After Obamacare fails, if
Hillary gets in, Democrats will push for government-run healthcare, like they
wanted in the first place. Looking at
the cost of the British and Canadian systems should give us some idea of the
problems we would be inviting if we allow government-run healthcare to become
law. Our best course of action
is to let healthcare be transformed by the free market without government
interference.
True cost of health care to average family is $11K per
year: 8/20/15, Emily
Chan, CTVNews.ca
While many Canadians
proudly boast about our country’s "free" health care, a new study has
broken down exactly how much money in many tax dollars go into the system each
year.
According to a new report by the right-leaning
Fraser Institute, the average Canadian family will contribute $11,735 in taxes
for public health insurance in 2015.
Many Canadians
underestimate the cost of health care for a number of reasons, says study
co-author Bacchus Barua, a senior economist with the Fraser Institute’s Centre
for Health Policy Studies.
First, people may wrongly
assume health care is free because they are not charged directly when they
visit the hospital or see a doctor.
“Unlike many other
universal health care countries, there is absolutely no form of deductibles or
co-payments or co-insurance when we receive health care, so we don’t get an
idea of treatment costs when we receive them,” he told CTV News Channel
Thursday.
Secondly, people may not
realize how much of their taxes go into health care because there isn’t a
single, collective health care tax. Instead, funding for the system comes from
multiple sources, including income taxes, the Canadian Pension Plan, and
Employment Insurance. This combination "blurs the true dollar cost of the
service," the study authors argue.
Lastly, Canadians may be
confused about costs because spending is often shown in aggregate sums,
resulting in numbers "so large they are almost meaningless." When
Canadians hear a total of $141 billion was spent in health care last year, for
example, it may be difficult to see how that affects individuals, the study
says. "This situation leads many people to grossly underestimate the true
cost of health care," the report says.
To reach their estimates on
the cost of health care, the report’s authors broke down the total cost of the
Canadian health care system in 2014.
According to Statistics
Canada, Canadians spent a total of $141 billion on health care that year. The
authors divided that number by the Canadian population, concluding that, on
average, each Canadian contributes $3,961 for health care each year.
However, as the report
notes, not every Canadian pays an equal amount in taxes. Dependents and
children are not responsible for paying taxes, while high-income earners must
pay more than low-income earners.
To account for this, the
study broke average Canadian families down into 10 income groups, concluding
that Canada’s poorest families pay $477 a year for health care, while the
wealthiest earners pay $59,666 a year.
The report also found that
the cost of health care is on the rise, increasing 1.6 times faster than the
average income.
Barua says that increase
should tell Canadians something about the sustainability of the system, “and
reminds us we need to be vigilant about how these increases are trending up.” Barua
and the study’s co-authors say they hope their findings will help Canadians
"more clearly understand just how much they pay for public health
care."
"With a more precise
estimate," they write, "Canadians will be in a better position to
decide whether they are getting a good return on the money they spend."
The Fraser Institute, which
has published multiple studies and commentaries critiquing the Canadian health
care system, describes itself as an independent and non-partisan research
organization.
http://www.ctvnews.ca/health/true-cost-of-health-care-to-average-family-is-11k-per-year-report-1.2525114
Canada keeps malpractice cost in check, by
Susan Taylor Martin, 7/26/16
For neurosurgeons in Miami, the annual cost of medical
malpractice insurance is astronomical — $237,000, far more than the median
price of a house.
In Toronto, a neurosurgeon pays about $29,200 for coverage. It's
even less in Montreal ($20,600) and Vancouver ($10,650).
The costs are strikingly different, largely because of the ways
in which Canada insures doctors and protects those who are sued:
• In 1978, the Canadian Supreme Court limited damages for pain
and suffering. Adjusted for inflation, the cap now is just over $300,000. The
United States has no federal cap on damages, though a few states, including
Florida, have imposed them.
• Instead of buying insurance from a for-profit company, as most
U.S. doctors do, Canadian physicians are covered through their membership in
the nonprofit Canadian Medical Protective Association.
Membership fees vary only by the type of work and region of the
country. All neurosurgeons in Ontario, for example, pay the same amount
regardless of how many times each may have been hit with a claim.
"We don't adjust our fees based on individual experience;
it's the experience of the group,'' says Dr. John Gray, the executive director.
"That's what the mutual approach is all about, and it helps keep the fees
down for everyone.''
Moreover, the association provides legal counsel for doctors who
are sued and pays the damages, no matter how much.
In the U.S. health care debate, malpractice is an emotional
issue, fueled by huge awards in a few well-publicized cases. President Barack
Obama was booed in June when he told the American
Medical Association he wouldn't push for limits on malpractice jury awards in his
plan to overhaul the health care system.
