Report warns of major health care cost in coming 20 years

[nec209]

Health-care spending is expected to shoot upward over the next 20 years, forcing Canadians to make big sacrifices to cure the ill effects of this "spending disease," according to a report released Wednesday by the C.D. Howe Institute.

 

Read more: http://www.ottawacitizen.com/health/Report+warns+health+care+spending+disease/4572530/story.html#ixzz1Irf64bfo

 

 

 

======

 

What is your though on this? The health care is on life support now with long delays in ER and shortage of doctors and staff.

Edited April 7, 2011 by nec209

[jackson33]

I suppose this is my day to facetiously reply, but what's your problem? People like me have been arguing with Canadians for years, their FREE HC is not free and someday your going to run out of those that have been paying the bills. Unfortunately, those Canadians that come to the US, for a host of reasons for many HC problems, will have no place to go, well maybe Cuba.

 

Your article say's HC cost in 2009 was 19% of GDP (well above the US) and will increase 6.4% each year for 20 years (think that's an extremely low estimate) and your probably looking at an annual 50% of GDP cost by 2031, which of course is not possible to sustain. The solution is really simple, privatize HC and let market forces dictate cost, not a Government Bureaucracy wanting only to maintain their own jobs.

 

As for old people being the cause, sure that must be considered, but do most Canadians really spend their retirement in Canada. I've known quite a few that lived in Florida, Arizona or California and I don't think they run back to Canada for their annual check up. I'm not really up to date on your welfare system, but from a couple illegal immigrant reports, I understand they feel it as generous or more so, than the US system and that could be adjusted. Other than killing those old people off (death panels), there's not much else you could do....IMO.

[imatfaal]

I suppose this is my day to facetiously reply, ....

Your article say's HC cost in 2009 was 19% of GDP (well above the US) and will increase 6.4% each year for 20 years (think that's an extremely low estimate) and your probably looking at an annual 50% of GDP cost by 2031, which of course is not possible to sustain. The solution is really simple, privatize HC and let market forces dictate cost, not a Government Bureaucracy wanting only to maintain their own jobs.

 

As for old people being the cause, sure that must be considered, but do most Canadians really spend their retirement in Canada. I've known quite a few that lived in Florida, Arizona or California and I don't think they run back to Canada for their annual check up. I'm not really up to date on your welfare system, but from a couple illegal immigrant reports, I understand they feel it as generous or more so, than the US system and that could be adjusted. Other than killing those old people off (death panels), there's not much else you could do....IMO.

 

facetiously and erroneously, as it turns out. What it actually says is as follows:

 

In its share of the GDP, total health-care spending will rise from 12 per cent in 2009 to 18.7 per cent in 2031, said Dion, a senior business adviser at Canadian law firm Bennett Jones LLP.

 

[jackson33]

My apologies, if I misread the link, but I kind of wonder why 19% in 2031, would be a problem, unless of course it has something to do with Government Control....

[Marat]

All countries with healthcare systems without user fees, or with substantially subsidized costs, devote far LESS of their GDP to healthcare costs than those with private healthcare systems. Thus the U.S. now spends 17% of GDP on healthcare, while Canada spends 10%, and England, France, Germany, and Japan spend between 7% and 10%. The reason is obvious: Healthcare has to cost much more in a private than in a public system, since in a private system you have to pay not just for objectively real health needs, but also for the huge profits that people setting a product for which there is an inelastic demand can charge. No one whose daughter is dying of cancer is in a position to do competitive shopping to get the lowest possible price for her care, so the monsters who overcharge for their services can balance their 'need' for a Bermuda golf vacation against your need to save your daughter's life, and guess who is in the stronger bargaining position?

 

Also, in a public healthcare system, the government in effect unionizes all its citizens to constitute a gigantic collective bargaining force to bring down the costs from healthcare suppliers, which again lowers costs. Another factor lowering costs in a public healthcare system is the fact that since there is no cost disinducement to treat diseases at their earliest stages, preventive medicine can keep costs from escalating because developing medical problems have to be neglected by patients who can't afford to treat mild conditions in their early stages.

 

The central myth in all healthcare cost analysis is the notion that healthcare only costs money if the government pays for it, and that it will somehow not be a cost burden if it is paid for by each individual. But as has been argued above, since healthcare becomes more expensive when paid for by each individual rather than by the government, the total cost to society of disease increases rather than decreases by not having a public healthcare system. There is also the odd idea that the 'cost' of disease becomes less if healthcare is not adequately provided. But someone whose productivity is diminished because he cannot afford healthcare, or who actively suffers and experiences a diminished quality of life because he cannot afford healthcare, still has to be seen as representing a real social cost. It is absurd to regard only the treatment of disease paid for in money as a genuine social cost, while untreated disease which saves money is not a genuine social cost.

