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Thread: Health care costs

  1. #101
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    Health care costs have no where to go but up.

    No matter how many more staff positions they add, there is only so much tax payer money that there is around.

    Can also add blame to the greedy pharma companies.

    The health care system in Canada is essentially bankrupt.

  2. #102
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    Quote Originally Posted by Bill View Post
    Health care costs have no where to go but up.

    No matter how many more staff positions they add, there is only so much tax payer money that there is around.

    Can also add blame to the greedy pharma companies.

    The health care system in Canada is essentially bankrupt.
    it's not quite that simple. if we want to "maintain the status quo" in terms of what our health care coverage provides, the costs could probably be reduced over time, never mind just "maintained". if we want to go back in time, we could refuse to cover any transplant activity. we could delist mammograms. along with anything else related to gene testing. we would stop providing ct or mri procedures. the problem is that we don't want to "maintain" health care costs. we want more and more access to more and more expensive things for the same cost. and that won't happen. it's not just "greedy pharma companies" and it's certainly not "greedy nurses" but in no small part it's greedy consumers. after all, if we weren't demanding free and universal access to everything that comes along no matter the cost, there well might be enough nurses, porters, health care aides and doctors. it's interesting that many of those procedures we now take for granted as part of the public health care system (i.e. heart transplants and bypass surgery and hip and knee replacements) were once very cutting edge and were in fact pioneered and paid for by the private sector, not public health care. it was only when the costs came down and the procedures became more reliable and less risky that they were "adopted" by public health care systems, a relationship that worked well for both sectors for decades.
    "If you did not want much, there was plenty." Harper Lee

  3. #103

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    All this while limiting the things that would save us money like the right to a dignafied death instead of a long drawn out one.

    Low cost Holistic approaches

    ooo and here is an idea PREVENTION.

    Keep shoving those big macs down, because we can just give ya a tripple Bypass and a pace maker.

  4. #104
    grish
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    Quote Originally Posted by MrOilers View Post
    Quote Originally Posted by grish View Post
    Particularly in the health field, the risks of competition (such as cutting corners where corners should not be cut) may outweigh the benefits (using the business model of looking at things).
    Cutting costs is not the same thing as cutting service. Why can't some people understand that? There is always a minimum standard that must be met, and if doctors, surgeons, hospitals, and clinics can all meet these standards in quicker and cheaper ways shouldn't that be encouraged? The thing is, it is not. Ther in ZERO incentive to improve anything.

    One problem is that everyone is so dead-set against any kind of changes or innovation in our current system. Your attitude throughout this thread exemplifies this.

    For example, if a clinic figures out a way to do surgeries in half the time it takes to do elsewhere, they get slapped for spending their money too fast. Meanwhile, all they are doing is giving patients the same service more efficiently. Yet the clinic is forced to slow down or only do half as many surgeries with this new procedure, and as a result the patients have to wait longer for their surgeries. Meanwhile, no money is saved, the operating room was sitting empty some days, and many patients' health deteriorated while waiting twice as long for surgeries, and as a result their care needs become more complex (i.e. more expensive surgical procedures and more difficult recovery).

    For the record, that is not a hypothetical scenario. I worked in one position in public health where I saw that EXACT scenario unfold. I gained a new level of disgust with our health care system that day.
    MrOilers,
    I have a problem with:
    Cutting costs is not the same thing as cutting service. Why can't some people understand that?
    this is not a question. this is a statement disguised as a question trying to suggest I do not understand something. That is not a good way to have a conversation or a debate. Also some mention about my attitude--I think you should start reading my words imagining a person interested in a debate, with strongly held opinions rather than attitude. I have a great desire to first ensure that public system is done right before we can claim it doesn't work and start looking for other options.

    Cutting cost is also different from maximizing the profit. Cutting costs is different from improving the health care. Cutting service is one way to cut costs and cutting costs is one way to increase profit. Now that we understand and hopefully agree on some of the basics of this, lets move on to talking about the best health care.

    I hope we can agree on the following:

    Our experience with public health in Alberta is not the ideal experience with public health. As a result, good examples from Alberta system of public health care represent the good in a good public health system, while bad examples represent areas to improve.

    You can bring examples from what you have seen as areas for improvement of the health care system in alberta, but they are not examples of the failure of the whole concept of public health.

    One of the claims (including MrOilers) is the need for incentive to reduce time and reduce costs amongst other things, and ultimately improving health care.

    First of all, I think this is an unfair characterization of health care workers. Such statements (that they do not have an incentive to provide better health care without financial incentive) means that we believe these people would only help you for money and not out of compassion. I believe that for the most part the people in medicine are there for the patients first, second and third, and other things like money and prestige a distant 4th and 5th.

    Let me talk here about incentives such as reducing of time.
    Currently, physicians in Alberta have two general ways to be paid. One is billing for services and procedures. The other is an AFP--an alternative funding plan. Both of these will be options in private health system.

    Many people who have had an unrewarding experience with a family physician have experienced the first option. Since some physicians including most general practitioners are paid per service and per procedure, there is a strong incentive to have a quick turn-over of patients (i.e. seeing the most patients in the least amount of time). The same can be applied to procedures (minor or major). People who do not have a satisfactory experience with a visit to the doctor frequently refer to feeling like being on a conveyor belt. In fact, there are studies suggesting that the level of satisfaction increases the moment a physician pulls up a stool next to a patient to sit down rather than standing even if the overall amount of time is the same.