"We got a crazy situation where Obama is talking about the
cost of medicine but he said, 'I don't believe in caps,' " complains Dr.
Dennis Agliano, past president of the Florida Medical Association. "If you don't have
caps, the sky's the limit and there's no way to curtail those costs.''
But malpractice lawsuits account for less than 1 percent of the
U.S. health care tab. The same is true in Canada.
"The trends we're seeing comparing our data to the American
data is that the frequency of litigation against physicians has been
progressively falling over the last 10 years,'' Gray says.
In 2007, Canadian doctors were hit with 928 legal actions, a 17
percent drop from 2003. Only about 100 cases a year go to trial.
One reason: Canadian law firms, unlike U.S. firms, often require
plaintiffs to pay for an initial investigation to determine whether the claim
has merit. That cost discourages many people from pursuing a lawsuit.
Another deterrent, plaintiffs' attorneys say, is that the
Canadian Medical Protective Association is aggressive in defending its members
because it is in the unique position of insuring virtually all of the country's
76,000 or so doctors.
"It's different from the U.S., where you have a great
number of private insurers, each with a different corporate mentality to
litigation,'' says Richard Halpern, a Toronto attorney.
"Here, we don't see nuisance payments to settle cases, we
see where the CMPA is prepared to throw all the money at it to defend it no
matter what it's worth. Litigation in Canada is therefore very, very expensive,
and there are very few plaintiff's lawyers with the wherewithal to carry
through with these cases.''
The association's legal fees have risen, but its track record is
strong: Of the cases tried in 2007, judgments went in the patient's favor 25
times and the doctor's 70 times. The median amount of damages was about
$91,000.
Although Canada allows jury trials, the few cases that go to
court are usually tried in front of a judge. "Some of my cases are too
complex for a jury, and it does prolong the trial and use up a lot of
resources,'' Halpern says."On the other hand, I do believe we don't make
enough use of juries. Juries may be more sympathetic, particularly when you do
obstetric cases. There's the sympathy factor.''
Halpern is awaiting a judge's ruling in a case in which a baby
was born with cerebral palsy because a nurse failed to realize the baby had been
starved of oxygen in the womb. Halpern would be surprised if the judge awarded
punitive damages.
"We generally don't pursue that here in Canada because most
medical cases involve negligence,'' not intentional wrongdoing, Halpern says
"I've never seen a punitive damage award in a medical malpractice case.''
Florida's largest malpractice verdict came in 2006 when jurors
awarded $217 million in punitive and other damages to Allan Navarro, a Tampa
man who became a paraplegic after suffering a stroke misdiagnosed as sinusitis.
On appeal, Navarro settled for less but the case fueled the
debate over tort reform and the litigiousness of American society. Canadian
lawyers can advertise, though it is rare to see billboards or TV ads like those
in Florida.
"This country has a system in which mass advertising of
services encouraging individuals to file lawsuits, meritorious or
non-meritorious, is a mentality that just isn't present in countries like
England and Canada,'' says Dr. Robert Yelverton, chief medical officer for Women's
Care Florida.
The company, with 107 doctors in Central Florida, requires
patients to waive their right to a jury trial.
Despite the push for tort reform, the facts don't warrant what Public
Citizen,
a nonpartisan research group, calls the "politically charged hysteria
surrounding medical malpractice litigation.''
The number of U.S. malpractice payments in 2008 was the lowest
since creation of the federal National Practitioner Data Bank, which has tracked
payments since 1990. And the average payment — about $326,000 — was the
smallest in a decade.
Florida has limited attorney fees and imposed a cap, generally
$500,000, on noneconomic damages. Partly as a result, malpractice insurance
rates have dropped, though they are still far higher than those in Canada.
For orthopedists who do risky spinal surgery, the annual base
rate for $1 million in coverage is $72,000 in the Tampa Bay area and $140,000
in Miami. The most any Canadian orthopedist pays is about $12,000.
"I do know that most of my orthopedic colleagues have no
malpractice insurance and can't afford it,'' says Dr. Michael Wasylik, a Tampa
surgeon and past president of the Hillsborough County Medical Association. "That's one way not
to get sued: don't have insurance.''
The downside of that strategy: Florida doctors who "go
bare'' on insurance can have their license suspended if they are unable to pay
a judgment of up to $250,000. (Wasylik is insured.)
While malpractice litigation accounts for only about 0.6 percent
of U.S. health care costs, the fear of being sued causes U.S. doctors to order
more tests than their Canadian counterparts. So-called defensive medicine
increases health care costs by up to 9 percent, Medicare's administrator told
Congress in 2005.
