Socialized Medicine - Now what??
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Introduction
It looks like we are moving in that direction. So I have a few questions for our Canadian and European OMLers. These are just things I have been wondering as more and for Americans ask more Socialized Health Care.
Socialized / Nationalized
Is it the same thing? Is this just semantics?
Is Blue Cross caput?
What happens to all of the insurance companies, their employees and their investors?
GS - ???
Do doctors and all other health care providers now work for the government? I know we could not have paid back medical loans on my hubband's civil service paycheck.
Facilities
Who owns the hospitals and clinics?
Who pays?
We pay approx. $450 per month now for our Gov. health care insurance. Comparatively speaking, it is about average coverage. No dental, vision or extras. (So much for the wonderful benefits a gov. employee gets). Will we now just pay the government? More or less? Who pays for all of those not working? Do the people who make more $$ pay more $$.
What determines care level?
Who decides what procedures are covered. Example, right now a company can choose to allow surgeries for obesity, infertility, etc; or not, depending upon what they negotiated in their policy. Can you pay a higher premium for additional procedures?
Just a few
These are just some of the questions that have been rolling around in my head. I have no doubt that this will come to pass. I would just like a heads up on how it works.
I'm not looking for a tussle...just some answers as to how it works elsewhere from real people who live with it, or comments from those in the know.
I'm not looking for a tussle...just some answers as to how it works elsewhere from real people who live with it, or comments from those in the know.
O.k. I'm gonna leave a bunch of smaller comments because the last on blew up and never saved!! DAMN it!!!!
a) Socialized and Nationalized are the same pretty much. The Government controls the health care system.
b) Blue Cross is alive and well. My family of 3 pays $70 dollars a month for dental and prescription costs. We pay 20%, blue cross covers the rest. Vision can also be added at an additional, if small, cost. Blue Cross is not needed at the hospitals and clinics, that is what the Medicare system is for.
a) Socialized and Nationalized are the same pretty much. The Government controls the health care system.
b) Blue Cross is alive and well. My family of 3 pays $70 dollars a month for dental and prescription costs. We pay 20%, blue cross covers the rest. Vision can also be added at an additional, if small, cost. Blue Cross is not needed at the hospitals and clinics, that is what the Medicare system is for.
c) The Doctors and nurses are all unionized. They work for the regional health districts, which in turn are controlled by the Provincial Government. EVERYTHING is overseen by the Federal Gov't.
d) All hospitals and clinics are owned by the Provinces themselves.
d) All hospitals and clinics are owned by the Provinces themselves.
e) Our Medicare is paid for by our taxes. Going to the hospital, I take my medicare card and that's it. I'm covered.
The Fed's collect our taxes, and send the money to the appropriate Province for their health system. Any extra money that is needed also comes from the Fed's, who get it from... you guessed it.... taxes. We NEVER see a bill. Years ago I was in the hospital for double pneumonia, 7 days. I simply walked out when they said I could go. No bill. Same for outpatient and any necessary service.
This system covers everyone.... and if a homeless person or tourist from another country need our services, they are taken care of. TECHNICALLY, a non Canadian will be given a hospital bill if they have no travelers insurance... but I have heard stories of people who got services for free.
The Fed's collect our taxes, and send the money to the appropriate Province for their health system. Any extra money that is needed also comes from the Fed's, who get it from... you guessed it.... taxes. We NEVER see a bill. Years ago I was in the hospital for double pneumonia, 7 days. I simply walked out when they said I could go. No bill. Same for outpatient and any necessary service.
This system covers everyone.... and if a homeless person or tourist from another country need our services, they are taken care of. TECHNICALLY, a non Canadian will be given a hospital bill if they have no travelers insurance... but I have heard stories of people who got services for free.
f) Your doctor decides what needs to be done and what doesn't. If it is necessary, then it will be covered.
Obesity for example. The doctor will try diet and exercise long before medication, and WAY before surgery. That's what's great, no added bonus for the Dr. to push you into $$$ surgery.
Another example. After the birth of my son, I told my Dr. I wanted a vasectomy. After a year, he finally agreed. He waited to make sure that I wasn't making a rash, spur of the moment thing. He waited to make sure it was necessary, which it was. Another child would have drastically effected my families quality of life, so the surgery was done. NOW.... to get it reversed, not an emergency or quality of life issue... will cost me $1500... again, because it is not important to quality of life.
As far as paying more.... it's all in taxes. Actually, with tax breaks for the rich..... the rich probably pay LESS than I do on percentage of income.... but that is just the way taxes work.... and it sucks
A doctor should determine what is necessary.... NEVER an insurance agency that's only job is to make $$$$$$$!!!!!!
Obesity for example. The doctor will try diet and exercise long before medication, and WAY before surgery. That's what's great, no added bonus for the Dr. to push you into $$$ surgery.
