Part of the problem for Canada and Australia are the relative sizes of the countries vs the number of people. Canada is really big and health care works very well in cities, but not so well in the hinterlands - cause they are so VAST. You could toss a bunch of Texas sized states into Canada and hardly see them. (let's not to it literally - extinction events, eh?) Brings the average down I'm sure. Australia is in a similar boat, sub-continent sized place, not a huge population, and the urban areas are well treated but I bet you have trouble in the outback too because of the distances. By the way I loved watching an Australian show back in the 60s called "The Flying Doctor" or some such name. Gave one a clue as to the problems for medical care in vast spaces...
The UK and Europe are rather compact compared to Canada and Australia.
I can deny anyone what belongs to me. People in general have always denied others to some extent, which they are free to determine. That's why I've bought meals for homeless people but don't give them money any more.
Wonder what medical blunder left him with cardiac arrest ?>:-} ...Jim Thompson
-- | James E.Thompson | mens | | Analog Innovations | et | | Analog/Mixed-Signal ASIC's and Discrete Systems | manus | | STV, Queen Creek, AZ 85142 Skype: skypeanalog | | | Voice:(480)460-2350 Fax: Available upon request | Brass Rat | | E-mail Icon at
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Thinking outside the box... producing elegant solutions.
"It is not in doing what you like, but in liking what you do that is the secret of happiness." -James Barrie
To be clear though, emergency room care is not dependent on being able to pay in the US. What I was referring to was a level one step back from true emergencies. In the US if you need care for a condition that will deteriorate or cause complications is not treated soon (but not immediately) the ability to pay is a factor in getting care. A cousin who had no money was suffering from a serious illness and had to wait days until a charity was found who would pay for the medication. In the meantime his condition deteriorated.
I guess people's concerns about the type of care Canada offers is that something similar would happen while on a waiting list for treatment.
It only takes one example of such an issue or worse, one example that isn't what it is presented to be which is essentially a lie. I've heard the same things about healthcare in the UK by someone who should know better, but was on a tear about how bad socialized medicine would be here in the US. He took an example and claimed it showed how you could die waiting for a test to see how bad your condition was when it was actually a routine test administered every 5 years in which case a few months wait just isn't an issue.
They say he lived in the hospital while being healthy enough to visit the pub, home and go on "holidays". Certainly here he would have received the medical care required but it would seem he would be in a nursing home rather than staying in the hospital. Also, it would be the worst, shit place you can imagine. In the US public paid nursing homes are dirty, stinking places where the poor are shuffled off to die. That's no joke and no lie. I've seen a number of them that make my stomach turn.
BTW, since the question was about insurance, that would not be a factor in long term nursing care. Insurance has a limit on nursing care duration. After that you either have long term care insurance which few of us have or you pay yourself. When your money runs out you end up on Medicaid and your quality of life definitely can suffer.
Wong! We have a Constitution that is supposed to protect us from the tyranny of the majority. You don't get a vote on my life. I fully understand that you see the Constitution as a minor roadblock to your utopia. One that's better ignored than changed.
The flip-side of that applies in the US. There are no *limits* on the number of providers that can settle in a particular area. No centralized "throttle" on the amount of care that can be disbursed (sold).
A PCP can decide he *needs* to see you "periodically" to monitor your chronic condition (hypertension, diabetes, COPD, etc.) and just keep churning you through his waiting room -- as often as your insurance
*or* wallet can tolerate! In doing so, effectively increasing the size of the "market" to make his practice viable.
OTOH, with less of a supply of care providers, that same doctor might opt NOT to see you as often -- because he doesn't want to work weekends, etc. Suddenly, *you* are deemed capable of monitoring your own BP; or, your A1c can be checked less often (amusing that the condition of the market has an impact on the care a patient receives, eh?)
A provider trying to get his practice established may want more contact with his fewer patients (customers). Both to build a bond with them
*and* elicit payments. A provider with a long established practice may already have those bonds in place AND less need for transactional "sales".
