush was in office believing that we all felt the same as he did in relation to Iraq. How many people thought since he was our President, that we must support his ideals and his agenda? I didn't. I didn't vote for the man (nor did I vote for Obama - truth be told, Colin Powell has had at least one vote for the past 3 elections from my great state, and someday, he can thank me for that write-in vote).

4) I don't disagree there is something wrong with the insurance programs here in the US. I don't disagree that there needs to be something done about providing care to all without running the hospitals into the ground financially.

I say get the business people out of the mix and their billion dollar salaries (the CEOs), limit the executives and the numbers of executives at those insurance companies, cut down on pharmaceutical ramp up time for therapeutic drugs, disengage the lawyers (who by the way are the ones who wrote the piece of garbage that piece of garbage signed), and let the doctors who do the doctoring do their jobs.


Elizabeth said...

I really don't understand where you get your info on our system.
Anyone can go to a doctor here, why would there be a waiting period or a review for anyone who wanted to see a doctor whether they are sick or healthy. Many healthy people go to doctors all the time and not just in this country.

My 72 yr old Mother started having vison problems, within a week she had a brain biopsy, then brain surgery to remove the tumor.
My 75 yr old father had severe heart disease and several heart attacks. They got the care they needed. My 2 yr old grandson had energency surgery 2 weeks ago for a bowel obstruction. I could go on and on but the point is they got good timely care.
Our country provide care to everyone without running the hospitals into the ground. Could it be done better, I am sure it could.

As far as the government not allowing medications to be prescribed again I have no idea where you are getting your info. Doctors can prescibe any medications they choose too. Medications are not something covered by the governement unless you are on welfare or on the seniors medicare program.
many people have individual drug insurance plans through their work that covers their drugs at a family cost of about $60 a month,

As far as experimental treatments go there are many here, my mother took several experimental drug treatments because of her brain tumor.
Experimental drug treatments go on all the time and some are world wide in which Canada takes part in.

I don't know where you are getting your info but it is not accurate.

I am sorry that you are judging all Canadians because of a few and one in particular who it seems was very cruel to you and your son. But that had nothing to do with his being a Canadian. There are horrible people everywhere.

I certainly don't judge all Americans by President Bush and you don't think people should either but yet you are judging us because of a few rotten apples.

A Doc 2 Be said...

I get my information from the people who live and work and die in Canada.

I understand you want to have your country seen as a beacon for others to resemble.

I don't want my country to have your country's healthcare system.

You have examples that contradict mine; I have examples that contradict yours. I'm sure we could go back and forth :) My information IS accurate from the people who were treated by Canadian physicians... that does not mean I'm wrong. It means that my information is different than yours.

Elizabeth said...

You are getting your info from a very limited number of people. I live here and yes I have seen mistakes but I am betting no more mistakes then there are in other countries. England in another country that had universal health care.

I never said our health care system was perfect not was I trying to have it seen as a beacon for others to emulate.

But isn't it better to have a system where everyone gets care than a system where only the well insured and the rich get the really good care...

A Doc 2 Be said...

I'm not sure where you get your information from but MOST people in the U.S. are not wealthy or well insured.

See how that works?


People perceive this country as a country that only takes care of the rich, or those who are well insured.

And yes, I believe all are entitled to health care BUT

Obamanation forcing the rich to pay for everyone else's health care, forcing elderly care to be decided by boards, and physicians taking pay cuts is NOT the answer.

People using the ER as a routine doctor visit is NOT the answer.

People coming in and demanding an MRI because the old HMO model is ingrained in their neural fiber that the service only costs $10, is part of the problem

Insurance company CEOs thinking they are far more entitled to big wages than the physicians who actually treat the patients IS part of the problem.

Overzealous lawyers getting huge claims for patients who, while injured, IS part of the problem.

Do you know who wrote the current law signed by Obama?


Think about that.

Lawyers dictating what physicians can and should be able to do.

Lawyers dictating what physicians should be paid.

What lawyer do you know that has expertise being a physician as well?

Not many, and I'm not sure of one who helped write this piece of garbage legislation.

Elizabeth said...

I was not implying that everyone in the US was rich or well insured, not by a long shot would I ever think that nor do I understand how you got that from what I said but my intent of the comment "But isn't it better to have a system where everyone gets care than a system where only the well insured and the rich get the really good care..." was basically it seems that the people who get the great care in the US are the people who are well insured or are well off. The uninsured get what they can pay for and in this day and age of high health care costs they can't afford the great health care the US has to offer.

