[PublicAnimalNo9]

I've been thinking about this for awhile now. I have a couple of rough ideas of how we could have a 2 tiered health care system while ensuring the public option remains viable.
The first idea is to have a minimum of 2 doctors working the emergency depts, with 2 more on call. One would be doing provincial health plan work while the other does cash. Doctors would have their shifts rotated so that all of them would work both sides of the coin, so to speak.
With the cash work, not all the money would go to the doctors obviously, as some would be used towards hospital operating expenses.
We could essentially double the number of doctors working emerg depts without doubling the cost to the public.

The second idea probably won't be very popular but, those that pay for private health care would not be allowed to write it off their taxes simply because there is a public option available. Exceptions may apply. The private option would be primarily for expediency, not necessarily better quality. Although by sharing some facilities, both systems could wind up giving better quality health care.

3rd, restrict public health care to citizens and gainfully employed immigrants and their immediate families. This would also be extended to legitimate refugees. Those that arrive illegally but are permitted to remain and those arriving through "family class" immigration would not receive public health care unless they too are gainfully employed or have been here long enough and actually got their citizenship.
That means, among other things, no showing up in Canada whilst 9 months pregnant with conveniently lost or stolen paperwork, to get a freebie.


What do you guys think and do you have any ideas as to how a two tiered system could work in Canada?

[jeff744]

Wait, you want to increase the doctor openings? We are already drastically short of doctors to the point many are making double to triple what they should. Then with two tiers were will have specialized hospitals popping up so despite being next door to one you have to go to a public accepting one 20 minutes away. This also encourages line jumping for the people that pay more so just because a person has private funding they can skip a two month waiting list. They would also be given priority for things like hearts, surgery rooms, etc, all of which put the less equipped public in more danger.

If you have the money go to the states, otherwise you can wait in line like everyone else.

[martin14]

I wouldnt make ER into a cash business, people on their way to ER or their families
are too freaked to make good decisions.

After ER, if you have the money to pay for faster service, go for it.
But I would closely track the use of government facilities to make sure
the REAL costs are paid by a private plan, not just a cushy rental agreement.
And no tax deductions either.

And I agree with you 9, about restricting free care to those who kick into the
system.

$1:

to the point many are making double to triple what they should...
you can wait in line like everyone else.

Thank you Comrade, good to see people like you who object to doctors being
paid leading the drive for doctors to exit Canada for the States.

Idiot

[PostFactum]

martin14 martin14:

Thank you Comrade, good to see people like you who object to doctors being
paid leading the drive for doctors to exit Canada for the States.

Idiot

I was understanding why people do it living in worse country, but not in equal.

[Brenda]

Over the weekend, I talked to a lady who broke her shoulder when she slipped on an icy drive way. 7 weeks ago. She thought "meh, gonna be ok", so went home and to bed. Next day, she went to the emergency room, and she was told she needed surgery. They operated on her the next day, put metal plates in it, etc. Obviously, she needs physical therapy. Now, she lives about an hour from the hospital, where she could get that therapy for free. But she cannot afford the gas or taxi ride to get there. She can also not afford a physical therapist in her town. So she doesn't get any therapy. She can't lift her arm...

Personally, I think that is ridiculous.

[PostFactum]

Brenda Brenda:

Over the weekend, I talked to a lady who broke her shoulder when she slipped on an icy drive way. 7 weeks ago. She thought "meh, gonna be ok", so went home and to bed. Next day, she went to the emergency room, and she was told she needed surgery. They operated on her the next day, put metal plates in it, etc. Obviously, she needs physical therapy. Now, she lives about an hour from the hospital, where she could get that therapy for free. But she cannot afford the gas or taxi ride to get there. She can also not afford a physical therapist in her town. So she doesn't get any therapy. She can't lift her arm...

Personally, I think that is ridiculous.

Hearing stories like that, I think that in some cases we make no sence in medicine at all. We made something good that can't use. Some kind of paradox. It's like to have a plane that is not flying.

[dino_bobba_renno]

I could see maybe expanding a bit on the private services all ready provided within Canada but I don't personally buy into the idea of having paid doctors in the ER.

There's all ready a ton of private clinics which offer a multitude of services, you could expand on those on the condition that they have to take a certain % of high priority cases from the public system when they public system gets over stretched (which is all most all the time).

I don't know why people fear having more private involvement, it's all ready here. There are clinics in BC, AB, Qu and On that we seldom hear about and for anyone who does have the kind of money that would be required at a private clinic there's the US right next door.

I don't personally buy into the "we will loose doctors from the public system to the private system" argument either. That's all ready happening, they're heading down south. At least with a few private clinics here in Canada we would at least stand a chance of keeping some of them here in Canada where we could work out an agreement with the private sector to make use of them.

[CommanderSock]

2 Tiered is really the only way to go in the future.

The rich should not be able to opt out for paying into public healthcare. We should expand the private sector clinics and the services they offer.

[CommanderSock]

2 Tiered is really the only way to go in the future.

The rich should not be able to opt out for paying into public healthcare. We should expand the private sector clinics and the services they offer.