 

Within any single family, if a child were dying of cancer, the family would obviously regard it as rational to devote a huge proportion of its budget to saving the life of the child rather than to buying a second car or indulging in any other sort of expenses. So it should also be seen as rational by society as a whole that the costs of disease and human suffering should have priority of funding over comparatively optional social costs, such as providing excess salaries and bonuses for bankers who are already rich, buying more tanks when we already have 3000 worth $10,000,000 each, bombing Libya and CAUSING civilian casualties there in order to fulfil the UN Security Council mandate to intervene to PREVENT civilian deaths, and other such absurdities.

 

If society is aging and healthcare costs naturally increase with age, then it is simply rational for society to spend more money on healthcare, just as all the individuals in a society would do as they became older.

[nec209]

I suppose this is my day to facetiously reply, but what's your problem? People like me have been arguing with Canadians for years, their FREE HC is not free and someday your going to run out of those that have been paying the bills. Unfortunately, those Canadians that come to the US, for a host of reasons for many HC problems, will have no place to go, well maybe Cuba.

 

Your article say's HC cost in 2009 was 19% of GDP (well above the US) and will increase 6.4% each year for 20 years (think that's an extremely low estimate) and your probably looking at an annual 50% of GDP cost by 2031, which of course is not possible to sustain. The solution is really simple, privatize HC and let market forces dictate cost, not a Government Bureaucracy wanting only to maintain their own jobs.

 

As for old people being the cause, sure that must be considered, but do most Canadians really spend their retirement in Canada. I've known quite a few that lived in Florida, Arizona or California and I don't think they run back to Canada for their annual check up. I'm not really up to date on your welfare system, but from a couple illegal immigrant reports, I understand they feel it as generous or more so, than the US system and that could be adjusted. Other than killing those old people off (death panels), there's not much else you could do....IMO.

 

 

The health care cost is exploding in US too and more Canadians make trips to see a doctor and check ups do to free health care than the US. And there are some crappy insurance companies that do not want to cover you health care cost so people do not go see doctor to the problem is too late and you get more medical problems and cost more.

 

The reason health care cost is exploding in US and Canada is mostly 4 reason .

 

1. aging population

2. the inventions of CT scan and MRI that was not there before.

3. Doctors and staff over pay .

4. CEO`s and board of directors that make $1,000,000 a year.

 

The reason countries like USSR and Cuba can have such high number of Doctors and staff per population is simple .

 

1.They did not have alot of the CT scan and MRI

2.no CEO`s and board of directors has it all run by communist party

3.Doctors and staff got little pay

 

Has for other countries like South America ,Asia ,Africa and Central America their health care when comes technology,care and treatment is 50 years or more behind the US . And the doctors and staff get little pay.

Edited April 8, 2011 by nec209

[Marat]

It's odd that with all the talk of the need to cut healthcare expenditures, there is almost never any mention of the fact that doctors' salaries are insanely over-inflated for what these refrigerator repairmen working in flesh rather than metal actually deserve. In an earlier thread I showed that if American physicians' salaries were reasonably reduced. $30 billion a year could be saved. Since U.S. physicians would still be very highly-paid compared to those in other countries, they also could not threaten to leave the U.S. if their incomes were reduced.

[John Cuthber]

"2. the inventions of CT scan and MRI that was not there before."

Such things are helpful in getting an earlier diagnosis. That usually means easier and cheaper treatment.

The UK health service has MRI machines; they will only have been purchased after a cost benefit analysis showed that they would pay for themselves.

 

But I think you are right about the others.

[nec209]

Health-care injection $190M

 

Alberta's health superboard will spend $190 million in new funding to improve emergency waiting times and speed access to cancer care and knee replacements, after new statistics show the system continues to struggle to meet some targets.

 

Between October and December 2010, for instance, cancer patients continued to wait 6.3 weeks from their referral to their first appointment with a radiation oncologist, instead of the target of 4.9 weeks for the year end. Waits stalled from the previous quarter and actually went up from the first quarter of the year, when they sat at 5.4 weeks.

 

Cataract patients waited 45.9 weeks to have their cataracts removed at the end of 2010, longer than the target of 37.3 weeks set for the third quarter of the health authority's fiscal year (which ends March 31). Ontario cataract patients wait 14.9 weeks. Alberta's cataract waits were the worst of 10 provinces, according to a 2009 Canadian Institute for Health Information report.

 

Patients needing new hips waited 42.9 weeks for surgery, more than 10 weeks longer than the quarterly target of 30.3 weeks and the March 31 target of 28 weeks.

