Time For US Healthcare to Catch Up With the Rest of the Civilized World

By Dr David Laing Dawson

Watching CNN, the reports, the discussions, the arguments, the experts, the talking heads, the Democrats and Republicans, Obamacare, The Affordable Care Act, Repeal and Replace, phase 1, phase 2, pre-existing conditions, medicare expansion/contraction – the whole exhausting American Healthcare discussion – two things come to mind:

The first is the obvious. For God’s sake just adopt the Government single payer option. Join the rest of the advanced nations. It is cheaper. It is better. Per person you already pay more in taxes to support your limited medicare and all the other complicated subsidies than we in Canada pay for the whole shebang. We are healthier. And it would free up a lot of administrators, accountants, politicians, and lawyers to do something useful.

The second was a little more subtle. All this exhausting time and energy arguing about, and designing, some polyglot public/private health care system is really not about health. It’s about an insurance scheme that will pay doctors and hospitals for medical fixing of acute illnesses and accidents. Medical fixing is just a part of being and staying healthy.

If you could settle on a single payer option then much of that time, energy, administrative overload could be better used to address health in all its complexities: prevention, social determinants, secondary prevention, tertiary prevention, maintenance, management of chronic illness, diet, obesity, lifestyle, addictions, mental health….. at the moment a kid with Cystic Fibrosis in Canada will outlive her counterpart in the US by 10 years.

There is one other aspect to the current American “health care system” of which I have lately become more aware. While the main concern remains large segments of the American population receiving no medical care apart from Emergency visits, or able to afford only partial treatment of acute and chronic illnesses, there is another side to this coin:

Over investigation and over treatment for those who can afford “the best”. Your celebrities often get shitty medical care, from Marilyn Monroe, to Michael Jackson to Prince to, apparently, Donald J. Trump. This is also true of many of your highly specialized for profit residential treatment facilities. Many offer some real medicine mixed with a lot of flimflam, with length of stay and investigations determined by the money available.

For Profit has no business in medical investigation or treatment. Inevitably it means many will do without and many will get too much. And the burden, ultimately, still falls on the taxpayer.

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6 thoughts on “Time For US Healthcare to Catch Up With the Rest of the Civilized World

  1. Unfortunately, there is a lot of hypocrisy in the Canadian system which simply wastes public money and people’s energy too. I was invited to give my input to a Caregiver Feedback session sponsored by the Ministry of Health and Long term Care. I suggested if you improved the Mental Health Care System, that would give the biggest break to Caregivers of people with mental illness. Guess what? Turns out Minister Hoskins has announced that we are now going to get our own tax payer funded Caregivers Organization for caregivers of people with every type of illness, with money for respite, tax credits and caregiver education! I would welcome the respite and the tax credits, but do we really need another publicly funded organization to arrange this? More bureaucracy. More about job creation than relieving the stress of Caregivers. Just like Homeless Shelters, and Food Banks are now part of the formal system, the massive amount of free labour mainly carried out by older women caregivers has now been made part of the formal system! So we have a health care system with these obscenely paid mainly male bureaucrats at the top the heap achieving their wonderful status and financial compensation on the backs of financially uncompensated older women who essentially hold the system together. Whoopee!

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    1. “I suggested if you improved the Mental Health Care System, that would give the biggest break to Caregivers of people with mental illness” ( See Kathleen above above)

      In my experience much stress would be removed from caregivers if their loved ones got adequate and timely care for their mental illness. Few get followup in any meaningful sense. Better followup is needed with support support services to patients You are so right Kathleen. Holding the hands of caregivers is in my view a smoke screen for is really needed. Tell that to Dr. Hoskins.

      Certainly all systems are far from perfect, but the U.S system and the direction it is going in further erodes what needs to happen. A single payer system would be better than the present silly mess in the USA . They constantly talk about individual choice, whereas if the services are so difficult to access there is no effective choice.

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  2. I worked in a hospital as a Registered Nurse in Buffalo and we saw Canadians come in for care for expensive high risk pregnancy care and level three nursery care because Canada deemed it too expensive to provide there. Canada has plenty of problems with their care.

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    1. Marcy, with single payer health care for all an ongoing problem is deciding where to spend the money. This is a complicated problem, often politicized. Before devoting a big chunk of the budget to a very expensive new treatment we need to determine it actually works. A good example is the Zamboni surgery for MS. It cost over a million dollars to actually test this procedure. And it does not work. At least it works no better than a pretend operation. But please note, with respect to your high risk pregnancy observation, that the risk of maternal death in Canada is 6 per 100,000 pregnancies, but 14 per 100,000 in the USA.
      Also note that some countries with universal health care have brought that down to 3 and 4/100,000.

      David

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  3. Yes after the mental health industry, the senior industry we now welcome the caregiver industry.
    I did not renew my Carp membership, and have unsubsribed from Zoomer each time they plunk me in again. I am due to terminate my caregiver link too., These orgs. demoralize me !!!
    When we had Family mental health alliance meetings, I was the only one reacting to the wailing offered by the Family Outreach and Response team.
    In those days B. could go to a CAMH provided Summer Camp that he enjoyed, and looked forward to. Had it been for more than 3 days I would have benefited from a wonderful guilt free respite. .
    We may be caregivers, but we cannot identify as such as the persons we care for do not know they are ill.
    My B. would be devastated if I hired a housekeeper and took off without him…

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