This has devolved into an Obama issue on your part and I don't understand what he has done or not done enough to write about it. Getting into that is mot on my agenda.

A Doc 2 Be said...

The uninsured use the emergency room as their health care provider which means the finance departments of the hospitals have to write off of those charges to goodwill or charity care, essentially paying for the uninsured to get coverage.

If a person with no insurance shows up in the emergency room of a hospital, BY LAW, the hospital cannot refuse coverage.

See, you are perceiving things wrong.

What is your first hand knowledge of US health care?

Have you been treated here?

I have. currently, I have NO insurance. I was in the ER over the holidays and was treated. I got a bill.

See how that works?

Elizabeth said...

I realize that if an uninsured person shows up at an ER they have to treat them but that is an unfortuate way to get proper health care. It's the same here if someone from another country shows up at the ER they treat them and treat them the same as they would a resident. They get a bill for treatment.

Yes I was treated in the US in an ER while I was travelling. I got great care which I paid for and expected to pay for. My travel insurance paid some of it back to me..

My US health care experience is as limited as your Canadian health care experience.

One of the biggest things that is wrong with our system is that people percieve health care as free and tend to abuse the system, running to the doctor for every little thing. Our ER's are over run with people who for whatever reason either don't have family doctors or use the ER as their family doctor and then complain when they have to wait for hours to see someone for a sore throat.

Our province has set up walk in clinics in most of our hospitals that have certainly helped to cut down on the non ER stuff that goes through the ER and increases wait times.

This has turned into an arguement over who knows more about each others health care system and I readily admit I know zip about what Obama just signed. I hope that over whatever time period they have to implement it , that it works out for the best for everyone because I believe everyone deserves health care and that is should not be about whether you can pay for it or not.
My intent was only to correct some misconceptions that you published.
I honestly feel bad that you have such a bad impression of the people in my country. I can assure you that we are all not the way you believe us to be.. If you ever come to Nova Scotia I would like the chance to change your mind about "most" of us.

A Doc 2 Be said...

I don't think we're arguing, we're discussing our perspectives on health care, our respective countries, and misperceptions.

When I traveled to Italy for the Winter Olympics in 2006, Bush was a very unpopular person. Actually, it was perceived that most Americans were unpopular.

In Italy, my son and I were on a "dom" riding around in a city that speaks no English. So, the passengers and I played charades in using my broken Italian and their broken English.

At the end of the ride, the main helper said, "You are not what I expected of an American." and then he laughed, led my son and I to the stores we were looking for, and said, "piacere mio!"

We got that a lot. Americans are perceived however/whatever media the people viewing/hearing what is shown/read.

Back to President Obama:

The reason SO MANY are up in disgust about this piece of legislation, is that Obama used his Democratic held congress to pass a bill the PEOPLE in this country do not want.

Let me reiterate:

the people of the United States of American DO NOT WANT this bill. They do not want it passed.

Obama, however, made promises during his election that he was looking dorky for not pursuing. So, he pushed it through.

This is almost exactly what President Bush did with the Iraq war except for... Bush was not exactly clear on what he knew, did know, still knows about what is being harbored in Iraq.

Bush pushed his agenda through with a Republican held congress.

Obama did the same exact thing with health care.

Neither of them is right.

And I pray, that this piece of crap legislation that turns MY health care over to the government, is repealed in November when the congress is more balanced as the Republicans take some seats back OR the courts say it was wrongful intervention on the part of the government in the daily lives of the American people.

A Doc 2 Be said...

And last, I'd LOVE to visit Nova Scotia - have friends in PEI - and always thought it must be a beautiful province :)

Liana said...

Forgot to add that your patients will be lucky to have you as their advocate :)

Elizabeth said...

Just don't come now, it's too cold.. unless you like to ski or make snow angels..
Nova Scotia looks very much like the Oregon coast.
PEI is beautiful but becoming so commercialized but I still love to visit. We are not that far away.

I hear you about the perception of Americans.. and the perception of Canadians, ever since our Enbassy in Iran saved some US embassy employees by hiding them and then getting them out of Iran we were all suddenly hero's... hmmm excuse me I had no part in that.. I am glad it happened.

My perception of American's comes from my US friends who are good decent people that I love to visit when I get the chance. My perception has nothing to do with the war in Iraq, Bush, health care or Obama.