 

 

Read more here http://www.edmontonjournal.com/Health+care+injection+190M/4619197/story.html

Edited April 15, 2011 by nec209

[Marat]

It is interestingly ironic that the richest province, awash in oil money, which is also the most right-wing province, is also doing so poorly in sustaining the public healthcare system. That shows how little the problem of healthcare funding has to do with the demand for services getting out of control and how much it has to do with underfunding because of right-wing politicians.

 

A dialysis center where I was working once hired a new nurse from Alberta, and one day I heard her chirping full of self-satisfaction to one of the patients about how healthcare was better in Alberta, because the patients were responsible for paying more of their own care since many services had been de-listed from the public healthcare plan. "This teaches them to be more responsible for their health!" she exclaimed, standing next to a patient dying from polycystic kidney disease, a condition 100% genetically pre-determined.

 

The thought of strangling that nurse passed my mind, but I decided it would be a bad career move.

[nec209]

Yes you can read about the problem here http://www.nationalpost.com/news/Suspend+health+save+system+study/4632483/story.html

 

And http://www.google.com/search?um=1&hl=en&rlz=1R2GGLL_enCA334&biw=1007&bih=506&q=Los%20angeles%20fire%20station%20map&ie=UTF-8&sa=N&tab=iw

 

What do you think is going to happen?

[Marat]

It is worth noting that because of the boom in oil prices a short while ago, from which the provincial government skims off a large proportion in taxes, Alberta was awash in cash. Instead of investing this in healthcare, which any individual family would do if it had a sick child who needed more money for his medical treatment, Alberta gave the money away to its citizens as tax surplus checks. Quebec had earlier done exactly the same thing with additional money given to it by the Federal Government intended to help with healthcare expenses, but not given as a conditional grant with formal use limits.

 

Obviously healthcare costs will spiral in the future, given three factors: The increase in the elderly as a percent of total population; the inability of preventive medicine to make much difference in actually heading off serious illness, which is largely unpreventable; the continuing improvements in devices for early diagnosis of illness in the absence of any improvements in the ability to treat disease, with the result that people's lives will be medicalized at great expense for a longer time before they are dead.

 

But this by no means should be taken to imply that we have to cut healthcare spending or not reduce it to keep pace with increased demand. Since disease is the most serious problem people can face, it obviously has to have priority over anything else we could buy. What individual would skimp on his cancer treatment to be able to afford repainting his living room? Why should a nation or its government think any differently on the larger scale? Also, if we do not increase healthcare spending to keep up with the increasing burden of disease on society, then the cost of disease will just have to be paid in another, possibly 'more expensive' form, in terms of the unproductivity, the hideous suffering, or the early death of the people we cannot afford to treat.

 

So there is no way to save on healthcare costs, other than reducing inflated physicians' salaries, hospital managers' compensation, drug and medical equipment costs which mostly go to profit or servicing some billionaire's patent rights, etc. These profit rights are created by patents which the state grants, so the state should feel free to limit them in service of the vastly superior interest of aiding the sick.

[lemur]

No one whose daughter is dying of cancer is in a position to do competitive shopping to get the lowest possible price for her care, so the monsters who overcharge for their services can balance their 'need' for a Bermuda golf vacation against your need to save your daughter's life, and guess who is in the stronger bargaining position?

Don't forget that the reason why there's so much money to bargain away from the person who is paying for their daughter's treatment is due to an economy that privileges certain business people because they have access to cash flows generated by things like Bermuda golf vacations and yacht sales, etc. I.e. the doctors are only cashing in on revenues that they themselves produce by spending their big incomes. In other words, it's just classism the same as in any other economy. The only difference in economies with social-governance is that income gaps are lessened while class-stratification is maintain by cultural norms to which people conform. So doctors in socialized medical systems still enjoy special privileges compared to 'lower classes,' but they're just not as measurable as those in a less regulated economy where privilege has a blatant price-tag on it. Please don't tell me that you believe class distinctions and discrimination are a thing of the past in the social-economies of this world.

[Marat]

I agree that the problem of class distinction is rampant, but at least when it takes the form of one person driving a Rolls-Royce while another has to get by with a bicycle, the cruelty of the distinction is less acute than when a family is bankrupted to pay the overinflated fees of an already fabulously wealthy surgeon to save their dying daughter.

[Dak]

The reason health care cost is exploding in US and Canada is mostly 4 reason .

 

1. aging population

2. the inventions of CT scan and MRI that was not there before.