    This is an example of a negative result of motivation through financial reward that could be in private system and as experienced in our imperfect version of public health care. Of course, attending to and improving of the experience being examined by a doctor can and should be improved, and the key is through education of physicians, a change in fee structure, a change in the expectations for the minimum standard of care, and maybe the opportunity for patients to go to a doctor who can and will pay more attention to them. The last one--having of options and competition--is what is frequently mentioned as reasons why having an alternative health care. But this alternative can be achieved simply by having more doctors to have that choice, paying doctors well (in case of family physicians--their overhead costs almost require them to run patient conveyor belts), and building rather than razing of hospitals. If more doctors are not graduated, by opening up an alternative health system will mean that instead of two doctors in the public system seeing 100 patients per day each, we will have one doctor in the private system seeing 40 patients per day who are desperate enough to pay the high fees and to avoid the even longer line ups in the public system as that remaining doctor is left to see 160 patients.

    The other option for being paid by a doctor is an Alternative Funding Plan that either pays an equivalent to a salary--a stable amount of money--so the doctor will be paid the same regardless of the number of procedures performed. This is a very broad look at things. AFP has many string attached including the minimum required work, expectation of research, etc.. This type of funding frees the doctors to spend more time with patients and attend to the improvement of practice through research. This addresses the concerns with continual improvement of health care.

    There are criticisms of this type of funding. The main one is that doctors on AFP do not tend to treat the same quantity of patients making the overall system a bit more expensive and requiring of more physicians.

    So, can public system deal with these two alternatives in some way to make practice improvement, quality health care, and reducing of costs a priority? Yes, but the result is counter intuitive. We need to train more doctors to give people choices, to reduce wait times, to allow them time to think about their practice and to make improvements. We need more nurses to assist doctors during procedures, to look after day-to day health issues of patients on wards, etc. We need more hospitals to bring health care options.

    Bottom line, we need to invest into the education and healthcare to try and build an equal and good health care. That could be through shifting of government priorities in funding allocations and through higher taxes.

    I also have something to say about investing in new technology and procedures. This is not a linear relationship between the cost, time, and procedure outcome. You could have a 200% increase in procedure cost shifting from "old" to "new" to get a 2% improvement (be it reduced recovery time, or a reduced mortality). I would question the incentive in a private system to implement the new if the return on investment may not be perceived as "worth it". An ideal system would justify all costs (at all costs) to improve health care.

  5. #105
    grish
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    I don't know. What's troubling you?

  6. #106
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    ^sorry there was a post in between yours and mine that got deleted.

  7. #107
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    Default Advisory committee not about delisting, insists Liepert

    Advisory committee not about delisting, insists Liepert
    BY JODIE SINNEMA, EDMONTONJOURNAL.COMSEPTEMBER 1, 2009 2:04 PM

    EDMONTON — A new advisory committee appointed by government to find “a new way to define publicly funded health services” is not about delisting services or cutting costs, but about strengthening the system for patients, said Alberta’s health minister.

    “I believe that Albertans want the assurance that the government has a plan to modernize our system and make it more effective and ensure that the system is there when they need it,” said Ron Liepert.

    “And that starts by having clear, effective legislation.”

    The 16-member committee will make recommendations about ways to improve patient access through legislative change.

    Full Story: http://www.edmontonjournal.com/healt...085/story.html

  8. #108
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    Sorry Liepert, but it's going to take a lot more than your "word" to convince me that this is the case... you're about as credible as Bernie Maddoff these days. And btw, if you value your reputation and political future, that's something you just might want to work on fixing.

  9. #109

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    Just posting an example of slow but steady improvement in research which might yield lower costs or better health or both... "Prostate cancer could be ruled out with simple MRI scan which prevents 25,000 biopsies"

    News out of the UK:
    Prostate cancer could be ruled out with simple MRI scan which prevents 25,000 biopsies


    "An economic evaluation will now be needed to demonstrate if this method is cost-effective, and should be taken up as standard of care, since internationally MRI prior to prostate biopsy is not universally practised.”



    http://www.telegraph.co.uk/science/2...5000-biopsies/
    And an article out of the US:

    Who Determines the Price of an MRI?

    JUNE 21, 2016

    Why Do We Pay 100% More for a Worse MRI?
    It’s a fair question. The NPR Podcast Planet Money asked that very question. What they found was quite shocking. One example in Pensacola Florida found it cost $800 outright for an MRI at one facility. But half a mile away it was $400.

    Okay, but the more expensive place probably had a better machine right? Nope, just the opposite, the less expensive facility had better equipment. Did one receive better MRI training? Not that either. Both had the same qualifications.

    Someone Else’s Money
    ...



    https://www.aimseducation.edu/blog/w...nes-mri-price/

  10. #110
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    Could not find a specific thread. in 2016 60 people chose medically assisted death in AB. By doing so, they invariable freed up health resources by their choice.

  11. #111

    Default Two tier health alive and well in canada

    So if you live in Canada, you pay more tax to get healthcare. If you live in the US you pay less tax but health insurance (often to a non profit service provider). The difference? In Canada, if your child gets sick, you get told you have to pay a million out of your own pocket to get treatment in the US. In the US it's covered. Even our health minister says she would pay the money for her child - easy to say when you earn the big bucks, not so easy for this family:

    http://calgaryherald.com/news/politi...ver-transplant

  12. #112

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    Best privatize it. Most Healthcare will be done with robots . . Government bloat/ unions will inhibit

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