A friend and her husband pay a $3K yearly *fee* for the PRIVILEGE of seeing their doctor -- BEFORE any care has been provided!
Other folks have doctors who won't accept payments from insurers (they don't want to have to keep staff on hand to deal with those third parties)
A crash team would have been dispatched (via ambulance, local staff, etc.) to deal with his heart attack. If he expired before they arrived,
The real issue is where he would have been *living* for all those years and how accessible that emergency care would have been, to him.
E.g., there is a single family home several blocks from here that is licensed for "continuing care" to folks who don't need the level of care that would be afforded in a hospital setting but need more than could be provided in an independent residence (e.g., they may be bed-ridden or need frequent monitoring, suffer from dementia, etc.). If he'd been housed, there, then it would be the responsibility of the folks operating that "facility" (hard to think of a 2000 sq ft home as a "facility") to contact EMS when/if they noticed his symptoms. The ambulance would be dispatched from the same place it would be dispatched had *I* had the same problem in my home. The same EMT's would care for him as would for me. They would take him to the nearest hospital (assuming he would need followup care) until he was stable.
Thereafter, he would be discharged (to whomever) as soon as his condition was stable/no longer life threatening.
This process could repeat, indefinitely. In each case, if he was "without means", the EMT and hospital would end up "eating" the cost. It would be considered part of their "cost of doing business" and reflected in the rates that they negotiate with insurance companies.
I.e., folks who CAN pay end up paying for those who can't. Life saving care isn't denied.
[So, it is in the best interests of folsk who CAN pay to ensure that the folks who CAN'T pay stay as healthy as possible! If they end up visiting an expensive provider -- e.g., ER -- for care that could have been avoided (preventative measures), then the costs of maintaining that providers service BORNE BY FOLKS WHO CAN PAY, falls]
My neighbor's wife was a "victim" of a medical complication (I hesitate to say it was negligence or other attributable error without an objective look at ALL of the facts -- not just those that my neighbor considers important enough to bolster his opinion!). She lived for ~10 years in his home at a "barely functioning" level. Not ambulatory, unable to eat, even deficient in communication abilities.
*Many* late night trips to the hospital in an ambulance. No idea who paid the bills as he doesn't work and she *couldn't* work. And, doubtful they had a pile of gold bricks buried out back...
Eventually, she didn't come home from one of those trips. If I had to make a wager, I'd bet that he owes a shitload of money. And, that their chances of seeing any significant portion of it are pretty slim.
What a load of applesauce. Insurance is not good for much but they *do* act as a safeguard to excessive medical care. Doctors have a group called the AMA which, among many other things, provide demographic information for doctors starting a practice. I was told this by a doctor who had chosen my hometown because of those demographics. A doctor would be stupid to open a practice where there are fewer patients per doctor, or I should say, fewer care dollars per doctor.
at 37. The UK at 18 - is quite a bit higher up. France is number 1, the Ne therlands, at 17, is just a head of the UK, and Germany - at 25 - still bea ts Canada and Australia.
The Royal Flying Doctor Service was started in 1928. My youngest brother is a medical doctor, and he worked for three years at Amata (close to border between the South Australia the Northern Territory, a long way from anywher e). His sicker patients got flown out routinely.
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Australia is the least densely populated country and continent (at 3 people per square kilometer). It's also one of the most urbanised, so the remote areas are very thinly settled.
Canada is only slightly more densely populated - at 4 people per square km.
The US, at 35 people per km^2, is a lot more crowded. Europe is another ord er of magnitude up. France at 122 people per km^2, is relatively sparely po pulated by comparison with the rest of Europe. Germany at 234 and the UK at 269 are more representative. The Netherlands, at 503 people per km^2, does feel itself to be a bit crowded.
If you think that they need food more than anything else, it's your right t o give them food rather than anything more negotiable. Do you stand there t o make sure that eat it all up? In the Netherlands registered drug addicts can get their maintenance dose at a clinic, but they have to take it under the eyes of the person dispensing it - they aren't allowed to take it away, because they might sell it to somebody else.
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