 

Just our ability to cure more: in ye olde days, cancer would've been treated pallitatively with a bromton cocktail; nowadays it involves actually curing the patient. Actually curing the patient is both better and more expensive.

 

Iow, the more we can fix, the more money we need to fix things; and we keep figuring out how to fix more things.

 

3. Doctors and staff over pay .

 

This is inconsistant with the OP's claim that there's a staff shortage.

 

If that's true, then increased wages could incentivize more people to staff the NHS.

 

4. CEO`s and board of directors that make $1,000,000 a year.

 

Probably a drop in the ocean. Hopefully, they're being payed as a percentage of the money they save by increasing efficiency.

 

More problematic is that pharmacology was jumped on as a panacea: work out the pharmacutical to cure a problem, then it can be mass-produced for (relatively) little, leaving you with 'only' the cost of diagnosing the condition and monitoring the treatment. However, patent laws inflate the cost of drugs (don't know too much about this, but i've heard it repeatedly suggested that the patent be shorter, allowing those $1,000/treatment drugs to drop to a price more comparable with paracetomol). Also, there's limits to what pharmacology can achieve, and not only that but pharma' keeps figuring out how to fix new things (like cancer) -- increasing the amount of things that we have to pay to fix -- whilst leaving the older things (like broken limbs) alone (i.e., still as expensive).

 

Addressing the patent issue to drive down the cost of pharmaceuticals might help. Also, genetic engineering could offer similar benifits whilst being more flexible than pharm's -- work out how to genetically engineer something to target cancer, to cure such-and-such a disease, etc, and then the costs drop down to 'merely' factory-producing the treatment, and the cost of diagnosing and monitoring the treatment: no expensive surgery, long-term care, etc. Possibly advances in robotics could help drive down the cost of surgery, bone-setting, etc.

 

I suspect this healthcare problem is why certain governments are being dicks and trying to nanny us into living healthyer (giving up smoking, consuming less salt, etc), in order to try to manage the pressure on the national- and private- health-systems.

[Marat]

Having the state offer bounties for the discovery of various new treatments, given as a single cash award to the discoverer, rather than as continuing patent rights, has been proposed as a method to reduce the costs of drugs. This was how Britain stimulated scientists in the 18th century to try to discover a reliable method to find longitude at sea.

[nec209]

3. Doctors and staff over pay .

 

 

This is inconsistant with the OP's claim that there's a staff shortage.

 

If that's true, then increased wages could incentivize more people to staff the NHS.

 

sorry what are you trying say here.

 

Don't forget that the reason why there's so much money to bargain away from the person who is paying for their daughter's treatment is due to an economy that privileges certain business people because they have access to cash flows generated by things like Bermuda golf vacations and yacht sales,

 

What does golf vacations and yacht sales have to with it? That money does not make its way to inprove science or understanding of the human body.

 

 

 

 

 

the doctors are only cashing in on revenues that they themselves produce by spending their big incomes

 

You mean they them self want that really bad.

 

The only difference in economies with social-governance is that income gaps are lessened while class-stratification is maintain by cultural norms to which people conform

 

 

What?

 

 

Please don't tell me that you believe class distinctions and discrimination are a thing of the past in the social-economies of this world

 

What do you mean?

 

Also note I think it was in the late 90's when Canada started to do cut backs and started to have long wait times in ER.

Edited May 20, 2011 by nec209

[Dak]

sorry what are you trying say here.

 

Well, at the start of this thread you said:

 

The health care is on life support now with long delays in ER and shortage of doctors and staff.

 

If there's a shortage of doctors and staff, it makes sense to raise their wages to try to encourage more people to become doctors and health-care-staff. You can't have it both ways: you can't drop their wages and expect more people to become doctors etc.

 

Unless you're arguing that there's not enough money to hire enough because they are too individually expensive?

[lemur]

Don't forget that the reason why there's so much money to bargain away from the person who is paying for their daughter's treatment is due to an economy that privileges certain business people because they have access to cash flows generated by things like Bermuda golf vacations and yacht sales,

 

What does golf vacations and yacht sales have to with it? That money does not make its way to inprove science or understanding of the human body.

Sure it does. People who make golf equipment, own golf courses, make, sell, maintain, and dock yachts, etc. invest and spend the money they make to pump GDP up to levels that sustain high incomes for those who have high income. If all doctors ever spent their money on was minimum wage labor and people who buy minimum wage labor; and if no one made any money on managing minimum wage labor except by making minimum wage themselves, then no one would be able to afford health care except as a fraction of their minimum wage disposable income. Or, otherwise said, higher income individuals maintain each other's privileged position by spending more money on each other than other people get paid or can afford.