Our government system would have the opposition party immediately bringing down the government and having an election if a bill was passed that the people did not want. Our Prime Minister is elected with the party so if the party gets voted out so does he.
This sytem has its good and bad points like everything else.

So this bill that was signed is not law yet, it has to pass another level of government..
I assume it can it be passed and rejected but can it be amended?

A Doc 2 Be said...

President Obama signed the legislation.

It is now U.S. law.

However, several states and their respective attorney generals have filed lawsuits in Federal Court to prevent the law from being enacted.

Our government works like this:

We vote for a candidate we like, or decide between the lesser of two evils.

Those votes are tallied.

Then those votes get so many electoral votes. Those electoral votes are the ones that actually elect the President of the U.S.

It is not a one for one vote but no electorate is going to go against the state's presidential voting.

After that, the President is sworn in.

We have three branches of federal government meant to keep everyone in check.

Our forefathers, Jefferson, Franklin, Washington, Hancock, et al wanted to make sure that no one person had totalitarian authority over the people of this country.


Congress makes laws.

President signs them, or vetoes them as he sees fit.

U.S. Supreme Court can overturn those laws.

That is where the AGs of the states are headed to stop this legislation.

Interesting times in my country.

Elizabeth said...

Our government was modeled on the British system. Canada is a constitutional monarchy and the Queens representitive in Canada is the Goveral General. The Queen is really just a figurehead.. that some would like to get rid of.
We have 3 levels of Government.
Federal, Provincial/territorial and Municipal.

The Federal level is a parliamentary-cabinet government. Our Prime Minister is much like your President really.
We have an appointed Senate that reviews laws made by the House of Commons. Senate appointments are for life and totally a waste of money in my opinion. Each Government in power will appoint their own people to any openings..
The move now is to have an elected Senate.

Our federal Court can overturn laws as well. The provinces often take issue with things the federal government does.

We have 3 main parties but can have more and you can run as an independant. Our electrorial system is first past the post. There has been a move to make it a percentage of the votes instead but that never seems to go anywhere.

There is no time limit for a party or Prime Minister to be in office, if they are elected over and over they stay in office. The last few years no one has lasted too long.
Not that I see much difference really no matter what party is in power.

We are a bilingual country ( don't ask me to speak French ) and at times it makes things interesting. Quebec threatens to leave confederation and become a country on their own. Good luck with that I say..

Liana said...

Agh. My other comment got deleted.

Anyway, to repeat myself and clarify a few things:

It's a common misconception that Canadians cross the border to get care. Less than 0.1% of Canadians report ever going to the U.S. to get medical care. Most of us can't afford it, for starters.

I am so, so sorry for your friend. You mentioned that she prayed for the capability to go down to the U.S. for treatment but never made it. Were financial constraints part of her difficulties? Because if that's the case, to me it seems clear that it highlights the difficulties associated with both systems. (Regardless, not to be nitpicky here, but you being told stories by Canadians does not constitute firsthand knowledge. Firsthand knowledge would be you actually getting sick or injured in Canada and needing to get treatment in our system.)

I do have to say though that in my experience, it's the patients waiting for elective and non-urgent consults who are frustrated by long wait times. Not people with emergent problems.

Experimental treatments are available in Canada. My husband's sister's father-in-law has metastatic lung cancer and is taking one of these.

If an evidence based treatment is needed but is not available in Canada, the government will actually cover the cost of sending someone to the U.S. if that's necessary.

And actually in some cases, U.S. patients get sent to Canada for medical care (ie a type of heart valve repair at Peter Munk in Toronto).

Some medications are not available here that are available in the U.S. but this mainly because drug companies don't see a profit motive (price controls, smaller population). Meds go through an approval process (mainly based on safety and efficacy). The government in the U.S. also has a similar regulating body called the FDA.

You asked why the richest people in the world tend to seek medical care in the U.S. instead of Canada. Likely it's because access to services here is based on triage, and it's a single tier system. Being able to pay more money is not going to get you treatment any faster, and you won't get many perks or frills associated with it either.

And finally, I'll repeat what I said before... your patients will be lucky to have you as their advocate.

A Doc 2 Be said...

Thank you, Liana! For clarification, pointers, and explanations.

Btw, I print ALL comments even those who disagree with me.

The only few that I have ever deleted were adult oriented. Not really sure how those people end up here anyway :)