[thirdEye]

Canadians should have to pay for health care

Funny, I thought we already paid for it through our excessive taxes.

How long can bad ideas prop up a failing system before something snaps?

[TheChick]

Something has to be done though. I'm not saying this solution is correct but our system can't be sustained as it is. So do we do nothing and ride it until it collapses completely or try alternatives?

[thirdEye]

TheChick TheChick:

Something has to be done though. I'm not saying this solution is correct but our system can't be sustained as it is. So do we do nothing and ride it until it collapses completely or try alternatives?

They haven't proposed any alternatives to the actual system though. They have only proposed alternative, or rather additional, funding sources.

[othello]

We should talk about what can be done to the system.

Here's what I understand to be the potential opportunities:

1. Reduce Demand by Encouraging Healthy Living

This is the social engineering answer. Spend money to encourage positive lifestyles. Tax those things (like cigarettes) that will eventually cause health problems and a burden on the system.

2. Reduce Demand by Charging Users

User fees or deductibles are basically a form of demand management, more than anything else. Otherwise, we would just use income taxes or health premiums to collect the money. The only reason to collect directly from users is to discourage use.

3. Reduce Redundancy and Waste

Clearly, there are opportunities here, but I'm not familiar enough with the details of the systems across Canada to understand or explain them.

4. Lower Costs by Delisting Services

Take some services that are currently fully government-insured, and make them fully user-pay / private insured.

5. Lower Costs by Optimizing Delivery Infrastructure and Processes

Again, probably some good opportunities here. Ideas, anyone?

6. Lower Costs by Lowering Wages

Unsustainable over the long-term.

7. Lower Costs by Providing Worse Service

Untenable.

That's my list. I don't have any great ideas, but would love to start a thoughtful discussion about how to improve the sustainability of the health care system, without just discussing funding sources.

If we couldn't just throw more money at it, how could we fix it?

[thirdEye]

Prevention.

Reduce future demand through screening and early detection of serious diseases like colon cancer, hemochromatosis, prostate cancer, diabetes, etc.

Prostate screenings have been delisted and must now be paid for in Ontario. Think of how many men that might discourage from having the test.

Regular eye exams have also been delisted even though they are considered preventative. Many people will no longer have regular eye exams because they don't want to pay. We will pay far more later treating diseases like diabetes that could have been caught early here.

Hemochromatosis isn't even regularly screened for, even though 1 in 250 are thought to have it. The conditions it causes when not detected will cost far more to treat than the simple blood tests required to detect it. We may all know of someone who died of it but didn't even know it.

A little bit spent on early detection now could save a lot spent on treatment later.

[thirdEye]

othello othello:

4. Lower Costs by Delisting Services

Take some services that are currently fully government-insured, and make them fully user-pay / private insured.

Yes, like non-medically necessary abortions, along with any form of cosmetic surgery not required as result of injury or illness.

[DMP08]

I have always belive in a "user fee" of sorts. Say you go into the hospital, if you make below X amount a year you pay nothing (like now) between X and X you pay whatever. Have it on a scale, those who can afford to, pay a slight user fee, like I'm talking 20 dollars max. It may stop mom from taking little 10 year old jimmy to emergency because he had a cough. People have started to view the system as a right when it is truly a privelege. But a sliding scale for visits could be used. People are now going to emergency for non emergency cases. Wait till monday and see your family doctor at the clinic about your sniffles.

[othello]

ThirdEye, I generally agree with your posts. Better prevention and screening, enabling early detection, should certainly save us money in the long run.

I'm generally not a big fan of user fee type systems, since I'm concerned that it would prevent people with legitimate health concerns from seeking early medical attention. However, there is certainly something to be said for encouraging people to seek out the most appropriate medical service.

Perhaps, we create a user fee system, where the user fee is waived if it is found that the individual sought the appropriate medical attention at the appropriate time. For example, mom who takes Billy in to the emergency room because he's got the sniffles has to pay some sort of user fee. But mom who takes Billy to her family doctor because he has swollen and sore glands, and discovers that Billy has mumps, doesn't have to pay the user fee. I'm not convinced that it's a great solution, but it's a thought.

Another thought would be to move towards delivery through an integrated emergency and preventative health centre, where you get screened by an appropriate medical professional when you arrive, and they direct you to the appropriate level of service, including emergency medical staff with the equipment and infrastructure necessary to address life-threatening emergencies, if necessary.