 

 

the doctors are only cashing in on revenues that they themselves produce by spending their big incomes

 

You mean they them self want that really bad.

Idk what you mean here. See my response to the previous quote.

The only difference in economies with social-governance is that income gaps are lessened while class-stratification is maintain by cultural norms to which people conformWhat?

In other words, income gaps decrease but class-stratification continues by means of status and cultural differentiation. People no longer pay more for a more expensive party but they still have exclusive parties where certain people are welcome and others aren't on the basis of class-status. People still prefer to date, marry, and have friendships within their social class. I think even more so because social mobility within less socially-controlled economies allows people to change classes, albeit there is sometimes a distinction made between 'old money' and 'new money.'

 

 

Please don't tell me that you believe class distinctions and discrimination are a thing of the past in the social-economies of this world

What do you mean?

It's a question. It means that I don't think these social patterns have faded and surrendered to egalitarianism. I think social superiority persists in various forms, especially in the form of national comparison. I.e. people with more social governments tend to be 'socialism snobs' who look down on people whose governments are less social. It's really mean because it is basically like saying, "haha, your rich people and governments don't love you and ours do. . . and don't think ours are going to love you either because we just take care of our own." They also fail to acknowledge that the least social economies make the best markets to invest in and exploit to get more money to up GDP in the socialist paradises.

Edited May 25, 2011 by lemur

[nec209]

Well, at the start of this thread you said:

 

 

 

If there's a shortage of doctors and staff, it makes sense to raise their wages to try to encourage more people to become doctors and health-care-staff. You can't have it both ways: you can't drop their wages and expect more people to become doctors etc.

 

Unless you're arguing that there's not enough money to hire enough because they are too individually expensive?

 

Try to go to med school you will see how hard it is to get in and how much it cost and your brain will explode after going to school do to information over load in one day.

 

The fact there is doctors is is amazing .

Edited May 31, 2011 by nec209

[Marat]

The majority of doctors are idiots. Essentially they act like short-order cooks, applying standard recipes to standard symptoms. Beyond recognizing the symptoms and remembering (or looking up in the Merck Manual) the standard recipes, they don't really do much. You have to remember that before the AMA was formed and medical propaganda started boosting the reputation of the profession, doctors were treated and regarded as ordinary tradespeople practising a craft, and they had to make their housecalls at the back door with the butcher, the carpenter, and maid. In part the dumbing down of doctors has been the result of the standardization of therapy by agencies like the FDA and the professional societies, which punish severely the least spark of imagination flickering in any doctor's approach to disease. If you become an M.D. and don't go into research, you'll wonder why you had to study all that science, since you are not allowed to put much if any of it into practice according to your own creative insight.

 

Doctors in certain specialties have never had the experience of curing anyone, and they are just white-coated bureaucrats handing out death sentences. At least refrigerator repair men occasionally get the fridge working again, and they still make housecalls. Most medicine today is just ritualzed and unimaginative 'management' of chronic conditions, suppressing symptoms at any risk from the side-effects of the treatment, pestering patients with repeated and useless tests, which often cause more problems than they could ever help in diagnosis (e.g., use of kidney-destroying dyes in radiological exams), and disciplining the patient to 'get the numbers right' at any cost to the quality of the patient's life.

[nec209]

So you saying the main problem is doctors are getting too much pay?

 

Or the government is not building enough medical schools?

[Marat]

In a way, both issues are the same. After the Flexner report, the number of medical students in the U.S. fell by half and the salaries of doctors skyrocketed, and the number of doctors per capita has been inadequately responsible to the increasing demand for health services for quite some time. Increase the number of doctors and the waiting lists for treatment will evaporate, the access to affordable medicine will increase, and the only net loss to society will be that doctors will have to confine themselves to owning a cadillac rather than a mercedes.

[nec209]

In a way, both issues are the same. After the Flexner report, the number of medical students in the U.S. fell by half and the salaries of doctors skyrocketed, and the number of doctors per capita has been inadequately responsible to the increasing demand for health services for quite some time. Increase the number of doctors and the waiting lists for treatment will evaporate, the access to affordable medicine will increase, and the only net loss to society will be that doctors will have to confine themselves to owning a cadillac rather than a mercedes.

 

The the rich paying the government to close medical schools so the cost of healthcare goes up?So the move to privatization?

Edited June 7, 2011 by nec209

[Marat]

Historically, the process was a little more indirect. The allopathic physicians got together under the umbrella of their professional assoction, the AMA, pooled their assets, and 'influenced' the government to declare that anything other than allopathic medicine was a fraud. This closed all the rival schools of medicine and drove their practitioners out of business, with the result that the number of certified physicians went down and fees went up for them.