[OnTheIce]

PublicAnimalNo9 PublicAnimalNo9:

I've been thinking about this for awhile now. I have a couple of rough ideas of how we could have a 2 tiered health care system while ensuring the public option remains viable.
The first idea is to have a minimum of 2 doctors working the emergency depts, with 2 more on call. One would be doing provincial health plan work while the other does cash. Doctors would have their shifts rotated so that all of them would work both sides of the coin, so to speak.
With the cash work, not all the money would go to the doctors obviously, as some would be used towards hospital operating expenses.
We could essentially double the number of doctors working emerg depts without doubling the cost to the public.

The second idea probably won't be very popular but, those that pay for private health care would not be allowed to write it off their taxes simply because there is a public option available. Exceptions may apply. The private option would be primarily for expediency, not necessarily better quality. Although by sharing some facilities, both systems could wind up giving better quality health care.

3rd, restrict public health care to citizens and gainfully employed immigrants and their immediate families. This would also be extended to legitimate refugees. Those that arrive illegally but are permitted to remain and those arriving through "family class" immigration would not receive public health care unless they too are gainfully employed or have been here long enough and actually got their citizenship.
That means, among other things, no showing up in Canada whilst 9 months pregnant with conveniently lost or stolen paperwork, to get a freebie.


What do you guys think and do you have any ideas as to how a two tiered system could work in Canada?

We need to discourage people from using the ER except in ACTUAL emergency situations.

The ER's here in Canada have turned into defacto walk-in clinics. ER's should be reserved for major injuries/trauma, broken limbs and severe cuts.

People shouldn't be taking their kids to the ER cause they have a cold, or because they have a sore wart on their hand (I actually saw this once).

We need to restructure the clinic network and have clinics defined as Private and Public, so that if you want to spend $100 to see the doctor faster, you have that option.

[Brenda]

$1:

We need to discourage people from using the ER except in ACTUAL emergency situations.

I totally agree with that, and if there were enough family doctors, there wouldn't be a problem.
Taking your kid to the ER because of a cold is ridiculous, and should come out of your own pocket, BUT, if there is no other way for you to get to a doctor...

[OnTheIce]

Brenda Brenda:

Over the weekend, I talked to a lady who broke her shoulder when she slipped on an icy drive way. 7 weeks ago. She thought "meh, gonna be ok", so went home and to bed. Next day, she went to the emergency room, and she was told she needed surgery. They operated on her the next day, put metal plates in it, etc. Obviously, she needs physical therapy. Now, she lives about an hour from the hospital, where she could get that therapy for free. But she cannot afford the gas or taxi ride to get there. She can also not afford a physical therapist in her town. So she doesn't get any therapy. She can't lift her arm...

Personally, I think that is ridiculous.

Unfortunately, not every service can be offered in remote areas as there just isn't demand for such facilities.

I hope you don't expect the government to start paying for people to attend the hospital for their care, that simply is unrealistic.

Borrow money from a friend or family member to pay for the gas to get to and from the hospital. Your health is worth it.

[Brenda]

OnTheIce OnTheIce:

Brenda Brenda:

Over the weekend, I talked to a lady who broke her shoulder when she slipped on an icy drive way. 7 weeks ago. She thought "meh, gonna be ok", so went home and to bed. Next day, she went to the emergency room, and she was told she needed surgery. They operated on her the next day, put metal plates in it, etc. Obviously, she needs physical therapy. Now, she lives about an hour from the hospital, where she could get that therapy for free. But she cannot afford the gas or taxi ride to get there. She can also not afford a physical therapist in her town. So she doesn't get any therapy. She can't lift her arm...

Personally, I think that is ridiculous.

Unfortunately, not every service can be offered in remote areas as there just isn't demand for such facilities.

I hope you don't expect the government to start paying for people to attend the hospital for their care, that simply is unrealistic.

Borrow money from a friend or family member to pay for the gas to get to and from the hospital. Your health is worth it.

What I expect is that what is insured gets extended... (is that English??) I mean, she can get her therapy in the hospital, but the local therapist can not help her? The service and therapy is the same.

$1:

I hope you don't expect the government to start paying for people to attend the hospital for their care, that simply is unrealistic.

I don't really get what you mean by that. They pay the therapist who works at the hospital to give her the therapy she needs, but they do not pay the local therapist to give her the exact same therapy...


Canada is a HUGE country. When you pay the same amount of taxes outside the big cities as people do in the city, you should be able to get the same service/amenities, ESPECIALLY when the service is already there.

[OnTheIce]

Brenda Brenda:

What I expect is that what is insured gets extended... (is that English??) I mean, she can get her therapy in the hospital, but the local therapist can not help her? The service and therapy is the same.

Here in Ontario, they will pay for coverage for physio at approved schedule 5 physiotherapy clinics , physicians offices that offer physiotherapy, and Community Care Access Centres (CCAC's) .

Perhaps the options are available for her, she's just not aware of them.

[peck420]

Can a 2 tier health system work?

Maybe in the short term, but over the long term, probably not. It will end up having the private tier take all of the best, and the public tier taxing the crap out of the population base to keep step. Then it will lead to opt out programs that will be taken by those that have...and those that also pay the most taxes (middle and upper class). Once that happens, public tier is dead.

Our system has its flaws, but it is a fine base system to improve on. I would rather have a single public healthcare with problems, than a 2 tier that is destined to failure.

Complete side: If people did use our system as it was designed (Family doctore -> medicentre -> emergency) an easy 65%+ of our current problems would vanish. Nothing like seeing a kid with a runny nose in emergency and an empty medicentre less than a block away...