Another example. After the birth of my son, I told my Dr. I wanted a vasectomy. After a year, he finally agreed. He waited to make sure that I wasn't making a rash, spur of the moment thing. He waited to make sure it was necessary, which it was. Another child would have drastically effected my families quality of life, so the surgery was done. NOW.... to get it reversed, not an emergency or quality of life issue... will cost me $1500... again, because it is not important to quality of life.
As far as paying more.... it's all in taxes. Actually, with tax breaks for the rich..... the rich probably pay LESS than I do on percentage of income.... but that is just the way taxes work.... and it sucks
A doctor should determine what is necessary.... NEVER an insurance agency that's only job is to make $$$$$$$!!!!!!
Good questions Pam. Education is key. Feel free to fire all the questions you have at any time.
I will do my best to help :)
I will do my best to help :)
Thanks for the questions Pam. I've been curious as to how this works as well. And thanks for the wonderful answers Raant. You've clarified a lot for me!
Hey, Raant, thanks for taking the time to fill in the blanks.
In my mind the scariest part would be the conversion. Not to mention the idea that the same government (federal, state and local) that handled Katrina will be trusted with my health care.
Here we have medical necessity and a doctor sends a letter than the insurance company doctor decides if it will be covered. Who does your doctor submit his request to?
What about 2nd opinions? Your doctor says he's got a rash, cut off his arm. You say, WHOA, I'd like a second opinion on that. Are those covered?
Has anyone ever studied to see if your taxes for medical care are equitable to what we pay in premiums (on average)?
In my mind the scariest part would be the conversion. Not to mention the idea that the same government (federal, state and local) that handled Katrina will be trusted with my health care.
Here we have medical necessity and a doctor sends a letter than the insurance company doctor decides if it will be covered. Who does your doctor submit his request to?
What about 2nd opinions? Your doctor says he's got a rash, cut off his arm. You say, WHOA, I'd like a second opinion on that. Are those covered?
Has anyone ever studied to see if your taxes for medical care are equitable to what we pay in premiums (on average)?
Hi Pam...
answer's to your questions :)
a) The Doctor decides what is necessary and what is not. It does NOT go to some back room "board" to decide. If their are any question to the procedure, a specialist is called to confer with the doctor.
I know it is difficult, but to understand this you need to forget the term "covered".
If it is medically necessary, they will do it.... that's what Medicare is.
b) second opinions are not uncommon and it is your right. Big decisions are rarely handled by one doctor alone, too much responsibility. It's all part of the system. You are never stuck with one doctor if you are sick and need a second opinion.
We do still retain all rights to sue for medical malpractice, but the courts want to hear about real malpractice... not frivolous shit. Unfortunately, those lawsuits are an everyday occurrence in your country.
answer's to your questions :)
a) The Doctor decides what is necessary and what is not. It does NOT go to some back room "board" to decide. If their are any question to the procedure, a specialist is called to confer with the doctor.
I know it is difficult, but to understand this you need to forget the term "covered".
If it is medically necessary, they will do it.... that's what Medicare is.
b) second opinions are not uncommon and it is your right. Big decisions are rarely handled by one doctor alone, too much responsibility. It's all part of the system. You are never stuck with one doctor if you are sick and need a second opinion.
We do still retain all rights to sue for medical malpractice, but the courts want to hear about real malpractice... not frivolous shit. Unfortunately, those lawsuits are an everyday occurrence in your country.
As far as comparing $$$ goes:
"In 2004, per-capita spending for health care in the U.S. was more than double that in Canada: in the U.S., it totaled US$6,096; in Canada, US$3,038."
http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems
_compared
Most of our total would be prescriptions, dental and vision, all not covered by Medicare. That's what Blue Cross is for (again, $70 per month/family of 3)
You pay no extra when you are in the hospital. Whatever they give you, poke you with, or smear and scan you with..... nothing comes out of your pocket.
Hopes this helps :)
"In 2004, per-capita spending for health care in the U.S. was more than double that in Canada: in the U.S., it totaled US$6,096; in Canada, US$3,038."
http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems
_compared
Most of our total would be prescriptions, dental and vision, all not covered by Medicare. That's what Blue Cross is for (again, $70 per month/family of 3)
You pay no extra when you are in the hospital. Whatever they give you, poke you with, or smear and scan you with..... nothing comes out of your pocket.
Hopes this helps :)
Nursing home's will cost you regardless of where you live. The doctor will visit you in the nursing home, and that is free. But Assisted Living facilities such as nursing home's are privatized.
Medicare is about getting you healthy, not housing and home care. That is not a necessity. There is a system, included in Medicare, that has a fleet of nurses to visit with people that cannot get to their doctor regularly. That, again, is included in the Medicare system.
Medicare is about getting you healthy, not housing and home care. That is not a necessity. There is a system, included in Medicare, that has a fleet of nurses to visit with people that cannot get to their doctor regularly. That, again, is included in the Medicare system.
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