"How much money is spent in this country to assure that
every test known to man is done to avoid a lawsuit?" asks Yelverton of
Women's Care Florida. "Defensive medicine is not talked about nearly
enough, although the costs are huge." - Susan
Taylor Martin susan@sptimes.com.
Comparison of malpractice insurance rates
|
Toronto
|
Miami
|
Tampa Bay
|
|
|
Orthopedic surgeon
|
$10,485
|
$140,000
|
$72,000
|
|
Obstetrician
|
$36,353
|
$191,000
|
$98,000
|
|
Neurosurgeon
|
$29,233
|
$237,000
|
$121,000
|
http://www.tampabay.com/news/canada-keeps-malpractice-cost-in-check/1021977
Canadian Health Care: Patients Waiting Longer
Than Ever For Treatment
Socialist
Medicine: Canadians
love their hockey and have historically been happy with their government-run health
care system. Hockey is thriving. The country's health care system, though, is a
wreck and getting worse.
It could be said the words
"Canada" and "health care" really don't go together because
some Canadians never make it to the doctor.
Too many die untreated due
to extended wait times to see a doctor, and those wait times have increased
again this year. They are now almost twice as long as they were in 1993, the
year Hillary Clinton tried to force government health care on Americans.
The Fraser Institute says
that in 2015, Canadians waited an average of 18.3 weeks
to see a specialist, "slightly longer than the 18.2 week wait reported in
2014" and "97% longer than in 1993, when it was just 9.3 weeks."
"Waiting for
treatment," writes Bacchus Barua, the Fraser report's author, "has
become a defining characteristic of Canadian health care."
Fraser has been compiling
reports on Canada's wait times for 25 years. It measures two intervals: the gap
between a general practitioner's referral to consultation with a specialist,
and the time span from that consultation to "the point at which the
patient receives treatment."
The longest median waits
in 2015 have been for orthopedic surgery and neurosurgery, while the shortest
waits have been for radiation oncology and medical oncology. (See chart.)
Of course there will
always be wait times for medical treatment, with emergency situations being the
exception. But some wait times are simply too long. Fraser said in Canada they
exceed a clinically "reasonable" length in 66% of cases.
Too often, the waits are
deadly. Consider only those needing heart surgery. We reported on these pages
two years ago that "in just one 12-month period (1996-1997), 71 Canadian patients
died in
just one province (Ontario) while waiting for just one procedure (coronary
bypass)."
The victim list is
actually much longer, as "another 121 never had the surgery because they
became too sick to survive it before their turn came up."
American hospitals and
doctors are offering to fill in the void by drawing in "Canadians weary of
long health care waits," says a report on the Syracuse.com website. And, the
report adds, the waits "are getting longer because of a doctor shortage
and overcrowded clinics and emergency rooms."
The same report says that
a Canadian consulting firm found that "as many as 900,000 Ontarians are
experiencing problems accessing medical care, a problem that is expected to get
worse and send more of them across the border for health care."
There will be nowhere for
them to go, though, if our government, which already controls about two-thirds
of health care, continues to increase its involvement. That won't leave many
options, as wait times here will grow to look like those in Canada. There is a
solution, of course: Reduce government's role in health care.
Comments
The
US needs to reduce malpractice and “defensive medicine” costs. All US voters should look at the malpractice
laws in their States.
Excessive
US malpractice costs cause US physicians to order questionable and unnecessary
tests. These can quadruple the cost of
treatment.
Excessive
post-op infections cause costs to rise and treatment scheduled in a hospital
can increase costs compared to having the same treatment in a surgical center
or non-surgical treatment at home.
Medical
bills should always be reviewed by the patients and/or their families, even if
these charges are paid by a third party like an insurance company or Medicare
to ensure that these charges were not fraudulent.
Charges
for treatments and tests should be provided to the patient and/or their
families prior to the tests or treatments being given.
Healthcare
use to cost less 40 years ago for many reasons.
Most hospitals were owned by churches and charities. Most patients were
able to pay out-of-pocket for many treatments. Malpractice suits were not
common or routine. Unnecessary tests
were not common or routine. Treatment
costs were always provided to patients up front. Doctors and hospitals allowed payment plans,
so patients could pay off expensive in-hospital treatments over time. Providers were not “required” to treat
patients who could not pay. They were referred to county hospitals.
We
should avoid government-run healthcare to avoid the high costs and waiting
times.
Norb
Leahy, Dunwoody GA Tea Party Leader
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